Talk:Broda Otto Barnes/Archive 1

Really?
This article doesn't have a talk page? This guy smells like a doctor who got detoured by a good discovery over into pseudo-science land. Also, are there no doctors who do not support Dr. Barnes? Where's the NPOV? Philip (Respond?)

Recent edits
I'd welcome some discussion about these edits, which are being reinserted by an IP. I'm concerned that they exacerbate a problem from which this article suffers: it reintroduces unreliable sources and primary sources affiliated with the subject. Relevant guidance can be found in our guideline on fringe theories and perhaps our reliable-sourcing guideline for medical topics. Per the latter, I'm concerned that the edits in question mine and juxtapose primary sources to "debunk" the mainstream view; this is an issue of original synthesis. I'd welcome more discussion here in place of edit-warring. MastCell Talk 04:06, 27 April 2009 (UTC)

Re: "current scientific knowledge"
MastCell. No problem with pointing out that the current medical opinion is about 5% for hypothyroidism, based on the NHANES survey (1994) published 2002. I wonder if the wording "current scientfic knowledge" is the right wording though. The reason is that in the NHANES used the upper TSH reference range of 4.6, however since then, the upper range as been lowered by the American Association of Endocrinologists to 3.04. Therefore the number of people suddenly now pushed into 'mild hypothyroidism' may be significantly more than 5% in that survey. Furthermore, the NHANES survey is not the only recent survey. After the NHANES "The Colorado Thyroid disease prevalence study" was completed (1995), published 2000. It used an even higher upper TSH range than NHANES (5.1mIU/liter) and even still found the elevated rate was 9.5%. If the most current AACE guidelines were applied to the Colorado study, the abnormal results would be significantly higher than 9.5%. So, what I'm suggesting is that the wording "current scientific knowledge" be replaced with "current mainstream medical opinion", or "current consensus in the medical community" etc. Mkronber (talk) 02:00, 30 April 2009 (UTC)
 * That illustrates some of the pitfalls inherent in using the literature. The Colorado study looked at patients recruited from statewide health fairs. That is a selected population, not representative of the general population, a point the authors make in Table 1 of their article. The Colorado study population had a median age of 56, vs. a median age of 32 in the general Colorado population. The study population was also significantly more female than the general population. It's not a representative population. Both advancing age and female gender are risk factors for elevated TSH; the Colorado study population is skewed toward a high-prevalence group for thyroid disorders. The authors don't hide that fact - they actually emphasize it - but it's the kind of thing that might not be apparent if you skim the article, and might lead one to draw an erroneous conclusion. In fact, the Colorado study population may have a prevalence of 9.5%, and the general population prevalence may be <5% - both can be (and probably are) true. The exact "normal" upper limit for TSH is a somewhat controversial topic; you cite a press release arguing for a lower TSH value, but other groups have more recently argued that TSH naturally increases with age, and that current TSH norms should be age-adjusted upwards to avoid improperly inflating the number of people diagnosed with subclinical hypothyroidism (e.g. ). I don't think anyone seriously argues that the prevalence is anywhere near 40%, though I'm open to being educated. But I digress. For the purposes of the article, either of the two alternatives you propose are fine with me. MastCell Talk 07:21, 30 April 2009 (UTC)
 * I also don't object as long as it's made more clear that these are blood test surveys, and that Dr. Barnes believed any blood test under-represents the prevalence of present or potential future disorder as diagnosed by basal low body temperature. Milo 08:08, 30 April 2009 (UTC)


 * MastCell: your points are well taken about the studies. And, I agree that here is no question that the mainstream medical opinion is currently anywhere close to 40% (which I also agree should be pointed out in the topic). I think that is that is what makes Dr. Barnes so notable and interesting--his disagreements with the mainstream. He was a doctor that was trained to diagnose hypothyroidism clinically in the 30's, and so when the diagnostic tests came along (basal metabolism, PBI, TSH, T4 etc.) he noticed right away that they were never accurate enough to be considered reliable for diagnosis on their own, and were missing people with clinical signs. Even his own basal temperature test was always used in combination with clinical signs and symptoms in his own methodology, and never on its own. Over time many of the tests were eventually discarded because it became apparent that the didn't match the clinical signs and symptoms of the disease, which is the really the definition of hypothyroidism.  Interestingly,  what you see in the literature today, both in the Colorado study and other papers (Baiser et al), is a similar commentary: that the laboratory parameters don't accurately match the clinical signs and symptoms.  So it seems that the discrepancy is largely explained by a disagreement about the accuracy of the various diagnostic tests--especially with regard to their ability to detect the mild forms of hypothyroidism. A good commentary of this can by found here: Gaby Paper pg.168 Here is a quote: "The firmness with which most physicians assert that a normal TSH level proves euthyroidism is surprising, considering such a notion is based largely on circular reasoning. Ever since the discovery in 1892 that an extract of animal thyroid tissue could cure myxedema, hypothyroidism has been defined as a clinical syndrome that responds to treatment with thyroid hormone. While various laboratory tests have been developed that correlate with thyroid status, hypothyroidism remains a clinical syndrome, and no clear reason has emerged to redefine it in terms of its laboratory correlates." - Dr. Alan Gaby, M.D.  Anyway, I digress as well, this topic is biographical and meant simply to accurately reflect what Dr. Barnes believed and wrote, not to argue whether he was right or wrong. Mkronber (talk) 14:21, 30 April 2009 (UTC)
 * For being "biographical" this article seems to omit a lot of the biography about the man. It seems to be more about his dubious research, with almost nothing about him. --Quartermaster (talk) 15:53, 4 May 2009 (UTC)


