Drug Safety Warnings in English, Russian, Arabic and Hebrew Wikipedia: A Cross-Sectional Audit of 33 Drugs Across Three Risk Domains
Journal:
medRxiv
Published Date:
Oct 22, 2026
Abstract
Background. Wikipedia is a leading consumer health resource, yet its medical content is audited almost only in English, and drug-safety warnings may be weaker in other editions. Objective. To test whether Russian, Arabic, and Hebrew Wikipedia articles carry less actionable drug-safety warnings than English articles. Methods. We audited 33 drugs in four language editions: 24 risk-positive drugs (eight each for glucose-6-phosphate dehydrogenase [G6PD] deficiency, teratogenicity, and QT-interval prolongation, benchmarked to reference standards) and nine negative controls. Three large language models, used as a measurement instrument, coded each warning 0 (not mentioned), 1 (mentioned), or 2 (explicit directive). A pharmacist resolved disagreements for G6PD and teratogenicity; the 12 QT disagreements kept the majority code, with an extreme-code sensitivity analysis. The prespecified analysis was a hierarchical Bayesian cumulative-logit model with English as reference. Results. Pooled cumulative odds ratios versus English were 0.41 (Russian), 0.25 (Arabic), and 0.31 (Hebrew), with posterior probabilities of 78%, 87%, and 87% that English warns more strongly; the 95% credible intervals included 1. Eight of nine language-by-domain estimates were below 1 (exception: Russian QT). Exploratory analyses suggested that the Russian gap mainly reflects missing or short articles, whereas Arabic articles less often escalated a mentioned risk to a directive. Wikidata's contraindication property appears in 12 statements in total, none for the audited drugs. Conclusions. Warnings were weaker in Russian, Arabic, and Hebrew than in English in eight of nine comparisons, with wide uncertainty from a small purposive panel and model codes not yet validated against human coding.
