Wikipedia:Mediation Cabal/Cases/2008-10-09 Attention-deficit hyperactivity disorder


 * Note: Please limit posts to this page to brief statements about the nature of the dispute until a volunteer adopts the case. Keep ongoing discussions about the topic to the appropriate talk page(s), but feel free to provide links to the talk page(s) where discussion has happened (and may be ongoing) for the convenience of the informal mediator and other parties. This will help keep discussion from fragmenting out across more pages and make it easier for a volunteer to review the case. Thanks!

Who are the involved parties?
Scuro and Jmh649

What's going on?
Uncivil behavior, edit waring, making false accusations, name calling, not seeking consensus, not answering questions, refusing to respond to certain editors, and bad faith.


 * One of the key issues for me is that he makes many unilateral changes to an article a day, without discussion on the talk, and then when anyone disagrees, he takes it quite personally and responds with bad faith. Even when he does raise a topic on the talk page (such as renaming the ADHD treatment page) he waits about an hour and then goes ahead and does it.  Lots of ownership, and very little collaboration.--Vannin (talk) 15:59, 9 October 2008 (UTC)


 * I am a administrator and a 5 year editor of this and many other articles, and a strong believer in both collaboration and mutual respect. Both are currently lacking with the current chaos in this article's edit process. One major player is very new to WP although highly-educated and knowledgeable on the subject. The lack of successful Wikipedia collaborative experience is painfully evident. The current "Chop, Delete, and Substitution" actions by this user borders on censorship of content so that opposing views cannot be seen. At best, it is hard to informally mediate, partially due to the sophisticated and technical subject matter. (I.E. just one reference he has provided is almost 400 pages long and differs greatly from many current references). Only restraint by other users (myself included) has kept this from situation from deteriorating into an edit war. I cannot volunteer to mediate because I do not meet our "uninvolved" criteria. I also think mediating this one is going to be a big challenge. Suggestions and tact have not worked to date. For the possible benefit of who ever steps up to the plate, some of my thoughts about the areas of concern and suggestions for improvement are posted on article's TALK page. Vaoverland (talk) 07:19, 10 October 2008 (UTC)
 * Well heavens to Betsy! Sounds like someone needs to explain themselves ;-) It'd help me out, at any rate. Xavexgoem (talk) 12:48, 14 October 2008 (UTC)
 * In about a 2 week period, things have calmed down some, but we still have issues of "ownership" and "my way", perhaps nowhere more than in the lead, with what amounts to reverts, although not done exactly as a revert. Vaoverland (talk) 09:38, 25 October 2008 (UTC)
 * The reverts continue with zero discussion. This is highly disruptive. Next steps?--scuro (talk) 13:39, 26 October 2008 (UTC)
 * I posted a note on his talk page and you mentioned something about this in your last edit summary. If he ignores us both, then it might be time to talk about further steps.--*Kat* (talk) 14:45, 26 October 2008 (UTC)
 * Renewed reverting with no input in talk. ( http://en.wikipedia.org/w/index.php?title=Attention-deficit_hyperactivity_disorder&curid=64976&diff=248254140&oldid=248253752 ) What are we to do as editors when we have clearly made a case in talk why the previous edit was better, at least two editors agree to this, and still James reverts unilaterally and repeatedly ignoring all communication? Input please. --scuro (talk) 19:44, 28 October 2008 (UTC)


 * Well a lot of it is clearly stated on the discussion page. This page is full of inaccurate references to the literature.  For example:  I refereced a systematic review that said the safety of ADHD drug has been determined to only 2 years.  Scuro changes this to 5 years.  I change it back to what the meta analysis says which is two years and he reverts it again.  He does not make reference to any new literature.  He keep the reference that I have placed but makes wikipedia inaccurate.  We can go thru the rest one by one if others want.  Doc James (talk) 19:44, 28 October 2008 (UTC)


 * We have been waiting 3 weeks for James to enter the discussion. He enters the discussion after reverting a key paragraph (third paragraph in) on the lead about ADHD being a controversial disorder, yet again with no discussion in talk. ( http://en.wikipedia.org/w/index.php?title=Attention-deficit_hyperactivity_disorder&curid=64976&diff=248254140&oldid=248253752 ) He has probably done so a dozen times. This is a paragraph which has an ample talk history and which a fellow editor felt was unbalanced. His source is shown to be lacking and also the conclusion he draws to be faulty. All of this has been discussed on talk. Furthermore, he quotes from this source in an inappropriate way creating OR in the way he uses info from the quote in a way it was not intended to be used. A new paragraph was created but it was continuously reverted without discussion back to his version. No talk, no attempt at compromise, no looking at the issues.


 * So after three weeks does he talk about this long standing isuue? Nope. Instead he focuses on a one word edit and his first bit of input is false. My initial edit gave a time frame, when before there had been none. I put down 5 years and before no time frame was given. ( http://en.wikipedia.org/w/index.php?title=Attention-deficit_hyperactivity_disorder&curid=64976&diff=248125234&oldid=248072741 ). James then changed that time frame from 5 years to 2 years. After doing so, he posts on here accussing me of reverting the time frame twice! How completely inaccurate. Not a good start to dialogue but in a nutshell it demonstrates all the problems we are having to date, such as unfounded accusations, and avoidance of meaningful discussion. I am willing to talk about that issue but first I would like to see some basic wiki etiquette principles laid down. On the top of my list would be no multiple reverting without meaningful prior communication on talk.--scuro (talk) 23:35, 28 October 2008 (UTC)

←Ok...so (question #1)...How does the same source say 2 and 5 years? What makes it 2 years; what makes it five years? Xavexgoem (talk) 23:38, 28 October 2008 (UTC) wikiquette is assumed on this page; if you don't want a blank slate, I'll happily close. I can't change anyone's behavior, but I can keep things in check.


 * So Scuro makes up a number without referencing it? Here is the line that I am refering to


 * Best available long-term (> 2 years) evidence. There are no RCTs assessing benefits and harms of long-term stimulant therapy in children. The only randomized long-term follow-up comes from an extension of the MTA trial, described above. Of 579 children randomized, 485 (84%) were followed up and restudied at 3 year.


 * What this means is there are no RCT beyond two years and that there was a restudy at three years of participants in a previous study. Therefore one can either take 2 years or if one is more lenient 3 years for follow up.  Were Scuro got the 5 year reference from beats me but he changed this sentence without changing the reference.


 * Now I think we should deal with each issue one at a time. We can start first with the lead paragraph.  Doc James (talk) 00:16, 29 October 2008 (UTC)


 * Let look at the reference http://www.ahrq.gov/clinic/epcsums/adhdsum.htm that supports the lead.


 * What it exactly says is "ADHD has been surrounded by great controversy involving clinicians, teachers, policymakers, parents, and the media. The range of opinion regarding the validity of ADHD extends from those who do not believe it exists and regard it as a myth, to those who believe that there is genetic and physiological evidence supporting its existence."


