Wikipedia isn’t good enough for anybody except nurses?

The verdict is in.  The quality of health information in Wikipedia is inadequate as a sole source for pharmacists [1], medical students [2], dentists [3], and patients [4].  However, it is good enough for use by nursing students [5]…well, sort of.

Determinations about adequacy are based on studies which evaluated the freely editable, online encyclopedia based on characteristics such as reliability, scope, and accuracy.  A clear consensus has emerged from that body of literature collectively rendering a decision that Wikipedia is not a suitable resource for high level consultation or citation.  The use (and citation in particular) of Wikipedia by healthcare students and professionals seems to irk practitioners and educators moreso when there are high quality alternatives, suggesting the perception that citing Wikipedia in those cases simply reflects a lack of awareness and laziness.  To be fair, Wikipedia founder Jimmy Wales has been unwavering in his stance that no encyclopedia should be used as a reference source for college level work or above. 

All of this leads to the most recent paper on this topic in Nurse Education Today [5].  It, too, is an assessment of health-related entries in Wikipedia.  However, it is notable for two reasons.  First, it differs from almost all the other articles in that it uses a methodology driven by compiling and analyzing the citations from Wikipedia entries rather than the content itself.  Second, the difference in language between the abstract and conclusion is fascinating.  The abstract closes with:

The quality of the evidence taken obtained from the 2500 plus references from over 50 Wikipedia pages was of sufficiently sound quality to suggest that, for health related entries, Wikipedia is appropriate for use by nursing students

Whereas the conclusion of the article is:

Whilst it is acknowledged that Wikipedia citations should be treated with some caution, the results of this modest study suggest that Wikipedia does have a role to play as a source of health related evidence for use by nursing students.

While this type of journal article ‘abstract-text dissonance’ is not completely rare [6,7] it is exacerbated here due to this article’s findings conflicting with every other study on the topic – at least based the abstract.  It also magnifies the problems that can occur when people draw conclusions based on only reading an abstract.  This has long been an issue for busy clinicians desperately trying to stay current.  However, today biomedical journal abstracts are easily accessible by anyone via PubMed (but the full-text usually remains shrouded by subscription access).  Dissemination of these abstracts is even more rapid, sometimes occurring real-time through tools like Twitter, Facebook, and email.  As healthcare professionals, we need to be careful not to fall into the trap of taking a shortcut and assuming skimming an abstract will allow us to critically evaluate a study.  The onus is also on us to help educate aspiring e-patients avoid these same missteps.

Overall, it’s quite possible that the contribution made by the Haigh article may be more significant as a teaching tool than as a piece of the research puzzle regarding the quality of Wikipedia.


P.S.  If you have gotten this far, it means you have not fallen prey to a similar phenomena with blog post titles – kudos!

[1] Clauson KA, Polen HH, Boulos MN, Dzenowagis JH. Scope, completeness, and accuracy of drug information in Wikipedia. Ann Pharmacother. 2008 Dec;42(12):1814-21.
[2] Pender MP, Lasserre KE, Del Mar C, Kruesi L, Anuradha S. Is Wikipedia unsuitable as a clinical information resource for medical students? Med Teach. 2009 Dec;31(12):1095-6.
[3] Stillman-Lowe C. Wikipedia comes second. Br Dent J. 2008 Nov 22;205(10):525.
[4] Leithner A, Maurer-Ertl W, Glehr M, Friesenbichler J, Leithner K, Windhager R. Wikipedia and osteosarcoma: a trustworthy patients’ information? J Am Med Inform Assoc. 2010 Jul-Aug;17(4):373-4.
[5] Haigh CA. Wikipedia as an evidence source for nursing and healthcare students. Nurse Educ Today. 2010 Jun 19. [Epub ahead of print]
[6] Ward LG, Kendrach MG, Price SO. Accuracy of abstracts for original research articles in pharmacy journals. Ann Pharmacother. 2004 Jul-Aug;38(7-8):1173-7.
[7] Pitkin RM, Branagan MA, Burmeister LF. Accuracy of data in abstracts of published research articles. JAMA. 1999 Mar 24-31;281(12):1110-1.