Algorithmic Amplification of Surgical Misinformation: How Social Media Prioritizes Engagement Over Accuracy and Distorts Patient Choices

The proliferation of surgical misinformation on social media platforms has raised significant concerns about its impact on patient decision-making and emotional well-being. This cross-sectional study analyzed ۸۷۴ publicly available posts (۴۳۲ Instagram, ۴۴۲ YouTube) across four elective surgeries (rhinoplasty, breast augmentation, spinal fusion, sleeve gastrectomy) to assess misinformation prevalence, engagement patterns, and downstream effects on user sentiment. Using the DISCERN instrument and expert validation (κ = ۰.۸۲), we classified ۳۳.۹% of posts as containing outright false/misleading claims, with Instagram hosting significantly more misinformation than YouTube (۴۱.۲% vs. ۲۶.۷%, p < ۰.۰۰۱). Algorithmic amplification of low-quality content was evident: false/misleading posts garnered nearly double the normalized engagement (۹.۰‰ vs. ۴.۸‰ for accurate posts, p < ۰.۰۰۱) and correlated with poorer DISCERN scores (ρ = −۰.۲۹). Sentiment analysis of ۲۱۴,۵۸۷ user comments revealed that misinformation-laden posts provoked more negative emotions (۳۲% vs. ۲۱% negative comments, p < ۰.۰۰۱) and doubled the odds of avoidance language (AOR = ۲.۰۳, ۹۵% CI: ۱.۵۵–۲.۶۶). Surgeon-authored content scored higher in reliability (DISCERN: ۵۰ ± ۹) but achieved lower engagement than layperson-generated material. These findings underscore the engagement–accuracy paradox in surgical social media ecosystems, where emotionally charged misinformation disproportionately influences patient perceptions. Clinicians and policymakers must prioritize strategies to amplify evidence-based content while mitigating algorithmic biases that favor sensationalism.

کلیدواژه ها:

Social Media ، Health Misinformation ، Elective Surgical Procedures ، Patient Decision-Making ، algorithms