A decade ago I consulted with a federal health agency on the redesign of its website. They wanted to use the web to make more health care information readily available to more people, but they didn't have much to offer. My suggestion was to leverage what we now call commons-based peer production, which then was mostly happening on the Usenet. The feds were deeply conflicted about that. They knew people were exchanging lots of useful information in newsgroups. But they also knew there was a lot of quackery, and they couldn't imagine themselves separating the wheat from the chaff. It was a valid concern. There was no way that they, alone, could patrol the likes of alt.support.arthritis and highlight the most useful advice for, say, people recovering from knee replacement....
Medicine is, among other things, a kind of information monopoly, as are other professional fields including IT. It's inevitable that peer production will challenge these information monopolies, and medicine is a particulary interesting test case. Watching for signs of change, I've been following medical blogs and podcasts. One that caught my ear recently was this interview with J. Scott Armstrong, a Wharton School professor whose interests include scientific peer review and transparency in medicine. At one point he discusses his own experience with prostate cancer. This guy is clearly not a typical patient. He regards his personal physician as an adviser who points him to relevant medical literature, discusses it with him, and helps him reach decisions. At one point, faced with possible prostate cancer, Armstrong's doctor referred him to a specialist because his PSA (prostate-specific antigen) was at level 5. The specialist told him that because it was level 5, he should have a biopsy. "Well yeah," Armstrong says in the interview, "I can read." He expected the specialist to add value -- to customize that general and widely-known recommendation in ways that accounted for his particular circumstances. That didn't happen.
Not everyone is willing or able to dig into the medical literature. But some are, and they can publish what they find for the rest of us to discover....Over time, as more such resources accumulate online, the web’s natural peer review and reputation effects will kick in. Health care folks can’t vet all this stuff, but they shouldn’t have to. People will vote with their links for the information that’s valid and useful. What will health care folks do then? Two things, I hope. First, work with us to gather and refine useful sources. Second, use their expertise to guide our interpretations of those sources.
Posted by
Peter Suber at 4/19/2006 10:28:00 AM.
The open access movement:
Putting peer-reviewed scientific and scholarly literature
on the internet. Making it available free of charge and
free of most copyright and licensing restrictions.
Removing the barriers to serious research.
I recommend the OA tracking project (OATP) as the best way to stay on top of new OA developments. You can read the OATP feed on a blog-like web page or subscribe to it by RSS, email, or Twitter. You can also help build the feed by tagging new developments you encounter.
