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davidrothman.net

Exploring Medical Librarianship and Web Geekery

 
 
 
 

Archive for Wikis

Annals of Pharmacotherapy on Wikipedia

I know I’m way behind on such things, but this article from the Annals of Pharmacotherapy deserves a mention, even one this belated:

Scope, completeness, and accuracy of drug information in Wikipedia.
Ann Pharmacother. 2008 Dec;42(12):1814-21. Epub 2008 Nov 18.
[PubMed] | [html] | [PDF]

The article compares drug information in Wikipedia to drug information in the Medscape drug reference.

“This study suggests that Wikipedia may be a useful point of engagement for consumers looking for drug information, but that it should be supplementary to, rather than the sole source of, drug information. This is due, in part, to our findings that Wikipedia has a more narrow scope, is less complete, and has more errors of omission versus the comparator database.”

And I loved this:

“…health professionals should not use user-edited sites as authoritative sources in their clinical practice, nor should they recommend them to patients without knowing the limitations and providing sufficient additional information and counsel. If these sites are recommended, it should be in the form of a permanent link pointing to the specific recommended version of an entry. Finally, the issues raised in Web 2.0 are not novel, nor are the approaches; consumer education, watchful editors, alert health professionals, and ethical online behavior remain, as ever, the foundation for the safety of Internet health information.”

Additions to the list of Medical Wikis

Added to the list:

  • Clinical Research Informatics Wiki

    Self-description: “…devoted to topics in clinical research informatics…exists to facilitate collaborative development of articles covering the breadth of the CRI domain.”
    Intended Audience/Users: Not listed.
    Contributors: Anyone who registers
    Editors/Administrators: Listed only by User ID.
    Editorial Policies: None listed.

  • MIGHEALTHNET
    Self-description: “This project aims to give professionals, policy makers including health authorities, researchers, educators and representatives of migrant and minority groups easy access to a dynamically evolving body of knowledge and a virtual network of expertise.”
    Intended Audience/Users: “…professionals, policy makers including health authorities, researchers, educators and representatives of migrant and minority groups.”
    Contributors: Anyone who registers and who is approved by administrators.
    Editors/Administrators: Not listed.
    Editorial Policies: Other than these copyright disclaimer notes, none listed.
    Note: This is the UK Wiki of MIGHEALTHNET. Other Wikis serving a similar purpose for other nations can be found here.

The Book!

Got my hands on my copies of the book today! How exciting!

Yay!

You can buy a copy from:
Springer Publishing

or here:

I’m looking forward to eventually seeing it in WorldCat. :)

Congratulations to Melissa Rethlefsen (who wrote a heck of a lot more than I did)! You should really go email Melissa now and tell her how much she rocks.

UNYOC (CE slides) and NYLA Tomorrow

My apologies to the awfully nice folks who attended the CE course I taught at UNYOC a couple of weeks ago! I’ve taken far too long to get these slides posted:

Also: I’ll be on a panel at NYLA tomorrow (Friday, 11/6/2008) afternoon at 4:00 PM- please say hello if you’re going to be there! As usual at these sorts of things, I’ll know almost nobody. But hey- I might get to meet Polly Farrington!

Pam Dolan on Medpedia in American Medical News

Amidst all the coverage of Medpedia that has generally seemed to be derived from a press release is this more informative article from Pam Dolan at American Medical News.

I’m quoted in the article:

Medical librarian and blogger David Rothman, who regularly writes at DavidRothman.net about medical wikis, expressed concerns about the regular monitoring of Medpedia’s content. “If the academic institutions … wish to avoid embarrassment, I’d recommend that they dedicate some time of their health care experts to regular review of articles,” Rothman wrote.

He estimates about 65 medical wikis exist. He’s not sure what the involvement of prominent medical institutions will mean to the project, noting that comparisons won’t be possible until the site is up and running.

