Evaluating the quality and reliability of inflammatory bowel disease-related short videos on BiliBili and TikTok: A cross-sectional study

Abstract

Background

Inflammatory Bowel Disease (IBD) is a chronic condition with increasing global prevalence. Short-video platforms like TikTok and Bilibili are popular health information sources, but their IBD-related content quality remains uncertain.

Objective

To assess the quality and reliability of IBD-related videos on TikTok and Bilibili.

Methods

We analyzed the top 100 IBD-related videos from each platform (200 total). Quality was evaluated using Global Quality Scale (GQS), modified DISCERN (mDISCERN), and JAMA benchmarks. Engagement metrics and quality scores were correlated.

Results

TikTok videos had higher engagement (P < .001) and better median scores (GQS: 3, mDISCERN: 3, JAMA: 3) than Bilibili (GQS: 3, mDISCERN: 3, JAMA: 3; P < .05). Gastroenterologist-created videos scored highest. GQS correlated positively with engagement (r = 0.16–0.26, P < .05), while mDISCERN correlated only with likes, shares, and saves (r = 0.16–0.18, P < .05). JAMA scores negatively correlated with duration (r = −0.24, P < .001).

Conclusions

IBD-related short videos showed moderate quality, with TikTok outperforming Bilibili. Gastroenterologist-produced content was most reliable. Viewers should critically evaluate such health information to avoid misinformation.

Keywords

inflammatory bowel disease health information short videos Bilibili TikTok

Introduction

Inflammatory Bowel Disease (IBD), encompassing ulcerative colitis (UC) and Crohn’s disease (CD), represents a chronic and relapsing inflammatory disorder of the gastrointestinal tract.¹ Recent decades have witnessed a marked global increase in IBD incidence, particularly in newly industrialized nations.² For instance, Asian and South American countries have experienced significant epidemiological transitions, with China projected to reach 1.5 million IBD cases by 2025.³ The disease profoundly impacts patients' quality of life, manifesting as chronic abdominal pain, diarrhea, malnutrition, and other debilitating symptoms that impair daily functioning and psychological well-being.^4,5 Furthermore, the substantial annual healthcare expenditures impose considerable economic burdens on affected families. Despite notable advancements in medical treatments that have extended patient survival, the complex and lifelong management of the disease remains a daunting clinical challenge.^6–8 These considerations underscore the paramount importance of elevating public awareness and understanding of IBD, as this is essential for achieving better health outcomes and alleviating the overall disease burden.

The digital revolution has fundamentally transformed health information acquisition patterns.⁹ Short-video platforms like TikTok and Bilibili have emerged as predominant health information sources due to their accessibility, engaging formats, and interactive features.^10,11 These platforms leverage visually compelling content, particularly videos, to facilitate the dissemination of complex medical knowledge, thereby significantly enhancing information accessibility and public engagement while making health information easier to absorb and remember.¹² However, the absence of peer-review mechanisms and stringent regulatory oversight has resulted in highly variable content quality, with numerous videos containing misleading or inaccurate information. Several studies have indicated that the majority of health-related content on Douyin lacks scientific accuracy, while Bilibili also faces similar issues concerning the completeness and reliability of its content.^13,14

Although existing studies have evaluated video quality for various conditions (e.g., cervical cancer,¹⁵ cryptorchidism,¹⁶ lymphedema¹⁷) on these platforms, the reliability of IBD-specific content remains largely unexamined. This study employs a multidimensional assessment framework to systematically evaluate the quality and reliability of IBD-related videos on TikTok and Bilibili. Our findings aim to provide evidence-based recommendations for public health information selection while informing platform content regulation policies to optimize health communication in the digital era.

