Social exposure and digital content dynamics: an evaluation of most viewed YouTube videos on addiction, violence and poisoning

Authors

Abstract

AimThis study aimed to evaluate the content quality of the most-viewed YouTube videos on poisoning, addiction, and violence, which are topics of direct relevance to public health and safety.
MethodsSystematic searches were conducted on the YouTube platform using the keywords “poisoning,” “addiction,” and “violence.” The reliability of the videos was assessed using the modified DISCERN tool, while the overall information quality and standard were evaluated using the Global Quality Scale (GQS). Based on scores from both instruments, videos were categorized into three groups: high/excellent quality, moderate quality, and low quality.
ResultsAmong the videos analyzed, 5.7% (n=6) were classified as high/excellent quality, 28.3% (n=30) as moderate quality, and 66% (n = 70) as low quality. Videos in the high/excellent quality group had significantly higher median DISCERN scores compared to moderate and low-quality videos (p<0.001). No correlation was found between video popularity and GQS scores. However, GQS and DISCERN scores demonstrated a strong and significant positive correlation (p<0.001, r = 0.666). Strong positive correlations were also observed between total likes and total comments, as well as total views (p<0.001; r=0.645 and p<0.001; R=0.786, respectively).
ConclusionThis study shows that the quality and reliability of forensic-related content on YouTube vary considerably, with a notable proportion of videos containing incomplete or potentially misleading information. These findings underscore the need for improving the accuracy of online health-related content.

Keywords

Introduction

The current era is characterized by the predominance of information and communication technologies. As digitalization accelerates, access to information has diversified, enabling individuals to obtain the knowledge they need through various channels, among which digital platforms have emerged prominently.¹
Technological advancements have significantly facilitated information access. Digital search engines, in particular, have become among the fastest and most accessible sources for health-related information, largely replacing traditional media channels. YouTube exemplifies this transformation; it has evolved into an important video-based information platform widely used not only for entertainment and social interaction but also for sensitive domains such as health, forensic medicine, and psychology.^2,3
Forensic medicine encompasses topics such as addiction, violence, and poisoning, which directly affect broad segments of society and require ethical sensitivity and careful attention.⁴ How content on these subjects is presented on publicly accessible digital platforms like YouTube, and how it is consumed by users, holds significance for both academic research and societal impact.
Although the societal effects of digital media content have been widely discussed in the literature,^5,6 the risks posed by the unregulated dissemination of ethically sensitive content remain underexplored. Although previous studies have examined health-related information on YouTube, studies specifically evaluating forensic-related topics such as addiction, violence, and poisoning remain limited.
This study aimed to analyze the most-viewed YouTube videos on addiction, violence, and poisoning and to evaluate their structural characteristics, information accuracy, and overall quality.

Materials and Methods

This study was designed as a descriptive cross-sectional content analysis. This descriptive and analytical study systematically evaluated trending YouTube content related to poisoning, addiction, and violence. Keywords were identified based on commonly searched terms and trending expressions on the platform, and the terms “addiction,” “violence,” and “poisoning” were used for video searches. The search was conducted on February 19, 2026, via YouTube (www.youtube.com), and the results were sorted in descending order of view count. Based on similar studies in the literature, the number of videos to be analyzed was determined.⁷ Prior research reported that approximately 90% of relevant content is found within the first 60 search results; therefore, the top 60 most-viewed videos for each keyword were included.^8,9,10 Exclusion criteria encompassed duplicate videos, non-Turkish content, forensic topics outside the study scope, commercially promotional content, and videos deemed inappropriate in terms of content integrity.
Quality AssessmentVideo quality was evaluated using the Global Quality Scale (GQS), a widely accepted tool for assessing digital video content. The GQS rates videos on a 1–5 scale: scores of 4–5 indicate good/excellent quality, 3 indicates moderate quality, and 1–2 indicates low quality.^2,8,9,10 Specifically:
Videos scoring 1–2 were considered low-quality, providing insufficient or potentially misleading information.
Videos scoring 3 indicated moderate quality, potentially containing both accurate and inaccurate information.
Videos scoring 4 were high-quality, largely accurate, and educational, though minor deficiencies could exist.
Videos scoring 5 were technically strong, fluent, fully evidence-based, and supported by up-to-date references.¹¹
All included videos were independently assessed by two physicians experienced in commonly encountered forensic topics in primary care. Inter-rater reliability was calculated using Cohen’s kappa coefficient, and disagreements were resolved by a third expert.
Reliability AssessmentVideo reliability was analyzed using a modified version of the DISCERN instrument developed by Charnock et al. The original DISCERN consists of 16 items assessing reliability (items 1–8), content quality (items 9–15), and overall quality (item 16).¹² In this study, five core DISCERN criteria were applied: clarity of presentation, reliance on scientific and up-to-date sources, neutrality of information, reference to additional resources, and coverage of uncertain or controversial areas. Each item was scored “yes” (1) or “no” (0), yielding a total score range of 0–5, with higher scores indicating greater reliability. Similar scoring approaches have been reported in prior video content analyses.¹²
Video ParametersFor each video, the upload date, total duration, and total views, likes, and comments were recorded. Daily averages were calculated for views, likes, and comments, and analyzed alongside total counts.
Video SourcesVideo sources were classified into five categories: academic institutions/universities, physicians, non-physician healthcare professionals, TV journalists/researchers, and YouTubers.
Ethical ApprovalOnly publicly accessible videos on the YouTube platform were included. No human or animal participants were involved; therefore, ethics committee approval was not required. Similar methodological approaches have been used in previous studies.^10,13,14
Statistical AnalysisStatistical analyses were conducted using SPSS Statistics. Descriptive statistics included frequencies, percentages, minimum, maximum, and median values. Data distribution was assessed using the Kolmogorov–Smirnov test. Non-parametric comparisons between groups were performed using the Kruskal–Wallis test, with post hoc analyses for significant differences. Relationships between variables were examined using Pearson correlation analysis. Inter-rater agreement was assessed with Cohen’s kappa coefficient (0.885). A p-value <0.05 was considered statistically significant.
Reporting GuidelinesThis study is reported in accordance with the STROBE guidelines.

