Talk:Acupuncture/Archive 17

Restoring consensus wording re Ernst review

 * Update: the somewhat-convoluted consensus wording  reflects the rather convoluted source material.  But since Ernst '11 is a review of reviews that span 2000-2009, its findings are pretty outdated, and there's no good reason to keep it in the lede when we have recent, unambiguous stuff available.  See below:  Better sources for efficacy in lede; MEDDATE.  --Middle 8 (contribs • COI) 09:56, 25 October 2014 (UTC)

original thread-starter follows: Self-explanatory ES, and left a note on Doc James' page (section here) since I was reverting him. My edit restores the latest consensus wording which was a bold edit by User:Vzaak  that accords with the source Ernst 2009. QuackGuru among others accepted this edit as we see in archived talk. That was a broad consensus; there were a lot of editors involved spanning more than one talk page, and those who didn't comment implicitly accepted Vzaak's edit per WP:SILENCE.

That said, I think that when it comes to efficacy we can do better than Ernst's 2009 review of reviews whose dataset spans 2000-2009. But for safety that source remains fine. --Middle 8 (contribs • COI) 07:37, 13 October 2014 (UTC)


 * You reverted my edits to the lede and body, saying "violation of consensus". WHAT???
 * As stated, my edit restored the broad consensus reached at archived talk supporting Vzaak's edit. In fact, as stated, you supported that consensus. (1) Please justify your edit in light of consensus, and show evidence for any supposedly more recent broad consensus. (Note that in e.g. this recent version, the wording in the body reflects Vzaak's consensus wording. Is there any discussion of what that later changed?)  (2) Please explain why you changed your mind.
 * Also, above, you said: "Better sources were found and editors have moved on." (3) Which "better sources"?
 * Again, I'm being very specific. I sometimes have a hard time understanding your writing.  So if you indicate which question you're replying to, it will help me with WP:DR a great deal.  Thanks, Middle 8 (contribs • COI) 08:50, 13 October 2014 (UTC) revised 09:05, 13 October 2014 (UTC)
 * I do not see the justification for
 * "A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain..."
 * When this can be summarized as
 * "A systematic review of systematic reviews..."
 * Why exactly is "highlighted recent high-quality randomized controlled trials"? A proper systematic review for an intervention of course only includes high quality RCTs. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:27, 13 October 2014 (UTC)


 * (e/c) Because it was a review of reviews and the RCT was cited as an exception. The dataset was reviews of efficacy for pain, a majority of which were actually positive.  But Ernst considered those results dubious, because of the low quality of many RCT's that the reviews looked at.  (The reviews spanned 2000-2009, so the RCT's they looked at go back even further.)  As part of his explanation of why he thought the positive reviews dubious, he pointed to some high-quality RCT's, including one from 2010, Suarez-Almazor, to which the phrase "real acupuncture was no more effective than sham" (on the last page of the review) refers.  Then he went on to predict (correctly) that in the future, as RCT's got better, results would be likely to show small efficacy or none.
 * So we need to get both the spirit and the letter right while doing violence to neither. To do that we need to stick with the precise, consensus wording as long as we're citing Ernst 2009 in the lede for efficacy.  And better, use more up-to-date reviews that actually find lack of efficacy.
 * Also see my comment on your talk page. And feel free, Doc James and all editors, to email me if you'd like a copy of the review. --Middle 8 (contribs • COI) 13:50, 13 October 2014 (UTC)
 * Addendum: So why not just cite more up-to-date reviews?  The answer so far seems to be that QuackGuru is hot to see the phrase "real acupuncture is no better than sham" in the article (see here, where he proposes using a weak source for the claim, and here, where he wanted to use Moffet, another weak source that actually failed MEDRS, per Alexbrn, and was finally deleted by Doc James ).  But that wording, "real acu is no more effective than sham", is of course synonymous with saying "acu isn't effective", which we already say for most conditions anyway.  We should just (a) report the most recent results on efficacy and (b) explain to the reader what sham/placebo acu is:  real acu at fake points, or fake acu at real points. I've tried this -- see above -- and QuackGuru escalated the drama and went to User:Kww, begging to let him take me to AN for "editing against consensus", which is pretty fucking ironic since my edits then and now actually uphold consensus, i.e. Vzaak's edit. --Middle 8 (contribs • COI) 13:50, 13 October 2014 (UTC) edited 14:10, 13 October 2014 (UTC), Middle 8 (contribs • COI) 06:31, 27 October 2014 (UTC)


