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From the Townsend Letter
January 2009


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briefed by Jule Klotter

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Medical Scans
Health insurers are hiring radiology benefit managing companies to pre-screen and give prior authorization for computed tomography (CT) and magnetic resonance imaging (MRI) scans. By employing these companies, insurers reduce the number of unnecessary tests and cut spending. Costs for these procedures can vary widely, depending upon the test facility and the purpose of the test. MRIs cost between $400 and $3,500 (www.comparemricost.com), and CTs cost between $270 and $4800 (www.comparectcosts.com). Medicare spent $14.1 billion on outpatient imaging in 2006 – double the amount spent in 2000. Bloomburg.com says that doctors prescribed 115 million scans in 2007. Nearly half of these scans provided no additional useful information that affected diagnoses or treatment, according to a July 28, 2008 report from America's Health Insurance Plans (a trade group).

Radiology benefit managing companies approve most requests for MRIs and CTs, but the use of pre-screening and prior authorization has slowed runaway use of imaging technology. Pre-screening encourages practitioners to use less costly, equally informative tests (e.g., ultrasound for suspected appendicitis) before using more expensive tests. One insurer told Bloomburg.com that the radiology growth rate among its clients had decreased from over 20% "to the low single digits." Medicare may eventually turn to pre-authorization service, also. At this time, the agency pays scanning facilities less for their services if a patient receives more than one procedure in the same day. In addition to pre-screening, the agency may begin to negotiate for discounts from imaging facilities and publicize facilities that charge less for their services.

Goldstein A. Medical scans waste $30 billion a year, insurers say (update 1). Bloomberg.com. July 28, 2008. Available at: www.bloomberg.com. Accessed September 29, 2008.

Autism-Chelation Study Canceled
In September 2008, the National Institute of Mental Health canceled a scheduled trial that was designed to evaluate succimer (DMSA) chelation therapy as a treatment for autism. The trial would have tested the hypothesis that mercury exposure contributes to autism, according to MedPage Today. Researchers would have recruited 120 autistic children, ages four to ten years, "with detectable but not toxic levels of mercury or lead in their blood." The FDA has already approved succimer as a treatment for lead toxicity. NIMH decided to pull the study because of a 2007 rat study, conducted by Diane E. Stangle and colleagues. That trial showed that succimer chelation causes "lasting and pervasive cognitive and affective dysfunction, comparable in magnitude to [the dysfunction caused by lead exposure]" (Environmental Health Perspectives; February 2007). These findings raised concern that children in the study, who had low levels of lead or mercury, would be harmed by succimer. An NIMH review board decided that "…there was no clear benefit to the children who would participate in the chelation trial and that the study presents more than a minimal risk." Instead of pursuing further data collection and review, which would have taken about four more years, NIMH decided to cancel the study: "During those four years, it is quite likely that additional research on the basic pathology of autism will provide deeper understanding of the causes of autism and more refined avenues for developing treatments."

The NIHM cancellation of this chelation therapy trial is puzzling. First, the rat study "provides clear evidence" that succimer chelation relieves cognitive and behavioral problems in rats with lead toxicity, according to its researchers. In addition, the cognitive and affective dysfunctions in lead-exposed rats parallel the dysfunctions found in children with lead toxicity. Stangle and colleagues conclude: "The present findings thus suggest that if a succimer treatment protocol that produced a substantial removal of [lead] from the brain could be identified for humans, a functional benefit might be derived." The researchers, however, were concerned to find that succimer caused adverse effects in normal rats – that is, rats with no exposure to lead and no sign of dysfunction. The NIMH study did not have a cohort of metal-free children in its design.

According to the NIMH study's design, recruited children would have had a diagnosis of autism and blood mercury levels of 0.1 to 44 mcg/dL or blood lead of 0.1 to 10 mcg/dL. "The upper bounds are the accepted thresholds for toxicity requirement," according to MedPage Today. This statement is not accurate, according to the Risk Assessment Information System (RAIS) from the Department of Energy's Office of Environmental Management. In RAIS toxicity summaries for mercury and lead, symptoms of CNS toxicity becomes noticeable at about 10 mcg/dL of mercury and 30 mcg/dL of lead. The site says that "…toxicity values presented in these toxicity profiles….are subject to change." In the case of lead, "…no clear threshold is evident."

