Wikipedia talk:Manual of Style/Medicine-related articles/Archive 5

Naming for swine flu outbreak
Should it be 2009 H1N1 outbreak or 2009 swine flu outbreak? See Talk:2009 swine flu outbreak. MOS:MED conflicts with WP:COMMONNAME in this regard. Dabomb87 (talk) 03:05, 5 May 2009 (UTC)
 * Overall, the endless and pointless discussions at that article seem to have a lot of WP:ILIKEIT and WP:IDONTLIKEIT in them, and not much sense. I am unhappy about this guideline being invoked as proof that editors is required to move the article to 2009 H1N1 flu outbreak (a term, by the way, that does not comply with this guideline, because "flu" is imprecise:  there's a reason that Flu_(disambiguation) exists).
 * This guideline does not supersede Wikipedia's policy on naming conventions, of which WP:COMMONNAME is one part. It isn't intended to supersede it, either:  it's intended to prevent sloppiness and inaccurate "common name" choices that might, for example, confuse the nearly meaningless term heart attack with myocardial infarction, or result in leukemia being renamed "blood cancer".
 * I think that this question has come up three times in the last few months. Perhaps we should re-write this section to explicitly refer to WP:COMMONNAME and thereby to "allow" common names when they are both accurate and adequately precise?  WhatamIdoing (talk) 06:27, 5 May 2009 (UTC)

Order of sections
Before I change anything, is there a reason the "prevention" section is positioned between the "diagnosis" and "treatment" sections? This is quite disruptive for the flow of an article, as prevention efforts should probably be discussed closer to the "epidemiology" section. JFW | T@lk  13:39, 10 May 2009 (UTC)
 * Seems a reasonable change. The actual order of sections in even the best (FA/GA) articles tends to deviate from MEDMOS, which is fine if that helps produce a logical ordering. Colin°Talk 14:58, 10 May 2009 (UTC)
 * For developmental disorders like autism, Screening (the alternative for Prevention) should come just before Diagnosis, as screening is closely related to (and precedes) diagnosis. If Epidemiology is to come near Screening, I'd suggest the order Epidemiology, Prevention/Screening, Diagnosis, Treatment/Management, as opposed to putting epidemiology at the end of that list. This would require moving the Epidemiology section in Autism but I think this'd be an improvement. (Disclaimer: I think epidemiology's important....) Eubulides (talk) 19:06, 10 May 2009 (UTC)
 * I think that this sort of issue is why the guideline explicitly permits editors to use the most sensible order for the specific disease, instead of rigidly adhering to a script. Medical conditions are far too variable for a one-size-fits-all prescription.
 * As for Autism: Screening is not necessarily a substitute for Prevention.  I might recommend a very short section on Prevention:  "There are no known ways to prevent autism."  If wanted, it could then go on to discuss the now-disproven ideas (e.g., skip vaccines, don't be a 'refrigerator mother', that kind of thing), but the fact that a disease is not apparently preventable (at this time) doesn't mean that the article should not discuss its non-preventable nature.
 * I think that having Prevention near Epidemiology (which in turn should generally be near Prognosis) makes good sense for a large number of articles. Prevention of, say, lung cancer or heart disease is closely related to the risk factors (e.g., smoking) that are discussed under Epidemiology.
 * I don't, however, think that Epidemiology should normally be very high up in the article. Most of these sections contain statements like, "This disease affects exclusively young children, equally divided between boys as girls".  I think our average reader cares much more about the symptoms/diagnosis/treatment/prognosis cluster, and therefore I think that this information should be presented first.
 * In terms of a concrete proposal: I'd move ==Prevention== down so that it immediately precedes ==Epidemiology==.  WhatamIdoing (talk) 21:23, 10 May 2009 (UTC)
 * Perhaps we should be more explicit that the MEDMOS list of suggested sections does not dictate an order that works for all disease articles. Colin°Talk 22:55, 10 May 2009 (UTC)
 * "The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition" isn't clear enough? WhatamIdoing (talk) 03:40, 11 May 2009 (UTC)
 * I didn't spot it, and I wrote it. Must get my eyes fixed. I didn't read the section introduction above the subsection. Colin°Talk 08:08, 11 May 2009 (UTC)

"Flu"/"Influenza" RfC
Seeing as it's under discussion at the moment, it may be prudent to seek a project-wide consensus on the use of the words "flu" or "influenza", namely: which one should be used? While influenza is the official name for the disease, "flu" also gets quite a bit of official usage. See, for example, Avian influenza and Swine influenza against 1918 flu pandemic and 2009 swine flu outbreak. Sceptre (talk) 11:09, 5 May 2009 (UTC)

Straw poll
Please keep this to signing your name only; post your opinion in the "discussion" section.

Influenza

 * 1) Sceptre (talk) 11:09, 5 May 2009 (UTC)
 * 2) WP:COMMONNAME comes second to WP:MEDMOS naming conventions. Regards, --— Cyclonenim | Chat 23:01, 5 May 2009 (UTC)

Context is everything

 * 1) Colin°Talk 12:41, 5 May 2009 (UTC)
 * 2) I think we should heavily lean toward using the scientific and most precise name, i.e. influenza in this case, but in some contexts if the colloquial name is much more commonly used we can go with that.  delldot   &nabla;.  19:02, 6 May 2009 (UTC)
 * 3) If a particular outbreak is called something, then the outbreak -- which is a historical event, not a medical condition -- should get whatever the common name was, even if that name were a cute nickname or apparent gibberish. A disease article should be called its proper name medical sources, which is, in the instant example, influenza instead of flu (because the specific disease is not any of the other things sometimes called flu).  If there's a common-medical-name (seen in, for example, popular medical encyclopedias like MedLine or the Merck Manual) and another name in use solely by subspecialists, then I'd tend in favor of the common-medical-name as a compromise between an inappropriate "nickname" and an incomprehensible "jargon".  Similarly, the virus article should get its proper name, as designated by virologists, unless that name is so esoteric and jargon-y that no one except virologists ever use it.  In the end, we don't want "science über alles"; we want editors to use good judgment.  WhatamIdoing (talk) 19:57, 6 May 2009 (UTC)
 * 4) Agree with flu disambiguation, or flu redirect. Implicit in this is the thought that the long word is the proper one, but sometimes an editor is too lazy, or the short syllabled flu (not a disease) falls into the rhythm of the sentence. :) HarryAlffa (talk) 17:28, 21 May 2009 (UTC)
 * 5) Avenue (talk) 13:05, 27 May 2009 (UTC)
 * 6) I am of the same mind as delldot. AGK 17:26, 28 May 2009 (UTC)
 * 7) Ditto. Fvasconcellos (t·c) 21:37, 28 May 2009 (UTC)
 * 8) My preference is actually use both but that was not an available option. I think common language usage is quite acceptable for articles likely to be read by the non-technical reader, as long as the common usage term is not inaccurate.  (Hopefully, medical professionals are not uwing Wikipedia as an primary source.)  That is reader friendly.  Yes, it should be initially introduced using its proper term "influenza", but (optionally) calling it "flu" after that is perfectly acceptable, and not inaccurate.  (Consider whether the Rhode Island and Providence Plantations article should use the full name throughout?)  -- Tcncv (talk) 03:42, 31 May 2009 (UTC)

Editor's preference

 * 1) Let editors use whichever they want.--Rockfang (talk) 17:01, 26 May 2009 (UTC)
 * instruction creep Stifle (talk) 08:58, 29 May 2009 (UTC)

Discussion

 * An article on a disease should follow MEDMOS naming conventions. So we have influenza, swine influenza, avian influenza and we should not have human flu. An article on a historical or current event is not a disease and should be named after what people call the event. If people refer to the 1918 flu pandemic or the 2009 swine flu outbreak then we have to live with that regardless of what scientists and doctors decide to call the organism or resulting disease. In answer to WhatamIdoing's question in the section above, MEDMOS already refers to Naming conventions policy and I don't see evidence that we need to allow "flu" or "belly button" or "boob", etc to become article titles in a serious encyclopaedia. Those names are all commonly used, accurate and precise ("flu" on its own is quite precise and the reason why flu is a redirect and not a DAB page). Colin°Talk 12:41, 5 May 2009 (UTC)
 * I should point out that the 1918 pandemic is more commonly known as "Spanish flu" and that the 2009 outbreak is slowly being referred to more as H1N1 than swine flu. Sceptre (talk) 17:04, 5 May 2009 (UTC)
 * As a cardiologist I would personally use the medical definition Influenza A(H1N1), as used by the World Health Organisation . However, as a (newish) Wikipedian I would err towards including what is used in a large number of sources (example: ) - Swine flu. May I suggest a compromise? How about an inclusive approach - Influenza A(H1N1) (Swine flu), or Influenza A(N1H1), commonly known as Swine flu, at the start of the page, referring to it thereafter as Influenza A(H1N1). As long as we have redirects from Swine flu (which IMHO is what people will use for search queries) to Influenza A(H1N1) or vice-versa I will be happy.AlexandrDmitri (talk) 23:01, 12 May 2009 (UTC)
 * However it should be possible for a reader to type in a name and get directly to a page rather than rely exclusively on a direct. UK seems to be officially terming as "Influenza A/H1N1" (ie with a "/" rather than brackets). The inclusive approach "Influenza A(H1N1) (Swine flu)" you suggest is unhelpful partly as no one is ever going to think to search on that inclusive combination, and it also seems technically imprecise: for as well as not all swine flu being H1N1 and not all H1N1 being in pigs, the combination misses the point that of H1N1 in pigs, only the one specific reassortment of the genes is currently involved in human outbreak. Hence we have top levels of Influenza, middle levels Influenza A virus subtype H1N1 and Swine influenza, and finally as a bottom level 2009 swine flu outbreak (which is more specific than just influenza A/H1N1 of pigs). Whilst last in list switches to use of "flu" and so is consistent with 1918 flu pandemic, I think both these should be switched to use "influenza" per Colin's original proposal (similarly everyone termed the cow disease mad cow disease or perhaps BSE, but no one commonly says Bovine spongiform encephalopathy which is the actual article name). David Ruben Talk 01:37, 13 May 2009 (UTC)
 * Thank you for your feedback. Firstly I agree entirely that Influenza, Influenza A(H1N1) and Swine influenza are three different things. Secondly I personally prefer the use in the text of "Influenza A(H1N1), commonly known as Swine flu" as opposed to Influenza A(H1N1) (Swine flu). Thirdly I support the use of influenza over flu, although my comment about users searching for Swine flu rather than Swine influenza remains. The UK Department of Health refers exclusively to Swine flu. The UK Health Protection Authority (HPA) is particularly unhelpful referring to Swine influenza, Swine flu, A(H1N1) and A/H1N1 all on the same page. As long as the maximum number of people looking for an article can find it, whatever the means and whatever query they use, the more user-friendly Wikipedia will be as far as I am concerned.
 * As to the use of A/H1N1 versus A(H1N1) I accept that there is currently little consensus for either, but would be prudent on an international site of setting a precedent based on a country basis. As I found little consistency between and indeed within countries (France being an excellent example with the Government and press using A/H1N1, A(H1N1) and even A-H1N1), I took the WHO as an worldwide reference. If other worldwide references use A/H1N1 then that would change the debate. I note that the English Wikipedia currently uses A(H1N1) whilst the French Wikipedia is inconsistent  using A/H1N1 and A(H1N1) within the same article.AlexandrDmitri (talk) 15:48, 13 May 2009 (UTC)
 * Wikipedia articles generally avoid using a slash (/) in their titles per WP:MOS. WhatamIdoing (talk) 18:45, 13 May 2009 (UTC)

Research as section in medical specialties
I doubt that "Research" is an essential section in medical specialties. Just as in articles of diseases, they may tend to be filled with miscellaneous individual studies that have any link to the subject. I scrolled through Medical specialties to find any such sections, and the only one I found was Pulmonology, and it could basically be replaced with "research that involves any of the Pulmonology". Mikael Häggström (talk) 05:39, 15 May 2009 (UTC)


 * Thank you, Mikeal! Very valid point. NCurse work 06:35, 23 May 2009 (UTC)


 * Articles on medical specialties usually include a History section which can start way, way back and continue to recent discoveries (and their discoverers). An indication of what's currently being worked on can be included there, if warranted. Notable results of current research will in a few years be history. My 2 cents. - Hordaland (talk) 22:09, 23 May 2009 (UTC)

Links to charities
Someone reverted with a claim that "we link to charities all the time". Yeah, and people add spam all the time too, that doesn't make it right either. Charity links violate WP:EL standards, and if people have been adding them they shouldn't be, regardless of what some subpage of s style manual claims. This was already discussed over at the main page about links. If you have a problem with that, take it up there. DreamGuy (talk) 02:56, 13 June 2009 (UTC)


 * We don't have a problem with WP:EL because this guideline does not contradict it in any sense -- although your changes very clearly did. The fact that information is at a .org website doesn't automatically mean that it's spam or that it violates WP:EL.  Informative pages, like this one are justifiable under WP:EL regardless of whether they are published by a charity.
 * The point this guideline is primarily interested in is the fact that the standard "no chat boards", "no blogs", and "this is not an advertising opportunity for your local group" rules apply even to medicine-related articles because Wikipedia is WP:NOT a web directory for patients. WhatamIdoing (talk) 05:13, 15 June 2009 (UTC)


 * The claims that your version doesn't contradict WP:EL and the claim that the version I changed it to, which was to make it conform to WP:EL, conflicted with it are both nonsense. Of course .org addresses don't automatically mean it's spam, and I never said anything of the sort. .Org doesn't have anything to do with charities anyway, that's just for organizations of all sorts. The "no advertising" applies to "no places that want you to donate money" as well. *Informational pages* on websites that happen to be charities are welcome links, but links to the main pages of charities do not conform to WP:EL rules in any way, shape or form. And, again, if you have a problem with WP:EL standards I suggest you take it up on the appropriate talk page, not here.  DreamGuy (talk) 20:30, 16 June 2009 (UTC)