 * I likewise find Middle 8's proposed rewording greatly weakens the conclusion of the systematic review, and amounts to little more than whitewashing. Dominus Vobisdu (talk) 13:35, 13 October 2014 (UTC)
 * Have you read the review -- not just the abstract? I doubt it, or else you'd know that the phrase "real acupuncture was no more effective than sham" (on the final page) refers to the RCT by Suarez-Almazor (2009), with which Ernst was contrasting the dataset (which was reviews from 2000-2009 that found for efficacy, albeit with contradictions, hence Ernst's citation of newer, better stuff like Suarez-Almazor).
 * And please explain this edit summary -- where you revert my restoring Vzaak's consensus wording and repeat QuackGuru's ES "violation of consensus".  Oh really?  Show us that contrary, more recent consensus?  I doubt you can point to that either, since it doesn't exist.
 * Neither the source nor the edit history backs you up. I think -- and I think it's obvious -- that you're just trying to wing it, making broadly "anti-acupuncture" edits that you figure must be correct.  Dude!  Way to edit an encyclopedia!  --Middle 8 (contribs • COI) 14:06, 13 October 2014 (UTC)

You could try a RfC Doc James  (talk · contribs · email) (if I write on your page reply on mine) 15:36, 25 October 2014 (UTC)
 * No need for an RfC when there is a consensus. Jayaguru-Shishya (talk) 18:13, 25 October 2014 (UTC)
 * What consensus? Can you prove that? The Banner talk 18:20, 25 October 2014 (UTC)
 * Middle 8 has tried again to edit against conneusus. No consensus for the wording. I think editors need to quit trying to add unnecessary or misleading details to the lede. QuackGuru  ( talk ) 01:48, 26 October 2014 (UTC)

Restoration of verifiable material
I removed material that failed verification per source and replaced it with an earlier, verifiable piece of text. I got reverted, however, by Dominus Vobisdu per "Fringe whitewashing". Taking that no explanation for such revert was given,, what was your reason for such a revert? Instead of editing collaboratively, your edit without any reason seems like a personal attack making accusations of "fringe" and "whitewashing", and such behavior cannot be tolerated at an encyclopedia. Jayaguru-Shishya (talk) 15:28, 13 October 2014 (UTC)
 * See my comments just above; same issue. Dominus Vobisdu is as wrong as can be on this, both on the history (both you, J-S, and I indeed restored consensus wording) and the source (per above).  After the dust settles here, I will escalate the issue to a noticeboard unless D.V. changes course.  --Middle 8 (contribs • COI) 15:37, 13 October 2014 (UTC)


 * It's embarrassing, the way you guys are doubling down and not engaging on substance. Epitome of 2nd sentence of WP:NPA.
 * Re COI: I've seen no evidence J-S has one, and I've plainly declared mine. --Middle 8 (contribs • COI) 18:51, 13 October 2014 (UTC)
 * Personally, I see your being an acupuncturist as an asset because you can offer your expertise to edits. You're not editing an article on "Middle 8 the Acupuncturist". LesVegas (talk) 20:18, 13 October 2014 (UTC)
 * Thanks! A lot of editors don't really understand WP:COI.  Sometimes subject-matter experts find that "no good deed goes unpunished" around here.  :-/ --Middle 8 (contribs • COI) 05:52, 14 October 2014 (UTC)

Put simply: The reason Ernst's review-of-reviews doesn't find unambiguously for lack of efficacy is because the dataset is old-ish reviews (spanning 2000-09) based upon still-older RCT's, which weren't designed very well. With newer and better RCT's we started seeing more and more convergence toward the null result (no efficacy vs. placebo). Ernst '09 predicts this... and cites one such RCT as an example of real being no better than sham. Hence consensus language : A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain real acupuncture was no better than sham acupuncture. But we'd be better off using a newer, less ambiguous review, rather than a superseded one that requires clarification. --Middle 8 (contribs • COI) 08:36, 14 October 2014 (UTC)


 * OK, here is a full copy of Ernst '11 at researchgate.com. correction: it's Ernst '11 not Ernst '09 (thanks to User:ImperfectlyInformed, whose diff is also informative.)  It's about two broad topics, efficacy and risks, and we're concerned with the former.  Especially look at the Intro, Discussion and Conclusions.  Which literature is Ernst talking about when he mentions real vs. sham, on p. 762?  --Middle 8 (contribs • COI) 09:59, 14 October 2014 (UTC) <small.edited 09:43, 21 October 2014 (UTC): corrected name; it's Ernst '11

Thanks for the PDF, Middle 8, I'll try to have a look. When it comes to the achieved consensus, I think it withstands some random removals. After all, Wikipedia is not a democracy (WP:DEMOCRACY). Jayaguru-Shishya (talk) 14:56, 17 October 2014 (UTC)


