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Online Health Care Information: Proceed with Caution

By: NCSF  on:  Jun 3 2014
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Since Wikipedia’s launch in 2001, it has become the most popular general reference site on the Internet. It is a widely used resource for health care information among not only the general public but also physicians and medical students; 47-70% of whom admit to using it as a reference. Wikipedia’s fundamental design as a “collaborative database” allows users the ability to add, delete and edit information. This characteristic has raised concern in the medical community regarding the reliability and accuracy of the information on the website. A recent study published in the in Journal of the American Osteopathic Association has substantiated these concerns, finding numerous factual errors in 9 out of 10 Wikipedia articles when compared to recognized peer-review journals.

The 10 most costly conditions in the US were identified from the Agency for Healthcare Research and Quality: heart disease, cancer, mental disorders, trauma-related disorders, osteoarthritis, chronic obstructive pulmonary disease/asthma, hypertension, diabetes, back problems and hyperlipidemia. Researchers then identified 10 Wikipedia articles that were most closely related to each of those conditions. Reviewers consisted of internal medicine residents or rotating interns who were randomly assigned to examine two of the Wikipedia articles, giving the study two independent reviewers for each article. The reviewers were asked to identify every assertion (implication or statement of fact) in the Wikipedia article and fact-check each assertion against a peer-reviewed source that was published or updated within the past five years. Each reviewer reported concordance (assertion in Wikipedia confirmed by a peer-reviewed reference) or discordance (assertion in Wikipedia contradicted by a peer-review reference) between Wikipedia and peer-reviewed sources. Researchers who did not participate in the original review process compared both reviews of each article and tallied the concordance and discordance for each.

The reviewers found a statistically significant discordance between Wikipedia and peer-reviewed sources for assertions found by both reviewers in all but 1 of the conditions, trauma-related disorders. This demonstrates that most Wikipedia articles on these conditions contained information that is inconsistent with peer-reviewed sources and suggests that health care professionals, trainees, patients and the general public should use caution when using Wikipedia to answer questions regarding patient care. It also reinforces the idea that physicians and medical students who use Wikipedia as a medical reference should be discouraged from doing so.

The findings of this study should not come as a huge surprise as Wikipedia articles do not go through the same rigorous peer-review process as medical journals. Wikipedia is a convenient tool for initial information gathering, but it should be used in conjunction with other resources that have medical advisory boards, are peer-reviewed or are run by public health authorities like the U.S. Centers for Disease Control and Prevention or the Department of Health and Human Services.

Hasty RT, Garbalosa RC, Barbato VA, Valdes Jr PJ, Powers DW, Hernandez E, John JS, Suciu G, Qureshi F, Popa-Radu M, San Jose S, Drexler N, Patankar R, Paz JR, King CW, Gerber HN, Valladares MG, Somji AA. Wikipedia vs peer-reviewed medical literature for information about the 10 most costly medical conditions. J Am Osteopath Assoc. 2014; 114(5):368-373.

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