Health information on Wikipedia

From Wikipedia, the free encyclopedia

The online encyclopedia Wikipedia has, since the late 2000s, served as a popular source for health information for both laypersons and, in many cases, health care practitioners. Health-related articles on Wikipedia are popularly accessed as results from search engines, which frequently deliver links to Wikipedia articles.[1] Independent assessments have been made of the number and demographics of people who seek health information on Wikipedia, the scope of health information on Wikipedia, and the quality of the information on Wikipedia.[2]

The English-language Wikipedia was estimated in 2014 to hold around 25,000 articles on health-related topics.[3] Across Wikipedia encyclopedias in all languages there were 155,000 health articles using 950,000 citations to sources and which collectively received 4.8 billion pageviews in 2013.[4] This amount of traffic makes Wikipedia one of the most consulted health resources in the world, or perhaps the most consulted resource.[4]

Accuracy and usefulness of content

Academic studies

A 2007 study examined a sample of Wikipedia pages about the most frequently performed surgical procedures in the United States, and found that 85.7% of them were appropriate for patients and that these articles had "a remarkably high level of internal validity".[5] However, the same study also raised concerns about Wikipedia's completeness, noting that only 62.9% of the articles examined were free of "critical omissions".[5]

A 2008 study reported that drug information on Wikipedia "has a more narrow scope, is less complete, and has more errors of omission" than did such information on the traditionally edited online database Medscape Drug Reference.[6]

A 2011 assessment of 50 medical articles on Wikipedia found that 56% of the references cited on these pages could be considered reputable, and that each entry contained 29 reputable sources on average.[7]

A 2011 study examined Wikipedia pages about five statins, and concluded that these pages did not contain incorrect or misleading information, but that they were often missing information about drug interactions and contraindications to use.[8]

Another 2011 study examining Wikipedia articles on the 20 most widely prescribed drugs found that seven of these articles did not have any references, and concluded that "Wikipedia does not provide consistently accurate, complete, and referenced medication information."[9]

An assessment of Wikipedia articles in 2012 on dietary supplements found that Wikipedia articles were "frequently incomplete, of variable quality, and sometimes inconsistent with reputable sources of information on these products."[10]

A 2013 review of nephrology content on Wikipedia found it to be "a comprehensive and fairly reliable medical resource for nephrology patients that is written at a college reading level".[11]

A 2013 scoping review published in the Journal of Medical Internet Research summarized the existing evidence about the use of wikis, Wikipedia and other collaborative writing applications in health care and found that the available research publications were observational reports rather than the primary research studies which would be necessary to begin drawing conclusions.[12]

A 2014 study that examined 97 Wikipedia articles about complementary and alternative medicine (CAM) found that 4% of them had attained "Good article" status, and that CAM articles on Wikipedia tended to be significantly shorter than those about conventional therapies.[13]

In May 2014 the The Journal of the American Osteopathic Association published an article which concluded that "Most Wikipedia articles for the 10 costliest conditions in the United States contain errors compared with standard peer-reviewed sources."[14][15] Following this paper, many other media sources reported that readers should not trust Wikipedia for medical information.[16][17][18][19] Wikipedia's contributors to its health content defended Wikipedia and criticized this study,[20] as the research is considered severely flawed including basic methodological flaws like the conclusions are not supported by the data provided.[21]

A 2014 study found that when the FDA issues new safety warnings about drugs, in 41% of cases reviewed Wikipedia articles about those drugs were updated to give the new safety information within two weeks.[22] Another 23% of Wikipedia drug articles were updated to give this information within an average of about 40 days, but 36% of articles are not updated with this information within a year.[22]

A 2014 comparison between selected drug information from pharmacology textbooks and comparable information on the English-language and German-language Wikipedias found that the drug information in Wikipedia covers most of what is essential for undergraduate pharmacology studies and that it is accurate.[23]

The readability of Wikipedia's articles for epilepsy and Parkinson's disease was critiqued and found to be difficult to read.[24][25] Another study found that Wikipedia's information about neurological diseases was significantly more difficult to read than the information in the American Academy of Neurology's patient brochures, the Mayo Clinic's website, or MedlinePlus.[26] Another 2015 study, this one authored by Samy Azer, reported that Wikipedia should not be used to learn about concepts related to pulmonology students.[27] Another 2015 study by Azer found that Wikipedia entries about cardiovascular diseases were "not aimed at a medical audience" and were mainly inaccurate due to errors of omission.[28]

A 2016 study found that Wikipedia information about common internal medicine diagnoses was written at a higher grade level than any of the four other sites studied (NIH, WebMD, Mayo Clinic, and "diagnosis-specific websites").[29] In contrast, another study published the same year found that medical students reading about three unstudied diseases on AccessMedicine and Wikipedia experienced less mental effort than did readers of the same diseases on UpToDate.[30]

A 2016 study found that drug information on Wikipedia was less accurate and complete than that on the medical reference site Micromedex.[31]

A 2017 study compared the accuracy of Wikipedia articles about the 33 most popular medications with medication guides to the accuracy of their medication guides. The study found that the Wikipedia articles were generally less accurate than were the corresponding medication guides.[32]

