Articol-5-Preoteasa

www.stomaeduj.com
                    ORAL IMPLANTOLOGY
                    FEATURES OF HIGHLY VIEWED YOUTUBE VIDEOS ON
Review Articles
                    ALLON4 AND SKY FAST & FIXED
                    Cristina Teodora Preoteasa1a*b , Ramona Mihaela Toma2bb, Laura Iosif3cb , Elena Preoteasa3db

                    ¹Department of Scientific Research Methodology and Ergonomics, Faculty of Dental Medicine, Carol Davila” University of Medicine and Pharmacy Bucharest,
                    Bucharest, Romania
                    ²Private practice, Bucharest, Romania
                    ³Department of Prosthodontics, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, Bucharest, Romania

                    a
                      DMD, PhD, Associate Professor; e-mail: cristina.preoteasa@umfcd.ro; ORCIDiD https://orcid.org/0000-0003-4732-6721
                    b
                      DMD; email: ramonatoma4@gmail.com;
                    c
                     DMD, PhD, Assistant Professor; e-mail: lauraiosif1@yahoo.com; ORCIDiD: https://orcid.org/0000-0001-8372-4247
                    d
                      DDS, PhD, Professor; e-mail: dr_elena_preoteasa@yahoo.com; ORCIDiD: https://orcid.org/0000-0002-2764-4135

                    ABSTRACT                                                                           https://doi.org/10.25241/stomaeduj.2021.8(2).art.5

                    Introduction The study aimed to assess features of highly viewed YouTube videos on an alternative
                    of implant-supported fixed prosthesis, namely All-on-4 and SKY fast & fixed, compared to those with a
                    considerably lower number of views.
                    Methodology Eighty YouTube videos were analyzed, 40 that registered the highest numbers of views, and
                    as control 40 with a considerably lower numbers of views. The search was conducted in February 2020. Data
                    were collected on bibliometric indices, general video features and medical information presented.
                    Results Highly viewed videos had variable features, tended to date at least 4 years back, with a 5-minute
                    duration, in English, either in spoken or written form, with multiple forms of media content, information
                    presented by the dentist, mainly on implant placement and definitive fixed prosthesis, clearly indicating
                    identification data on the dentist’s and the dental clinic name. When compared to videos with a considerably
                    lower number of views, the latter are often longer, in other languages than English, have images as multimedia
                    content, the information presented frequently includes theoretical medical aspects, fragments from clinical
                    interventions, information on definitive fixed prosthesis, and frequently mention identification data on the
                    dentist’s name and the dental materials used.
                    Conclusions Highly viewed videos on dental theme as All-on-4 and SKY fast & fixed have features that
                    differentiate them from those with a considerably lower number of views. Knowing this information helps
                    making videos that meet the users’ needs and are more likely to reach their purpose, namely the general
                    population education.
                    KEYWORDS
                    Patient Education; Dental Implant; Prosthodontic; Media.
                    1. INTRODUCTION                                                              that assessed the information quality of medical
                                                                                                 aspects presented by online videos suggested that
                    Nowadays patient-information sources on medical                              YouTube is not currently an appropriate source
                    issues are numerous and diverse. In fact, online                             of information, considering sometimes it spreads
                    resources are an important category, they are used                           misinformation [4,5]. Analyzing such documents,
                    considerably more frequently, with an impact that                            it can be easily noticed that they are different in
                    still needs to be better known considering their                             many respects. Considering their increased use, it
                    various content and sometimes doubtful credibility                           is important to know the features of highly viewed
                    [1,2]. Among the online resources, videos are a                              online videos, which allows medical professionals
                    particular category that registers an increased use,                         to make not only videos that transmit the correct
                    being a good tool for medical information for both                           information, but also ones that are likely to be
                    the public and medical professionals [3]. They can                           accessed by many persons, and therefore reach their
                    be accessed on different platforms, among which                              purpose to educate. The aim of this study is to assess
                    YouTube is one of most popular. Previous research                            features of highly viewed YouTube videos on an
                                   OPEN ACCESS This is an Open Access article under the CC BY-NC 4.0 license.
                                   Peer-Reviewed Article
                        Citation: Preoteasa CT, Toma RM, Iosif L, Preoteasa E. Features of highly viewed YouTube videos on All-on-4 and SKY fast & fixed. Stoma Edu J.
                        2021;8(2):120-124
                        Received: May 08, 2021; Revised: June 03, 2021; Accepted: June 22, 2021; Published: June 24, 2021
                        *Corresponding author: Dr. Cristina Teodora Preoteasa, DMD, PhD, Associate Professor, Department of Scientific Research Methodology and Ergonom-
                        ics, Faculty of Dental Medicine, University of Medicine and Pharmacy “Carol Davila” Bucharest.
                        Address: 4–6 Eforiei Street, 50037 Bucharest, Romania
                        Tel: 0040726275525; e-mail: cristina.preoteasa@umfcd.ro
                        Copyright: © 2021 the Editorial Council for the Stomatology Edu Journal.