Another problem with NIMH's decision is that it ignores research on toxic metals in tissue other than blood. A June 2007 study, for example, found that the baby teeth of children with autism spectrum disorder have "significantly (2.1-fold) higher levels of mercury but similar levels of lead and…zinc" compared to the baby teeth of "typically developing children." These Arizona State University researchers say, "Baby teeth are a good measure of cumulative exposure to toxic metals during fetal development and early infancy, so this study suggests that children with autism had a higher body burden of mercury during fetal/infant development." Hair mineral analysis is another way to gauge metal toxicity. Several studies, including a 2003 study sponsored by SafeMinds, have found lower levels of mercury in hair samples belonging to children with autism: "Hair mercury levels in the autistic group [n=94] were 0.47 ppm versus 3.63 ppm in controls [n=45]." The mothers of children in the autistic group "had significantly greater exposure to mercury from amalgam filings and thimerosal-containing Rho D immunoglobulin injections than did a control group." Other studies with similar findings have resulted in a hypothesis that some autistic children cannot excrete heavy metals as efficiently as unaffected children.

Another puzzling aspect about the NIMH decision is that many parents have already reported positive results with chelation therapy. In response to the study's cancellation, Talk About Curing Autism, a support and advocacy group, stated: "Anecdotally, Talk About Curing Autism has either seen or heard of thousands of children [who] have had many of their autistic symptoms decrease due to this therapy. By discontinuing this study, the NIMH will not prove the effectiveness of chelation therapy one way or another." Parents will continue to seek chelation for their children, and health authorities can continue to say that no scientific evidence supports its use – simply because no government-sponsored study has been performed.

Adams AJ. Elemental hair analysis test for heavy metal toxicity and mineral deficiencies. The Patients' Voice. Spring/Summer 2008:6,8. Available at: www.pfamhealth.net.

Adams JB, Romdalvik J, Ramanulam VM, Legator MS. Mercury, lead, and zinc in baby teeth of children with autism versus controls. (abstract) J Toxicol Environ Health A. 2007 Jun; 70(12):1046-51. Available at: www.ncbi.nlm.nih.gov/pubmed/17497416. Accessed October 27, 2008.

Gever J. NIMH cancels autism chelation trial. MedPage Today. September 19, 2008. Available at: www.medpagetoday.com/neurology/autism/tb/10979. Accessed October 13, 2008.

Holmes AS, Blaxill MF, Haley BE. Reduced levels of mercury in first baby haircuts of autistic children. (abstract) Int J Toxicol. 2003 Jul-Aug;22(4):277-85. Available at: www.ncbi.nlm.nih.gov/pubmed/12933322. Accessed October 27, 2008.

Meletis CD; Zabriskie N. Is autism the coal miner's canary of America's health status? The Patients' Voice. Spring/Summer 2008:5,7. Available at: www.pfamhealth.net.

Stangle DE, Smith DR, Beaudin SA, Strawderman SM, Levitsky DA, Strupp BJ. Succimer chelation improves learning, attention, and arousal regulation in lead-exposed rats but produces lasting cognitive impairment in the absence of lead exposure. Environmental Health Perspectives. February 2007;115(2): 201-209. Available at: www.ehponline.org/members/2006/9263/9263.pdf. Accessed October 13, 2008.

Bioenergetic Devices and Functional Medicine
Some functional medicine practitioners use energetic techniques and devices to help them assess (and sometimes treat) patients. Pulse diagnosis, used in Chinese and Ayurvedic medicine, and applied kinesiology, developed by George Goodheart, are two such techniques. Like pulse diagnosis, applied kinesiology and similar muscle testing techniques give clues to body functioning. Pulse diagnosis, however, has a far longer history and takes a skilled practitioner years to learn. More recently, computerized energy devices have become popular.

