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In the next week or two, we have to evaluate this site and its progress… but this is turning out to be one of the more difficult to figure out. So I'm opening a broad discussion asking you to share your impression of this site thus far, in hopes that something may resonate regarding how useful (or not) this site will be going forward.

  • Does this site add anything to the Internet?
  • How particularly "insightful" have you found the information? Was it both thorough and well-researched, and subsequently well-vetted?
  • Have we established a strong foundation to build a world-class resource for this subject?

I know that's a pretty tall order.

The issue I'm struggling with is that there are some great contributors providing fantastic content to this site. But that "professional-level" advice is also scattered among a lot of popular-culture table talk that "sounds good"… but who knows. The problem comes when we cannot tell the difference; or at least it's not coming across that we can tell the difference on this site.

When we created this site, I didn't really expect the world's doctors and nutritionists to come flooding in on day one. That doesn't really concern me. But when we're purporting to crowd-source an authoritative collection of "health information" on the Internet, that's a pretty bold claim — so we better darn well be able to suss out the difference between an insightful, well-researched answer, from one filled with vagaries, folk wisdom, and general platitudes. I'm not sure we set the bar that high.

I know I'm being a bit hyperbolic; I don't actually find a lot of "wrong" information on this site — but the overall tone of what we are offering is that of a circle of friends sitting around the lunch table sharing stuff they heard somewhere. Yes, we all know "a little" about general health issues, but do we know when to take a step back when we can't really speak all that authoritatively on a subject (especially during these highly-precarious, formative weeks)? I know folks are just trying to help, but we certainly have enough traffic and enthusiasm many times over. What I'm not sure of is if we have the right founding community to equip and establish this particular site. This is something we have to ascertain during the private beta. It's not something we can do "later".

That's my initial impression. What is yours?

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    I think that as long people use proper resources and moderators without medical backgrounds are put in then we should be Ok. But updating the material should happen naturally as people go through the content. – Pobrecita Apr 3 '15 at 6:58

11 Answers 11

17

It's not as bad as I feared it could be. But it's also not really good. I raised the issue of requiring references very early because I feared that otherwise the site might become a place where anyone can peddle their favorite theory, and if it sounds plausible enough, it'll be upvoted.

What I realized is that the answers with many references aren't actually better than the ones without references. You can find a reference for pretty much anything related to health, the really hard part is evaluating them and putting them into context.

Overall, the community is not as critical as I'd like. My perspective as a Skeptics mod is probably skewed, but I know just how much bad information about health is out there. I expect solid evidence, or at least the admission that we don't really have any solid evidence yet.

I'm not really seeing anything here yet that actually makes the internet a better place. It doesn't make it worse at the moment, but that's not much to say given the amount of terrible health advice you can find on the internet.

Update impressions after nearly two weeks:

My opinion is now more negative than it was at the beginning. Answers just need to look good, the community is not evaluating them critically enough in many cases and just upvoting them based on appearances.

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    With so much publication biais even with references it is hard to provide high-quality answers :/ – Franck Dernoncourt Apr 4 '15 at 0:22
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    Already has my +1, but I’m also in agreement on the addendum. Critical analysis of data is hard without the building blocks. In a setting like SE where we insist that anyone is allowed to offer (/peddle) their favorite answer, the community needs education about how to evaluate their claims. IMO, these are concepts that most people can pick up if they are explained. Another question to directly address that. – Susan Apr 11 '15 at 16:13
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    I will admit that I also find myself largely despairing for another reason: If citations aren't providing a good filter, they may actually be providing a bad one. For example, I don't usually write answers if I don't have time to find citations, which removes what I would at least like to believe would be good answers from the potential pool. – Fomite Apr 13 '15 at 18:34
9

I didn't plan to participate to Health, initially. I did because First Aid was closed on Area51 while first aid was declared a valid subject for Health. So I came here a little bit "by default", and I must say I had a good suprise:

  • I found interesting questions that I wouldn't have thought about and that interested me as much as the answers they received (those that are documented, elaborated, so helpful),
  • I asked a few questions, and one of them received a very valuable answer. I am therefore confident for the two others,
  • And I could see that first aid, the subject that made me come here, is also active. Not very, but reasonably let's say. Enough to make me confident.

