At the recent Digipharm meeting (29-30 September) in London, I led a discussion about Wikipedia using live Twitter-voting (thanks to the adrenaline-pumped efforts of my colleague Dave Clarke, who made it work on the day!) to see what the audience of pharma marketers and communicators thought about this phenomenon, the largest collection of knowledge the world has ever seen.
Why is Wikipedia important?
It is highly visible in Google for almost all subjects from blast furnaces to the Rolling Stones. This is because (among other things)
- It is content-rich – lots of text about each subject, descriptive headings, images with labels.
- Its link popularity. It has lots of links to it and from it and what’s more the links are to and from related content.
- It is updated regularly. Google likes websites that get updated frequently.
The reason we all love Google is that it has a pretty good algorithm for putting the most relevant and up-to-date content as the top search results, so we trust Wikipedia because Google does.
What about the pharmaceutical industry?
But for our industry, Wikipedia is “The Elephant in the Room”. It is big, obvious, can’t be ignored, and yet we continue to behave as though it isn’t there. Why?
Perhaps our customers don’t use Wikipedia – can doctors and patients really trust it? Studies suggest they do – according to Manhattan’s latest research (Taking the Pulse and Cybercitizen 2010), 75% of physicians use it regularly and it is the top patient information resource in all countries surveyed.
Are they getting a good service from Wikipedia? Generally, no. A peer-reviewed study (2008) compared Wikipedia to Medscape Drug Reference (MDR), by looking for answers to 80 different questions covering eight categories of drug information, including adverse drug events, dosages, and mechanism of action. The results are shown in the graph – more than 80% success with MDR but only 40% for Wikipedia.
None of the answers from Wikipedia were determined factually inaccurate, while they found four inaccurate answers in MDR. But the researchers found 48 errors of omission in the Wikipedia entries, compared to 14 for MDR.
Why are drug pages on Wikipedia so incomplete?
The answer to this was provided by the Digipharm audience. We found that only 18% of them had updated a Wikipedia drug page, and almost 90% of the pharmaceutical companies present had no policy or strategy to keep Wikipedia up to date:
Why doesn’t the industry do something?
To get to the bottom of this question we asked a few more, and the answers we got were quite encouraging.
For example, the APBI Code says “reference material for prescription only medicines may be included on the Internet and be accessible by members of the public provided that they are not presented in such a way as to be promotional in nature”. What about Wikipedia itself? Here’s what the audience thought:
Wikipedia’s guidelines simply say you should “Avoid, or exercise great caution when editing articles related to your organisation, or its competitors, as well as projects and products they are involved with” and ensure you adhere to the guiding principles:
So, the industry code and Wikipedia guidance are consistent – content should be referenced, unbiased and non-promotional.
So why don’t we update pages about our drug products?
Maybe because there is still some uncertainty about accountability:
In fact Wikipedia has robust version controls and it can be clearly identified who has updated what. Provided you edit pages whilst logged-in, your edits can be attributed to you, but others are not. Furthermore, if a page is vandalized or inadvertently made inaccurate by another user, it is easy to revert to the accurate version in a couple of clicks, as a full page history is stored.
For an industry that is both information- and expertise-rich and comfortable with manuscripts written from an unbiased point of view with good citation, it seems an anomaly that we have not embraced this platform, a generally-considered-successful experiment in information democratization.
Perhaps, as one physician colleague said, it is because it is not “peer-reviewed”. But that depends who you consider your “peers” to be, doesn’t it?
This is a resource for everyone, so in this case everyone – doctors, patients, caregivers, the general public – are the peers. Wikipedia works as an encyclopaedia because generally people only update topics they are interested in and have some knowledge of. A patient’s contribution about a health condition, provided it is factual, is as valid as a physician’s.
Surely as an industry that values transparency, medical accuracy and high quality information standards we should be dealing with this dominant presence in the information landscape of all our customers?
In other words… can we at least acknowledge “The Elephant in the Room” and start talking about how to address it, in the interests of better patient care?