Methods

Search strategy and data collection

This was a cross-sectional study designed to evaluate the quality and reliability of IBD-related short videos on two popular Chinese social media platforms, BiliBili and TikTok. On March 4, 2025, we systematically collected the top 100 search results for “炎症性肠病” (Inflammatory Bowel Disease) from both Bilibili and TikTok (China’s version) using newly registered accounts. To rigorously control for algorithmic personalization bias, a standardized technical protocol was implemented. All searches were performed from the same computer and a fixed public IP address within a concentrated 4-hour window. Before each search session, the browser’s cookies, cache, and browsing history were cleared, and a fresh private browsing (incognito) window was opened to isolate the query from any local data. The newly created accounts had no prior browsing, liking, commenting, or following activity, ensuring they represented a neutral user profile with no engagement history. This multi-layered protocol was designed to simulate a standardized, first-time search environment, thereby minimizing the influence of platform-specific personalization algorithms on the retrieved video rankings. After removing duplicate videos (defined as identical content from different uploaders) and irrelevant entries based on title screening, we obtained a final sample of 100 videos per platform. We confined our analysis to the top 100 videos, as multiple studies have demonstrated that videos beyond the top 100 exert no significant influence on the analytical outcomes.^13,18,19 For each video, we recorded the title, uploader characteristics, duration, engagement metrics (likes, comments, shares, saves), and days since published.

Classification of Videos

To ensure methodological consistency with prior studies while accommodating the specific characteristics of IBD-related content, videos were classified using taxonomies adapted from established frameworks for health-related short videos. Uploader source was categorized as gastroenterologist, non-gastroenterologist, patient, or science communicator.^20,21 Content type was structured into four themes: disease knowledge (including information on anatomy, epidemiology, basic research, etiology, symptoms, diagnosis, and prognosis), diet and lifestyle, medication/surgical treatment, and reports/news.^13,20 Format was coded as live video or animation.¹⁴ This structured categorization supported systematic analysis of video characteristics and their relationship with quality scores. Additional details are available in the online supplementary material.

Methodology for assessing video quality and reliability

Video quality and reliability were systematically evaluated using three validated instruments: the modified DISCERN scale(mDISCERN), JAMA benchmark criteria, and Global Quality Score (GQS). The mDISCERN instrument assessed reliability through five dichotomous items (1=present, 0=absent), with total scores categorized into five reliability tiers: unreliable (0-1), marginally reliable (2), moderately reliable (3), largely reliable (4), and highly reliable (5).²² The JAMA score evaluated four fundamental quality attributes (authorship, attribution, currency, and disclosure), yielding a maximum possible score of 4 points.²³ Content quality was further assessed using the GQS 5-point Likert scale (1=exceptionally poor to 5=excellent quality).²⁴ For more detailed information, please refer to the online supplementary material.

Evaluation process

Two trained medical evaluators (BW C and XY C) independently scored all videos following standardized training to ensure rating consistency. In cases where the ratings from the two evaluators were inconsistent, an arbitrator (XJ Z) was consulted to assign the final score. Thereafter, all authors unanimously agreed on the final ratings.

Ethics approval and consent to participate

All data (videos and their associated metadata) used in this study were publicly accessible. This research involved no interaction with human subjects, no collection of private information, and was conducted in compliance with the general terms of service of the respective platforms. Therefore, ethical approval and individual creator permissions were not required.

Statistical analyses

Given the non-parametric distribution of the data, results are presented as medians with interquartile ranges (IQR). Nonparametric tests were applied for group comparisons: the Mann–Whitney U test for two-group analyses and the Kruskal–Wallis H test for multi-group comparisons. Inter-rater reliability, calculated using Cohen’s κ coefficient, was interpreted per Landis and Koch criteria: κ>0.80 (almost perfect agreement), 0.61-0.80 (substantial agreement), 0.41-0.60 (moderate agreement), and ≤0.40 (poor agreement). Spearman’s correlation assessed (a) inter-variable relationships among video characteristics and (b) associations between video ratings and other parameters. All tests were two-tailed, with P <.05 considered statistically significant. Data analysis was conducted using GraphPad Prism version 9.0.0 for Windows.

Result

Video characteristics

Based on our keyword search, we obtained 200 videos for data extraction and analysis: 100 from TikTok and 100 from Bilibili. The general characteristics of the videos are presented in Table 1, which shows that compared to TikTok videos, Bilibili videos had longer durations and more days since publication, but fewer likes, comments, shares, and saves (P<.001) Figure 1.

