Wikipedia talk:WikiProject Medicine/Archive 120

List of mystery diseases
I can't think of the title, but I'm nearly sure we have at least one other article that's also about diseases of unknown etiology. Does anyone remember what the article is? Natureium (talk) 15:35, 3 January 2019 (UTC)
 * Don't know if it's the one you're recalling; but did find List of unsolved problems in medicine via Special:WhatLinksHere/Nodding_disease Little pob (talk) 15:45, 3 January 2019 (UTC)
 * Are you thinking about the renamed list that is now at List of diagnoses characterized as pseudoscience? Or something more like List of unsolved problems in medicine?  There was also Articles for deletion/List of syndromes and diseases with unknown etiologies from a while ago.  (This search might be interesting.)  WhatamIdoing (talk) 15:48, 3 January 2019 (UTC)


 * I think it was List of unsolved problems in medicine that I was thinking of. Looks like they could be merged, and probably a better title found. Natureium (talk) 15:55, 3 January 2019 (UTC)
 * Aaaaaaarrrrggggghhh! Another horrendous list article on Wikipedia. The current List of unsolved problems in medicine is terrible, to the point that I'd support WP:TNT. It is very partial and incomplete. It is completely unreferenced. It imparts no information of any value. It is unclear what it takes to be included there. Kill it. Kill it with fire. Bondegezou (talk) 17:01, 3 January 2019 (UTC)
 * Yup it is dreadful. Nearly all diseases have some aspect of it that is unsolved. Doc James  (talk · contribs · email) 09:45, 4 January 2019 (UTC)
 * The other unsolved problems articles are a lot better: they have structure, they have references. I worry they are still very open to WP:OR, but they offer a way forward. I may try some BOLD edits. Bondegezou (talk) 10:11, 4 January 2019 (UTC)
 * OK, a beginning: see List of unsolved problems in medicine. I hope others can do more. Bondegezou (talk) 10:32, 4 January 2019 (UTC)

RfC relevant to medical editors
Addressing the question of whether practitioners of alternative treatments have an inherent COI when editing on their practices. Guy (Help!) 15:01, 4 January 2019 (UTC)


 * more opinions(gave mine)--Ozzie10aaaa (talk) 18:07, 4 January 2019 (UTC)

America's Health Insurance Plans edit requests
Hi all, I've been hired by America's Health Insurance Plans to request some updates to its article. I'm also hoping to help address the flag on the article. My requests are on the article's talk page. If anyone here is up for taking a look and offering feedback, I'd appreciate it tremendously. I've had some difficulty getting a response to my requests. Thank you! Mary Gaulke (talk) 04:19, 26 December 2018 (UTC)


 * Hi . I had a brief look but others may know better. A "History and development" section might be good to start with. I found, and . Whispyhistory (talk) 09:35, 27 December 2018 (UTC)


 * Thanks, I appreciate your input! I'll dig into the links you shared. Mary Gaulke (talk) 21:25, 4 January 2019 (UTC)

Discouraging see also sections
The MEDMOS says "See also: Avoid the See also section when possible; prefer wikilinks in the main article and navigation templates at the end." Can someone explain why this is? Natureium (talk) 15:33, 4 January 2019 (UTC)
 * There is a general prejudice against SA sections, which tend to get cluttered up with either links that are already in the main text, or things that are barely relevant. If it's that relevant, say so (and why) in the text. A bare link is usually not very informative. Some people oppose any SA links at FAC, which I think is a bit draconian myself. Johnbod (talk) 20:42, 4 January 2019 (UTC)
 * In addition to Johnbod's good points, MEDMOS prefers conveying information with good context. A list of bare links has little of that, but WP:SEEALSO does encourage annotations of links if they are not obvious. What might be a more acceptable alternative is to create a "related topics" section that embeds the links in prose that gives context. -- 21:12, 4 January 2019 (UTC)
 * +1 to Mark and John. Doc James  (talk · contribs · email) 10:57, 5 January 2019 (UTC)
 * I think that MEDMOS's advice might need to change. If memory serves, the general thinking was that redundant links were often bad, and long lists were usually bad, and that the use of navboxes was rising.  (Yes, it's actually that old.)  But now we've got another situation, namely that navboxes are invisible for more than half of our readers.
 * As a first thought on the ==Related topics== section, it sounds like a prose version of ==See also== with decent descriptions (which ought to be more widely used), and it might be hard to shoehorn in all the links into sensible prose. WhatamIdoing (talk) 19:05, 6 January 2019 (UTC)