 * I believe that phenomenon has been noted before... :) MastCell Talk 18:36, 4 May 2009 (UTC)


 * Biographical only means that the article is titled with the name of a person rather than a non-personal subject. It can lightly cover any broad subject with which the the person was notably involved, and should cover in detail any issue of notable interest involving that person. Biographical articles are frequently the main article that gestate child articles if the main article gets too large, so this is the place to develop them.


 * You may be dubious per Merriam-Webster meaning 2, but per meaning 1, Barnes' solidly evidence-based research is not. For editors deeply interested in statistical research, and the biochemistry of hormone molecular receptors with names like "alpha 1" – that's where this article seems to be heading to meet the objections of casual critics. Milo 00:21, 5 May 2009 (UTC)
 * Since the article already details that Barnes was born in a log cabin and was married a second time, I'm not aware of what remaining omitted biography could amount to a lot. Milo 00:21, 5 May 2009 (UTC)

A mess
The article officially looks like a dog's breakfast. There are about 11 extraneous section headers - one for each organ-specific set of maladies which Barnes believed were caused by undiagnosed hypothyroidism. These can all be summed up in one section, particularly since all of the sourcing is to Barnes' own books and organizations directly affiliated with him, and there is no independent perspective on his claims. This is WP:COATRACKery; the article does not exist to expound at length on each of Barnes' claims in his own words, but to neutrally summarize them with the help of independent, reliable, third-party sources. MastCell Talk 19:00, 4 May 2009 (UTC)


 * He only needs third party sources to be notable, not reliable. It isn't a coatrack, his ideas belong in his article. His ideas in another article would be a coatrack. --Richard Arthur Norton (1958- ) (talk) 19:03, 4 May 2009 (UTC)


 * That's a curious viewpoint. Would you agree that independent reliable sources would be useful in constructing an encyclopedic article? As to coatracking, skip down to the Mono-Topic Fringe Biography; with every additional section credulously hyping Barnes' claims, devoid of any independent context, you're turning this into exhibit A. At this point, my major objection is stylistic - the numerous short sections, largely devoid of anything beyond regurgitation of Barnes' claims, are difficult to read. What exactly is the objection to condensing and summarizing them? MastCell Talk 19:16, 4 May 2009 (UTC)


 * Sorry, but a personal essay is not Wikipedia policy. I prefer Wikipedia policy independent of the person making the argument. What alternative person or product is the article trying to promote? I am not following your coatrack logic. --Richard Arthur Norton (1958- ) (talk) 23:29, 4 May 2009 (UTC)


 * The article contains little actual biographical detail on Barnes, and his peer-reviewed papers (supposedly the basis of his notability) are treated as an afterthought. Most of the article is devoted to credulously rehashing the more extreme of Barnes' claims, citing various obscure and low-quality sources and devoid of any sort of appropriate context. That's the basis of the coatrack issue, from where I'm standing. I didn't catch your answer: what, exactly, was the objection to condensing and summarizing the 11 sections about Barnes' claims? MastCell Talk 05:07, 5 May 2009 (UTC)


 * Those few sections that are actually short, appear to need expansion editing and referencing, not summarizing in pursuit of a perceived marginalization agenda. Some of those common, serious conditions are recurrent with, or resistant to, drug treatment. Patients having them deserve to read a full and accurate exposition of Barnes' proportion of success in treating each condition with hormones.
 * There is nothing odd about such multiple condition cure success. Adrenal steroid hormones and their analogs are well known to cure many conditions by the induced replication of enzymes and other proteins. Since thyroid is another major hormone component required to induce replication, it can be logically expected to have a cure success rate analogous to adrenal steroids, but with less risk.
 * Accordingly, I judge your new WP:COATRACK claim to be a false light, to incrementally gain the outcome properly unavailable to you at AfD.
 * Milo 00:51, 5 May 2009 (UTC)


 * When you're willing to put aside your personal ruminations and discuss actual sources and article content, I'll be happy to discuss. I don't see how the sections can be expanded in the absence of reliable sources. Have these numerous claims and their obvious benefit to humanity been assessed independently by any reputable or scholarly sources? MastCell Talk 05:07, 5 May 2009 (UTC)

MastCell, this a polite (and required) warning that you're toeing the line on tendentious debating. Before you firmly put your foot over it, please back off.