Table 1.

Characteristics of the videos in TikTok and Bilibili.

Variable	Bilibili(n=100) Median (IQR)	TikTok(n=100) Median (IQR)	Wilcoxon rank-sum test zscore P value
Likes	16(4,92)	195(100,481.5)	8.03	<.001
Comments	3(0,18)	19(8.5,49.5)	5.82	<.001
Shares	8(2,33)	34(9.5,114.5)	4.83	<.001
Saves	14(2,76.5)	42.5(18.5,129.5)	4.11	<.001
Days since published	724(462,1308.5)	390.5(146,542.5)	5.88	<.001
Followers	1363(105,9993)	25000(11000,41000)	7.08	<.001
Total likes	2734(154,30820)	113000(47000,211000)	7.29	<.001
Duration	185(97.5,503)	94(67,139.5)	5.48	<.001
GQS score	3(3,4)	3(3,4)	2.86	.002
Modified DISCERN score	3(2,3)	3(3,4)	3.35	<.001
JAMA score	3(2,3)	3(3,3)	2.16	.007

Figure 2 and Tables 2 and 3 provide a detailed breakdown of the video characteristics on Bilibili and TikTok. Regarding the sources of the videos, gastroenterologists uploaded the most videos on Bilibili (60/100, 60%) and TikTok (88/100, 88%), followed by individual science communicators on Bilibili (23/100, 23%) and non-gastroenterologists on TikTok (6/100, 6%). Surprisingly, videos from gastroenterologists received fewer likes, comments, saves, and shares compared to those from patients and science communicators. The most common type of video content on both platforms was disease knowledge, accounting for 64% on Bilibili and 57% on TikTok. Videos related to reports and news were the least common on both platforms. However, videos concerning reports and news garnered more likes, comments, saves, and shares on Bilibili, whereas videos about disease knowledge received more engagement on TikTok. Additionally, 65% (65/100) of the videos on Bilibili were live videos, while 35% (35/100) were animations. On TikTok, 99% (99/100) were live videos, and 1% (1/100) were animations. Despite the prevalence of live videos, animations were more popular on the Bilibili platform.

Table 2.

Characteristics of the videos across sources and content in Bilibili.

Variable	Likes	Comments	Shares	Saves	Days since published	Duration
Video uploaders(n=100), median (IQR)
Digestive specialist(n=60)	13(2.5,48.5)	1.5(0,14.5)	5.5(1,24.5)	8(2,42)	728.5(449,1339)	121.5(88,419.5)
Non-digestive specialist(n=8)	120(32,617.5)	21.5(5.5,58)	39.5(16,213)	124(36,517.5)	760(592.5,1485)	288.5(138.5,918.5)
Patient(n=9)	28(12,213)	13(2,74)	11(1,27)	20(4,74)	733(391,1122)	256(96,530)
Science communicator(n=23)	13(4,174)	2(0,9)	11(3,60)	17(6,256)	647(355,1110)	303(109,812)
Video contents(n=100), median (IQR)
Disease knowledge(n=64)	13.5(2.5,57.5)	2(0,13)	6(1,21.5)	7(2,43.5)	734.5(350.5,1414)	171(86,355)
Diet and lifestyle(n=17)	17(6,64)	2(1,16)	16(4,38)	39(8,84)	674(574,762)	395(112,1429)
Medication or surgery(n=12)	14(4.5,93)	2(0,25)	9.5(2.5,45.5)	27.5(8,45)	947.5(592.5,1174.5)	151.5(112,915)
Reports and news(n=7)	132(25,1300)	73(5,382)	31(11,51)	79(17,160)	391(164,1290)	530(365,812)
Video formats(n=100), median (IQR)
Animation(n=35)	14(3,219)	2(0,20)	14(3,100)	17(6,256)	784(310,1398)	289(108,471)
Live video(n=65)	17(5,50)	3(0,18)	7(1,27)	10(2,46)	706(540,1194)	144(89,529)

Table 3.