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Preoteasa CP, et al.
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                                                                                                                    Review Articles
alternative of implant-supported fixed prosthesis,       The majority of the videos were in English, but
namely All-on-4 and SKY fast & fixed, compared to        while videos without spoken or written language
those with a considerable lower number of views.         communication registered lower number of views
Comparisons were made regarding the videos               (e.g., a median of 92974 views in the group of
general characteristics such as age, length, language    high viewed videos), those in English and in other
used, multimedia content, as well as some aspects        languages registered higher and similar number
related to their medical theme, namely the presenter’s   of views (median of 192542 views for the videos
training, type of medical information presented,         in English, and 192703 views for the videos in
reference to treatment steps, identification data.       other languages). In highly viewed videos various
                                                         multimedia content was used, as text, audio,
2. METHODOLOGY                                           video and images in the majority of them. More
                                                         frequently the dentist presented or explained the
For this study a search on YouTube in February           information in highly viewed videos, while patients
2020 was conducted. The search terms used were           more frequently presented this information in the
"All-on-4" and "Fast and fixed". There were 40 videos    videos with a considerable lower number of views,
analyzed that registered the highest numbers of          but the difference was not statistically significant. In
views, and as control 40 videos with a considerable      none of the videos the dental assistant or the dental
lower numbers of views.                                  technician presented the information. In most highly
Data were collected on the following aspects:            viewed videos fragments were included from the
- bibliometric indices i.e., number of views, likes,     clinical interventions, along with presentation of
dislikes, and comments;                                  theoretical aspects, with a statistically significant
- general features of the video: the date the video      higher frequency than in the videos with a lower
was posted; length of the video (registered in           number of views. With a low frequency, aspects as
seconds); the language used in the video (registered     treatment cost and insurance coverage, treatment
as English, other language, or without spoken or         alternatives, maintenance procedures, dentist-
written communication); multimedia content (if they      patient relationship, types of materials used,
comprised text, images, audio, videos, animation,        history of dental implants were mentioned. In most
and also registering the number of modalities used);     highly viewed videos information was included on
- medical aspects: presenter (dentist, dental nurse,     implant placement and definitive fixed prosthesis,
dental technician, patient, unclear, no one); type       while in most of those with a considerable lower
of medical information presented (theoretical            number of views aspects were discussed related
aspects, dentist interviews, fragments from clinical     to follow-up, patient evaluation and implant
interventions, imaging data, other); medical infor-      placement. Identification data were more frequently
mation presented in regard to treatment steps (data      encountered in highly viewed videos, most freq-
collected during patient evaluation, during surgical     uently being mentioned the dentist name (Table 1).
intervention for implant placement; of interim
prosthesis, of the definitive fixed prosthesis, during   4. DISCUSSION
follow-up); identification data on the dentist, dental
clinic, dental implant manufacturer, and dental          Highly viewed videos on dental theme as All-on-4
materials used.                                          and SKY fast & fixed have different features, tend to
A statistical analysis was performed using the           date at least 4 years back , with a duration of about 5
Statistical Package for the Social Sciences (SPSS        minutes, mainly in English, either in spoken or written
Statistics) Considering the data distribution,           form, with multiple forms of media content (text,
nonparametric tests were used. For the group             audio, video, images), with information presented
comparison the Mann Whitney test and chi-square          by the dentist, mainly on implant placement
test were used, according to variable type. The          and definitive fixed prosthesis, clearly indicating
p-values < 0.05 were considered to be statistically      identification data on the dentist’s name and the
significant.                                             dental clinic name. When compared to videos with a
                                                         considerable lower number of views, the latter have a
3. RESULTS                                               greater number of likes, dislikes and comments, have
                                                         a longer duration, have spoken or written language
Eighty videos were analyzed, 40 videos with the          communication in other languages than English,
highest number of views (between 71332 and               have more frequently images as multimedia content,
1232391 views), and 40 with a considerably lower         the information presented includes more frequently
number of views (between 964 and 1562 views).            theoretical medical aspects and fragments from
Highly viewed videos dated back a median of              clinical interventions, as well as information on the
nearly 4 years, ranging widely, from 4 months to         treatment steps more frequently on definitive fixed
almost 11 years. The median of their duration was        prosthesis and less frequently on follow-up, mention
nearly 5 minutes, almost double compared to the          more frequently identification data regarding the
one observed in the group with lower number of           dentist’s name and the dental materials used, and
views, the longest video being almost 50 minutes.        less frequently data on the dental clinic.


