Wikipedia and Medicine: Keys to Success

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An overview of Wikipedia's Role in Medical Education

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Wikipedia and Medicine: Keys to Success

  1. 1. Wikipedia and Medicine Keys To Success James Heilman MD, CCFP(EM), WPMEDF President, Wikipedia Administrator, User:Jmh649 Jake Orlowitz Wikimedia Foundation Grantee, WPMEDF Board member, Wikipedia Administrator, User:Ocaasi Wiki Project Med Foundation Global medical education and outreach non-profit All text under a CC-BY-SA 3.0 license
  2. 2. Wikipedia’s mission [1] Imagine a world in which every person on the planet shares in the sum of all human knowledge. That is what we’re doing. (for free, in the language of their choice)
  3. 3. Wikipedia’s volunteers [2] 20 million registered users 130,000 active users 1,400 administrators … working for free, with no central control
  4. 4. Wikimedia’s scope [3] 286 languages 15 projects images, data, dictionary, travel guide, species, quotes, books, source material, wiki software...
  5. 5. [4] Wikimedia Foundation San Francisco 150 employees Donor funded Non-profit No-ads!
  6. 6. Is Wikipedia Read by Nearly Everyone?
  7. 7. Wikipedia’s scale [5] 30m articles, 4m English 16 million images 8000 views per second 500 million unique visitors per month 3.7 billion monthly mobile pageviews 2.1 billion edits, 700 million English edits
  8. 8. Medical stats [6] ● 30,000 medicine and pharmacy articles ● 200 million+ page views each month ● More than the WHO, NIH, or WebMD
  9. 9. [7] Clinical usage ● 50% to 90% of physicians use Wikipedia ● 35 to 70% of pharmacists use Wikipedia ● Most frequently used source by junior MDs ● 94% of medical students use Wikipedia
  10. 10. Wikipedia use [high] amongst medical students Web2.0 resources are internet-based tools, such as ‘wikis’ and social networking sites, allowing users to actively participate in the creation and editing of information. Wikipedia is increasingly being used by medical students and physicians when actively searching for health information (Judd & Kennedy 2010). While the paucity of formal editorial review of such resources warrants scepticism, there is increasing evidence about its reliability and potential use (Rajagopalan et al. 2011). We sought to determine the prevalence of Wikipedia use amongst medical students at one institution, through a selfadministered 12-item online questionnaire. A total of 361 students participated in the study across six years of the course. The mean participant age was 21 with a non-significant over-representation of females (57%). Wikipedia was used by 341 students (94%) while studying medicine. The most common reasons reported for using Wikipedia were ease of access (98%) and ease of understanding (95%). A lack of confidence in performing literature reviews was cited by 10% of the respondents. In those students who did not use Wikipedia, 85% reported it as an unreliable resource. There was no significant correlation between the year of medical school and the use of Wikipedia (R2 = 0.67, p = 0.12). However, there was a significant correlation between the year of medical school and the use of Wikipedia as the first resource (R2 = 0.81, p < 0.02), with older years less likely to use Wikipedia as the initial resource. Similarly, there was an inverse correlation between the year of medical school and the use of Wikipedia as the only resource (R2 = 0.70, p < 0.05), as the most common resource (R2 = 0.67, p < 0.05) and its perceived reliability (R2 = 0.73, p < 0.05). Multivariate regression analysis models found the year of medical school to be an independent predictor of the use of Wikipedia as the first resource (p < 0.05), only resource (p < 0.005) and most common resource (p < 0.05). The use of Wikipedia is almost ubiquitous throughout medical school for medical education. The ease of access and understanding, as well as readily usable and consumer-friendly interfaces, means students often turn to this, rather than traditional authoritative resources. While the reliance on Wikipedia reduces throughout medical school, this is likely due to confidence and ability to concurrently use other resources as well as perceived reduced reliability. Medical school administrators would benefit from embracing and developing web2.0 resources and include their use in ongoing dynamic medical education.
  11. 11. Doctors use, but don’t rely totally on, Wikipedia According to research shared with Wikimedia UK, use of Wikipedia for medical information is almost universal among a sample of doctors. Many of them praise its accuracy, but they are aware of its faults and that it needs to be read critically. The investigators conducted an online survey of medical staff at two large hospital trusts in England. Nearly all the 109 responses included free-text comments. Unsurprisingly, the respondents all consult Wikipedia. The survey was concerned with whether they consult it for medical information and whether it affected their clinical practice. Ninety percent said they look up medical information on Wikipedia, citing its ease of access and clear, concise layout among its advantages. Among those who denied using it, some commented that they only used Wikipedia for background knowledge: in other words, they were using it. Even the keen users of Wikipedia stressed that they never base clinical decisions on Wikipedia alone. They saw it as a starting point, to be read critically and consulted alongside other sources. Representative quotes include: “I use Wikipedia to gain a quick overview of a subject/topic that I am unfamiliar with or to jolt my memory of a subject. I would never base management or treatment of a patient I find there – for that I use my own knowledge, hospital protocols/guidelines, textbooks and advice from colleagues.” “Most Wikipedia articles explaining diseases/disorders have been copied from a credible source such as a book or journal. Hence for the most part disease descriptions tend to be accurate and can be trusted. However I would nevertheless check it from other sources.”