As I usually do when I’m interviewed or quoted, I thought I’d post the entirety of my comments here. Pam got my views partially from this post I wrote about Medpedia and partially from an email. Pam’s questions are bolded:

My question for you is whether or not medpedia will be the largest collaboration of its kind for a medical wiki…

That depends on what you mean by “largest” and what we learn about Medpedia when it comes out of Beta. We haven’t yet seen how many contributors/editors it has or how many articles/words it contains. We won’t know for months after it begins how active a community it has. What other metrics could be used to measure “largeness”? The names of affiliated institutions? Medpedia doesn’t really say exactly what contributions those institutions are making (aside from, apparently, allowing the use of their names and logos).

…and if it will raise the bar for those wanting to develop medical wikis in the future.

I think that remains to be seen. So far, Medpedia looks to the public like a press release and a mock-up. When it is up and running, we can begin to compare it to other efforts. Until then, such comparisons aren’t possible.

More Health Information Wikis

I’ve added a few new sites to the list of medical wikis.

No, I’m not going to add Medpedia to it because Medpedia is still in beta. I’m flabbergasted how much press it is getting while not even visible to the public. They must have hired the right PR firm.

Wikis recently added to the list are noted below (details are in the list itself):

A Question About Knol

Could someone please explain to me why Knol will be any more successful than Squidoo has been?

Notes on Medpedia’s changes

I first wrote about Medpedia in January.

I noted in my post that Medpedia did not seem to specify what would qualify an applicant to become a contributor. Medpedia’s Angela Simmons addressed this in the comments:

Anyone with medical and health knowledge is encouraged to apply to become a Contributor. It is not a requirement that you have medical credentials; however, it is important that you are passionate and knowledgeable about at least one topic related to medicine, health and the body.

My concern here is that clinicians should not use an information resource built by people who are not qualified health professionals. Passion is not, in my view, a sufficient qualification.

I also asked Angela if Medpedia was intended to be a resource for professionals (like UpToDate) or a resource for healthcare consumers (like MedlinePlus). Angela replied:

Initially, Medpedia will be a resource for the general public. Over time, with 1000’s of clinicians and researchers on the site, discussing what should be on the main pages, Medpedia will also become a resource for medical professionals, health educators, and medical schools.

This did not seem promising to me. I don’t believe that a single article on a topic can appropriately serve both healthcare professionals and healthcare consumers- their needs are usually quite different.

Medpedia seems to have addressed some of these concerns since that time. Their index page now only invites “Medical Professionals” to “Apply to be a Member, ” and the FAQ says:

There are multiple ways of contributing. If you are an MD or PhD in the biomedical field, you can apply to become an Editor and make changes directly to Medpedia articles (See more below). If you are anyone else, you can use the “Make a suggestion” link at the top of any page to make a suggestion for that page. An approved Editor will review and potentially add your suggestion.

Also interesting to note that Medpedia will be advertising-supported (neither Ganfyd nor AskDrWiki are ad-supported. AskDrWiki is a non-profit). Again from the FAQ:

To support the costs of operation in the future, non-invasive, text-based advertising will be shown on the Medpedia website through third-party ad networks such as Google’s AdSense or Healthline’s third party ad service. Next to these ads on the page will be a link “Flag inappropriate ads” so that the community can keep the ads on the site clean and useful.

Then there’s the question of how reliable the content will be. The FAQ says:

The seed content available on Medpedia at launch is up to date, accurate, and provided by reputable sources. After launch at the end of 2008, once Editors start making edits and adding new pages to the seed content, it is possible, and even likely that there will be mistakes and language that is unclear. This is the nature of a collaborative wiki.

If the site is meant to be used by healthcare professionals, I’d strongly recommend a routine (Monthy? Quarterly?) review of each article by an admin to make sure the content is accurate and up-to-date. To say “it can’t be kept reliable because it is a wiki” is, in my thinking, a cop-out. After all, Medpedia’s own FAQ says the site is meant to be “…a platform to share the most up-to-date medical knowledge.” If the academic institutions listed on the front page of Medpedia wish to avoid embarrassment, I’d reccommend that they dedicate some time of their healthcare experts to regular review of articles.

