Titre du document Auteurs
Email: [email protected] h4p://decision.chaire.fmed.ulaval.ca
Wikis and Collabora>ve Wri>ng Applica>ons in Health Care: Preliminary Results of a Scoping Review Patrick Michel Archambault (1), Tom H Van de Belt (2), Francisco J Grajales III (3), Marjan J Faber (2), Andrea Bilodeau (4), Catherine Nadeau (4), Simon Rioux (4), Craig E Kuziemsky (5), Mathieu Emond (1), Cynthia Fournier (1), Gunther Eysenbach (6), Karine Aubin (7), Irving Gold (8), Marie-‐Pierre Gagnon (7), Alexis F Turgeon (9), Julien Poitras (1), Jan A.M. Kremer (2), Marcel Heldoorn (10), France Légaré (11)
(1) Faculté de médecine, Université Laval, Quebec, Canada; (2) Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; (3) Faculty of Medicine, University of Bri^sh Columbia, Vancouver, Canada; (4) Centre de santé et de services sociaux Alphonse-‐Desjardins (CHAU de Lévis), Lévis, Canada; (5) Telfer School of Management, University of Obawa, Obawa, Canada; (6) University of Toronto and University Health Network, Toronto, Canada; (7) Faculté des sciences infirmières, Université Laval,
Québec, Canada; (8) Associa^on of Facul^es of Medicine of Canada, Obawa, Canada; (9) Axe Traumatologie – Urgence – Soins Intensifs, Centre de recherche FRQS du CHA universitaire de Québec, Quebec, Canada; (10) Federa^on of Pa^ents and Consumer Organisa^ons in the Netherlands, Utrecht, Netherlands; (11) Canada Research Chair in Implementa^on of Shared Decision Making in Primary Care, Quebec, Canada
Studies excluded (n=2797) -‐Author with “wiki” in his/her name (n=541) -‐Published before 2001 (n=885) -‐Duplicates (n=1371)
Studies screened on >tle and abstract (n=4437)
Studies screened on full text (n=359)
Studies screened for results (n=193)
Included studies (n=88)
Studies retrieved from targeted databases (n=7234)
Studies excluded (n=4078) -‐Not men^oning wikis, knol or online collabora^ve wri^ng applica^ons (n=2861) -‐Not related to health field (n=1059) -‐Research protocol (n=7) -‐Conceptual framework (n=6) -‐Conference summary (n=4) -‐Editorial or opinion (n=108) -‐Literature review (n=33)
Studies iden>fied for further synthesis (n=166) -‐Gene^cs/genomics (n=87) -‐Biology (n=33) -‐Chemistry (n=5) -‐Library science (medical or health) (n=14) -‐Medical informa^cs (n=12) -‐Clinical trials and wikis (n=10) -‐Psychology of wiki users (n=5)
Studies excluded No results (n=104) Study pending transla>on (not yet analysed) (n=1)
Background Ø Collabora>ve wri>ng applica>on (CWA) use in health care is growing. Ø Although wikis, Google Docs and similar CWAs may be useful in
facilita>ng knowledge transfer, no systema>c review has yet been conducted to evaluate their role in knowledge transla>on (KT).
Objec^ves Ø To explore the depth and breadth of evidence about the safe, effec>ve
and ethical use of CWAs in health care. Ø Research ques>on: What is the extent of the knowledge concerning the
barriers to, the facilitators of, and the impacts of using CWAs as KT interven>ons in health care?
Methods
Conclusion Ø There is a need for adequately designed
primary research assessing the impact of using wikis and CWAs to improve knowledge transla>on in health care.
Ø The appropriate experimental design needs to be determined.
Ø Many barriers will need to be addressed before conduc>ng such a study.
Results
Ø Our protocol has been published in JMIR Research Protocols (2012). Ø The following databases were searched (from their crea>on to
09/2011): PubMed, Embase, Cochrane, CINAHL, PsychInfo, Eric and ProQuest Disserta>ons & Theses.
Ø Search terms: “wiki”, “wikis”, “web 2.0”, “social media”, “Google Knol”, “Google Docs” and “collabora>ve wri>ng applica>ons”.
Ø Ar>cles were included if: 1) they studied the use of wikis, Google Docs, Google Knol, or any CWAs; 2) in health care; and 3) presented empiric quan>ta>ve or qualita>ve results.
Ø Ar>cles were excluded if they only discussed blogs, discussion forums, or communi>es of prac>ce.
Ø A “collabora>ve wri>ng applica>on” was defined as a category of social media that enables the joint synchronous and/or asynchronous edi>ng of a web page or an online document by many end-‐users.
Ø Due to the large number of cita>ons, we decided to exclude papers published before 2001 (the year Wikipedia was created) and to focus our ini>al data extrac>on on papers about CWAs that facilitated the clinical aspects of caring for pa>ents or that helped train clinicians.
Ø Based on qualita>ve content analysis, we charted, collated, summarized and reported the results.
Ø Figure 1. Flow chart
Ø Table 1. Most frequently reported Barriers/Facilitators and Perceived Beneficial/Nega>ve Effects
Ø Figure 2. Field of included studies
Ø Figure 3. Types of CWAs in included studies
Ø Figure 4. Study design of included studies
Ø Figure 1 presents the descrip>on of the excluded and included studies. Ø 88 studies have been included for full-‐text analysis (Figure 1). Ø We have iden>fied many areas of the literature that will require further
synthesis. In par>cular, the field of gene>cs and genomics research has generated many publica>ons (n=87).
Ø Medicine was the field that generated the most research about CWAs (Figure 2) in the clinical area of health care.
Ø Wikis are the most studied CWA (Figure 3). Ø Few studies use a rigorous study design (only 3 RCTs) (Figure 4). Ø There are many case reports presen>ng the perceived beneficial effects
about the use of CWAs in health care (Table 1). Few papers present perceived nega>ve effects, however many barriers to their use exist.
Ø No study has explored how CWAs influence the different phases in the knowledge to ac>on process.
Barriers Facilitators Perceived beneficial effects
Perceived nega>ve effects
Lack of skills to use wikis
High usability Improves collabora>on/ communica>on
Informa>on overload
Time constraints and workload
Face to face training Saves >me and resources
Decreases quality of communica>on
Lack of familiarity with wikis
Human resources (IT support)
Higher quality of classroom assignments
Allows personal views to be
overrepresented
Poor validity/scien>fic quality of the informa>on
Incen>ves (authorship/financial/social recogni>on)
Increases knowledge
Faster dissemina>on of poorly validated informa>on and
medical prac>ces not supported by evidence
Poor usability Trialability Increases confidence/ engagement/ ownership
Loss of autonomy – feeling of being monitored
Fear of being the first to contribute
High quality informa>on
Connects geographically
dispersed people
Repe>>ve content
Confiden>ality/privacy concerns
Low cost of sonware Decreases duplica>on of work
Creates conflict – edi>ng wars
case study/ case report (n=36)
descrip^ve quality assessment of wiki content (n=21)
survey (n=20)
cohort/ cross-‐sec^onal/ case-‐control study (n=4)
randomised controlled trial (n=3)
controlled before-‐and-‐aler trial (n=3)
controlled clinical trial (n=1)
medicine (n=27)
educa^on (n=16)
nursing and other allied health fields (n=13)
pharmacy (n=10)
mental health (n=5)
general health informa^on (n=6)
public health (n=3)
library/informa^on science/medical informa^cs (n=3)
den^stry/maxillofacial surgery (n=2)
EMS/disaster management (n=2)
medical gene^cs (n=1)
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