Edit Wars in Medical Wikipedia


Wikipedia uses the "wisdom of crowds" concept which postulates that scores of non experts do a better job writing an article than a single expert. It is probably true. Most experts are busy people and do not have time to write, edit and protect from vandals more than one million articles.

Any social media website (and Wikipedia is one of them) has a relatively small number of devoted users who keep the project going and do the bulk of contributions. For Wikipedia, these users are about 500 and they are called administrators. They are in charge of keeping the encyclopedia what is supposed to be -- an encyclopedia -- and not a self-promotion tool.

What happens when administrators disagree with regular contributors? Edit war. There are revisions and versions changed back and forth until sometimes users are even locked-out of "Wikipedia land."

How is this related to medicine?

According to a recent Medscape editorial, "Wikipedia is the future of medicine, and it's good." There is a Clinical Medicine project on Wikipedia which one day may become the most comprehensive medical textbook. Dean Guistini of UBC Academic Search - Google Scholar Blog also started a wiki at University of British Columbia.

I was reading the Wikipedia article about Polycythemia and since I had an illustrative typical case of secondary polycythemia on ClinicalCases.org, I decided to add it in the "External Links" section at the bottom of the page. That was a well-intentioned and innocent addition, I thought. One of the administrators, JFW, disagreed, called my little effort "advertisement" and deleted the link. We discussed it at the talk page and since I tremendously respect people who take care of the world's largest encyclopedia (for free), I just moved on.

Some people are tougher to deal with though. One hair-transplant surgeon is having fierce fights on his talk page regarding his contributions to Wikipedia which are dubbed by some administrators "commercial" and "promotional." If you have 4-5 minutes, I would recommend reading the whole page to get a feel of what an edit war looks like:

Welcome to Wikipedia. We invite everyone to contribute constructively to our encyclopedia. Take a look at the welcome page if you would like to learn more about contributing. However, unconstructive edits, such as your changes to the Raymond V. Damadian page, are considered vandalism, and if you continue in this manner you may be blocked from editing without further warning. Please stop, and consider improving rather than damaging the hard work of others. Thank you. Talk: Administrator.

Plastic surgeon:

Unconstructive edits, vandalism? nonsense. The page on Raymon V Damadian contains numerous factual errors and much evident confusion about the technology which I was just attempting to correct. I'm and MD PhD who was there when all this stuff was going on. Even published papers in the field and know many of the princopals. See my comments at. Talk:Raymond V. Damadian.
There is (was?) also a Wikipedia page about one of the medical bloggers, Summer Sethi, which was labeled for deletion as a "vanity page":
Strong delete: Wikipedia is not a resume or publication list. There are perhaps thousands of other medical researchers with similar publications, nothing shows why this person is any more notable than them. --Ragib 23:59, 2 September 2006 (UTC)
The Full-body scan article is another example of a disagreement between contributors and administrators.

A fine line

Administrators like JFW and Samir are the backbone of the Clinical Medicine project in Wikipedia. Their job is to keep the vandals and self-promotion types out of the encyclopedia. If you make contributing too difficult though, "regular guys" may just go somewhere else.

Wikis in Plain English References: Who Edits Wikipedia? Philipp Lenssen. Raw Thought: Who Writes Wikipedia? Aaron Swartz. Wikipedia:Lamest edit wars, via Yahoo picks. Make the Largest Encyclopedia in the World Better. I already did (I hope) Related: Why Slate is Wrong About “the myth of Web 2.0 democracy” DavidRothman. net, 02/2008. Wikipedia: A Key Tool for Global Public Health Promotion (review article)
MT @giustini: How does Wikipedia treat health and medicine topics, see my overview of the literature http://t.co/Rzkd2dEM47


  1. Good post, but you haven't written about the most recent debate over breats implants. As an admin, I also had to take part in this medicine-related editwar. Finally, we had to protect the page from further editing.

    Just a comment on your contributing to that external section. You have a great blog, but it is a blog. According to Wikipedia:What is not Wikipedia page, we can't show blogs in the external links section of the articles. That's why it has been removed.

    By the way, we need plenty of people like you to help us improving the medicine-related articles.

    Hope to see you soon there.

  2. There is also a problem with organizational vanity posting and wikiturfing (which can just as easily constitute an ad). When I tried to introduce and defend unflattering information about Kaiser Permanente, I found myself up against multiple Kaiser employees (you can still see the IP address of one if you look on the Changes page). On Wikipedia, ganging up wins: they have policies that prevent one person from being able to defend unpopular (in the sense the "gang" is against it) changes. Wikipedia can be an incredible time-suck, and several other people who wanted to tone down Kaiser's promotional tone were just worn down . I've left off editing for the time-being, too, since my user-account gets tracked: instead I look for opportunities to train other people how to do it, and I let the know that the Kaiser wikiturfing is egregious.

    There really isn't anything to prevent a corporation from turning a Wikipedia article into a brand vehicle. However, I was disappointed in how unresponsive the high priests of Wikipedia were to this issue. Their lack of intervention meant that Kaiser essentially got away with it.

    Several people have tried to put this issue in the same category as the correctness of medical information - for which they fairly point out that doctors have more credibility and thus almost a moral authority in controlling the article. However, doctors have no superior authority in discussing Kaiser as a business organization. The same principles about discouraging business promotion should apply to Kaiser as it would to any other business.

    Ps. Admins abused protection for the Kaiser article to prevent me from editing anonymously, therefore enabling Kaiser employees to hone in on my edits. At one point they also tricked an admin into protecting the page after purging my edits, through to the admin's credit they saw this and reversed the protection quickly.

    Also, there is no ban on linking to blogs. Linking to blogs is discouraged in Wikipedia policy because it tends to self-promotion. However, when the blog is by a recognized authority or adds substantially to the understanding of the topic (including various angles of "bias", as long as that bias is labeled), then they may be "meaningful and relevant". In other words, admins should be using their discretion and taking it to the talk page instead of telling people that blogs aren't allowed.

  3. You misattributed a comment. You state the warning notice beginning "Welcome to Wikipedia. We invite everyone to contribute constructively to our encyclopedia..." was left by an administrator. Looking at the history of that discussion page, it was left by an unlogged-in IP address. It was probably the user with whom the doctor was having the initial argument. Most of the admins on that user discussion page are the ones asking people to calm down.

  4. The admin was correct in removing your addition to the Polycythemia article. Although your blog entry contained much useful information it was not the kind of addition that is allowed to the External links section. We are VERY picky about what is allowed in External links for obvious reasons. Remember this is an encyclopedia. Would you expect an Encyclopedia Britannica article on a medical topic to reference a blog? Probably not. If you are really interested in improving the article, don't worry about the External links section, try working on the text of the article itself. In a year or two Wikipedia probably won't even allow External links anyway (judging by how much spam they attract).