 * Nobody is objecting to WP:EL guidelines. This is the appropriate talk page for discussing how the WP:EL guidelines apply to WP:MEDMOS. When looking at the change in question, I frankly don't see the connection to the above discussion. Both the old and the new version recommend against linking to charities, for example. Can someone please explain what this dispute is about? Eubulides (talk) 21:34, 16 June 2009 (UTC)


 * Of course, WP:EL contains no blanket ban against linking to charitable organizations. Why someone would make the blatantly false claim that it does is puzzling to me. Dlabtot (talk) 21:41, 16 June 2009 (UTC)


 * DreamGuy, are you aware that "don't like to a charity website" is interpreted "don't link to 'any page, no matter what its contents are, if it's part of a charity website"? Because whatever your intentions were, what you actually wrote on the page was an unqualified and sweeping restriction against "Links to charitable organisations". WhatamIdoing (talk) 00:12, 17 June 2009 (UTC)

Recomendations for sections for treatments
I was looking at how to organise Hyperbaric medicine into a more coherent article and came here hoping for guidance on sections and/or layout, as I've found the suggested layouts for other medical topics very helpful in the past. Would the guidance in "Medical tests" be my best starting point (suitably amended), or does anyone have some firm ideas of the sections most appropriate for "Treatments"? Better yet, is there any chance somebody might write such ideas into the guidance here? --RexxS (talk) 21:33, 4 July 2009 (UTC)

Naming conventions
The purpose of a policy or guideline is to document consensus on an issue. I can see that WP:Manual of Style (medicine-related articles) has that consensus and is accurately documented here. However, this directly contradicts what is documented at WP:Naming conventions. This is because the guideline here does not show up as "other accepted Wikipedia naming conventions" in the list of exceptions at WP:Naming conventions. I would have expected that guidelines for naming medical articles would be part of that list. Is there any reason why that is not so? --RexxS (talk) 20:30, 8 July 2009 (UTC)


 * It's just an oversight, I expect. I fixed it. Eubulides (talk) 21:04, 8 July 2009 (UTC)
 * Thanks for that. Hopefully, it should clarify the discussion on the straw poll at Talk:Nitrogen narcosis. All input welcome! --RexxS (talk) 23:04, 8 July 2009 (UTC)


 * A warning about shooting yourself in the foot if you do this too much. (One more reason to use "common" Wiki article names) You may not know that Google page ranks by exact article name (or whatever links they've set as equal to the name), and does not see any hits based on internal wiki-redirects, if those aren't obvious for google for other reasons. Thus, flu shot redirects to influenza vaccination on Wikipedia, but not on Google, because Google hasn't performed its own redirect to make the terms equivalent (Google does not look to see what Wikipedia does, when doing its own search-term-redirects, sorry to say). Thus, a google search on "Flu shot" will NOT get you the wikipedia article, or any redirected article, for many pages (and this article hardly gets any pageviews, showing that most Wikipedia hits still come from Google). In effect, the Wikipedia article doesn't exist for Google, and this cannot be helped at the Wikipedia end except by naming it "Flu shot." However, in another case, where Google itself has done the redirect, typing "Flu" into Google will get indeed get you the Wikipedia Influenza article, as your second hit. But that's because Google has redirected the search. My point is that if you're not careful, you'll end up naming your Wiki technically "correctly" but if Google doesn't follow you in the redirect, nobody will ever see the Wiki article on the Google search, no matter how you re-direct things on Wikipedia. It's well to remember that. If you want this stuff to be read, keep the titles as something Google users will search on. BTW, feel free to test what I say. Look at the number of page hits for this article using http://stats.grok.se/ then do the same after you've renamed it and redirected to it. You'll find to your shock that it doesn't work. It's not the same. You have to write a letter to Google to "fix" it. Yeah, Google has already redirected heart attack to myocardial infarction. But you can't depend on them to do it. So, two things I suggest: 1) if you're planning to rename a Wikipedia medical article, do a Google search on that name vs. the name it had before. If there's a big disparity, leave it be. 2) Any full WP articles which don't show up on the Page #1 of a Google search, are probably already misnamed! (Misnamed means by defintion, where Google can't find it). That means you just wasted that amount of work you put into the article, and if you don't believe it, and think most people are still finding the stuff on WP using the WP-search engine, just do a page-views reader-check using the software above, and you'll probably be disabused of that idea. S  B Harris 23:35, 8 July 2009 (UTC)
 * Just a question: should our criteria for naming conventions be based upon Google search algorithms?AlexandrDmitri (talk) 02:40, 9 July 2009 (UTC)
 * That depends on whether or not you're writing to educate, or writing to be correct. If nobody ever finds your Wikipedia article, you'll never even get the chance to set him straight on the "correct" terminology. Much less anything about the pathology (for what's in a name? That which we call a heart attack by any other name would be just the same process). S  B Harris 02:51, 9 July 2009 (UTC)


 * I would never support moving an article to some slang name like "flu shot" just to please Google searchers. JFW | T@lk  18:19, 9 July 2009 (UTC)

The implementation of Google PageRank is deeply mysterious but I very much doubt Google hand-craft redirects as a result of letter writing campaigns. Google seems to cleverly return the real article page no matter how you try searching. Perhaps it knows about WP redirects (I doubt it needs to) or perhaps the real pages just have more high-quality links to them. Therefore, http://stats.grok.se/ on an article won't tell you if people are searching for that exact article title (though using it on a redirect will tell you how many people go via the redirect from doing a WP search, following an internal link, etc). My search for "flu shot" successfully returns our Influenza vaccine article #1, contrary to your experience. Mucking about with changing article names is going to confuse Google temporarily because it hasn't had a chance to re-index. I'm sure if someone moved Poliomyelitis to Polio then Google would start returning the latter after a short period. So I say stop worrying Google and let it worry about indexing the web. BTW: it is a flu jab in the UK (jag in Scotland). Colin°Talk 20:51, 9 July 2009 (UTC)

Ordering and naming of article sections
Would like to bring up a discussion of how often we should be following this MOS. I personally think it should be virtually all the time unless there is a compelling reason not to. It makes navigating medicine related articles faster and easier. One thus always know classification will come first for example.

I have changed a number of pages to follow this. I think there are some concerns however. Comments?-- Doc James (talk · contribs · email) 22:45, 11 July 2009 (UTC)


 * I think that we make a good recommendation, but that a reason need not be "compelling" to justify changes.
 * For example, we generally recommend that classification schemes be explained early, because sometimes you can't possibly understand the rest of the article if you don't understand the difference between "Type 1" and "Type 2". However, there are times when it's simply unimportant:  What if a classification scheme exists, but nobody uses it?  Perhaps it's outdated, or irrelevant, or only used in certain areas of research.  It doesn't make sense for an article to dive immediately into something that 99% of the readers won't care about.
 * Similarly, conditions or treatments that are of largely historical interest might want to address the history first, so that the reader knows that it's outdated. WhatamIdoing (talk) 23:46, 11 July 2009 (UTC)
 * There are two ways of looking at 'classification'. One is the classification of the disease within all diseases and the other is classification of types of this disease. The former is important and draws on aspects from many sections; it is often summarised in the lead sentence or paragraph. For example, that a disease is chronic, neurological, progressive, and genetic, etc. The latter isn't always appropriate and may require a level of understanding of the disease that means it needs to be moved further down. It might sometimes also be relatively unimportant and of interest only to specialists.
 * Our MOS section heading guidelines are deliberately accommodating as we cover everything from the inconvenient to the life threatening. I would oppose making them more than suggestions. Colin°Talk 07:14, 12 July 2009 (UTC)


 * I have reverted James on a number of my "pet articles" (call it a case of mild WP:OWN) because I have serious misgivings about the section order being enforced retroactively. Sometimes "classification" only makes sense well after there has been a thorough discussion about clinical features, pathophysiology, diagnostic testing etc. To suddenly move such a section to the top can thoroughly disrupt article flow.
 * "Classification" is also not the same as "diagnostic criteria", but the content for similarly titled sections is likely to overlap. I agree with WhatamIdoing that classification schemes should only be mentioned if they are actually used, and strictly speaking a secondary source should be provided to support this. JFW | T@lk  09:10, 12 July 2009 (UTC)

Nocturnal emissions
"A nocturnal emission is a sleeping disorder."

That's what our article says. It's now included in a Sleep template as a sleep disorder. If this is incorrect, as I suspect, will someone who knows for sure please fix it? Thanks, Hordaland (talk) 18:50, 12 July 2009 (UTC)
 * Thanks for the fix, which was what I expected. I've now moved 'nocturnal emission' in the sleep template from Sleep disorders to Benign phenomena.  - Hordaland (talk) 23:07, 15 July 2009 (UTC)

Treatment section of diseases
The usually ordering of treatments in my experience is: lifestyle / psychological, medication, surgery and this is the ordering I think we should use in articles on diseases. Should we add this to the MOS? Some editors think they should be listed by effectiveness. Any comments?-- Doc James (talk · contribs · email) 13:33, 22 July 2009 (UTC)


 * Depends completely on the relative importance of each treatment. Generally, this is the order a physician would use when treating an illness because medications have side-effects and operations have complications. I can think of situations where the most common/likely treatment is operative, and non-surgical solutions are being developed. JFW | T@lk  17:33, 22 July 2009 (UTC)


 * I agree that it depends on the situation.
 * On a separate, but related issue, would it be helpful to include a very brief description of treatments here, such as "(including self-care, lifestyle changes, exercises, coping strategies, medications, surgeries, etc.)"? I think in some cases we skip self-care and lifestyle changes, or forget that they're properly considered "treatments".  WhatamIdoing (talk) 18:54, 22 July 2009 (UTC)
 * Don't forget watchful waiting! Perhaps better would be a new subsection describing the typical sections for a treatment article; then that "very brief description" could simply point to the new subsection. Eubulides (talk) 01:29, 23 July 2009 (UTC)


 * For me too it depends on the situation and I feel that it is going to be hard to come up with a consensus on a specific order: I don't think for example that a GP and an Emergency Room doctor are going to agree on this one. -- Alexandr Dmitri (Александр Дмитрий) (talk) 19:34, 22 July 2009 (UTC)
 * The reason why I bring this up is that this is the format used for most articles succh as obesity, hypercholesterolemia, and hypertension. It is the format used also on ADHD.  An editor however feels that putting pyscholgical treatments first rather than medications is a violation of undue weight.  I however diagree and beleive that wikipedia article should have a consistent format thus making it easier to find what one is looking for without having to read the entire article.-- Doc James  (talk · contribs · email) 00:30, 23 July 2009 (UTC)
 * It's certainly not the case that putting psychological treatments first is necessarily undue weight. For example, in the Autism article special education programs and behavior therapy are rightly mentioned first (before medication), as they are the most popular and proven management techniques. I'm not sure, though, that we could reach consensus on an order that would work well for all articles. It is plausible that, depending on the article, one might want to sort the treatments by effectiveness, or by cost-effectiveness, or by popularity, or by the order that one would typically try them, or by the order that they were discovered, etc., etc. Eubulides (talk) 01:29, 23 July 2009 (UTC)
 * Thank you for those links, which lead me to check up on a few more articles. The statement "I however diagree and beleive that wikipedia article should have a consistent format thus making it easier to find what one is looking for without having to read the entire article" mislead me into believing that articles were being used for medical advice, something we don't do on Wikipedia. However, two of the articles Stomach_pump and Overdose confirmed my intial scepticism of the proposed ordering, where I would place psychological treatments towards the end (currently they are missing entirely). As to the issue of undue weight, that to me is more a case of the importance accorded to a section, irrespective of its placement in a linear discussion. -- Alexandr Dmitri (Александр Дмитрий) (talk) 05:30, 23 July 2009 (UTC)
 * The treatment section for overdose overdose is given in the order in which the treatments are carried out which I agree is more appropriate.-- Doc James (talk · contribs · email) 05:36, 23 July 2009 (UTC)
 * My previous examples were perhaps not as appropriate as they should have been. Re-reading your initial statement you meant "diseases", and whilst I 100% agree with you that lifestyle changes / psychology as a first line method can be essential (especially when dealing with the morbidly obese for example), another example springs to mind: prostate_cancer. That definitely fits better into the "disease" description. There again, I would improve the article with follow-up care after diagnosis and treatment, with psychology, though I'm not quite so sure we have enough reliable and verifiable knowledge for lifestyle changes. This debate is extremely useful as User:WhatamIdoing rightly states for improving our articles in general, though I fear that using MOS is a bit of a sledgehammer used to tap in a nail on what I perceive (please do not hesitate to correct me) as a local problem. Regards -- Alexandr Dmitri (Александр Дмитрий) (talk) 09:48, 23 July 2009 (UTC)
 * In the management section for ADHD, behavioural interventions are placed first, this intervention in isolation has been shown to be the least effective treatment option. The section on behaviour interventions states, Parent training and education have been found to have short term benefits. Family therapy has shown to be of little use in the treatment of ADHD". The most effective treatment is medication with behavioural interventions, then medication alone. The least effective treatment is behavioural interventions only.--scuro (talk) 04:19, 24 July 2009 (UTC)

