Wikipedia and Medicine

(An introduction)

James Heilman

MD, CCFP(EM), Wikipedian

Wikimedia Canada

All text is under a CC-BY-SA license

Our goal

“Imagine a world in which every single person on the planet is given free access to the sum of all human knowledge. That's what we're doing.” 

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Wikipedia Co Founder Jimmy Wales

What is a wiki?

• Software first developed in 1994 by Ward Cunningham which creates a website that allows the collaborative editing of inter linked articles
• Content can be added, changed or deleted via a web browser
• Thousands of sites are based on this software
• Means fast or quick in Hawaiian

A little about myself

• Small town ER doc
• Some academic affiliation but am a long way from a University (~400Km)
• Became involved in 2007/2008 after coming across a poor quality medical articles
• An active volunteer ever since

Is Wikipedia Read by Nearly Everyone?

Some numbers

• Largest and most popular reference work on the Internet, 5th most popular website in the world (the first four being Google, Facebook, Youtube and Yahoo)
• 492 million unique visitors per month as of May 2012 (roughly 18 billion page views)

More than 30% of global internet users visit Wikipedia monthly (482 million), approx 15% daily

And that did not include mobile use

Medical stats

• ~200 million page views for more than 25,000 medical articles 
• More than 40 million page views for medication articles each month
• 50% to 100% of physicians use Wikipedia (most frequently used source by junior physicians besides Google)
• 35 to 70% of pharmacists admit to its use

How does this compare to others health content sites?

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Does Wikipedia Cover Nearly Everything?

Size of the English version as of Aug 2010

• Largest reference work on the Internet
• Equivalent to ~1660 volumes of the Encyclopedia Britannica
• As of June 2012 ~23 million articles in 285 languages (4.0 million in English)

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Growth

Does Wikipedia Have a Huge Number of Editors?

A few numbers

• Anyone can edit (35 million registered accounts) many more editing anonymously
• 82,200 people contribute >5 edits a month
• 10,500 people contribute more than 100 edits a month
• The numbers who edit medical content are much less

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Editor numbers peaked in 2007

• The easy work has been done
• More stringent criteria for contributing
• Can be a difficult place to edit (lots of policies, can get personal)

Editors in English

Admins peaked shortly after

Can One Just Come and Write What They Want?

First and foremost an encyclopedia

• Attempting to summarize the evidence and widely supported positions
• It is not:
• To promote specific ideas or host original research results
• A textbook, here to "inform" rather than "instruct" 
• A collection of external links to other sites. 
• Other types of content may be suitable for other Wikimedia projects

Reference, Reference, Reference

• Editors of Wikipedia are not verifiable thus the content needs to be supported by references. 
• Review articles (either literature reviews or systematic reviews) are strongly preferred for medical/scientific content. 
• Major textbooks may also be useful sources as are statements by governmental bodies. 
• So yes will anyone can contribute unreferenced or poorly referenced material will often be rapidly removed

If you do not provide a reference...

Are You Allowed to Edit?

How it works

• anybody can edit, at least some of the content initially
• multiple safeguards
• automation is used to revert vandalism/spam
• new changes are monitored by "recent change patrollers"
• "watch lists" alert interested editors of new edits
• a trusted group of volunteers called admins have additional tools (page protection, ability to block editors)
• controversial content may be locked
• certain links are "blacklisted"
• mechanisms to determine conflict of interest

Vandalism by IPs verses registered users

Does What One Writes Matter?

Pageviews of a specific page

Is Wikipedia Peer Reviewed?

Article rating scale

Featured articles / good articles

• Must undergo semi formal peer review
• Overall 3,628 FAs and 15,621 GAs
• Medicine has 55 FAs and 121 GAs
• Featured articles get displayed on the main page
• Are frequently written by experts
• Typically written primarily by one or a few people

Pictures

Adding images

• Images are stored at the sister site, Wikimedia Commons
• Currently more than 13 million media files available and freely reusable
• Typically released under Creative Commons licenses
• This means that if people reuse your images their work must also be Creative Commons
• They must give you attribution
• If commercial companies wish to use your images they typically contact you

Carry a camera!

• Me preparing for work
• Patients are happy to have pictures taken
• If identifiable remember get signed consent

Who Are We Writing For?

General population

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• This means both academics and the lay public
• We try to write the main article as an overview 
• Sub articles then contain greater detail (nesting)
• We present content in a factual rather than instructional manner
• Other WMF projects
• Simple Wikipedia (simplified wording)
• Junior Wikipedia (simplified ideas)

Is Wikimedia Just an Encyclopedia?