Harrison's 2015 unreliable?
Would like input on whether it's good to remove 2015 Harrison's from acupuncture on the rationale that the 2018 one might say differently, and that it's too old because already have different 2016 sourcing.

Harrison's 2015 says "no evidence for efficacy" in tension-type headache. This contrasts with two 2016 Cochrane reviews already cited which found "moderate" evidence for efficacy -- so do we keep out Harrison's just because 2015 < 2016?

And in general should we be deleting uncontroversial 2015 Harrison's citations until we get a copy of the 2018? --Middle 8 (t • c &#124; privacy • acupuncture COI?) 19:10, 6 January 2019 (UTC)


 * Pretty damn sure the answers are "NO" and "NO" but I wanted to raise the issue neutrally. --Middle 8 (t • c &#124; privacy • acupuncture COI?) 19:12, 6 January 2019 (UTC)
 * It's not "unreliable". But the way you added it didn't improve the article. Why add a source which hasn't considered any evidence, when we have a new source which has? This doesn't help us reflect knowledge better. Alexbrn (talk) 19:16, 6 January 2019 (UTC)
 * Pretty sure they looked at the evidence before commenting on it. They may well have decided it was too weak to be meaningful and thus reached a different conclusion than Cochrane.  Or not. Point being we can't assume they didn't look at it.  --Middle 8 (t • c &#124; privacy • acupuncture COI?) 19:45, 6 January 2019 (UTC); added sentence 19:53, 6 January 2019 (UTC)
 * I don't think that we should be making assumptions that reputable textbooks don't consider evidence. Reliable sources are not required to show their work to Wikipedia editors, or even to provide us with a list of footnotes.  WhatamIdoing (talk) 20:49, 6 January 2019 (UTC)
 * By 2018, do you mean the 20th edition? Natureium (talk) 19:50, 6 January 2019 (UTC)
 * Yes.Middle 8 (t • c &#124; privacy • acupuncture COI?) 19:51, 6 January 2019 (UTC)
 * The 20th edition says in chapter 422 under TREATMENT Tension-Type Headache: "For chronic TTH, amitriptyline is the only proven treatment; other tricyclics, selective serotonin reuptake inhibitors, and the benzodiazepines have not been shown to be effective. There is no evidence for the efficacy of acupuncture." That's the only mention of acupuncture with regard to headache. Natureium (talk) 19:56, 6 January 2019 (UTC)
 * Terrific, thanks! --Middle 8 (t • c &#124; privacy • acupuncture COI?) 20:00, 6 January 2019 (UTC)

Prostate cancer related articles
I have started a discussion at Conflict_of_interest/Noticeboard regarding potential conflict of interest at some prostate cancer related articles. It may be helpful for editors with medical expertise to have a look and give an opinion. Thank you. Edgeweyes (talk) 16:47, 7 January 2019 (UTC)
 * commented--Ozzie10aaaa (talk) 17:54, 7 January 2019 (UTC)

Expression of Mouse Interleukin-4 by a Recombinant Ectromelia Virus Suppresses Cytolytic Lymphocyte Responses and Overcomes Genetic Resistance to Mousepox
Greetings, wanted to ask for comments on something that might be worthy of its own article.

I did just read this publication and it is a pretty straightforward and unremarkable laboratory experiment.

