Evaluating Cannabis Information Quality for Thai Breast Cancer Survivors Using QUEST: A Mixed-method study

Background/aims: To evaluate the quality of medical cannabis (MC) content on social media platforms accessed by Thai breast cancer survivors post its legalization in 2019.

Methods: A Mixed-method study was conducted with engagement with a breast cancer survivor support group throughout. They identified MC contents accessed by breast cancer survivors via social media platforms. The contents were categorized based on the i) content creators; ii) platforms used and iii) content category. Four researchers used the Quality Evaluation Scoring Tool (QUEST) to assess the quality of the content, scoring between 0 to 28 and classified them as ‘good’ or ‘bad’ based on expert ratings. The inter-observer reliability was analyzed. Youden index was used as the cut-point and a p value < 0.05 was deemed statistically significant. Fairclough’s Critical Discourse Analysis was subsequently undertaken to explore discourses within the ‘bad’ quality contents.

Results: 64 contents were evaluated, with categorizations revealing 33.9% from news channels, 25.8% governmental sources, 19.4% healthcare providers, and 19.4% alternative medicine providers. The majority were uploaded on YouTube (48.4%). The inter-observer correlation of QUEST scores was significant at 0.86 (p<0.05), with a mean score of 12.1±7.6. Content was deemed ‘good’ with an expert rating over 3 and a QUEST score threshold of 15, achieving 81.2% sensitivity and 97.5% specificity. The content creator was the sole significant factor distinguishing between ‘good’ and ‘bad’ quality. Two discourses were identified: i) Normalization of cannabis and ii) The romanticization of cannabis as a panacea. Both affirm the use of MC without discussing its contraindications and adverse effects.

Conclusions: A notable variance of MC information accessed amongst Thai breast cancer survivors is concerning. Findings urge regulatory interventions by the Thai government to implement stringent regulations and controls over cannabis content creators to safeguard information quality and public health.