  12. 12. Wikipedia’s pillars Neutral point of view Verifiability Consensus Civility Open copyright [8]
  13. 13. Your Keys to Success ● Referencing ● Paraphrasing ● Formatting ● Simplification
  14. 14. Referencing
  15. 15. [9] References, References...
  16. 16. Can Anyone Just Come and Write What They Want?
  17. 17. [10] WP:MEDRS
  18. 18. Found on the “talk page”
  19. 19. Paraphrasing
  20. 20. No copying and pasting ● Violates our copyright license ● Not permitted ● We do not do “fair use” text ● Quotes should be rare ● You must put everything in your own words [11]
  21. 21. Formatting
  22. 22. WP:MEDMOS [12] ● Follow naming conventions and order of sections ● Write for the average reader Do not use the term patient or “you” Do not use “jargon”: eg. kidney not renal ● Write for a global audience (use global data) ● Avoid lists of links to other pages or sources ● State the facts (do not need to state the journal or author) ● Compose an encyclopedia, not a how-to manual
  23. 23. Simplification
  24. 24. Who Are We Writing For?
  25. 25. [13] The General Population ● Both academics and the lay public ● Simple language where possible ● Main articles are an overview  ● Sub articles can contain greater detail (nesting) ● General public does not care about confidence intervals
  26. 26. Health Information for All In the Language of Their Choice
  27. 27. [14] Translation needed ● Problem: Little health care content exists in many languages ● Factor: Majority of medical research and publications written in English ● Solution: Translate from English into other languages
  28. 28. European: German, French, Italian, Spanish, Dutch, Polish, Russian, Portuguese
  29. 29. Translation goals [15] ● 80-100 key health care articles, > 2,000 pages of text ● Improve to a professional standard in English ● Translate into as many other languages as possible (including simple English) ● Integrate the translations into Wikipedia ● Give easy and inexpensive access to everyone (via collaborations with cell phone companies)
  30. 30. Translation partners [16] ● Translators Without Borders ○ An NGO founded in 1993 ○ Humanitarian translations into other languages ● Wikiproject Medicine ○ A group of volunteers within Wikipedia who are interested in improving medical content Wiki Project Med Foundation
  31. 31. Global access [17] ● Problem: Those in the developing world have poor access to computers / the Internet ● Factors: Even though cell phones are widespread (6/7 people), data charges are expensive ● Solution: Cell phone companies give Wikipedia access without data charges ● WMF has agreements with cellphone companies to give access free of data charges to ~500 million people in Africa, Middle East, Asia, and Eastern Europe.
  32. 32. [18] Global impact ● Tens of thousands die for lack of low cost interventions ● Access to information is a major factor (HIFA2015) ○ 8 of 10 caregivers do not know the key symptoms of pneumonia ○ 4 of 10 mothers in India believe fluids should be withheld if their child has diarrhea ○ More than 60% of Africans said that a friend or family member could have been saved if they’d had information in their own language ● Wikipedia is a viable way to address this knowledge gap.
  33. 33. Is Wikipedia Peer Reviewed?
  34. 34. [19] Wikipedia’s reliability As accurate as Britannica Errors fixed quickly over time “Many eyeballs make all bugs shallow” Virtual filter Teaches information literacy
  35. 35. Multiple safeguards 1. Edit Filter automatically rejects known vandalism patterns 2. ClueBot reverts and flags suspicious edits with a machine-learning bot 3. Humans review malicious changes tagged with language recognition tools 4. Vandalism patterns are checked against metadata and historical trends 5. Recent changes patrollers scroll through new edits 6. Editors alerted to each change on all pages in their article watchlist 7. Specialists and experts report and fix mistakes when they see them 8. Millions of readers identify and correct errors when they come upon them 9. Link blacklists lock out known spam sites and unreliable sources 10. Detection mechanisms to determine conflict of interest 11. Administrators to block disruptive editors and protect pages
  36. 36. Featured / Good articles ● Semi-formal peer review ● Total: 4,033 FAs and 18,442 GAs ● Medicine: 58 FAs and 145 GAs (<1%) ● Frequently written by experts ● Primarily by one or by a few people ● More formal peer review and author credit? [20]
  37. 37. Can you Edit?