Reinhold Voll, a German physician, developed Electro-Acupuncture according to Voll (EAV), the grandfather of many energy devices used in functional medicine, in the 1950s. EAV measures reciprocal resistance between two electrodes. Patients hold a passive cylindrical electrode in one hand while the practitioner applies low voltage current to specific acupuncture points with the second electrode. The current flowing between the two electrodes is measured in microamperes by an ohmmeter. Measurements above the set norm indicate inflammation or over-activity, and those below the norm indicate blockage or weakness. Dr. Voll used an extensive number of acupuncture points in his assessments. Helmut Schimmel, one of Voll's students, simplified the process by using fewer acupuncture points and placing ampules of organ tissue, homeopathics, or other "medicaments" into the circuit. This VEGATEST-Method allows practitioners to see the effect of a supplement, treatment, or possible allergen on a patient's system. In recent years, computer programs have made the VEGATEST ampules unnecessary. Neither Voll nor Schimmel viewed electro-dermal screening as a replacement for standard testing. Rather, these devices are meant to help clinicians "[expand] clinical diagnostics into a previously unreachable range of functional disturbances."

The diagnostic methods of functional medicine. 1 November 2005. Available at: http://tokranmed.ru/en/box/public.php?subaction=showfull&id=
1130832900&archive=&start_from=&ucat=1&
.
(one link on two lines)
Accessed September 29, 2008.

Kessler WD. Computerized segment electrography. Available at: http://www.dr-kessler.com/segment_electrography.php. Accessed November 17, 2008.

Washington State Targets Energy Devices
In December 2007, the Food and Drug Administration (FDA) decided to block the importation of the Electro-Physio-Feedback-Xrroid system (EPFX), an energy device manufactured in Hungary by William Nelson, because of a Seattle Times probe. Seattle Times reporters Michael J. Berens and Christine Willmsen painted Nelson and the EPFX as frauds that prey on the ignorant and ill in their November 19, 2007 article. Much of the article focuses on dangers caused by non-professional EPFX operators and on Nelson's sales tactics. Nelson left the US in 1996, after he was indicted for felony fraud. He refused to stop making claims that the EPFX, registered as a biofeedback device, can heal serious illness. Maybe the EPFX is a scam. I don't know. I could not find any non-commercial evaluations of this device or online case reports from health care professionals. The Seattle Times did not include any interviews with medical practitioners who use the device. Instead, the reporters present a few anecdotal cases in which very sick people, who were treated by EPFX non-professional operators, died. The reporters call them "victims…causalities in the growing field called ‘energy medicine'…." The reporters made no attempt to look at the decades (centuries, in the case of Chinese and Ayurvedic medical traditions) of energy medicine research.

If the reporters had bothered to check PubMed, they would have quickly found at least two clinical studies involving energy devices. A 2002 Russian study by B.I. Islamov and colleagues report, "Changes in the lymphocyte antioxidant system indicate that bioresonance therapy activates nonspecific protective mechanism in patients with rheumatoid arthritis." A 2006 German placebo-controlled study found that "[t]he MORA bioresonance therapy can markedly improve non-organic gastro-intestinal complaints." (Bioresonance uses frequency to lessen or cancel dysfunctional frequencies emitted by the body or organisms in the body.) If energy medicine is simply a matter of the placebo effect, why did the "main outcome parameters" in this study's control group respond "only slightly" when the active group show marked improvement?

Seattle Times' biased investigation was powerful enough to push the FDA into action and to incite Rob McKenna, Attorney General for Washington State, to write the FDA and ask the agency to extend its EPFX investigation to other energy medicine medical devices. The FDA reply, dated January 28, 2008, did not leap onto the bandwagon: "FDA is always active in its surveillance of the medical device industry and watchful for risks to health," Timothy A. Ulatowski, Director of Office of Compliance, replied. "We triage the risks to health that we detect or that come to our attention and allocate our resources depending on the degree of risk." He adds, "I've increased our surveillance of Internet promotion and advertising. Consumers must also be vigilant, and any educational communications you can make available will help."

