Improving the Quality of Consumer Health Information on Wikipedia: Case Series

Wikipedia page views for health research: a review

Wikipedia is an open-source online encyclopedia and one of the most-read sources of online health information. Likewise, Wikipedia page views have also been analyzed to inform public health services and policies. The present review analyzed 29 studies utilizing Wikipedia page views for health research. Most reviewed studies were published in recent years and emanated from high-income countries. Together with Wikipedia page views, most studies also used data from other internet sources, such as Google, Twitter, YouTube, and Reddit. The reviewed studies also explored various non-communicable diseases, infectious diseases, and health interventions to describe changes in the utilization of online health information from Wikipedia, to examine the effect of public events on public interest and information usage about health-related Wikipedia pages, to estimate and predict the incidence and prevalence of diseases, to predict data from other internet data sources, to evaluate the effectiveness of health education activities, and to explore the evolution of a health topic. Given some of the limitations in replicating some of the reviewed studies, future research can specify the specific Wikipedia page or pages analyzed, the language of the Wikipedia pages examined, dates of data collection, dates explored, type of data, and whether page views were limited to Internet users and whether web crawlers and redirects to the Wikipedia page were included. Future research can also explore public interest in other commonly read health topics available in Wikipedia, develop Wikipedia-based models that can be used to predict disease incidence and improve Wikipedia-based health education activities.

Public Awareness of the Fencing Response as an Indicator of Traumatic Brain Injury: Quantitative Study of Twitter and Wikipedia Data

BACKGROUND

Traumatic brain injury (TBI) is a disruption in normal brain function caused by an impact of external forces on the head. TBI affects millions of individuals per year, many potentially experiencing chronic symptoms and long-term disability, creating a public health crisis and an economic burden on society. The public discourse around sport-related TBIs has increased in recent decades; however, recognition of a possible TBI remains a challenge. The fencing response is an immediate posturing of the limbs, which can occur in individuals who sustain a TBI and can be used as an overt indicator of TBI. Typically, an individual demonstrating the fencing response exhibits extension in 1 arm and flexion in the contralateral arm immediately upon impact to the head; variations of forearm posturing among each limb have been observed. The tonic posturing is retained for several seconds, sufficient for observation and recognition of a TBI. Since the publication of the original peer-reviewed article on the fencing response, there have been efforts to raise awareness of the fencing response as a visible sign of TBI through publicly available web-based platforms, such as Twitter and Wikipedia.

OBJECTIVE

We aimed to quantify trends that demonstrate levels of public discussion and awareness of the fencing response over time using data from Twitter and Wikipedia.

METHODS

Raw Twitter data from January 1, 2010, to December 31, 2019, were accessed using the RStudio package academictwitteR and queried for the text "fencing response." Data for page views of the Fencing Response Wikipedia article from January 1, 2010, to December 31, 2019, were accessed using the RStudio packages wikipediatrend and pageviews. Data were clustered by weekday, month, half-year (to represent the American football season vs off-season), and year to identify trends over time. Seasonal regression analysis was used to analyze the relationship between the number of fencing response tweets and page views and month of the year.

RESULTS

Twitter mentions of the fencing response and Wikipedia page views increased overall from 2010 to 2019, with hundreds of tweets and hundreds of thousands of Wikipedia page views per year. Twitter mentions peaked during the American football season, especially on and following game days. Wikipedia page views did not demonstrate a clear weekday or seasonal pattern, but instead had multiple peaks across various months and years, with January having more page views than May.

CONCLUSIONS

Here, we demonstrated increased awareness of the fencing response over time using public data from Twitter and Wikipedia. Effective scientific communication through free public platforms can help spread awareness of clinical indicators of TBI, such as the fencing response. Greater awareness of the fencing response as a "red-flag" sign of TBI among coaches, athletic trainers, and sports organizations can help with medical care and return-to-play decisions.

Library instruction and Wikipedia: investigating students' perceived information literacy, lifelong learning, and social responsibility through Wikipedia editing

Objectives:

This article presents a multiyear pilot study delineating practical challenges, solutions, and lessons learned from Wikipedia editing experiences with first-year medical students at the John A. Burns School of Medicine at the University of Hawai‘i at Mānoa. The purpose of our project was to determine the feasibility and effectiveness of Wikipedia editing to improve information literacy and lifelong learning skills and to investigate aspects of social responsibility in first-year medical students.

