Otorhinolaryngology-Themed Autonomous Sensory Meridian Response (ASMR) Videos on YouTube: Clinical Representation and Viewer Engagement.

Abstract

Autonomous sensory meridian response (ASMR) videos simulating medical encounters have gained popularity on social media. This study aimed to assess the thematic focus and clinical representation of otorhinolaryngology-themed ASMR videos using a novel expert-based scoring system and to examine their relationship with viewer engagement. Fifty-six YouTube ASMR videos were analyzed and categorized by subspecialty, procedures, and engagement metrics. A clinical representation score (CRS) was developed to assess the degree of clinical representation, and inter-rater reliability for the total score was evaluated using an intraclass correlation coefficient (ICC). Viewer interaction was measured using video view rate (VVR) and daily engagement rate (DER). Pearson correlation and ANOVA were used (p < 0.05). Otologic content predominated (96.4%), with otoscopy (89.3%) and earwax removal (53.6%) most common. Rhinologic (33.9%) and head and neck (41.1%) content were underrepresented. Endoscopic or surgical procedures appeared only once each (1.8%). No video addressed facial plastic surgery. Most videos showed moderate (58.7%) or low (28.3%) clinical representation; only one (2.2%) achieved high CRS. A significant inverse correlation was found between CRS and both VVR (r = -0.38, p < 0.01) and DER (r = -0.56, p < 0.001). This first cross-sectional content analysis of otorhinolaryngology-themed ASMR videos reveals a dominance of otologic content with limited clinical accuracy or scope. The inverse association between CRS and viewer engagement suggests that the most popular videos may offer the least clinical realism. Although not educational in intent, their widespread reach raises important concerns about shaping public expectations of otolaryngologic care. N/A.