Even though electrodermal screening and its offspring have been used for over 50 years in Europe, legitimacy for energy devices is going to be a hard-won battle in the US. Claims that FDA registration signifies effectiveness is deceptive. Kiran Schmidt, Director of Inergetix, Inc. (device manufacturer), explains on the company website, "…establishment registration and medical device listing do not mean the FDA has approved or cleared a product for marketing as a medical device or found it to be safe and effective for its intended uses." At this time, "bioresonance," "informational medicine," and "energy devices" bring up zero search results on FDA's database.

Berens MJ, Willmsen C. How one man's invention is part of a growing worldwide scam that snares the desperately ill. The Seattle Times. November 19, 2007. Available at: http://seattletimes.nwsource.com. Accessed September 29, 2008.

FDA Reply. Available at: www.devicewatch.org/eav/fda_reply.pdf. Accessed October 7, 2008.

FDA urged to curb bogus "energy medicine" devices. Available at: www.devicewatch.org/eav/letter_to-fda.shtml. Accessed October 7, 2008.

Islamov BI, Balabanova RM, Funtikov VA, Gotovskii YV, Meizerov EE. Effect of bioresonance therapy on antioxidant system in lymphocytes in patients with rheumatoid arthritis.(abstract) Bull Exp Biol Med. 2002 Sept;134(3):248-50. Available at: www.ncbi.nlm.nih.gov. Accessed October 11, 2008.

Nienhaus J, Galle M. Placebo-controlled study of the effects of a standardized MORA bioresonance therapy on functional gastrointestinal complaints (abstract; article in German). Forsch Komplementmed. 2006 Feb;13(1):28-34. Available at: www.ncbi.nlm.nih.gov. Accessed October 11, 2008.

Schmidt K. Registering a device with the Food and Drug Administration (FDA). Available at: www.energy-medicine.info/fda-registration.html. Accessed October 29, 2008.

Willmsen C, Berens MJ. FDA bans import of unproven machine. The Seattle Times. December 9, 2007. Available at: http://seattletimes.nwsource.com. Accessed October 7, 2008.

Computed Tomography Scan Hazard
Computed tomography (CT) exposes patients to higher levels of radiation than most doctors realize, according to a review article in the New England Journal of Medicine. In CT (also known as CAT) scans, a computer integrates X-rays taken from different angles to form a detailed cross-section picture. Radiation dosage varies with the organ being scanned, the size of the patient, and the scanner being used. (The 64-slice scanner emits more radiation.) A CT scan of the abdomen exposes patients to 10 mSv of radiation, 500 times the radiation produced during a single chest X-ray. Studies of radiation workers in the nuclear industry and of Japanese survivors of atomic-bomb blasts show a significant increase in cancer risk among people who receive between 5 and 150 mSv.

Most practitioners and patients are unaware of CT's risks. In the NEJM review article, Columbia University researchers David J. Brenner and Eric J. Hall report that about 75% of surveyed radiologists and emergency room physicians "significantly underestimated the radiation dose from a CT scan" (Radiology, 2004;231:393-8). When disease symptoms are present, CT scans often help determine a diagnosis. However, too many people without any symptoms at all undergo CT screening "just in case." Even the FDA discourages this growing practice of CT screening: "…the FDA has never approved CT for screening any part of the body for any specific disease, let alone for screening the whole body when there are no specific symptoms of disease at all." Another concern is the growing use of CT scans to diagnose appendicitis in children. Children are more sensitive to radiation than adults. Ultrasonography, for the most part, is just as accurate as CT but does not cause radiation damage.

Brenner and Hall suggest three ways to lessen CT radiation exposure. First, newer scanners have an automatic exposure-control option that helps reduce radiation dose to patients. Brenner and Hall also suggest using magnetic resonance imaging (MRI) or ultrasonography whenever possible. (CT is the most accurate diagnostic technology for some conditions.) Finally, Brenner and Hall recommend prescribing CT only when symptoms and a lack of diagnostic alternatives justify its use. They write, "…if it is true that about one-third of all CT scans are not justified by medical need, and it appears to be likely, perhaps 20 million adults and, crucially, more than one million children per year in the United States are being irradiated unnecessarily."