Methods:

Lessons were provided through a combination of in-person and online instruction via the WikiEdu learning management system (LMS). Students next selected a health-related Wikipedia article to edit. After the editing experience, structural completeness data were collected from the WikiEdu LMS. Feedback was collected via an anonymous retrospective pre-post survey to assess the students' attitudes toward their perceived information literacy skills and the social responsibility of improving Wikipedia articles. Nonparametric tests were conducted to compare pre versus post outcomes.

Results:

Fifty-seven (79%) participants in the 2018 cohort and forty-nine (64%) participants in the 2019 cohort completed the retrospective pre-post survey. In both cohorts, respondents showed statistically significant increases (p<.05) in self-rating of all ten domains of information literacy and social responsibility after completing the program.

Conclusions:

This study showed that medical students are competent editors of Wikipedia and that their contributions improve both the quality of the articles and their own perceived information literacy. Additionally, editing medicine-related articles provides an opportunity to build students' social responsibility by improving content on an open platform that reaches millions each day.

Evaluating the Psychometric Properties of the eHealth Literacy Scale (eHEALS) among Polish Social Media Users

Social media have become mainstream online tools that allow individuals to connect and share information. Such platforms also influence people’s health behavior in the way they communicate about personal health, treatment, or physicians. Individuals’ ability to find and apply online health information on specific health problems can be measured using a valid and reliable instrument, the eHealth Literacy Scale (eHEALS). The objective of this study was to evaluate the psychometric aspects of the Polish version of this instrument (eHEALS-Pl) among social media users, which has not been explored so far. We examined the translated version of the eHEALS in a representative sample of Polish social media users (n = 1527). CAWI (computer-assisted web interviews) was a method to collect data. The reliability of the eHEALS-Pl was measured by calculating the Cronbach alpha coefficients and analyzing the principal components. Exploratory factor analysis and hypothesis testing was used to assess the construct validity of the instrument. The internal consistency of the eHEALS-Pl was sufficient: Cronbach alpha = 0.84. The item-to-total correlations ranged from r = 0.514 to 0.666. EFA revealed a single structure explaining 47.42% of the variance, with high factor loadings of the item ranging from 0.623 to 0.769. Hypothesis testing also supported the validity of eHEALS-Pl. The eHEALS-Pl evaluation supported by social media users reviled its equivalence to the original instrument developed by Norman and Skinner in 2006 and it can be used to measure e-health literacy. Since there is no prior validation of the eHEALS among social media users, these findings may indicate important directions in evaluating digital skills, especially in relation to the current challenges related to the COVID-19 pandemic.

Wikipedia provides better quality medical information on male sexual dysfunctions than Baidu Encyclopedia (Preprint)

Background

Sexual dysfunction is a private set of disorders that may cause stigma for patients when discussing their private problems with doctors. They might also feel reluctant to initiate a face-to-face consultation. Internet searches are gradually becoming the first choice for people with sexual dysfunction to obtain health information. Globally, Wikipedia is the most popular and consulted validated encyclopedia website in the English-speaking world. Baidu Encyclopedia is becoming the dominant source in Chinese-speaking regions; however, the objectivity and readability of the content are yet to be evaluated.

Objective

Hence, we aimed to evaluate the reliability, readability, and objectivity of male sexual dysfunction content on Wikipedia and Baidu Encyclopedia.

Methods

The Chinese Baidu Encyclopedia and English Wikipedia were investigated. All possible synonymous and derivative keywords for the most common male sexual dysfunction, erectile dysfunction, premature ejaculation, and their most common complication, chronic prostatitis/chronic pelvic pain syndrome, were screened. Two doctors evaluated the articles on Chinese Baidu Encyclopedia and English Wikipedia. The Journal of the American Medical Association (JAMA) scoring system, DISCERN instrument, and Global Quality Score (GQS) were used to assess the quality of disease-related articles.

Results

The total DISCERN scores (P=.002) and JAMA scores (P=.001) for Wikipedia were significantly higher than those of Baidu Encyclopedia; there was no statistical difference between the GQS scores (P=.31) for these websites. Specifically, the DISCERN Section 1 score (P<.001) for Wikipedia was significantly higher than that of Baidu Encyclopedia, while the differences between the DISCERN Section 2 and 3 scores (P=.14 and P=.17, respectively) were minor. Furthermore, Wikipedia had a higher proportion of high total DISCERN scores (P<.001) and DISCERN Section 1 scores (P<.001) than Baidu Encyclopedia. Baidu Encyclopedia and Wikipedia both had low DISCERN Section 2 and 3 scores (P=.49 and P=.99, respectively), and most of these scores were low quality.