While it's true that just one editor uses the 'undue weight' argument, there are several who would rather see medication moved back to the top among treatments for ADHD. User:Sifaka explained her/his reasoning in late May and explained again around the same time James started this thread. And I wrote "Seems to me that in an encyclopedia aimed at the general public, the preferred or most oft-used treatment should come first. Physicians/scientists who might check what Wikipedia has to say on the subject should understand that reasoning." I don't know that we are right, but we are at least three. Cheers, - Hordaland (talk) 13:18, 24 July 2009 (UTC)
 * Or should we mention the safest treatment first? ie lifestyle interventions followed by medication, followed by sugery in most cases.-- Doc James  (talk · contribs · email) 13:24, 24 July 2009 (UTC)
 * I see the pros and cons for the ADHD example, where I think this debate should be continued and hopefully resolved. If we can't resolve it there, I see little chance (or even suitability) of finding a consensus on the MOS which de facto applies to a wide range of articles. Medecine is a complicated and vast subject, treated in different ways in different countries, and all-encompassing ordering set out here seems too top-down for me. -- Alexandr Dmitri (Александр Дмитрий) (talk) 15:39, 24 July 2009 (UTC)

So is there any actual objection to changing that line to:


 * Treatment or Management (e.g., self-care, lifestyle changes, exercises, coping strategies, medications, surgeries, watchful waiting, psychotherapy)

or words to that effect? If there are no objections in the next day or two, then I (or someone else) will make this change. WhatamIdoing (talk) 17:10, 24 July 2009 (UTC)
 * No objections. I would tend to put exercise, medication and surgery in the singular, but that is a personal preference. I was also going to comment on the comma after the "e.g." but note that that is standard in American English :) -- Alexandr Dmitri (Александр Дмитрий) (talk) 17:45, 24 July 2009 (UTC)

Edit warring is evil: "Abuse"
Internetmeme and Bevinbell, I invite you to stop adding and removing "abuse" from WP:MEDMOS, and to start a discussion right here. Other editors can then provide their perspectives and make the decision. WhatamIdoing (talk) 21:34, 2 August 2009 (UTC)

Suggested sections for drug articles
Common practice seems to include off-label use under or as a subheading of "Indications", which makes sense to me, as it is not a legal issue per se. If no one objects, I'll change
 * Legal status (including illicit use, off-label use or unlicensed preparations if notable and sourced)

to

—Fvasconcellos (t·c) 15:38, 17 August 2009 (UTC)
 * Indications (including off-label use and available forms, if notable) [...]
 * Legal status (including illicit use or unlicensed preparations if notable and sourced).


 * That seems reasonable for drugs of abuse/misuse including propofol, morphine, etc.. However I would guess that the majority of drugs would not need a "Legal status" section. Axl  ¤  [Talk]  20:13, 19 August 2009 (UTC)
 * Yes, that's one of the reasons why I object to the current wording. Off-label use is worth mentioning far more often than recreational use et al. Fvasconcellos (t·c) 03:00, 20 August 2009 (UTC)

Too much use of the word 'patient'
Write for the average reader and a general audience—not professionals or patients, as the nutshell states, any editor may be using the style guide so I believe it should adhere to this principle as much as possible. There are plenty of uses of the word 'patient' and I think many could be avoided, I have made one change 'recruiting patients for clinical trials' to 'volunteers' but would like an idea of the consensus on the rest.L&there4;V 01:07, 20 August 2009 (UTC)
 * Here's another idea to avoid use (and simplify the guide a tad) ... Suggest dropping the 'for patients, professionals, or other affected people (even if run by a charitable organization)' clause in External_links, all support group links are to be avoided - so no need to specify. L&there4;V 01:07, 20 August 2009 (UTC)
 * I disagree. The additional wording is helpful to clarify the scope of "support groups". The would be especially relevant if an edit war occurs with a single purpose editor. Axl  ¤  [Talk]  07:28, 20 August 2009 (UTC)
 * Fair enough, give them no room to manoeuvre, my main problem is that it doesn't set a good example for how we'd like articles to be written, best to get into good habits from the start ( for the editors that actual read the MOS before editing extensively. Also on the being specific front, patients to me interprets as 'a person being the subject of treatment' and does not cover those who may have an ailment with no physician .. it's pedantic I know. L&there4;V 23:55, 25 August 2009 (UTC)

I agree that some uses of the word "patient" could be changed. However I don't regard this as a major problem in a Wikipedia guideline. Axl ¤  [Talk]  07:29, 20 August 2009 (UTC)
 * Ok I'll make sure I post here first (unless obvious as in the volunteers example) L&there4;V 17:02, 20 August 2009 (UTC)


 * This isn't important to me, but I don't especially like "volunteers" in the context of clinical trials; I'd be happier with "people". WhatamIdoing (talk) 18:57, 20 August 2009 (UTC)
 * Have deleted volunteers, seems to read ok without people,volunteers or such. L&there4;V

Here's a few examples of the changes I suggest... L&there4;V 23:55, 25 August 2009 (UTC)
 * 'Write for the average reader and a general audience—not professionals or patients' -> 'Write for the average reader and a general audience—not professionals or those affected'
 * 'Sometimes positive and negative medical test results can have, respectively, negative and positive implications for the patient.' the patient -> the person being tested.
 * 'Clinical significance means that the results are large enough to be noticed by the patient and will make a difference in the effect of the disease or condition on the patient.'  -> ... 'noticed by an individual and will affect their symptoms or prognosis.'
 * 'Links to web-based or email-based support groups for patients, professionals, or other affected people (even if run by a charitable organization)' -> ... 'support groups, professional forums, or any other discussion groups - even if run by a non-profit organization.'
 * I do like those suggested changes. - Hordaland (talk) 02:56, 26 August 2009 (UTC)


 * Apparently, disease-specific charitable organizations are frequently named "(Disease) Support Group" in the UK, so I don't think that is an ideal word choice. We do want links to (informative and detailed pages on) charitable organization's websites, just not to their "forums" or "chat rooms".  WhatamIdoing (talk) 04:29, 26 August 2009 (UTC)

Most Common Name vs INN
Ok, for those of you who don't know, the Epinephrine article has had repeated discussions over whether the article should be called Adrenaline or Epinephrine. However their as been no clear consensus (sp?) the main "problem" is that both names, are medical names, but Adrenaline is the most common, while Epinephrine is the INN, so I was wondering if maybe the manual of style should be clearer on which should be favoured. —Preceding unsigned comment added by 86.145.110.32 (talk) 22:18, 28 August 2009 (UTC)


 * WP:MEDMOS is quite clear that the INN should be used. Eubulides (talk) 22:32, 28 August 2009 (UTC)
 * Yes. Per WP:COMMONNAME, common names should be used "[e]xcept where other accepted Wikipedia naming conventions give a different indication". Fvasconcellos (t·c) 22:41, 28 August 2009 (UTC)


 * I don't think that it's even possible to say what is the "most common", since the choice of word varies so much by context. The same lay person who typically refers to adrenaline in the context of an unpleasant surprise will use the term epinephrine to describe the contents of an EpiPen.  Consequently, I'd say that the answer depends on whether the article is primarily about the regulated therapeutic or about the naturally produced substance.  Where the two diverge, there's no sense in making the natural substance adopt the drug regulator's name for it -- unless the article is primarily about the pharmaceutical aspects of the subject, in which case there's no sense in making the therapeutic use the natural substance's name.  WhatamIdoing (talk) 07:29, 29 August 2009 (UTC)


 * Because it is made in a chemical plant or bioreactor makes it distinguishable from what is found "naturally"? There was a discussion along similar lines at "bioethanol" some time back. Apart from perhaps small differences in isotopic ratios, they are exactly the same in physical form, chemical properties, etc. I don't think we should be introducing a false dichotomy. --Rifleman 82 (talk) 08:38, 29 August 2009 (UTC)
 * Yes, I agree that it's not that simple; I've been giving this a lot of thought, particularly because of the adrenaline/epinephrine debate (been going on for years now), and the only conclusion I can come to is that these particular cases (endogenous hormones also used as drugs) should be discussed and the title decided on by consensus. This isn't the only one, either—we don't have an article on hydrocortisone, for instance; it redirects to Cortisol. As WhatamIdoing puts it, this isn't really a question of most common/less common (e.g. benztropine versus benzatropine or paracetamol versus acetaminophen), in which case the Manual of Style is very clear on what the title should be. Fvasconcellos (t·c) 13:51, 30 August 2009 (UTC)
 * Rifleman, it's not just whether or not the substances are chemically identical to a first or second approximation; the fields of pharmacology and biology simply don't always use the same name for the same substance. The clinical pharmacist isn't automatically "right" or "wrong" just because the academic biologist typically uses a different word to describe the same thing.  WhatamIdoing (talk) 05:56, 31 August 2009 (UTC)

Of course both names are acceptable generally! The point we're discussing, I believe, is that certain names of equal meaning are preferred in certain contexts. On the other hand, two refer to epinephrine and adrenaline in the same article may be confusing, especially for the reader who skims to the section he wants. To call epinephrine "epinephrine" throughout the article should be factually correct, though it may be a little strange to the person whose context prefers the other name. But that's not that uncommon in Science anyway. Examples include the tau versus delta nomenclature for NMR, the trivial names for sugars, the IUPAC systematic names versus accepted trivial names, etc. --Rifleman 82 (talk) 06:11, 31 August 2009 (UTC)

Naming conventions, again
An RfC about whether unscientific names must always be used may interest editors of this page.

MEDMOS has long recommended the plain English -- but only where a plain English name is sufficiently precise and accurate, which gives us Myocardial infarction instead of "heart attack" (which is also used to refer to cardiac arrest and sudden cardiac death, and even plain palpitations by some people), but Chronic kidney disease instead of "Chronic renal disease", because both of these terms are adequately precise and accurate, and "kidney" is more accessible to most readers. The RfC is about whether "MI" should be deprecated in favor of "heart attack".

If you have an opinion (support, oppose, or anything else) on this subject, please feel free to share it. WhatamIdoing (talk) 21:58, 13 September 2009 (UTC)

Explanations for headers?
In the 'Sections' section, I think it would be helpful to have parentheticals explaining what should go in each section. I recently had someone in a GA review ask me what goes in a classification section. I'm thinking something along the lines of what we already have for some of the points, e.g. Society and culture (e.g., stigma, economics, religious aspects, awareness, legal issues). What do others think? delldot  &nabla;.  01:48, 6 October 2009 (UTC)


 * I'm not sure how to describe classification so that it would make sense to a person who doesn't find it self-evident. Either a disease has a classification system (or multiple systems), in which case you report whatever the reliable sources say about it, or it isn't classified, in which case the reliable sources will be silent on the subject, and you exclude the section entirely.  This is intended for articles like Leukemia; the section won't exist in a large number of disease articles.  WhatamIdoing (talk) 03:50, 6 October 2009 (UTC)

Complications
Re: sections on disease articles, should complications come under "Signs and symptoms"/"Characteristics" or "Prognosis"? --AdamSommerton (talk) 21:44, 7 November 2009 (UTC)


 * I tend to discuss short-term complications under "signs and symptoms", and long-term ones under "prognosis". JFW | T@lk  23:08, 7 November 2009 (UTC)


 * Ok, thanks a lot. --AdamSommerton (talk) 23:21, 7 November 2009 (UTC)


 * I sometimes put typical "pre-diagnosis" complications under ==Signs and symptoms==, and post-diagnosis/post-treatment complications under ==Prognosis==. Complications directly attributable to a treatment usually seem to go under ==Treatment==.  You should feel free to use your judgment.  WhatamIdoing (talk) 02:23, 8 November 2009 (UTC)

Organization of articles pertaining to both a virus and a disease
WP:VIRUS has had a discussion about the reorganization of articles that pertain to both a virus and disease. The resultant reorganization gives pages such as Hepatitis A with a section on virology, epidemiology, pathophysiology, and medical aspects. Medical aspects than contains everything else This introduces a false division IMO. One implying that virology, epidemiology and pathophysiology are somehow not medical aspects.

