Quality, reliability, and dissemination of lung cancer information on short-video platforms in China: a cross-platform content analysis of TikTok, Kwai, and Rednote.

BACKGROUND: Short-video platforms have become major sources of health information in China, influencing public awareness and health behavior. However, the quality and dissemination patterns of lung cancer-related content across different platforms remain unclear. This study aimed to evaluate the informational quality, reliability, and engagement patterns of lung cancer short videos on three leading Chinese platforms.

METHODS: We conducted a comprehensive cross-sectional content analysis of 1,288 lung cancer-related videos retrieved from TikTok, Kwai and Rednote. Video quality was systematically evaluated using a multidimensional toolkit, including the Journal of the American Medical Association (JAMA) benchmark criteria, Global Quality Scale (GQS), modified DISCERN (mDISCERN), and the Patient Education Materials Assessment Tool (PEMAT-U/A). We analyzed heterogeneity and correlations of quality and engagement metrics (likes, comments, shares, collections) across platforms, creator types, content themes, and presentation formats.

RESULTS: Overall information quality was suboptimal (Median JAMA = 2; Median GQS = 3). Significant heterogeneity (p < 0.001) was found, with TikTok demonstrating the highest quality, while Kwai exhibited the lowest quality but high engagement. Videos by physicians and news agencies demonstrated significantly higher reliability, understandability, and actionability than those by non-professional creators (p < 0.001). Disease knowledge videos-particularly those focusing on prevention, definitions, and risk factors-exhibited superior quality compared to personal experience or metastasis-related content. Expert monolog videos were the most common and effective presentation format. Engagement did not align linearly with quality. Patient vlogs and metastasis-related videos achieved higher interaction rates despite lower accuracy, indicating a "quality-engagement paradox." Weak-to-moderate positive correlations were found between GQS and engagement, while PEMAT-A was negatively correlated with likes and comments.

CONCLUSION: Marked disparities in the quality and dissemination of lung cancer-related short videos exist across Chinese platforms. Professional, evidence-based content enhances reliability, whereas emotional and visually driven content drives engagement. Strengthening algorithmic governance, metadata transparency, and expert involvement-alongside audience-centered, evidence-informed communication-may enhance the educational value and public health impact of short-video platforms.