Evaluating the reliability and quality of osteoporosis content on TikTok and BiliBili: A cross-sectional content analysis

Objective This study evaluated the information quality and user engagement of osteoporosis-related videos on Bilibili and TikTok, and examined their associations with uploader characteristics, content topics, and video quality factors. Methods On October 11, 2025, we conducted a systematic evaluation of the information quality and reliability of the top 100 Chinese-language short videos related to osteoporosis on TikTok and BiliBili platforms, ultimately including 171 valid videos for analysis. Using the Global Quality Scale (GQS) and a modified DISCERN instrument, we assessed multiple dimensions of video content. Furthermore, Spearman correlation analysis and the Kruskal-Wallis test were employed to examine how platform type, uploader category, and content characteristics influence video quality. Results A total of 171 videos were included in the analysis, comprising 82 from Bilibili and 89 from Tiktok. Bilibili videos exhibited significantly longer durations compared to Tiktok videos (median 307.5 seconds vs. 151.0 seconds; P < 0.001). Conversely, Tiktok videos demonstrated significantly higher user engagement metrics, including median number of likes (3407.0 vs. 65.0; P < 0.001), collections (1432.0 vs. 78.0; P < 0.001), and shares (677.0 vs. 48.5; P < 0.001). Regarding uploader characteristics, professional institutions contributed only 4.1% of the total sample. Nevertheless, videos uploaded by professional institutions achieved the highest median GQS score (4.50) and mDISCERN score (4.00), significantly surpassing those uploaded by professional individuals and non-professional individuals (P = 0.011 and P < 0.001, respectively). User engagement metrics strongly intercorrelated ( r = 0.87 –0.94, all P < 0.001 ) but correlated only weakly with quality scores ( ∣ r ∣ < 0.27 ). Conclusions Bilibili videos feature longer durations and more detailed content, whereas TikTok videos demonstrate superior user engagement. Videos uploaded by professional institutions attained higher quality ratings compared to other uploader types, although this finding is based on a small subsample (n=7) and should be interpreted with caution. Medication-related content attracted the greatest public attention. Nevertheless, the weak correlation between user engagement and quality scores indicates that high popularity does not equate to high informational reliability. These findings underscore the need to strengthen professional credentialing mechanisms and optimize algorithmic recommendations to enhance both the scientific accuracy and communicative reach of osteoporosis health information on short video platforms.