Independent reliable sources as defined by WP:V/WP:RS are adequately available to back up the major non-independent sources for this article. If you don't like them that would be irrelevant. If you claim them to be lacking for technical evidence that would be wrong (I did the research as you requested at AfD) – but that would likewise be irrelevant.

I don't think you realize how badly you damaged your intellectual reputation with denialism during the AfD. As far as I'm concerned, your opinions per the AfD record on this article are not factually objective, and should be closely scrutinized for agenda bias. You seem to be engaged in a long-term crusade against those things alternative health and medicine advocate. At best, Wikipedia frowns on crusades per Arbcom; at worst it's a bannable offense. In this case, since this subject is not alternative, and has both evidence-based and scientific merit, your oppositional pursuit of it contrary to the facts is perceivable as beyond simple crusading to the pointlessly obsessive. Please consider a Wikivacation instead of further wikistressing the editors here. If necessary, I'm prepared to sign an RFC/U on you, though I hope it won't come to that. You might or not 'win' an RFC/U, but I think you will not come out of it smelling good, and no doubt it would increase your previously expressed sense of being victimized. Since we actually agree on many positions, I would prefer to not encourage your less reasonable opponents to take you to RFC/U/2 and /3, where you might eventually lose if your present attitude further deteriorates.

I don't like discussing editors instead of edits, but I can foresee where this is going. I want to avoid the need for a pound of cure. Better to set limits now and endure whatever flash powder or gasoline you might choose to throw onto the cinders, than to engage in progressive article editing while having to fend off an attempted backdoor AfD by a thousand tendentious cuts. Milo 00:51, 5 May 2009 (UTC)


 * I would welcome the involvement of additional editors. If you feel I've crossed a line, then such involvement might help clarify the situation. You are, of course, welcome to pursue any sort of process you feel would be appropriate. I will tell you that from where I sit, you are overly concerned with attacking me personally, and insufficiently concerned with the content and sourcing of the actual article. Like most people, I don't respond particularly well to threats and bullying, and I've been around long enough to recognize when I'm being goaded. If you want to talk sources and article content, then I'm listening. If you want to make this personal, then I'm not. MastCell Talk 04:56, 5 May 2009 (UTC)

Disease headings not visible at contents
''05:57, 5 May 2009 ImperfectlyInformed (reorganize to reduce the number of section titles, add introduction of the diseases section)

The reorganization is mostly ok to a point. But the reader cannot now see at a glance of contents what diseases are covered, even though each has a non-section heading. The diseases are important and interesting to the many patients of them who are also readers. I don't consense to making them hard to find, so they should be converted as the text stands into subordinate sections. Milo 08:03, 5 May 2009 (UTC)


 * This is supposed to be a biographical entry, not a fringe-medicine dictionary. Why is so much space given to this? Per WP:UNDUE and WP:COATRACK, this should probably be trimmed a lot further - as in the discussion above. The diseases aren't the topic of this article. Verbal   chat  10:37, 5 May 2009 (UTC)


 * The major editing challenge with this article is not reliable secondary sources – they are available – it is dispelling the myths among unbiased editors willing to be guided by the objective facts.
 * Barnes in his time was a mainstream medical researcher with over a hundred peer-reviewed articles in respected major journals (including JAMA and Lancet). His major diagnostic discovery, the Barnes Basal temperature Test, was listed in the Physicians Desk Reference for many years (Langer, 2006, p.12).
 * Since you have incorrectly assumed the article content is fringe medicine, you have inadvertently engaged in unauthorized marginalization of some of Barne's notable treatment success work properly covered in detail.


 * • Not "fringe medicine" : Per WP:FRINGE: "Examples include" ... "esoteric claims about medicine". Per M-W.com "esoteric": "1 a: designed for or understood by the specially initiated alone". Even if very difficult to understand, knowledge which passes the mainstream peer-review process is not formally esoteric in the sense of a fringe theory. This isn't particle physics. Anyone with a modest knowledge of hormone biochemistry can understand the details of Barnes' discoveries, and he explained the basics in widely read popular books.
 * • Not "WP:COATRACK" : Per WP:COATRACK: "'An article about an astronaut might mostly focus on his moon landing. A moon trip that took only a tiny fraction of the astronaut's life takes up most of the article. But that does not make it a coatrack article. The event was a significant moment in the subject's life, and his main claim to notability. A reader is not misled by the focus on the moon trip.'" In this case, Dr. Barnes career was prolific, including notable treatment or prevention of challenging major diseases. To avoid systemic bias, notable work of a biographical subject requires coverage in reasonable detail of each work, for notable but non-famous as well as famous people. By analogy, why not summarize Newton with his education, plus 'He made discoveries in mathematics, optics, mechanics, and gravitation.' Or using the populist ' I never heard of it' argument, detail Newton's classically famous works, but state only that 'He also worked secretly in alchemy.'
 * • Not "WP:UNDUE" : "Per WP:UNDUE ... trimmed a lot further" WP:UNDUE cuts both ways. Since you made the mistake of assuming WP:FRINGE without checking the facts, you have violated WP:UNDUE by attempting to marginalize Barnes notable works through summarization.
 * • Not an obituary summary : "This is supposed to be a biographical entry"..."Why is so much space given to this?" As though a Wikipedia "biographical entry" is no more than an obituary recitation? The WP:COATRACK quote above makes it clear that most of the article for biographical entries may contain detailed coverage of things for which persons are notable. These notable disease treatments don't belong in their own articles until and unless this one gets too large.
 * In conclusion, your major removal of article content is based on a cascade of logical conclusions following on unresearched false premises. I don't consense it and call for restoration of the missing notable content. Milo 20:18, 5 May 2009 (UTC)