Brenner DJ, Hall EJ. Computed tomography – an increasing source of radiation exposure. The New England Journal of Medicine. November 29, 2007; 357(22):2277-2284. Available at: www.nejm.org. Accessed October 5, 2008.

Ozner M. Avoiding the radiation dangers of cardiac CAT scans. Life Extension. March 2008:51-59.

US Food and Drug Administration. Whole body scanning using computed tomography (CT). April 17, 2002 (last update). Available at: www.fda.gov/cdrh/ct/screening.html. Accessed October 5, 2008.

Functional Medicine
Functional medicine deals with the body's regulatory functions, which underlie chronic illness and promote good health. Like Chinese, Ayurvedic, and other traditional medicine systems, functional medicine considers disruption of the body's innate regulatory systems to be the cause of illness. Serious illness can be prevented by maintaining good function in these regulatory systems. "Functional medicine sees disease, not as an enemy," writes Elizabeth Lipski, PhD, CCN, "but as an opportunity for change and growth."

The primary goal of functional medicine is sound cellular metabolism and healthy mitochondrial respiration. To achieve this goal, practitioners begin by assessing and supporting intestinal function. Normally, the intestinal mucosa allows absorption of desirable nutrients and evacuation of toxic waste in a timely manner. Diet choices, stress, toxins in food and water, and pharmaceuticals (e.g., non-steroidal anti-inflammatory drugs and antibiotics) contribute to leaky gut (hyper permeable mucosa) and dysbiosis (too few beneficial microorganism and too many harmful ones). As a result, toxins are absorbed into the bloodstream, straining the liver's detoxification function. As tissue toxicity and oxidative stress increase, cellular function declines. Repairing intestinal function and supporting the liver are cornerstones of functional medicine. Addressing immune/inflammatory imbalance and hormone imbalance are others.

Functional medicine practitioners use laboratory tests that examine blood, hair, stool, urine, breath, and/or saliva to assess functional status. Instead of trying to diagnose a disease, these tests assess underlying conditions: nutritional status, digestive function, food and environmental allergies, amino acid balance, energy metabolism function, hormone balance. A lactulose/mannitol challenge, for example, evaluates intestinal permeability. Saliva tests assess hormone status. Some practitioners have also found bioresonance and electrodermal screening devices helpful complements to laboratory measurements.

The Institute for Functional Medicine, founded by Jeffrey and Susan Bland in 1991, offers workshops and other educational opportunities, including continuing medical education (CME) courses for physicians. For more information, contact www.functionalmedicine.org.

Brady D. Functional medicine. Dynamic Chiropractic. April 5, 1999. Available at: www.chiroweb.com. Accessed September 29, 2008.

Institute for Functional Medicine. The History of Functional Medicine and The Institute for Functional Medicine. Available at: www.functionalmedicine.org. Accessed November 2, 2008.

Institute for Functional Medicine. What is functional medicine? Available at: www.functionalmedicine.org. Accessed November 2, 2008.

Lipski E. Understanding functional medicine. Available at: www.innovativehealing.com. Accessed September 29, 2008.

Harry Oldfield
What does an energy field look like? How do we study it if we can't see it or measure it? British biologist Harry Oldfield is one of many scientists who have turned their interest to energy fields. He has developed three devices so far that provide a way to explore bioenergetic fields: Polycontrast Interference Photography, Electro-Scanning Method, and Electro-Crystal Therapy. In recognition of his work, the International Society for the Study of Subtle Energies and Energy Medicine (ISSSEEM) awarded him The Alyse and Elmer Green Award for Innovation in 2006.