The Wikimedia Movement

• Three main parts
• The Wikimedia Foundation: raises money to keep the lights on, helps with developing the underlying software
• The volunteer community: writes the content, creates the policies and guidelines that govern the site
• The national chapters / Thematic organizations: involved with partnerships and local events
• The Wikimedia foundation is a not for profit
• Advertising is not allowed on any of the projects

Main projects

Wikibooks: Textbooks and manuals

Wikipedia: Encyclopedia

Wikisource: Library of open source documents�Wikinews: News source

Wiktionary: Dictionary and thesaurus

Wikiquotes: Quote compendium

Wikiversity: Learning material

Wikidata (new): Language independent data

Meta-Wiki: Wikimedia coordination

The Wikimedia Family

Licensing

• Content is licensed under a CC BY SA
• CC means "Creative Commons"
• BY means "By Attribution"
• SA means "Share Alike"
• Content is therefore free to use and reuse
• Stuff based on this content however must be under the same license

What is not Wikimedia

• WikiLeaks: A site that published secret documents and is not really a wiki at all
• WikiAnswers: A question and answer site
• Wikia: A farm of wikis
• Intellipedia: A closed wiki run by US intelligence
• Conservapedia: An encyclopedia with a US conservative angle
• Many others

Wikipedia is of course the best known of the projects

• Multilingual encyclopedia (Started in 2001)

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Health Information for All in a Language of their Choice

Why do we need this?

• Every day tens of thousands die for want of simple, low cost interventions. A major factor is a lack of information per HIFA2015
• 8 of 10 caregivers do not know the key symptoms of pneumonia
• 4 of 10 mother in India believe fluids should be withheld if their child has diarrhea (see this frequently in my own country as well)
• Wikipedia is a viable way to address this knowledge gap. And maybe the only viable way.

Who are involved?

• Translators Without Borders
• An NGO founded in 1993
• Humanitarian translations into other languages
• Content Rules
• For profit company
• Specializes in simplifying text
• Wikiproject Medicine
• A group of volunteers within Wikipedia who are interested in improving medical content

What we are working on?

• 80 key health care articles (currently more than 2,000 pages of text)
• Improve them to a professional standard in English
• Followed by translation into as many other languages as possible (including simple English)
• Integration the translations into Wikipedia
• Get easy and inexpensive access for everyone including via collaborations with cell phone companies

80 key articles

Why other languages?

• Issue: Little health care content exists in many languages
• Problem: Some of this is due to most medical research / publications occur only in English
• Solution: Translate an high quality articles from English into other languages
• Each article translated by one translator and verification by a second
• Currently working on 30 to 40 languages but hope to expand to all 285 languages

Internet content by language

Internet users by languages

Proportion of articles by language

Population by native language

Integration

• Articles are then integrated back into the appropriate language version
• Done with the help of local Wikipedians in those languages

Getting access to the world

• Issue: Those in the developing world have poor access to computers / the Internet
• Problem: They can get access via cell phones but data charges are expensive
• Solution: Convince cell phone companies to allow Wikipedia access without data charges

Telephone partners

• The WMF has recently signed agreements with two cellphone companies (Orange and Telnor) which are going to give access without data charges to 300 million people in Africa, the Middle East, Asia and Eastern Europe.
• More partnerships are being developed.

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Authorship

Can Wikipedia Advance your Career?

Authorship

• Not listed anywhere in the main part of the article
• Can be found under
• History tab
• By clicking on images
• Via a few simple tools
• Sometimes on the talk pages
• Editors may but are not required to use their real names

Collaboration with journals

• Issue: We need to get more academics involved
• Problem: Wikipedia does not give the recognition required for advancement in academia
• Solution: From collaborations with journals (PLoS, Open Medicine, JMIR) to co publish Wikipedia articles under author's real names
• First article is in the publication process

Is Wikimedia a Big Company?

Wikimedia Medicine

• A proposed thematic group / chapter
• To promote the improvement of medical content within Wikipedia and its sister projects globally
• To promote the creation of open medical content in all languages of the world
• Currently seeking volunteers

So why contribute?

• You believe all people deserve access to high quality health information
• You want a useful method to develop your own understanding of your field
• You are looking for an international group of academics with which to discuss medicine
• Consider it like the Rotary clubs but instead of developing scholarships we are building an online library
• There is no money, there is no fame

Questions I have of you?

1. What concerns do you have with Wikipedia 
2. What previously prevented you from getting involved
3. What would encourage your involvement

Questions?

James Heilman

jheilman@wikimedia.ca

User:Jmh649

www.wikimedia.ca

Editing Workshop

• This will be a chance for everyone to explore Wikipedia and try editing for themselves
• If you have any questions please shout them out or put up your hand

Create an account

First create an account. Than add {{New user bar}} to your user page

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How you can help?

Creating a new article

http://en.wikipedia.org/wiki/List_of_diseases_(S)

A few pages in need of help

• Hypomagnesemia
• Hypermagnesemia
• Hypercalcaemia
• Hyponatremia
• Hypernatremia
• Hypokalemia
• Hyperphosphatemia
• Pancreatitis
• Erythroderma
• Adrenal insufficiency

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A good way to learn how to edit is to look at high quality pages.

Watson (Jeopardy match)

So what is happening with other encyclopedias

• Encyclopædia Britannica: This is its last year of hard copy publication (now just digital)
• Collier's encyclopedia went out of print in 1998
• Citizendium which was started in 2007, 2010 encountered a lack of funding, less than 100 editors / small number of articles
• Google Knol started in 2007 closing down in 2012