 * Do you mean condone? I disagree with your misinterpretations, and I didn't even bring up WP:FRINGE or make remarks about obituaries, but since you bring it up - yes I think that WP:FRINGE applies too. Verbal   chat  21:08, 5 May 2009 (UTC)


 * "I didn't ... make remarks about obituaries" You may clarify exactly what you meant. You claimed the article was a biography and made a complaint about so much space being given. I picked the obvious example of an obituary, as a biography that doesn't take up much space. Encyclopedic biographies can be expected to cover everything notable that a person did.
 * Space at Wikipedia is not an issue. WP:NOTPAPER: "...because Wikipedia does not require paper, we can include more information...".
 * "I didn't even bring up WP:FRINGE" No? You mean you were making a 10K deletion of referenced text under a claim of "fringe medicine" – as a WP:IDONTLIKEIT personal opinion without guiderule support? Tsk, tsk, you are a newb – that's not permitted at Wikipedia. In fact it's uncomfortably close to vandalism, but now that you know I'm sure you won't do that again.
 * "I think that WP:FRINGE applies" That's not good enough. I've isolated the controlling WP:FRINGE guiderule on medicine articles above, provided the definition of the key word "esoteric", showed that Barnes work does not meet the definition of esoteric, and therefore the 10K of referenced text cannot be deleted using WP:FRINGE as a valid reason.
 * "I disagree with your misinterpretations" You can't merely say "I disagree" and make it stick. If you can do so, you have to explain why I'm wrong, using an exposition of logical reasoning the way I did. If you can't do that, you have to concede the debate point ('take the point'), or go silent on it. You can't just stubbornly keep on saying the same unsupported thing, or that becomes a WP:IDIDNTHEARTHAT tendentious debate violation.
 * Consense is the, ah, verb form of "consensus". Milo 07:01, 8 May 2009 (UTC)

Assessment
It is possible that this article meets the B-class standards, but I'd rather that assessment was performed by someone more familiar with the subject and the usual standards for a biography. WhatamIdoing (talk) 18:12, 5 May 2009 (UTC)
 * I suggest deferring assessment for a few months until the article is closer to being stable. Major notable content removals, reinsertions, structural reorganization, and new sources to be added mean that any current assessment is not likely to remain meaningful. Milo 20:18, 5 May 2009 (UTC)

A normal temperature range of only 0.2 C?
Our article currently states: ''A measurement of 97.8F (36.6C) or below was considered by him to be highly indicative of hypothyroidism, especially when hypothyroid symptoms are present. A reading over 98.2F (36.8C) was indicative of hyperthyroidism''. That seems extraordinary - that if your body temperature doesn't fall within a 0.2 C range you have a thyroid disorder - particularly given modern knowledge of wide variations in basal temperature among normal individuals. My question: is this an accurate representation of Barnes' claims? As a separate matter, can someone more well-versed indicate whether Barnes took issue with truly modern thyroid function tests (e.g. TSH)? The parts of his book that I've been able to read on Google Books complain at length about older, obsolete methods of thyroid testing, but don't mention currently used tests. MastCell Talk 22:31, 5 May 2009 (UTC)
 * "if your body temperature doesn't fall within a 0.2 C range..." That's correct when stated in Fahrenheit, per Barnes, Hypothyroidism (1976), p.46. 98°F ±0.2 is the easiest way to remember it.
 * "...modern..." I take that to mean "contemporary" since "modern" (roughly 1918-1991) could be understood to include Dr. Barnes' career lifetime.
 * "...knowledge of wide variations in basal temperature among..." My understanding is that Dr. Barnes' did the definitive survey research in this area. First on 1000 college students reported in JAMA, 1942 (p.43), and then on 1000 soldiers with Dr. Ehrlich (Barnes, 1976, p.43). The latter study report was not mentioned on the same page, but perhaps that was the one appearing in the Lancet.
 * "...normal individuals..." "There is a definite range for normal basal temperature." (Barnes, 1976, p.5) In my understanding and words, Barnes made a previously unknown discovery of what constitutes normal. "Normal" to evolution is any individual who reproduces, legal-medical "normal" is everyone without a courtroom-certifiable diagnosis, but normal to Barnes, through peer-reviewed scientific medical research, was this range of human temperatures in which there were the fewest health complaints and least external observations of mental malfunction.
 * ...you have a thyroid disorder" Not exactly. The article states it better "to be highly indicative of hypothyroidism". Barnes mentions other causes of low basal temperature "—for example, starvation, pituitary gland deficiency, or adrenal gland deficiency." (Barnes, 1976, p.46)
 * "That seems extraordinary" Per Langer: "But even though the temperature tests' accuracy has been abundantly demonstrated, we do not lean exclusively on its results. We verify them with classical symptoms of hypothyroidism and the patients thorough medical history, carefully correlating and interpreting data." (Langer, 2006), p.13.