  38. 38. [21] How to contribute 1. Go to the article which covers your area of research. 2. Click [edit] 3. Type your drafted text into the text box, using the editing toolbar for easy formatting 4. Add in key points summarizing findings from your sources 5. Use your own phrasing so it’s not an exact copy 6. Write in clear, accessible language so that it’s a good fit for a smart but general audience. 7. If other review articles had different findings, put yours in context without taking a side 8. Add a citation at the end of your text (after the punctuation) * Cite toolbar: choose Template:Cite Journal. Fill in the fields. Insert Reference. * DOI or PMID: <ref>{{cite doi|DOI HERE}}</ref> or <ref>{{cite pmid|PMID HERE}}</ref> 9. Click Save. 10. Engage in civil, constructive conversation about improvements and suggestions. You did it!
  39. 39. Questions? James Heilman jmh649@gmail.com http://enwp.org/User:Jmh649 http://www.wikimedia.ca Jake Orlowitz jorlowitz@gmail.com http://enwp.org/User:Ocaasi @JakeOrlowitz Wiki Project Med Foundation wikiprojectmed@gmail.com https://meta.wikimedia.org/wiki/Wiki_Project_Med @WikiProjectMed
  40. 40. 1. 2. 3. 4. 5. 15. 16. Wikipedia’s mission http://slashdot.org/story/04/07/28/1351230/wikipedia-founder-jimmy-wales-responds Wikipedia’s volunteers http://en.wikipedia.org/wiki/Special:Statistics Wikimedia’s scope http://en.wikipedia.org/wiki/Wikimedia_projects Wikimedia’s Foundation http://en.wikipedia.org/wiki/Wikimedia_Foundation Wikipedia’s scale http://en.wikipedia.org/wiki/Wikipedia:Statistics http://reportcard.wmflabs.org/ http://en.wikipedia.org/wiki/Wikipedia:Size_of_Wikipedia Medical stats http://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine http://en.wikipedia.org/wiki/Wikipedia:WikiProject_Pharmacology" Clinical usage http://www.jmir.org/2011/1/e14/ http://blog.wikimedia.org.uk/2012/04/doctors-use-but-dont-rely-totally-on-wikipedia/ http://www.ncbi.nlm.nih.gov/pubmed/23137251 Wikipedia’s pillars http://en.wikipedia.org/wiki/Wikipedia:Five_pillars Citation needed http://xkcd.com/285/ WP:MEDRS http://en.wikipedia.org/wiki/Wikipedia:MEDRS No copying and pasting http://en.wikipedia.org/wiki/Wikipedia:Copyright_violations WP:MEDMOS http://en.wikipedia.org/wiki/Wikipedia:MEDMOS The general population http://en.wikipedia.org/wiki/Wikipedia:Make_technical_articles_understandable Translation needed http://infodisiac.com/blog/2012/02/wikipedia-readers/ http://en.wikipedia.org/wiki/List_of_languages_by_number_of_native_speakers http://w3techs.com/technologies/overview/content_language/all Translation goals http://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Translation_Task_Force Translation partners http://translatorswithoutborders.org 17. 18. 19. 20. 21. Global access Global impact Wikipedia’s Reliability Featured / Good articles How to contribute 6. 7. 8. 9. 10. 11. 12. 13. 14. http://meta.wikimedia.org/wiki/Wiki_Project_Med http://wikimediafoundation.org/wiki/Wikipedia_Zero http://www.hifa2015.org/about/why-hifa2015-is-needed/ http://en.wikipedia.org/wiki/Reliability_of_wikipedia http://en.wikipedia.org/wiki/Wikipedia:Quality#Grades http://en.wikipedia.org/wiki/Wikipedia:MEDHOW http://en.wikipedia.org/wiki/Wikipedia_talk:WPMED All images used are from Wikimedia Commons: http://commons.wikimedia.org
  41. 41. online http://meta.wikimedia.org/wiki/WPMED facebook WikiProjectMed twitter @WikiProjectMed email wikiprojectmed@gmail.com Join us! If you add neutral, encyclopedic content to Wikipedia, it will likely become the most viewed information on that subject in the world. In many countries, Wikipedia is the only source that exists for medical information in that language. By working with Wikipedia you help strengthen the ties between research and public health, giving patients and medical professionals starting points for deeper research. Why it matters Wikipedia is the 5th most visited website in the world: 500 million unique visitors per month, 8,000 views per second, over 30 million pages. 40,000 English Wikipedia encyclopedia articles cover nearly every major area of health, medicine, and and pharmacology. These articles are viewed 250 million times every month: more than the WHO, the NIH, or WebMD. Studies support Wikipedia’s increasingly influential role as the dominant online reference delivering medical information to the lay public as well as to medical students and clinicians. The world comes to Wikipedia: it’s essential that the most current, accurate, and reliable information is present there. Who we are A global nonprofit made up of active Wikipedia editors who care about medicine. Our goal is to share the sum of all medical knowledge with every person on the planet, for free, in the language of their choice. The Wikipedia community is eager to help you contribute. We want to connect your critical work to our inspiring mission. The Puzzle Globe is a registered trademark of the Wikimedia Foundation and is used with the permission of the Wikimedia Foundation. WikiProjectMed is not endorsed by or affiliated with the Wikimedia Foundation.

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