Friday, September 19, 2008

Wikipedia and Palliative Medicine: A Call to Arms

The internet is the go-to place for patients and families to research health information, but as many have warned the information should be vetted and probably 'discussed with your physician.' Publishing online simplifies the sharing and redistribution of information, which brings the obvious downside of finding useless information and mis-information.

In palliative medicine you see lots of efforts at trying to educate individuals and groups at the local, regional, and national level about the strengths of palliative care and how our field approaches such complex situations. What if for 3 months we got together as a field to ensure searchable content from a high-utilization source like Wikipedia was factual, easy to understand, and accurately reflected the themes, tools, and issues related to our field?

I have occasionally dabbled in Wikipedia editing but have not had the time to get past only a few minor edits on some palliative care related pages. Editing the information is not too hard if you know how to use a computer. Some of the formatting guidelines are a little tricky to learn, but for anyone who is dedicated, I bet it is doable.

AAHPM recently had a page started and it has a lot of good information written by Crazyerinsync, whoever that is. But more could be written, for example I added the locations of several of the Annual Assembly locations for historic reference.

Here are some good examples of palliative care related articles on Pallimed:

Opioid: There is a lot of information on this page that I have not been able to find easily in journals or books. Things I have confirmed from the Wikipedia page from other sources have been pretty accurate. But there is still room for clean-up and refined editing, for example:

In palliative care opioids are always used in combination with adjuvant analgesics...
A few good editors could really see this is not wholly accurate. It should read 'are usually' or 'are commonly.'

Generally most of the specific medicine pages are pretty well detailed, but could you some fact checking and clearer editing. Morphine is one of the better ones and it was a recent 'featured article on the Medicine Portal, but hydromorphone is long and rambling.

Some of the less stellar examples inc

Palliative Care: The page is all over the place and has no coherence. Actually 'hospice' redirects to 'palliative care' which is unusual in that many people have some understanding of hospice but are not quite familiar with the term 'palliative care.' There is enough nuanced differences to the general reader of Wikipedia, that I believe 'hospice' and palliative care' should be separate pages.

Terminal Sedation: Not very detailed, especially about the ethical arguments for and against. Probably should be renamed 'palliative sedation.'

Do not resuscitate: Sorely lacking accurate and supported data regarding survival after CPR. Wikipedia editors have even tagged it as having questionale neutrality. The 'CPR' article is actually written pretty well. It would be nice to see the DNR article with that much information.

Children's Hospice
: Mostly just a bunch of lists.

Advance Directives: Nothing more then a pamphlet of info. Simply descriptive.

Defibrillation: No information regarding ethics of deactivation.

Anorexia and Cachexia: Hungry for more material.

: Did anyone see this coming...not much there.

etc., etc.

So do any readers have any ideas of how to rally a project of storming Wikipedia to create a whole lot of new content and reorganize and edit some of the current palliative care related material? Even if it just started with identifying articles to be worked on as a community that would be a start. If there is enough interest we could start a WikiProject collaboration.

Would it be helpful if Pallimed highlighted 2-3 articles per month to be worked on?
Would it be helpful to start another blog for those interested in a project like this?

Help brainstorm this out...even if you think this is a dumb idea. Say so!

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