 * I do not feel that I have misrepresented it. True it is 9 years old.  There are however other reference older then this.  It is from a governmental source so I would say is off good quality.  I feel that it would be foolish to preface everything with "in 1999 there was a controversy about ADHD involving..."  "Or that in 2001 ADHD med were found to be effective" Doc James (talk) 00:23, 29 October 2008 (UTC)
 * Blech..."What we've got here is a failure to communicate." :-P Are the numbers being made up, or is there a plausible (if invalid) reason that one editor would think 2 years and the other 5? Best we stick with a simple sourcing dispute before going in full-bore. Xavexgoem (talk) 01:05, 29 October 2008 (UTC)


 * The reference makes no mention of five years.Doc James (talk) 01:33, 29 October 2008 (UTC)
 * Gotcha... I'm seeing the source. FWIW, it seems to say "Best available long-term (> 2 years) evidence" and later "at 3 years[...]" - I assume that's why you switched it to 3 in the latest version - is there any clear demarcation line where the source says "past this, we have no clue"? Or does the source explicitly say that the trend is basically proportional to length of treatment (e.g., worse/better at (say) 6 years compared to 3) Xavexgoem (talk) 01:46, 29 October 2008 (UTC) 'Cuz, y'know, I could pull the V->OR switcharoo ;-)


 * You lost me. RCT are how harm, benefit, and safety are determined.  What this article is saying is that we do not know what the effects of stimulants are beyond 2-3 years.  Doc James (talk) 04:02, 29 October 2008 (UTC)


 * I think I know where the 5 years issue comes from. It is in the talk archive.  I found a reference   - Barkley, Russell (2006). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. New York: The Guildford Press, 608-645. ISBN 2005016986. with a chapter on stimulants that says  "Three controlled and one open-label study have examined the efficacy and safety of stimulants over 4- to 60-month treatment durations for children with ADHD CHarach, Ickowicz, & Schachar, 2004; Gillberg et al., 1997; MTA Cooperative Group, 1999; Schachar, Tannock, Cunningham & Corkum, 1997; Wilens, Pelham, et al., 2003). Schachar et al. (1997) investigated methylphenidate compared to placebo in 91 children with ADHD over a 4-month clinical trial. The children continued to demonstrate benefits of methylphenidate over the 16-week trial. Lack of weight gain was a side effect documented in the treatment group (Scharch el al., 1997). This study has now been extended for 5 years, and data are reported on 79 of the original 91 children (Charach et al., 2004)" etc. etc.  leading to "These longer-term results include data from a total of 1,021 stimulant treated children. Both methylphenidate and amphetamine preparations have been studied in these longer-duration clinical trials. The data are encouraging in that stimulants continue to be effective for the core symptoms of ADHD and appear well tolerated over 4 months to 5 years of treatment"   --Vannin (talk) 04:28, 29 October 2008 (UTC)


 * Okay so we gloss over Jame's false accusation of my making a double revert...which never happened. No apology. It's disappointing that we have to go on like this.


 * To the question of the # of years. I was quantifying the issue from memory and the sentence didn't mention RCT. I have read of benefits going beyond 5 years for education but not behaviour. The edit was done in good faith. Yes, it is true that there are no RCT's (randomized controlled trials ) that go five years because as the National Health and Research Council has stated, it is unethical to do so over extended periods of time. A) The medication has a proven benefit, to give someone with a disorder, a placebo or no treatment for five years, would be cheating them out of a proven treatment that can change their life, especially over extended time periods. B) Over five years or more, dosages may need to be optimized, how can you do that in a controlled study where variables are to be kept to a minimum? Each individual is different, as is their dosage. ADHD medication is not dependent on weight, it is dependent on the severity of the disorder which is not at all predictable. Thus you have a number of variables which can't be kept static over longer periods of time, and still give optimum treatment. This could be why it is only the University of British Columbia that is bringing up the issue of long term RCT studies. It's not exactly a top research school.--scuro (talk) 04:36, 29 October 2008 (UTC)


 * Excuse me? You write based on memory rather then referencing what you write.  This is one of the many issues I have with Scuro's editting.  Please provide a reference were it says it is unacceptable to do a study longer then two years.  The benefits are not as rosy as you say.  Everyone agrees that the side effects are real.  And who says that BC is not a top research school?  RCT are how one determines effectiveness of treatment this cannot be determined in a observational study.  As we state earlier a lot of people get better with and without treatment by the time the reach adulthood.  A meta analysis of RCTs is the highest quality of evidence and this is what I have provided.  It therefore hold more weight then what Vannin referenced but his points can be used but if used need to be referenced.  I would ask the Scuro stop adding unreferenced matterials based on his "memory" and personal experience.Doc James (talk) 05:23, 29 October 2008 (UTC)


 * I would like to discussion the inclusion of alternative theories of ADHD the under causes section. Scuro called them all fringe points of view and removed them from the article.  I have replaced them even though I did not write this information.  One of the topics is supported by an NHS paper that was resently published and is therefore not fringe.  Should we discuss this further on the talk page?Doc James (talk) 10:55, 29 October 2008 (UTC)
 * I'll start a discussion there.--*Kat* (talk) 11:10, 29 October 2008 (UTC)


 * Excuse me? Do I hear you correctly? You are now stating that every edit needs a reference? Especially edits that expand upon the article and add new information??? Perhaps a refresher on how to edit in Wikipedia is in order. Here is a link stating ethical issues with long term stimulant research. www.nhmrc.gov.au/publications/synopses/withdrawn/ch36.pdf Beyond that, much of what James states is opinion. --scuro (talk) 11:55, 29 October 2008 (UTC)


 * Yes references what one adds is how wikipedia works. What do you think?  Also what is the link you provided for exactly?--Doc James (talk) 12:07, 29 October 2008 (UTC)


 * If I may chime in with several comments intended to be helpful here, and NOT intended to be hurtful to anyone,


 * as may be the situation with others, I was contributing long before WP changed the criteria for attributing sources to the current higher standard. That leaves me with the awkward challenge now of having previously researched accurate information without closely tracking sources that I now need to attribute if I want to use it. Frustrating, oh yes, but those of us from that earlier period need to grow in our own work procedures for the good of Wikipedia. I hope relative newbies unaware of that will be patient in that regard and not assume bad faith as I think I just read in threads above (which were not directly related to me).


 * some of our current editors (i.e. like me) may have ADHD themselves. If so, that may facilitate a tendency for intense editing sessions (during periods of hyperfocus), as well as impatience with others. I try to remember that my time perceptions are not in sync with many other editors OR even the National Institute of Standards and Technology Clock, and modify my own behavior accordingly.


 * I am glad to see mediation and efforts to limit/remove personality aspects to the areas of disagreement among us. Everyone needs to keep focused in items and try to limit he said/she said. Perhaps those of us irritating others will learn to be better and more courteous Wikipedians through this process. That would be a true Win-Win. Thanks for all the help, mediators. Vaoverland (talk) 15:09, 29 October 2008 (UTC)


 * "Wikipedia does not require perfection"WP:EP. Simply put, you can add to the article and it doesn't have to be a pristine version nor do you need the highest quality citation to accompany the addition. A citation is not necessary for every edit, especially when new material is added. If another editor wants to improve the edit they can do so. If another editor questions the information they would post in talk or put a fact check tag on the piece of info. That would lead to dialogue on the talk page, and with 99% of the editors simple communication would solve any problem. You can choose to revert, but this shouldn't be done more then once until an issue is resolved on the talk page. It shouldn't be done at all if another editor requests this, especially if two editors are on opposite ends of an article. Again, in such a case communication should happen first. It is a sign of good faith and respect. So no, references are not needed until requested, although references never hurt.


 * The citation provided fufills this request: "Please provide a reference were it says it is unacceptable to do a study longer then two years". RCT are not ethical when they go on for an extended period of time and the "blind" group misses out on proven theraputic benefit. This is a standard in scientific experiments. The citation provided speaks to this issue and speaks specifically to ADHD and ADHD medication. It puts into question Jame's notion that RCT trials are the only way to determine the long term benefits/drawbacks of ADHD medication. It also puts into to question the assumption that since there are no long term RCT trials, we know nothing about this and the absence of such trials is a negative.--scuro (talk) 16:02, 29 October 2008 (UTC)


 * http://www.ncbi.nlm.nih.gov/pubmed/16511362 - Study states average use is only 33 months. What do you do if he majority of your subjects drop out of the study? What validity would a study have?