Prediction:
(Just a guess, but) I think Medpedia’s content will end up focusing mostly on the information needs of healthcare consumers. In that sense, I think it’ll resemble MayoClinic.com

Criticism aside, here are some things about Medpedia that I DO like:

  • Editors/contributors must be qualified health professionals
  • Editors/contributors cannot be anonymous
  • Content is freely usable under a GNU Free Documentation License

What do you think? Do you anticipate other problems I may have missed? Maybe you think I’m being too critical? Share your thoughts in the comments.

Three Suggestions for the MLA: Inexpensive Web Projects

At the AMA’s Medical Communications Conference, I insisted to a communications professional from a state professional association that professional associations needed to take advantage of social Web technologies and utilize them to the benefit of their members.

When pressed to explain WHY professional associations should do this, I said that those professional associations who don’t adopt these technologies will find that their members (and potential members) will use these technologies (without assistance from their professional associations) to organize without organizations1. Where will the professional associations be left when that happens?

With that in mind, here are some projects I’d love to see the MLA pursue.

1. Stop publishing books on dead trees

As I understand it, books published by the MLA are generally written by uncompensated MLA members, edited by uncompensated MLA members, and selected for publication by a committee of uncompensated MLA members. The selling of these books does not raise much (if any) money for the MLA.

Since this book publishing makes no money and the MLA members are okay with donating their time, why not post the book content online in the members-only section of MLAnet and make access to them a benefit of membership? The cost of providing this content would be reduced for the MLA and the content itself would become available to (and searchable by) all members of the MLA, regardless of their institutions’ book budgets. If any members just HAVE to have an MLA book on paper, MLA can make them available for order via Lulu, shifting the cost of print copies exclusively to the reader.

2. Make an “open source” resource to compete with Doody’s Core Titles

Alan Fricker was the first person who put this idea in my head.

Know who writes reviews for Doody’s without compensation? Largely MLA members.

Know who makes the decision to include access to DCT in their budgets? MLA members.

Why couldn’t the MLA offer a platform that accomplishes the same thing as DCT and invite all of the Doody reviewers to instead review for the MLA? The argument for both librarians and other clinical professionals would be that, if the resource is made available to all MLA members as a benefit of membership, everyone’s libraries can be better-informed and reallocate the money that used to be spent on DCT towards other needs.

Perhaps a (free) Pligg installation in the members-only section of MLAnet would do the trick?

3. Create a hedges and filters wiki

A handful of people I know have spent a good bit of time trying to convince me that librarians sometimes actually prefer to hoard their expertise and would be unwilling to share the hedges and filters they’ve spent time developing and perfecting. I prefer to hope that hoarding is on its way out and that the better model of unrestrained sharing will completely supplant it. With copy-and-paste ease, it’d be a pretty easy kind of wiki for librarians to contribute to- and the usefulness to working librarians (and to those who train new librarians) would be enormous.

Your turn!

These are just three ideas. Are they bad ideas? What else would be a good Web project for the MLA to take on? Let me know in the comments?


1 I haven’t read this book yet, but I love the title and urge you to please send me a copy.

MLA 2008: Plenary Session IV Slides

David Rothman

Amanda Etches-Johnson

Melissa Rethlefsen

Bart Ragon

WikiEcho (cardiography wiki)

Added to the list of medical wikis:

WikiEcho

Self-description: “Wikiecho is a project to create a free, up-to-date and reliable online resource covering the rapidly advancing field of echocardiography.”
Intended Audience/Users: “This website is intended to be used by medical students, residents, physicians, cardiology fellows, cardiologists and cardiac sonographers.”
Contributors: Anyone who registers.
Editors/Administrators: Not listed.
Editorial Policies: Minimal, available here.