It changes the emphasis of the article and IMO makes it less generally oriented and more specialist oriented. People care equally about both the treatment of a viral illness, it epidemiology, and the virus itself. The levels we have at MEDMOS should continue to be used. Comments? Doc James (talk · contribs · email) 13:38, 8 November 2009 (UTC)


 * Comment — this has arisen following a discussion here: Talk:Hepatitis B. The discussion at the virus project is here: Wikipedia_talk:WikiProject_Viruses/Archive_1. Graham Colm Talk 14:07, 8 November 2009 (UTC)
 * P.S. The diff for hepatitis A is here:. Graham Colm Talk 14:18, 8 November 2009 (UTC)


 * I have re-read the discussion at the Virus project and I did not see any agreement on the structure of articles with regard to introducing a heading called "Medical aspects" with sub-headings. The discussion was about when and if articles should be split into the disease and the disease-causing organism. I do not like the current structure of Hepatitis A at all. Similarly, I do not agree that the recent structural changes to Hepatitis B should be reverted, although I accept that some editors might think the present structure is not ideal. I hope that this discussion does not revert to the old debate about whether separate "disease" and  "cause"  articles are  preferred because, at the moment, I think we have got the balance more-or-less right. Graham Colm  Talk 15:04, 8 November 2009 (UTC)


 * Thanks, Doc James, for taking initiative in this discussion. Before we begin, I want to make it clear that this discussion is neither novel nor naive. Both you and GrahamColm has expressed concern that structural changes made in Hepatitis B may be reverted, please don't feel that this is an issue until after we have conceded. To my knowledge, the discussion on WP:VIRUS GrahamColm posted actually began on Arcadian's talk. Since then, I agree with Graham that we've got the balance more-or-less right. The question now is, IMO, how do we organize it relative to the other subjects? Spreading it out to be "generally oriented" seems messy, which is why I am contending that there should be some hierarchical structure. The first step is distinguishing differences, and the most apparent were Microbiology and Clinical aspects. For example: "Prevention, Symptoms, Diagnosis, Prognosis, and Treatment" concerns itself more with the patients while "Structure, Genome, and Replication" concerns itself more with the virus. I agree with Doc James that "Medical aspect" is confusing. First question, if we were to rename "Medical aspects" to "Clinical aspects" would this be a solution? Second, if we were to keep Hepatitis B as it is, would Virology still be its own section with its three or four subsections, I'm alluding to your first major change in June where it became Classifications? ChyranandChloe (talk) 23:56, 8 November 2009 (UTC)


 * For conditions caused by a single virus / group of viruses I think leaving it as virology is fine. I have changed my opinion on the edit I made in June.  All the viruses I am sure will than have their own page so that this section should just be an overview which than links to the main page.  I am hesitant to subdivide off a section and thus move treatment, prognosis, signs and symptoms to subheading regardless of what it is called.  My main justification is that this is a general encyclopedia and the information in these sections will each on there own hold as much importance for the general reader as the section on virology.  Doc James  (talk · contribs · email) 01:46, 9 November 2009 (UTC)


 * Looking at Hepatitis B and Hepatitis B virus, I'm not sure that I'd start the "disease article" with a summary of the virology. It should be included, IMO, but it's both jargon-filled and (importantly) unnecessary for understanding 99% of the rest of the article.  I'd move it to the end, and let the "disease" come first in the "disease article".  WhatamIdoing (talk) 02:01, 9 November 2009 (UTC)


 * It could fit in the place of the cause/genetics section. We could than add virology along with the previous two to the WP:MEDMOS guideline. Doc James  (talk · contribs · email) 02:17, 9 November 2009 (UTC)
 * It should be a separate section, but, I agree, at the end. This is exactly what I did with Rotavirus. Graham Colm Talk 06:30, 9 November 2009 (UTC)
 * (outdent) Agree with above, added Virology into WP:MEDMOS listed with Causes and Genetics (added Replication and Morphology with alternative names), revert if I jumped to conclusions. "Virology" could be listed last in Hepatitis B since the name of the disease corresponds with the common name. However, in Rotavirus, where the title corresponds a viral genus and the disease is Rotaviral enteritis or Viral gastroenteritis, I would have been reluctant to have arrived at the same conclusion. ChyranandChloe (talk) 04:49, 10 November 2009 (UTC)


 * Doc James, you said "information in these sections will each on there own hold as much importance for the general reader". Please elaborate. How would you (1) determine and (2) verify that each section holds equal importance? Is this a rule that can be generalized to all virology articles? I want to be able to replicate your though process, lest we continue to arrive at different conclusions. ChyranandChloe (talk) 03:01, 13 November 2009 (UTC)


 * Hey CC if you are looking up information pertaining to a disease ( I am not referring to the articles about a particular virus ). IMO you will care equally about the symptoms, as you will about the treatment, or the virology.
 * So I am for applying WP:MEDMOS to all articles that are about diseases or conditions. Some diseases are exclusively due to genetics and the cause section has been replaced with this.  Some are due exclusively from viruses and I would sport uses virology in place of the cause section.  The other section should retain there same organization.  If one looks at a page such as Obesity nearly each of the sections has an entire main page dedicated to it.  The same could eventually happen with Hep B.  Cheers  Doc James  (talk · contribs · email) 16:39, 13 November 2009 (UTC)
 * I was focusing on just the justifications of why symptoms, treatment, prevention should not be subsectioned. In some articles concerning virology, the clinical aspects are historically less developed than epidemiological and virological aspects, and therefore hold less importance. "IMO you will care equally[...]" doesn't seem verifiable when generalized, sorry for the confusion, can you elaborate that part. ChyranandChloe (talk) 20:11, 15 November 2009 (UTC)
 * Mainly it is a bit of give and take so that we can have consistency in organization between all articles on disease. I see no justification why symptoms, treatment, etc should be subsections of medical aspects. Doc James  (talk · contribs · email) 21:54, 15 November 2009 (UTC)

Are we talking about the same thing? I understood Doc James' objection being to this:

==Medical stuff==
 * ===Symptoms===
 * ===Treatment===

but not to:

==Symptoms== ==Treatment==
 * ===Medications===
 * ===Self-care===
 * ===Surgery===

These both involve "subsections". I don't think that anyone objects to the second, but I can easily imagine people objecting to the first (in at least 90% of the relevant articles). WhatamIdoing (talk) 05:34, 16 November 2009 (UTC)
 * Yes I disagree with the first and agree with the second Doc James  (talk · contribs · email) 16:09, 16 November 2009 (UTC)


 * (outdent) Yep, on the same page, WhatamIdoing welcome back. Doc James, "I see no justification[...]" in the opposite, is fallacy negative proof. You're assuming that because there's no justification in sub-sectioning symptoms, treatment, etc under Clinical aspects, the alternative would be right. I value consistency considerably, but extending this to all articles, which include the 10% of cases where "the clinical aspects are historically less developed than epidemiological and virological aspects" does not seem (1) justifiable and (2) verifiable. I want a solid and complete answer to both. ChyranandChloe (talk) 08:03, 17 November 2009 (UTC)


 * WRT hepatitis B the so called medical aspects are well developed. Epidemiology is also a medical aspect.  Now just because they may not be well developed currently on Wikipedia does not mean that they should be structured to be less prominent than content that is better written.  WP:undue weight sort of applies. Doc James  (talk · contribs · email) 17:30, 17 November 2009 (UTC)


 * Although I've conceded that Medical aspects is confusing and reconciled to Clinical aspects instead, to which you've ignored. I understand undue weight, and I'm not using Hepatitis B as an example, but those 10% of cases found elsewhere. ChyranandChloe (talk) 06:18, 18 November 2009 (UTC)


 * I am not happy with clinical aspects either. I see no justification to make certain sections subsections either under clinical aspects or medical aspects. Doc James  (talk · contribs · email) 06:31, 18 November 2009 (UTC)
 * C&C, do you have any examples of those "10% of cases" in mind? (I'm not sure that we should write this page for the rare case anyway, but it might be helpful in understanding your point.)  WhatamIdoing (talk) 06:43, 18 November 2009 (UTC)


 * (outdent) Doc James, your central argument was that "virology, epidemiology and pathophysiology" are medical aspects, and that subsectioning "everything else" under it creates a false division. Clinical aspects isn't Medical aspects, therefore no false division. Is this correct? Answer this question. ChyranandChloe (talk) 05:58, 20 November 2009 (UTC)


 * Epidemiology generally includes risk factors (e.g., age and sex), which I think most editors (and all physicians) would believe is a 'clinical aspect' of a disease. You don't screen men for breast cancer because of the epidemiology, not because men are incapable of having breast cancer.  WhatamIdoing (talk) 08:05, 20 November 2009 (UTC)


 * I think there are many reasons why we should not subsection half the topic in an article. Putting it under "clinical aspects" which may be slightly better than medical aspects is still not an improvement and only confuses things.  The format we have in the guideline is better. Doc James  (talk · contribs · email) 13:34, 20 November 2009 (UTC)


 * I trust your judgement Doc James, however the "many reasons" doesn't tell me what those reasons are. When do you plan on publishing your thought process, or am I somehow asking for something proprietary? ChyranandChloe (talk) 02:21, 22 November 2009 (UTC)


 * This page works solely on consensus of what the editors want to recommend to each other. I see no other support for this proposal.  Perhaps we should go write an encyclopedia, instead of having a detailed discussion of the perceived merits of one editor's opposition.  WhatamIdoing (talk) 17:17, 22 November 2009 (UTC)

Treatment / management
Recommendation to present this section in a consistent fashion IMO should be made. Something such as thus maybe?

==Management==
 * ===Self-care/conservative===
 * ===Psychological===
 * ===Medications===
 * ===Surgery===
 * ===Alternative medicine===

Doc James (talk · contribs · email) 16:13, 16 November 2009 (UTC)


 * I think that there is frequently too little information to justify subsections under ==Treatment==, but it might make a good "e.g." list on that line.
 * This is a reasonable list of major categories; can anyone think of any others? Perhaps something like ===Physical/occupational/speech therapy=== (standard post-stroke rehabilitation).
 * As a point of implementation, editors should choose the most sensible order of these sub-items in each article, whether that means listing first-line treatments listed first, or most common treatments, or whatever seems sensible. We don't want to the order to result in undue emphasis on self-care simply because it's listed first (or whatever item is ultimately listed first).  WhatamIdoing (talk) 19:56, 16 November 2009 (UTC)


 * I think recommendations on order would be a good idea. Treatment is usually listed in the above order. Doc James  (talk · contribs · email) 21:53, 16 November 2009 (UTC)
 * I think this is a good idea. It usually won't be needed, but when it is, it would be good to have header recommendations. --Arcadian (talk) 23:31, 16 November 2009 (UTC)


 * The correct order depends on the problem at hand. "Self-care" and "psychotherapy" is basically useless for colon cancer, but surgery effects cures, and medications often improve lifespans.  By contrast, self-care is the ideal first treatment for the common cold, and is necessary for the relief of uncomplicated lower back pain.  WhatamIdoing (talk) 04:49, 17 November 2009 (UTC)

Agree with WhatamIdoing. I'm not convinced we have a problem here that needs this solution. Some things don't fit: where do eyeglasses, plaster-casts and dietary changes go? Out disease-disorder range is too vast to warrant this level of detail or rigid ordering. MEDMOS neither mandates sections nor enforces an ordering -- it says these are just suggestions and the order may be changed. Really, the ordering is only there to achieve some consistency if the order would otherwise be completely arbitrary. Often, there's a natural ordering. I could see that in some cases the (urgent) surgery comes first and the post-surgery self-care comes next. And recommending section headings below top-level may lead to paragraphs being broken up into stubby unconnected parts. Having a section heading of "Alternative medicine" would be a magnet for a list of unproven remedies. Treament/maintenance-therapies should be listed here because they are effective, not because they fit some subheading. Colin°Talk 13:36, 17 November 2009 (UTC)

I think this is overly prescriptive, and won't be helpful in many cases, and could lead to stubbiness. Sandy Georgia (Talk) 15:34, 17 November 2009 (UTC)


 * While I don't think we want to lock ourselves into a specific order, I think it would be very helpful to change the existing bare line about "Treatment or Management" to:
 * Treatment or Management (e.g., Self-care/conservative measures, psychological, medications, surgery, alternative medicine)
 * or something along those lines. IMO a major use of this list is figuring out whether or not the article is "comprehensive".
 * Colin, I think that "diet changes" are a form of self-care, but if you've got a word or two that summarizes the medical equipment, I'd be happy to include it. WhatamIdoing (talk) 18:59, 17 November 2009 (UTC)
 * I'm thinking, of course, of ketogenic diet, which isn't "self-care". I understand there's a whole field of "medical nutrition therapy" for various illnesses. These require a dietitian. Oh, and physiotherapy, speech therapy, .... Colin°Talk 19:36, 17 November 2009 (UTC)
 * I agree with WAIDs comments. This will help people determine if the topic has been covered. Doc James  (talk · contribs · email) 19:07, 17 November 2009 (UTC)


 * I see peoples concerns. My reasons for bringing this up is that as a management section gets longer it often becomes a haphazard collection of bullet points without any definitive organization.  The MOS is only a guideline however.  And one expects writers to adapt it to the situation. Doc James  (talk · contribs · email) 20:16, 17 November 2009 (UTC)

Consistency is not what we seek. I prefer "treatment" over "management" because it is more relevant to the average reader. I don't think that there should be a particular hierarchy because it depends on the condition under discussion. For some conditions, the main treatment is surgery and there are also medical options. For other conditions it is vice versa. This is a matter of editorial judgement and should not be forced. JFW | T@lk  20:57, 17 November 2009 (UTC)


 * How about if we remind people of some of the possibilities, and suggest a couple of ways to order the section? Something like this:
 * Treatment or Management. This might include diet, exercise, medication, palliative care, physical therapy, psychotherapy, surgery, watchful waiting, and many other possibilities. It can help to discuss treatments in a plausible order in which they might be tried, or to discuss the most common treatments first.
 * Eubulides (talk) 21:24, 17 November 2009 (UTC)
 * Excellent. Colin°Talk 21:47, 17 November 2009 (UTC)
 * There's much more to self care than just diet and exercise -- fairly rigid sleep schedules help people with bipolar disorder; warm compresses soothe pain in children with ear infections, regular practice of 7-11 breathing reduces panic attacks -- and it's frequently overlooked, so I think it should be specifically named. WhatamIdoing (talk) 23:04, 17 November 2009 (UTC)


 * Agree with Eu suggestion. Doc James (talk · contribs · email) 01:44, 18 November 2009 (UTC)
 * Thanks, and no further comments so I that (with self care added). Eubulides (talk) 20:22, 20 November 2009 (UTC)

Trade names
There's a discussion at Wikipedia talk:WikiProject Medicine and Talk:Metformin that belongs here. How and to what extent should the brand names for drugs be mentioned in their drug articles. Colin°Talk 17:57, 5 December 2009 (UTC)

Here's my 2p:

Colin°Talk 18:17, 5 December 2009 (UTC)
 * 1) The lead sentence of a Wikipedia drug article should be very easy to understand and explain what the drug is and does. Consider whether it is good prose. Remember it is a sentence, not an infobox in linear form.
 * 2) Our manual of style should not be designed round optimising Google search results. That's Google's problem, not ours.
 * 3) The initial patented brand (and possibly also brand-owner/inventor) are notable and quite possibly the "common name" to many readers.
 * 4) Generic "brand" names are nearly always non-notable. I regard their collection as WP:LISTCRUFT and they are typically not sourced. Older and popular generic drugs can have dozens, even hundreds of brands (e.g. vallium). There are more important things to cover in our articles and most certainly more important things for the lead section never mind the lead sentence.
 * 5) Wikipedia has a built-in mechanism for handling the many->one name->article issue: redirects.
 * 6) (slightly off topic) I'm not keen on the lead sentence containing pronunciation (particularly the illegible IPA) or etymology (which tends not to be an issue with drugs). We are not a dictionary and anything that disrupts the flow of the lead sentence or puts readers off (like back-to-front letters and squiggles) is a negative IMO.
 * 7) http://stats.grok.se/ is wonderful but page hits don't tell you how people searched. If you search with Google, you'll come to Wikipedia on the Metformin page even though you searched for Glucophage.