 * "whether Barnes took issue with truly modern thyroid function tests (e.g. TSH)?" Barnes, 1976, does not mention "TSH" by my search for those letters. But TSH is an indirect, feedback loop measure of thyroid hormone supply, about which Barnes wrote, "The amounts of money in wallet or bank account, like tests for the amount of hormone in gland or bloodstream, tell us nothing about how much is being spent." (Barnes, 1976, p.42)
 * Dr. Langer uses TSH, BBTT, and clinical symptoms. He discusses the unreliability of conventional hypothyroid "normal" test results, which certainly includes TSH, and desirability of multiple hypothyroid testing procedures (Langer, 2006, p.13).
 * Milo 10:14, 6 May 2009 (UTC)


 * OK; but the article is not about Langer, but about Broda Barnes. We shouldn't imply that Barnes criticized truly modern/contemporary tests like TSH unless he actually did so, right? And no, Barnes did not do the "definitive" research on normal body temperature. Wunderlich studied 25,000 people in the 1860s and for at least a century thereafter was considered the definitive word on the subject. More recently, a 2002 systematic review of all methodologically sound research on normal body temperature published between 1935 and 1998 failed to cite any of Barnes' work, suggesting that he is not viewed as having produced any definitive (or, indeed, relevant) research on the topic . MastCell Talk 21:42, 6 May 2009 (UTC)


 * ←"Wunderlich studied 25,000 people in the 1860s" I think there's been a context slip. Normal body temperature is different from normal basal temperature. Using my words, I recall that Barnes said the former varied widely compared to the latter, and that only the latter was suitable for metabolic rate testing of thyroid utilization.
 * "2002 systematic review (PMID 12000664) [Märtha Sund-Levander, 2002] failed to cite any of Barnes' work." It sounds to me like Barnes, 1942, and (I assume) Barns, 1945 were properly excluded as a significantly different field of study. Since average normal body temperature is higher than average normal basal temperature by 0.6-0.7°F, including Barnes' two studies might have have shifted the systematic review's mean lower and reduced its standard deviation.


 * "We shouldn't imply that Barnes criticized truly modern/contemporary tests like TSH unless he actually did so" It's a truth vs. verifiability problem. Barnes may or not have been there when the TSH test was consensed at a meeting of thyroidologists in 1973 (Rethinking the TSH Test, David Derry MD, PhD). But he surely knew about it, and probably he was still evaluating TSH in 1975-1976 when he finished writing Hypothyroidism: The Unsuspected Illness (1976). Langer, Starr, and Derry are all critical of TSH tests for cause, and Derry does not mention Barnes or basal temperature tests. Thus, prior to his death in 1988 and his book on hypoglycemia (Barnes, 1989), there is no reason to believe that Barnes was any less critical of TSH tests than they were.
 * When truth is persuasive or at least likely, but not verifiable, I recall WP advice to state the facts and let the reader draw their own conclusion. For example: "'Dr. Barnes believed that measurements of thyroid hormone supply could not provide information about how it was being metabolically utilized. He wrote, 'The amounts of money in wallet or bank account, like tests for the amount of hormone in gland or bloodstream, tell us nothing about how much is being spent.' (Barnes, 1976, p.42). {A quote from p.41 may be better} ¶ Adopted by thyroidologists in 1973, the TSH blood test was not mentioned in Dr. Barnes book published 1976. TSH testing is an indirect measure of the amount of thyroid supply in the bloodstream.'"
 * Now, contemporary pro and con information about TSH testing can be inserted here. Licensed medical doctors use it, but a significant minority of them have specific reliability concerns about it, and accordingly some use the Barnes Basal Temperature Test as well. Milo 08:16, 7 May 2009 (UTC)
 * No, I don't think we're going to insert "pro and con information" into this article about a test which Barnes apparently never even mentioned. My question was: Did Barnes discuss current standard thyroid function tests (e.g. TSH)? The answer appears to be no. If I've misunderstood, please point me to Barnes' writings on the subject, as you seem more familiar than I. MastCell Talk 16:41, 7 May 2009 (UTC)
 * "No, I don't think we're going to insert "pro and con information" As you wish. Per neutral point of view policy on controveries, if no con, then no pro. All specific mention of TSH gets removed from this article. Milo 19:23, 7 May 2009 (UTC)
 * I think that's covered by WP:POINT. There is no "pro-TSH" information, nor is TSH mentioned in the article at present as far as I can tell. There is an indication to the reader that Barnes' methods are at odds with current medical knowledge. I believe that such an indication is required by WP:NPOV as well as by basic respect for the reader. If the reader is unable to determine from this article that Barnes' claims are at odds with mainstream medical knowledge, then we have failed the reader as well as our editorial obligations. What content change are you proposing, specifically, when you suggest removing "all specific mention of TSH"? MastCell Talk 00:23, 8 May 2009 (UTC)


