Initial evaluation of an internet- based wiki platform for cancer - - PowerPoint PPT Presentation

Initial evaluation of an internet- based wiki platform for cancer management guidelines!

Ian Olver AM CEO Cancer Council Australia

Problems with written guidelines!

• Out of date before ink dries because of new

evidence constantly being published!

• Wide stakeholder consultation is important but

adds to the delay!

• Hand searching the literature is expensive and

time consuming!

• Paucity of data on impact!

What is a wiki?!

• Cancer Council Australia solution was to develop

guidelines on a mediawiki platform!

• A wiki (swift in Hawaiian) is a website that allows the

creation and editing of interlinked web pages via a web browser using a simplified mark-up language!

• It is a collaborative website - in this case closed so

that only authors only can add content but anyone can comment !

Where do the new papers come from?!

We will start with hand searching but that is unsustainable for continuous updating! What papers are likely to change a guideline?!

• Meta analyses and phase III studies (rarely phase II)!
• The 3 sources of papers to update are:!
• The authors of a section !
• The larger expert group and general public!
• Automatic electronic notification of new papers or hand search !

Topic leader notification on his/her user page !

Link%to%appraisal%form% Table%of%papers%that% need%to%be%appraised%

Evaluating each paper!

The section experts will evaluate each paper with a format like an annotated bibliography!

• Study type (phase I, II, III, IV, meta analysis)!
• Level of evidence I, II, III-1,III-2, III-3, IV)!
• Number of patients!
• Quality of evidence rating (high, medium, low)!
• Size of effect rating (1,2,3,4)!
• Relevance of evidence (1,2,3,4,5)!
• Economic Evaluation (Y/N)!
• Include/Reject (give reason) !

!

The wiki critical appraisal form!

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Body of evidence table!

Public consultation!

Features:)) In)a)simple)comment)box,)the)user)can) 1) comment)on)content;)or) 2) directly)no<fy)the)working)party)of) new)evidence)that)has)emerged)

Web Analytics
 How people navigate the site !

Lung Guidelines!

• 54 clinical questions and 22 authors!
• 1607 articles retrieved form the literature and

1770 critical appraisals! !

• There were 156 comments in 9 weeks!

!

• There were 13,341 page views at 1.22 mins per

view and 29.14 bounce rate!

Public Consultation !

In the endometrial guidelines there were;! !

• 80 visitors per month (50.55 new visits) !
• 3.01 pages per visit!
• 4.21 visits per page !
• 50% bounce rate !

! !

Lung Cancer!

Future Wiki!

• Could also link to a clinical trials database so

that an investigator could see what practice is, what new papers there are and what trials are

• ngoing and identify the gaps as to plan the next

trial!

• Link to detailed treatment guidelines (EviQ)!

!

• Add educational tools (e.g. Q-stream)!