The disconnect between quality and popularity in digital health information provision: a cross-platform analysis of photoelectric anti-aging content on TikTok and Bilibili

Short-video platforms have become important sources of medical aesthetic information, but the quality, reliability, and safety-related completeness of photoelectric anti-aging content remain insufficiently characterized. This study evaluated photoelectric anti-aging videos on TikTok and Bilibili and examined the mismatch between clinical information quality and public engagement. In this cross-sectional study, 187 eligible videos were included, comprising 95 from TikTok and 92 from Bilibili. Video characteristics, engagement metrics, uploader type, and five clinical content dimensions were extracted. Video quality and reliability were assessed using the Global Quality Score (GQS), modified DISCERN (mDISCERN), and the Patient Education Materials Assessment Tool (PEMAT). Group comparisons, Bonferroni-adjusted post hoc analyses, Spearman correlation, multivariable linear regression, and inter-rater reliability analyses were performed. Bilibili videos showed higher GQS and PEMAT-U scores than TikTok videos, whereas TikTok videos had a higher median number of shares. Across both platforms, coverage of contraindications, potential risks, and post-treatment care remained limited. Doctor/medical-institution accounts had higher GQS scores and more frequent coverage of treatment mechanisms, whereas patient/general-user videos more frequently covered post-treatment care. A quality–popularity mismatch was observed: GQS was not significantly associated with likes (unstandardized B = 0.238, P = 0.259), whereas non-professional uploader status was associated with higher engagement after adjustment for GQS (unstandardized B = 0.700, P = 0.030). However, the model had low explanatory power (R 2 = 0.027). Photoelectric anti-aging videos on short-video platforms show heterogeneous quality, incomplete safety disclosure, and a mismatch between scientific reliability and public engagement. These findings suggest that popularity should not be equated with medical credibility. Improving digital medical aesthetic information may benefit from clearer creator disclosures, more complete safety communication, practical guidance from professional organizations, and stronger public digital health literacy.