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), MariePierre 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 AlphonseDesjardins (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 Collabora>ve wri>ng applica>on (CWA) use in health care is growing. 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 To explore the depth and breadth of evidence about the safe, effec>ve and ethical use of CWAs in health care. 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 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. The appropriate experimental design needs to be determined. Many barriers will need to be addressed before conduc>ng such a study. Results Our protocol has been published in JMIR Research Protocols (2012). The following databases were searched (from their crea>on to 09/2011): PubMed, Embase, Cochrane, CINAHL, PsychInfo, Eric and ProQuest Disserta>ons & Theses. Search terms: “wiki”, “wikis”, “web 2.0”, “social media”, “Google Knol”, “Google Docs” and “collabora>ve wri>ng applica>ons”. 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. Ar>cles were excluded if they only discussed blogs, discussion forums, or communi>es of prac>ce. 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 endusers. 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. Based on qualita>ve content analysis, we charted, collated, summarized and reported the results. Figure 1. Flow chart Table 1. Most frequently reported Barriers/Facilitators and Perceived Beneficial/Nega>ve Effects Figure 2. Field of included studies Figure 3. Types of CWAs in included studies Figure 4. Study design of included studies Figure 1 presents the descrip>on of the excluded and included studies. 88 studies have been included for fulltext analysis (Figure 1). 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). Medicine was the field that generated the most research about CWAs (Figure 2) in the clinical area of health care. Wikis are the most studied CWA (Figure 3). Few studies use a rigorous study design (only 3 RCTs) (Figure 4). 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. 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/ crosssec^onal/ casecontrol study (n=4) randomised controlled trial (n=3) controlled beforeandaler 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)