Op-ed: Wikipedia isn’t really the patient’s friend

The following op-ed was published on July 15th, 2009 in the USA Today.

“I researched my condition on Wikipedia.” That’s what more doctors, myself included, are hearing from patients every day.

Wikipedia is the Web’s most popular online encyclopedia. Its more than 13 million articles cover almost every topic imaginable. It is among the most visited sites primarily because its articles routinely show up near the top of search engine results, like those from Google.

The ability to research diseases and drugs on the Web has empowered patients in managing their health. More than 160 million adults in the U.S. have gone online to look for medical information. With two-thirds of them beginning their Internet health inquiry using a search engine, it is no wonder that Wikipedia has become a common medical resource for patients. More than half, according to the Pew Internet & American Life Project, reported that their most recent Web session influenced how they took care of themselves or for someone else, illustrating how critical online health information has become.

But Wikipedia’s medical entries — as has been reported with other entries on other issues — are not reliable for the simple fact that they are prone to manipulation, as is all Wikipedia content.

Anyone can write and edit its topics, which means millions of non-doctors can essentially dispense medical advice. In several instances, pharmaceutical companies intentionally tried to delete or modify Wikipedia entries that mentioned adverse effects associated with their drugs.For example, in 2007, a claim that the psychiatric medication Seroquel made teenagers “more likely to think about harming or killing themselves” was deleted from the Wikipedia entry by a computer registered to AstraZeneca, the drug’s manufacturer.

Even more troubling is that doctors, too, appear to be increasingly reliant on Wikipedia. According to a survey of 1,900 physicians by Manhattan Research, a health care market research firm, nearly half of doctors going online for professional purposes reported using Wikipedia as a source of medical information. That number has doubled in the past year alone.

The threat is obvious. Can you imagine your doctor stepping out from the exam room, tapping away at his or her computer seeking the advice of Wikipedia? Research has documented the danger. A study from The Annals of Pharmacotherapy compared drug information from Wikipedia with the Medscape Drug Reference, a resource whose information is reviewed by pharmacists. Researchers found that Wikipedia omitted important information, including drug side effects. Another entry overlooked a commonly prescribed pain medication’s association with miscarriages.

This isn’t to say patients shouldn’t research their medical conditions to become better informed. But it’s imperative that patients not rely on Wikipedia as the primary source of their health research. Websites sponsored by the government, academic medical centers, or professional medical societies all have more authoritative information that can be relied upon.

Jay Walsh, head of communications at the Wikimedia Foundation, says: “Wikipedia shouldn’t be taken as a 100% reliable source of medical information. … But Wikipedia always strives for a degree of improvement.”

And as for physicians, there’s no excuse turning to Wikipedia as a source when reputable medical resources are a few more keystrokes away. Although these other sites might require more time for a busy clinician, doctors need to eschew convenience to ensure their decisions are based on sound medical information.

Quality patient care demands no less.