Are Traditional Peer-Reviewed Medical Articles Obsolete?

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We depend on peer-reviewed articles in print and online. But is this method obsolete? And is there a better way? Traditional medical articles are often outdated before publication. Consider HIV, SARs, avian flu -- even hormone replacement therapy. They're not comprehensive: For any topic, we have to read dozens of articles to be informed. And bias is always present, regardless of peer review.

Enter Wikipedia, the online encyclopedia created by Wales and Sanger in 2001.^[1] With just 1 full-time employee, Wikipedia has more Web readers than The New York Times. It already displays about 800,000 articles, growing by some 50,000 articles a month, in many languages.

Based on a radical new model of publishing, on Wikipedia nearly anyone with a Web connection can start or edit an article. Contributors must agree to write in neutral point of view (NPV). Opinion is fair game for deletion by the first Wikipedian who reads it -- typically within 30 seconds of publication.

There are simple, yet sophisticated quality controls. Copyrighted material plagiarized from other Web sites is automatically detected and deleted. But the best quality control is that any reader who finds an article with an error or omission can correct it on the spot. Amazing!

For readers, Wikipedia is a win. In traditional publishing, readers must wade through many articles on a subject, each written by a few experts, published at 1 moment in time. In Wikipedia you read 1 living article written by many, continually updated by many. Who needs 50 articles on avian flu when 1 will do? And Wikipedia content is often the best on the Web, which means the best anywhere.

For writers, Wikipedia offers neither authorship, recognition, reward, nor punishment. Articles aren't indexed, but with Google and Yahoo!, who needs it? The motivation for writing is love of information and a desire to share it. I say a variant of Wikipedia for medicine is the future -- and it's good.

That's my opinion. I'm Peter Frishauf, founder of Medscape.

Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed, for the editor's eye only or for possible publication via email: glundberg@medscape.net