Quality, reliability and engagement of aortic dissection-related health information on TikTok: a cross-sectional study from China.

Background: TikTok (or named as Douyin in mainland China) has emerged as a major source of health information. Aortic dissection (AD) is a rapidly fatal emergency in which delayed recognition or misinformation can have catastrophic consequences, yet the quality of short-video content on this condition remains unclear. This study aimed to systematically assess the quality and reliability of AD-related videos on TikTok and to examine their association with user engagement and video features. Methods: A systematic search was conducted on TikTok using the keyword "aortic dissection" to identify videos published before March 1, 2026. Videos were included if they addressed AD and excluded if they were duplicates, irrelevant to the topic, or involved medical insurance content; 151 videos were ultimately analyzed. Video features (uploader type: healthcare professionals, general users, or news media; duration; and engagement metrics) and quality/reliability were evaluated using the Global Quality Scale (GQS, 1-5) and modified DISCERN (mDISCERN, 0-5) by two independent specialists. Continuous variables are presented as median [interquartile range (IQR)], and analyses used the Mann-Whitney U test, Spearman correlation, and multivariable linear regression. Results: Across the 151 videos, overall quality was moderate [median GQS: 3 (IQR, 2-4) and median mDISCERN: 2 (IQR, 1-2)]. Most videos (92.72%) were uploaded by health professionals (mainly physicians). Videos posted by health professionals had significantly higher GQS and mDISCERN scores than those posted by non-health professionals (GQS: P<0.001; mDISCERN: P=0.003). In the adjusted models, video length was positively associated with GQS (β=0.002, P=0.003) and mDISCERN scores (β=0.001, P=0.049), whereas higher numbers of likes and comments were associated with lower GQS (likes: β=-0.002, P=0.005; comments: β=-0.041, P=0.004) and mDISCERN scores (likes: β=-0.001, P=0.02; comments: β=-0.024, P=0.007), demonstrating a distinct "popularity paradox". Conclusions: Although Chinese-language TikTok videos on AD are predominantly created by health professionals, overall quality remains suboptimal. Longer videos tend to be higher quality, whereas high-engagement content exhibits lower reliability. Measures such as adopting structured storytelling formats and platform-certified labels could help transform TikTok into a reliable tool for public education on critical illnesses.