Evaluating the content quality and trustworthiness of snakebite envenomation videos on social media platforms: insights from TikTok and Bilibili

BACKGROUND: Snakebite envenomation is a severe medical emergency and major global health threat. As short-video platforms increasingly shape public access to health information, accurate and reliable digital education is essential for snakebite prevention and first-aid decision-making. Although the quality of medical videos on short-video platforms has been examined for several diseases, little is known about the quality, reliability, and content characteristics of snakebite envenomation-related videos on major Chinese platforms. This study aimed to systematically assess the quality, reliability, and content characteristics of snakebite envenomation-related videos on TikTok (Douyin) and Bilibili, and to explore strategies for improving the quality of online health information. METHODS: On February 17, 2026, we searched TikTok (Douyin) and Bilibili using the keywords "snakebite envenomation" and "snake envenoming". After videos with content irrelevant to the study keywords, commercial advertisements, duplicate videos, and videos uploaded within the preceding week were excluded according to predefined criteria, 220 eligible videos were included in the final analysis. For each video, we extracted duration, audience engagement metrics, uploader type, and other basic characteristics. Video quality was independently evaluated in a double-blind manner using the Global Quality Score (GQS), modified DISCERN (mDISCERN), and Journal of the American Medical Association (JAMA) benchmarks. Group differences were analyzed using Mann-Whitney U and Kruskal-Wallis tests, and correlations among variables were assessed using Spearman's rank correlation. RESULTS: Of the 300 initially screened videos, 220 were included in the final analysis, comprising 114(51.82%) videos from TikTok (Douyin) and 106(48.18%) from Bilibili. Most videos were presented in Mandarin Chinese. Etiology, clinical manifestations, treatment, and diagnosis were frequently covered, whereas epidemiology and prevention were less commonly addressed. Bilibili videos were significantly longer than TikTok (Douyin) videos 311.00 (150.75, 514.25) vs 101.00 (58.50, 171.00) seconds (P < 0.001), whereas TikTok (Douyin) videos had significantly more shares 59.00 (10.25, 717.75) vs 34.00 (3.00, 282.25) (P = 0.049). The overall median GQS, mDISCERN, and JAMA scores were 3.00 (3.00, 4.00), 3.00 (3.00, 3.00), and 1.00 (1.00, 2.00), respectively. No significant platform-based differences were observed in GQS or mDISCERN scores, but JAMA scores differed significantly between platforms (P = 0.020). Videos uploaded by healthcare professionals and nonprofit organizations had significantly higher GQS scores than those uploaded by individual users 4.00 (4.00, 5.00) and 4.00 (3.00, 4.00) vs 3.00 (2.00, 3.00), respectively; (P < 0.001), as well as higher JAMA scores both 2.00 (2.00, 2.00) vs 1.00 (1.00, 1.00) (P < 0.001). Engagement metrics were strongly interrelated (all P < 0.001), but showed limited associations with quality scores. GQS and JAMA correlated only with shares (P = 0.015 and P = 0.045, respectively), whereas mDISCERN was positively correlated with likes, collections, comments, and shares (P = 0.042, P = 0.025, P = 0.011, and P = 0.004, respectively). CONCLUSIONS: Snakebite envenomation-related videos on TikTok (Douyin) and Bilibili provided moderately useful health information, but showed important limitations in preventive content coverage and information transparency. Videos uploaded by healthcare professionals and nonprofit organizations were generally of higher quality and transparency than those uploaded by individual users, while audience engagement was not consistently aligned with content quality. These findings highlight the need for greater professional involvement, clearer source disclosure, and more standardized prevention- and first-aid-oriented content to improve the reliability and public health value of snakebite-related information on short-video platforms.