Characteristics of the videos across sources and content in TikTok.

Variable	Likes	Comments	Shares	Saves	Days since published	Duration
Video uploaders(n=100), median (IQR)
Digestive specialist(n=88)	201.5(94,467.5)	18.5(8,49.5)	30.5(9,111.5)	40.5(17.5,120)	400.5(132,500)	91(66,123.5)
Non-digestive specialist(n=6)	148(111,485)	13.5(4,20)	36.5(9,326)	55(18,184)	553.5(165,1081)	192.5(85,237)
Patient(n=3)	359(108,715)	46(45.389)	92(18,120)	56(46,176)	236(223,746)	279(150,335)
Science communicator(n=3)	177(160,53479)	22(14,1977)	48(47,3302)	34(32,8730)	311(89,315)	173(67,190)
Video contents(n=100), median (IQR)
Disease knowledge(n=57)	207(100,558)	24(9,58)	37(10,118)	56(18,141)	405(294,622)	99(67,162)
Diet and lifestyle(n=14)	168(74,445)	15.5(6,47)	32.5(10,145)	23.5(9,97)	459.5(132,789)	69.5(65,148)
Medication or surgery(n=25)	183(133,406)	14(10,39)	27(9,101)	41(26,114)	152(120,410)	93(77,112)
Reports and news(n=4)	239.5(70.5,439.5)	19(10,31)	26(9,49)	39(21.5,85.5)	260.5(59.5,747)	163(73,260.5)
Video formats(n=100), median (IQR)
Animation(n=1)	66(66,66)	3(3,3)	12(12,12)	18(18,18)	259(259,259)	310(310,310)
Live video(n=99)	201(100,485)	19(9,51)	35(9,116)	44(19.135)	395(140.583)	94(67,139)

Video quality and reliability assessments

The video quality was assessed using the GQS, while reliability was evaluated through the mDISCERN and JAMA scores (Table 4). There was a high degree of concordance, with a κ value of 0.79.

Table 4.

The GQS, DISCERN, and JAMA scores were evaluated based on different video sources, contents, and formats related to IBD.

Variable	GQS (Median (IQR))	Modified DISCERN (Median (IQR))	JAMA (Median (IQR))
Video uploaders
Digestive specialist	3(3,4)	3(2.5,4)	3(3,3)
Non-digestive specialist	3(3,4)	3(2,3)	3(2,3)
Patient	2(2,2)	1(1,2.5)	1(1,1)
Science communicator	3(2,4)	2(2,3)	2(1,3)
Video contents
Disease knowledge	3(3,3)	3(2,3)	3(2,3)
Diet and lifestyle	4(3,4)	3(3,4)	3(3,3)
Medication or surgery	4(3,4)	3(3,4)	3(2,3)
Reports and news	3(2,3)	2(1,3)	2(1,3)
Video formats
Animation	3(3,4)	3(2,3.5)	2(1,3)
Live video	3(3,4)	3(2,4)	3(3,3)

Comparison of platforms. The video quality and reliability assessments revealed moderate performance levels across both platforms. TikTok videos achieved median (IQR) scores of 3 (3-4) for GQS, 3 (3-4) for mDISCERN, and 3 (3-3) for JAMA. Bilibili content showed comparable yet slightly lower median scores: 3 (3-4) for GQS, 3 (2-3) for mDISCERN, and 3 (2-3) for JAMA. Comparative analysis demonstrated TikTok’s statistically significant superiority in all three quality metrics (GQS, mDISCERN, and JAMA) relative to Bilibili (Figure 3), suggesting more consistent content quality and reliability on the TikTok platform.

Comparison of uploaders. Gastroenterologists consistently exhibited superior video quality in all three assessment criteria. Non-gastroenterologists and science communicators typically produced higher-quality videos than patients, yet their performance still lagged behind that of gastroenterologists. Notably, patient-generated videos consistently ranked lowest across all scoring systems (Figure 4).

