WikiProject MedicineBMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d3387 (Published 08 June 2011) Cite this as: BMJ 2011;342:d3387
- Lyndal Trevena, associate professor
In January 2011, members of WikiProject Medicine published an article about the intricacies, strengths, and weaknesses of Wikipedia as a source of health information and compared it with other medical wikis.1 The article poses some interesting challenges and opportunities for the global community as Wikipedia’s seven year old WikiProject Medicine reaches an estimated 150 million viewers every month.
The claimed usage of Wikiproject Medicine is just under half of the 362 million monthly viewers of its parent Wikipedia, which is now the sixth most popular site on the internet.2 This seems set to rise if search engines such as Google continue to show this site at the top of search results and with an upcoming iPhone application that will make it even more convenient and accessible.
The WikiProject Medicine group within Wikipedia has developed systems that make this project superior to many other health wikis and provide the potential for future improvements. These systems include grading of article quality and importance, a set of referencing guidelines for authors, and links to PubMed Plus and PubMed from article pages. Impressively, of the more than 25 000 medical articles published, all but 304 have been assessed, according to the WikiProject article quality grading system,3 by one of the 206 group members. A grade is “subjectively” assigned by a project member after an author’s request. Unfortunately, only around 70 articles have been graded as suitable for a “feature article or listing,” which means the article is well written, comprehensive, well researched, neutral, stable (not subject to edit wars), and follows particular style guidelines. Most articles are graded as either incomplete or a “stub,” providing “little meaningful content.” With the exception of a small star given to “feature articles” the grade is publicised only to readers who register for that specific feature.
Improving this quality grading process could be a key step towards improving the overall quality of the information. Ideally all articles would achieve a featured article grade, but authors and readers are not provided with any feedback from the WikiProject Medicine reviewer that could help them to revise and improve their article and aspire to this level.
As with any open source document there is a risk that information will be tampered with and that harmful information may be posted. The group has introduced anti-vandalism features, such as page protection and blocking, and has attempted to flag “unreliable” and “unstable” pages. However, this kind of monitoring requires commitment by trusted administrators and editors. This is a key factor in whether the project truly has the potential to become a sustainable and effective resource.
Given that Wikipedia is run by a charitable organisation, Wikimedia Foundation, authors and reviewers need to continue to provide and revise content without compensation or recognition. It is laudable that Wikipedia creates a virtual community of authors that includes professionals and laypeople, and that articles written by laypeople have been shown to be trustworthy.4 However, the group will have to tackle the tension between promoting a free speaking virtual community of authors that publishes exclusively under pseudonyms and the need to declare conflicts of interest and allow greater transparency for readers. It is currently difficult to detect commercial and other conflicts of interest, although such conflicts are likely in articles where particular treatments are over-represented compared with current clinical practice guidelines. Some would argue that authors (and reviewers) should be named for ethical reasons in peer reviewed journals and other publications, although it is uncertain what effect this would have on the quality of content and reviews in Wikipedia.5
The quick, easy, and free access to Wikipedia makes it attractive to many people, particularly those in developing countries, where internet access remains slow and costly. It is also promising that non-English articles are appearing, although they are rare compared with English ones; 129 articles are published on hypertension in English but only six in Bahasa Indonesian. Chinese contributions are non-existent, which is a pity given the burden of disease from hypertension in that nation. If WikiProject Medicine truly is to become a resource for informing healthcare in non-English speaking countries there are real challenges in harnessing experts in these nations to write, review, and update content. Also, it could provide an excellent opportunity for authors to publish in their own language, reflecting health practices in their own health systems and cultures. The same quality checks and balances outlined above will still need to apply.
WikiProject Medicine promotes itself as an information source for healthcare providers and students. One qualitative study reported that 70% of junior doctors used Wikipedia for health information at least once a week.6 With time constraints continuing to be a major barrier for clinicians trying to access evidence based information, the simplicity and speed of the Wikipedia format is appealing. Clinicians have continually stated that they want simple summaries of evidence rather than lengthy detailed technical items that require access to complex and sometimes expensive databases.7 If we really want to see the dissemination of evidence based information and facilitate putting evidence into practice, perhaps we need to start writing articles for Wikipedia.8
Cite this as: BMJ 2011;342:d3387
Competing interests: The author has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Provenance and peer review: Commissioned; not externally peer reviewed.