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Anthropologist discusses Wikipedia’s implications for health information

pid_24010Many of us turn to Wikipedia for quick answers to medical questions: What's an amniocentesis, or what's the difference between autism and Asperger's?

Stanford University Press recently published Common Knowledge: An Ethnography of Wikipedia by anthropologist Dariusz Jemielniak, PhD, who studies managerial culture and has long been active in the Wikipedia community. As a fellow anthropologist, I was curious about his perspective and I wondered how medical knowledge is different in the age of Wikipedia.

When I interviewed the personable Jemielniak, he offered some insightful answers to my questions:

How empowering is it for people to have knowledge at their fingertips, on the internet? How is this different from finding information in reference books?

The basic difference is that on Wikipedia it's usually put in lay terms. It's readable, it's comprehensible... With information, people have the perception that they know something about their condition. I'm not sure if they're right - obviously, knowledge is not just one tidbit of information. On Wikipedia you can't learn the relations between all kinds of knowledge - you need to have a medical degree to really understand that - but patients feel they are operating in a situation of informational deficit... Information on Wikipedia probably makes people have this feeling of empowerment, though I'm not really certain whether in all cases this contributes to their overall health. Sometimes they'll misunderstand, misconstrue, or misinterpret because they don't have the systematic knowledge.

In your ethnography, you discuss how the decentralized power in Wikipedia's management changes the knowledge structure away from institutions and certified expertise. Without an authority structure, how do you determine who's an expert?

On Wikipedia, the point is you don't have to know if someone is an expert... Trust is transferred from formal expertise to procedure. If you follow procedure to the letter, by default you're producing proper knowledge. If you use correct sources, if you cite all the sources that you found, if you're doing justice to whatever you read, by default on Wikipedia it's assumed that you're just as good as an expert.

What about biases? In the book you say biases usually get toned down through copious editing.

I think on Wikipedia there's a strong scientific bias of a sort. If a community of people are contradicting what is considered to be the scientific knowledge, quite likely those activist groups will be ignored. If there is consensus in the academic world, this is what will prevail in Wikipedia.

You say Wikipedia is never "published" but in an ongoing process of creation. Is this better for updates about new research?

By all means, I think obviously. Thirty seconds after the new pope was elected this new information was on Wikipedia. On Britannica you'd probably have to wait one year. Traditional media takes a year to go through the publishing process. The continuous release mode that Wikipedia operates on allows for instantaneous improvements and corrections, which is wonderful, it's really great.

The pope is one thing, but research? How often are pages on research updated?

One of the problems is that research on Wikipedia is accurate at time of writing the article, but gets obsolete if people do not update. Articles that are most updated are ones people care most about… The real question is how many people actually read the incorrect information? Chances are, if there's a big proportion of people who care about a topic... the more likely it is to be updated.

Do you have a sense of who ends up writing most medical pieces?

We don't track professional careers, and credentials aren't really verified. It all relies on a crowd dispersed system of verification. We know that in practice... the articles on medical issues are not significantly worse than professionally generated sources.

Would most doctors want to contribute? You mentioned that professional benefits of open-source publishing are not so much the case for Wikipedia.

This is a very good point. Obviously among open sources there is a very wide divide between professionally driven or not professionally driven, and Wikipedia is not professionally driven, which is a result of its design. On Wikipedia you cannot really claim authorship of an article... anyone can modify what you have contributed... For professionals, the usefulness to your career is really low.

Far from dismissing Wikipedia in academia, Jemielniak went on in our talk to to refer Wikipedia as "a professor's best friend," and he recommends requiring students to write Wikipedia articles as part of final evaluations. He says it's a great exercise in finding and citing sources and synthesizing information, and plagiarisms are discovered instantaneously. It's also something that "gives back" to society. Moreover, Jemielniak says, "It's fun."

Previously: Is medical information on Wikipedia a public health problem?, What happens when pharma companies edit Wikipedia? and The importance of curation and communities when crowd-sourcing clinical questions
Photo by Stanford University Press

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