Oldfield worked with Kirlian photography for several years before developing Polycontrast Interference Photography (PIP). PIP shows pulsating bands of color and changing variations in light quality emanating from living organisms and from crystals on a computer screen. In humans, these images tend to correspond to energy meridian pathways, defined by traditional Chinese medicine, and chakras, defined by Ayurvedic medicine. (Pictures taken with PIP imaging are available at www.electrocrystal.com.) Eventually, PIP may lead to a new diagnostic tool. "In certain circumstances," according to the Managing Director of Oldfield Systems Ltd., Evy King, "…PIP technology is able to pinpoint disturbed energy states before they become evident by standard diagnosis, allowing practitioners and healers the chance to nip problems in the bud." In addition to PIP, Oldfield developed another way to assess energy fields called Electro-Scanning Method (ESM). ESM uses sound and radio frequencies to create three-dimensional numerical information in decibel levels about a subject's energy field. Oldfield's Electro-Crystal Therapy uses electronic oscillator equipment linked to select crystals to shift a stressed energy field towards equilibrium.

In the US, Oldfield has worked with Dr. Brian Dailey, a physician and member of the Monroe Institute's professional and advisory boards. The Monroe Institute (Faber, Virginia) is a non-profit research and educational organization "dedicated to the exploration of human consciousness." Oldfield has also worked with Dr. Claude Swanson, Dr. Norman Shealy, and Bruce Moen.

King E. Harry Oldfield's amazing imaging technologies. Nexus Magazine. April-May 2007;33-37+. Available at: www.nexusmagazine.com. Accessed September 29, 2008.

The Analyst™
Patient health histories have always played an important role in diagnosis. Now, health history services are being offered online. In some cases, these services are simply a way to get consumers to buy products being sold from the same website. I found one, however, that sells no products and has such an extensive questionnaire that I wonder whether if it might actually provide some benefit. The Analyst™ (www.diagnose-me.com) uses an extensive health history questionnaire and statistical probability to identify likely health problems and dismiss others. Users also have an option of receiving pertinent information about "mainly natural treatments that have benefitted others in a similar situation." The service offers users the option of having a licensed practitioner (MD, DC, or ND) review the computer analysis and any laboratory results or images they choose to send in.

The Analyst™ has two questionnaires with up to 900 multiple-choice questions, one for men and another for women. It took me about an hour and a half to complete the women's. The questions cover all physical systems and include diverse questions such as "When you exercise (run, walk fast, cycle, etc.), do you easily get a stitch in your side?" and "Do you have a sense of humor?" Hyperlinks to a glossary and related topics make the questionnaire user-friendly for lay people. The computer-only analysis costs $25 US. The computer analysis reviewed by one of the company's practitioners costs $55 US. A full report, in which a doctor reviews and summarizes the computer report, "adding his or her insights and [answering a patient's] specific questions," costs $77 US. A preliminary report, mostly a teaser, is available by e-mail for no cost. (When I didn't sign up for a report within a few days after taking the test, another e-mail offered a discount rate.)

Practitioners may find The AnalystTM or a similar in-depth questionnaire helpful for acquiring useful patient histories. A well-designed computer program will consistently ask a compilation of questions, derived from many reputable sources, without taking up a practitioner's already cramped time. It can also bring some objectivity to a history – depending upon the biases of the people who write text for the program. I am leery, however, of using online questionnaires to quantify health risks. How does the program add up factors to formulate whether a person has a high, moderate, or low risk or no risk of a disease? I am concerned that the program can plant negative seeds of worry in a naïve user who is relying on the program for health evaluation. Suggestion, positive or negative, is a powerful force. Also, the program's analysis of health risks can be skewed by inaccurate patient responses. Objectivity and statistics are useful, but I believe these factors give only part of a picture. No computer program can supersede the value of human intuition or the therapeutic value of human touch and human interaction that occurs with a caring, attentive practitioner.

Wikipedia Reliability
Wikipedia, a free and very popular online encyclopedia, gained legitimacy in December 2005 when the prestigious journal Nature reported that Wikipedia's accuracy for science-based articles nearly equaled the highly regarded Encyclopedia Britannica. Nature's assessment was based on a study in which experts reviewed 42 pairs of scientific articles. Each pair, devoted to a single topic, consisted of one article from Britannica and one from Wikipedia. The experts, "most of [whom] chose to remain anonymous," were academic scientists, according to Britannica's refutation of the study. Nature asked the reviewers to look for factual errors, critical omissions, and misleading statements. The study reported four serious errors and 123 lesser problems in the Britannica articles compared to four serious problems and 152 lesser problems in Wikipedia's. Philip Coppens, in an article for Nexus Magazine, compared the average number of mistakes per article: "2.92 mistakes per article for Britannica and 3.86 for Wikipedia, or three versus four mistakes." That is, Wikipedia had nearly one-third more errors or misleading statements according to this study. Nature presented the results as a vindication of Wikipedia, saying "…high-profile examples [of major errors in Wikipedia] are the exception rather than the rule" and that "the difference in accuracy [between Britannica and Wikipedia] was not particularly great." In actuality, the difference between the two may be much greater.

