Talk:WikiJournal of Medicine/Readability of English Wikipedia's health information over time

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WikiJournal of Medicine
Wikipedia-integrated • Public peer review • Libre open access

WikiJournal of Medicine is an open-access, free-to-publish, Wikipedia-integrated academic journal for Medical and Biomedical topics. <seo title=" WJM, WikiJMed, Wiki.J.Med., WikiJMed, Wikiversity Journal of Medicine, WikiJournal Medicine, Wikipedia Medicine, Wikipedia medical journal, WikiMed, Wikimedicine, Wikimedical, Medicine, Biomedicine, Free to publish, Open access, Open-access, Non-profit, online journal, Public peer review "/>

<meta name='citation_doi' value='10.15347/wjm/2019.007'>

Article information

Authors: Aleksandar Brezar[a]ORCID iD.svg , James Heilman [a][i]ORCID iD.svg 

Brezar, A; Heilman, J. 


Plagiarism check

Artículo bueno.svg Pass. WMF copyvio tool using TurnItIn. Only trivial duplication such as affiliation address were detected and are not regarded as plagiarism.--مصعب (discusscontribs) 11:12, 3 May 2019 (UTC)

First peer review

Review by Edward Purssell , City, University of London
This review was submitted on , and refers to this previous version of the article

This is an interesting and well conducted study, with no obvious methodological flaws. However, I do have a question about the fundamental assumption behind the study-which is that Wikipedia entries should be 'readable' and that they are necessarily aimed at a lay audience. I use Wikipedia when teaching sometimes precisely because it is at a level suitable for professionals and is often more up-to-date (and sometimes authoritative) than text books; this would inevitably not be the case if entries were made readable at the level that the authors seem to suggest. I think a stronger case needs to be made for this being a good thing; and in order to do this the authors would need to establish that this information was not easily available elsewhere in a way that is readable (for example in the UK we have NHS Choices). Otherwise you may end up removing a source of information for professionals with no real gain to patients. I guess the question is "who is the intended audience for Wikipedia health articles?"


We have Wikipedia:Writing_better_articles#Provide_context_for_the_reader which says "Wikipedia is an international encyclopedia. People who read Wikipedia have different backgrounds, education and opinions. Make your article accessible and understandable for as many readers as possible. Assume readers are reading the article to learn. It is possible that the reader knows nothing about the subject, so the article needs to explain the subject fully." We also have Wikipedia:Make technical articles understandable.

Personally I consider a grade 12 reading level to be good (maybe even ideal). Doc James (discusscontribs) 23:37, 3 May 2019 (UTC)

Second peer review

Review by Andrea Simpson , La Trobe University
This review was submitted on , and refers to this previous version of the article

Minor Comments:

  1. It is not clear to the reader about what is unique to this paper until the Strengths and Limitations section. Suggest moving up to Introduction before research aims. Also isn't looking at effects over time also
  2. Discussion: do the authors have any theories for why the improvement over time shown in the results? And any ways we could continue to improve these scores?
  3. Methods: Justify why only the top 25 articles were selected for analysis

Thank you for taking the time to review our article and for your comments. Changes have been made accordingly. --Abrezar (discusscontribs) 16:23, 9 July 2019 (UTC)

In June of 2015 WPMED strengthened its advice to use easier to understand language.[]
The top 25 were chosen to simplify the analysis. Doc James (discusscontribs) 20:38, 9 July 2019 (UTC)

Third peer review

Review by Niall McCrae , King's College London
This review was submitted on , and refers to this previous version of the article

A fascinating survey, showing that internet resources for the general public are prone to ‘professional closure’ by use of impenetrable jargon. Wikipedia is meant for all, not simply expert readers. In my view, it is an indispensable skill of academic or professional writing to make your message accessible. The Sun newspaper is a good illustration of how political events or other complex topics can be described in terms that are understood by people at the lower end of the reading scale. Plain English is not incompatible with good science.


Thank you for taking the time to review our article. Improving the readability of online information is definitely a key element for making it accessible to a larger audience. --Abrezar (discusscontribs) 16:50, 9 July 2019 (UTC)

Thanks :-) And we of course are happy to have more people join us to help with simplification. Doc James (discusscontribs) 20:42, 9 July 2019 (UTC)

Fourth peer review

Review by Mark Hayter , University of Hull
This review was submitted on , and refers to this previous version of the article

This was a very interesting article - well written and thorough. No apparent flaws. I did wonder whether there ought to be a better explanation of the readability tests and analysis for a lay audience - they are very technical and more clarity and sign posting if necessary to allow a lay reader to engage more with the scale and methods used by the authors.


Thank you for taking the time to review our article and for your kind words. We agree that the readability formulas are very technical and we will explore ways to simplify this section. --Abrezar (discusscontribs) 16:53, 9 July 2019 (UTC)

We could just link to the English articles to provide more details :-) Doc James (discusscontribs) 20:47, 2 October 2019 (UTC)

Fifth peer review

Review by Parveen Ali , University of Sheffield
This review was submitted on , and refers to this previous version of the article

Many thanks for letting me read this useful and well written manuscript. The mansucript is useful but I think authors need to justify why appropriate readibility is important and why should one assume that the readers are patients and not professionals. Also please suggest implication and recommendation as to what authors can do to improve readibility.


