Beyond Overall Quality: Clinical Completeness of Foreign Body Airway Obstruction Videos on Douyin and Bilibili: A Cross-Platform Content Analysis

<title>Abstract</title> <p>Foreign body airway obstruction (FBAO) is a time-critical emergency in which bystanders may need to make rapid, conditional first-aid decisions. Short videos can broaden access to first-aid education, but their clinical completeness and safety require evaluation beyond visual appeal or engagement. We conducted a cross-sectional content analysis of 360 records retrieved from Douyin and Bilibili; 114 Douyin and 87 Bilibili FBAO-related videos were included. Quality was assessed with the Global Quality Score (GQS), modified DISCERN, Journal of the American Medical Association (JAMA) benchmark criteria, Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), Video Information and Quality Index (VIQI), and standardized action accuracy across 12 shared action items. Between-platform comparisons used 2-sided Mann-Whitney U tests; Spearman rank correlations explored associations of video characteristics with quality outcomes, and missing values were not imputed. Among 201 included videos, the median GQS was 4 on both platforms (P=.980). Douyin had higher modified DISCERN scores (median 3, IQR 3–4 vs 3, IQR 2–3; P&lt;.001) and JAMA scores (median 3, IQR 3–3 vs 2, IQR 2–3; P&lt;.001) than Bilibili. Bilibili had higher PEMAT understandability (median 76.92%, IQR 53.85%-88.46% vs 69.23%, IQR 46.15%-76.92%; P=.042) and standardized action accuracy (median 58.33%, IQR 41.67%-83.33% vs 41.67%, IQR 33.33%-58.33%; P&lt;.001). On Douyin, only 13.3% of videos advised allowing effective coughing and 16.8% advised activating emergency services, compared with 83.7% and 45.3%, respectively, on Bilibili. FBAO videos on both platforms showed different strengths but shared clinically important safety-information gaps. Production and review should explicitly verify recognition of severe obstruction, advice to allow effective coughing, emergency-service activation, age-specific maneuvers, and escalation after unresponsiveness.</p>