He and a team of researchers evaluated Google searches and page views on the free, online, user-updated encyclopedia Wikipedia. During the 60 days before and 60 days after an FDA safety warning had been announced, they looked at the available pages for 22 prescription drugs, covering a range of conditions from hypertension, to chronic myelogenous leukemia and hepatitis C.
On average, there was an 82% increase in Google searches for the drugs during the week following an FDA announcement and a 175% increase in Wikipedia page views for the drugs on the day of the announcement, as compared with baseline trends. Altogether, the selected drugs triggered 13 million searches on Google and 5 million Wikipedia page views during the study period.
Among the pages viewed, 41% were updated within 2 weeks after an FDA warning was issued. Pages for drugs to treat conditions affecting more than 1 million U.S. patients were likely to be updated more quickly, with 58% updated within 2 weeks. For less prevalent conditions, only 20% were updated within two weeks. Overall, 23% of Wikipedia pages were updated within an average of 42 days, while about 36% remained unchanged more than a year later.
For example, despite an FDA-issued black-box warning on the cancer drug brentuximab vedotin in January 2012, two-years later there was still no mention of the warning on Wikipedia, which the study authors said substantiates concerns raised by previous studies over the reliability of online drug information. At the same time, there was a 50% increase in Google searches for the drug the week following the announcement, and a 141% increase in views of the drug's Wikipedia page.
“I wouldn't say there is inaccuracy across the board, but there is also not accuracy across the board,” Seeger said.
Wikipedia is an open-edit reference model, which means anyone anywhere in the world can change an entry. Other recent studies also have looked at its content, including one published in May in the Journal of the American Osteopathic Association, which found that Wikipedia articles on the 10 most costly medical conditions contained many errors. That study's authors urged caution, not just by patients, but also by physicians and healthcare professionals who turn to the site to answer patient care questions.
Though the NEJM study did not investigate who actually makes the updates to Wikipedia's drug information content, the authors say there are opportunities for public health officials to actively participate in the “curation of medical information.”
They noted, for example, a project at the University of California, San Francisco called Wiki Project Med, in which enrolled medical students receive course credit for reviewing and editing Wikimedia articles, adding citations to support unreferenced text and providing a form of peer review.
“Public health officials have historically focused on printed drug labels and “Dear Health Care Provider” letters from the FDA,” the study concluded. “But new technologies offer the opportunity to reach patients and physicians more efficiently and effectively.”
Follow Sabriya Rice on Twitter: @MHSRice