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February
17,
2009 -- 5:00pm EST
Medpedia -- OMG!!!
So 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.
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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outdated and blatantly incorrect information about interventional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.
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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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