WikiDoc

Added to the List of Medical Wikis:

Wiki Doc

Self-description: “WikiDoc is intended to be a shared resource for housestaff (in preparation for morning report), medical students (in preparation for morning rounds) and fellows (in preparation for conferences). Nurses and attending physicians may find it valuable to share and improve upon their fund of general medical knowledge.”
Intended Audience/Users: “housestaff…medical students…fellows…Nurses and attending physicians.”
Contributors: “Editors-in-chief” (who appear to be in charge of single pages or sections) must apply and be approved, but “[y]ou don’t need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button…” Anyone who registers can edit information on this Wiki.
Editors/Administrators: Listed editorial board. Editor-in-Chief is C. Michael Gibson, M.S.,M.D., Harvard Medical School, Boston MA, USA
Editorial Policies: None listed (aside from disclaimer)
Additional notes: Wiki has a lot of pages on prescription drugs filled with content lifted (with attribution) from the NLM…but these pages are not locked- they can be edited by anyone who registers.

Kvetching about Susannah Fox and “Health 2.0″

This is a good example of the kind of “Health 2.0″ stuff that baffles me. The speaker in this video is Susannah Fox of the Pew Internet and American Life Project. She is speaking at the Health 2.0 Conference. You can watch the embedded video or read the text of her remarks (from here) beneath it.

After the market crash, there were quite a few people on the internet sidelines who were eager to say “I told you so” and warn people against the dangers of the internet. My favorite example is the 2001 press release from the American Medical Association suggesting that Americans make a New Year’s resolution to “trust your physician, not a chat room” since the information found online puts “lives at risk.”

So…is Fox actually disagreeing with those who think it wiser to seek advice from physicians than to take seriously medical advice received from anonymous strangers in internet chat rooms? As I see it, acting on medical advice from an unidentified, unqualified strangers on the internet can “put lives at risk.”1

Of course most people ignored that advice and flocked online for health information, just as they ignored the advice of the recording industry and flocked to music downloading sites.

This analogy to the recording industry is a very poor one.

If a consumer illegally downloads an mp3 of a commercially-available pop tune instead of buying it on iTunes, he is essentially getting the same product (the same audio, compressed for fast downloads) in a superior version (no DRM) for a lower cost (free instead of about a buck). If a consumer goes to an unidentified stranger in a chat room, he’s probably not getting a qualified physician (at the very least, he has no assurance that the person he’s taking advice from has the appropriate education and skills to dispense advice), so he’s consuming a significantly inferior product.

When the RIAA advises people not to download songs illegally, they do so because they believe illegal downloads erode the profits of the recording companies. It cannot, however, be argued that pirated music could do harm to consumers. When the AMA advises that doctors are a more trustworthy source than strangers in chat rooms, they very well might be trying to protect the income of primary care physicians- but they’re also right that medical advice from unqualified, unidentified providers can cause harm.

Fox goes on in the extended text version of her remarks:

But let’s give the AMA some credit. Inaccurate and outdated medical information does exist online.

To say that “[i]naccurate and outdated medical information does exist online” is an awful understatement that seems to erroneously imply that online healthcare misinformation is rare.

Medical librarians say people should check the source and date of the health information they find online. But few sites display those quality markers and few e-patients look for them.

First, medical librarians judge the quality of an online resource by a whole lot more than just the source and date.

Second, really reliable sites absolutely do display these markers. If few patients look for quality indicators, the reasonable solution is to help healthcare consumers be more discerning and to help guide them quickly to quality information. One way physicians and other healthcare providers can help their patients do this by directing them to MedlinePlus. Also, if consumers don’t have the information literacy to navigate the health information published online by authoritative institutions like the National Library of Medicine, how the heck are they going to sort through the inevitably massive amount of information put up by other consumers?

I do not believe that online resources collaboratively created by patients will solve the problems and dangers of healthcare misinformation online.