1) I think that it is important for a couple of reasons to include trade names; search engines give weight to bolded terms and first couple of sentences and many people search via brand names, (this probably varies depending on the drug). The encyclopedia also is concerned with this because on WP:COMMONNAME it says this "Search engine testing sometimes helps decide which of alternative names is more common." So we do want to increase traffic. For example if we delete or move way down the page "klonopin" and rivotril for clonazepam or "prozac" for fluoxetine, haldol for haloperidol, losec for omeprazole etc or even remove trade names completely, then traffic is going to go way way down.

2) The other reason is this, we are meant to be writing for the lay reader or general reader. Many lay readers will only recognise the drug via its brand name, eg losec, prozac, haldol rather than omeprazole, fluoxetine, haloperidol unless they are prescribed generic.

3) The lead, per WP:LEAD should define what the drug is, ie drug class and uses and what it is commonly known as to the general public and professionals, so we need to include common trade names.

If there are lots of trade names, as we are the english version of wikipedia, then I suggest restricting the trade names to english speaking countries. If the list of trade names is still too long, then I recommend restricting it to the most notable ones.-- Literature geek |  T@1k?  18:20, 5 December 2009 (UTC)

I agree with you Colin that non-notable generic trade names can also be excluded, I am thinking of notable ones which I think readers would expect to find at the start of the article.-- Literature geek |  T@1k?  18:23, 5 December 2009 (UTC)

When redirects are setup for trade names, those trade names should be mentioned in the lead. One editor deleted the trade names for Metformin several times, when reverted buried them at the end of an article and locked them there with a consensus needed tag. I simply cannot think of something more unfriendly to the reader than to be redirected to an article by a Wikipedia search and having to read through the whole article seven screens down to find the reason one was redirected to the article. This is the case currently with the search term Obimet, Riomet, Fortamet and others which are redirected to Metformin. The last but one edit had the names a few lines down from the lead sentence, probably a reasonable compromise between readability and need. Darrell_Greenwood (talk) 19:12, 5 December 2009 (UTC)


 * I agree with what you are saying but this discussion is now on all drug articles on wikipedia and getting guidance on this given in the MEDMOS. I assume that your views are the same for all pharmacology articles?-- Literature geek |  T@1k?  19:25, 5 December 2009 (UTC)


 * Yes. My views are the same for all pharmacology articles. (Parenthetical remark, pity the novice editor, me, who was trying to revert vandalism on the Metformin article and finds this has started three discussion threads spread across Wikipedia :-) ...My view is simple. If I pick up a box of say, Obimet, I should be able to put that trade name into Wikipedia search, and if redirected, have the term show up on the first screen, NOT seven screens down as the case is with Obimet and Metformin at this moment.  Darrell_Greenwood (talk) 04:26, 6 December 2009 (UTC)

To address your points Colin. Point 1. I agree with. Point 2 I am not suggesting any extensive optomisation which is done by system administrators of wikipedia anyway, just this single issue is highly relevant to people finding our articles. Point 3 Not true for many drugs, yes the initial trade name is notable but it depends on the country, such as differences between USA and UK and other countries, eg paroxetine is known as paxil in USA but in UK even doctors and pharmacists will not have heard of paxil but will know it by seroxat. Point 4 I agree. Point 5 I don't think is relevant as most traffic comes from search engines, not wikipedia's internal engine. Point 6 It can be useful for difficult to pronounce words but I can see where you are coming from and is probably not necessary for most articles. Point 7 Yes I agree, useful tool.-- Literature geek |  T@1k?  19:25, 5 December 2009 (UTC)


 * The lead sentence should not be distracted by relatively unimportant topics such as pronunciation and a boatload of trade names. People who visit the article are most likely to be interested in what the drug does, not in how it is marketed or pronounced. I suggest moving the trade names and the pronunciation (if any) to the infobox. Eubulides (talk) 23:03, 5 December 2009 (UTC)
 * I and nor is anyone else advocating for boat loads of trade names, only for the common ones, maybe you are misinterpreting my post or the discussion. My concern is that the general reader/lay person is not going to recognise a "funny sounding chemical name" so the common brand names should be mentioned so they know the article is what they are looking for.-- Literature geek |  T@1k?  23:59, 5 December 2009 (UTC)
 * Ah, sorry, I did misunderstand the question. In some cases the common trade name would be appropriate. When in doubt, though (e.g., different common trade names used in different English-speaking parts of the world, with some controversy over which should appear in the lead) I'd move them to the infobox or something like that. Eubulides (talk) 00:35, 6 December 2009 (UTC)


 * Not to worry, I just realised that I misinterpreted Colin's comment about the web statistics page hehe! :) Easy done. I thought that he was praising it but was mentioning its weaknesses and he is indeed correct. Their about page shows that they http://stats.grok.se/about do not record via http referrer wiki webserver data from search engines (which is what is needed) but simply the article title which was accessed so is not relevant to brand name searches on search engines, ugh. :)-- Literature geek |  T@1k?  00:58, 6 December 2009 (UTC)

I came here from a note at the Pharmacology WikiProject. I'm not entirely sure that I have understood all the threads leading here, or what is being disputed, but I agree that the most commonly used English-language brand names should be in the lead, because that's what most readers will look for. --Tryptofish (talk) 00:09, 6 December 2009 (UTC)


 * What irritates me in the specific discussion is the abuse of this guideline: the editor in question essentially said that because MEDMOS recommended the inclusion of "A" and "B", that MEDMOS was somehow also requiring him to delete "X", "Y", and "Z" -- despite this page not actually addressing those points.
 * In general, I think there's a place for redirectshere sorts of information in an article, because we want readers to know that they're in the right place. Dumping a long list of brand names into the first sentence will not always be the right way to go about that.
 * I am wary of one-size-fits-all rules on this point. The brand names are WP:DUE in some cases (e.g., "aspirin" vs. "Aspirin®").  The "first" or "real" brand name can also vary by country (e.g., "MabThera®" in the EU and "Rituxan®" in the US are both the same thing).  Sometimes the brand name really does matter (e.g., drugs with a narrow therapeutic index), so that what you say about the "brand name" version might not be true about a given genertic.
 * On the other hand, just because a generics firm like Teva has decided to create a "brand name" that nobody's ever heard of doesn't mean that we need to include that. If nobody really knows any particular name, then it's not WP:DUE.  WhatamIdoing (talk) 00:26, 6 December 2009 (UTC)

Proposed modifications to MEDMOS
Okay, "think" that there is an emerging concensus that MEDMOS is not clear on this issue. I am going to propose a change to MEDMOS. Remember it is only a suggestion. Feel free to completely disagree or tweak my suggestion and also to propose your own text. Lets find concensus.

"The initial brand name and manufacturer follows, in parentheses; common brand names generally should be included but long lists of trade names should be avoided. Less common generic trade names and those from non-english speaking countries should usually be avoided."

I have bolded the additional suggested text, the unbolded already exists in MEDMOS.-- Literature geek |  T@1k?  01:11, 6 December 2009 (UTC)


 * I dislike using the word notable on Wikipedia to mean anything other than WP:Notability. It confuses some editors.  WhatamIdoing (talk) 01:16, 6 December 2009 (UTC)


 * Ah yea, good point, I can see people confusing it with notability. I have changed it to "common" and did slight rewording. :)-- Literature geek |  T@1k?  01:21, 6 December 2009 (UTC)


 * Added in the word "usually", we need some flexibility for some of our more obscure drug articles which are only available in one or two countries. For example delorazepam is only available in Italy and to my knowledge no other country. We have many generally stub/short articles like this, where the only brand name is used in one or two non-english speaking countries. Much of this is common sense but just incase. Keep the comments coming folks. :)-- Literature geek |  T@1k?  01:47, 6 December 2009 (UTC)


 * Looks good to me. Darrell_Greenwood (talk) 04:31, 6 December 2009 (UTC)

Not yet convinced. There is a reason MEDMOS only recommended the initial trade name(s). I accept that some drugs are launched with different names in different countries, but those names will all be the names given by the patent holder or their licencees. Remember that if the odd article or so would benefit from more names in the lead, this guideline doesn't stop it. The proposed text makes them mandatory (to the extent that a guideline can). Can anyone give sufficient examples of generic "brands" that are notable enough to be mentioned in the lead sentence so that we'd want to repeat that across all drug articles. How would one arbitrate on "common"? It would be nearly impossible to source. I've had enough drugs in my watchlist over the years to know that adding a new brand to the lead sentence is one of the most common drive-by additions that an anon can make. How would you go about proving that brand was only available in Poland? How would you stop the lead of diazepam having a dozen brands? Which of them would you choose? Why should the readability of the lead sentence be impaired because a tiny minority of readers searched using the brand on their generic packet? I think the lead sentence is precious and urge folk here to come up with an alternative if they feel that listing generic brands is useful.Colin°Talk 08:26, 6 December 2009 (UTC)


 * If the lead sentence is precious, how about a sentence early in the lead section? Like http://en.wikipedia.org/w/index.php?title=Metformin&oldid=329469245 Darrell_Greenwood (talk) 19:32, 6 December 2009 (UTC)


 * As I've said elsewhere, I am pretty sure that not only "a tiny minority of readers" search by trade names. Coming back to a possibility mentioned by Eubulides: Why don't we put the less common (however that is defined) trade names in the drugbox, where they are more or less on the first screen for readers to see, yet don't obstruct the lead sentence? Second possibility: something like "The drug is sold under the trade names Trade name 1, Trade name 2 and others; for a full [or more complete] list see below ." --ἀνυπόδητος (talk) 10:47, 6 December 2009 (UTC)
 * Let's be clear about the trade names. There's no dispute that the initial-brand patent trade names are widely used and familiar to the general reader. They are notable enough to be considered a WP:COMMONNAME and mentioned in the lead, and MEDMOS already recommends they be mentioned. The issue here is generic trade names. Colin°Talk 11:08, 6 December 2009 (UTC)
 * Yes, I was talking about generic names. But I'm not sure whether they are necessarily less widely used than the initial names, especially with old drugs. (Just as an example: Before this discussion, I couldn't have told whether Glucophage, Diabetex or Meglucon was the first trade name in Austria.) --ἀνυπόδητος (talk) 12:02, 6 December 2009 (UTC)
 * I remember once trying to explain to a relative of mine that "Glifage" and "Dimefor" (two trade names for metformin in Brazil, Glifage the Merck original, Dimefor a generic) were the same drug. Search behavior is exactly that—behavior. How should Wikipedia handle the possibilities? Are redirects enough? I used to think so, but now I'm not sure. I agree that the lead sentence is precious, as Colin puts it, and accepting the inclusion of trade names does create the problem of managing listcruft. How ironic... Fvasconcellos (t·c) 12:24, 6 December 2009 (UTC)

Hello Colin, I have done a bit of investigating and spoken to a pharmacist here in the UK and he seems to confirm your position as far as generic trade names go, they are not notable and thus we should not add generic trade names to wikipedia articles. He did say that there are rare examples of notable generic trade names and gave the example of the generic trade name "half beta programe" which is a trade name of a generic version of propranolol. Most generic trade names are either mentioned in very small print or often not at all on the packet or packet insert.

What about something like what I wrote below?

"The patented brand names and manufacturer follows, in parentheses. Long list of brand names should be avoided; brand names in non-english speaking countries should generally be avoided and generic trade names should not be added."

I now oppose adding generic trade names and think that we should only mention patented brand names. The very rare exceptions such as half beta programe doesn't need a guideline on MEDMOS and should be covered by WP:IGNORE and WP:COMMONSENSE.