 * TSH testing is controversial. As discussed above, you have a choice to consense either TSH silence or to describe the TSH controversy. Per WP:NPOV, one side of a significant controversy can't be presented as imprimatur, medical or otherwise.
 * "What content change are you proposing, specifically, when you suggest removing "all specific mention of TSH"?" None at the moment, but I'm consensing for edits similar to the draft above, either with or without TSH.
 * "nor is TSH mentioned in the article at present" It was previously inserted by 65.93.175.29 and you removed it.
 * "covered by WP:POINT" I see no relevance to WP:POINT.
 * "Barnes' methods are at odds" Since Barnes' didn't directly mention TSH, TSH is a separate issue to be decided preferably before composing the controversy text about his mentioned methods. Milo 12:35, 12 May 2009 (UTC)
 * In the interest of productivity and respect for proper use of the talk page, I'll decline to respond further until you have a specific content change to propose. MastCell Talk 18:43, 13 May 2009 (UTC)

Clean-up suggestions
in the editiI will put my assume good faith on that the cite style isn't to intimidate other editors but it's very hard to make even the most basic edits when everything is collapsed and condensed. Also the quote parameter seems to be employed here rather zealously. Are these really needed in every case? My impression is they should be savored for when something truely controversial pops up. -- Banj e b oi   20:56, 6 May 2009 (UTC)
 * I agree, ctrl-f and two tabs was the only way of editing. Is there an auto-fix for this. The quotes often seem to have little to do with the statement being supported. Verbal   chat  20:59, 6 May 2009 (UTC)


 * What are you talking about? II  | (t - c) 21:07, 6 May 2009 (UTC)


 * I think it's about the excessive use of quotes in the footnoted refs. Aside from issues of bias that arise when a single editor mines specific quotes from sources - how do we know these are representative? - I think the main issue is that the source code for the article becomes extraordinarily hard to read. I think that's what Banjeboi is getting at - if you try to edit the article, you get lost in a thicket of footnoted quotes. At this point I would favor removing all of the footnoted quotes from the references. I'm aware that this went all the way to ArbCom in the past, featuring the editor who has added the footnoted quotes here. That said, it's probably worth having a discussion about whether they should be removed, and trying to reach a consensus. My feeling is that the quotes are a) unnecessary, b) potentially subject to skewing, and c) make the article extremely difficult to edit and maintain. I would therefore favor removing them. MastCell Talk 21:50, 6 May 2009 (UTC)


 * There are two issues. One is the quote parameters, they seem unneeded, ergo a tad pointy. Unless exceptional claims are made they likely can be removed. The other issue is that when one clicks to edit they are greeted with one mass of data with little separation between cites and text; for instance, something in the infobox would have to be carefully picked out which takes a lot longer if the lines were kept separate which seems standard everywhere else. This is the only article I've seen do that. -- Banj e  b oi   21:56, 6 May 2009 (UTC)


 * The lack of separation between citations and text seems nearly universal...see my userpage (Ref reform) for thoughts on that. However, wikED is a nice way to make things easier. II  | (t - c) 06:32, 7 May 2009 (UTC)


 * Because they interlock, the less important quote parameters issue first:
 * I don't usually enter quote parameters, but I use them when they are there. Arguably, they could benefit future Wikipedia indexing projects.
 * I use WikiEd Gadget version (User talk:Cacycle/wikEd) so parameters don't hinder my editing. WikiEd colorizes different features and make the plain text more easily stand out for copy editing. I turn it off with the lower left button (see mouseover text) in the WikiEd panel when I write talk posts.
 * I don't see much point in removing quote parameters given all the other inline wikitext. It will become further complicated as not only footnotes and references but active display features proliferate. My gadget version WikiEd only works on limited size sections, but maybe the download versions work on entire large articles.
 * Next, I strongly oppose the removal of quotes, but of course I support relevant quotes. I've long added quotes when I reference. Lack of quotes adds doubt to a doubtful statement, especially when the referred book is offline. Yet a not-relevant quote self-signals the need for finding another or editing the article statement to WP:V standards. I refer you to the Arbcom technical evidence presented by RAN. RAN states the same case I would have made for the great encyclopedic value of quotes.
 * This is an medical article in which the discoverer's scientific credibility rests on exposition of all points of view using excellent quotes. Without it, arriving deletionists will repeatedly argue that statement x, or y, or z, is wrong, and inclusionists wouldn't be able to keep up with the constant demand for repeated lookup research on the nuances of the same quotes. Milo 00:46, 7 May 2009 (UTC)
 * I don't think that neutrality or accuracy depend on mining quotes from each of the books we reference. If someone questions the content of a source, then it should be sufficient to produce the quotes here on the talk page in response. They need not clutter the article. Most editors don't use WikiEd, and it discourages new editors from getting involved when they click edit and are smacked in the face by a wall of impenetrable text (this is already an issue, as this thread makes clear). Virtually all of our articles, biographical and otherwise, make extremely sparing use of the quote= template. I don't see why this article should be handled differently, or at least you haven't convinced me with canned rhetoric about heroic inclusionists and evil deletionists. MastCell Talk 04:50, 7 May 2009 (UTC)