However, some of the sources citing it mention it as an example of how dangerous pathogens may be accidentally created in laboratories. I wonder if one could write an article on this topic (say Accidental creation of dangerous pathogens or something more specific such as Interleukin-4 transduced ectromelia virus experiment) or whether there is a more general topic on accidentally engineered biohazards. Thoughts? Jo-Jo Eumerus (talk, contributions) 20:43, 7 January 2019 (UTC)


 * Engineering a virus to express an anti-inflammatory cytokine to suppress the immune response sounds extremely dangerous. There is a section of an article (Global_catastrophic_risk) that already cites the above mouse pox source. Perhaps that section could be expanded.  An article on Interleukin-4 transduced ectromelia virus experiment seems a bit too specialized and narrow. Boghog (talk) 21:20, 7 January 2019 (UTC)

Kent/Sussex Detoxification Center
There's a discussion at Articles for deletion/Kent/Sussex Detoxification Center that might benefit from some experienced eyes - I found some sources, but they look a bit odd to me. Girth Summit  (blether) 18:53, 7 January 2019 (UTC)


 * give opinion(gave mine)--Ozzie10aaaa (talk) 21:52, 7 January 2019 (UTC)

Open Access Job at World Health Organisation (Deadline January 17th)
From Ian Coltard, Manager of Copyright, Licensing and External Publications:

"Our team has advertised a G5 position in Geneva. Despite the rather unexciting WHO job title “Assistant (Documents)”, this position will be at the heart of our work in digital licensing and distribution, and in particular our expanding work in the area of open access. We are also looking to improve the tracking of the use and uptake of our publications, so there will also be an opportunity to be part of this developing area of our work."

https://careers.who.int/careersection/ex/jobdetail.ftl?job=1805648&tz=GMT%2B01%3A00&fbclid=IwAR2f3nXrAdtUvdiSHQ0DTsmfg0KxFg5ktPeA8rj5ZlhegIT0sCaxz8XYzdk

Thanks

John Cummings (talk) 18:22, 7 January 2019 (UTC)

Job posting - medicine - Geneva
The World Health Organization is hiring a document manager to advance their open access program. This is a one year position and they are offering CHF 74,343 or ~ US$75,000. I think this could be relevant to Wikipedia's medical content if the person in this role would collaborate with Wikipedia. WHO has excellent content that no one reads, and Wikipedia has okay content that is maximally popular. Our organizations should collaborate to leverage each other's strengths.


 * Assistant (Documents) - (1805648)

I got this posting from, who is Wikimedian at UNESCO. He also is keen on suggesting the position to wiki editors. If there is anyone in our wiki social circle who would be interested in applying then I would support their candidacy with others from the meta:Wikimedians in Residence Exchange Network.

Thanks.  Blue Rasberry  (talk)  18:29, 7 January 2019 (UTC)


 * Thanks, just a note about the salary, some but not all UN staff positions are not liable for income tax meaning you receive the full amount, I don't know the classification of this position. John Cummings (talk) 18:54, 7 January 2019 (UTC)
 * WHO currently publishes mostly under an NC license. They adopted this against the advice of a bunch of people and seem fairly adamant to stick with this closed license. Whoever takes the position will need to be exceedingly convincing to make positive change... Doc James  (talk · contribs · email) 01:48, 8 January 2019 (UTC)