The first point is from far the most important. The idea is to have Q/A useful for the whole community, this is where the value of a SE site actually resides.

This good surprise came with a bad suprise though. The community. It's a little bit as if voting down with no explanation was a national sport here. I've seen several questions harshly voted down today while they are actually valid and can receive excellent answers. One of them voted below zero just received a brilliant and documented answer a few minutes ago. I don't understand that. A bunch of users afraid of questions? Or vandalism? The same issue happens with answers, in a lesser extent.

I think this behaviour is not prone to encourage people to ask and answer, even if they have actually valuable things to ask and knowledge to answer. It is more prone to lead users to find other sources of information.

All this being said, it is way too early to come to a conclusion. This is only the beginning of the day 2, and a couple of days is roughly nothing.

8

At risk of echoing what some of the others have said well already, my impression of the site so far is mostly good, but not great.

On the positive side, I've seen some good, insightful questions and some really great, well-researched and clear answers. To echo what @michaelpri said, I think that this could eventually be the go-to place for solid answers to medical questions on the internet. I especially see the usefulness of site that cuts through all the noise and answers "common" or "pop culture" medical questions in a straightforward, evidence-based way.

That brings me to the bad: as is to be somewhat expected, there have already been a number of lower-quality answers that reference things like Ayurvedic healing, yoga, "natural is always better than synthetic", or simply are pop-culture "common sense" answers. I think the solution here is two-fold:

  • Attract more hard experts and scientists to the site. Of course, this will take some time. Make this a place where these types of contributions are highly valued.

  • Be fairly strict with rules about requiring references and evidenced-based, high-quality answers, especially right now while we're in the beginning stages.

7

My initial impression was this would be a great site to participate in and answer questions. After only a day of using the site, that jubilation has worn off. The reason is because the community seems very hostile and negative at the moment in my opinion. I was thinking the user base would be similar to the bio user base, but I am afraid I was wrong. With that being said, the site tends to be more off putting them welcoming. Again, this is from my limited experience on the site.

Maybe I am being unfair by comparing it to the user base of Bio, but due to the similar nature and some overlap of the health can have with Bio, I came thinking this and may be the reason I think this since I didn't come in with a blank slate. However, this my initial impression for better or worse.

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    What are some examples you can point to where you felt this hostility? (This comment may accidentally sound more hostile than is intended -- I'm genuinely asking.) – Nate Barbettini Apr 3 '15 at 13:55
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    @NateBarbettini I am not going to single anyone out but comments don't have to equate to hostility either. As shlublu said, downvoting appears to be a sport here. In my experience, academic style exchanges usually elicit a certain type of person. This site, which I felt would be more academic, appears to operate under the SO mindset. Downvote first ask question later. Questions being closed which are good questions. – user139 Apr 3 '15 at 14:34
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Overall I think the site is trending well. The bro-science answers are being either downvoted or at least not upvoted, and the better answers are filtering to the top.

As far as the overall content, part of the problem is that the general person really doesn't know that much about health, so they rely on what Aunt Sally told them about colicky babies, and now everyone with a connection has a blog. As it was put by a medical doctor "We don't know much, and much of what we know is wrong".

I think the site will attract higher level participants in a public beta, and that it will fill a needed place for people to go for quality advice and answers.

