If I understand your point correctly, I think we agree. I thought Eysenbach’s article rightly asserted that there is value in both. My greatest complaint about Deshpande and Jadad is that they imply apomediation can (and should) replace expertise.

They’re saying some hugely stupid things. If they’re motivated by what you call an undisclosed conflict of interest, they’re schmucks as well.

All that said, I’m not sure I agree a blog post with comments demonstrates or tests apomediation. However, Rachel submitting it to StumbleUpon might.

Hi Michele!

I think our traditional evaluation methods could probably stand a lot of improvement- but I don’t think that the wisdom of the crowd comes close to approaching the value of peer review when it comes to evaluating the quality of health information.

Thanks for the comments!

If Drs. Deshpande and Jadad have family members with worrying illnesses, do they consult the best available clinical expert, or go to the wisdom of the crowd?

The irony here is: If you want to learn about ehealth or the role of social networking in health, are you asking an ehealth expert (e.g. Mr Chief Innovator and Founder, Centre for Global eHealth Innovation, Canada Research Chair in eHealth Innovation, Dr Jadad), or are you consulting the wisdom of the crowd? Surely – by publishing this blog post – you decided to put the apomediation model to a test. And apomediation works – by people posting comments on your blog you may learn from a comment at http://healthinformaticist.wordpress.com/2009/01/20/why-bother-apprasing-medical-info-on-the-web/ that these authors Deshpande and Jadad have in fact a huge undisclosed conflict of interest – they omit to mention the minor fact that they own or are involved in a commercial medical social networking site. They cite their fancy academic titles in the paper but forget a simple conflict of interest statement – at many universities such behavior would be grounds for dismissal or an academic misconduct investigation.

So experts have their pitfalls, conflicts of interests, etc as well. So what is better, apomediation or intermediation? As Eysenbach stated in his original apomediation theory, there is a place for both, and people switch back and forth, depending on their situation, prior knowledge etc. It is never EITHER experts OR peers/wisdom of crowds etc.