The current wording is being interpreted by an editor to mean that only a single brand name can be mentioned. Let me know your thoughts.-- Literature geek |  T@1k?  14:45, 8 December 2009 (UTC)


 * Excuse my ignorance, but aren't generic brand names patented? What about FV's example "Dimefor", and my "Diabetex" and "Meglucon"? They are generic, and are not rare examples at all. Neither are they set in very small print. (Yes, these are examples from non-English speaking countries. I'd just like to know whether, and in which way, the situation is different in the UK, USA etc.) --ἀνυπόδητος (talk) 16:50, 8 December 2009 (UTC)
 * They are trademarks. The drug is patented. What Literaturegeek is referring to is the brand name given by the manufacturer who holds (or held) the patent on the drug. That's the name the media use when talking about so-and-so's new blockbuster treatment and how it has just doubled the company's share price. The media never use generic brand names when talking about drugs. The options are really just initial-brand-name or generic INN name. I agree with him that the text should be modified to indicate that there may be more than one of these, if the drug company uses different brands in different countries. I don't think the proposed wording works for me and it is more verbose than necessary. I'd like to know if the situation is different in the US. I get the feeling the US is much more brand-focussed than the UK, perhaps because marketing to consumers is allowed. Colin°Talk 17:15, 8 December 2009 (UTC)
 * No, "generic brand names" are not patented, they are trademarked. We certainly do not want to have every different drugstore chain's brand name for acetaminophen listed. The original brand (Tylenol) clearly should be listed. Even now that the patent has lapsed, that brand will retain familiarity to many readers. There might be some merit in mentioning the first off-patent brand in some cases. Beyond that, if a generic brand name is listed at all, it certainly doesn't belong in the lead or the infobox. Anywhere in the article, it will still be found by the mediawiki search button. —Preceding unsigned comment added by LeadSongDog (talk • contribs) 17:59, 8 December 2009 (UTC)
 * List_of_paracetamol_brand_names Darrell_Greenwood (talk) 18:21, 8 December 2009 (UTC)


 * Yes, I believe that the US is far more brand-focused. The entire world has some brand awareness, for that matter.  Compare the headlines for Vioxx®, rather than rofecoxib in the news.  I can easily imagine people not knowing what sildenafil is, but is anyone unaware of Viagra®?
 * The US may be far too aware of brands: I once had a depressing exchange with a nurse(!):
 * Nurse: Have you taken ibuprofen?
 * Me: No, the doctor said not to take ibuprofen.
 * Nurse: Oh.  Well, how about some Advil®?
 * Me: That's the same drug.
 * Nurse: Well, then why don't you try some Motrin®?
 * Me: Because it's the same drug.
 * I give this story in an effort to amuse some of you, and to remind the rest of you that this conversation, and the potential decision, is far too tightly focused on recent prescription-only medications. We need a rule that works just as well for aspirin, acetaminophen (which is paracetamol), and ibuprofen as it does for metformin.  IMO, the proposed text above doesn't address this kind of reality.  WhatamIdoing (talk) 22:50, 8 December 2009 (UTC)

That is the angle where I am coming from as well WAID. Brand names are well known but often people do not know the chemical/generic name.

Colin here are my views to continue the conversation here as requested.

On the issue at hand, I think that marketed brand names licensed by the patent holder should be included in the lead. Generic trade names are not necessary as they are only of interest to bureaucracies and pharmacies heads who order in generics. No one else would know the generic trade names, they are not prominant in packaging or insert, thus a statement on MEDMOS advising against inclusion of generic trade names would be wise. I am opposed to moving all brand names out of the lead. Below is my suggested text.

"The initial brand name(s) and manufacturer follows, in parentheses. Long lists of brand names in the lead should be avoided and generic trade names should not be added."

The initial wording says that "patented brand name" singular. This conversation came out of an editors interpretation of MEDMOS meaning only one brand name can be mentioned, bare this in mind. At the very least it should say "initial brand names" plural.

There is some minor disagreements on this talk page between whether it should be limited to 2 or 3, or 3 or 4 or even 5 brand names. For most articles there only are 2 or 3 brand names to mention anyway. However, MEDMOS is only a guideline and is not meant to be for wikilawyering by editors so really as long as it says clearly that long lists should not be included in the lead then that is enough in my view, commonsense, editorial consensus and good editorial judgement will resolve any disputes on articles. Lets not analysis paralysis on possible scenarios on what is meant to be only a guideline is my suggestion, lets just either decide no change is needed or come up with some sensible adjustment and leave the rest to editorial judgement and consensus on article talk pages. The main concern is no long lists in the lead and we all agree and my proposal says that MEDMOS does not recommend long lists. These are my views. :)-- Literature geek |  T@1k?  10:14, 9 December 2009 (UTC)

List cruft
Unless we are careful, lists attract cruft. It is to some degree futile trying to come up with self-imposed restrictions like "only list common brand names" or "only list important side effects" when such rules are never read by the anon who drives by. They will add their Polish generic brand and it will be jolly hard for you to justify removing it without biting the newbie. You might compile a list of side-effects that rose above placebo. The newbie will add the funny dreams he got and the depression his friend got. The POV pusher will add the single death that occurred on the trial as a side-effect of equal weight and likelihood as headache. Disease symptoms can suffer from the same problem. One strategy for dealing with this is to be explicit about the list's entry criteria in the body text. For example, saying "Initially marketed as Viagra." or similar.

My feeling is that while you could get away with "Common brands include A, B and C" in a traditional publishing model, it just doesn't work on Wikipedia because all the letters to X, Y and Z will be added sooner or later. And there are just too many drugs to watchlist them all.

What are your thoughts on this and have you got suggested strategies for avoiding list cruft. For example, do you think solid sourcing helps discourage unsourced additions? How should editors deal with such drive-by additions if perhaps they can't actually access the source to verify if it is a good addition or not? Colin°Talk 17:31, 8 December 2009 (UTC)

I have trimmed several lists of brand names by just writing in the edit summary something like, "list is much too long, restricting to english speaking only countries for the english encyclopedia". Something like that, I would hope the anon would see wisdom in this and have not had any disagreements with other editors when doing such edits that I can recall. I think anons are more annoyed when they spend half an hour writing original research and/or doing a synthesis or using poor sources and seeing all their hard work reverted but it is the way of the game. This guideline is really only read by well established medicine and pharmacological editors, so I don't think that this guideline will lead to listcruft; it is people who do not read guidelines who are most likely to cause listcruft. I included the suggested line of "long lists [in the lead] should be avoided" so that would eliminate your concern of having huge lists of brand names in the lead. Most newbies and anons don't read guidelines. I know that I didn't read guidelines or properly understand them until I had been on wikipedia for well over a year, longer for some guidelines and to have an indepth knowledge of them. I wish that I had read the "instructions" early on but I learn the hard way oh well. I think that brand names should be sourced, although I don't think that wording is necessary for the guideline as it could provoke wikilawyering or where people are deleting well known common sense brand names because they are uncited or adding fact tags etc. I think that it is beyond the scope of this guideline to be advising people on how to deal with listcruft. I think most established editors would apply common sense and or sourcing to trim down listcruft in the lead regarding brand names. I am only saying that we should be mentioning brand names which are specifically marketed under their brand name. For example, drugs which when someone gets the drug it calls it "seroxat", "kapake", "lipitor", "tylex", "solpadol" and when someone gets the box it has that brand name in big letters across the frongt and the package insert says "About your medication seroxat", about your medicaation kapake, it contains the active ingredient X etc.-- Literature geek |  T@1k?  03:04, 9 December 2009 (UTC)


 * I think Wikipedia should have a list just not in the lead. uptodate gives a comprehensive list of every brand name from every country.  Not everyone however can afford the $300USD for UTD.  And as a resource for people in the developing world and students having this info might be useful.
 * For example some brand names that are the same refer to different drugs in different countries.
 * I have seen people from other countries and have no idea what they are on as they quote there local brand names.
 * This would be done best in its own section.
 * This for example is the text uptodate gives for acetaminophen "

Canadian Brand Names Abenol®; Apo-Acetaminophen®; Atasol®; Novo-Gesic; Pediatrix; Tempra®; Tylenol®

International Brand Names A-Mol (TH); Acamol (CN, IL); Acamol To-Go (IL); Acamoli Baby (IL); Acamoli Forte suppositories for Kids (IL); Acenol (PL); Acet (PH); ACET suppositories (SG); Acetalgin (CH); Acetamol (IT); Adinol (MX); Adorem (CO); Afebrin (HK); Afebryl (LU); Alcocin (IN); Alvedon (SE); Amol (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE); Anadin (PL); Anadin dla dzieci (PL); Analgiser (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE); Analphen (MX); Antidol (PL, TW); APAP (PL); Aptamol (IN); Arfen (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, MY, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZA, ZM, ZW); Atamel (PE); Avadol (MY); ben-u-ron (HU); Ben-U-Ron (PT); Benuron (JP, PL); Biogesic (ID, PH, SG); Biogesic Suspension (HK); Biopain (PH); Calapol (ID); Calpol (AE, BF, BH, BJ, CI, CY, EG, ET, GH, GM, GN, IE, IL, IQ, IR, JO, JP, KE, KW, LB, LR, LY, MA, ML, MR, MU, MW, NE, NG, OM, PL, PR, QA, SA, SC, SD, SL, SN, SY, TH, TN, TZ, UG, YE, ZA, ZM, ZW); Causalon (AR); Cemol (TH); Children's S Tylenol (KP); Christamol (HK); Claradol (MA); Codipar (PL); Cotemp (TH); Croix Blanche (LU); Curpol (LU); Dafalgan (BE, LU, PL); Dafalgan odis (LU); Daga (TH); Denamol (TH); Dirox (AR); Dismifen (MX); Dol-Stop (LU); Dolex (UY); Dolgesic (ES); Doliprane (FR, IN, MA, PL); Dolitabs (FR); Dolomol (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE); Dolorol (ZA); Dolprone (LU); Doluvital (MX); Dolviran (MX); Dymadon (AU); Efferalgan (HU, LU, PL); Efferalgan 500 (CR, DO, EE, GT, HN, NI, PA, SV); Efferalganodis (FR); Enelfa (LU); Etoran (PL); Europain (HK); Febridol (AU); Fervex (BR); Filanc (MX); Gelocatil (ES); Geluprane 500 (FR); Grippostad (PL); Hedex (IE); Hoemal (MY); Itamol (ID); Itamol Forte (ID); Lekadol (HR, PL); Lemgrip (BE, LU); Lexalgin (PH); Lonarid mono (LU); Lotemp (TH); Lupocet (HR); Maganol (ID); Mebinol (PE); Mejoralito Junior (MX); Mejoralito Pediátrico (MX); Metagesic (PH); Mexalen (AT, CZ, HN, HU); Minopan (KP); Momentum (LU); Mypara (TH); Nalgesik (ID); Napafen (EC); Napamol (ZA); Napran (PH); Naprex (ID); NEBS (JP); Neuridon (LU); Nordinet Infantil (MX); Novo-Gesic (PL); Pacimol (IN); Pamol (DK); Panadol (AE, AU, BE, BF, BG, BH, BJ, CH, CI, CN, CY, EE, EG, ET, FI, FR, GB, GH, GM, GN, GR, HK, HU, ID, IE, IL, IQ, IR, JO, KE, KP, KW, LB, LR, LU, LY, MA, ML, MR, MU, MW, NE, NG, NL, OM, PK, PL, QA, SA, SC, SD, SL, SN, SY, TH, TN, TW, TZ, UG, UY, YE, ZA, ZM, ZW); Panadol Actifast (MY, SG); Panadon (HR); Panamax (AU); Panodil (DK, NO, SE); Paracemol (PL); Paracenol (PL); Paracet (NO); Paracetamol (HR, PL); Paracetamol Pharmavit (HU); Paracetamol-ratiopharm (LU); Parafizz (MY); Parageniol (PY); Paragin (TH); Parahexal (AU); Paramidol (PE); Paramol (IL, PL, TW); Parapaed (DE); Parapaed Junior (NZ); Parapaed Six Plus (NZ); Parcemol (HK); Parcemol Forte (HK); Parvid (PH); Paximol (SG); Pe-Tam (LU); Pedipan (KP); Penral-Night (KP); Perdolan Mono (LU); Perfalgan (PL); Pharmacen-M (MX); Pinex (NO); Plicet (HR, PL); Poro (MY, PH, SG); Puernol (IT); Raperon (KP); Rapidol (CN); Reliv (SE); Remedol (PR); Revanin (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZA, ZM, ZW); Rhinapen elixir (KP); Rubophen (HU); Salzone (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZA, ZM, ZW); Saridon (CO); Sedalito (MX); Selegesic (PH); Sensamol (IL); Serimol (HK); Setopain (KP); Setopain ER (KP); Sinedol (MX); Supadol mono (LU); Suspen ER (KP); Tabcin (PL); Tamifen (EC); Tasmen (KP); Tazamol (PL); Tempra (EC, GR, ID, JP, LU, MX, TH); Tempte (TW); Teramol (PH); Teramol Forte (PH); Turpan (ID); Tylenol (AT, BR, CH, DE, FR, JP, KP, MX, PH, PT, TH, VE); Tylenol 8-hour (TH); Tylenol Acetaminophen Extended Relief (CL); Tylenol Extra Fuerte (PY); Tylenol Forte (AE, BH, CY, EG, IL, IQ, IR, JO, KW, LB, LY, OM, PL, QA, SA, SY, YE); Tylex (BB, BM, BS, BZ, CR, DO, GT, GY, HN, JM, MX, NI, NL, PA, SR, SV, TT); Winadol (CO, VE); Xebramol (TH); XL-Dol Infantil (MX)


 * I have people tell me well I took some ibuprofen, advil and motrin and it still didn't get better. Another reason why this info is important for the lay public IMO. Doc James  (talk · contribs · email) 04:26, 9 December 2009 (UTC)


 * Acetaminophen does have a huge amount of brand names. The list that you have given could be massively shrunk by restricting brand names to english speaking countries only. People in spanish speaking, german speaking and french speaking countries will be pulling up de.wikipedia.org, fr.wikipedia.org and es.wikipedia.org pages from their search engines so it is not necessary to write for readers who will not be reading the english encyclopedia. Yea and it can actually be dangerous when patients don't know that advil and motrin are the same drug (overdose) although that is not wikipedia's concern I think it is worth baring in mind. Doc would you for example be opposed to say sertraline having zoloft and lustral written in the lead?-- Literature geek |  T@1k?  04:39, 9 December 2009 (UTC)


 * I think where there are say more than 5 or 6 important brand name marketed drugs in english speaking countries that to avoid listcruft it may be worth creating a sub section in the article.-- Literature geek |  T@1k?  04:45, 9 December 2009 (UTC)


 * I agree only a few ( 2-3 ) belong in the lead IMO. If there are lots they should be moved to there own section near the end of the article. Doc James  (talk · contribs · email) 05:15, 9 December 2009 (UTC)