  • "The bro-science answers are being either downvoted or at least not upvoted, and the better answers are filtering to the top." - Yes, I'm observing that too, I don't know whether this is an effect of that discussion, but today is way more positive than yesterday on a climate standpoint - May I vote up your answer twice btw ? Just for once, please say yes guys :) – Shlublu Apr 3 '15 at 15:02
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    @Shlublu - I've seen quite a few comments and downvotes in the last day saying "Hey, if you're gonna make that claim, back it up. Where are your references?" which makes me believe that after the initial "get my questions in" rush, people are taking a little more time to read and assess both questions and answers. – JohnP Apr 3 '15 at 15:03
  • Makes complete sense. I see that too, that's a good trend. – Shlublu Apr 3 '15 at 15:05
4

For the first two days, I feel the site has gone well. I wasn't planning on participating much, but I answered my first question and I liked it more than I thought I would, so I kept at it. I think that this site has potential. We will go through tough times as we decide what is on and off topic. There will be disagreements. But I think that this site could be one of the top sites on the SE network, if the time is put in. We could even possibly reach a level where we are the source for medical info. That second one will be tougher, but it is something good to strive for.

As of now, I think it is a bit too early to make any harsh judgments. Eventually, there will be more and more medical professionals joining this site, but this could take a while. For now, all we need is people who are interested enough to put in the time and do the research.

Improving the site

I think that references are important and though there can be good answers without references, providing a link or two to a study will show people that the information is legitimate. The only problem I can see happening with encouraging references is that people will only give references. The order of importance should be information, then links to provide evidence of why the answerer is right.

Another thing we will need to do is promote the site. Obviously we want more traffic, but what I'm talking about is getting more good users to come in. More questions is great, but what will happen if we don't have enough people to answer them. I do think we'll get better users over time, but we should be actively advertising this community. It wouldn't surprise me if this site became a site where a small percentage of the users answer all of the questions and then the rest just ask a few questions. If we are able to convince better users to join us, then we can steer clear of this problem.

One last thing is that I think we will have to choose moderators as soon as we can. I am active in the Lifehacks beta (I'm actually a mod) and we didn't get our mods chosen until close to day 100. In that time, we didn't have very many authority figures to step in and to clean up content. I think that getting moderators quickly will be essential for Health.SE to be successful.


Personally, I think it's a bit too early to really be able to evaluate this site. In a few weeks, I think everyone will have a more accurate opinion on this site.

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    I agree it is way too early to do a proper evaluation. See meta.health.stackexchange.com/questions/69/…. The purpose here isn't to short-change you in the proper time to develop this site. It's just to start a dialog to raise and examine these issues ealier while the direction of the site is still easily maneuverable. – Robert Cartaino Apr 2 '15 at 23:29
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    @RobertCartaino Ahh, that makes sense why you've posted this so early. I think this site will need to put moderators in place quickly so we will have more authority characters to control the content. Hopefully it won't take as long as Lifehacks. :P – michaelpri Apr 2 '15 at 23:32
3

In private beta folks are reaching for questions and not coming on them organically (as part of their daily life). As such, they seem to be rather vague and not well thought out.

For example, in a subject that I know a lot about, (I've had chronic (i.e. daily) migraines for 3 years, and had intermittent migraines all of my life).

There are currently two questions in that tag, and neither is very interesting to me. One is unanswerable (how is the cause of migraines determined other than trial and error? It's not, trial and error is still used) and the other is irrelevant to a migraine sufferer (how to determine severity of a migraine? It doesn't matter, an official classification as "severe" or "mild" doesn't change the impact on your daily life).

I suspect (based on my experience with the way Pets.SE has aged) that the questions will get better (and have better answers) as people go through their daily lives and come up with questions and then think "huh, I should ask that on Health.SE" instead of opening a box at Health.SE and thinking "what can I post here".


HOWEVER, I do have a major concern when that shift starts happening.

We've faced a consistent problem with Pets.SE that I totally expect to see here. People will type stuff into the question window that will make you scream "WHY ARE YOU ON THE COMPUTER AND NOT VISITING A PROFESSIONAL".

Examples:

We've discussed if these types of questions should be automatically closed, and (after about 18 months in beta) we've come to the consensus that they should be left open. We can still provide some assistance.

Sometimes the person has talked to their vet, but the vet didn't give them very detailed information or the person wasn't in a frame of mind to remember/absorb the information. One example was My cat ate (part of) a balloon. What should I do?. The pet owner remembered to watch for "strange behavior" and we were able to answer with some specific behaviors to look for.

