Stereotactic Body Radiotherapy for Lung Cancer: An Understandability/Actionability Assessment of YouTube Videos

Purpose: Stereotactic Body Radiation Therapy (SBRT) is a radiation therapy technique to precisely treat certain lung cancers while sparing normal tissue. In today’s technological climate, more patients are using the internet to gather information about upcoming therapies. This study aims to characterize and assess the understandability and actionability of videos on YouTube about SBRT for lung cancer directed toward patients.

Methodology: YouTube was searched in April 2023 using six keywords related to SBRT for lung cancer. Using Relevance based sorting, the first 60 videos for each search term were reviewed for inclusion. Included videos were in English uploaded for general public information. Categorical and quantitative data were collected on each video, and descriptive statistics were compiled. Videos were then assessed for understandability and actionability using the Patient Education Materials Assessment Tool for Audio Visual Materials (PEMAT-AV). The PEMAT-AV includes 13 items to assess understandability and four items to assess actionability and produces separate percentage scores for each domain. Reviewers used a standardized process to independently assess each material and then met to review and reconcile discrepancies to produce consistent scores.

Results: The first 60 searches from six key phrases came up with 360 videos, and 105 videos were included for analysis. Videos upload dates ranged from 2007 to 2023. The maximum number of videos were uploaded by private channels (72%), followed by academic channels (18%) and non-profit channels (10%). Videos uploaded from academic channels had the highest average number of views, likes, duration, and comments. Results from the PEMAT-AV analysis are in Table 1. Analysis showed that only 12 (11%) of the videos scored favorably in understandability and actionability. The mean score for understandability across all videos was 59%, and only 20 videos had an average score of 80% or higher. However, the materials scored well on use of active voice with 80% of materials receiving a favorable score. Other noted strengths of videos were including text on the screen and text that was easy to read (86%). About 80% of videos used active voice, and about 96% of materials scored well on information presented in a logical order that would make sense to a user. With respect to actionability, the mean score was 48%. Only 50% of the materials identified at least one action for the user to take.

Conclusions: Patients are watching mostly SBRT lung videos uploaded by academic institutions. These videos had strengths in understandability with regard to presenting information logically, using active voice, and including text that was easy to read. Videos could be further improved by taking steps to address actionability.

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