 * http://books.google.com/books?id=KStJo6hRS48C&pg=PA281&lpg=PA281&dq=%22long+term%22+and+safety+and++%22stimulant+medication%22&source=web&ots=EtAg4tbl6O&sig=22lEpqYuE8FyzasCXGu2Yfhd3Hg&hl=en&sa=X&oi=book_result&resnum=10&ct=result
 * Barkley explains why there are no long term RCT studies and that it seems that there are likely no significant long term effects.


 * http://books.google.com/books?id=EkyTTvjNRZAC&pg=PA626&lpg=PA626&dq=%22long+term%22+and+safety+and++%22stimulant+medication%22&source=web&ots=AFBYNwcIoy&sig=GCqvZF1-xPtXF-E4qZKEY4koooY&hl=en&sa=X&oi=book_result&resnum=3&ct=result :::More Barkley and cited studies on longer term effects and it seems that we can draw a conclusion.


 * Here is a citation that lays it all out. https://doi.org/10.1023%2FA%3A1009563504319 "Current ethical principles of conduct for biomedical research specifically prohibit designs that withhold or deny ldquothe best proven diagnostic and therapeuticrdquo treatment to any participant in a clinical study, including those individuals who consent to randomization into a control group. Studies of psychophysiological therapies are often criticized on the grounds they lack a placebo or sham treatment control group. This paper briefly reviews the history of the problem and discusses the ethical standards that govern human research as derived from the Nuremberg Code and the Declaration of Helsinki".--scuro (talk) 04:26, 30 October 2008 (UTC)

The issue I have with Scuro is that he doesn't believe ADHD is controversial. He states that there are only two people who believe this is true. I quote from him "In reality I think minority is a bit generous because the number of scientific and medical bodies and experts in the field that hold this view could be counted on a hand...perhaps two"

I have provided many good references to everything I write. Scuro removes what ever he feels doesn't fit his belief. Other editors have had problems with him aswell if you look at his discussion page and at older edits.

I have provided numerous reference here are a few:

Here is an article from the NHS http://www.nice.org.uk/nicemedia/pdf/CG72FullGuideline.pdf

Here is a textbook on Developmental Psychopathology that describes the controversy well. This is a secondary source. http://books.google.com/books?id=UlQjE-Ka09sC&pg=PA358&dq=ADHD+controversy&ei=WivjSJLXF4TkygS_3I3iBA&sig=ACfU3U1RIgDI45e5ETkBaR8iWd929M1ysA#PPA358,M1

Next is the cyclopedia Britannica. Yes even more famous then wikipedia. It has a section on the controversy. This is a tertiary source. http://www.britannica.com/EBchecked/topic/279477/attention-deficithyperactivity-disorder/216017/Controversy-mental-disorder-or-state-of-mind

Medscape discusses it. http://www.medscape.com/viewarticle/442882_5

The US government. http://www.ahrq.gov/clinic/epcsums/adhdsum.htm

Another well know site. http://www.medicinenet.com/script/main/art.asp?articlekey=50774

The controversy is even discussed in the BJP. http://bjp.rcpsych.org/cgi/content/full/184/5/453

Personally I think that Scuro should be banded from editing on this topic as he has repeatedly refused to reference what he writes and repeatedly removed well referenced material.

Doc James (talk) 04:33, 30 October 2008 (UTC)


 * You can attempt to tar, feather, and brand me later using any sort of slander you like. For the moment, stick to the topic at hand which is the safety of long term use of stimulants. If we take each of your complaints one at a time, more often then not, they are lacking. In every case where I have been heard out, be it at the village pump, or your ANI on me, I have vindicated what I have done on this article.--scuro (talk) 05:00, 30 October 2008 (UTC)
 * Collapsed - try to just focus :-) Xavexgoem (talk) 05:03, 30 October 2008 (UTC)


 * You have a strange definition of vindicated and I would like to ask all involved in moderating this to look both at the village pump and the ANI. Here is the reference to the ANI http://en.wikipedia.org/wiki/Wikipedia:Administrators%27_noticeboard/IncidentArchive481#The_ADHD_article_and_Scuro

--Doc James (talk) 10:19, 30 October 2008 (UTC)


 * Here, As in the ANI, and the village pump (http://en.wikipedia.org/wiki/Wikipedia:Village_pump_(policy)/Archive_55#WRT_ADHD_Can_one_cite_web_based_information_from_the_Mayo_Clinic.3F ) when there is actual back and forth communication on a single subject, what I have been getting at is supported and not refuted. Using the citations I have provided here in this MC, I think the sentence in the lead should now state, "that no significant long term safety issues have been found". Input welcome, changes will be made shortly to the lead.--scuro (talk) 11:51, 30 October 2008 (UTC)


 * No I think changing it is wrong. What reference are you basing this on?  The RCTs have found concerns with side effects and didn't find much long term evidence of evidence.  The only trial data beyond two years was small and had a great deal of loss to follow up.  See: http://ti.ubc.ca/en/letter69


 * WRT if the village portal agreed with you I would recommend that everyone read it for themselves.  Logical Premise for one did not agree with Scuro and neither did a number of other editor.


 * I think three seperate editors have recommended that Scuro be topic banded for all his disrupting efforts.

Doc James (talk) 12:17, 30 October 2008 (UTC)

All y'all exhausting my effort to even care what happens during mediation. First one to address the issues without pointing fingers ("disruptive efforts"?) gets a cookie and a good chance of actually being heard while contributing sanely to the project. Otherwise, this doesn't stand a chance in hell, and this medcab request is just another blaze in the forest fire. Content, not contributors. Sign here:
 * Xavexgoem (talk) 20:25, 30 October 2008 (UTC)
 * *Kat* (talk) 22:43, 30 October 2008 (UTC)
 * scuro (talk) 00:15, 31 October 2008 (UTC)
 * Doc James (talk) 01:38, 31 October 2008 (UTC)
 * Vaoverland (talk) 01:51, 31 October 2008 (UTC)
 * Vannin (talk) 03:47, 31 October 2008 (UTC)

What would you like to change about that?
I would like Scuro to reference what he writes. Apply the same criteria for all forms of evidence rather then trying to pick and chose based on the researchers conclusions. And finally if he could properly format his refereces. If he doesn't follow this I would like him banded from editing on this topic.

I'd like Jmh649 to follow wiki protocol on these issues.

Mediator notes

 * Trying to keep things simple, and pushing for AGF which I find...lacking ;-)
 * Q1 has been placed above, primarily (it appears) between scuro and Doc James. Once consensus has been reached there, I'll start to structure. Please have faith.

Proposed Compromise on the Controversy Issue
Just a thought: Why don't we rephrase the sentence to start with, "Historically, ADHD is a controverisal diagnosis..." --*Kat* (talk) 10:03, 29 October 2008 (UTC)


 * Sure very reasonable.--Doc James (talk) 10:43, 29 October 2008 (UTC)


 * The one thing is that it is currently controversial aswell. The controversy is discussed by the NHS paper in 2008.--Doc James (talk) 04:19, 30 October 2008 (UTC)
 * "ADHD has been a controversial diagnosis since..." :-) Xavexgoem (talk) 04:23, 30 October 2008 (UTC)
 * Not like it was before. There will always be some discontent in regards to it.  --*Kat* (talk) 22:45, 30 October 2008 (UTC)
 * Normally this would be an excellent undertaking. Yet I find my efforts being scattered, communication being scattered. So, I hope you don't mind that I delay here, my apologies for blocking this approach for the time being. I have a goal.--scuro (talk) 00:37, 31 October 2008 (UTC)

Lets resolve one issue and go from there
The first content issue which was brought up was the point that a sentence in the lead, and a citation of a systematic review which supported it, was not questionable...I assume...without a superior systematic review. This has been previously referred to as question #1 in the MC.

