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BMJ Open. 2020 Feb 20;10(2):e033655. doi: 10.1136/bmjopen-2019-033655.

Adding evidence of the effects of treatments into relevant Wikipedia pages: a randomised trial.

Author information

1
Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK clive.adams@nottingham.ac.uk.
2
Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK.
3
Health Sciences, Research, John Wiley Ltd, Chichester, UK.
4
Department of Critical Care, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK.
5
Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
6
General Medicine, Nottingham University Hospitals Healthcare NHS Trust, Nottingham, Nottinghamshire, UK.
7
Orthopaedics, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK.
8
Emergency Department, Gold Coast University Hospitals, Gold Coast, Queensland, Australia.
9
Faculty Management and Business Science, University of Aalen, Aalen, Germany.
10
The Acute Stroke Unit - Huggett Suite, Royal Lancaster Infirmary, Lancaster, UK.
11
Haematology, Gateshead Health NHS Foundation Trust, Gateshead, Gateshead, UK.
12
Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester, Leicester, UK.
13
Psychaitry, University of Melbourne, Melbourne, Victoria, Australia.
14
Department of Anaesthesia, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
15
Bristol Medical School, University of Bristol Faculty of Health Sciences, Bristol, Bristol, UK.
16
Fakultät Gesundheit, Sicherheit und Gesellschaft, Hochschule Furtwangen University, Furtwangen, Germany.
17
Community Recovery Psychiatry, North East London NHS Foundation Trust, London, UK.
18
Liaison Psychiatry, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
19
Wikimedia UK, Wikimedia Foundation, London, UK.
20
Acute Medicine, Lewisham and Greenwich NHS Trust, London, UK.
21
Accident and Emergency, Epsom and Saint Helier University Hospitals NHS Trust Epsom Hospital, Epsom, Surrey, UK.
22
Nottingham Ningbo GRADE Centre, Nottingham China Health Institute, The University of Nottingham Ningbo, Ningbo, China.
23
Division of Epidemiology and Public Health, School of Medicine, The University of Nottingham, Nottingham, UK.

Abstract

OBJECTIVES:

To investigate the effects of adding high-grade quantitative evidence of outcomes of treatments into relevant Wikipedia pages on further information-seeking behaviour by the use of routinely collected data.

SETTING:

Wikipedia, Cochrane summary pages and the Cochrane Library.

DESIGN:

Randomised trial.

PARTICIPANTS:

Wikipedia pages which were highly relevant to up-to-date Cochrane Schizophrenia systematic reviews that contained a Summary of Findings table.

INTERVENTIONS:

Eligible Wikipedia pages in the intervention group were seeded with tables of best evidence of the effects of care and hyperlinks to the source Cochrane review. Eligible Wikipedia pages in the control group were left unchanged.

MAIN OUTCOME MEASURES:

Routinely collected data on access to the full text and summary web page (after 12 months).

RESULTS:

We randomised 70 Wikipedia pages (100% follow-up). Six of the 35 Wikipedia pages in the intervention group had the tabular format deleted during the study but all pages continued to report the same data within the text. There was no evidence of effect on either of the coprimary outcomes: full-text access adjusted ratio of geometric means 1.30, 95% CI: 0.71 to 2.38; page views 1.14, 95% CI: 0.6 to 2.13. Results were similar for all other outcomes, with exception of Altmetric score for which there was some evidence of clear effect (1.36, 95% CI: 1.05 to 1.78).

CONCLUSIONS:

The pursuit of fair balance within Wikipedia healthcare pages is impressive and its reach unsurpassed. For every person who sought and clicked the reference on the 'intervention' Wikipedia page to seek more information (the primary outcome), many more are likely to have been informed by the page alone. Enriching Wikipedia content is, potentially, a powerful way to improve health literacy and it is possible to test the effects of seeding pages with evidence. This trial should be replicated, expanded and developed.

TRIAL REGISTRATION NUMBER:

IRCT2017070330407N2.

KEYWORDS:

medical education & training; schizophrenia & psychotic disorders; world wide web technology

Conflict of interest statement

Competing interests: All posts and edits were undertaken by the user Lena08041993, with any conflicts of interest and affiliation of this account with the Cochrane Schizophrenia Group clearly declared on the user’s talk page (https://en.wikipedia.org/wiki/User:Lena08041993). DT is affiliated to the Wikimedia Foundation.

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