 * I completely disagree to having a section with names, completely unencyclopedic from my point of view. Just as a side comment: I am Spanish and I never either look or contribute at the Spanish Wikipedia due to its in general low-quality. The fact that the English Wikipedia is in English does not mean that has to better cover things on English speaking countries. I do not believe it is a valid reason to decide to put some names over others... Maybe we could create something like anexes after the references, that way it would be less unaesthetic but most probably this whole proposal is going to end in listcruft. --Garrondo (talk) 08:16, 9 December 2009 (UTC)

We're not a database of drug brand names for folk too dumb to read the packaging. They can search Drugs.com if they want to look up generic brands IMO. We're an encyclopeadia, not a pharmaceutical database. We have no duty of care to our readers (I'm not saying we shouldn't be responsible) but we are not the pharmacist who asks you "What other drugs are you taking" when you go to buy something. I was hoping this discussion would be on strategies for limiting listcruft, not arguments for it or for the creation of dedicated cruft sections. Colin°Talk 08:50, 9 December 2009 (UTC)


 * I disagree. Does not belong in the lead but should be included in a section of its own.  This is important information especially for searching for medications.  Many bottle do not have generic names on them for example. Doc James  (talk · contribs · email) 08:57, 9 December 2009 (UTC)
 * I'm surprised at this. In the UK it is illegal to dispense a prescription-only medication without a patient information leaflet (though it does happen). There are probably rules for pharmacy-only medications too. So I'm very surprised that the US would sell medicines that didn't state clearly what the ingredient was, never mind all the other patient-information stuff. Colin°Talk 09:04, 9 December 2009 (UTC)


 * The same can be said for other sections like side effects, contraindications, interactions, we could say we are not a database for "folk to dumb to read the packaging". Anyway I would like to restate that I have from the start of this conversation and proposals suggested including the specific statement in MEDMOS saying "long lists of brand names should be avoided". I think that most infact all people would interpret that to mean only a few brand names max. Thus I don't mean to be argumentative but I cannot see how this could encourage editors to do the opposite i.e. make a very long list.-- Literature geek |  T@1k?  09:14, 9 December 2009 (UTC)


 * In Indonesia you can walk into a store and buy intravenous antibiotics. We need to remember that we are writing for a global audience who may not have the same resources we do. Doc James  (talk · contribs · email) 09:17, 9 December 2009 (UTC)

I will likely bow out of the conversation gracefully soon. I did not realise that this conversation was going to generate a lot of disagreement. I thought a consensus to tweak a sentence or two in the article could be quickly reached. I don't want to appear that I am digging in my heals or anything and I don't want to fall out with anyone. :) -- Literature geek |  T@1k?  09:21, 9 December 2009 (UTC)


 * Literaturegeek, your views are valuable too. I'm keen to find out what different people think, rather than to close down the discussion towards making a decision (and didn't really want this section to be about the brand-name-in-the-lead argument, which should be conducted further up). So far, we seem to have wide ranging views on what wikipedia is for. In my mind, Wikipedia is not there to help the guy who is buying his own IV antibiotics without any medical help. Perhaps there's a need for a website for those folk, but it probably wouldn't be an open wiki. Colin°Talk 09:30, 9 December 2009 (UTC)


 * Thanks Colin, I just saw disagreement on so many fronts. Ok my views. I think it is wise to focus discussions and I have done so in the above section.Wikipedia_talk:Manual_of_Style_(medicine-related_articles) I think that whether to include all brand names from all over the world in a seperate section I think is beyond the scope of this guideline. Very few drug articles have such sections, at least the ones I am familar with and I think that since even amongst ourselves here there is no middle ground emerging that it should be left up to editorial judgement, common sense and consensus on the article talk pages. I am weakly opposed to including non-english speaking countries eg all brand names used all over the world. I do not think that they should be included in infobox nor below references, they are either included somewhere in the article body or they are not included at all is my opinion. I personally don't think that MEDMOS should give guidance on this issue at least unless it becomes an issue on the encyclopedia. My main concern is the lead which I have commented on above, that I do think is important for MEDMOS as we are introducing and defining the subject matter to lay readers/general audience.-- Literature geek |  T@1k?  10:24, 9 December 2009 (UTC)


 * Here's a summary of my current thoughts:
 * The 'initial brand name' should be plural, because nobody wants to figure out whether 'MabThera' or 'Rituxan' was truly the first brand name for rituximab.
 * Major brands/major alternative names are usually WP:DUE and (when DUE) are encyclopedic. Cola should mention Coca-cola and Pepsi (but probably not smaller brands); Ibuprofen should probably mention Advil and (based on this and this, Motrin (which may have been the first brand name in the US), but probably not the store label that I would buy.
 * If the list of WP:DUE names is short and sweet, then it can be disposed of in the lead (i.e., above the table of contents, not necessarily the very first sentence). If it's long and/or ugly (see aspirin), then it might be better placed elsewhere in the article.
 * Comprehensive laundry lists of every possible name (anywhere in the article) aren't WP:DUE and aren't encyclopedic in the article about the substance itself. It would be like listing every possible model of car at Automobile.  If there are good sources (e.g., sources that discuss the multiplicity of brands), then the article can See also to a List of ___ brand names .  In that instance, a comprehensive list might be entirely acceptable.
 * Any rule that we write should be sufficiently weaselly that our intention to apply WP:COMMONSENSE is clearly indicated.
 * Does anyone actually disagree with any of these statements? WhatamIdoing (talk) 20:03, 9 December 2009 (UTC)


 * I do not see any problem with the above. Doc James (talk · contribs · email) 20:11, 9 December 2009 (UTC)
 * I agree with all of your points whatamidoing and you worded it better than I. I think your idea of creating an article for list of brand names is a good idea. It probably will only apply to a handful of drug articles but it is a good solution to one of the disagreements. While not dealing with brand names there is something similar for benzos, list of benzodiazepines.-- Literature geek |  T@1k?  20:25, 9 December 2009 (UTC)
 * If editors want to list a limited number of "common" brands in the lead then that's up to them and their watchlist. As I said, I don't think you'll be able to restrict the list without regular pruning. I'm opposed to MEDMOS guidelines requiring or recommending more than the initial brand(s) of the patent holder for the lead sentence. The current Ibuprofen approach is probably reasonable for such a famous drug, though the lead sentence truly is a crime against the English language. Colin°Talk 20:51, 9 December 2009 (UTC)
 * Well how about if we make a one letter change to MEDMOS, which I think that we have consensus on? "The initial brand name(s) and manufacturer follows" If there are continuing strong views amongst editors on other issues then we can discuss them. :)-- Literature geek |  T@1k?  21:02, 9 December 2009 (UTC)
 * I don't see any problem with the one-letter change. My only issue with WhatAmIDoing's points is the failure at point 4 to limit listcruft. Lists are exempt from neither WP:V nor WP:RS, at least not in theory. They still must be referenced. In practice, few of them are. Without a very significant effort, they will rapidly grow stale. Two or three external links to authoritative sources might be justified, but entire list-class articles full of unmaintainable content would be, at least to my mind, a detriment to the project. LeadSongDog come howl  22:02, 9 December 2009 (UTC)


 * I have ✅ #1. WhatamIdoing (talk) 22:28, 9 December 2009 (UTC)

List cruft restarted
Hi guys, I was wondering if it is worth restarting this conversation as what to do with excessive patented brand names has not been decided. I think that the consensus is that initial patented brand names should be mentioned in the lead. There was also consensus to avoid generic trade names. There was no concensus on what to do when we have lots of patented brand names including tose used in non-english speaking countries. Some editors were opposed to restricting the list to only english speaking countries and I can understand why.

So should we include them in the indications section under a subsection on availabiity where we also discuss available forms eg tablet/liquid/IV/IM or should we include a field in the infobox? What are people's views? I am thinking of articles where there are maybe a dozen or so patented brand names world wide.-- Literature geek |  T@1k?  20:08, 26 December 2009 (UTC)
 * Can you give examples of some drugs where the initial patent holder (or their licencees) used more than a few brand names worldwide? Colin°Talk 20:26, 26 December 2009 (UTC)
 * There are many generic drugs with a dozen -- or even more than a hundred -- trademarked names (particularly for common over-the-counter meds), but I'm not sure that any drug has been marketed under a dozen different names by a single patent-holding manufacturer. WhatamIdoing (talk) 21:22, 26 December 2009 (UTC)


 * Most drugs have about a dozen different name:
 * Ramipril for example

Altace®;Apo-Ramipril®;CO Ramipril;GEN-Ramipril;Mylan-Ramipril; Novo-Ramipril;RAN-Ramipril;ratio-Ramipril;Sandoz-Ramipril Acovil (ES);Altace (VE);Cardace (ID, IN);Corpril (TH);Delix (DE);Heartprilprotect (KP);Hyperil (ID); Hypren (AT);Lostapres (AR);Naprix (BR);Piramil (EE, TH);Pramace (SE);Prilace (AU);Quark (IT);Ramace (AU, BE, DK, FI, LU, MY, NL, PH, SG);Ramicor (PL);Ramipil (KP);Ramipres (CN);Ramiprin (KP);Ramipro (PH); Ramitace (TW);Ramixal (ID);Rampil (ZA);Ramtace (TH); Redutens (ID);Triatec (BR, CH, CN, DK, GR, ID, IL, IT, NO, PT, SE);Triateckit (FR);Tritace (AR, AT, AU, BB, BE, BF, BJ, BM, BS, BZ, CI, CL, CR, CZ, DK, DO, EC, ET, GB, GH, GM, GN, GT, GY, HK, HN, HR, HU, IE, JM, KE, KP, LR, LU, MA, ML, MR, MU, MW, MX, NE, NG, NI, NL, PA, PH, PK, PL, PR, PY, SC, SD, SL, SN, SR, SV, TN, TT, TW, TZ, UG, UY, ZA, ZM, ZW);Tryzan (AU); Unipril (IT);Vesdil (DE)
 * I agree that we do not need the apo, GEN, CO etc even though I would not be set against including it. If some one is so inclined a section with this information is informative.  Makes one realize just how significant and convoluted marketing is.  Makes the pages easier to translate into different languages.  And much more interesting then the history of rugby / soccer and we have a entire wikiprojects on them.  Not to mention WP:Manga :-)  Doc James  (talk · contribs · email) 22:47, 26 December 2009 (UTC)
 * The example you give is a drug that is not protected by a patent. These names could all be from different manufacturers.  WhatamIdoing (talk) 23:27, 26 December 2009 (UTC)


 * Clopidogrel / plavix than: Ateplax (PE);Ceruvin (MY);Cloart (KP);Clopilet (IN);Clopivaz (PH);Deplat (TW);Iscover (AR, AT, AU, BE, BG, CH, CO, CZ, DE, DK, ES, FI, FR, GB, GR, HN, IE, IT, NL, NO, PT, RU, SE, TR);Kovix (KP);Maxgrel (KP);Noclot (PK);Plagerine (PH);Plamed (KP);Plavitor (KP);Plavix (AR, AT, AU, BB, BD, BE, BF, BG, BJ, BM, BO, BR, BS, BZ, CH, CI, CL, CN, CO, CR, CZ, DE, DK, DO, EC, ES, ET, FI, FR, GB, GH, GM, GN, GR, GT, GY, HK, HN, ID, IE, IL, IN, IT, JM, JP, KE, KP, LR, MA, ML, MR, MU, MW, MX, MY, NE, NG, NI, NL, NO, PA, PE, PH, PK, PL, PR, PT, PY, RU, SC, SD, SE, SG, SL, SN, SR, SV, TH, TN, TR, TT, TW, TZ, UG, UY, VE, ZA, ZM, ZW);Q.O.L. (KP);Ravalgen (EC)


 * Q.O.L. What are they thinking!!! are they nuts!!! What kind of name is that... Doc James  (talk · contribs · email) 23:36, 26 December 2009 (UTC)

(Undent) Until we all decide to stop using brand names ( which is unlikely to ever happen ) this information is critical and may at times be like and death. It is more than a passing curiosity. If we are good enough to do it properly than it should be included. I have seen some papers on this exact topic in the past but am packing for Japan and do not have time to dig them up. I strongly support its inclusion as I believe Wikipedia should be the sum of all human knowledge. That we should provide free information for those who cannot afford Uptodate. Some pharmacies do not gives generics. Assume they are in the pay of the drug reps but that is just me being cynical. Doc James (talk · contribs · email) 23:41, 26 December 2009 (UTC)

Ok I have done some research. From what I can tell a lot of the generics in countries other than the UK are marketed via brand name. See below for ciprofloxacin.-- Literature geek |  T@1k?  14:51, 27 December 2009 (UTC)

I have used ciprofloxacin as an example. Click on picture links and you will see they are brand name marketed versions of ciprofloxacin where the brand is more prominant than the generic name.

ciproflox, quinox, Ciloxan, cipro, ciprodil, Baycip, Ciprol, Ciproxin, Proquin, Ciflox, Ciproxine, Biamotil, Biamotil-D, Ciprobiot, Ciproflox, Ciproxan, Ciproxen, Maxiflox, Maxiflox D, Proflox, Proxacin, Quinoflox Cifloxin, Ciproval, Ciproval, Grifociprox, Cifloxinal Cifran, Ciphin, Ciplox, Ciplox D, Ciplox TZ, Ciprinol, Ciprobay, Septocipro, Rigoran, Piprol, Catex, cetraxal, Uniflox, Ciprox, Pantotile, Bivorilan, Flociprin, Ginorectal, Limoxin, Nafloxin, Ciproxyl, Medociprin, Uroxin, Ciprodex, Ciprogis, Antimed, Apoflox, Bioflox, Ciprain, Ciproxina, dinaflox, Eufloxin, Floxatina, Patox, Sinfexina, Cilox, Cipflox, Cipromax, Cipromet, Cirok, Laitun, Cipronex, Ciprium, Estecina, Nivoflox, Sifloks, Dynafloc, Uroxin, Aceoto, Aceoto plus, Globuce, Sepcen, Ciprocep, Microflox, Poli-Cifloxin, Ciflosin, Ciproktan, Loxasid, Sanset, Siprobel, Siprosan, Ciflox, Ciproquin, Quinoftal, Quinotic, Quinotic HC, Cipro HC, Otobiotic, Cilodex, Cylocort, Ocimix, Cetraxal Plus, Quinocort

Here are the patented brand names by the patent holder Bayer pharm. See Bayer logo on packaging in below pictures. So as you can see limiting to only initial brand names by patent holder still leads to up to 7 or more brand names world wide.