Other views

Wikipedia co-founder Jimmy Wales has said that lack of health information increases preventable deaths in emerging markets and that health information from Wikipedia can improve community health.[33] Wales presented the Wikipedia Zero project as a channel for delivering health information into places where people have difficulty accessing online information.[33]

As a result of public interest in the 2014 Ebola virus epidemic in West Africa, Wikipedia became a popular source of information on Ebola.[34] Doctors who were Wikipedia contributors said that Wikipedia's quality made it useful.[34]

Alternative medicine

People who promote alternative medicine have complained that Wikipedia negatively portrays holistic health treatments including energy medicine, Emotional Freedom Techniques, Thought Field Therapy and Tapas Acupressure Technique.[35] In response, Wales has stated, "If you can get your work published in respectable scientific journals – that is to say, if you can produce evidence through replicable scientific experiments, then Wikipedia will cover it appropriately."[35][36][37] Similar concerns have been raised regarding its coverage of homeopathy.[38]

Wikipedia policy for articles that "could reasonably be perceived as relating to human health" comes under the policy for medicine-related articles which is science-based.

Extent of usage

The majority of people in the United States use the internet as a source of health information.[39] One 2013 study suggested that 22% of healthcare searches online direct users to Wikipedia.[40]

Wikipedia was described in 2014 as "the leading single source of healthcare information for patients and healthcare professionals".[41] A study of a particular group of veterinary students found that the majority of these students sought and found medical information on Wikipedia.[42] Some doctors have described their use of Wikipedia as a "guilty secret".[43]

Wikipedia's health information has been described as "transforming how our next doctors learn medicine".[44] Various commentators in health education have said that Wikipedia is popular among medical students.[45][46]

Academic citations

Wikipedia has been inappropriately cited as an authoritative source in many health science journals.[47][48]

Impact on psychological tests

In 2009 a doctor and Wikipedia editor, James Heilman, incorporated public domain images of the Rorschach test into Wikipedia.[49] Psychologists complained that the increased public exposure to these tests devalued their clinical utility, and that public health was harmed as a result.[49]

Nature of contributors

A 2014 interview study found that around half of the editors of health-related content on the English-language Wikipedia are health care professionals, while the other half includes some medical students.[3] An author of this study wrote that this provides "reassurance about the reliability of the website".[3] The study also found that the "core editor community", who actively monitor and edit most health-related articles on the English-language Wikipedia, numbered around 300 people.[50] The study found that people who contribute on these topics do so for a variety of reasons, including a desire to better learn the subjects themselves, and a sense of both responsibility and enjoyment in improving others' access to health information.[50]

Usage of traffic statistics in health monitoring

Just as Google Flu Trends was able to correlate searches for flu to local outbreaks of flu, page views of Wikipedia articles on flu-related topics have been found to increase in populations experiencing the spread of flu,[51][52] and of other diseases such as dengue fever and tuberculosis.[53][54]

Projects to improve health information on Wikipedia

In 2009 the National Institutes of Health attempted a pilot project for integrating health information into Wikipedia.[55] In 2011, it was reported that Cancer Research UK had started a program whereby some of its staff would edit Wikipedia's cancer-related articles.[56]

The University of California, San Francisco has a program for encouraging students to contribute health content to Wikipedia.[57]

In response to studies showing that the majority of patients and providers use the Internet to find health information,[58][59] the Maternal and Child Health (MCH) Library developed a New Media Primer to increase the skills of health care providers in using social media to share information on public health.[60] A 2012 article from Children’s Hospital of Eastern Ontario described the development of a disease-specific primer for providers and patients guiding both to the highest quality and most reliable new media sites.[61]

See also

References

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  2. ^ Heilman, James M; Kemmann, Eckhard; Bonert, Michael; Chatterjee, Anwesh; Ragar, Brent; Beards, Graham M; Iberri, David J; Harvey, Matthew; Thomas, Brendan (2011-01-31). "Wikipedia: A Key Tool for Global Public Health Promotion". Journal of Medical Internet Research. 13 (1): e14. doi:10.2196/jmir.1589. PMC 3221335Freely accessible. PMID 21282098. 
  3. ^ a b c Faric, Nusa (December 5, 2014). "Around half of Wikipedia's medical editors are experts". Wikimedia Blog. 
  4. ^ a b Heilman, James M; West, Andrew G (2015). "Wikipedia and Medicine: Quantifying Readership, Editors, and the Significance of Natural Language". Journal of Medical Internet Research. 17 (3): e62. doi:10.2196/jmir.4069. ISSN 1438-8871. PMC 4376174Freely accessible. PMID 25739399. 
  5. ^ a b Devgan, Lara; Powe, Neil; Blakey, Brittony; Makary, Martin (September 2007). "Wiki-Surgery? Internal validity of Wikipedia as a medical and surgical reference". Journal of the American College of Surgeons. 205 (3): S76–S77. doi:10.1016/j.jamcollsurg.2007.06.190. 
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