Social media addiction
The Social media addiction article needs attention from editors well-versed in MEDRS. I removed a number of statements which were clearly WP:SYN or unsourced, but some of the remaining sources may be speculative or not reflect current medical consensus. The overall article seems to be written as an argument in support of social media addiction instead of a balanced, detached description. Any help would be appreciated. –dlthewave ☎ 17:38, 6 January 2019 (UTC)
 * an editor nominated it for GA?--Ozzie10aaaa (talk) 11:57, 7 January 2019 (UTC)
 * Yes, the primary contributor has nominated it twice. –dlthewave ☎ 15:49, 7 January 2019 (UTC)
 * I object starting with the first sentence "Social media addiction is a medical condition caused by overuse of social media" Natureium (talk) 15:06, 7 January 2019 (UTC)
 * dlthewave asked about "current medical consensus". I'm not sure that there really is a "consensus".  It seems to be more in a "he said/she said" state.  (There's probably a medical consensus that it's not a true addiction.)  WhatamIdoing (talk) 17:31, 7 January 2019 (UTC)
 * It's a bit of a mess. I've done some cleaning up. More needed. Bondegezou (talk) 17:58, 7 January 2019 (UTC)
 * Primary contributor (who built the article in Dec 2018 from a redirect) appears to be a WP:SPA repeatedly violating WP:SYN. As mentioned he's the one repeatedly nominating it for GA. WP:COIN or WP:ANI may be needed eventually? Virtually no sources in the article are on the non-official "Social media addiction", instead the sources are on ADHD or Internet addiction.
 * IMO should be redirected back to Social media if not Internet addiction. --Treetear (talk) 18:00, 7 January 2019 (UTC)
 * Now the COI user went ahead and created Digital dependencies and global mental health. Essay-like, probably also WP:SYN since much of the content is copied over from past revisions of Social media addiction, and didn't go through AfC. This is getting problematic. --Treetear (talk) 22:41, 7 January 2019 (UTC)
 * is doing great work here, but still more eyes would be useful. We have an enthusiastic new editor who needs to be nurtured, but we also have a lot of dubious content that needs pruning. Bondegezou (talk) 09:37, 8 January 2019 (UTC)

Summarizing new articles from ADA on low carb diet page
I am having an issue with updating the Low-carbohydrate diet entry.

Recently the ADA released the "2018 consensus report on Type 2 Diabetes by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)"

The American Diabetes Association also released its "Professional Practice Committee: Standards of Medical Care in Diabetes—2019."

These two documents mark a sea-change in ADA policy toward low carb diet. It is now included as an option for Medical Nutrition Therapy (MNT), which is recommended by the ADA.

What's happening is that any attempt to accurately summarize these articles as they relate to LC diets is being instantly reverted or edited in very biased and slanted manner. The editor I am having this disagreement with suggested I request help here.

Here is the talk page: Talk:Low-carbohydrate diet

Thank you, CarbShark (talk) 04:28, 22 December 2018 (UTC)

Let me just say I admire the fact you are trying to update this article. But unfortunately I think you are taking out of context what is in these sources, I could be wrong about this but the user you talk about is an experienced editor and warned you about this. I think the best thing to do would get the opinion of. MatthewManchester1994 (talk) 22:25, 18 December 2018 (UTC)

So I had a look at these references and this is interesting:

(my bold). Can you explain how this fits your claim that there is "a sea-change in ADA policy toward low carb diet"? I am not seeing any long-term health benefits from this diet in relation to diabetes, and the ADA contrary to what you claim on the talk-page is not specifically recommending this diet. MatthewManchester1994 (talk) 22:37, 18 December 2018 (UTC)


 * Yes, certainly. First it is a sea-change in that prior to this release the ADA has regarded Low Carb diets as dangerous and promoted a low fat diet for years. In this paper, while they have not completely reversed course and recommended LC diets above all others (which I never claimed) they included low carb diets in the discussion of Medical Nutritional Therapy. And excluded the low fat diet.
 * In the section on diet where they make their recommendations they recommend diets or eating patterns that meet a set criteria. Then in the descriptions of those diets they indicate that LC diets (and others) meet the criteria they established. They added caveats for LC diets (which IMO are not justified, that's just me) and those should be mentioned in the article.
 * Do you agree that the edits and reverts following my summaries of these two papers were biased against LC diets?
 * Do you agree that the edits and reverts following my summaries of these two papers were biased against LC diets?
 * Do you agree that the edits and reverts following my summaries of these two papers were biased against LC diets?