Results

A total of 180 videos were initially screened, and 74 were excluded based on predefined criteria. All excluded videos were deemed unrelated to the study objectives, and 18 of these were uploaded by independent YouTubers. Following the screening process, the final analysis included 106 videos.
The median duration of the included videos was 79.5 seconds (range: 10–3,322 seconds). The median number of views was 177,610 (4,746–16,106,490), and the median number of comments was 129 (0–6,249). Detailed descriptive statistics for the videos are presented in Figure 1.
According to the Global Quality Scale (GQS), the videos demonstrated heterogeneous quality levels: 5.7% (n = 6) were classified as high-quality, 28.3% (n = 30) as moderate-quality, and 66% (n = 70) as low-quality. Inter-rater reliability was high, with a Cohen’s kappa coefficient of 0.885.
Analysis by source revealed that videos uploaded by academic institutions/universities were predominantly in the high- or moderate-quality categories (n = 7). Approximately half of the physician-generated videos were of moderate quality (n = 7). In contrast, most videos produced by TV/journalists and independent users fell into the low-quality category, with 78.1% (n = 25) and 67.6% (n = 25), respectively. These findings indicate that content quality may significantly vary according to the uploader’s profile. The distribution of GQS scores by source is detailed in Figure 2.
When evaluating GQS and modified DISCERN scores by uploader type, academic/university-sourced videos scored significantly higher than other groups (p < 0.001). Conversely, TV/journalist and independent user videos consistently received lower scores. No significant differences were observed between uploader groups in terms of total likes, daily views, or daily comments (p = 0.159, p = 0.248, p = 0.388, respectively) (Supplementary Table 1).
Higher video quality was associated with increased modified DISCERN scores, with significant differences observed between quality groups (p < 0.001). However, no statistically significant differences were identified between quality groups for daily views, daily comments, or total likes (p = 0.448, p = 0.491, p = 0.252, respectively) (Table 1).
Correlation analyses between video popularity metrics (total views, likes, and comments) and GQS and DISCERN scores revealed no significant association between popularity and GQS scores. A significant and strong negative correlation was observed between DISCERN scores and total comments (p = 0.017; r = -0.861), whereas DISCERN scores were positively correlated with total likes (p = 0.042; r = 0.671). GQS and DISCERN mean scores exhibited a strong positive correlation (p < 0.001; r = 0.666).
Additionally, total likes were strongly and positively correlated with total comments and total views (p < 0.001; r = 0.645 and p < 0.001; r = 0.786, respectively). Similarly, total comments were strongly positively correlated with total views (p < 0.001; r = 0.642).