 * You claimed the text failed verification and now you will "try to have a look"? https://en.wikipedia.org/wiki/Acupuncture#cite_note-Ernst_2011-8 Click on the Ernst 2011 source and you will see a little symbol of a PDF file. The PDF file has been in the article for quite some time. I read the source gain. Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture. That would be a misinterpretation of the source and the conclusion of an editor. It was the 2011 source that came to that conclusion. We do not need to say or mention it was referenced to the high-quality randomized controlled trials, anyhow. If we did something like that for every sentence this article would be ridiculously written. QuackGuru  ( talk ) 06:02, 19 October 2014 (UTC)
 * It was the RCT Suarez-Almazor to which the text about real being no better than sham refers, and this should be obvious to editors who are applying scientific literacy in reading the source (and not being disingenuous). --Middle 8 (contribs • COI) 09:47, 21 October 2014 (UTC)
 * The part "highlighted recent high-quality randomized controlled trials which found" claims the RCTs came to that conclusion. That is a OR. I explained it was the 2011 source that made that conclusion.
 * It may be the RCT Suarez-Almazor is what the text refers to but that was not what was added to the article and it is unnecessary to explain where the text was sourced to. QuackGuru  ( talk ) 10:03, 21 October 2014 (UTC)
 * Perhaps you meant it just the other way around, QuackGuru? The source still fails to verify the claim; it does, however, find that in reducing pain real acupuncture was no better than sham. In my earlier edit, I removed that piece of text that failed verification and replaced it with the previous verifiable one.
 * Perhaps you could advise me which part exactly supports that conclusion? Jayaguru-Shishya (talk) 18:34, 20 October 2014 (UTC)
 * Your edit fails V and I already explained why. There is no justification for it. QuackGuru  ( talk ) 18:48, 20 October 2014 (UTC)
 * @ No, it doesn't fail VER; we have consensus to that effect.  You say there's no justification for the edit, and that was a good question Doc James asked  -- but since you follow talk pages closely, I think you may have seen that I explained the situation already and he didn't respond.  Indeed, nobody else who reverted my consenus-restoring edit  has responded to my explanations, so WP:SILENCE can be assumed.  It's obvious we had a broad consensus in July that hasn't changed, and is substantively sound according to that consensus discussion.  Time to move on.  --Middle 8 (contribs • COI) 11:29, 22 October 2014 (UTC)

@, continuing from your comments at 10:03, 21 October 2014: Glad to see you back; you went silent shortly after my replies to you above. I know we all want to keep WP:DR moving forward, so please respond to my questions 1, 2 and 3 there. Brief recap: after some discussion, I recently remembered that we actually had a broad consensus  (including discussion at WT:MED, in which lots of editors participated) to use Vzaak's edit, which said "A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain real acupuncture was no better than sham acupuncture". And you supported that wording, enthusiastically, with a big "" in your ES. It was great to see us all on the same page with what you called a "good compromise". Given your support ( edit: at the time /edit ) and the breadth of consensus, it seems to me we should just respect that consensus and move on, shouldn't we? I look forward to your responses. Again, since we sometimes have trouble communicating, please indicate specifically which questions you're replying to -- that will help me, and I suspect others here, a great deal. Thanks! --Middle 8 (contribs • COI) 10:24, 21 October 2014 (UTC) edited 13:37, 22 October 2014 (UTC), 03:17, 25 October 2014 (UTC)
 * I explained it was OR over and over again. The newer discussion showed editors support using the text for a conclusion. QuackGuru  ( talk ) 16:58, 21 October 2014 (UTC)
 * I agree with Middle 8 restoring the firm and sound wording of the text, it has been discussed already to a great extent. Since nobody is responding to the discussion, the established consensus can be assumed. Jayaguru-Shishya (talk) 20:17, 21 October 2014 (UTC)
 * I did respond to the discussion. Read my previous comment. No editor has been able to provide a rational argument to including the unnecessary wording. QuackGuru  ( talk ) 20:27, 21 October 2014 (UTC)