 * I don't believe I'm being unreasonable nor am I insisting that it has to be my version. If there is an issue (for example, I didn't distinguish between T1 and T2 diabetes in part) then that can be collaboratively edited to correct that issue, rather than entirely discard the edit or replace it with something far more biased in the other direction. CarbShark (talk) 22:53, 18 December 2018 (UTC)
 * You are correct the user is an experienced editor, and yes, he has warned me. He suggested I bring this issue up here to get someone with medical expertise and fresh eyes to look at the page. That certainly seems reasonable.CarbShark (talk) 22:53, 18 December 2018 (UTC)
 * Will look at this in more detail in a day or two when I get home. Doc James  (talk · contribs · email) 00:22, 19 December 2018 (UTC)
 * If you come to an agreement, I suggest using a more precise expression than "sea change" which may not be understood by all readers. Cheers, &middot; &middot; &middot; Peter (Southwood) (talk): 04:16, 19 December 2018 (UTC)
 * This is a truly major change for that organization, and we need to revise some articles in response. I think it will be important to present the information in context (e.g., "one of several acceptable diet plans", without implying that it's the best option or the only recommended option), but it should be added.  The magnitude of the change for that org can be dealt with at the article about that org.  Articles on Type 2 diabetes and low-carb diets need, at minimum, to be revised to remove any mention of their opposition, and some of them should probably be revised to say that the ADA accepts them.  (Also:  Note that their acceptance of low-carb diets in general is not the same thing as them supporting every single low-carb or no-carb diet that's ever been devised.)  WhatamIdoing (talk) 02:11, 20 December 2018 (UTC)
 * That is reasonable. The ADA recommends MNT, and lists criteria for MNT eating plans, and then says LC diets (and other diets) meet those criteria. But, yes, they do not specifically say they "recommend low carb diets." It should also be mentioned that they have caveats for LC diets that they do not for other diets (although in my opinion those caveats also apply). It should also be pointed out the ADA indicates LC diets have shown the potential to reduce the need for medications for T2 diabetics, which they do not indicate for other diets. Finally the ADA link should be clearly identified as their Standard of Care document, not just "ADA says"CarbShark (talk) 18:22, 20 December 2018 (UTC)
 * User:WhatamIdoing what text at type 2 DM do you feel needs changing? It already say a low carbohydrate diet may improve BS control. Doc James  (talk · contribs · email) 00:07, 21 December 2018 (UTC)
 * Could you explain what difference you perceive between 'the ADA link should be clearly identified as their Standard of Care document' and 'just "ADA says"'? --RexxS (talk) 15:46, 21 December 2018 (UTC)
 * The ADA Standard of Care carries more weight than a simple ADA editorial or opinion. It's the guidance that is provided to caregivers (clinics; dietitians, etc.) and should be distinguished from the somewhat dismissive "ADA says".CarbShark (talk) 04:16, 22 December 2018 (UTC)
 * The problem with that,, is that it's pure editorialising. Your opinion is that the ADA Standard of Care carries more weight, but in fact, that's not a judgement for Wikipedia editors to make about article text (it may be a judgement to make in deciding which sources to include, but that's a different issue). Find an independent reliable source that says it carries more weight and the point can be made in the article, sourced to that independent source. Otherwise, I'm afraid that it's necessary to follow WP:NPOV and neutrally report what was stated by ADA – after all, the citation will link to the the ADA Standard of Care, so we wouldn't be hiding anything from the reader, just treating the source in the same way that we would any other. --RexxS (talk) 10:43, 22 December 2018 (UTC)
 * RexxS it is clear and obvious that the ASA Standard of Care carries more weight than a random editorial published by the ADA. This follows from WP:MEDRS where we are required to "summarize scientific consensus" and regard " practice guidelines issued by major professional medical or scientific societies" as being some of the very very best sources for WP. Have a look at Introduction: Standards of Medical Care in Diabetes—2019. It is hard to read that without thinking that this represents a gold standard of sourcing and a body whose opinions and recommendations are justified by quoting with direct in-article attribution. I have always found that the documents produced by consensus conferences or by these sorts of practice guidelines, which grade the evidence and clearly annotate their recommendations with the power of evidence behind them, to be excellent resources. Our articles should use them as foundation blocks. The claim you make "Find an independent reliable source that says it carries more weight" is misunderstanding of WP:WEIGHT, a false hurdle, and making an opponent jump through hoops that no editor here would be expected to have to jump through.