Issues here which I would like to see resolved are: i) does a systematic review and any content on the article it supports, always take precedence over any other evidence presented which is not a superior SR? ii) how one challenges such an assertion when the SR is out of touch, and iii) how one resolves such an issue to everyone's satisfaction.

Is this a good place to start? And if so, on this page or the talk page?--scuro (talk) 00:59, 31 October 2008 (UTC)
 * Those are good questions... I think we should remain on this page for now, for reasons I can only describe as wantonly Machiavellian ;-) (what is an SR? Do you mean RS, by chance?) Xavexgoem (talk) 03:45, 31 October 2008 (UTC)

SR = systematic review. I'm ready to communicate. Let me know when we can start.--scuro (talk) 04:06, 31 October 2008 (UTC)
 * Ah, my bad. *Kat* has offered to help; for me, I need to get to bed... so it'll probably be tomorrow (12h from this timestamp) that I'll be in full wikiswing :-) Xavexgoem (talk) 04:09, 31 October 2008 (UTC)

If a systematic review of randomized controlled trials published in a peer reviewed source disagree with what you previously believed one has to consider if what they previously believed is wrong. Doc James (talk) 04:21, 31 October 2008 (UTC)

I agree with you, that is generally excellent evidence. The question I have is the UBC source for q#1, a systematic review of randomized controlled trials published in a peer reviewed source? And if it is not how would you characterize this source?--scuro (talk) 04:34, 31 October 2008 (UTC)


 * The paper from UBC is a review of randomized controlled trials published in a peer reviewed source. It came out in 2008.  Now if there were another current paper of similar quality that had a different conclusion then one would state one found one thing and the other found something different.  I however have not seen another systematic review that claims long term safety.
 * Another plus to this source is that there are no pharmaceutical conflicts of interest by the authors. They are completely government funded and accept no pharmaceutical funding.  This is a serious problems with Barkley's work.  He receives lots of drug company funding and there is very good evidence showing that drug company funding effects study's results and conclusions.

Doc James (talk) 11:18, 31 October 2008 (UTC)

Who are the authors and what academic peer reviewed journal was it published in?--scuro (talk) 11:34, 31 October 2008 (UTC)

Here is the web site. You can read all about the organization. http://www.ti.ubc.ca/en/AboutUs --Doc James (talk) 12:19, 31 October 2008 (UTC)

In examing the website I see no outside link to an academic peer reviewed journal, that has this "systemic review" within it. I have also not found an author(s) to the "systemic review". James, have you seen this SR in a academic peer reviewed journal? And if you have, can you kindly provide a link to the APRJ?--scuro (talk) 15:53, 31 October 2008 (UTC)


 * The web page explains the process that is taken to produce the Therapeutics Letter. It is produced by an arms length governmental funded organization.  Some of the authors are listed on the page.  This is like the FDA of NHS guidelines and reviews which are published by the organization itself.  Doc James (talk) 21:03, 31 October 2008 (UTC)


 * Here is a paragraph about ADHD medications from the NICE review "10.14.1Quality of evidence reviewed. The quality of the evidence reviewed was generally moderate to low. Efficacy studies were typically of short duration only (range, 21 to 238 days) and authors were usually not explicit regarding the inclusion or exclusion of ADHD coexisting conditions. Most studies compared a single active drug with placebo. There are few direct ‘head-to-head’ comparisons of active drugs.  Interpretation of harm-related outcomes was limited to a small number of short-term clinical trials that reported harm data. Overall, adverse events have been reported infrequently and poorly, and further research is recommended."


 * This means that long term safety data is lacking. I have found another systematic review on long term safety from 2008 however am unable to get a copy of the whole article.  If anyone has access please let me know.  Otherwise I might order it.  http://www.jpnonline.com/view.asp?rID=30274

--Doc James (talk) 22:01, 31 October 2008 (UTC)


 * So what we have here is a source that is not peer reviewed, nor published in any academic journal. It is a bi-monthly newsletter. http://www.ti.ubc.ca/en/TherapeuticsLetters It is a review of literature by different working groups of the "Therapeutics Initiative". Who are members of the International Society of Drug Bulletins. Who are the specific authors of this review?


 * Would you agree then, that this is not an ideal source for a biomedical article, as posted in your link below on sources?--scuro (talk) 03:52, 1 November 2008 (UTC)

No it is peer reviewed. It is published by the therapeutics initiative. It is medical position statements from nationally and internationally reputable expert bodies. It is a secondary source and is a literature review.

Now the NICE guideline and a book from Barkley's also say the same thing as the TI. That there is no good long term evidence of safety beyond 2 - 3 years is in many citations. It is interesting as Barkley has defined long term safety as 18 months in his more recent books. And the uses this to claim long term safety. The guy's books are a bit of a joke. The drug funding has obviously biased his conclusions. Doc James (talk) 06:07, 1 November 2008 (UTC)


 * Lets start with facts and focus on this source alone. The newsletter is not published in any reputable medical or academic journal and consequently is not subject to a peer review of scholarly experts within that field. The newsletter is subject to a review and this review could be undertaken by nurses, lawyers, doctors, pharmacists etc...all from the province of British Colombia in Canada. http://ti.ubc.ca/en/AboutUs#ScientificCommittee This sort of review may suit the needs British Colombia but by no means should be considered scholarly work, nor should it be considered work that has been subject to the review experts from around the globe, within this field of expertise. Their findings should not be extrapolated to be our scientific understanding of the long term safety of stimulant drugs. That would be improper synthesis. Could we agree to this?--scuro (talk) 13:04, 1 November 2008 (UTC)


 * No I think that your analysis is incorrect. Other sources however say the same thing.  So I can add multiple references to this statement.  But will do so in a few days.--Doc James (talk) 23:05, 1 November 2008 (UTC)


 * "You think it is incorrect"? We could save a lot of time here. All we simply need is a statement that the citation is not what it was made out to be. I'm sure it's obvious to everyone that this citation is not a scholarly work. What scholar(s) wouldn't put their name on their paper? What systemic review isn't published in any journal? At this point we could be discussing next steps: what value does this citation have, should the citation be removed, are there any conclusions on the article that were taken from the citation, what should be stated instead? If you find it necessary to find a citation, simply provide the best source you can find, multiple sources are not needed.--scuro (talk) 12:17, 2 November 2008 (UTC)

Once again let let others comment. We disagree. We all know your point of view. For your info some of the authors are listed on the TI page. One is James McCormack. It is peer reviewed. And what it says as you previously mentioned is not controversial as mentioned on the talk page. And no you do NOT get to unilaterally removed these references. Doc James (talk) 14:17, 3 November 2008 (UTC)

I had hoped that when the obvious is in front of us, that both us would admit as much. It's going to be a long drawn out process if the most obvious things are challenged to the 9th degree, and for what end? Is this not wiki lawyering? But sure, if you want outside opinion, then let me put it into a clear cut question. Is the UBC an ideal source, in that it is both published in a medical journal and has a proper peer review by scholarly experts in the field as chosen by that journal?--scuro (talk) 16:48, 3 November 2008 (UTC)


 * I would view it as a review, comparable with other reviews. I don't think I would put it ahead of other reviews, though.  Reviews, and meta-analyses are all subject to some bias in that they have a set of criteria for which studies to include and also in what they conclude from the studies they review.  The therapeutics letter is focussed on one set of criteria.  It is a bit short, though, and so does not have the same scope as the more traditional academic book chapter to go into depth with discussion of the issue.  --Vannin (talk) 03:39, 4 November 2008 (UTC)


 * Does the opinion below change your mind about the issue Vannin? Here is what a researcher who I contacted about the Therapeutic letters stated.