 * @ Yes, I saw your comment (starting with "I explained it was OR...."). The diffs you linked to were not explanations, but simply assertions that the consensus text (from Vzaak) was OR.  No, it is not OR to quote a source correctly.  Additionally, you cited two diffs from a September discussion at WT:MEDRS that opposed consensus wording; however, we both know that there were also editors favoring it (and with more detailed analysis based on the source's grammar) -- just read that discussion and see comments from Peter Coxhead (08:40, 3 September 2014 UTC) and 2/0 (15:12, 4 September 2014 UTC).  More importantly, that discussion, having fewer participants and no consensus, does not supersede the July discussions (on this page and at WT:MED, cf. Vzaak's discussion-closing edit), which had more participants and did reach a consensus.
 * So with respect to the three questions I asked, you did offer an answer to (1), but you still haven't shown evidence for any supposedly more recent broad consensus than in July (for Vzaak's edit). You have not explained (2) at all, i.e. why you changed your mind -- not that you have too, but it is odd.  Nor (3) have you explained your statement that "Better sources were found and editors have moved on" (3) Which "better sources" -- but we can let that one go since you're not pressing it.  Still, that leaves (1), which is fundamental to consensus.
 * And most importantly, you are totally overlooking the context of Ernst's statement about real vs. sham. So I would ask some new questions: (4), are you suggesting that any statement X made in a review article, no matter what the context, can be cited as "the review found X"?  If so, that's prima facie unsound; and if not, then (5) why do you think context doesn't matter in this case?  Maybe English isn't your first language (and that's OK, obviously), but I assure you, grammatically, that the antecedent for Ernst's statement re real vs. sham is indeed Suarez-Alamazor.  (6) Do you see that the dataset is reviews, and that they're old and based on poor quality RCT's?  (7) In light of (6), do you see that Ernst is contrasting his dataset with Suarez-Almazor's RCT?
 * Additionally, we don't say that Ernst '11 found real to be no better than sham just because Ernst found that to be true in later papers. Which is why I've been saying we should cite later papers instead.... and I hope that that point makes it clear that I am not trying to "whitewash" anything; I just think content errors hurt the project.
 * And in light of our difficulty communicating in the past, I wish you would answer my queries specifically, e.g. "My answer to Middle 8's question 1 is (...); my answer to his question 2 is (...)? That would help me a lot, and it's not an unreasonable demand.  So, work with me on this, OK?  Thanks!  --Middle 8 (contribs • COI) 11:21, 22 October 2014 (UTC) edited 13:34, 22 October 2014 (UTC), 22:28, 22 October 2014 (UTC)
 * But I did explain the problems with the current wording. It is reasonable to ask you to follow WP:COIADVICE. You did declare you have a COI, right? QuackGuru  ( talk ) 19:09, 23 October 2014 (UTC)
 * Your diff simply says you changed your mind about how to read Ernst '11, which sort of answers my #2, but still leaves 4,5,6 and 7 unaddressed. I'm giving you every opportunity to move discussion forward. Re COI, etc., see long reply below  (or read the link in my signature, which anticipates your question). --Middle 8 (contribs • COI) 15:02, 24 October 2014 (UTC) edited 01:30, 25 October 2014 (UTC)

Continued controversial changes

 * Revision as of 13:16, 8 July 2014 Middle 8 deleted sourced text but claimed the source doesn't support the general statement.


 * Revision as of 05:45, 31 August 2014 Middle 8 replaced sourced text with original research in the lede. His edit was also a violation of lede because it did not summarise the body.


 * Revision as of 07:58, 1 September 2014 Middle 8 reworded the text to alter the meaning of the sentence. The part "may be" was original research. See Talk:Acupuncture.


 * Revision as of 12:52, 7 September 2014. Middle 8 replaced sourced text with SYN and OR. For example, the part "that indicates a lack of effectiveness" was original research.


 * Revision as of 06:33, 13 October 2014. Middle 8 restored disputed text again.


 * Revision as of 09:14, 13 October 2014. Middle 8 restored disputed text again.


 * Revision as of 15:52, 21 October 2014. Middle 8 restored disputed text again. According to his edit summary, he claims I agree with him.

Let's review: "These findings should be seen in the light of recent results from high-quality randomized controlled trials. Cherkin et al.[14] have shown that, for chronic low back pain, individualized acupuncture is not better in reducing symptoms than formula acupuncture or sham acupuncture with a toothpick that does not penetrate the skin." Reference number 14.

"This view was further strengthened by a recent randomized controlled trial in patients with osteoarthritis examining the effects of acupuncturists’ communication style [128]." Reference number 128.

The part "highlighted recent high-quality randomized controlled trials" refers to it should be seen in the light of recent results from high-quality randomized controlled trials. The source does not indicate it was the conclusion of the recent high-quality randomized controlled trials. and this is not how to summarise sources. No other text (specially in the lede) needs to explain what sources a review may or might have referred to.

"Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham." This was an independent sentence that did not specifically refer to any randomized controlled trials. It is you opinion (educated guess) that you think the source refers to RCTs for that specific sentence. It is unencyclopedic writing to have this extreme level of detail, anyhow.

See WP:COI: "If the article you want to edit has few involved editors, consider asking someone at the talk page of a related Wikiproject for someone to make the change.

If another editor objects for any reason, then it's a controversial edit. Such edits should be discussed on the article's talk page."

Did Middle 8 violate WP:COIADVICE by knowingly making a controversial disputed edit? Middle 8, do you agree to follow WP:COIADVICE and revert your controversial edit and wait for consensus? QuackGuru ( talk ) 19:09, 23 October 2014 (UTC)


 * Hmm, many diffs loose from their context, and only accompanied by your personal commentaries. So have these issues been subjects of conversation before, and what are you suggesting exactly? Perhaps links to the original discussion would give a better picture than individual diffs alone? Especially when you are bringing up diffs from as early as last June, some clarification would be more than welcome! Cheers! Jayaguru-Shishya (talk) 13:17, 24 October 2014 (UTC)


 * @QuackGuru -- First, re my COI, it doesn't sound like you've read my declaration (see here or in my signature line) carefully. I have a COI (like any party with an interest in an outcome), but it doesn't make me ineligible to write a Cochrane review, for example.  Nor does it reach Wikipedia's threshold, where COIADVICE kicks in.  WP:COI has said, for years, that simply having a profession doesn't create a COI.  Which makes sense:  since I could write a Cochrane review on acupuncture, it would be pretty stupid for Wikipedia to restrict my editing simply on professional grounds.  I know that some of the most ardent skeptic-warriors would very much like to see acupuncturists constrained by COIADVICE, but less partisan editors have observed, repeatedly, that doing so would be a kind of WP:GAME.