 * Quotes should stay in references. MastCell himself fought almost every source as being unreliable or not supporting the information in the text. The proof is there for everyone to see that it supports it. A book needs to check sources once, an "encyclopedia anyone can edit" needs them checked over and over as changes are made, and text is inserted into the article. And I don't want to think we are going to have another AFD after the article is trimmed of its quotes, again saying there is no info that supports any claims in the article. --Richard Arthur Norton (1958- ) (talk) 05:07, 7 May 2009 (UTC)
 * I'm not sure I understand. I know it's hard to see past my personal villainy, but I don't recall any complaints of mine that were solved by producing quotes. My concerns had to do with the overall quality of sourcing - obscure, low-profile, practically self-published books and primary sources affiliated with the author, lacking any sort of independence or objectivity. Adding quotes from those low-quality sources doesn't actually address my concerns about them. But I know better than to get into a lengthy fight with someone who's already dragged this matter out into an ArbCom case. Make the article uneditable if you like. MastCell Talk 16:46, 7 May 2009 (UTC)


 * Agree with Richard that the quotes should stay unless the article can be verified easily. They aren't in most articles because most aren't this controversial and most people don't bother to add them. I don't see any reason to remove them; it seems a bit presumptuous to say that Milo will always be around to produce the quotes. —Preceding unsigned comment added by ImperfectlyInformed (talk • contribs)


 * Quote parameter suggestion. OK, as a compromise since sources have been questioned in the past yet reprinting quotes is arguably seen as also problematic ... could we comment them out so they remian in the editing text yet aren't reprinted in the Notes section? I personally still find them annoying but if there is a solid reason for them existing at least let's not fill the ref section with them. Does this seem like a reasonable compromise? -- Banj e  b oi   10:24, 7 May 2009 (UTC)


 * Cite formatting suggestion. I haven't a clue what WikiEd is but I think it's fair to say a core principle of Wikipedia is that anyone can edit and this style seems to counter that. I don't think we have to fully rollback to full expanded cites but at least partially to allow the general reader the ability to easily find and correct perceived deficiencies may make sense. No one has, OK well not many folks have accused me of being a simpleton but I find it rather intimidating to do anything here. As editors our job is to build access and communication so I feel this may have overstepped some accessibility gate. Perhaps unintention but the net effect is that I feel unable to edit and I'm easily considered more experienced than the vast majority of our users. Would a partial expansion of cites be acceptable? -- Banj e  b oi   10:24, 7 May 2009 (UTC)
 * I really don't understand what you're saying. I know you edit Barney Frank, and the quotes there are just the same as here. Many people don't like the way citations are handled on Wikipedia, as you can see on Ref reform. II  | (t - c) 16:24, 7 May 2009 (UTC)
 * Curious analogy. Barney Frank uses quotes in 3 of its 64 references. That's a reasonable, appropriate, and restrained use of the quote= parameter, in line with general practice. On the other hand, this article pulls quotes from about 75% of its references, often adding no demonstrable value, as others have pointed out. I agree that the Barney Frank article could serve as a model, but it hardly supports the excesses here, right? MastCell Talk 16:50, 7 May 2009 (UTC)
 * See Benji's comment above. Quotes do not seem to be what he is talking about. He is talking about the way that cites and text are mixed together. He keeps referring to "fully expanded cites". I don't know what that means, but I can't see how it has any connection to quotes. Expanding a citation would presumably lengthen it. II  | (t - c) 16:58, 7 May 2009 (UTC)
 * I read it differently, but I'll let him clarify if he chooses to. MastCell Talk 17:37, 7 May 2009 (UTC)
 * Earlier he said: "There are two issues. One is the quote parameters, they seem unneeded, ergo a tad pointy. Unless exceptional claims are made they likely can be removed. The other issue is that when one clicks to edit they are greeted with one mass of data with little separation between cites and text..." Sorry if curt comments like "see above" sound snarky; don't take it personal...:| Like I said, I have a personal interest in separating citations and text, but the practice of mixing the two is ubiquitous. II  | (t - c) 17:43, 7 May 2009 (UTC)
 * I like relevant quotes No really - I do; I have added dozens to potentially contentious or misapprehendable statements. They should be kept as brief and on-topic as possible, though, and used sparingly. For instance, the quote on current reference 1 (Trib. 1940-09-18) says only that he was associated with University of Illinois Research hospital, which is not really a statement requiring much in the way of nuance or original context. Not that it is worth fighting over - sheesh. - 2/0 (formerly Eldereft) (cont.) 14:29, 7 May 2009 (UTC)
 * And when someone changes the link to what the hospital is called now, that original information will be lost. I have been looking for the article on what the hospital is called now, but what if I am wrong. No one will know, since they will no longer be able to compare it to what was in the original. That is the whole point behind it. People make errors and only when complete quotes are used can people check them. Anyone can just stick in a reference to a book and no one will read the entire book again to see if it is correct. Give me the exact text, I type it in Google and there it is for me to read and check. Only when I know the exact wording is it possible. If the editor uses a synonym in the article, I may never find the original quote again without reading the entire book again. --Richard Arthur Norton (1958- ) (talk) 16:35, 7 May 2009 (UTC)