Conclusions

Wikipedia provides more reliable, higher quality, and more objective information than Baidu Encyclopedia. Yet, there are opportunities for both platforms to vastly improve their content quality. Moreover, both sites had similar poor quality content on treatment options. Joint efforts of physicians, physician associations, medical institutions, and internet platforms are needed to provide reliable, readable, and objective knowledge about diseases.

Wikipedia in Health Professional Schools: from an Opponent to an Ally

As an online encyclopedia, Wikipedia is the world's largest reference Web site, with 1.7 billion visits per month. Given how easy it is to access and read, students use Wikipedia globally, despite most faculty members' admonitions. Since 2013, health professional schools worldwide have incorporated Wiki-editing into their formal curricula. These courses impact students by (1) strengthening their ability to evaluate evidence-based content and (2) multiplying their contributions to society through improvements to Wikipedia articles accessed by millions. We showcase several models of incorporating Wikipedia-editing assignments into health professions education worldwide. These successful initiatives can be replicated everywhere.

Bibliometric analysis confirms expected trends in consumer health information publications

BACKGROUND

This study provides an overview of consumer health information (CHI) scholarly communication trends.

OBJECTIVES

To explore CHI publications trends, journal citations, prolific authors, countries of origin, and distribution of CHI publications.

METHODS

A bibliometric analysis was used; 8953 records from the Web of Science (WoS) and peer-reviewed journal articles from databases, including LISA, MEDLINE, ERIC, PREMEDLINE and EMBASE were analysed.

RESULTS

Publications on CHI rapidly increased from 1980 to 2019, especially during the 1990s and 2000s. Most journals that have published CHI research are based in North America and Europe.

CONCLUSION

The increase in the CHI literature corresponds with that in Internet usage in the 2000s, and explains the availability of CHI content online. This trend is associated with the widespread adoption of personal computers (PCs) and other Internet-enabled gadgets.

A Health Information Quality Assessment Tool for Korean Online Newspaper Articles: Development Study

BACKGROUND

Concern regarding the reliability and accuracy of the health-related information provided by online newspaper articles has increased. Numerous criteria and items have been proposed and published regarding the quality assessment of online information, but there is no standard quality assessment tool available for online newspapers.

OBJECTIVE

This study aimed to develop the Health Information Quality Assessment Tool (HIQUAL) for online newspaper articles.

METHODS

We reviewed previous health information quality assessment tools and related studies and accordingly developed and customized new criteria. The interrater agreement for the new assessment tool was assessed for 3 newspaper articles on different subjects (colorectal cancer, obesity genetic testing, and hypertension diagnostic criteria) using the Fleiss κ and Gwet agreement coefficient. To compare the quality scores generated by each pair of tools, convergent validity was measured using the Kendall τ ranked correlation.

RESULTS

Overall, the HIQUAL for newspaper articles comprised 10 items across 5 domains: reliability, usefulness, understandability, sufficiency, and transparency. The interrater agreement for the article on colorectal cancer was in the moderate to substantial range (Fleiss κ=0.48, SE 0.11; Gwet agreement coefficient=0.74, SE 0.13), while for the article introducing obesity genetic testing it was in the substantial range, with values of 0.63 (SE 0.28) and 0.86 (SE 0.10) for the two measures, respectively. There was relatively low agreement for the article on hypertension diagnostic criteria at 0.20 (SE 0.10) and 0.75 (SE 0.13), respectively. Validity of the correlation assessed with the Kendall τ showed good correlation between tools (HIQUAL vs DISCERN=0.72, HIQUAL vs QUEST [Quality Evaluation Scoring Tool]=0.69).

CONCLUSIONS

We developed a new assessment tool to evaluate the quality of health information in online newspaper articles, to help consumers discern accurate sources of health information. The HIQUAL can help increase the accuracy and quality of online health information in Korea.

Developing a scalable framework for partnerships between health agencies and the Wikimedia ecosystem

In this era of information overload and misinformation, it is a challenge to rapidly translate evidence-based health information to the public. Wikipedia is a prominent global source of health information with high traffic, multilingual coverage, and acceptable quality control practices. Viewership data following the Ebola crisis and during the COVID-19 pandemic reveals that a significant number of web users located health guidance through Wikipedia and related projects, including its media repository Wikimedia Commons and structured data complement, Wikidata.

The basic idea discussed in this paper is to increase and expedite health institutions' global reach to the general public, by developing a specific strategy to maximize the availability of focused content into Wikimedia’s public digital knowledge archives. It was conceptualized from the experiences of leading health organizations such as Cochrane, the World Health Organization (WHO) and other United Nations Organizations, Cancer Research UK, National Network of Libraries of Medicine, and Centers for Disease Control and Prevention (CDC)'s National Institute for Occupational Safety and Health (NIOSH). Each has customized strategies to integrate content in Wikipedia and evaluate responses.