Let us say that a healthcare consumer has heard that ginkgo biloba will help improve his concentration. He visits MamaHerb (a consumer-created wiki for “natural remedies”) and decides there’s no reason why he shouldn’t start taking ginkgo.

MedlinePlus, on the other hand, goes into significant detail about potential risks and reasons why our consumer might want to reconsider or discuss with his physician before taking ginkgo.

Semantics
Some will probably say that I’m defining “Health 2.0″ too narrowly. After all, the term only makes sense if it refers to the application of “Web 2.0″ trends to the needs of healthcare consumers. The Health 2.0 Conference apparently featured Phreesia, an service which I cannot work out a way to describe as “Web 2.0.”. 2


1 I’d also really like to see that AMA 2001 press release- I haven’t been able to find it yet..

2 Phreesia is an application which offers providers’ offices a convenient technology in exchange for the opportunity to market drugs to the patient. As a patient, I’m already annoyed with how badly physicians allow pharma marketing to infiltrate their offices and bombard their patients. So if “Health 2.0″ is just a buzzword for “innovations in healthcare IT” or “the next generation of healthcare,” why bother with the “2.0″ suffix?

Rachel Walden on Replacing LIS Journals with Blogs

In response to this post about Marcus Banks’ assertion that Professional Librarian Journals Should Evolve into Blogs, Rachel Walden (a medical librarian, a blogger and an editor at the JMLA) left the following comments:

…I tend to agree with T. Scott on these matters1, for several reasons. I don’t see any reason why librarianship journals as blogs should be singled out as a specialty (goose, gander, etc.) in this discussion, so I’ll talk about this more generally.

1) I believe there is value in having a final version of a manuscript on the record. Getting things out quickly isn’t the only goal in publishing a paper, or shouldn’t be. A larger goal is to contribute to the body of knowledge on a topic, in a way that can be cited and referred to and built upon in the future. If the idea is that authors would post their work to a blog and solicit comments, presumably that manuscript is in a constant revisional state, forever and ever, unless the authors finally shut down comments (at what point is the amount of critique enough?) and post a “final” version. This is perhaps more important when large flaws are detected, and it is nice to have a record of the final version of the manuscript. When citing it, are you citing the final version, or some version in which the author tweaked something in the post? If you cite it, will changes happen later that render your reference irrelevant? I think this process would make it harder to talk about what a given author said or did, and it also puts a tremendous amount of trust in the authors not to change things in a way that is dishonest or unethical. With an official “final” version, the author is officially on the record, and I think that’s an important concept.

2)”The argument for pre-publication peer review is that it filters out poor research.” Marcus seems to believe that this isn’t an issue for library research, or at least that the stakes aren’t high enough to matter. I would ask whether librarians seeking tenure and professional respect are really willing to hang themselves out there like this, simply assuming that what they’ve done is good enough for public consumption. Like Scott, I believe this simply isn’t true. Librarians are perfectly capable of producing research that, in its initial state, would be ripped to shreds by competent reviewers. I suspect that many would prefer that critique to happen more privately, to give them a chance to rethink their assumptions and presentation before opening themselves up to professional criticism and embarrassment.

3) Peer review takes work. When a committed board of peer reviewers exists with a demonstrated interest in the process and a deadline for providing feedback, and an editor does the work Scott mentions prior to publication, it is a certainty that an author will receive feedback. Blog comments are an unreliable thing. Commenters may never hit on the one true major flaw of a manuscript, may not have the expertise to critique to manuscript, or may simply not have time to digest a full manuscript in its raw form and suggest all of the appropriate revisions. The manuscript and the professional body of knowledge may suffer from this, as its not just the shiny, catchy papers that need feedback and critique.