 * Second, re Ernst' 11, I don't know why you're re-litigating this. We reached a broad consensus in July, and it still applies, even though you changed your mind.  And July's broad consensus got it right.  Your analysis above misreads context.  Here's the full paragraph from the top of p.762 of Ernst '11, color-coded for clarity.  My clarifications are in [brackets]:


 * These findings [i.e. the findings of the older reviews Ernst examined, which were positive but contradictory; see Discussion on p.761] should be seen in the light of recent results from high-quality randomized controlled trials.  [note: ref. 128 is Suarez-Almazor '09.]  In the primary studies included in the systematic reviews evaluated above, the risk of bias was often considerable. Adequately controlling for nonspecific effects in future is likely to demonstrate that acupuncture has no or few specific effects on pain [89].


 * Remember, this is a review of reviews spanning 2000-2009, and those reviews are based on RCT's that are even older. A LOT has changed since then, and that's why this paragraph exists: so that Ernst can contrast those reviews with newer, better RCT's.  The text in  and the text in .  Your assertion to the contrary  is incorrect.  We can't just pick a sentence from, e.g., the brown or purple text above and say "this was a finding of Ernst" -- that's absurd!  Context matters.  To find out what the findings of Ernst '11 are, look at the abstract, or the last two sentences of the paragraph above, where he is actually discussing his dataset.


 * The only way in which "real acupuncture was no better than sham" is a "finding" of Ernst '11 is in a very hazy "spirit of the law" sense, insofar as he predicts the trend of future research as methods improve. But our job is to get both the spirit and the letter right without screwing up either.  To do that, all we have to do is use more recent sources that are less ambiguous than Ernst '11.  That's a better use of your energy and mine.


 * Third, re your complaints about my edits: If I were you, I'd be careful about throwing around perfectly reasonable edits, because they may well boomerang back at you.  You've already tried that multiple times at Kww's user talk, but he's been silent.  You're attempting to imply that by making an edit more than once, I must be fighting consensus, but in fact I'm restoring July's consensus, which you've been edit-warring against: a classic boomerang situation. I'll respond below only to show how meritless your objections are, for the record.


 * 1. Revision as of 13:16, 8 July 2014 Middle 8 deleted sourced text but claimed the source doesn't support the general statement.
 * And I was right (See also #3 below). This was resolved with a consensus-forming bold edit by Vzaak in July. (Discussion here & links therein, and sections preceding)


 * 2. Revision as of 05:45, 31 August 2014 Middle 8 replaced sourced text with original research in the lede. His edit was also a violation of lede because it did not summarise the body. 
 * Perfectly good edit -- very simple explanation of controls -- but you (QuackGuru) define OR as any sort of paraphrasing or summarizing of sources. See WP:CGTW, #5.


 * 3. Revision as of 07:58, 1 September 2014 Middle 8 reworded the text to alter the meaning of the sentence. The part "may be" was original research. See Talk:Acupuncture.
 * Similar to #1; Edit is fully consistent with ES, and ES is true. See Ernst '11, pp. 761, especially 1st paragraph under "4. Discussion."


 * 4. Revision as of 12:52, 7 September 2014. Middle 8 replaced sourced text with SYN and OR. For example, the part "that indicates a lack of effectiveness" was original research.
 * Similar to #2. Any editor who knows the topic area and understands SYN/OR will recognize this as a good summary of study design.  I can't help it if you keep reverting good edits.


 * 5. Revision as of 06:33, 13 October 2014. Middle 8 restored disputed text again.
 * This was restoring consensus wording per #1.


 * 6. Revision as of 09:14, 13 October 2014. Middle 8 restored disputed text again.
 * Same as #5.


 * 7. Revision as of 15:52, 21 October 2014. Middle 8 restored disputed text again. According to his edit summary, he claims I agree with him.
 * Same as #5. And just as my ES says, you did support this in July: Your ES gave it a thumbs up.


 * All in all, it's time for you to stop fighting a broad consensus that was factually correct, and to stop accusing others of violating consensus when you're actually the one doing that. That kind of conduct is very likely to boomerang.