''Well, I had no clue what a "therapeutics letter" was. My first guess was a literature review that isn't peer-reviewed. My second guess was an opinion piece. A Google search answered that one very quickly, but it is disguised to make it appear academic to the non-scientist.''

''A therapeutics letter is what the "Theraputics Initiative" calls each of their bi-monthy newsletters! http://www.ti.ubc.ca/en/TherapeuticsLetters''

''The group is part of a larger group who are aggressively fighting what they call "big pharm". It sounds like a great initiative - to promote research that is financially independent of the pharm companies, but what the layperson does not know is that most research is not funded by those companies. Most research is conducted by universities under private foundation and government-funded grants.''

''The short-term compares only two articles. Meta-analysis or not, it's the perspectives of two authors and not a first-hand evaluation of evidence.''

Their criticism of the MTA study is rediculous. ''- They mislead the reader by saying a majority in the "community care" group received stimulant medication. While this is true (it was 67% that received it at some point during the study), the layperson might think this meant they received the same treatment as the medication group. They didn't. Compliance is a huge issue, but it is more closely monitored by the researchers when it is the treatment (the medication group). One follow-up study that used data collected in the MTA found that the most influential factor in determining the success of treatment was the treatment. Those who received medication were on track for success. The second most interesting factor was the mother's level of depression. Depressed mothers = no compliance. The findings suggest that children respond to medication, but only when they take it!'' ''-Although there are comparisons in the MTA study that are not significant after a Bonferonni correction, this is misleading. The study was extremely over-analyzed and the researchers were conscienteous in correcting for the number of hypothesis tests. I don't know your statistics knowledge, so I'll assume you haven't been exposed to Bonferonni. It's an adjustment to the acceptable error. We normally set our criteria for statistical significance at .05, which is the probability that our test statistic would occur if there were no treatment effects. If the observed value is less than this, we take that as evidence that there ARE treatment effects. If we run 2 tests, the probability that one of the tests results in this kind of error is nearly doubled. Each test increases this probability. A Bonferonni correctioin divides the acceptable error into equal pieces, so if I run 5 tests, each has a criteria of .01. The corrections in the MTA studies made several of these probabilities appear nonsignificant even though the observed proabilities were extremely low (<.001, .0003, etc.)'' -They say there were no differences on an anxiety scale that is not a measure of ADHD symptoms. ''-They present the follow-up findings as if they showed no differences among the treatment conditions. Indeed, the follow up measures do not differ among the groups. This is probably because more than half of the children, regardless of their original treatment group, were taking medication.''

EVEN THESE PEOPLE couldn't deny the benefits, though. --scuro (talk) 12:22, 4 November 2008 (UTC)


 * They mislead the reader by saying a majority in the "community care" group received stimulant medication. While this is true (it was 67% that received it at some point during the study), the layperson might think this meant they received the same treatment as the medication group. They didn't.... They present the follow-up findings as if they showed no differences among the treatment conditions. Indeed, the follow up measures do not differ among the groups. This is probably because more than half of the children, regardless of their original treatment group, were taking medication.


 * Interesting passage. First he says the TI mislead by saying that the majority were on stimulants.  THEN he says that yes the majority were on stimulants.  They he says accuses the TI of presenting the finding such that they found no difference.  Then HE says that they found no difference.


 * This guy is great. He agrees with everything he says he disagrees with.  Then throws in some stats to make his analysis sound smart.  --Doc James (talk) 13:22, 6 November 2008 (UTC)


 * He does however make a bunch of inaccurate statements. This is not an anti pharma group.  This is a group who look at evidence based medicine.  They prefer that one basis there decisions on evidence rather the drug company published material.


 * Yes most research is government funded. But this obfuscates the point.  Research comes in two different types clinical research and basic research.  The first being based on the second.  Basic research is almost all government funded and is the majority.  Drug studies are mostly pharma funded.  What his point is I do not know.


 * Does everyone remember Vioxx (venlacoxib) and Celebrex (celecoxib)? The TI published an article on it in 2001.  I have never prescribed either having always stuck to cheaper and safer NSAIDS based partly on the TI assesment.  Then what happens in 2005?  The shit hit the fan when what the TI said four years earlier became common knowlegde.


 * Then what about the new cholesteral med Ezetimibe. Well much of the US jumped on the band wagon based on pharma advertising we Canadian held back and waited for the evidence.  What did they find?  That it doesn't help and just cost lots of many.


 * The USA it seems is ready to follow what ever big pharma tells them. And to pay what every big pharma asks.  They do this often blindly.


 * We in Canada are much more advanced. We wait and see what the evidence show.  This gives us health care which cost half as much as that in the USA well at the same time giving better patient oriented results.  I have seen much hype come and go.  Doc James (talk) 13:36, 6 November 2008 (UTC)


 * Focussing on the question at hand, which is the Therapeutics letter, (and not going off on yet more tangents), I would say that it is one of a number of reviews. It does not "trump" other reviews and is limited in that it does not have a lot of analysis.  If I was writing an article for publication I would include it in the literature review but it is not definitive and I would include the conclusion from the other chapter review that I provided, which goes beyond the therapeutics letter and is much more positive about long-term safety.  --Vannin (talk) 18:20, 6 November 2008 (UTC)


 * Since I am the author of the passage quoted by Scuro, I will defend it (& myself). Your criticisms are not valid. You have either misread parts of the message or misunderstood it; this is understandable since it is slightly out of context here. I did not "agree" with what I "disagreed" with at all. So please allow me to clarify.


 * First, I said it was MISLEADING. It is framed to MISLEAD. I did not say it was "incorrect". It is missing important context and leads the reader to a WRONG conclusion.


 * The statements made in the newsletter regarding the failure of the MTA study to find a difference in anxiety are IRRELEVANT. Anxiety is not an ADHD symptom, and stimulants are not prescribed for anxiety. This "systematic review" is not systematic at all. It is a witch hunt.


 * I certainly did not include a description of statistical methods to "sound smart". It was an EMAIL TO A FRIEND, not a "letter to the editor" and Scuro knows my background. I have no need to impress Scuro and had no reason to think my words would appear elsewhere (although I have no objection to this, either). My experience has been that this kind of attitude is generally a defensive one; if you don't understand it, the person who said it must be arrogant.


 * The point I made was that analysis of the follow-up data is EXTREMELY CONSERVATIVE. Nothing in science is black & white and it is, IMO, unreasonable to reject outright a finding that has a 3 out of 10,000 chance of error, especially given the context of these particular findings.


 * The "Therapeutics Initiative" IS an anti-pharm activist group. The "independence" they describe in their mission is a facade.
 * I do not draw scientific conclusions from drug-company literature, either. I prefer peer-reviewed academic journals to activist propaganda. The former is free of ANY biased influence - drug company funding or political agenda. The authors of the newsletter are not relevant and neither are their credentials. Science does not recognize such things. What is relevant is what evidence exists to support the argument.


 * My point? My point is that people with the knowledge and training to conduct and criticize scientific research (i.e., scientists) publish their findings in academic journals, not newsletters. People who conduct research that is published in these sources do so without the funding or agenda of drug companies OR activists.


 * The bottom line: peer-reviewed academic journals are not perfect, but they are the least biased source of knowledge. There is no shortage of them, either. Although scientific research is often flawed, the flaws are detected, discussed, and corrected for BY SCIENTISTS because science is transparent. Politics are not.


