AANS Neurosurgeon | Volume 29, Number 1, 2020

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Toward Medical Democracy: Improving Wikipedia for Our Patients’ Sake

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Born in 1994, I am a member of what some would consider the digital native generation. We grew up in a world rich with communication technology and most never knew a time without the internet. For example, U.S. medical students who will become neurosurgical interns in July 2020 were about six years old when Google was founded.1,2 For digital natives, the internet is inextricably integrated into our personal and professional lives. When we have questions, our first step is often to consult the web.

I do just that every day of my medical student career – reading UpToDate™ to research clinical questions, using smartphone applications to check dosing information and searching online journal databases for peer-reviewed literature. But as a teenager, when a family member was diagnosed with Parkinson’s disease, my first search was not on UpToDate™. I turned to the closest thing a layperson had: Wikipedia.

As a concerned family member, a well-written Wikipedia article on Parkinson’s disease provided me with a general foundation upon which I could build knowledge. Browsing the section on deep brain stimulation helped me begin to understand the beauty of the brain and the delicacy of its complex chemistry – it actually sparked my interest in neurosurgery. But perhaps more importantly, that webpage was a source of comfort as I sought to understand what was happening to someone for whom I cared. Once I learned more about the symptoms and course of the disease, I felt empowered to serve as a partner in their medical care. I craved information and there it was, at my fingertips, with just a few clicks of a mouse.

The convenience of open-access internet resources has made them an increasingly popular tool for people seeking medical information. Most patients conduct at least a cursory Google search for their symptoms or disease, landing on Wikipedia, WebMD or Mayo Clinic sites. This practice is so prevalent that I have, on occasion, heard surgeons cynically comment about patients trusting “Dr. Google” more than their actual doctor. If patients are already seeking out medical information on the internet, is it not incumbent upon us to ensure that it is high-quality? Rather than become frustrated with patients who are motivated to learn, we in the medical community can instead partner with them to make sure they are not ending up with misinformation.

WiKi Medicine

A taskforce is already underway for the systematic improvement of existing Wikipedia pages that cover medical topics. WikiProject Medicine is an initiative led by physicians and scientists committed to moderating the rigor and accuracy of health-related Wikipedia content. They have made it easy for medical professionals to improve articles by publishing guidelines for authors, monitoring new edits and enforcing a quality grading scale to ensure lack of bias and encourage the extensive use of high-quality citations. Volunteers are invited to edit articles that have the highest level of public interest, as determined by the number of page views and the most potential for improvement.

Medical professionals at every level of training can improve the quality of online health information through this project. Some medical schools have even started offering Wikipedia-editing courses to fourth-year medical students. In the 2017-2018 academic year, medical students from three different institutions edited 71 health-related pages, which were viewed 2,688,5000 times during the courses alone.3 Wikipedia is one of the most highly trafficked health care websites, so these articles have enormous global impact. In 2013, for example, the 29,000 English-language medical articles in Wikipedia were viewed over 2.28 billion times.4

Imagine if every neurosurgeon chose to improve just one article that was relevant to the bulk of their patient population. Spinal decompression, for example, is currently rated “Start” quality, indicating that both the content and organization require substantial improvement.5 Meningitis, on the other hand, is graded as a “Featured Article” and can serve as an example of the quality to aim for in medical Wikipedia articles. The project is already laid out via the WikiProject Medicine infrastructure. All it requires is a group of highly motivated people with a critical eye, attention to detail and intimate knowledge of what information is important to patients. I cannot think of a group that this description fits better than neurosurgeons.

The author would like to acknowledge Susan Durham, MD, FAANS, (neurosurgery division chief and professor) and Alan Segal, MD, (associate professor) at the University of Vermont Larner College of Medicine for their mentorship and valuable discussions, which contributed to this article.

References

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1. Association of American Medical Colleges. (2017). Table A-6: Age of Applicants to U.S. Medical Schools at Anticipated Matriculation by Sex and Race/Ethnicity, 2014-2015 through 2017-2018. https://www.aamc.org/system/files/d/1/321468-factstablea6.pdf.

2. Google. (n.d.). About Google: Our Story. https://about.google/our-story/.

3. Joshi, M., Verduzco, R., Yogi, S., Garcia, M., Saxena, S., Tackett, S., … Azzam, A. (2019). Wikipedia Editing Courses at Three US Medical Schools in the 2017-2018 Academic Year. MedEdPublish8(2). doi: 10.15694/mep.2019.000146.1

4. Heilman, J. M., & West, A. G. (2015). Wikipedia and Medicine: Quantifying Readership, Editors, and the Significance of Natural Language. Journal of Medical Internet Research17(3). doi: 10.2196/jmir.4069

5. WikiProject Medicine/Assessment. (2019, October 14). Quality Scale. Retrieved from https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Assessment#Quality_scale.

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