http://www.theatlantic.com/business/archive/2015/08/wikipedia-editors-for-pay/393926/
The Covert World of People Trying to Edit Wikipedia—for Pay
On January 11, 2013, James Heilman, an emergency-room physician and one of
Wikipedia’s most prolific medical editors, was standing watch over the
online encyclopedia’s entry for a back procedure called a kyphoplasty. The
page originally suggested that the procedure’s effectiveness was
“controversial,” and an unidentified Wikipedia user had proposed
https://en.wikipedia.org/w/index.php?title=Percutaneous_vertebroplastydiff=532478067oldid=532468933
changing
the text to “well documented and studied”—a characterization that Heilman
thought wasn’t supported by existing research. He rejected the change.
Kyphoplasty, along with vertebroplasty, the procedure it shares a Wikipedia
page with https://en.wikipedia.org/wiki/Percutaneous_vertebroplasty, is a
common treatment when someone’s spine breaks—a frequent occurrence in
people with osteoporosis, which makes bones brittle—and then doesn’t heal
naturally. The procedure is meant to reduce the pain of a fracture, even
though it sounds unpleasant: It consists of inflating a tiny plastic
balloon near the fracture, removing the balloon, and then injecting a
toothpaste-like plastic cement into the resulting crevice and letting it
harden.
The procedure grew popular in the ‘90s, despite the fact that its
effectiveness wasn’t backed up by definitively convincing research. By the
time two studiespublished in 2009
http://www.nytimes.com/2009/08/06/health/research/06spine.html?pagewanted=all
found
that vertebroplasty—and, by extension, kyphoplasty, which is similar but
has not been tested in controlled experiments—was no more effective than a
placebo treatment, at least 100,000
http://www.nytimes.com/2011/05/26/opinion/26redberg.htmlof the two
procedures were being performed every year. (It’s hard to say an exact
number, as the procedures are not recorded in any national database.) In
2011, Medicare paid out around $1 billion
http://www.nytimes.com/2011/05/26/opinion/26redberg.html for
vertebroplasties and kyphoplasties, and the number of the procedures
performed each year is not estimated to have decreased significantly since
then.
Some are concerned about the money being spent on a procedure that’s
controversial and sometimes risky. “To my mind, [kyphoplasty] is an
unproven modality and based upon current evidence would have to say it
works as well as vertebroplasty, which is to say likely to work as well as
a placebo,” says Rachelle Buchbinder, a professor of epidemiology and
preventive medicine at Australia’s Monash University, as well as a
co-author of a recent vertebroplasty review
http://www.cochrane.org/CD006349/MUSKEL_vertebroplasty-for-osteoporotic-vertebral-compression-fracturespublished
by the Cochrane Collaboration, a network of independent researchers. She
notes that in Australia, where she lives, public funding for the procedures
was withdrawn after the two 2009 studies were published. “From my
perspective there is no longer any dispute,” she says.
There are experts who disagree. Sean Tutton is a professor of radiology at
the Medical College of Wisconsin, and spoke to me on behalf of the Society
of Interventional Radiology, which put out a position paper with other
medical societies that called vertebroplasties safe and effective under the
right circumstances. “If my mother had a vertebral-compression fracture and
after several weeks of conservative management with bed rest, plus or minus
bracing, and appropriate pain management, if she still was having ongoing
pain and disability, I would treat her,” he says. “I wouldn't even think
twice.”
As James Heilman thought more about the attempted edit to the page for
vertebroplasty and kyphoplasty, he grew curious about who might be trying
to write over the controversy of the procedures, so he Googled the would-be
editor’s Wikipedia username. Sifting through the results, he saw that a man
named Kim Schelble had an email address that contained the same nickname.
Schelble, Heilman found, was employed by Medtronic, a company that sells
medical devices used for, among other things, kyphoplasties.
There is little evidence to suggest that kyphoplasties are any better than
vertebroplasties, but to a medical-device manufacturer, there’s an
important distinction: A kyphoplasty kit sells for thousands of dollars
more than a vertebroplasty kit, which generally costs a few hundred
dollars. Medtronic doesn’t supply the latter, but it spent nearly $4 billion
http://www.mercurynews.com/breakingnews/ci_6481649 in 2007 to purchase a
company that makes some of the products included in a kyphoplasty kit.
“Their concern is that those at Medicare might read the Wikipedia article,”
Heilman says. “If I go to Google, and I put in ‘percutaneous
vertebroplasty,’ the first page that comes up is Wikipedia.” Is it really a
concern that some high-level decision maker at Medicare or a hospital
