Important safety additions may be lacking, researchers say
By Alan Mozes
WEDNESDAY, June 25, 2014 (HealthDay News) -- Many Wikipedia entries about prescription medications aren't up-to-date and accurate, a new study contends.
Wikipedia, an online, self-described "free-content encyclopedia," depends on the continuous collaborative input of unpaid volunteers, who can add new information or make edits to existing posts on a 24/7 basis.
But investigators said they found that when it comes to providing reliable information on drugs, the editing isn't always timely, particularly with respect to lesser known medications.
"And the problem is that patients may not have the background or training to assess what's good medical information and what's not," said study co-author John Seeger. He's an assistant professor in the division of pharmacoepidemiology and pharmacoeconomics at Harvard Medical School and Brigham and Women's Hospital in Boston.
"So if the information they find online isn't up-to-date, we have a real challenge," he said.
Seeger and his colleagues wrote a perspective piece on the subject in the June 26 issue of the New England Journal of Medicine.
The researchers noted that by some estimates, more than half of all Americans in 2013 went sifting for some type of medical information online.
The most popular means for doing so involved using search portals such as Google, as well as going directly to websites like WebMD and Wikipedia.
With roughly 500 million unique visitors searching Wikipedia every month (according to Wikipedia), it may well be the most popular health information website in the world.
Seeger's team said that searching Wikipedia for medical information has inherent problems. While a few Wikipedia entries are locked in order to prevent "online vandalism," most postings are not. In fact, most postings are accessible to nearly anyone, with many Wikipedia contributors functioning anonymously.
Approximately 80,000 active contributors make updates -- with no fixed time frame -- to roughly 30 million Wikipedia entries spanning 285 languages, according to Wikipedia's own entry about itself. The risk is that at any point in time, the medical information the site contains could either be inaccurate or out-of-date.
To address this concern, Seeger and his associates decided to explore to what degree Wikipedia entries reflected U.S. Food and Drug Administration drug-safety communications in an accurate and timely manner.
Specifically, the team looked at 22 drug safety warnings regarding prescription medications that the FDA issued over a two-year period between 2011 and 2012. The warnings covered drugs used to treat conditions such as high blood pressure, hepatitis C and leukemia.
Starting 60 days prior to each FDA warning and continuing until 60 days afterward, the study authors assessed the informational accuracy of Wikipedia entries related to each drug.
There were more than 13 million Google searches and 5 million Wikipedia page views for these drugs during the study period. During the week after the safety warnings, there was an 82 percent average increase in the number of Google searches, and a 175 percent increase in the number of page views for the drugs included in the warnings, according to the study.
Overall, 41 percent of the relevant Wikipedia entries had been updated within two weeks following an FDA safety warning. Nearly a quarter (23 percent) took more than two weeks to update, while more than a third (36 percent) still didn't reference the FDA warning a year after it was issued, the study authors said.
After digging deeper, the team found that not all drugs were treated equally on Wikipedia. The most common drugs -- meaning those used to treat more than 1 million American patients -- were much more likely to be updated in that time frame.
For example, while 58 percent of entries concerning popular medications were properly updated with two weeks, that number fell to just 20 percent regarding less commonly used drugs, the study authors said.
Despite the findings, Seeger said his team believes that -- in the Internet age -- most patients actually do hear about FDA drug warnings in a timely fashion.
He noted that "this is evidenced by the sharp increase in online activity around these products just after the communications."
Still, he advised patients to seek out multiple sources when looking online. That practice may lower the risk of consumers being misinformed or missing something altogether. And, he advised that patients discuss what they learn with their doctor.
Dr. Amin Azzam, an associate clinical professor in the department of psychiatry at the University of California, San Francisco (UCSF), said the study findings "confirm what we all intuitively surmise."
"Consequently," he added, "if health professionals want to be making positive impacts on the health of the public, then we would all be making larger differences by actively contributing to improving the accuracy of that information."
And to that end, UCSF has instituted a for-credit elective course that enlists medical students to review Wikipedia's medical entries and update them for accuracy. Azzam said that this past spring alone, more than 17,000 corrections and improvements were made by UCSF students.
For more information on the quality of online health information, visit the U.S. National Institute on Aging.
SOURCES: John D. Seeger, Pharm.D., Dr.P.H., assistant professor of medicine, division of pharmacoepidemiology and pharmacoeconomics, Harvard Medical School and Brigham and Women's Hospital, Boston; Amin Azzam, M.D., associate clinical professor, department of psychiatry, University of California, San Francisco; June 26, 2014, New England Journal of Medicine
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