Automated creation of a critical care reference

One of the reasons we are so passionate about using a wiki for knowledge organization, is the ability to intelligently derive information from other information. The wiki is a dynamic platform.  Caution up front, this post will not focus on medical knowledge as many of our blog posts, but will discuss the technical details of how we used the wiki to automate the creation of 14 pages of data with over 50 medication and equipment doses.   The process provides an example of how placing medical knowledge on a wiki provides an exponential number of opportunities of organization, derivation, and advanced learning.


The first concept to explore is structured vs unstructured data.  At the most basic form, data that has information attached to it is structured and data that has no describing information is unstructured.  The data that describes data is known as metadata.  This fundamental concept makes a wiki extremely powerful for organizing information compared to a blog (which is unstructured or at most semistructured).  Information on a blog is only useful for retrieval for reading, linking and searching.  There is no manner of combining data from one blog post with another blog post to create a derivative post, unless you manually copy and paste. Even then the data is static and updating one site does not update all other sites reposting the information. Without structuring the data, it is impossible to dynamically reference.


Enter the Template

On the wiki there are many ways of structuring data.  One of the easiest is via templates.  A templates groups data with other like data.  The most impressive use of templates to date on WikEM is the Antibiotics by Diagnosis.  Each grouping of antibiotics for a specific diagnosis are linked together as a template.  When an antibiotic dose is changed for a specific disease process it changes on all pages using the template.  Not only does this minimize errors, it also provides for ease of updates when new guidelines and evidence changes practice.

Building the Content

To create the Critical care quick reference, information was organized into two templates, a list of doses and values for equipment calculations, and a calculations page that would perform the weight based dosing.  Then every page for age specific Screen Shot 2015-04-15 at 8.34.25 PMdosing would automatically generate and populate with all the necessary calculations.  When viewed separately that look unimpressive, but when combined they can create the the dosing of a 3.5kg newborn in seconds. In a sense, the wiki behaves exactly like an excel spreadsheet where formulas populate all the necessary content.  Changing the value of one cell populates all other cells referencing the original value.

The Future

This example is just the tip of the iceberg for using the structured data of a wiki. We already use the content for offline sync on mobile apps, and wikipedia uses a significant portion of their wikidata for updating content across languages. The possibilities are endless and can even extend to institutional specific data, protocols, and care pathways.


-Dan Ostermayer, MD

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