Type any drug name into Google and the odds are good that a link to Wikipedia will be among the top results. According to Alexa Wikipedia has consistently been in the top-20 most visited sites on the Internet since 2006. And with 75% of American internet users turning to the web for health information, millions of e-patients will inevitably end up on a Wikipedia drug page.
But how accessible is the Wikipedia drug content for patients, given that most American adults read somewhere between a 4th and 8th grade level (National Center for Educational Statistics, 2003)? Devin Pelcher, a Pharm.D. candidate at Nova Southeastern University, addressed this in a recent talk at Medicine 2.0, entitled “Readability of the Top 50 Prescribed Drugs in Wikipedia.”
Bachelors Degree Required?
Pelcher analyzed the Wikipedia pages for the 50 most frequently prescribed drugs in the U.S., judging the relative reading difficulty of each and measuring these results against the average American comprehension level.
While the Department of Health and Human Services, using the Flesch-Kincaid Grade Level (FKGL) assessment standards, classifies anything at a reading level above grade 9 as “difficult,” Pelcher found the mean grade level of the 50 sampled drugs was 15.5–well above a high school education.
Health Information Readability Also Poor
Pelcher also used an additional readability test in order to measure certain criteria the FKGL neglects to address. This system, called the Health Information Readability Analyzer (HIReA) looks at what makes a passage easy or difficult to read. It scores text on semantic, lexical, syntactic, cohesive, and stylistic scales running from 1.0 (very easy to read) to -1.0 (very difficult). Again, most of the most commonly prescribed drug’s Wikipedia pages were found to be well outside the reading level of most Americans.
Are Patients the Intended Audience?
While its clear that for the average reader the Wikipedia article on a given drug may be largely inscrutable in terms of basic information, its difficult to determine what the broader implications are. Wikipedia articles are “crowd-sourced” from many different people and not from any one “official” sources. And while millions of patients may end up on Wikipedia pages, the goal of the drug articles is not patient education.
Simpler Is Not Always Better
Furthermore, a close look at specific cases reveals that simpler may not be better. The page for lansoprozole, a proton-pump inhibitor found to be one of the most difficult to read, provides detailed information about interactions with other drugs, side effects, and a comprehensive list of brand names the drug is sold under. The “easiest” article, for the blood pressure medication dyazide, is a mere two lines long and omits much information crucial to an e-patient looking for an informed opinion.
Will e-Patients Write The Fix?
Pelcher’s research is a fascinating look at how language can be a barrier even in a world of democratized information, but in focusing on the inaccessibility of “difficult” pages, it may neglect that these very pages might prove to be the most comprehensive.
Wikipedia’s greatest strength is that articles are living documents, shaping themselves to meet the needs of the community. With Pelcher’s findings in hand, perhaps readability and vital details can co-exist. But it will take a knowledgeable writer to craft the solution. Perhaps a “What Every Patient Needs to Know” section or “Links for Patient Education” addition should become standard elements on Wikipedia drug pages.
If you decide to add that Wikipedia content for a drug you are familiar with, let us know.
The original post of this article mistakenly referred to Pelcher as holding the title of Professor and mistakenly credited Pelcher with the creation of the HIReA. We regret the errors.