 * A better idea: let's use more recent sources.  Ernst '11, as I said, relies on reviews from 2000-2009, which are based on RCT's probably going back to the early 1990's.  The Streitberger needle didn't even come along until ca. 1998!  Ernst '11 is full of outdated information, which is why he made a prediction in the last sentence of the excerpt above.  Better, less ambiguous sources now exist.  --14:51, 24 October 2014 (UTC) copy-edit and format, 15:16, 24 October 2014 (UTC), minor edits 18:52, 24 October 2014 (UTC)


 * See below at section Better sources for efficacy in lede; MEDDATE re suggestions on improving sourcing and getting around tedious wording disputes associated with older sources. --Middle 8 (contribs • COI) 09:23, 25 October 2014 (UTC)

There is broad consensus for the concise wording
User:Dominus Vobisdu, User:McSly, User:Jim1138, User:Roxy the dog, User:Doc James, User:Bobrayner, prefer the accurate wording. There is no need to add the complicated or inaccurate details to the lede. User:RexxS articulated that "This is completely against our policy of respecting secondary sources; none of us can know how many sources, primary and secondary, he has examined to reach his conclusion." User:RexxS also explained that adding the amateur detective work of Wikipedia editors is precisely what we don't do in MEDRS. User:Yobol stated that "Ernst spends an entire paragraph (the largest paragraph in the discussion section, as a matter of fact) to basically endorse two high quality primary studies finding "real" wasn't different than "sham". My interpretation: It would be incorrect to say that discussion about sham acupuncture was the only or primary conclusion of the paper; however, does seem to be a conclusion Ernst is making and therefore citable as a source for that conclusion." The text is sourced and the 2011 review is MEDRS complaint. QuackGuru ( talk ) 19:40, 26 October 2014 (UTC)
 * QuackGuru, we both know that the real/sham wording is about a particular RCT and not an overall "finding" of Ernst '11. Your wording isn't factually true, but it is truthy.
 * I agree with Yobol's observation in a sense, but only in a "spirit of the law" way, and it's a stretch.
 * You're citing only editors who agree with you. Discussions on this have ranged from inconclusive to opposing your preferred wording. Neglecting that is dishonest.
 * Dislking the more complex wording isn't the same as endorsing the simpler wording. There's a third choice of dropping the real/sham wording altogether.  It's not in the abstract, and it's not an accurate description of Ernst's findings.
 * I know as well as anyone that the trend in acu research has been toward the null (where real and sham are equivalent), or clinically insignificant differences between real and sham. But "real is no better than sham" is not a "finding" of this paper. If Wikipedia wants to play it truthy and sloppy, that's the way it is.  I think we can do better than that, and get the letter and spirit of the law right without screwing up either.
 * --Middle 8 (contribs • COI) 04:56, 27 October 2014 (UTC) editedMiddle 8 (contribs • COI) 05:19, 27 October 2014 (UTC)
 * Doc James, e.g., wrote "I am of the opinion that one can just summarize the conclusions of the review which is "in conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain." ". --Middle 8 (contribs • COI) 05:01, 27 October 2014 (UTC)
 * 2/0 wrote: "Middle 8's reading of the source in context agrees with mine that the sentence "Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham" is a report of the conclusion reached by Suarez-Almazor 2010. Ernst 2011 is pretty harsh on the quality of available evidence and should by no means be cited as supportive of the practice, but this particular statement is providing context for the results being reported: it is not a result itself of the present work." --Middle 8 (contribs • COI) 05:05, 27 October 2014 (UTC)
 * We are already including a conclusion and the conclusion in the lede.
 * Complicated wording is sloppy wording. Verification for the concise text was previously provided and your proposals are tantamount to original research.
 * I provided evidence there are several editors who disagree with you. That is your choice if you ignore consensus. You should not delete it from the lede because you don't like the concise wording for the lede. The text should be concise and not be complicated, especially in the lede for the general reader.  QuackGuru  ( talk ) 05:18, 27 October 2014 (UTC)
 * No, I was not being disingenuous here. Read comments from other editors who disagree with your personal interperation. Your changing your comment after I replied. It would be easier to follow if you striked your comment. QuackGuru  ( talk ) 05:43, 27 October 2014 (UTC)
 * (e/c) You're citing editors who were then reverted and didn't object to talk page discussion, cf. WP:SILENCE, and that's not very honest. We had broad consensus in July (discussion here) that the more complex wording is the proper way to parse the source (as long as you insist on keeping the real/sham wording), and you supported that.  It's not clear why you changed your mind.  You wrote: "Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture."  WHAT?  How do you figure that? --Middle 8 (contribs • COI) 05:48, 27 October 2014 (UTC)
 * It would be most concise to just cite the abstract as Doc James suggests and bypass the disputed wording. --Middle 8 (contribs • COI) 05:57, 27 October 2014 (UTC)
 * Do you think any other editor is or was being disingenuous too? I citing editors who reverted the complex wording and they don't have to argue on talk page discussion. See WP:EDITCONSENSUS. I just did explain the concise wording with including sham vs real acupuncture is better and I did explain it was a conclusion from the review. You can read my recent comments again if you still don't understand my arguments. Now that the text is not too wordy for the general reader you don't like it? There is a general consneus for COI editors to follow WP:COIADVICE and there are ways for dealing with WP:SPA. See Conflict of interest. Do you think your edits are Conflict of interest? QuackGuru  ( talk ) 06:16, 27 October 2014 (UTC)
 * Yes, you are being far more than disingenuous, fellow editor; you are outright lying in order to get your way. See below. --Middle 8 (contribs • COI) 07:41, 27 October 2014 (UTC)
 * Taking into account that a broad consensus indeed was achieved, reverting against the consensus just because "I don't like it" is not an excuse. On the opposite, WP:TALKDONTREVERT makes it very clear that it is an obligation of every editor to discuss the issues at Talk Page. What matters is "the quality of arguments"; the editors you mentioned QuackGuru, they didn't even participated the discussion.
 * "In determining consensus, consider the quality of the arguments, the history of how they came about, the objections of those who disagree, and existing policies and guidelines. The quality of an argument is more important than whether it represents a minority or a majority view. The arguments "I just don't like it" and "I just like it" usually carry no weight whatsoever. [...] This obligation applies to all editors: consensus can be assumed if editors stop responding to talk page discussions, and editors who ignore talk page discussions yet continue to edit in or revert disputed material may be guilty of disruptive editing and incur sanctions. (WP:TALKDONTREVERT)"