4) Related to #3, it would be important to determine whether a manuscript was just open to whoever felt like commenting (or not), or if peer reviewers would be assigned drop by and comment. Would they be allowed to do so anonymously? Could an editor comment anonymously? If not, would the editor continue to make the needed comments Scott mentions about organization and content? I know some have advocated for peer review that is not anonymous, but I suspect that harsher, yet needed, criticisms might be held back if they had to be publicly written with a name and IP attached.

I’m not saying it couldn’t be done. These are just a handful of issues I see as barriers that would have to be considered. Ultimately, I think part of the question is whether we’re so determined as authors to put our unfiltered thoughts out there as fast as possible, or whether we’re really interested in being accountable and on the record and contributing to the professional knowledge base in a substantial way, even if it takes a little longer. I want to think about this a little longer.

The first of Rachel’s four points made me think about wikis. Since most articles on most wikis lack “final versions,” they might have the same problem that Rachel describes here. Imagine we have a wiki for an academic discipline where contributors are vetted professionals in their disciplines, where the administrators are transparently listed, where rigorous editorial policies are strictly enforced, and where there is an active community of revision that seeks to constantly improve entries. In this hypothetical, we’ll also imagine that the wiki is, for these reasons, considered an authoritative resource by most academics in the discipline it serves. In this hypothetical, how would such a resource be cited when, as Rachel points out, there may not be a “final” version? As it turns out, this isn’t really very hard because good wiki software includes a revision history for every page2. Wikipedia itself suggests how it can best be cited in a way that clearly indicates what revision the citing author is referring to by including in the citation the date on which the information was retrieved from the Web. Where blogging software would fail to solve this problem is in that most blogging platforms do not have a convenient way of tracking revision history. Developers: Could we please have a WordPress plugin for “versioning” posts?

Getting it out quickly

When it comes to technology topics, I think that getting the information out quickly is especially important because the technology changes so dang quickly.

For a while there, I thought about TechEssence as kind of informal, blog-based journal on technology topics of interest to LIS people. It went without being updated for long periods and in recent months Roy Tennant has been the only person posting to it, but it is a good concept, isn’t it?

I think that library technologists would probably be mostly comfortable throwing their work onto the Web for immediate criticism and would, in fact, rely on their peers to examine their work critically. I mean, have you ever seen technologists discuss technology books? Most geeks I know seem to have a compulsion to get out the red pen and start correcting what they see as flaws.

So…

So if Marcus moves forward with his goal of making a blog-based LIS journal (something I’m still not entirely convinced is a good idea), I’d suggest making technology its focus and developing a revision history plugin for WordPress.

New JEAHIL: Semantic Web Applications in Biology and Medicine

The Journal of the European Association for Health Information and Libraries has a new issue out.

On page 41 of the PDF, check out an article by Ioana Robu (”Semantic Web applications in biology and medicine”) that updates “An introduction to the Semantic Web for health sciences librarians” (J Med Libr Assoc. 2006;94(2):198-205.) with information about semantic Web applications.

While you’re in that PDF, also consider checking out:

  • Benoit Thirion recommends recent literature starting on page 45.
  • Starting on page 47, Oliver Obst’s “Web 2.0″ column makes notes on developments on the Web since the previous issue of the JEAHIL.

Presentation on Health Information in Second Life (SLHealthy Wiki)

Patricia Anderson has posted the slides for her presentation on the SLHealthy Wiki.

Medpedia

Probably should add this to the List of Medical Wikis…but perhaps I’ll hold off until it is out of private beta.

The mission of The Medpedia Project is to build and support a community of volunteers to organize — and make understandable — the world’s best information about medicine, health, and the body and to make it freely available through the website Medpedia.com.

The Medpedia.com website is currently in private beta. If you would like to join The Medpedia Project, apply to be a Contributor.

Contributors seek to compile the very best search results for 10,000’s of health related terms, as well as establish a neutral point of view in all the content on the site. Contributors know that Quality and Comprehensiveness on Medpedia.com is an ongoing work. Older pages tend to be more comprehensive and balanced, while newer pages tend to be shorter, and may temporarily contain misinformation or vandalism. Search results on Medpedia.com are continually edited and improved by Contributors, generally resulting in an upward trend of quality.

