Wikipedia talk:Identifying reliable sources (medicine)

Simply bad
Bendegúz Ács asked a little while ago for more information about the sentence that "A source can also simply be bad, where biases in criteria make it less than ideal." Here's a short explanation, in case anyone's interested:

We have criteria that help editors identify sources that are generally better (e.g., peer-reviewed sources, secondary sources, recent sources). However, no single criterion definitely makes a source be good (WP:NOTGOODSOURCE). In addition to all the criteria, you have to use common sense and have a good understanding of the subject. Sometimes a source seems superficially good, but when you read it, you discover that it's just bad. In such cases, you should use your WP:Editorial discretion to avoid relying on a bad source.

Here are some simple examples of how real-world bias could lead an editor to decide that a source is just bad:


 * The subject is a disease that's very common in poor countries, but your source tells you about the disease in a wealthy country.
 * You need to write something about pregnancy, and the clinical trial involves only males. (That's how the world ended up with the Thalidomide scandal, by the way.)
 * The subject is pediatrics, and the data is all from elderly people.

The main reason that we don't explain is because the potential sources of bias are enormous. Editors who are uncertain about whether their source can support the claims they are making should be discussing the specifics on the article's talk page or at Wikipedia talk:WikiProject Medicine. WhatamIdoing (talk) 02:41, 23 February 2024 (UTC)


 * Thank you for the clarification and the examples, they definitely make this particular issue much easier for me to understand. However, I would still like to suggest some improvements to the sentence. I think here there are two separate potential issues that may make a source bad, and both are worth mentioning separately.
 * One is what your examples are about, and I would call this something along the lines of "subjects/subgroup analysis with low relevancy" or "irrelevant/overly restrictive subjects/subgroup analysis", since the main issue I can identify in your examples is that the source fails to take into account most of the people affected by the topic. I think this particular issue would be worth mentioning in a separate sentence because it does seem important.
 * The other one is about problems that are so particular about a study that it is not possible to easily fit into any well-defined criterion. I would not limit these problems to "biases", however, since not every problem possible to make a study bad is considered a bias. So maybe mentioning it in this way would be an improvement: "A source can also simply be bad, due to a bias, or other problem, too particular to be covered by a common editorial criterion. In cases like this, WP:Editorial discretion may be used."
 * What do you think? Bendegúz Ács (talk) 23:30, 23 February 2024 (UTC)
 * It might be better to re-write the whole sub-section from scratch. I think it is meant to cover things like pesticide manufacturers claiming that their products are utterly harmless. WhatamIdoing (talk) 22:55, 24 February 2024 (UTC)
 * I would support a rewrite, but I am not competent enough to come up with a suggestion for a complete new text for the sub-section. I would be happy to review it, though. Bendegúz Ács (talk) 15:01, 25 February 2024 (UTC)
 * I've considered just blanking it. Do we truly need WP:MEDBIAS, or is it WP:CREEPY and redundant with other pages?  It's only been linked in discussions about a handful of articles.
 * @Bon courage, what do you think? Could we live without it? WhatamIdoing (talk) 07:11, 7 March 2024 (UTC)
 * Hah! Have never paid any attention to this. It arrived in 2016. WP:DONTSHOUTBIAS eh!? Bon courage (talk) 07:26, 7 March 2024 (UTC)
 * Oh, that would have been around the time that we tried (and failed) to put a medicine-specific version of WP:DUE in this guideline. WhatamIdoing (talk) 22:58, 7 March 2024 (UTC)
 * I don't see anything there that needs to be (medicine) specific and the "Personal conflicts of interest" isn't about "reliable sources" either. I'd vote for blanking both. The concerns there about biased sources or biased editors belong in general guidelines. -- Colin°Talk 08:55, 7 March 2024 (UTC)
 * Since nobody's thought this would be useful during the last ~two months, I've removed it. Removal doesn't mean that it's bad advice.  It just seems unnecessary in this particular guideline, and redundant with others (e.g., the Neutral point of view policy). WhatamIdoing (talk) 03:41, 6 June 2024 (UTC)

Meta-analyses need careful scrutiny, peer-reviewed or not.
This is a cautionary tale. 𝕁𝕄𝔽 (talk) 19:15, 28 April 2024 (UTC)


 * Thanks, that's interesting.
 * I have been wondering recently why peer review doesn't involve putting each article through an evidence-based checklist (e.g., the Newcastle–Ottawa scale for non-randomized studies; the most relevant checklist for the subject matter could be agreed upon by the reviewers and the editor) and the results published alongside the article. It might make it easier to discover junk science before publication. WhatamIdoing (talk) 21:47, 28 April 2024 (UTC)
 * A number of journals now require (or at least strongly encourage) articles to follow appropriate guidelines including completed checklists (usually as part of Supplemental Material). EQUATOR has guidelines/checklists that cover many types of articles. For example, here is part of my boilerplate for rejecting bad MR papers:
 * "As you prepare your manuscript for submission to another specialty journal, you may be able to improve it by following one or more of the EQUATOR Guidelines's checklists ( https://www.equator-network.org ). Mendelian randomization studies must adhere to the best practice as described in the following guideline https://wellcomeopenresearch.org/articles/4-186/v3 and be accompanied to MR-STROBE checklist ( https://www.equator-network.org/reporting-guidelines/strobe-mr-statement/ )." Jaredroach (talk) 21:27, 12 July 2024 (UTC)

Thalassophobia
I have an impression that the huge section Diagnosis and Spmothoms is written as an advertisement by snake oil peddlers, such as CBT desensitization, etc. One can find plenty of such phobia-curing webpages in the internets. In its entirety it can be cut and pasted into each and every phobia article only replacing the name of phobia. I suspect this is actually done by various headshrinkers. Can someone write a common page, like, Symptoms and treatment of specific phobias, with proper MEDRS oversight, and then simply refer to it everywhere 99.73.36.110 (talk) 23:39, 7 June 2024 (UTC)


 * I suspect that such a page would look a lot like Thalassophobia. It already looks similar to Specific phobia. WhatamIdoing (talk) 00:41, 8 June 2024 (UTC)

Reconsidering a blanket-ban of primary sources
The express reason given is essentially a re-hash of the "reproducibility crisis," but I have to say, should we even be trusting these "fact-checking"-like organizations for whom we essentially defer the power of keeping out bad knowledge?

