From hematuria warning to precision immunotherapy: an AI-assisted cross-platform analysis of bladder cancer information on social media
Social media videos incompletely connect hematuria warning with pathology‑based precision immunotherapy in bladder cancer.
Bladder cancer often presents with hematuria, while modern management increasingly depends on pathology-based risk stratification, immunotherapy, and biomarker-informed treatment. This study evaluated whether social media videos adequately connect early hematuria warning with precision bladder cancer care. Methods: We conducted a cross-sectional, AI-assisted structured extraction and urologist consensus-scored content analysis of publicly available videos from Bilibili, Douyin, and YouTube. Videos were searched on May 17, 2026, using the keywords corresponding to hematuria and bladder cancer, with relevance ranking. Content quality was assessed with DISCERN, GQS, PEMAT, general content completeness, the Bladder Cancer Warning Score (BCWS), and the Bladder Cancer Precision Immunotherapy Score (BC‑PIS). After rubric calibration, BC‑PIS scores were averaged across three reviewers; videos with a mean BC‑PIS ≥ 11 were classified as adequate. Results: In the hematuria module, 368 of 400 videos were included. BCWS differed significantly across platforms, with mean scores of 6.59 ± 1.57 for Bilibili, 7.34 ± 1.09 for Douyin, and 7.99 ± 1.65 for YouTube (P < 0.001). Adequate warning information was present in 48/120 (Bilibili), 79/99 (Douyin), and 120/149 (YouTube) videos. In the bladder‑cancer module, 363 of 395 videos were included. The three‑rater mean BC‑PIS differed significantly across platforms: 3.28 ± 3.45 for Bilibili, 10.21 ± 2.03 for Douyin, and 7.71 ± 4.75 for YouTube (P < 0.001). Adequate precision‑immunotherapy information was identified in 7/124 (Bilibili), 33/90 (Douyin), and 44/149 (YouTube) videos. Reliability analysis yielded overall ICC(2,1) values of 0.693 for BCWS and 0.876 for BC‑PIS; Fleiss' kappa values were 0.691 and 0.725. All 149 included YouTube hematuria videos were matched by platform‑specific sequence number and retained in the BCWS reliability analysis. Conclusion: Social media videos incompletely connect hematuria warning with pathology‑based precision immunotherapy in bladder cancer. Greater professional involvement and platform‑level quality control are needed to improve online bladder‑cancer education.
Effective early recognition and timely referral are essential for optimal bladder‑cancer outcomes. If public‑facing online content fails to adequately convey hematuria as a potential warning sign and the subsequent need for risk‑stratified, immuno‑ or precision‑based therapy, patients may experience delays in evaluation, misinterpretation of symptoms, or insufficient knowledge of available treatment options. Addressing these gaps can improve patient engagement, reduce diagnostic delays, and support shared decision‑making.
Evidence level: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.