In other cases we try to outline how serious the situation is to convince the person to take their animal to the vet, such as What can I do for my turtle who fell down three floors?

We've also given advice on how to talk to veterinarians (what types of questions to ask), such as Tightly curled over tail and strange gait.

This type of stuff is helpful, but I'm not sure if it's the right approach on a site for human health.

2

It's going great, better than I thought.

However I feel as I'm missed a lot, because the exact date/time beta launch wasn't specified anywhere, I've checked on Monday/Tuesday daytime couldn't log-in (GMT), logged-in on Wednesday morning, bum, >50 questions, and I was like - what's going on, where all these questions came from, migrated from somewhere? Or maybe it's just gap in time zones, that's all, so nothing new.

It's great that so many people have so many questions and I'm finding it interesting, sometimes:

  • funny (I wish I could answer: How can a person die from extensive masturbation? or at least more rep to read it again what was about exactly, my first thought on it was A Million Ways to Die, however I think if this was decided as not appropriate question, somebody should save it at least into Wayback Machine for further interested audience who missed interesting content due to time zones😊;

  • too specific/localised where only <0.1% general population is affected and it's still perfectly fine (all people should have the right to know about their health), but probably not for initial beta (as these questions needs more time and effort and I think people simple ignoring them, because they want to focus on 50 more interesting questions, not on some health cases/sickness/syndromes X which they never heard it);

  • disconnected (e.g. hip ache caused by position of wisdom tooth? which is fairly similar to how weather correlates to number of pirates), I'm not against it, but I don't think all possible correlations between X and Y can be covered by studies and be reliable at the same time simple tradition approaches which are usually criticised,

  • interesting, and I think everything is going on the right track.

It's still to early to come into any conclusions after 1-2 days, as some people are affected by time zones and lack of time and I hope many people will come over the weekend and will put some effort into it as well.

Suggestions:

  • currently we've 1.4 answer ration, so this indicates we've too many questions and too less answers - I think it's better to have less questions with better answers to be more canonical at start, than too many out-of-place questions and with only few answers, (didn't you play stackegg?:)
  • there are still 25 unanswered questions, please pick up one and answer it or suggest OP what could be still missing,
  • if you're asking the question, try to think of others and look on the bigger picture of it - how I can rephrase my question to be a great example for the site and further duplicates by trying to eliminate too specific things from it - it can take a minute and can increase range of affected people (0.01% to 20%) making a big difference, better quality questions attract better answers and more people would vote, so everybody would benefit from it.
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The site is pretty much as I'd expected, with some good answers that have references and some more lay person answers, which don't tend to get voted up as much.

I'm interested as to why you are asking this so soon. The site has been up for 2 days. There are betas that have literally been going for years. Why does this site have to be a near-instantaneous success for it to stick around (it sounds like you'd be happy to shut it down)? I remember with French.SE, we took many months to really get things going. And it's still in beta.

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    I agree, it is very early. But in a week or so, we'll be evaluating the private beta to see if it can go public. As to "why so soon", I just posted this to the Community Managers: > I kinda hate to launch a discussion like this^ so early on, but at 100 questions already, I'm afraid their momentum might make it impossible to address and correct large-scale issues if we wait much longer. That's about it. – Robert Cartaino Apr 2 '15 at 23:01
  • As @RobertCartaino says, this is the private beta. Private betas only last a couple of weeks, and then the assessment is made as to whether the site graduates to the public beta. The beta sites you see for "years" have passed their private beta stage already and are working towards full site graduation. – JohnP Apr 3 '15 at 14:52
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i have recently joined the website to ask a couple of questions and have felt that it is right to answer some questions back.

Now, I might not know the full answer to something but if I have a partial answer or can give a clear direction as to how and where to look then this shouldn't be a problem.

So I find that when people don't like my answer they use many excuses to delete where they could accept that it is for the person asking the question to work with me who is answering it, if they wish to have further information such as references.