Thank you so much for taking the time to review our articles and sorry for the delayed response! We have tried to emphasize the importance of readability in the introduction of the article. We have also added additional information re: Wikipedia's target audience. Some general suggestions to improve readability were also added. Thank you again! --Abrezar (discusscontribs) 21:50, 3 September 2019 (UTC)

Sixth peer review

Review by anonymous peer reviewer ,
This review was submitted on , and refers to this previous version of the article

Thank you for the invitation to review the manuscript entitled “Readability of Wikipedia's Health Information Over Time”. I have read and reviewed the preprint shared at

Overall Review: I suggest accepting this manuscript. Please note the following suggestions, comments, and minor revisions:

  1. Methodology: The methodology of this study looks good. I think that choosing to evaluate the top 25 most viewed papers in English is a good place to start.
  2. Interpretation of results: An a minor revision, I would like to see the authors suggest how the readability of articles can be further improved.
  3. Consideration for future directions: How do the authors suggest we balance readability and accuracy vs providing a resource for many different users? A future study could look at the readability of the lead versus the body of the article, for example. Given that Wikipedia articles contain “wiki-links” for more technical terms, how does this affect the readability? (i.e.: Even though large medical words exist in articles, they can be linked for an explanation. Does this improve article interpretation for someone who does not have a medical background? How many people click on these links while reading articles?)
  4. Conclusion: The conclusion section presently states “It is important for healthcare professionals to be aware of the readability of online resources and refer their patients to health resources that are adapted to their literacy level. “. Does this mean that the authors are suggesting that healthcare professionals should not suggest patients consider Wikipedia when looking for more information?

Thank you very much for your thoughtful comments and suggestions. We have made changes to address your comments. --Abrezar (discusscontribs) 21:53, 3 September 2019 (UTC)

Seventh peer review

Review by Peter Draper , University of Hull
This review was submitted on , and refers to this previous version of the article

Health professionals and lay people use Wikipedia as a source of information. Researchers using a range of readability indexes have shown that the content of health articles can be difficult to understand, requiring a level of education beyond many lay people. This is important because, according to the article, health literacy is a strong predictor of health. The article shows that the readability of the 25 most frequently accessed articles has improved since 2018.

This is one of those articles that made me think 'why has nobody ever done this before?' There is a strong case for making articles more accessible, not only for the sake of patients but also I suspect for the health professionals who read them too. The approach is robust and convincing. The article is clearly written, as one would expect given the topic. However the fact that I had to read it several times reminds me that there is a trade-off between readability and a level of technical detail that will always challenge people who are not expert in the field.

The method used in this paper could be applied to other, related questions where readability is important, such as the material provided to students, and other forms of health information provided to patients. I wanted to know a bit more about the strategies that have been used to improve the accessibility of Wikipedia's articles and whether they could be used more widely. I would like to suggest that the authors consider outlining what these are.


Thank you very much for your comments and for taking the time to review our article. In 2015, Wikipedia published an updated Manual of Style for medicine-related articles which emphasized the use of plain English and it also reinforced that the target audience is the "general reader", and not patients or health care professionals specifically. We have updated our article to add more information on this. --Abrezar (discusscontribs) 21:57, 3 September 2019 (UTC)

Eighth peer review

Review by Daniel B. Oerther , Missouri University of Science and Technology
This review was submitted on , and refers to this previous version of the article

Overall, I found this to be a well-written and informative article. I found it easy to follow, useful, and innovative. In my opinion, it contributes new knowledge and is worthy of publication. My primary concerns with the article include:

  1. conflation of "medical", "disease", and "health" concepts throughout (for example, "top 25 medical articles" does not necessarily correspond to the "disease" articles selected). Therefore, I recommend that the authors reconsider their use of terms and increase the precision of their selection.
  2. arbitrary mixing of definitions of "grade level reading" and "health literacy". These are not necessarily the same thing as someone with a low grade level reading with significant math and science training could be significantly different in terms of health literacy as compared to someone with a high grade level reading with training primarily in poetry (my point: understanding English text and understanding medical concepts are not necessarily the same thing and I believe these two concepts are conflated throughout the article).
  3. One limitation is that the history of edits of the articles are not considered. For example, what if an article had been vandalized and repaired or other types of changes to occur in a publicly curated database (I don't expect the authors to necessarily control for these items, but I would like to see a description of limitations include some of these types of thoughts).
  4. One limitation of the method is that the authors do not describe "why" they choose to "only" analyze the first paragraph. Yes, this is the part of the article that regular appears in a google search, but it may be incorrect to presume that the entire article has the same readability.
  5. And finally, I would like to see the authors speculate about "why" the trend if for articles to remain overly complicated and "how" articles can be improved to increase readability for both medical and public audience. It seems that the authors have identified a very useful point to study, have presented some useful results, but haven't taken this to the next level of suggesting a way to "fix" what they've observed. In conclusion, I find this to be an enjoyable, informative, and useful article fit for publication.

Thank you so much for your comments and for taking the time to review our article. Your comments were noted and changes made accordingly. There was definitely some conflation of terms in the initial draft that have been addressed. We will also be discussing additional limitations based on your comments and have added some recommendations to further increase the readability of Wikipedia's articles. Please don't hesitate if you have any further comments. --Abrezar (discusscontribs) 22:02, 3 September 2019 (UTC)

We considered it to be more important to have an easier to understand lead. On mobile only 40% of people open a section beyond the lead. Doc James (discusscontribs) 20:54, 2 October 2019 (UTC)

Mean versus average

I have added mean in brackets after the first occurence. In my opinion that should be sufficient. Doc James (discusscontribs) 00:36, 8 October 2019 (UTC)