Guideline completeness, dangerous misinformation, and engagement of pediatric asthma videos on Chinese short-video platforms: a cross-sectional infodemiology study

<title>Abstract</title> <p>Background Pediatric asthma management depends on caregivers having accurate, actionable information. In China, parents increasingly encounter asthma advice through short-video platforms, but generic video-quality scores may not capture guideline completeness or safety-relevant misinformation. We assessed pediatric asthma videos on three Chinese short-video platforms to determine whether generic quality and engagement metrics identified dangerous misinformation. Methods In this cross-sectional content analysis, we screened 300 videos retrieved from Douyin, Kuaishou, and Bilibili on 16 April 2026 and analyzed 241 eligible videos. Two reviewers independently scored each video using established quality and patient-education instruments and two guideline-anchored, study-specific tools: the 14-domain Pediatric Asthma Content Index (PACI) and the 18-item Asthma Dangerous Misinformation Checklist (ADMC). We used group comparisons, Spearman correlations, multivariable models, false discovery rate correction, and prespecified sensitivity analyses. Results Medical professionals authored 202 of 241 videos (83.8%), but their share ranged from 100.0% on Douyin to 58.8% on Bilibili. Generic quality was moderate (Global Quality Score median 3.0), whereas guideline completeness was low (PACI-14 median 3/14) and diverged from generic quality patterns across platforms (Bilibili 5, Douyin 3, Kuaishou 2; P &lt; 0.001). Dangerous misinformation was identified in 44 videos (18.3%) and Grade A misinformation in 22 (9.1%), both highest on Kuaishou. ADMC count correlated most strongly with lower PACI-14 completeness (Spearman rho=-0.45) and only weakly with generic quality or engagement measures (all |rho|&lt;=0.20). In adjusted models, Kuaishou videos had lower PACI-14 completeness (beta=-2.03; P &lt; 0.001) and higher odds of any dangerous misinformation (odds ratio 3.83; P = 0.025) than Bilibili. Engagement did not independently track completeness or misinformation. Conclusions Generic quality and engagement metrics were insufficient to identify safety-relevant misinformation in pediatric asthma videos. Disease-specific guideline completeness was most strongly associated with misinformation burden. Evaluations of pediatric asthma content should include guideline completeness and actionability, with attention to written asthma action plans, inhaler technique, exacerbation recognition and home management, and the controller-reliever distinction.</p>