Medpedia.com is maintained by Medpedia.com Inc., a part of Ooga Labs, a technology greenhouse in San Francisco, and runs on Mediawiki, an open source software project which runs many wikis including Wikipedia. Like Wikipedia, the content created on Medpedia.com is freely licensable under the GNU Free Documentation License (GFDL).

Medpedia Board of Advisors

* Joseph B. Martin, MD, PhD — Former Dean of the Faculty of Medicine at Harvard University
* Linda Hawes Clever, MD, MACP — Clinical Professor, University of California San Francisco Medical School
* Gilbert S. Omenn, MD, PhD — Professor, University of Michigan Medical School

I’m interested to see the application to become an contributor…

…but I’m puzzled to see no critieria for the acceptance of applications.

As a way of building community, Medpedia is also starting up a blog network:

The Medpedia Blog Network is made up of Medpedia Contributors who are also high-quality bloggers that cover medicine and health. The Blog Network helps Contributors find new readers, and helps Medpedia users find other sites with relevant content.

Interesting to see another take on how to administer a medical wiki and it’ll be fun to see how it evolves.

More on wikis for health librarians

Go and read:

Introducing Web 2.0: wikis for health librarians
Eugene Barsky and Dean Giustini
Journal of the Canadian Health Libraries Association
Volume 28, Number 4, Fall 2007
ISSN 1708-6892

It is good, but I thought a good compliment to an article titled “wikis for health librarians” might be to make note of a number of other wikis for health librarians:

Examples of wikis being used by health librarians:

Embedded slideshow above. If you’re reading this in an aggregator that doesn’t display it, you’ll need to visit the site to see the slideshow.

I suspect there are more. Leave a comment and let me know what sites should be added to this list?

ACP Internist on Medical Wikis

Jessica Berthold has written a very good, short article for ACP Internist about medical wikis for which I was interviewed in November.

The entire text of the interview is below.

What are your thoughts on the latest iteration of AskDrWiki? In the last few months, the site has taken many of your suggestions– for eg, posting an editorial policy, verifying the credentials of contributors. Does it still have flaws that need corrected?

I’m sure it does, but the use of wikis for this purpose is still a very new idea. If critics keep being vocal and if AskDrWiki’s administrators continue to constructively respond to criticism, AskDrWiki may help establish for others the best practices through which a medical wiki can be built and maintained.

What, in your opinion, is an acceptable way for a practicing physician to use AskDrWiki, and what is unacceptable? Does this apply to all medical wikis?

A physician could reasonably use AskDrWiki the same way a high school student would use Encyclopaedia Britannica (or Wikipedia)- as a starting point at which to begin research. An inadvisable use would be to stop one’s research there.

Of course, the most ideal use of AskDrWiki by a physician would be for the physician to register, read critically, and make changes where he/she sees room for improvement. The more health professionals who are keeping an eye on the content to ensure accuracy, the better.

Based on some of the criteria I’ve seen you write about, I am guessing that you would rank AskDrWiki and PubDrug at the top of the list of existing medical wikis, in terms of having reliable, trustworthy information. Is that true? Are there other medical wikis you find equally, or more, reliable?

I think that ganfyd approaches the credibility that AskDrWiki and PubDrug have earned. However, some excellent wikis really have different goals than to be “a medical Wikipedia”. The MacSurgWiki would be a good example of this.

It is easy, when discussing wikis, to mistake Wikipedia as a paradigm instead of one application of the wiki as a tool for collaborative document development.

Some of the traits you’ve named that indicate a reliable medical wiki include a detailed editorial policy, a review process for submitted information, verification of contributors’ credentials, and a clear listing of the names of editors and administrators. Are there other traits?

