Popularity and quality of Crohn’s disease information on Tiktok and Bilibili: a cross-sectional infodemiology study

Patients increasingly use short-video platforms to obtain information about Crohn’s disease (CD), a lifelong disorder requiring repeated decisions about immunosuppressive and biologic therapy, nutrition, surgery, and when to seek urgent care. Misleading or incomplete online advice may contribute to nonadherence, unsafe self-management, or delayed clinical evaluation. However, the extent to which highly visible CD-related videos provide high-quality, reliable, and clinically useful information remains unclear. This study evaluated the educational quality and reliability of Chinese-language CD-related videos on TikTok and Bilibili, examined whether popularity and engagement corresponded to expert-rated scores, and characterized creator and video features relevant to gastroenterology patient education. We conducted a cross-sectional infodemiology study of 200 CD-related videos, comprising the first 100 eligible videos identified on TikTok and the first 100 eligible videos identified on Bilibili. New platform accounts were used during data collection to reduce personalization bias. Two independent physician reviewers assessed each video using the Global Quality Score (GQS) and an adapted eight-item DISCERN reliability subset. The summed DISCERN reliability total was categorized into a prespecified five-level adapted DISCERN reliability index. Inter-rater agreement for the two five-level ordinal outcomes was assessed using linearly weighted Cohen’s kappa with 95% confidence intervals. Between-group analyses were nonparametric; multiplicity was controlled within prespecified analysis families for item-level comparisons, correlation analyses, and Dunn’s test with Bonferroni adjustment. TikTok videos had higher engagement than Bilibili videos, including median likes (295 vs. 118, P < 0.001), comments (62 vs. 23, P = 0.001), shares (66 vs. 15, P < 0.001), and saves (92 vs. 54, P = 0.019). TikTok videos were more recent (median 79 vs. 988 days since publication, P < 0.001) and shorter (85 vs. 280 s, P < 0.001). Overall educational quality and reliability were moderate. The median GQS was 4 (IQR 2–4) on TikTok and 3.5 (IQR 2–4) on Bilibili ( P = 0.245), while the median adapted DISCERN reliability index was 3 (IQR 2–3) on both platforms ( P = 0.524). Spearman correlations between engagement and expert-rated outcomes ranged from near zero to modestly negative; no engagement indicator was positively associated with higher GQS or adapted DISCERN reliability index scores. Several modest inverse associations remained after Holm adjustment within the correlation matrix. Popular CD-related videos on TikTok and Bilibili provide information of moderate educational quality and reliability. Popularity and engagement should not be interpreted as proxies for educational quality or reliability; factual accuracy and guideline concordance require direct assessment. Videos from professional sources tended to receive higher scores, but professional source status alone should not be treated as evidence of factual accuracy. Clinicians, academic institutions, professional societies, and platforms should work together to provide identifiable, current, and evidence-based IBD education and to address high-risk misconceptions encountered in clinical practice.