Popularity Does Not Reflect Quality: A Cross-Platform Assessment of Pulmonary Embolism Health Information on Chinese Video Platforms

Pulmonary embolism (PE)-related videos are widely consumed as online health information, yet user engagement may not reflect informational quality and reliability. We evaluated 456 PE-related videos from TikTok (n = 205), Bilibili (n = 142), and RedNote (n = 109). Video characteristics, publisher type, engagement metrics, and content features were extracted. Quality and reliability were assessed using the Global Quality Score (GQS) and modified DISCERN (mDISCERN). Significant platform differences were observed in engagement patterns, publisher composition, content distribution, and quality scores. Only 33.3% of videos mentioned venous thromboembolism (VTE) prophylaxis. Engagement metrics were strongly intercorrelated but showed weak associations with GQS and mDISCERN. Ordinal logistic regression identified publisher type as a strong independent predictor of quality. Videos produced by medical organizations were more likely to achieve higher GQS (OR = 4.69, 95% CI 2.10–10.46) and mDISCERN scores (OR = 2.55, 95% CI 1.10–5.92), whereas videos not mentioning VTE were less likely to receive high scores. These findings indicate substantial heterogeneity in PE-related videos. They also suggest that highly disseminated content may not always be evidence-based, highlighting the importance of greater institutional participation and guideline-oriented prevention messaging.