Quality, reliability, and user engagement of hepatitis B–related short videos on TikTok, Bilibili, and Xiaohongshu: a cross-platform cross-sectional study

BackgroundCHB remains a major public health burden in China. TikTok, Bilibili, and Xiaohongshu have become key channels for health information, yet the quality, reliability, and transparency of such content remain uncertain.MethodsOn November 12, 2025, the top 100 eligible HBV-related videos from each platform (N = 300) were assessed using the Global Quality Scale (GQS), modified DISCERN instrument (mDISCERN), and Journal of the American Medical Association benchmark criteria (JAMA). Two raters independently scored each video; discrepant ratings were resolved by consensus or senior adjudication, and final consensus scores were used for the main analyses. Inter-rater agreement was assessed using linearly weighted Cohen's κ. Group differences were evaluated using the Kruskal–Wallis H test followed, when significant, by Dunn's post hoc test with Holm adjustment. Spearman correlations and multivariable ordinal regression models were used to examine unadjusted and adjusted associations.ResultsA total of 300 videos were included, with 100 from each platform. Inter-rater agreement was substantial for GQS (κ = 0.774, 95% CI 0.705–0.839), almost perfect for mDISCERN (κ = 0.928, 95% CI 0.888-0.962), and moderate for JAMA (κ = 0.503, 95% CI 0.410-0.590). mDISCERN and JAMA scores differed significantly across platforms, whereas GQS scores did not. Medical personnel had higher rank distributions than normal users for GQS, mDISCERN, and JAMA after Holm adjustment. In adjusted models, Xiaohongshu was associated with higher GQS scores than Bilibili, normal-user uploaders were associated with lower GQS scores than medical personnel, and longer video duration was associated with higher GQS scores. JAMA showed threshold-specific associations with platform, uploader type, and video duration. The adjusted cumulative mDISCERN model was not formally interpreted because of sparse-data instability; a bias-reduced adjacent-category model was reported as an exploratory sensitivity analysis. Engagement metrics showed weak and inconsistent correlations with quality scores.ConclusionsAmong highly visible hepatitis B-related short videos retrieved under prespecified search conditions, video quality varied by assessment instrument, platform, and uploader type. Adjusted associations were instrument- or threshold-specific, and engagement metrics should not be treated as proxies for reliability or transparency.