 * ICBSeverywhere (talk) 04:47, 8 November 2008 (UTC)


 * House keeping notes: I moved ICB's post so as not to cut into Jame's post and put it in chronological order. She is new.


 * There it is in a nutshell...not a review at all because it is not published in a peer reviewed medical or scientific journal. A dead give away also is that no author put their name to that piece. ADHD attracts all sorts with an agenda and they can go to any length to make their case....that is, except proper science. On a different note, James can we finally give up the ghost on this citation? Time to move on? Once again I have demonstrated that I am on the right side of an issue. So can we stop the brush off and get back to the concept of: good faith, proper polite communication, an end to edit warring, and seeking consensus?--scuro (talk) 05:51, 8 November 2008 (UTC)

Practical matters -stripped tags and edit waring
While we are coming to consensus here a lot of new information and citations are being added to the article. Some of the information and citations are of questionable quality. In the past, tags have been added to the article that have been stripped without discussion in talk, with edit waring to keep it that way. Could we agree that no tag should be taken from the article unless the original editor does so, or there is a general consensus of editors who agree to this?--scuro (talk) 13:25, 1 November 2008 (UTC)
 * Probably not a bad idea during a mediation, if you all think it'll help smooth things out. Any other opinions on the matter? Xavexgoem (talk) 20:06, 1 November 2008 (UTC)


 * I do not think adding tags to everything which Scuro disagrees with adds anything to the article. A US government site http://www.ahrq.gov/clinic/epcsums/adhdsum.htm gives one quote he has tagged claiming it is not neutral as it is from 1999.  I can add a ref dealing with each of the sub groups if wanted that is more recent.  But Scuro seems to demand much more evidence for points he disagrees with then one he agrees with.  This is a guy who make references to power point site, drug company websites, and people personal web sites.  So there would be a lot of silly tags that would need to be added if we decide to go this route.--Doc James (talk) 23:10, 1 November 2008 (UTC)
 * Scratch that then... you two seem to working for different goals? What do you both want for this article? Xavexgoem (talk) 00:16, 2 November 2008 (UTC)
 * I thought this wasn't supposed to get personal. Content not the contributor. He finds vault with me above and does so by name. What did that pledge mean that we all agreed too two days ago? Take a look at my original complaint: Uncivil behavior, edit waring, making false accusations, name calling, not seeking consensus, not answering questions, refusing to respond to certain editors, and bad faith. Even while under the eye of an administrator it doesn't stop. I don't want to be badgered and smeared. I want the editing process respected. WP:BRD


 * Xacexgoem, you wanted us to focus on one thing and we did. The citation really is an insignificant issue in the grander scheme of things. Stimulants have been proven to be safe up to two years, after that too few studies have been done to draw any sort of meaningful conclusion. I've given citations which state this is for ethical reasons. Whether it is for ethical reasons or not, it's not a big deal. But it is a line that I have stood my ground on, and not been edit warred off of. As we can see I was justified in finding fault with the citation. I did ask two researchers about the "therapeutic letters" and simply put, they rolled their eyes. The conclusion drawn is faulty. The methodology is poor, but more importantly they have nothing to do with a true peer reviewed systemic review. I see no reason why I can't edit in peace. It certainly can't be because I don't have a grasp on the subject, or that I am unwilling to follow any wiki process.--scuro (talk) 03:47, 2 November 2008 (UTC)


 * Back to the issue, we should all assume good faith. Why assume that I am going to add tags to "everything"? Even if I were to add tags to "everything", do you not think that I could be reasoned with? The issue here is that more than one editor feels stifled because of edit warring. Why shouldn't contributors be allowed to alert readers that they feel certain passages have flaws or bias? Wikipedia has a process but it means nothing if a "might is right" approach is allowed to dominate Wikipedia.--scuro (talk) 12:30, 2 November 2008 (UTC)

Lets let others comment.--Doc James (talk) 14:11, 3 November 2008 (UTC)

Just an update. James again unilaterially stripped a POV tag without discussion in talk or here. (http://en.wikipedia.org/w/index.php?title=Attention-deficit_hyperactivity_disorder&curid=64976&diff=249404945&oldid=249398554) Should we not all be following this model WP:BRD? --scuro (talk) 17:00, 3 November 2008 (UTC)


 * The second stripping of POV tag. http://en.wikipedia.org/w/index.php?title=Attention-deficit_hyperactivity_disorder&curid=64976&diff=249487753&oldid=249461353 This issue was brought up subsection entitled:"define the controversy and who are the adherents of the controversy". It was not resolved. In fact the quote from the reference which was, labeled archival material only, appears to be improper synthesis. Now we have a double unilateral strip of a tag. No attempt at talk. This is exactly the sort of behaviour that doesn't follow WP:BRD and must stop.--scuro (talk) 22:41, 3 November 2008 (UTC)


 * This was discussed and it was agreed that the past tense would be used to indicated that at some point in the past the controversy involved clinicians. It still does involve clinicians aswell however.  You still seem to insist on tagging everything you do not like.  I guess you are marking it for future deletion with your over all goal being to removed all evidence of there being any controversy in the field of psychiatry.  Wow they must have druged you good.--Doc James (talk) 22:46, 3 November 2008 (UTC)


 * http://en.wikipedia.org/w/index.php?title=Wikipedia:Mediation_Cabal/Cases/2008-10-09_Attention-deficit_hyperactivity_disorder&diff=249510358&oldid=249509197
 * Another clear example of a direct personal attack. At this point I'd like some action taken and ask if that should be done outside of this forum?
 * As to second the stripping of the tag. The agreement to the past tense was a separate discussion. In the, "define the controversy and who are the adherents of the controversy", the improper synthesis of the quotation and citation were pointed out not to be meeting wiki standards. James did not respond to these suggested shortcomings.--scuro (talk) 23:32, 3 November 2008 (UTC)
 * I'm impressed that you can stay so calm in the face of these insults. Well done.  I know that JMH has asked for comments about the tags.  I think that right now with the need to focus on one issue at a time, the tags could be useful as a tags for things to work on at a later point in time and that seems more than reasonable.  I still find that editing is going on in all directions and the logical progression is lost, which is part of the going round in circles feel to the whole process.  --Vannin (talk) 00:02, 4 November 2008 (UTC)
 * This is better then the main talk page. Insults yes, but I got those on the main page too. Here there is focus on a few very specific issues even though we are moving at a snails pace. Although it may not seem like it, it is better under the eye of an administrator. James did ask for comment on the UBC link. If you have the time, do so. He made that request at the bottom of the "Lets resolve one issue and go from there", thread.--scuro (talk) 03:09, 4 November 2008 (UTC)
 * Right, I've answered under that thread. Hope that helps us inch forward--Vannin (talk) 03:40, 4 November 2008 (UTC)
 * Now we have the third stripping of a tag without meaningful discussion in talk. This is edit warring plane and simple. ::::::http://en.wikipedia.org/w/index.php?title=Attention-deficit_hyperactivity_disorder&curid=64976&diff=249508832&oldid=249508073
 * We go back to the original complaint and see that most of the behaviours (Uncivil behavior, edit waring, making false accusations, name calling, not seeking consensus, not answering questions, refusing to respond to certain editors, and bad faith) continue under the eye of an administrator. Xavexgoem, we need your help. Why should any contributor who gives their time freely endure this?--scuro (talk) 05:44, 5 November 2008 (UTC)
 * Diff of 3R template on James's talk page. http://en.wikipedia.org/w/index.php?title=User_talk:Jmh649&curid=18315537&diff=250055603&oldid=247792574 --scuro (talk) 16:56, 6 November 2008 (UTC)