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                    YouTube videos on All-on-4 and SKY fast & fixed
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Review Articles      Table 1. Features of videos analyzed.

                                      Variable                Highly viewed videos            Low viewed videos                P

                    Likes (median)                                       332,5                         4                     <0,001*
                    Dislikes (median)                                    39,5                          0                     <0,001*
                    Comments (median)                                    25,5                          0                     <0,001*
                    Date (median)                                 April 3rd 2016              September 16th 2016             0,126
                    Duration (median)                                 289 seconds                 145 seconds                0,006*
                    Language: English:other:none (no.)                  28:8:4                       35:0:5                  0,007*
                    Multimedia content
                    - text (no.)                                          34                          32                     0,246
                    - images (no.)                                        25                          15                     0,012*
                    - audio (no.)                                         34                          35                     0,785
                    - video (no.)                                         31                          34                     0,685
                    - animation (no.)                                     15                          15                     0,858
                    - media forms (median)                                4                           3,5                    0,142
                    Speakers
                    - dentist (no.)                                       19                          11                      0,065
                    - patient (no.)                                       13                          20                      0,012
                    - unclear (no.)                                       5                           5                      >0,999
                    - nobody (no.)                                        10                          10                     >0,999*
                    Type of medical information presented
                    - theoretical aspects (no.)
                    - dentist interviews (no.)                            18                          5                      0,001*
                    - fragments from clinical interventions               16                          9                      0,064
                    (no.)                                                 23                          14                     0,024*
                    - imaging data (no.)
                                                                          14                           9                      0,165
                    Refer to treatment steps
                    - patient evaluation (no.)                            19                          22                     0,658
                    - implant placement (no.)                             20                          21                     0,991
                    - interim prosthesis (no.)                            11                          7                      0,230
                    - definitive fixed prosthesis (no.)                   24                          14                     0,013*
                    - follow-up (no.)                                     11                          24                     0,006*
                    Identification data
                    - dentist name (no.)                                  29                          18                     0,005*
                    - dental clinic name (no.)                            21                          31                     0,037*
                    - dental implant manufacturer (no.)                   14                          7                      0,054
                    - dental materials (no.)                              9                           2                      0,018*