We propose the development of an interactive guide on the Wikipedia and Wikidata platforms to support health agencies, health professionals and communicators in quickly distributing key messages during crisis situations. The guide aims to cover basic features of Wikipedia, including adding key health messages to Wikipedia articles, citing expert sources to facilitate fact-checking, staging text for translation into multiple languages; automating metrics reporting; sharing non-text media; anticipating offline reuse of Wikipedia content in apps or virtual assistants; structuring data for querying and reuse through Wikidata, and profiling other flagship projects from major health organizations.

In the first phase, we propose the development of a curriculum for the guide using information from prior case studies. In the second phase, the guide would be tested on select health-related topics as new case studies. In its third phase, the guide would be finalized and disseminated.

FAIR and open multilingual clinical trials in Wikidata and Wikipedia

This project seeks to conduct language translation on metadata labels for research publications, attribution data, and clinical trials information to make data about medical research queriable in underserved languages through Wikidata and the Linked Open Web. This project has the benefit of distributing content through Wikipedia and Wikidata, which already have an annual userbase of a billion users and which already have established actionable standards to practice diversity, inclusion, openness, FAIRness, and transparency about program development. The impact will be localized access to basic research information in various Global South languages to integrate with existing community efforts for establishing the same. Although Wikidata development in this direction seems inevitable, the cultural and social exchange required to establish global multilingual research partnerships could begin now with support rather than later as a second phase effort for including the developing world. Wikipedia and Wikidata are established forums with an existing active userbase for multilingual research collaboration, but the research practices there still are immature. By applying metadata expertise through this project, we will elevate the current amateur development with more stable Linked Open Data compatibility to English language databases. Using the wiki distribution and discussion platform to develop the global conversation about data sharing will set good precedents for the trend of global research collaboration.

Evaluation of the Liver Disease Information in Baidu Encyclopedia and Wikipedia: Longitudinal Study

Background

The internet has changed the way of people acquiring health information. Previous studies have shown that Wikipedia is a reasonably reliable medical resource, and it has been ranked higher than other general websites in various search engines. Baidu Encyclopedia is one of the most popular encyclopedia websites in China. However, no studies have shown the quality of the content provided in the Baidu Encyclopedia.

Objective

This study aimed to evaluate the quality of liver disease information provided by Wikipedia (in English) and Baidu Encyclopedia (in Chinese) and to perform a comparison of the quality and timeliness of the articles published in these two encyclopedias. Moreover, a 3-year follow-up study was conducted to compare if the information in both these websites was updated regularly over this period.

Methods

We searched for information on liver diseases by using the International Statistical Classification of Diseases and Related Health Problems 10th Revision Version 2016 codes on Wikipedia (in English) and Baidu Encyclopedia (in Chinese). The quality of the articles was assessed using the DISCERN instrument, which consists of 3 sections. We recorded the latest editing date of the webpages and calculated the date interval to evaluate the update timeliness of these websites.

Results

We found 22 entries on liver diseases in Baidu Encyclopedia and 15 articles in Wikipedia between September 15, 2016, and September 30, 2016, and we found 25 entries in Baidu Encyclopedia and 16 articles in Wikipedia between September 15, 2019, and September 30, 2019. In section 1 of the DISCERN instrument, the mean (SE) scores of Baidu Encyclopedia entries were significantly lower than those of Wikipedia articles. In section 2 and section 3 of the DISCERN instrument, the DISCERN scores of Baidu Encyclopedia entries were lower than those of Wikipedia articles, but the differences were not statistically significant. The total DISCERN scores of Baidu Encyclopedia entries were significantly lower than those of Wikipedia articles. The update interval of the entries in Baidu Encyclopedia was found to be significantly longer than that of the articles in Wikipedia.

Conclusions

This study shows that the quality of articles and the reliability of the research content on liver diseases in Wikipedia are better than those of the entries in Baidu Encyclopedia. However, the quality of the treatment choices provided in both Wikipedia and Baidu Encyclopedia is not satisfactory. Wikipedia is updated more frequently than Baidu Encyclopedia, thereby ensuring that the information presented has the most recent research findings. The findings of our study suggest that in order to find accurate health information, it is important to seek the help of medical professionals instead of looking for a prescription amid the confusing information provided on the internet.