Comparison of content. To determine which types of content best meet standards of quality and reliability, we compared scores across the four content themes (including disease knowledge, diet and lifestyle, medication/surgical treatment, and reports/news). Among the four content themes, videos focusing on ‘diet and lifestyle’ were the most effective, achieving the highest overall quality and reliability scores (GQS, mDISCERN, JAMA). In contrast, case reports and news-based videos showed consistently suboptimal scores across all metrics. Meanwhile, videos covering disease knowledge as well as medication or surgical interventions exhibited moderate to good quality and reliability in all three assessment frameworks (Figure 5).

Comparison of format. Although live videos are more commonly seen than animations, the quality scores for these two types of videos are quite similar in the DISCERN and GQS rating systems, with no significant difference observed. However, it is worth noting that in the JAMA rating system, live videos have a significantly higher score compared to animations (Figure 6).

Spearman correlation analysis

Given the non-normal distribution of the data, Spearman’s rank correlation analysis was employed to examine the relationships between video engagement metrics (likes, comments, shares, and saves), video duration, time since publication, and three quality assessment scales (see Figure 7 and Tables 5 and 6). The results demonstrated significant positive correlations among all engagement metrics (P < .05). Video duration showed only weak positive correlations with shares (r = 0.18) and saves (r = 0.24). Regarding quality assessment, GQS scores exhibited significant positive correlations with all engagement metrics (r = 0.16–0.26, P < .05), whereas mDISCERN scores were positively associated only with likes, shares, and saves (r = 0.16–0.18, P < .05). Notably, JAMA scores showed a significant negative correlation with video duration (r = −0.24, P < .001) but no significant associations with other metrics (P > .05).

Table 5.

Spearman correlation analysis between the video variables.

Variable	Likes	Comments	Shares	Saves	Days since published	Duration
Likes
r	1	-	-	-	-	-
P value	-	-	-	-	-	-
Comments
r	0.90	1	-	-	-	-
P value	<.001^a	-	-	-	-	-
Shares
r	0.87	0.83	1	-	-	-
P value	<.001^a	<.001^a	-	-	-	-
Saves
r	0.88	0.83	0.93	1	-	-
P value	<.001^a	<.001^a	<.001^a	-	-	-
Days since published					-	-
r	-0.08	0.01	0.12	0.09	1	-
P value	.23	.86	.09	.23	-	-
Duration
r	-0.01	0.04	0.18	0.24	0.17	1
P value	.87	.54	.01^a	<.001^a	.01^a	-

^aSignificant at P<.05.

Table 6.

Pearson correlation analysis between video variables and the GQS, Modified DISCERN, and JAMA scores.

Variable	GQS	Modified DISCERN	JAMA
Likes
r	0.24	0.18	0.10
P value	<.001^a	.01^a	.18
Comments
r	0.16	0.11	0.05
P value	.01^a	.11	.50
Shares
r	0.26	0.16	0.07
P value	<.001^a	.02^a	.34
Saves
r	0.26	0.16	0.04
P value	<.001^a	.02^a	.59
Days since published
r	-0.07	-0.10	-0.02
P value	.35	.18	.82
Duration
r	-0.0007	-0.08	-0.24
P value	.99	.26	<.001^a

^aSignificant at P<.05.

Discussion

IBD represents a chronic inflammatory intestinal condition of growing global prevalence that imposes significant long-term health burdens.²⁵ The accessibility of short video platforms such as TikTok and Bilibili has established them as primary health information sources for IBD patients. Nevertheless, the absence of rigorous medical content vetting processes on these platforms contributes to substantial variability in information quality.²⁶ Recognizing both the persistent health education needs of IBD patients and the expanding influence of short-form video content in medical communication, this study conducted a systematic assessment of IBD-related video quality and reliability across these platforms, aiming to facilitate patient identification of trustworthy health information.