 * Ciflox
 * Ciproxin
 * Ciproxine
 * Ciproxina
 * Baycip
 * Cipro
 * Cipro IV

Questions, do we list all seven Bayer patented brand names in the lead? If not then do we say only those in English countries to restrict the list? Or else where do we list them? This is relevant to an unresolved dispute on Talk:Metformin but has implications for all pharmacology articles.

What about branded generics? Do we exclude them from any section of the article such as infobox or availability sections? Do we do what was done here, List of paracetamol brand names?-- Literature geek |  T@1k?  14:51, 27 December 2009 (UTC)

Happy New Year everyone! Ok, I assume everyone has been busy over Christmas and the New Year. I would like to pass my views.

Branded generics should not be added to the article because, there are so many of them and because they are frequently going off the market and getting replaced with different generic brand names. I feel the only other thing in my view that remains to find consensus on is what happens if there are say quite a few initial brand names world wide, say around 5-7, are they included in the lead? My opinion is yes they should be but if other editors disagree, where should they go? Should a field be created in the info box? Or should they just be mentioned in say the indications section when discussing available forms (eg tablet, IV etc)? Manual_of_Style_(medicine-related_articles)-- Literature geek |  T@1k?  09:27, 1 January 2010 (UTC)

Or alternatively is everyone just sick of this conversation LOL! :P We are almost done with it anyway.-- Literature geek |  T@1k?  09:34, 1 January 2010 (UTC)


 * I think having a section on brand names ( both branded generics and original brand names) is a good idea. As I stated before I we include all nations it will make changing languages easier. Doc James  (talk · contribs · email) 06:15, 2 January 2010 (UTC)
 * I don't think Doc James' suggestion is feasible on an open wiki. Especially one where I can probably quickly name all the active editors and there are thousands of drugs. Why try to replace Drugs.com in this regard: we are an encyclopaedia, not a database store of all the worlds information. I would be strongly opposed to medmos even suggesting such a section would be a reasonable idea. The WP:V sourcing and maintenance would be a nightmare 24/7 task for the whole project.
 * Literaturegeek seems to have found an example of a patent holder launching seven brands for the same drug. I suggest this is still rare (and getting more so in this global market) and probably not worth covering by MEDMOS. It does seem common sense to limit those brands to English speaking countries as we are the English Wikipedia. Again, I don't think that is worth mentioning. Colin°Talk 07:20, 2 January 2010 (UTC)


 * I do agree that this would be difficult and yes there is only a few dozen of us who actively edit medical articles so it is probably not currently feasible on any scale. Is this justification however to never attempt it?
 * If someone however has the tenacity to put together a section like this why not? It would give place to remove excess names from the lead without deleting them. Doc James  (talk · contribs · email) 08:21, 2 January 2010 (UTC)
 * I'm not advocating me make a guideline against such a list. If someone wants to do it on a small scale and watchlist the result, that's up to them. There are better uses of one's time IMO and for some drugs such a list could be longer than the article itself. If, on the other hand, someone semi-automated dumped a big load of brand->drug data from Drugs.com or elsewhere into Wikipedia, that would be rather unwelcome. And, of course, every single brand would need a cited reliable source. Colin°Talk 10:20, 2 January 2010 (UTC)
 * Agree completely. Doc James (talk · contribs · email) 23:36, 14 January 2010 (UTC)

Symptoms and signs
We have a number of pages that pertain to symptoms rather than disease per say for example headache, abdominal pain, chest pain, hypertrichosis. We need to put together some guidance on what general structure we should use for this type of article. Does not fit completely under disease / syndrome and ends up creating some duplication. Doc James (talk · contribs · email) 23:36, 14 January 2010 (UTC)


 * I have started to try to organize things here. Input would be appreciated. User:Jmh649/Sandbox8  Doc James  (talk · contribs · email) 06:02, 16 January 2010 (UTC)


 * I've swiped your plan from Sandbox8, which I liked overall, and have made a few changes and boldly tossed it into the usual list of WP:MEDMOS. Any editor is welcome to improve on it.  In particular, I'm not perfectly satisfied with "Associated medical conditions".  Diff dx is provider-centric jargon, so I'd like to avoid that term.  WhatamIdoing (talk) 04:22, 17 January 2010 (UTC)


 * Thanks for that. Sorry tweaked it a bit before I saw your response here. I find "Associated medical conditions" a little clumsy.  Would prefer either "Possible diagnosis" or "Differential diagnosis". Doc James  (talk · contribs · email) 04:28, 17 January 2010 (UTC)
 * No worries: both/and is a valid aproach.  I'll keep hoping that someone will have a truly brilliant solution, but in the meantime, we've got something that I think is functional and helpful. WhatamIdoing (talk) 04:46, 17 January 2010 (UTC)


 * It is just that we have slashes between syndrome/disease? Doc James  (talk · contribs · email) 22:36, 17 January 2010 (UTC)
 * I hadn't noticed the pattern you were trying to match (memo to self: must engage brain more often).
 * Apparently, we shouldn't, from what I've read in the past. Slashes (forward ones, at least) seem to be interpreted as sub-pages sometimes (and thus could take an unsuspecting person off to a non-existent page).  But, of course, it may only affect a small number of readers, etc.  But there's nothing wrong with using "and" as an alternative, if you'd like to include medical signs.   WhatamIdoing (talk) 23:18, 17 January 2010 (UTC)

Thank you for taking the time to do this Doc, guidance on this is needed. I think that it looks good. I did make one bold change to the first sentence. Feel welcome to change it if anyone disagrees.-- Literature geek |  T@1k?  00:49, 18 January 2010 (UTC)


 * Thanks all Doc James (talk · contribs · email) 01:10, 18 January 2010 (UTC)

Medical jargon
A discussion has started at Midazolam about whether indication meets the requirement that a Wikipedia article should be accessible. Indication (medicine) indicates that indication has a special meaning in the domain of medicine. We should avoid terms that require experienc in a particular field of knowledge to be understood. Note also that the medical meaning is substantially different from the common meaning. I cannot think of a good replacement. But here is a first trial, to be modified or replaced: Symptoms and states where use is recommended. --Ettrig (talk) 23:39, 5 February 2010 (UTC)
 * Indication just means "what there is evidence that it is useful for". I think this word is fine.  The wording suggested above is to long. -- Doc James  (talk · contribs · email) 05:23, 6 February 2010 (UTC)

I'm probably the one that's guilty of going against the "cabal" here and starting this, so I apologize. That being said, my primary reasons for doing this are mostly style-related. In my professional opinion here, while "indications" is technically correct, I think we have to also consider who our primary readers are, as well as the purpose of Wikipedia. While I think that many editors will easily see that use of the word "indications" seems more correct because that's what you see on the official drug information from the pharmaceutical companies, as well as in many textbooks, I still think it's a bit too technical for a general purpose encyclopedia intended for mass consumption. And we have to keep in mind that the purpose of including articles about medications and drugs is not to duplicate the official pharmaceutical information from the drug manufacturers. So, I think using a title like "therapeutic uses" clearly states to the general public what the section in question is going to discuss, and because of that should be the favored title of the section.

So, since we're supposedly based on consensus here, I welcome other comments from other editors on this proposal. WTF? (talk) 18:08, 9 February 2010 (UTC)


 * I think that it depends on how you're using the word. "Evidence from clinical trials indicates effectiveness in _____" is perfectly plain English.  "This drug has an indication of ____" is bad writing style.  WhatamIdoing (talk) 19:18, 9 February 2010 (UTC)


 * Jargon can be a barrier to understanding when the word is opaque and the usage doesn't help the reader infer its meaning. Too many of our medical articles are impenetrable. But people read encyclopaedias to improve their learning, and part of that is learning the correct technical term for something. The correct terms are indications and contraindications. I think it is clear that the contents of the Indications section is a description of the situations where the drug is prescribed or procedure is performed. So by reading the section, they will learn what the word means. And if one writes "XXX is indicated for the treatment of YYY", then I'm sure most readers could grasp what the word means here, even if they find it unfamiliar. I think the word implies more formality that just "XXX is used to treat YYY", though that form may be better in some cases. If the text said "indicated", I'd expect to see sources that indicate official approval for the drug in that case. I wouldn't expect that word to be used for off-label or experimental therapies.


 * BTW, wrt "evidence that it is useful for". Don't confuse this with indications. Some drugs are indicated for treatments despite there being little or no evidence (with good and bad reasons and consequences). Some drugs have evidence (to a degree) but are not (yet) officially indicated for that treatment. And some drugs are just water: even homoeopathic remedies have indications. :-) Colin°Talk 20:45, 9 February 2010 (UTC)


 * "Indication" and "contraindication" are indeed medical jargon that we can't expect the average reader to know (and I agree with Colin that the words are often misunderstood). When these terms come up in articles that I help edit, I try to rewrite the text so that the article does not assume that the reader knows what they mean. For example, please see Chiropractic , which uses the word "contraindication" but places it in a context (a definition of absolute vs. relative contraindication) which should make things clear even to naive readers. Eubulides (talk) 21:23, 9 February 2010 (UTC)

I think that some people here are misinterpreting what the disagreement was about. It is about section headers, not about reducing jargon in the article body. Specifically an editor expressed a view that "indications" is too technical a term for a section header.Manual_of_Style_(medicine-related_articles) This is what the disagreement was/is about. So do we change our guidance to say therapeutic uses or do we leave as is? I don't really mind one way or the other.-- Literature geek |  T@1k?  12:41, 22 February 2010 (UTC)


 * I am happy with either indications or therapeutic uses. Doc James (talk · contribs · email) 13:05, 22 February 2010 (UTC)


 * Or alternatively, the MEDMOS guidance could have both indications and therapeutic uses as options? Wikipedians seem to use them interchangably.-- Literature geek |  T@1k?  13:08, 22 February 2010 (UTC)


 * Yes I do not see any problem with that. Doc James (talk · contribs · email) 13:36, 22 February 2010 (UTC)

"Do not hype a study by listing the names, credentials, institutions, ...."
There are countless examples in wikipedia like "a recent Cochrane review found" - and I think that this is in many cases good practice to indicate the quality of a particular source immediately visible inside the article. Should that be avoided? Many articles are overloaded with tons of references which are quite interesting but the reader should easilly see which source is of general interest and which is only marginally interesting without looking up every single footnote while reading. For this reason I also like Harvard citation style better than footnotes.

What are the opinions on that? Richiez (talk) 12:33, 22 February 2010 (UTC)


 * The journal it was published in and the authors should not be mentioned 99% of the time. I make an exception for the Cochrane collaboration some of the time. Doc James  (talk · contribs · email) 13:04, 22 February 2010 (UTC)


 * If the 'hype' can be done in a couple of words, and you have some positive reason for including it, then it might be acceptable in some instances. Editors should use their best judgment.
 * What must be avoided is a long description of the author's credentials, as if famous people are infallible. I've seen things that look very much like this:  "The largest clinical trial in the history of this disease was conducted in 2008 and 2009 by the Nobel-nominated Prof. IM Portant, MD, FACP, TLA at the oldest continuously operating medical school in the world, Staid University, with funding from the famed Celebrity Charity."
 * Such hype is always undesirable, and almost always indicates other problems, including cherry-picking and over-reliance on primary sources. WhatamIdoing (talk) 19:35, 22 February 2010 (UTC)


 * Hype can only really be justified if the hype itself can be supported with secondary sources. E.g. an important negative Cochrane Review can certainly be mentioned as such if secondary sources report this (e.g. lactulose in hepatic encephalopathy - my current editing project). JFW | T@lk  20:04, 22 February 2010 (UTC)


 * Generally speaking it's better not to use in-text attribution such as "A 2009 Cochrane review concluded X". Just write "X". Or, if X is controversial and other reliable sources say not-X, write "A 2009 systematic review concluded X" and then go on to summarize the other sources. Eubulides (talk) 20:48, 22 February 2010 (UTC)


 * The problem is sometimes the unreliable sources which people add for various reasons. Ie there is one Cochrane review and hundreds of trials of which a large portion is probably manufacturer sponsored etc. It is much easier to say "a Cochrane review" than to review the quality of the other sources which other people might have contributed - and even when I find out it was a questionable sponsored trial marking it in the text as such is very problematic. Richiez (talk) 13:26, 23 February 2010 (UTC)


 * Leave the job of reviewing the primary research literature to the experts who have published their findings in a quality source. See WP:MEDRS. Find the best secondary sources (such as your Cochrane review or a good literature review). Chuck out all the text based on primary research papers. Try to restict any mention of research (as opposed to facts drawn from the research) to the History section of an article. Don't (in your article writing) raise concerns about a trial that were not either raised already by the researchers or by very reliable sources commenting on the trial. That it was "manufacturer sponsored" is not an automatic indication of biased results. Colin°Talk 14:09, 23 February 2010 (UTC)