I'd like to point out that when we learn things we often forget the reference source so it is far too time consuming to reference every thing in an answer, the responsibility is upon people to satisfy themselves that the answers that they read is suitable for them. Not everything has an immediate right or wrong answer.

I have found that the learning curve is very steep in this website for the beginner to the point of perfectionism as people (moderators or users with power) take a very punitive administration style.

I am very unhappy that were certain users are unhappy with my answer they are adversely marking comments for deletion without providing guidance or support. I very much object to this style of marking things to be deleted by some administrator where no one else has objected.

this approach is very dry and insulting. Moderators should leave a comment and not delete answers just because they are in their opinion in complete.

I also very much dislike collective action where one moderator votes down an answer and others swarm in voting down like a pack of wolfs.

There is t my experience no peer mentoring and no active support or encouragement for new person's like me who has to face repeated unconstructive criticism from this website reviewing user accounts.

  • Interesting experience, I can understand on the coding SE's the principle of "left as a exercise to the reader" but with health topics there are a lot of myths that people will stand by unless proper evidence proves them wrong. In PF SE we see this a LOT with the myths about losing weight and people will dig their heals in and claim X gimmick smoothie diet or Y ab exercise is all that is needed to lose weight and the only way to get the OP to accept the answer is with a fully referenced answer, fitness.stackexchange.com/questions/31181/… – Gunge Aug 12 '16 at 6:58
  • @JJosaur I understand what you are saying but there are things we learn that we learn from books and journals but I haven't memorised my source of the data. Do you think that a university student can recite all the references? My problem is that there are somethings I know [to a certain debth) that I don't have references for so what am I meant to do? – Fred.A Aug 12 '16 at 21:41
  • If I may (this follows my comments to your question on Health SE Meta): How about you search the medical literature on of the databases available (ex Pubmed)? Probably, this is what most of the people providing good answers are doing. It doesn't take that much time (particularly if you are used to literature searching). And from my experience as a student, my teachers don't ask me to recite all my references but just to list them... So I don't really understand why you don't want to take a little bit of your time to provide those references, which could improve the quality of your answers. – Felipe Aug 12 '16 at 23:25
  • excellent, thank you for your suggestions, I have actually just installed a reference manager software so that I can keep better track of my references. – Fred.A Aug 13 '16 at 12:54
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Overall Impression

I joined into this site as it has a lot of cross-over from physical fitness stack exchange, especially with diet and such. I saw the quality of posts on here and encouraged by the volume of posts per day I set to work on flagging and answering.

After a few weeks I have noticed a few things, good points first:

  • There are a lot of newer users (<200 rep) answering questions.
  • The appointed mods (JohnP looking at you) that are reasonably active in their moderation.
  • There are a lot of questions being asked.
  • Some of the questions are brilliant, and the OP's are keen to challenge answers put forward. For example: UTI bacteria climbing up urine stream!

Onto some 'areas for improvement' or 'opportunities':

Userbase

It appears that the active user base for SE at the moment is a mix of Indians, British and Americans (some Canadians). There is a clash with the British evident. As a Brit, I get free healthcare from qualified professionals in a accredited building 24hrs a day 7 days a week, 365 days a year, I just have to pay a fixed price for prescriptions. Americans and Indians do not have that luxury and I think this is the reason we get so many "please diagnose X" questions; because the users want to see if a easy fix is available to them to save them a buck (or rupee).

Of course, all of the above paragraph is pissing blindly off a cliff so I may be wrong. But you asked for my impression and there it is.

Moderation

The appointed moderators are tip-top, no issue there. The community rep-appointed moderators don't exist in a large enough number to moderate the volume of posts coming through.

Meta Discussion

What meta discussion? I asked a question a few days ago and it has 16 views and no answers. That is pathetic for the question volume/visits on this site!

Tags/Wiki

Tags are in pretty good shape, lots of sensible options available, the wiki for those tags is pretty bare-bones though.

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