Education & Social Media

Cath Lab Digest talks with WikiDoc creator C. Michael Gibson, MS, MD, about WikiDoc, Tweetbook, and his work as CEO of the Baim Institute for Clinical Research.

Editor's note: Read the article behind this interview with Drs David Fischman and Michael Savage, the creators of Tweetbook: Cardiovascular Interventions.


Can you tell us about WikiDoc?

I created WikiDoc in 2005. The content is about medicine in general, and we have had 2200 young people work with us to create and edit that content. We are coming to the end, with virtually every disease written about. Now it is time to keep WikiDoc alive and green, and part of that is having new cases reported on our platform. Tweetbook: Cardiovascular Interventions is the first real project to do that.

Many major journals have moved away from publishing case reports, perhaps to maintain a higher impact factor. Has it opened up a niche?

Impact factor is one of many ways of quantitating impact, where you rank journals based on how many times articles are cited. Impact in the world of social media is quite different: it is how many people are viewing the content. There are many more people lurking than retweeting or citing content, so simply capturing the number of citations or retweets or some similar quantity doesn’t always capture the true impact. There are different ways people learn. Some learn by didactic approaches, but others learn much more through case-based approaches. Many physicians say, well, the guidelines don’t fit any of my patients. I think practicing doctors really do enjoy and value case reports. We are trying to give those a legitimate home, one that does have references and is peer-reviewed, and is easily and freely accessible. One distinguishing feature about our concept is it’s free. You don’t have to pay; you just go to the site, and you are free to use and redistribute the content as well, as part of a “copyleft” (vs “copyright”) doctrine, which states redistribution is free as long as you give the original source credit.

What would you like to encourage from visitors to WikiDoc?

Don’t just be a lurker and reader. We encourage everyone to join our team of 2200 people to add content and critically review content. Peer review, in the past, has meant a couple of well-respected people looking things over. Peer review really, in my mind, should mean all peers looking it over. We open the content up to the whole world for review, comment, and change. It is part of the open access movement we are trying to promote.

You are active on Twitter (@CMichaelGibson). How do you use it?

I try not to take it too seriously. I’m the kind of person who puts up pictures of my dogs. It’s called social media for a reason. But there are some good, legitimate uses of social media. I use it to promote public health issues — less for cardiology, even though I am a practicing interventional cardiologist. We don’t pay enough attention to many public health problems throughout the world. I try to make sure those issues get attention, rather than exclusively focusing on heart disease. Public health policy issues, infectious disease issues — all these things are something I try to highlight and discuss. We have all this evidence-based medicine and guidelines, but the guidelines in Western Europe and the United States may not be applicable to other parts of the world, where they don’t have access to the technology that we do. Guidelines and practices are all local, and we have to make sure we are cognizant of the fact that people can’t always afford all of the expensive things we recommend. It’s good to hear from people who say, “We can’t afford this drug, so we use that drug in our country.” Hopefully everyone around the world can get aspirin, a medicine that literally costs pennies, but reduces mortality in ST-elevation myocardial infarction (STEMI) by 40%. The World Health Organization does a good job of listing essential medicines that every country should have and everyone should have access to. As more generics come out, hopefully that list of essential medicines grows.

Can you tell us about your work with the Baim Institute for Clinical Research?

It began nearly 30 years ago, in a closet-sized room, where I had a computer in one corner that was my angiographic core lab. In another corner was Rick Kuntz on his computer, where he was collecting data from our patients. Rick’s corner of the room became what is known as the Harvard Clinical Research Institute (HCRI). My corner of the room became the PERFUSE Research Institute, more focused on pharmaceutical trials. It’s funny, because the TIMI Study Group also began in that small closet, as well as PERFUSE and HCRI. It has been amazing over those 30 years. We have done 1,000 studies, have 50+ drugs and devices that have gone through the FDA, and 3500 manuscripts from different members of those teams. The legacy continues. I am the CEO and last year I began to unify both HCRI and PERFUSE. The name of the entity was switched to that of Don Baim, the interventional cardiologist who was my and Rick Kuntz’s mentor when we were fellows at Beth Israel Deaconess Medical Center, in his memory. We now have about 170 people working at the Baim Institute for Clinical Research, which is a non-profit entity, and have about 150 ongoing trials, registries, and projects. 

Any final thoughts?

Information wants to be free. Let information flow freely from patients to doctors and from doctors to patients, and when you have free-flowing information, healthcare is enriched.

Editor's note: Read the article behind this interview with Drs David Fischman and Michael Savage, the creators of Tweetbook: Cardiovascular Interventions.