Impact of the Price of Gifts From Patients on Physicians' Service Quality in Online Consultations: Empirical Study Based on Social Exchange Theory

BACKGROUND

Gift giving from patients to physicians, which is prohibited in traditional clinical settings in China, has been found to occur in online health communities. However, there is debate on the validity of online gifts since physicians gain an economic benefit. Moreover, the potential impact of these gifts, particularly with respect to the financial value of the gift, on the online consultation service quality remains unexplored.

OBJECTIVE

The aim of this study was to explore the impact of gift price on the quality of physicians' online consultation service. Insight into this impact is expected to help resolve existing debate on the appropriateness of the gift-giving practice in online consultations.

METHODS

A dataset of 141 physicians and 4249 physician-patient interactions was collected from the Good Physician Online website, which is the largest online consultation platform in China. Based on social exchange theory, we investigated how gift price affects the quality of physicians' online consultation service and how this impact changes according to the physician's service price and number of all gifts received. Manual annotation was used to identify the information support paragraphs and emotional support paragraphs in the answers of physicians. The quality of the information support paragraphs, rather than the complete answer, was used to test the robustness of our model.

RESULTS

Gift price had a positive impact on the quality of physicians' online consultation service (β=4.941, P<.01). This impact was negatively mediated by both the physician's service price (β=-9.245, P<.001) and the total number of gifts they received (β=-5.080, P<.001).

CONCLUSIONS

Gift price has a positive impact on physicians' online behavior, although the impact varies among physicians.

Situating Wikipedia as a health information resource in various contexts: A scoping review

BACKGROUND

Wikipedia's health content is the most frequently visited resource for health information on the internet. While the literature provides strong evidence for its high usage, a comprehensive literature review of Wikipedia's role within the health context has not yet been reported.

OBJECTIVE

To conduct a comprehensive review of peer-reviewed, published literature to learn what the existing body of literature says about Wikipedia as a health information resource and what publication trends exist, if any.

METHODS

A comprehensive literature search in OVID Medline, OVID Embase, CINAHL, LISTA, Wilson's Web, AMED, and Web of Science was performed. Through a two-stage screening process, records were excluded if: Wikipedia was not a major or exclusive focus of the article; Wikipedia was not discussed within the context of a health or medical topic; the article was not available in English, the article was irretrievable, or; the article was a letter, commentary, editorial, or popular media article.

RESULTS

89 articles and conference proceedings were selected for inclusion in the review. Four categories of literature emerged: 1) studies that situate Wikipedia as a health information resource; 2) investigations into the quality of Wikipedia, 3) explorations of the utility of Wikipedia in education, and 4) studies that demonstrate the utility of Wikipedia in research.

CONCLUSION

The literature positions Wikipedia as a prominent health information resource in various contexts for the public, patients, students, and practitioners seeking health information online. Wikipedia's health content is accessed frequently, and its pages regularly rank highly in Google search results. While Wikipedia itself is well into its second decade, the academic discourse around Wikipedia within the context of health is still young and the academic literature is limited when attempts are made to understand Wikipedia as a health information resource. Possibilities for future research will be discussed.

Wikipedia: A Medical Student Educational Project to Edit Wikipedia in Preparation for Practicing Evidence-Based Pain Medicine

OBJECTIVE

Wikipedia is commonly used to acquire information about various medical conditions such as chronic pain. Ideally, better online pain management content could reduce the burden of opioid use disorders. Our goal was to improve the quality of the content available on Wikipedia to make it more accurate and applicable to medical students and the general public while training medical students to practice evidence-based medicine and critically assess their sources of information.

METHODS

An elective class in Neuroscience, Pain, and Opioids composed of 10 medical students met biweekly to discuss landmark and practice-changing research articles in the fields of acute pain, chronic pain, and opioid management. The professor chose Wikipedia articles relevant to this course. Three independent viewers analyzed the quality of citations, anecdotal medical content, and content value for both patients and medical professionals. As part of their coursework, students then edited the Wikipedia articles.

RESULTS

Although some of the Wikipedia pain topic content (6.7% ± 2.0) was anecdotal, financially biased, or inconsistent with Western Medical Practice content, overall articles included primarily high-quality citations (85.6% ± 3.1). On a 0-5 Likert scale, students felt content would be moderately helpful for both medical students/professionals (3.4 ± 0.2) and laypersons (3.5 ± 0.2). Editing and adding citations was feasible, but novel material was often reverted.

CONCLUSION

A significant amount of pain medicine content was relevant and amenable to student editing. Therefore, future use of this tactic could provide a unique opportunity to integrate evidence-based medicine into the medical curriculum and have a direct impact on the widely available medical information. Future refinement in the editorial process may also further improve online information.