 * Jayaguru-Shishya (talk) 18:42, 27 October 2014 (UTC)
 * So, are you going to continue to ignore WP:COIADVICE or are you only going to make Conflict of interest? QuackGuru  ( talk ) 08:15, 27 October 2014 (UTC)
 * Classic IDHT: I've twice replied on this, and anyone can read my COI declaration (in my signature), which you undoubtedly have.
 * Additionally, I noticed that you placed the COI template Template:Connected contributor on top of this page on 13 October 2014. (In good faith I have filled it in further .) But putting it there was gratuitous, since that template states:
 * I've obviously made an informed choice already since I already have a COI declaration (see history). And your question about COI was the third time you've asked me. Your repeated "questioning" (as if you didn't know the answer) is disingenuous.  --Middle 8 (contribs • COI) 14:56, 27 October 2014 (UTC)
 * I've obviously made an informed choice already since I already have a COI declaration (see history). And your question about COI was the third time you've asked me. Your repeated "questioning" (as if you didn't know the answer) is disingenuous.  --Middle 8 (contribs • COI) 14:56, 27 October 2014 (UTC)

WP:LIE: Just don't.
It's one thing to complain about reasonable enough edits, and another to push truthy mainspace edits, but I draw the line at outright dishonesty, which is what we are now seeing from User:QuackGuru. He stated: "Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture." He's referring to RCT's cited by Ernst '11 at the top of p.762: namely Cherkin's famous "toothpick" study  and Suarez-Almazor's study on knee osteoarthritis that also looked at bedside manner. Both of these studies very clearly found for no efficacy. QuackGuru's full quote:


 * "I read the source again. Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture. That would be a misinterpretation of the source and the conclusion of an editor. It was the 2011 source that came to that conclusion."

Only the woo-iest of woo-pushers would argue that Cherkin's "toothpick" study found other than a null result. There is no way someone can possibly both be medically literate and truthfully make that statement, and we know QuackGuru is medically literate. Nor is there any way one can approach matters here with the usual trenchancy and then go all wobbly and plead that we're seeing good-faith error. This is simply "end justifying the means" stuff and is inappropriate. He's saying this only to push the view that Ernst's comments about real/sham are an "overall finding" as opposed to a comment on a particular RCT. He could have just been honest and said, as Yobol did, that it's reasonably construable as "a" finding. I get that. But in order to get his way, QuackGuru was willing to say whatever it takes, even a bald untruth.

Rather than working from sources, QuackGuru has fixated on the phrase "real acupuncture is no better than sham" and tried to find any source possible to get it in. See here, where he proposes using a weak source for the claim, and and here, where he wanted to use a review by Moffet, another weak source. Moffet is from a "fringe journal" and actually failed MEDRS, as Alexbrn noted, which Doc James finally deleted). QuackGuru is usually the first to object to such MEDRS-compliant sources.  But not when it suits his agenda, in this case.

As far as the current dispute goes, I'm not going to spend much more energy debating QuackGuru's prefered "simple-yet-inaccurate" wording, unless others want to file an RfC/A. I know very well that it looks tendentious and POV-pushy for me, as an acupuncturist, to argue against anything critical of acupuncture -- after all, even if it's technically inaccurate, it's consistent with Ernst's prediction that "Adequately controlling for nonspecific effects in future is likely to demonstrate that acupuncture has no or few specific effects on pain". (And of course we could just cite that, but that's not good enough for the page's owner.)