                    The age of the videos may be a factor that has an               the fact that they probably understand it more easily.
                    impact on the document’s visibility, but this research          Explanations relatively often include medical terms,
                    similar to others found that most highly viewed                 which are sometimes difficult to understand in the
                    videos on a specific medical theme have very                    native language, sometimes even more difficult to
                    different range in this regard, the trend being of              understand in other languages, these being among
                    about 4 to 5 years [6,7].                                       the barriers and difficulties in understanding medical
                    The specific particularities of the video most                  information [10]. Other researchers found similar
                    probably have an impact on its viewing. They should             results, as the one of Dutta et al. [11], that found that
                    not be too long or too short. This study suggests that          videos in Hindi on COVID-19 pandemic had a higher
                    the duration should be of about 5 minutes. Other                number of views than those in English.
                    studies found that the duration of highly viewed                Similar to other research on other medical topics,
                    videos on other medical themes is longer, of about              patients’ testimonials and dentist interviews are
                    10 minutes [7], or of about 8 minutes [8], or less, of          frequently used to present information [12,13]. This
                    about 3 minutes [9]. Probably the complexity of the             study shows that videos in which the speakers are
                    medical topic has an impact on the video length.                dentists are more likely to register a higher number
                    Chen et al. [8] study results found that useful videos          of views compared to videos in which the speakers
                    are of a larger duration compared to misleading                 are the patients. This may be explainable considering
                    videos.                                                         the information may be considered more valid when
                    These studies show that videos in English were                  is presented by a specialist in the field.
                    most used. Even so, there were videos in other                  It is important to adequately include medical
                    languages with a very high number of views. An                  information that is pertinent to the subject dis-
                    explanation may be that individuals frequently                  cussed in the video, but also aspects that are
                    search information in their native languages, due to            important from the patient’s perspective [14].



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The results of this research indicates that highly                    age of a movie must have an influence on its views.




                                                                                                                                          Review Articles
viewed videos presented more frequently                               The older the movie, the higher the number of views,
information on the definitive fixed restoration.                      because the probability that an old movie is picked
Considering the treatment alternatives analyzed,                      up is higher than the one for a brand-new movie
All-on-4 and SKY fast & fixed are indicated for                       been picked, unless a filter is set for most recent
completely edentulous patients, most frequently                       ones. The number of views is not a quality criterion
treated by removable complete denture, definitive                     but a result of filter choice, of aggressive marketing
fixed restauration is an important factor for decision                by the manufacturer and other non-disclosed
making from the patient’s perspective, thus, most                     parameters in YouTube. The number of likes is low
probably the presentation of this information                         with a frequency of 0,064% being insignificant. The
increased the number of views of those videos.                        method used did not allow to target the trueness of
Other research on YouTube videos on medical topics,                   the information presented. Hence, it is impossible
such as Tang et al. [13], suggest that medical content                to deduct if the implant treatment is good, bad or
influences the number of views, given the viewer’s                    problematic. Another study limitation is the fact
interest.                                                             that a comparison was made to a limited number of
The method used for this research is similar to                       videos with a considerably lower number of views,
other studies in the scientific literature [6,9]. View                the rest of them probably having various other
count of YouTube videos was the indicator used to                     characteristics. Also, considering the specific topic
rank documents according to their being accessed.                     analyzed i.e., All-on-4 and SKY fast & fixed, most
This index was presumed to help identify and                          probably videos on other dental and medical topics
differentiate videos with a greater or lower impact                   may present different particularities. In this research
on forming the consumer’s opinion. As others (e.g.,                   users were considered to be private individuals.
likes), it has flaws related to several factors, as it does
not indicate that the video was viewed entirely, is                   5. CONCLUSION
influenced by the video age, it is suspected not to be
very accurate, as there is usually a small number of                  Highly or less highly viewed videos on dental
videos with a considerable higher number of views.                    themes as All-on-4 and SKY fast & fixed are meant
Even so, considering the increasing use of Internet                   for the general population and bear no scientific
sources of information, bibliometric indicators have                  or educational value. In the level of evidence these
to be defined, and many of them for Internet videos                   video's score less than a case-report. The number
are based on view count, as an indication of the video                of views depends on the parameter chosen
success. Bibliometric indicators for Internet media                   and is not a measure of quality nor of trueness.
is an area that needs to be better known. We must                     Video-information as found on YouTube cannot
clearly state that view count it is not an indicator                  replace well-executed formal studies published in
of content quality, which was also not aimed to                       peer-reviewed dental journals and should not be
be an objective of this research. This study was                      recommended to clinicians or to patients.
meant to try to identify some of the characteristics
that facilitate creating a success video from the                     CONFLICT OF INTEREST
perspective of persons without medical training. This                 The authors declare no conflict of interest.
information could be useful for medical practioners
when creating a video for patients’ education and                     ACKNOWLEDGMENTS
information.                                                          All authors have an equal contribution to this manuscript as the
                                                                      first author.
4.1. Study limitations
The study limitations are the following: YouTube has                  AUTHOR CONTRIBUTIONS
27 filters which determine which videos are shown                     CP: concept, data analysis, data interpretation, critical review.
first. A view is defined as a click on this movie, it does            RT: concept, data analysis, data interpretation .
not mean that the whole movie has been viewed. The                    LI: concept, data analysis, data interpretation .

