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February 17, 2009 -- 5:00pm EST

Medpedia -- OMG!!!
MedpediaSo yet another web-based health site was launched today, with great fanfare in the New York Times, CNET and other news outlets.

According to Medpedia's founder:

[James] Currier is aiming to build the most complete database of information from medical professionals and combine it with forums for consumers and patients to share treatment stories, raise questions and directly engage with the physicians editing Medpedia’s content.

Since the New York Times featured a screen shot of a page titled "Coronary Artery Angioplasty", I felt it was fair game to critique the information on the angioplasty page and its sister page on "Cardiac Stents".

Cutting to the chase, I am far from impressed. In fact, I read these two pages and my reaction, as per the title of this posting, was OMG!!! If the information contained in these two entries is any indication of the accuracy of the rest of Medpedia, I would definitely advise patients to go elsewhere.

The entries on angioplasty and stents are riddled with outdated and blatantly incorrect information about interventional treatments for coronary artery disease. I am truly surprised, given the sources that Mr. Currier cites in his statement to the New York Times:

Mr. Currier said Harvard Medical School, the National Health Service in England, the Centers for Disease Control and Prevention, and the School of Public Health at the University of California, Berkeley, are among the medical organizations that have donated more than 7,000 pages of content to Medpedia. Some institutions, including the N.H.S., the American Heart Association and the University of Michigan Medical School, will encourage staff and faculty members to contribute to Medpedia.

It sounds impressive, to be sure, but here is just a sampling of the misinformation (with corrections) on the topic of angioplasty and stents:

Medpedia states: "A heart attack occurs when blood flow through a coronary artery is completely blocked. Sometimes the accumulation of plaque causes the blood vessel to burst and a blood clot to form on the vessel surface." Bizarre to say the least. Arteries bursting?? This is not even close to a description of a heart attack.

In describing an angioplasty, Medpedia states: "The doctor passes a long, thin, flexible tube (the catheter) through the sheath, over the guide wire, and up to the heart. The catheter is moved to the blockage, and the guide wire is removed." Perhaps this may be seen as wonkish, but the guide wire is NEVER removed during the procedure. It is the "rail" over which all catheters are advanced. It is only removed when the procedure is over and the patient is judged stable.

In describing "cardiac stents", Medpedia states: "The meshwork of stents is usually made of metal, but sometimes a fabric is used. Fabric stents, also called stent grafts, are used in large arteries." Well...except that (1) "fabric stents" actually contain metal and (2) they have nothing whatsoever to do with coronary artery disease or cardiac stents -- stent grafts are used, sometimes, to treat a triple A -- Abdominal Aortic Aneurysm -- this is an unrelated medical issue which has nothing to do with blocked coronary arteries.

Medpedia states that: "In about 20% of cardiac stent placements, the artery narrows again within six months of the angioplasty." Correction: with drug-eluting stents (DES), the numbers for restenosis are in the single digits. This is not news -- DES were introduced in the U.S. five years ago!

Medpedia states that: "Treatment with radiation can also limit this growth [restenosis]. For this procedure, a doctor places a wire where the stent is placed. The wire releases radiation and stops cells around the stent from growing and blocking the artery. This procedure, involving intracoronary radiation, is known as brachytherapy." Unfortunately for Medpedia, not only has brachytherapy not been proven useful, but both companies making brachytherapy equipment ceased manufacturing several years ago.

And I could go on, but I'll end with this...Medpedia states that "Metal stents preclude patients from having a magnetic resonance imaging (MRI) test within the first few months following the procedure." Except that the FDA approved both the Cypher and Taxus DES for immediate MRI FIVE YEARS AGO! In fact on Angioplasty.Org, we have a Patient Forum Topic just answering questions about this issue. Correction -- it is perfectly safe to have an MRI immediately following stent placement.

As a rough estimate, it would seem that much of the information about interventional medicine on Medpedia is five years old.

Angioplasty.Org has been online since 1997, has thousands of patient postings, and reports the most current news about stents, angioplasty and interventional medicine. Considering the quality of the information about this area that I've seen on Medpedia, I would not call it Web 2.0 -- rather Web minus 1.25.

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