Discussion

The twenty-first century has been characterized by the integration of digital technologies into daily life and a rapid global increase in internet usage. With free access and the ability to reach wide audiences, YouTube has emerged as one of the most widely used video-sharing platforms. Particularly during and after global pandemics with high mortality, the public’s need for rapid and easily accessible information has driven increased reliance on digital media. Consequently, YouTube’s use as a source for medical information has also markedly risen.
However, the presence of medical content on the platform does not guarantee that all videos are reliable or of high quality. Alongside scientifically accurate and informative content, low-quality or misleading information is also widely available. The prevalence of such content can facilitate the dissemination of misinformation, negatively impact health literacy, and increase public anxiety. Therefore, systematically examining and evaluating YouTube-based information on forensic medicine topics of public interest represents an important public health necessity.
Our findings indicate that a majority of videos on addiction, violence, and poisoning were of low quality. Conversely, the limited number of videos classified as high or moderate quality was predominantly produced by academic/university or physician sources. Videos created by TV/journalists and independent users were mostly concentrated in the low-quality category.
According to the GQS, 5.7% of videos (n = 6) were high-quality, 28.3% (n = 30) moderate-quality, and 66% (n = 70) low-quality. Although the number of studies in this area is limited, Nicholas et al. reported that only 16% of assessed videos fell into the high-quality group. Similarly, Villafañe et al. found that the majority of videos had a low level of evidence.^15,16 Erdoğan et al., in a study conducted during the pandemic, reported that more than half of the videos were categorized as low or moderate quality.¹⁷
These findings are consistent with previously reported studies evaluating medical information on YouTube, indicating that a substantial portion of forensic medicine-related YouTube content falls into low or moderate-quality categories. Overall, a consistent pattern emerges in which high-quality, evidence-based content remains limited.
In our study, high- and moderate-quality videos were primarily produced by academics/universities and physicians, whereas low-quality videos were mainly from TV/journalists and independent users. Bora et al. similarly reported that high-quality videos predominantly originate from universities, while low-quality content is largely created by independent users. However, Bora et al. also noted that TV/journalist videos appeared in the high-quality group, which contrasts with our findings.¹⁸
These results underscore the importance of the content creator’s profile in determining the quality of medical information on YouTube. Our findings indicate that academic institutions/universities and physicians are the main providers of high- and moderate-quality content, though the number of such videos is limited. This highlights the need to support and encourage evidence-based, unbiased, and high-quality medical content production by these groups.
Another notable finding is the high number of low-quality or misleading videos and their potential to reach large audiences. Our data indirectly support this observation, and previous studies have shown that low-quality videos may achieve higher visibility and view counts.^18,19
Furthermore, the number of videos produced by TV/journalists and independent users exceeded those produced by academic/university, physician, and other healthcare professional sources, reinforcing their quantitative dominance and access potential on the platform.
Interestingly, low-quality videos in our study received substantial numbers of likes and comments, indicating that even videos of lower quality can generate strong user engagement in forensic medicine topics.
However, this observation does not imply a direct causal relationship between viewer preference and content quality; factors such as presentation style, simplicity of language, title selection, and accessibility likely influence engagement levels. Nonetheless, the high engagement with low-quality content highlights a critical concern: incomplete or inaccurate information can potentially reach large audiences, warranting careful consideration in public health communication.

Limitations

YouTube-based studies inherently carry certain methodological limitations. Videos should ideally be evaluated independently by multiple physicians, and it must be acknowledged that the scoring systems employed contain some degree of subjective assessment. Furthermore, analyses were limited to the top 60 videos listed at the time of review. Due to YouTube’s dynamic and continuously updating nature, view counts, user interactions, and content characteristics may change over time.
Only Turkish-language content was included in this study, which may limit the generalizability of the findings. Considering that the platform’s algorithm can be influenced by prior user searches, all search histories were cleared before the evaluation to minimize potential algorithmic bias. Finally, the sample size should also be recognized as a limitation when interpreting the results.

Conclusion

The findings indicate that a substantial proportion of YouTube content related to addiction, violence, and poisoning lacks adequate scientific quality and an evidence-based foundation. High-quality videos remain limited in number. When considered alongside previous studies in the literature, these results highlight a significant reliability gap in sensitive forensic content shared on digital platforms. The findings emphasize the importance of increasing the production of scientifically grounded, peer-reviewable content by academic institutions and clinical experts, particularly for forensic topics that are of high public interest and sensitive in nature.

Declarations

Abbreviations

DISCERN: Quality assessment instrument for health information
GQS: Global Quality Scale
max: Maximum
min: Minimum
SPSS: Statistical Package for the Social Sciences
STROBE: Strengthening the Reporting of Observational Studies in Epidemiology

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About This Article

Received:

February 27, 2026

Accepted:

April 15, 2026

Published Online:

April 15, 2026