YouTube Searching and Self-Treatment Behaviors Among Patients With Benign Paroxysmal Positional Vertigo Before and After Clinic Visits: Prospective Observational Study

Abstract

Background: YouTube has become a popular platform for patients seeking health-related information, including guidance on managing benign paroxysmal positional vertigo (BPPV). As self-diagnosis and self-treatment through online content grow more common, concerns have arisen regarding their influence on patients' health care decisions and treatment outcomes. However, little is known about how YouTube use and self-treatment behaviors change before and after clinical consultation, or whether these behaviors affect standard care for BPPV.

Objective: This study aimed to investigate changes in patients' YouTube searching and self-treatment behaviors before and after clinic visits for BPPV and to assess whether self-treatment influences standard in-clinic management.

Methods: A prospective study was conducted with patients diagnosed with BPPV who visited an otorhinolaryngology clinic in Korea from August 2024 to July 2025. On the final day of treatment, participants completed a survey, and chart reviews were performed to collect data on age, sex, canal involvement, chronic disease status, number of canalith repositioning maneuver (CRM) sessions, and pre- and postclinic YouTube searching and self-treatment. Differences in pre- and postclinic behaviors by gender were analyzed using Generalized Estimating Equations for repeated measures. The effect of self-treatment on the number of CRM sessions was assessed using negative binomial regression after confirming overdispersion.

Results: Among 147 patients (71% women), preclinic YouTube searching was reported by 28 (25%) patients, while postclinic searching decreased to 21 (14%) patients. Gender-stratified Generalized Estimating Equations analysis showed women had significantly higher odds of preclinic YouTube searching compared to postclinic (odds ratio [OR] 2.389, 95% CI 1.195-4.778, P=.01). Additionally, women with chronic disease had significantly lower odds of self-treatment (OR 0.13, 95% CI 0.016-0.976, P=.047). Negative binomial regression showed no significant association between self-treatment status and the number of CRM sessions.

This study demonstrates that YouTube searching and self-treatment behaviors for BPPV change following clinical consultation. These findings highlight the importance of patient education during clinical encounters in addressing previsit online information use and mitigating inappropriate self-treatment practices.

Keywords: self-treatment; YouTube; behavior; benign paroxysmal positional vertigo; health information.