To our knowledge, the quality of online IBD information, particularly on short-video platforms, remains underexplored. As a pioneering study addressing this research gap, our findings reveal that while the overall quality and reliability of these videos were moderate, TikTok videos demonstrated superior performance across all evaluation metrics compared to Bilibili.Though the underlying mechanisms were not examined, the observed disparity can be considered in light of several platform-related dimensions. For instance, TikTok is widely noted for its short-form, algorithm-driven format that facilitates rapid production and emphasizes concise presentation—features that may align with certain quality metrics used in our assessment. In contrast, Bilibili is characterized by longer-form content, stronger community-based curation, and more varied production cycles, which could lead to greater heterogeneity in both content depth and accessibility. Furthermore, differences in platform governance, such as content moderation approaches, may also play a role, though this remains a proposition for future policy analysis rather than a finding of this study. Ultimately, to move beyond these observational correlations and establish causal mechanisms, future research should directly analyze platform policies, audit algorithmic systems, and examine creator incentives through mixed-method approaches.

Notably, videos created by healthcare professionals, particularly gastroenterologists, showed significantly higher educational value, quality, and reliability than those from other sources. This advantage likely stems from their specialized IBD expertise, comprehensive understanding of clinical guidelines, and updated research knowledge. In contrast, non-professional creators (e.g., patients and science communicators) predominantly relied on personal experiences and subjective opinions, potentially introducing informational biases. These findings underscore the substantial impact of professional background on content quality. Interestingly, we identified an inverse quality-engagement relationship: gastroenterologist-produced videos achieved the highest quality scores but exhibited lower user engagement metrics compared to patient-generated content. These findings are consistent with the results of Chen et al., in that videos posted by thyroid experts in studies related to thyroid nodules, despite their superior content quality, received relatively less attention in terms of likes, comments, saves, and shares.¹⁴ In addition, similar phenomena have been observed in several other comparable studies, indicating that higher-quality videos do not necessarily attract more attention.^27,28 This paradox may primarily stem from the more rigorous terminology and complex professional language employed in high-quality videos, which present greater comprehension challenges for non-expert audiences. Additionally, platform algorithms that prioritize highly interactive rather than high-quality content may further exacerbate this gap.²⁹ Moreover, videos produced by patients tend to evoke public empathy, thereby garnering higher viewership.

Our analysis of IBD-related content on short-video platforms reveals a clear structural imbalance in information distribution. The majority of videos (60.5%) focused on disease knowledge, covering etiology, pathophysiology, and symptom recognition. In contrast, diet and lifestyle content constitutes a smaller proportion (15.5%). Despite not being the quantitative majority, this category achieved the highest median scores across the GQS, mDISCERN, and JAMA quality assessment tools, indicating that it delivers practical guidance with superior informational reliability, clarity, and standardization relative to its volume. This superior performance aligns with the findings of Miglioretto et al. (2024) regarding patients' high demand for practical dietary advice and reflects a clear public preference for actionable health information over formats like news-style videos and case reports, which consistently ranked lowest in our evaluation. However, diet and lifestyle content predominantly revolves around generic “do’s and don’ts' regarding food, generally lacking stratified and personalized nutritional management plans tailored to disease activity phases, complications, or individual nutritional status. Content directly related to treatment decisions (medication and surgical interventions, 18.5%) showed notable gaps. Pharmacotherapy videos introduced options like biologics but rarely addressed side effects, monitoring, or long-term safety. Surgical content emphasized procedures and outcomes but lacked sufficient detail on indications, risks, and postoperative pathways. This may compromise patients' ability to develop realistic treatment expectations and participate effectively in decision-making. Both platforms provided minimal structured psychosocial support, despite its recognized importance in chronic disease management. In conclusion, while short videos effectively broaden disease awareness, significant gaps remain in treatment decision support, risk education, personalized guidance, and integrated psychosocial care. We recommend that gastroenterologists and health communicators develop more evidence-based, patient-centered content that emphasizes practical, actionable advice—particularly in diet and lifestyle—using accessible language. This approach would better leverage social media’s potential for public health promotion and support patients in achieving sustainable self-management.