So be aware of what is happening. We have a dubious mainspace portrayal of an Ernst review and a completely ridiculous talkspace assertion about good RCT's for the sole purpose of supporting that mainspace edit. When a "skeptic" editor resorts to outright deception on order to push wording that is as critical as possible of an alt-med, is that good for the project? Maybe as long as we get the right answer. But we also saw this same editor wanting to use a non-MEDRS-compliant sources to get his desired wording. So no, we're not necessarily getting the right answers at all.

And yes I know this is a stupid dispute, and am going to take a break. --Middle 8 (contribs • COI) 07:41, 27 October 2014 (UTC)
 * It was you who continued this dispute when you deleted the text back in July and now that the text is not complex you want it gone from the lede. The 2011 source mentioned the randomized controlled trials but the review itself came to their own specific conclusion. QuackGuru  ( talk ) 08:15, 27 October 2014 (UTC)


 * Middle 8, I agree with you wholeheartedly so I wouldn't mind filing the RfC/A for this, and frankly, for other issues as well (like repeated removal of justified POV tags). I'm not an acupuncturist so I don't have the supposed COI you do, but I am still fairly new and haven't ever done this before. Would someone be willing to help assist me in this? LesVegas (talk) 17:42, 5 November 2014 (UTC)


 * The policy and guidelines for placing your favourite POV tags are clear, which is the reason they get removed when you place them. -Roxy the dog™ (resonate) 18:59, 5 November 2014 (UTC)


 * LesVegas, have you seen Talk:Acupuncture already? As the name says, there's an extensive summary of the outstanding issues in the article. Cheers! Jayaguru-Shishya (talk) 20:14, 5 November 2014 (UTC)


 * Yes, I sure have but never considered it to construct an RfC. Excellent idea! Thanks! LesVegas (talk) 06:22, 11 November 2014 (UTC)

Low impact factor journal
The impact factor is O.59 according to ResearchGate.

I'd rather delete the fringe journal because we have better sources such as a 2013 Cochrane review in the same section. We should review each journal on a case by case basis. Sometimes fringe journals can fill in the blankets for mundane claims but I think it is unnecessary to include this one. Thoughts? QuackGuru ( talk ) 18:33, 29 October 2014 (UTC)


 * QuackGuru, first, I want to commend you for not making a POV edit here. Thank you, thank you, thank you. I know you really don't like or believe in acupuncture so it is refreshing to see you propose deletion of an anti-acupuncture review for the sake of the article's quality, and again, I'm happy to see this behavior. But back to your question. Overall, it seems to me there is a great deal of information that is left out of the article. We need more studies, from everywhere, not less. I think this article needs to be expanded a great deal to include more studies from everywhere and on every topic. There is a rich amount of data we still need to mine. Then I think once we have a robust amount of data on the article, at that point, we trim. For now, impact factor should be a factor in placement, absolutely, but we shouldn't delete anything reliably sourced. Is the journal peer reviewed? LesVegas (talk) 17:32, 5 November 2014 (UTC)
 * This article should focus on acupuncture and the suggestion to include "more studies" would not meet the higher bar of WP:MEDRS. Recent reviews are most appropriate.
 * If we allow this low-quality source to stay we would allow over a hundred other low-quality sources to flood the article. There is already "a robust amount of data" in this article. QuackGuru  ( talk ) 19:38, 5 November 2014 (UTC)
 * QuackGuru, since you're really intent on removing this, fine, that's ok with me. We do have that Cochrane info so I won't fight you on this. But as a general rule, MEDRS doesn't say anything about impact factor. We have to make sure the sources aren't primary, are from peer reviewed journals, are recent (unless there's nothing newer on the subject) but impact factor has no bearing on a source being used or not. Yes, we don't want such sources in the lede, perhaps, and not more prominent than high impact factor sources. But reliable sources should always be allowed! and it's problematic if they're ever removed for any reason. LesVegas (talk) 06:11, 11 November 2014 (UTC)
 * For the record, I believe that QG is the last person that needs a condescending lecture like that !! -Roxy the dog™ (resonate) 06:16, 11 November 2014 (UTC)
 * Actually, QG has continually removed many reliable sources I and others have added. I will lecture him, and if the behavior continues, I will report him. LesVegas (talk) 06:27, 11 November 2014 (UTC)
 * Haha, good luck with that, but watch out for the boomerang catching you on the back of the neck. -Roxy the dog™ (resonate) 19:36, 11 November 2014 (UTC)
 * This has already been discussed earlier. As Roxy the dog™ said herself: "I don't believe there is a hard and fast rule on impact factor". User Brangifer supported this interpretation: "Correct. There isn't any. There can be many situations where it's not a factor, but in some it might be a decisive one.". I am more than happy to restore sources that have been removed solely on the basis of impact factor when no better reason exists. Please bring to my attention if such cases do exist. Jayaguru-Shishya (talk) 20:04, 11 November 2014 (UTC)

Note. MEDRS asks for independent sources. See Identifying reliable sources (medicine). QuackGuru ( talk ) 20:37, 11 November 2014 (UTC)