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                                                                                        Cristina Teodora PREOTEASA
                                                                                                 DMD, PhD, Associate Professor
                                                               Department of Scientific Research Methodology and Ergonomics
                                                                                                     Faculty of Dental Medicine
                                                                 “Carol Davila” University of Medicine and Pharmacy Bucharest
                                                                                                            Bucharest, Romania

                    CV
                    Cristina Teodora Preoteasa, DMD, PhD, Associate Professor Department of Scientific Research Methodology and
                    Ergonomics, “Carol Davila” University of Medicine and Pharmacy Bucharest, Bucharest, Romania. She obtained her
                    DMD degree in 2006 from the “Carol Davila” University of Medicine and Pharmacy Bucharest, Bucharest, Romania.
                    She completed two Master programs in “Biocompatible substances, materials and systems” and “Biostatistics”.
                    She became MS in Orthodontics and Dento-Facial Orthopedics in 2010. Her PhD thesis, entitled “Clinical and
                    experimental contributions on the interaction of orthodontic appliances with the hard structures of the teeth” was
                    presented in 2013. She is the author/co-author of more than 80 articles in peer-review journals and contributed
                    to 7 books published in Romania and abroad. She participated in several national and international professional
                    conferences. Her main interests include: orthodontics, dental research, dental education, prosthodontics, oral
                    implantology.



                    Questions
                    1. Which of the following statements about patient-information sources on medical
                    aspects is incorrect:
                    ‰a. Are numerous and diverse;
                    ‰b. Are sometimes of doubtful credibility;
                    ‰c. Patients use only online resources for medical information;
                    ‰d. Online videos are not good tools for medical information.

                    2. The correct statement regarding medical information videos:
                    ‰a. Can be only accessed on YouTube;
                    ‰b. Are used only for patients’ information;
                    ‰c. Are used only for medical professional information;
                    ‰d. Sometimes spread misinformation.

                    3. Which of the following statements about highly viewed YouTube videos on All-on-4
                    and SKY fast & fixed is correct:
                    ‰a. Have an average duration of 5 seconds;
                    ‰b. Are always in English;
                    ‰c. The presenter is most commonly a patient;
                    ‰d. Commonly include information on the definitive fixed prosthesis.

                    4. Highly viewed YouTube videos on All-on-4 and SKY fast & fixed, compared to videos
                    with a considerable lower number of views:
                    ‰a. Have on average a shorter duration;
                    ‰b. Have on average the same duration;
                    ‰c. Mention more frequently identification data on the dentist’s name;
                    ‰d. Are always in English.



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