Assessing the content quality of Douyin and Bilibili as health information sources for pulmonary tuberculosis: a cross-sectional study

Abstract

Pulmonary tuberculosis (PTB) remains a major global infectious disease, and short-video platforms are increasingly used for health information seeking. However, the quality, reliability, disease-specific accuracy, and safety of PTB-related videos on major Chinese platforms have not been well characterized. A cross-sectional analysis was conducted on PTB-related videos retrieved from Douyin and Bilibili on January 5, 2026. The first 150 videos from each platform were screened using the Chinese keyword “肺结核” (pulmonary tuberculosis). Video characteristics, uploader types, content categories, presentation formats, and engagement metrics were extracted. General quality and reliability were assessed using the Global Quality Score (GQS) and modified DISCERN (mDISCERN), respectively. TB-specific accuracy and potentially harmful information were evaluated using a study-specific Accuracy Score on a 0–3 scale and a Safety Risk Checklist. Nonparametric tests, Spearman correlation analysis, and multivariable linear regression were applied. A total of 263 videos were included. Overall, video quality was moderate (median GQS: 3.0), reliability was limited (median mDISCERN: 2.0), and disease-specific accuracy was moderate (median Accuracy Score: 2.0 on a 0–3 scale). No overtly misleading or potentially harmful claims were identified according to the predefined Safety Risk Checklist. Treatment-related content was the most common topic. In univariate comparisons, Bilibili videos were significantly longer and had higher GQS, mDISCERN, and Accuracy Score values, whereas Douyin videos showed higher engagement. However, after adjustment for platform, video duration, uploader type, total engagement, and video age, platform was not independently associated with GQS, mDISCERN, or Accuracy Score. Longer video duration and being uploaded by specialists were independently associated with higher quality-related scores, whereas total engagement and video age were not independent predictors. PTB-related short videos on Douyin and Bilibili provided moderate-quality information overall, but reliability and disease-specific completeness remained limited. Video duration and specialist uploader identity, rather than platform or engagement metrics, were the main factors independently associated with higher video quality, reliability, and TB-specific accuracy. These findings suggest that popularity should not be used as a surrogate for credible medical information and highlight the need for more evidence-based, guideline-concordant PTB communication on short-video platforms.