As a very general rule, active revisions are another good sign in a medical wiki. By looking at the recent changes page of a wiki [examples at Ganfyd and AskDrWiki] one can get an idea of how actively the wiki’s community of contributors is adding or editing content. This can indicate that the information is being kept up-to-date or that there is an active community keeping an eye on the content to ensure accuracy of the information. An unchanging wiki is not a healthy wiki.

Do you think medical Wikis will ever replace textbooks? What needs to change in order for that to happen?

In some ways, some wikis are already replacing textbooks for some purposes. I’m told by colleagues in medical school libraries that medical students frequently make use of wikis and other convenient, free online resources.

However, the larger trend here is not that wikis threaten to supplant books, but that online resources, whether free or subscription-based, threaten to supplant paper-and-ink resources.

I believe there will always be need for authoritative literature and that textbooks will never go away, but wikis and their descendent technologies will probably influence the way that online medical resources are managed and revised.

As medical wikis currently stand, what can they practically offer to a doctor that no other medium can?

Medical wikis currently contain no kinds of information that cannot also be found in other resources, online and on paper. The edge wikis have is not really in content, but in being free and convenient to use.

As a whole, what do you think of the quality of the existing crop of medical wikis?

The quality of medical wikis varies tremendously and virtually nothing can be said about them as a whole. One of the reasons I first started making notes on them individually was to highlight the fact that each wiki must be evaluated on its own merits in the same sense that any book must be examined on its own merits. It is as ridiculous to say “wikis are good” or “wikis are bad” as it would be to say that “books are good” or “books are bad.” Some books are great, others…not so much. Same for wikis.

Cleveland Plain Dealer on Medical Wikis (again)

Brie Zeltner of the Cleveland Plain Dealer contacted me weeks ago because they were planning on doing a follow-up to their previous article about AskDrWiki.

Their follow-up is here.

Here’s what they say about our interview in the article:

Critics of medical wikis have praised AskDrWiki for publishing an editorial policy, making a list of its editors and their credentials available on the site, and responding promptly to constructive criticism about the site’s design.

David Rothman, a medical librarian who has warned against relying on wikis for medical information, said AskDrWiki has made great strides in the past eight months. “It certainly is a safer source of medical information than it was,” he wrote in an e-mail, adding that the site is still meant as a resource for medical professionals.

Here’s the brief interview in its entirety:

In your opinion, has the web site improved since we published our article? In what ways? Is it a safe source of medical information right now?

They’ve written and posted an editorial policy- that’s a great step. It is certainly a safer source of medical information than it was, but it is important to note that it is meant as a resource for medical professionals. Healthcare consumers looking for health information would probably be better served by visiting MedlinePlus, a site maintained by the National Library of Medicine.

Do you still have reservations about medical wikis? About this one in particular? What are its greatest assets?
I absolutely have reservations about any source of healthcare information with inadequate editorial controls. AskDrWiki has greatly improved in this regard.

Do you think a site like this can ever be as reliable as a textbook or a medical library?
It is a huge mistake to compare any single resource to a medical library. A medical textbook is probably about as reliable as its editors and policies, so with editors and policies on par with those of a textbook, there’s no reason why a medical wiki can’t be made a reliable and trustworthy source.

What do you recommend to make the site a safer and more reliable source of information?
I’ve already made all the recommendations I have to offer. If I think of any others, I’ll pester Dr. Civello with them.

Do you keep in contact with AskDrWiki’s editors about the site?
We have traded a few emails. We have a number of common interests and goals.

I also added:

Brie, you may want to note in your article that the guys at AskDrWiki must be on to something because Elsevier, one of the biggest names in medical publishing, has started their own medical wiki. I posted some details here.

This may indicate that established publishers see sites like AskDrWiki as a real threat to their business.

I’d also like add now that it is great to see that AskDrWiki has achieved 501(c)(3) (not-for-profit) status. Congratulations and wishes for continued growth to Dr. Civello, Dr. Jefferson and all others who’re working to expand and improve this project.

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