Medical journals and Wikipedia: a global health matter

Approximately 7000 stillbirths occur daily worldwide, and the vast majority of them (98%) take place in low-income and middle-income countries (LMICs).1Lawn JE Blencowe H Waiswa P et al.for The Lancet Ending Preventable Stillbirths Series study groupwith The Lancet Stillbirth Epidemiology investigator groupStillbirths: rates, risk factors, and acceleration towards 2030.Lancet. 2016; 387: 587-603Summary Full Text Full Text PDF PubMed Scopus (856) Google Scholar Despite this enormous burden, progress to reduce the death toll is slow and insufficient.2Blencowe H Cousens S Jassir FB et al.for The Lancet Stillbirth Epidemiology Investigator GroupNational, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis.Lancet Glob Health. 2016; 4: e98-108Summary Full Text Full Text PDF PubMed Scopus (533) Google Scholar WHO released its Making every baby count3WHOMaking every baby count. World Health Organization, Geneva2016http://apps.who.int/iris/bitstream/10665/249523/1/9789241511223-eng.pdf?ua=1Google Scholar guide in 2016, which includes strategies aimed at addressing the challenge of stillbirths. Given the flurry of activity and attention on stillbirths from the Lancet Stillbirth Epidemiology investigator group and WHO, we expect that the wealth of information about stillbirths that is generated will filter down in a timely manner to where it is needed most: the general public. As is often the case for Wikipedians, we found that the stillbirth page4WikipediaStillbirth.https://en.wikipedia.org/w/index.php?title=Stillbirth&oldid=730929233Google Scholar on the English language Wikipedia was missing important information—eg, the major causes of stillbirth (malaria and syphilis) were not mentioned, and details on epidemiological aspects were scarce.1Lawn JE Blencowe H Waiswa P et al.for The Lancet Ending Preventable Stillbirths Series study groupwith The Lancet Stillbirth Epidemiology investigator groupStillbirths: rates, risk factors, and acceleration towards 2030.Lancet. 2016; 387: 587-603Summary Full Text Full Text PDF PubMed Scopus (856) Google Scholar Unsurprisingly, the Wikipedia pages on stillbirth in about 20 other languages were less detailed than the English language version. This worried us because not only is Wikipedia the world's most used source of health information online, but it is also one of the most widely used sources by medical students, doctors, and other health-care providers.5Heilman JM West AG Wikipedia and medicine: quantifying readership, editors, and the significance of natural language.J Med Internet Res. 2015; 17: e62Crossref PubMed Scopus (82) Google Scholar, 6Laurent MR Vickers TJ Seeking health information online: does Wikipedia matter?.J Am Med Inform Assoc. 2009; 16: 471-479Crossref PubMed Scopus (216) Google Scholar It is not difficult to imagine that the first online port of call for a woman, her partner, or her family following a stillbirth would be Wikipedia. Furthermore, many policy makers and other key stakeholders also read Wikipedia. Wikipedia is particularly relevant for LMICs, where internet access is often slow and expensive. We have been involved in developing mobile apps for offline use which contain all of Wikipedia's anatomy, pharmacology, medicine, and sanitation content in an attempt to address this issue. We have seen tens of thousands of downloads of the apps, with the majority from LMICs.7Google PlayMedical Wikipedia (Offline).https://play.google.com/store/apps/details?id=org.kiwix.kiwixcustomwikimedGoogle Scholar There is clearly a huge unmet need for health-related information, to the extent that some mobile network operators in LMICs do not charge for data costs when users are accessing Wikipedia (Wikipedia Zero8Wikimedia FoundationWikipedia zero.https://wikimediafoundation.org/wiki/Wikipedia_ZeroGoogle Scholar). However, this generous practice has been cautioned against because some people feel it infringes upon internet neutrality (the principle that internet providers should treat all data equally). In addition to the stillbirth article there are many others on Wikipedia associated with global health that require further attention. Wikipedia has the potential of being bolstered as a key tool for global public health promotion.9Heilman JM Kemmann E Bonert M et al.Wikipedia: a key tool for global public health promotion.J Med Internet Res. 2011; 13: e14Crossref PubMed Scopus (155) Google Scholar However, Wikipedia struggles to attract medical doctors or other trained health professionals as editors. We echo previous authors in inviting the medical community—and in particular medical journals—to incentivise Wikipedia editing with the goal of bringing about increased access to reliable, understandable, and up-to-date health information9Heilman JM Kemmann E Bonert M et al.Wikipedia: a key tool for global public health promotion.J Med Internet Res. 2011; 13: e14Crossref PubMed Scopus (155) Google Scholar in multiple languages. PLoS Computational Biology, for example, encourages its authors to post topics on Wikipedia.10Wodak SJ Mietchen D Collings AM Russell RB Bourne PE Topic pages: PLoS computational biology meets Wikipedia.PLoS Comput Biol. 2012; 8: e1002446Crossref PubMed Scopus (15) Google Scholar Promoting inclusive and equitable learning opportunities for all speaks to the aspirations of the Sustainable Development Goals. We suggest that medical journals actively promote and incentivise Wikipedia editing by the health-care community so that the most commonly used source of online health information is as reliable as possible. MRL reports a Research Foundation Flanders PhD Fellowship grant, and personal fees from Flanders' Agricultural Marketing Board, Alexion Pharmaceuticals, and Novartis. All authors are members of Wikimedia projects including Wikipedia and Wikiversity.

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