A Fundamental Screening Test In Vascular Surgery: How Is Youtube Represents Ankle Brachial Index Calculations
Michael F. Amendola, MD, Emnet Yibeltal.
VA Medical Center/VCU Health System, Richmond, VA, USA.
BACKGROUND:Novice learners are increasingly utilizing YouTube as an educational resource for common procedures such as ankle brachial index (ABI) measurements. We set forth to examine how the ABI exam is portrayed on YouTube.METHODS: YouTube was accessed in July 2016 with a cleared-cache web browserfor the keyword search categories: “ankle brachial index.” Only relevant videos were examined and had to have at least one of the following components 1. ABI and disease correlation, 2. use of a Doppler, and/or 3. demonstrated the procedure as a whole. These videos divided based on source: Surgeon/Physician Based versus Educational/Commercial Based. Characteristics examined included: if manual cuff was utilized, if a Doppler was utilized, if ABI calculation was correctly rendered, if a normal ABI range was listed, calcified vessels lead to false positive ABI values was mentioned, if the study was shown was in the supine position and if normal ABI values ranges provided. Time since posting, total views and video duration were examined. Fisher’s Exact Test* and t-test** were utilized.RESULTS: A total of 2,490 videos were found for the keyword search, of which 2.8% of videos (n=70) were relevant and examined furtherin two source groups. There was no significant difference in the two groups in terms of if manual cuff was utilized, if diabetic vessel false positive values in ABI were mentioned nor if the study was show in the supine position. Additionally, there was no differences in terms of total views, duration nor age of the videos between the two groups. CONCLUSIONS: Less than 3% of ABI videos found on YouTube had appropriate relevant content. Surgeon and physician-based ABI videos seem to display best practices. Interestingly, of all the videos examined, only one had a definite source of being from a surgeon. Vascular surgeons should improve their visibility in online learning resources especially in terms of demonstrating this most basic vascular surgery screening test. 
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