Have placed a diff of 3R template on Scuro's talk page. We have discussed the tags in the past and it was agreed that they would not be used. Doc James (talk) 17:24, 6 November 2008 (UTC)


 * "we" have indeed been discussing the tag issue on this page and so far the consensus is that while we are doing this mediation they are useful as tags for future issues. I really would like to see some response to the issue that JMH has already resorted to name calling after signing the agreement to stick to content, though.--Vannin (talk) 18:23, 6 November 2008 (UTC)


 * I remember no one seeking agreement on that issue James. One can't simply take snippets of discussion and extrapolate meaning from this to wide reaching agreement. That would be improper synthesis. You now have two contributors who disagree with you. Tags are needed until all contributors on this talk page follow wiki protocols. What we have now, is edit warring in a might is right approach to editing.--scuro (talk) 05:01, 7 November 2008 (UTC)

This is from above and refers to that passage. ''Just a thought: Why don't we rephrase the sentence to start with, "Historically, ADHD is a controverisal diagnosis..." --*Kat* (talk) 10:03, 29 October 2008 (UTC)'' We also discussed it once in the past. See the talk pages.--Doc James (talk) 13:48, 8 November 2008 (UTC)


 * Citations don't matter, text doesn't matter, if they are simply deleted or edit warred to be kept off or on the page. The issue is conduct. The one pledge we had here was broken within two days, no apology was given, nor was there a new commitment to get back "on the wagon". That would be a small step. In the end what is needed, is a commitment to follow all wiki procedure. Until that happens it is completely useless to go off on tangents. The issue above is about stripping tags unilaterally, without seeking consensus. What should have been done is to address the issue of removing the tag in talk. One can't simply extrapolate that because a discussion was held between two contributors about content, on a page frequented by many, that an issue is resolved and everyone can mind read that removing a tag is justified. Address the removal of a tag directly in talk and wait for feedback. If there is general consensus or no one disagrees then one would be on solid footing.--scuro (talk) 16:06, 8 November 2008 (UTC)

Next step - request for comment
WP:RFC

I'm simply going to collect diffs here over the next few days before I file a complaint. A commitment by James to follow wiki guidelines in the next day or two would be most welcome and stop this action.--scuro (talk) 05:12, 7 November 2008 (UTC)

False accusations/taunting
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=240320227&oldid=240320032
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=240303884&oldid=240301558
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=241165813&oldid=241105288
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=241235410&oldid=241235302
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=242190037&oldid=242164056
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=242280871&oldid=242278799
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=242194458&oldid=242190099
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=242479247&oldid=242474153
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=243426888&oldid=243426199
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=243459248&oldid=243458727
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=243815092&oldid=243815063
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=243820899&oldid=243820332
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=243822121&oldid=243821730
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=243827449&oldid=243822581
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=244416267&oldid=244411179

Edit warring

EXAMPLE (A small POV tag is removed four times beside the word "clinician". It was argued that the source states on it's webpage that, "it is maintained for archival purposes only" and the context was of a different time (1999), when ADHD was controversial. At that time we had the Ritalin class action lawsuits congressional hearings, and lots of media attention. Also the point that I tried to get across was that the threshold for a true controversy is a lot more stringent with Wikipedia. The sentence on the page was a direct quote stating it "involves" clinicians. This implied the present tense. I know no true minority group of clinicians who are revolting. DJ did not seek consensus, compromise, and simply reverted stating, "IT WAS DISUSSED".)


 * Previous version reverted to:
 * 1st revert:
 * 2nd revert:
 * 3rd revert:
 * 3r warning given
 * 4th revert:

IN DJ'S OWN WORDS:
 * This citation speaks for itself, read post and then DJ's response.
 * DJ admits to "stripping" two citations, one being the National Institute of Neurological Disorders and Stroke
 * DJ comments about how edit warring is "fun".

Bad faith
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=244457415&oldid=244456961
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder_controversies&diff=242286574&oldid=242284689
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder_controversies&diff=242284290&oldid=242283802
 * http://en.wikipedia.org/w/index.php?title=User_talk:Scuro&diff=242478291&oldid=242478061
 * http://en.wikipedia.org/w/index.php?title=User_talk:Verbal&diff=prev&oldid=249838587
 * http://en.wikipedia.org/w/index.php?title=User_talk:Stevenfruitsmaak&diff=prev&oldid=238636916

Personal attack
 * DJ comments, "they must have druged you good".

ownership issues
 * http://en.wikipedia.org/w/index.php?title=User_talk:Scuro&diff=249885323&oldid=245159770
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=244416267&oldid=244411179

not answering questions
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=249509623&oldid

sock puppetry
 * Notice the first sentence starts, "I assume (hope) DJ won't mind..." The post is sign stamped by Doc James. Yet is also time stamped as unsigned by 92.1.168.244.
 * In this link 92.1.168.244 thanks Doc James for his, "brilliant links".

attempts to find a resolution


 * http://en.wikipedia.org/w/index.php?title=Wikipedia:Mediation_Cabal/Cases/2008-10-09_Attention-deficit_hyperactivity_disorder&diff=248681242&oldid=248600078
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=244311802&oldid=244309145
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=242672490&oldid=242651530
 * http://en.wikipedia.org/w/index.php?title=Talk:Attention-deficit_hyperactivity_disorder&diff=247768965&oldid=247766668
 * http://en.wikipedia.org/w/index.php?title=User_talk:Scuro&diff=249897947&oldid=249885323
 * Xavexgoem mediating.
 * Scuro offers to mediate any dispute.
 * Vannin offers to mediate any dispute.

Everything I said I stand behind. Most of the above comments are really very good. Even though some are a bit sarcastic. But hey why not have a bit of fun. I must say though in seriousness that the page is now much better. Thanks Scuro for putting this together. Doc James (talk) 16:05, 7 November 2008 (UTC)


 * I should be done this process in a few days and will go for the RFC then. http://en.wikipedia.org/wiki/Wikipedia:RFC#Request_comment_on_users An RFC asks that: "Before requesting community comment, at least two editors must have contacted the user on their talk page, or the talk pages involved in the dispute, and tried but failed to resolve the problem. Any RfC not accompanied by evidence showing that two users tried and failed to resolve the same dispute may be deleted after 48 hours". We could solidify our case by making a final attempt at reconciliation and I am asking that a different contributor make the case since I will presenting it. I'd suggest that if this is done, the contributor focus on wiki etiquette only. Once that is done I'll collect the diff and move on from there.--scuro (talk) 23:20, 8 November 2008 (UTC)


 * FYI Scuro, I have commented on JMH's talk page regarding sarcasm but my comment was removed. I will try again.--Vannin (talk) 23:59, 8 November 2008 (UTC)

Sounds like an excellent idea. --Doc James (talk) 05:09, 9 November 2008 (UTC)


 * No, that is not what the RFC is looking for. As part of their application process they are looking for two separate contributors to offer to mediate. That can be done right here on this page since James reverts anything on his page not to his liking. All we need is for you, or someone else to offer to mediate, to seek peace. Who knows, it might even work.--scuro (talk) 06:36, 9 November 2008 (UTC)

Dear Scuro Here is what it comes down too. I am not going to let you remove well referenced sources ( like the one to the NHS guideline ). And your warring, repeatedly deleting, and trying to add doubt to everything you do not agree with is not going to work. You repeated threats do NOT intimidate me. They are however a bit of fun and I cannot help returning some of what you give. Scuro you have been tagged for POV pushing in the past. You have not listened to comments by others in the past. So this is taking persistance on my part.

