Evaluating the effectiveness of a wiki internet site for medical topics.

To evaluate the iterative process of a collaborative public database (a Wiki) as a reference for information on hand illnesses we tested the null hypothesis that the number and type of edits are comparable for web pages covering different topics. The history of 4 hand surgery related web pages on the English language Wikipedia (Trigger finger, Complex Regional Pain Syndrome (CRPS), Ganglion cyst, and de Quervain Syndrome) were analyzed from inception to July 2011. Each edit was classified as one of six types: an addition is an edit that adds material; a deletion removes material; a modification is a combination of addition and deletion, or any rearrangement; a minor edit is a correction of spelling, grammar, or formatting errors; vandalism is any edit that is intended to harm the page; a vandalism fixed is an edit that addresses harm. The edits were also rated as possibly controversial or not (defined as edits that present information with a clear bias or do not list reliable sources). For both the Ganglion cyst and Trigger Finger pages, readability was measured at 1 year increments. Our primary null hypothesis was that the proportion of constructive edits (addition, deletion or modification) did not differ between the 4 web pages. The percentage of constructive edits (additions, deletions, and modifications) was significantly different for each page: 121/234 (52 %) for de Quervain, 258/448 (58 %) for CRPS, 103/156 (66 %) for Trigger Finger, and 160/389 (41 %) for Ganglion cyst. The percentage of edits related to vandalism was also significantly different: 28/234 (12 %) for de Quervain, 33/156 (7 %) for CRPS, 21/156 (14 %) for Trigger Finger, and 135/389 (35 %) for Ganglion cyst. Vandalism was quickly identified and addressed. Twenty-six percent of all edits were classified as potentially controversial. Forty percent of possibly controversial edits were deletions. The topic of a Wiki web page for information on hand illness influences the degree to which edits are constructive. A Wiki for hand illness could be a very useful resource for patients with hand illness, but it requires careful moderation because only about half the edits are constructive. Cohort Study.