davidrothman.net

Update: Be sure to check out the List of Medical Wikis.

Welcome, Medical College of Wisconsin Librarians!
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When it comes to clinical information, I’m very wary of Wikis. Not necessarily opposed to them, but extremely hesitant. I find myself nodding when reading the Rapid Response to Dean Giustini’s How Web 2.0 is changing medicine from Sean N. Neill:

…a medical wikipedia may be the next step, but only if it is introduced very cautiously. The current medical wikis are not as the author suggests, “continually updated,” as there is no dedicated ongoing peer review process to appraise new contributions and updates. This could lead to serious safety issues.

(snip)

…There is no such thing as a free lunch and “a low cost alternative to commercial point of care tools like UpToDate,” may not have the same access to the current evidence base to support the recommended practice. If medical wikis are to be used they should be tightly regulated in accordance with the principals of evidence based medicine, with constant peer review, so as to maintain medical accuracy and patient’s wellbeing at all times.

I think Neill is right, and perhaps Dean Giustini does, too. After all, Giustini himself suggested the ‘Medizendium’ as a solution to concerns about authority.

But via the same set of Rapid Responses, I just came across Wikisurgery

There appears to be an article about it here:
Introducing Wikisurgery.com: The blueprint for a surgical architecture of participation.
International Journal of Surgery, Volume 4, Issue 3, Pages 140-143
R. Agha

Unfortunately, my library doesn’t have access to this journal, so I haven’t read it. Perhaps you’d like to send me a copy? Thanks!

This started me again thinking about wikis as a tool for collaborative creation of clinical information.

I don’t use Wikipedia as a resource for clinical information for professionals or consumer healthcare information, and recommend against it to anyone who asks. There are a number of excellent, free, authoritative resources online for health information, after all. Why use one with no authority, especially when the stakes (the health and well-being of human beings!) are so high?

I can’t see how Wikisurgery can be any more authoritative than Wikipedia. There seem to be absolutely no restrictions to who can contribute. To test this, I registered and created a nonsense article called “Flibbertygibbits,” saved it, checked to see that my nonsense was displayed.

When I went back in to remove the changes I had made (I have no wish to vandalize anyone else’s work) I discovered that I could not delete the page. I offer my sincere apologies to the administrators of WikiSurgery. I will understand if they delete my registration.

For that matter, I recommend they delete my registration.

If a Wiki-like format is to be used in the development of a tool for medical professionals, I can’t shake the feeling that a Citizendium model (Dean Giustini’s Medizendium idea) is greatly preferable to a Wikipedia model.

WikiMD allows anyone who registers to edit, and registration requires only a valid email address.

I have concerns about ganfyd too, but its registration process attempts to obtain proof that the person registering is a clinician in good standing. I’m not at all satisfied that their registration process weeds out those who shouldn’t be advising others, but at least they try.

PubDrug is getting up to speed and shows promise, but I’m able to add nonsense to it, too. Hopefully, registration is going to have strict requirements before a lot of information is added.

Open wikis that anyone can edit are great, but they’re not great for everything. These wikis would all do well to reconsider their registration policies. No competant medical librarian or clinical professional will rely on them until this happens.

(Afterthought: what are the other medical wikis that I didn’t mention here? I feel like I must be missing some.)

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December 28th, 2006 | Category: For Medical Libraryfolk, Technology, Wikis | Subscribe to comments | Both comments and pings are currently closed