Britannica asserts that the comparison is "fatally flawed" for several reasons. The Britannica articles used in Nature were, in some cases, manipulated. Britannica said Nature re-arranged and re-edited some articles. Reviewers of other articles criticized Britannica for important omissions, but Nature had given the reviewers only part of the article (e.g., its introduction instead of the entire piece). Nature also pulled articles from Britannica's children's version and from its yearbook series, which has more latitude for personal opinion than the encyclopedia itself. Further, Nature did not fact-check nor ask reviewers for sources that supported their criticisms. Some "errors" were simply a matter of opinion. Britannica staff says, "…where reviewers found genuine inaccuracies in the Britannica, we corrected them, but dozens of the so-called inaccuracies…were nothing of the kind; they were the result of reviewers expressing opinions that differed from ours about what should be included in an encyclopedia article."

Why does this matter? First,
Nature is highly regarded as a science journal. By giving Wikipedia its approval, it boosts the credibility of an already influential source. The widely used Google search engine places Wikipedia entries at the top. Whatever appears in Wikipedia automatically feeds into Reference.com and Answers.com. "The problem with Wikipedia is not that it exists," writes Coppens, "but that it has become the cornerstone for researchers scanning the Internet for information and blindly copying from Wikipedia entries, wrongfully assuming that they are neutral and correct."

Wikipedia
is compiled through the use of wikis, software that lets anyone edit, add, delete, or replace an entry. Wikipedia's changes are usually performed in anonymity under the cover of pseudonyms. Even its editors who monitor content use pseudonyms. The system lacks transparency and accountability. Wikipedia claims to have corrected problems that led to inclusion of inaccurate, even damaging, accusations on biographical sites, but manipulation of entries still occurs. Virgil Griffith developed Wikipedia Scanner to track Wikipedia edits to their source organizations. For example, he found that someone at Diebold (a maker of voting machines) deleted 15 paragraphs that criticized the company's machines. Politicians and government agencies have also edited Wikipedia files to their own advantage, according to Wikipedia Scanner. The biases of Wikipedia's anonymous editors are less easy to trace. They are the people who decide what will or will not be included.

Larry Sanger, co-founder of
Wikipedia, left the organization in 2002, a year after its creation. In October 2006, he started a competitor. Citizendium (http://en.citizendium.org) requires real names -- no pseudonyms or anonymity. Draft versions of articles are easily edited by readers, but "expert editors" approve "stable versions" of an entry and arbitrate the inevitable content disputes that arise. At the very least, Citizendium's transparency holds contributors and editors accountable for the facts and their biases (which we all have). Out of curiosity, I compared Citizendium's entry on homeopathy – a somewhat controversial topic – to Wikipedia's entry. I found Citizendium's information more detailed and without dismissive language. I hope Citizendium continues to grow.

Coppens P. The truths and lies of WikiWorld.
Nexus Magazine. October-November 2007;11-15,77. Available at: www.nexusmagazine.com. Accessed October 5, 2008.

CZ:Why
Citizendium? Available at: http://en.citizendium.org/wiki/CZ:Why_Citizendium%3F. Accessed October 5, 2008.

Encyclopædia Britannica, Inc. fatally flawed. Available at: http://corporate.britannica.com/britannica_nature_response.pdf. Accessed October 5, 2008.

Wikipedia study "fatally flawed." BBC News. March 24, 2006. Available at: http://news.bbc.co.uk/go/pr/fr/-/2/hi/technology/4840340.stm. Accessed. October 5, 1008.

 

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