Public health implications of allergic rhinitis information on YouTube and Bilibili: a cross-cultural analysis of content quality, engagement, and seasonal trends

Allergic Rhinitis (AR) affects over 500 million people globally, posing a significant public health burden. Video-sharing platforms like YouTube and Bilibili have become primary sources of health information. This study aimed to compare content quality, user engagement, and alignment with seasonal search trends of AR-related videos on these two culturally distinct platforms.

We retrieved the top 200 AR-related videos from each platform (keywords: "allergic rhinitis" for YouTube, "过敏性鼻炎" for Bilibili) published between January 2022 and January 2025. After applying predefined exclusion criteria (irrelevance, non-English YouTube videos, out-of-timeframe, advertisements), 240 videos (91 YouTube, 149 Bilibili) were retained. Quality was assessed using the Patient Education Material Assessment Tool (PEMAT), Video Information Quality Index (VIQI), Global Quality Scale (GQS), and the Modified DISCERN Scale (mDISCERN). We also integrated Google Trends and Baidu Index data to analyze video characteristics, engagement, and correlations with seasonal search trends.

AR-related video quality was generally low, though YouTube scored significantly higher than Bilibili in median PEMAT-Total (76.5 vs. 71.4), GQS (4 vs. 3), and mDISCERN (3 vs. 1) (all P < 0.001). YouTube featured more content from medical professionals (33.3%, n = 30/91), whereas Bilibili's was predominantly from non-professionals (61.4%, n = 92/149). Bilibili showed higher user engagement, with greater interactions through comments and donations. Both platforms showed spring and autumn search peaks, coinciding with allergen seasons. A moderate positive correlation emerged between Bilibili videos and Baidu Index (r = 0.37; P = 0.03), while YouTube videos correlated strongly with Google Trends (r = 0.63; P = 0.03). Professional content scored higher on both platforms, but treatment-related Bilibili videos correlated negatively with search volume (r = − 0.69; P = 0.01), signaling potential misinformation risks during peak periods.

For AR-related videos, YouTube offers better content quality, while Bilibili excels in user engagement. Both platforms need improved content quality and coverage. A seasonal "demand-content" loop exists between AR search trends and video content, carrying misinformation risks during peak periods. We recommend year-round promotion of evidence-based content, adding medical warnings to misleading information, and encouraging collaboration between medical professionals and social media creators.