While this study did not directly assess viewer expertise, platform-specific audience characteristics likely play a significant role in shaping content reception and engagement. TikTok, designed for mass appeal and brevity, presumably reaches a broader audience including patients, caregivers, and the general public who seek immediate, practical guidance for day-to-day management. This may explain the higher engagement with concise, actionable content, particularly in categories like diet and lifestyle. Conversely, Bilibili, known as a hub for in-depth knowledge sharing, likely attracts a viewer base with a higher proportion of students, young professionals, and individuals with pre-existing health or science interests, who may value detailed explanations of pathophysiology and treatment mechanisms. This divergence in audience composition and informational needs offers a plausible explanation for the observed platform differences in how high-quality, expert-generated content is received and interacted with. It underscores the necessity for health communicators to adapt not only content accuracy but also its depth, complexity, and framing to the predominant literacy levels and expectations of each platform’s user ecosystem. Future research should directly assess viewer demographics and health literacy to better align information supply with user demand and evaluate real-world comprehension and impact.

This study utilized Spearman correlation analysis to assess associations between video quality and user engagement metrics. Significant positive correlations were observed among likes, comments, favorites, and shares, indicating consistency across engagement indicators, consistent with prior findings.^14,30 Heterogeneity was evident in the relationship between video quality and user engagement. GQS scores exhibited significant positive correlations with all engagement metrics (r = 0.16–0.26, P < .05), aligning with earlier literature.^31,32 DISCERN scores correlated positively only with likes, shares, and favorites (r = 0.16–0.18, P < .05). JAMA scores showed a significant negative correlation with video duration (r = –0.24, P < .001) but no significant association with other engagement metrics. These results indicate variability in the strength of association between different quality assessment tools and user engagement. While GQS scores demonstrated the most consistent positive correlations, the overall associations remained modest. This may be attributable to the multifactorial nature of user engagement, which is influenced not only by content quality but also by emotional appeal, entertainment value, and algorithmic recommendations. The inverse relationship between JAMA scores and video duration may reflect a tendency for shorter videos to receive higher JAMA ratings, possibly corresponding to user preference for concise formats. Furthermore, moderate intercorrelations were observed among JAMA, DISCERN, and GQS scores, suggesting that although these tools emphasize distinct dimensions, they converge in their evaluation of overall video quality and reliability. In conclusion, although video quality shows some association with user engagement, this relationship is modest and influenced by multiple factors. Therefore, engagement metrics alone are inadequate for assessing video quality and reliability. Platform operators and content creators should emphasize scientific rigor and adherence to professional standards to improve the quality and reliability of health information dissemination.

This study presents the first systematic evaluation of IBD-related video quality and reliability across short-video platforms. Our study provides novel insights in three key areas. First, it addresses a critical knowledge gap by delivering the first systematic cross-platform analysis of IBD content on TikTok and Bilibili, two dominant but underexamined health information ecosystems in a high-prevalence context. To ensure methodological rigor, we conducted a concurrent analysis of both platforms to control for platform-specific biases, and implemented a comprehensive assessment framework integrating GQS, DISCERN, and JAMA scoring systems, thereby enhancing the representativeness and reliability of our findings. Second, we advance the methodological discourse beyond descriptive assessment by identifying the divergence between professionally evaluated quality and user engagement metrics. Our comparative analysis of different uploader categories revealed the substantial influence of professional background on video quality. This finding, combined with the observed quality engagement divergence, enables us to formulate testable hypotheses about how platform architectures, including algorithmic curation and content governance mechanisms, may systematically shape the quality of health information. This establishes a clear research trajectory for future informatics work in this area. Third, the study yields actionable insights with direct relevance for multiple stakeholders. For platforms, we recommend enhanced content review mechanisms and algorithmic prioritization of professionally produced, high quality health information. For healthcare professionals, our results highlight the importance of specialized training and active engagement in digital health communication to elevate the overall quality of medical information on short video platforms. For patients and the public, these findings offer practical guidance to navigate online health information more critically, thereby improving public health literacy. Together, these contributions provide evidence based implications for health policy development, platform content regulation, and public health communication strategies.

