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健康2.0与医学2.0:该领域的紧张关系与争议

Health 2.0 and Medicine 2.0: tensions and controversies in the field.

作者信息

Hughes Benjamin, Joshi Indra, Wareham Jonathan

机构信息

Department of Information Systems, Ramon Llull University, ESADE, 60-62 Av. Pedralbes, 08034 Barcelona, Spain.

出版信息

J Med Internet Res. 2008 Aug 6;10(3):e23. doi: 10.2196/jmir.1056.

Abstract

BACKGROUND

The term Web 2.0 became popular following the O'Reilly Media Web 2.0 conference in 2004; however, there are difficulties in its application to health and medicine. Principally, the definition published by O'Reilly is criticized for being too amorphous, where other authors claim that Web 2.0 does not really exist. Despite this skepticism, the online community using Web 2.0 tools for health continues to grow, and the term Medicine 2.0 has entered popular nomenclature.

OBJECTIVE

This paper aims to establish a clear definition for Medicine 2.0 and delineate literature that is specific to the field. In addition, we propose a framework for categorizing the existing Medicine 2.0 literature and identify key research themes, underdeveloped research areas, as well as the underlying tensions or controversies in Medicine 2.0's diverse interest groups.

METHODS

In the first phase, we employ a thematic analysis of online definitions, that is, the most important linked papers, websites, or blogs in the Medicine 2.0 community itself. In a second phase, this definition is then applied across a series of academic papers to review Medicine 2.0's core literature base, delineating it from a wider concept of eHealth.

RESULTS

The terms Medicine 2.0 and Health 2.0 were found to be very similar and subsume five major salient themes: (1) the participants involved (doctors, patients, etc); (2) its impact on both traditional and collaborative practices in medicine; (3) its ability to provide personalized health care; (4) its ability to promote ongoing medical education; and (5) its associated method- and tool-related issues, such as potential inaccuracy in enduser-generated content. In comparing definitions of Medicine 2.0 to eHealth, key distinctions are made by the collaborative nature of Medicine 2.0 and its emphasis on personalized health care. However, other elements such as health or medical education remain common for both categories. In addition, this emphasis on personalized health care is not a salient theme within the academic literature. Of 2405 papers originally identified as potentially relevant, we found 56 articles that were exclusively focused on Medicine 2.0 as opposed to wider eHealth discussions. Four major tensions or debates between stakeholders were found in this literature, including (1) the lack of clear Medicine 2.0 definitions, (2) tension due to the loss of control over information as perceived by doctors, (3) the safety issues of inaccurate information, and (4) ownership and privacy issues with the growing body of information created by Medicine 2.0.

CONCLUSION

This paper is distinguished from previous reviews in that earlier studies mainly introduced specific Medicine 2.0 tools. In addressing the field's definition via empirical online data, it establishes a literature base and delineates key topics for future research into Medicine 2.0, distinct to that of eHealth.

摘要

背景

“Web 2.0”一词在2004年奥莱利媒体Web 2.0会议之后开始流行;然而,将其应用于健康和医学领域存在困难。主要问题在于,奥莱利发布的定义因过于模糊而受到批评,其他作者则声称Web 2.0实际上并不存在。尽管存在这种质疑,但使用Web 2.0工具促进健康的在线社区仍在不断发展,“医学2.0”一词已进入大众词汇。

目的

本文旨在为“医学2.0”确立明确的定义,并勾勒出该领域特有的文献。此外,我们提出了一个框架,用于对现有的“医学2.0”文献进行分类,并确定关键研究主题、未充分发展的研究领域,以及“医学2.0”不同利益群体中潜在的矛盾或争议。

方法

在第一阶段,我们对在线定义进行主题分析,即“医学2.0”社区本身最重要的相关论文、网站或博客。在第二阶段,将此定义应用于一系列学术论文,以回顾“医学2.0”的核心文献基础,并将其与更广泛的电子健康概念区分开来。

结果

发现“医学2.0”和“健康2.0”这两个术语非常相似,包含五个主要显著主题:(1)涉及的参与者(医生、患者等);(2)对医学传统和协作实践的影响;(3)提供个性化医疗保健的能力;(4)促进持续医学教育的能力;(5)与其相关的方法和工具相关问题,如用户生成内容中可能存在的不准确信息。在将“医学2.0”的定义与电子健康的定义进行比较时,“医学2.0”的协作性质及其对个性化医疗保健的强调构成了关键区别。然而,健康或医学教育等其他要素在这两个类别中仍然是共有的。此外,这种对个性化医疗保健的强调在学术文献中并不是一个显著主题。在最初确定的2405篇可能相关的论文中,我们发现有56篇文章专门关注“医学2.0”,而不是更广泛的电子健康讨论。在这些文献中发现了利益相关者之间的四大矛盾或争论,包括:(1)“医学2.0”定义不明确;(2)医生认为因信息控制权丧失而产生的矛盾;(3)不准确信息的安全问题;(4)随着“医学2.0”产生的信息量不断增加而出现的所有权和隐私问题。

结论

本文与以往的综述不同,早期研究主要介绍了特定的“医学2.0”工具。通过基于在线实证数据探讨该领域的定义,本文建立了一个文献基础,并勾勒出了与电子健康不同的、未来“医学2.0”研究的关键主题。

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