Did you know, for example, the American Psychological Association, known for such works as the DSM-V and numerous textbooks likely to pass as verified work through here without a second thought, is actually a trade organization with the express intent of lobbying on behalf of practicing psychologists, in exchange extracting registration dues, and licensing fees?

Or that the American Pain Society, this time a non-profit society that nominally advocated on behalf of patients by publishing clinical practice guidelines, actually instead acted on behalf of pharmaceutical companies to propagate a treatment mandate to prescribe more products, in essence acting as a marketing channel where physicians were not primed to regard it critically?

I think it might be beneficial to re-investigate the ultimate authority of the organizations/publication guidelines we choose to let pass uncritically with more ability afforded to well-informed individuals to make their case that enough primary research exists to effectively include a consensus on matters of pathology and lines of inquiry related to potential treatment paradigms. We do ourselves a disservice when we shut out promising potential, and similarly to our readers too when academic literature acts more like a thicket than it does pathway. Additivefreesb (talk) 17:52, 12 July 2024 (UTC)


 * Which blanket-ban on primary sources are you referring to? Firefangledfeathers (talk / contribs) 17:56, 12 July 2024 (UTC)
 * Identifying reliable sources (medicine) isn't a blanket ban. Identifying reliable sources (medicine) is just common sense.
 * We have had multiple problems with primary sources, including:
 * editors cherry picking the one source that says something completely different from all the others (e.g., cigarettes don't cause lung cancer)
 * editors using obviously bad primary sources (e.g., the patent claiming that colloidal silver cures HIV, but it didn't test whether people had HIV in the first place)
 * editors believing the media hype (can result in bad content [because newspapers don't always get technical details right] and unbalanced articles [because it's all about what's in today's news, and next week it'll be some other vegetable that everyone's supposed to eat to prevent cancer])
 * authors spamming their own publications into as many articles as possible (this happens much less often with review articles)
 * plus, of course, all the problems with the reproducibility crisis and the general difficulty of figuring out which primary source to 'believe in', if the data is conflicting.
 * Primary sources are more likely to be tolerated in veterinary content or for very rare conditions. WhatamIdoing (talk) 18:38, 12 July 2024 (UTC)

I think something needs to be said of primary sources often also overwhelming both the average reader or editor, owing to both their sheer number, and the fact that even many well-intentioned editors are not deeply knowledgeable about all issues they write about.

Further, there is simply no blanket ban on primary sources. For instance, there is actually not even a recommendation to refrain from using secondary summaries from within primary sources (i.e. background sections or well chosen parts of discussion sections). One of the problems to allay is keeping Wikipedia from reading: xx et al. found 80% mortality, while xy found 79%, and zy found 81% - with WP:OR prohibiting us from summarizing these (which would be a problem due to evidence grading). This becomes less of a problem upon listing authoritative secondary sources, as they already do summation for us, and readers are likely to want to know what, for instance, both the CDC and WHO think about a specific issue.

This guideline already discusses pitfalls of relying on industry and industry-funded sources, and I would not object to a well-thought out extension on issues of industry influence on practice guidelines or biases in professional associations. WP:MEDORG (part of this guideline, which I worked extensively on) points to industry guidelines or guidelines from patient advocacy groups being considered below the threshold of MEDRS.

Perhaps, in the spirit of giving background to a well-though-out question, has input on considerations when MEDRS was originally drafted. CFCF (talk) 17:54, 13 July 2024 (UTC)


 * Lots of people worked on the early drafts of MEDRS. My significant part was realising the medical project's guideline, which was becoming MEDMOS, needed the RS stuff pulled out of it into a new page. But the key battles we had then were editors who thought they knew better than these secondary sources or who thought journalists on their favourite paper did better. Citing the secondary literature was something academics are taught to avoid so it didn't come naturally.
 * Coming back to the original question about our favoured MEDORG guidelines having a malign influence behind them. Consider then if we let editors build our medical articles much like someone might write their own review from the primary research studies. That same malign influence would appear on Wikipedia as editors cherry picking primary sources. There isn't a mechanism whereby Wikipedia might be expected to do better, and a fair amount of evidence that it would do worse.
 * Wikipedia has a unique editing model where anyone can edit but the consequence of this is we agreed to make the selection and summarising of primary research studies into "somebody else's problem". We found alignment with Wikipedia's preference for "secondary sources" with readily available reviews, guidelines and textbooks. Our model, of relying on existing publications and a crude grading system for those publications, isn't perfect. It is too easy to find oneself reading a journal by a bad publisher. As you point out, it is possible that some apparent authorities are merely fronts for vested interests. But this surely also malignly affects medicine as a whole, so is something the real world needs to fix for itself, rather than us hope we can work around the problem. -- Colin°Talk 09:47, 14 July 2024 (UTC)