This page needs more then a single point of view. A large portion of people see things differently then Dr. Barkley. He one self proclaimed ADHD expert well funded by drug companies. His point is represented on this page but so will the opinions of others and the evidence.--Doc James (talk) 13:51, 9 November 2008 (UTC)
 * An olive branch - a good faith offer of mediation
 * Doc James, if you have a content dispute with an editor, I offer to mediate that dispute, or find a mutually agreed upon mediator to mediate, if the the disputed contributor is me. As part of this agreement all editors agree to follow wiki guidelines and avoid the following: edit warring, commenting on other contributors, uncivil behaviour, and not seeking consensus.--scuro (talk) 15:18, 9 November 2008 (UTC)


 * JMH, I too am willing to mediate, or find a mediator, and to follow wiki guidelines. --Vannin (talk) 17:09, 9 November 2008 (UTC)

The issue is that Scuro denies the existence any controversy around ADHD. And this has really always been the only real issue. There have been many attempts to eliminate any other point of view other then that of Dr. Barkleys. This does not improve the ADHD article or reflect the general world view. If you have a different point of view that differs from that of some of the establishment and you get your point of view published in a major journal your point of view is wiki worthy. It is not fringe.

When a major guideline like the one that came out of the UK is published I had one editor ask how this could be refuted well another say that this somehow justified the claim that the UK must be behind the USA in ADHD research.

When it comes to tagging we could really add tags to everything. But that would be stupid. Therefore we can leave the two tags at the top until we all agree as they apply to everything below them.Doc James (talk) 22:16, 9 November 2008 (UTC)


 * Pragmatically speaking, content is secondary to conduct. It doesn't really matter what content, or viewpoint is held, if it is stripped unilaterally. Once again, I'll commit to following all wiki guidelines, especially etiquette guidelines. James will you also commit to this?--scuro (talk) 00:31, 10 November 2008 (UTC)

Content is important. Part of the wiki guidelines discusses formatting aswell.--Doc James (talk) 01:15, 10 November 2008 (UTC)


 * Sure content and even formatting are important issues. Does that mean you will commit to wiki etiquette guidelines so that we can discuss?--scuro (talk) 12:19, 10 November 2008 (UTC)

Formatting of references
It would be great if all editors would format there references. I have asked Scuro to do so multiple times with not response. Any measures one can take for this? Would be nice if he would follow wiki policy. Doc James (talk) 13:53, 8 November 2008 (UTC)


 * spelling and grammar would be great too. I always think of formatting as part of an iteration in the editing process.  Get the main point, get the details, refine the grammar and spelling, and then deal with formatting. --Vannin (talk) 18:38, 8 November 2008 (UTC)


 * Why learn to format a reference properly when one isn't sure that the passage or the citation will not be unilaterally edit warred off the page? The first step of this process is a commitment from all to following wiki protocols.--scuro (talk) 22:37, 8 November 2008 (UTC)

= For crying out loud =

A consensus statement ideally has 4 components. These can be explicit, or they can be woven into the style of your reply (might be nice to make it nearly invisible). Sometimes not all are needed, though people should be able to ask you about any of these elements if you skipped them. Make sure you know the answers to all these components before you hit "submit" The components are:


 * 1) A personal reason why you are in support of the action you are taking
 * 2) What would theoretically needs to be said or done to make you reverse that position
 * 3) A reason why you think others (will) support you (ie, why is this likely to gain consensus)
 * 4) What likely would need to be said or done to reverse the position of the community.

If you don't give the person you're reverting a reason that can be potentially disputed or agreed with ... [then you are not discussing] --Father Goose

My internet was down, and I apologize for letting this get out of control.

Here's my take, and it's true: Neither RFC/U nor RFAR nor any process -- aside from waiting for some party to slip up so an admin makes a temporary 48h block -- is going to keep the both of you off of the same article (RFAR might result in a 1RR restriction, but I think that's about it). And both of you, it appears, hate each other. The actual problem isn't content, it's behavioral: If you don't want to act together on the article -- and it appears you don't, despite the good arguments you're all making -- I have no choice but to close this and warn you both of serious ownership issues. Mediation doesn't work if parties aren't willing to cooperate, and mediation can't make any binding rules. Furthermore, I cannot act as an administrator for this dispute as that would be entirely beyond my role as a mediator (we all have back-channels, but I'm just too principled to use mine, dammit). "Wow they must have druged you good." is not acceptable communication, and you know that damn well, James. Were I there to witness that diff on my watchlist, this case would be closed and you two would be at each others' throats in more novel ways than pretending this page is getting either of you anywhere.

My status as a third party is limited to this:


 * 1) Someone brings an issue to the table, with suggestions and compromises; no absolutes.
 * 2) We talk about the issue with some respect towards each other (if you can't do that, I can't help ya)
 * 3) I say go for it, and hope you two stick with it. If there's a problem, we move onto another issue until you agree on something. That'll bring a smile to my weary face.

And that's the way it's going to be. This article is too big to deal with things categorically, so we're gonna start small. One issue at a time. Nothing general. What is your problem with X text, and do you think solution Y will work? What about solution Z? Is there a middleground between Y and Z? Can't we all just get along?

Start small. Both of you bring a separate, specific issue and we'll talk about them before we tackle the bigger things. Some degree of agreement between the two of you will need to take place before we can get anywhere. One citation at a time, if need be. Xavexgoem (talk) 07:00, 12 November 2008 (UTC) Ugh... I need a cigarette.


 * Issue 1 (Scuro): Xavexgoem, you have made an apples and oranges comparison. I do not have ownership issues because I have not added text to the page since Oct 27th., and have stopped editing the page entirely....compare and contrast that to James. It is totally wrong to characterize that I "hate" James or that I don't want to work together with James. You can't find a diff that shows that, where I can, and have found plenty of diffs that do. If you like I could find diffs of a dozen olive branches that I have extended to James, compare and contrast that to James. I have committed several times publicly to working within the framework of wikipedia convents and have asked James to do likewise. He has never accepted my offer.

My one issue from the start of this process is about behaviour. Other contributors have the same issue and are willing to state so publicly. We would all be happy if James committed to following wiki etiquette. I have always been willing to come to the table and I am still willing to come to the table. I am ready to move forward at any point in time.--scuro (talk) 13:07, 12 November 2008 (UTC)
 * I agree: everyone should be be open to ideas and be respectful to each other. But I think we'll make more headway if we focus purely on content. Xavexgoem (talk) 13:20, 12 November 2008 (UTC)
 * The "druged you good" comment was over the top for me. The atmosphere is poisoned, there have been no apologies.  --Vannin (talk) 15:28, 12 November 2008 (UTC)
 * I have no problem dealing with content and we can see that when this is done under supervision I have valuable contributions to make. I can also forgive and forget, I don't need an apology. I can start fresh anytime. But I see no reason for special treatment for one contributor. Either there is a commitment by everyone to all wiki etiquette or there isn't. That is the issue that three separate editors have with James. There is no other issue where two or more contributors have a problem with one editor. Without commitment, games like: sock puppets, name calling, edit warring etc don't allow for consensus building and harmony. I have learned that discussing content and editing when there is no respect is futile. this comment was added by Scuro, 16:17, 12 November 2008
 * Motion to close? Xavexgoem (talk) 16:43, 12 November 2008 (UTC)
 * I'd like to hear what James has to say first.--scuro (talk) 21:20, 12 November 2008 (UTC)
 * I second the motion. Thanks for trying Zavexgoem.--scuro (talk) 04:54, 13 November 2008 (UTC)


 * Issue 2 (James):

I am more then happy to deal with content. Everything I have added is referenced and from excellent sources. I really do not have anything more to add about references as it has all been brought up before. With unfortunately little agreement. Doc James (talk) 00:33, 13 November 2008 (UTC)