However, this study has several limitations that should be acknowledged. First, given the dynamic nature of short-video platforms where content is continuously updated, our data collection at a single time point may not fully capture the current content landscape. Second, the exclusive focus on Chinese-language videos limits the generalizability of our findings to other linguistic or regional contexts. Third, notwithstanding our efforts to control for algorithmic bias through a standardized search protocol, a fundamental limitation persists: the proprietary nature of platform algorithms means that residual bias from undisclosed ranking factors cannot be fully excluded. Fourth, this study did not collect data on the viewers themselves, such as their medical background, health literacy level, or status as patients or caregivers. Consequently, we could not assess how these factors influence trust in, comprehension of, or behavioral responses to the video content. Viewer expertise is likely a significant confounding variable in the relationship between content quality and engagement metrics, a limitation that must be considered when interpreting our findings. Additionally, although we employed standardized assessment tools (GQS, DISCERN, and JAMA scales) and maintained high inter-rater reliability, potential biases inherent in subjective scoring should be considered. Future research should expand the sample size and incorporate multi-language, multi-regional short-video platforms for comparative analysis to enhance the external validity of the findings.

Conclusion

In our study, we collected and evaluated the information quality of 200 IBD-related videos from two major short video-sharing social media platforms in China: TikTok and Bilibili. The findings revealed that the overall quality and reliability of these videos were at a moderate level, with TikTok videos slightly outperforming Bilibili in terms of quality and reliability. Videos shared by gastroenterology specialists and those related to diet and lifestyle demonstrated superior quality and reliability. Therefore, short video platforms should strengthen their monitoring and review mechanisms to enhance information quality and reliability. Meanwhile, patients should exercise caution and selectivity when browsing short videos on BiliBili and TikTok.

Supplemental material

Supplemental material - Evaluating the quality and reliability of inflammatory bowel disease-related short videos on BiliBili and TikTok: A cross-sectional study

Supplemental material for Evaluating the quality and reliability of inflammatory bowel disease-related short videos on BiliBili and TikTok: A cross-sectional study by Bowen Cheng, Xiaoyan Chen, Wenjie Shi, Xiaojiang Zhou in Health Informatics Journal

Footnotes

Author notes

Recent Relevant Publications: 1. Yang Liu, Feng Zhou, Xiaojiang Zhou, et al. (2025). SIGIRR alleviates intestinal mucosal damage in severe acute pancreatitis via the TLR4 signaling pathway. DOI: 10.1016/j.jcmgh.2025.101608. 2. Fangfei Wang, Feng Zhou, Xiaojiang ZhouORCID,*, et al. (2024). Macrophage Tim-3 maintains intestinal homeostasis in Dss-induced colitis by suppressing neutrophil necroptosis.Doi: 10.1016/j.redox.2024.103072.

Acknowledgments

The authors would like to express their gratitude to the participants who participated in the study.

ORCID iDs

Bowen Cheng

Xiaoyan Chen

Wenjie Shi

Xiaojiang Zhou

Ethical considerations

All information was accessed and obtained publicly, and no interaction with any individual was involved. No personal information, clinical data, or human specimens were used.

Consent for publication

Patients or the public were not involved in any aspect of our research, including its design, conduct, reporting, or dissemination plans.

Author contributions

Zhou XJ contributed to the study conception design; Cheng BW, Chen XY, and Zhou XJ were responsible for the review and scoring of the videos; Cheng BW and Shi WJ conducted the data analysis and prepared the manuscript; Chen XY and Zhou XJ interpreted the data and revised the manuscript; All authors contributed to the article and approved the final manuscript.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by The Jiangxi Institute of Nutrition and Health Management Medicine Cultivation project (No. 2023-ZDPY-01), and The Jiangxi Provincial Health Commission Science and Technology Plan Project (No. 202510223).

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, 18 Sage UK House Style and/or publication of this article.

Data Availability Statement

The data utilized and/or examined in this study can be accessed from the corresponding author upon request, provided that the request is justified and reasonable.*

Supplemental material

Supplemental material for this article is available online.

Appendix

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