 * That particular one doesn't bother me, but it's not worth edit-warring over. II  | (t - c) 16:24, 7 May 2009 (UTC)


 * Or through judicious application of the |page= parameter? I agree with II that it is not a huge deal ... just stylistically cumbersome. - 2/0 (formerly Eldereft) (cont.) 18:19, 7 May 2009 (UTC)

Quote parameter within cites suggestion

 * Quote parameter suggestion. I personally still find them annoying but if there is a solid reason for them existing at least let's not fill the ref section with them. As a compromise, since sources have been questioned in the past yet reprinting quotes is arguably seen as also problematic, could we comment them out so they remain for editors yet aren't reprinted in the Notes section? Does this seem like a reasonable compromise?

^ "The Thyroid Gland: Cures, Fallacies and Fixes.". Townsend Letter for Doctors and Patients. http://www.highbeam.com/doc/1G1-73959335.html. Retrieved on 2008-04-16. "Several decades ago, one of the dedicated thyroid experts, Broda Barnes, MD, was the first to advocate the administration of glandular thyroid extract ..."
 * Before

^ "The Thyroid Gland: Cures, Fallacies and Fixes." Townsend Letter for Doctors and Patients. Retrieved on 2008-04-16.
 * After (note: quote itself will remain with cite but not be published in the References section)

Comments
Please note nothing was actually removed. -- Banj e b oi   03:03, 8 May 2009 (UTC)


 * Problems:
 * 1) It's the worst case of both: not being able to see quotes for verification, and not making it any easier to edit wikitext.
 * 2) No reader or passing editor will know they're there.
 * 3) Eventually some bot will miscategorize this article as quoteless.
 * 4) Eventually some one will make them visible, or delete them.
 * Milo 05:28, 8 May 2009 (UTC)

Limited re-expanding of citations

 * Cite formatting suggestion. A core principle of Wikipedia is that anyone can edit and the current style seems to counter that. I don't think we have to fully rollback to full expanded cites but at least partially to allow the general reader the ability to easily find and correct perceived deficiencies. I find it rather intimidating to do anything here so likely newby editors do as well. As editors our job is to build access and communication so I feel the current style may have overstepped some accessibility gate, perhaps unintentionly. The net effect is that I feel unable to edit and I'm easily considered more experienced than the vast majority of our users. Would a partial expansion of cites be acceptable?


 * Before


 * After

Comments
This is just s suggestion but I think would help others be able to more easily edit here. I see the infobox has been re-expanded which I think is helpful. How exactly to add a bit more whitespace and breaks is a matter of style, my point is that one mass was rather intimidating so some middle ground may be more collegial -- Banj e  b oi   03:03, 8 May 2009 (UTC)


 * Pardon, how is this "re-expanding"? Do you mean 'removing empty parameters'? The difference between before and after seems to be that you've taken out
 * "|authorlink= |coauthors= ". (emphasis added above)
 * If it's important as a gesture of compromise, I suppose I could consense to it. Question is, would removing what appears to be such a small percentage of unimplemented wikitext, really be worth undoing the infrastructure building effort it took to put them there for future use, including automated parameter insertion by bot?
 * I think you're overestimating the difficulty for a newby registered user to make these wikitext clutter problems go away. WikEd Gadget is easy to install and use. Why don't you go to your "My preferences" page, click on the Gadgets tab, and checkbox [/]wikEd. For the moment, you may not even have to read the help page linked next to the checkbox. Just open a short article section for edit (not a full page). Click the lower left button in the control bar panel to the right of the screen. Assuming your install is bugless (mine was with Firefox), I think you will be pleased with how easy it becomes to edit both plain text and other types of wikicode, in conjunction with a browser having an instant incremental page search feature. Milo 05:30, 8 May 2009 (UTC)
 * WikEd is a useful gadget. However, it does not work with Internet Explorer, which excludes about 2/3 of Internet users from using it right off the bat. Even for the minority of people who use Firefox, it seems ludicrously at odds with this project's goal of accessibility to require that new editors install a JavaScript gadget in order to have the privilege of being able to decipher and edit the page. MastCell Talk 17:09, 14 May 2009 (UTC)