 * WP:WEIGHT doesn't require an explicit reliable source saying "ADA Standards of Care carries weight". Weight is a concept we care about, but like fame or power, many quality sources simply assume the reader knows this, rather than feel the need to mention it. Indeed you will probably find more sources explicitly praising charlatans than praising experts. Instead, WEIGHT is actually something determined by Wikipedians who are familiar with the quality sources on the article topic. Wikipedians are the ones that should know if ADA Standards of Care is widely cited in the literature and is considered authoritative -- they will know this by reading that literature and being familiar with the topic. Now, for such a huge disease as diabetes, it is not hard to find coverage explicitly and implicitly stating how important the ASA Standards of Care are. But I'm more concerned that your argument might be applied by some to rarer diseases or treatments. On such subjects, such consensus conference documents or clinical guidelines reports, are often worth quoting or paraphrasing and in-text attributing, because they really are what neurologists, etc use when deciding how to care for a patient or what drugs are recommended, when and how often to perform MRI scans, etc. They are far, far more important than some random review or a random article by a professional body, which often by definition are just the views of a few authors. It would be simply impossible to find a source explicitly praising such a guideline for a rare disease, except perhaps on a charity website, which may not be regarded as a great source. Some common sense required and acceptance that there are some editorial decisions that Wikipedians must make for themselves. We have ability to recognise an authority that speaks for medical scientific consensus and indicate that to our readers. Should, and only should, there be a disagreement in reliable sources about whether this authority is respected or represents consensus, then we consider further evidence necessary. -- Colin°Talk 12:32, 22 December 2018 (UTC)
 * , you've failed to read what I wrote, and have not grasped what is required for us to write neutral text. You may think it "clear and obvious" that a particular statement caries more weight than another, but that's just your judgement, and the moment we allow editors to impose their judgements on the text of an article, we give the POV-pushers free rein to spin articles to their purpose.
 * You have completely failed to understand the difference between the process of deciding which sources are the highest quality and most important to include in an article, which is the subject of WP:WEIGHT, and what is needed to write text based on what the sources say, rather than an editor's interpretation of them, which is the subject of WP:OR.
 * WP:OR couldn't be clearer: "all material added to articles must be attributable to a reliable, published source" and if I challenge text that explicitly draws attention to the weight due to ADA Standards of Care, then I expect the source that drew that conclusion to be produced, not some vague hand-waving about "Wikipedians are the ones that should know if ADA Standards of Care is widely cited in the literature and is considered authoritative." The job of Wikipedia editors in that area is to evaluate what sources to use, not to impose their own interpretations on the article text.
 * So it is nonsense to put forward the straw-man that WP:WEIGHT doesn't require an explicit reliable source saying "ADA Standards of Care carries weight". Nobody is asking for an third-party source to establish whether a particular source is good enough to use. But once you start writing text that contains the implication that 'ADA Standards of Care' carries more weight than another statement, you're going to have to back that up with external sourcing.
 * It does no favours to our articles to have experienced editors like yourself giving new editors a green light to write text that pushes their own POV, rather than sticking to what can be neutrally summarised from the best sources. --RexxS (talk) 13:07, 22 December 2018 (UTC)
 * RexxS, could you take your helmet and battle fatigues off for a minute and and just go read WP:WEIGHT and re-read exactly what you wrote. I'm not really interested in having an argument with someone who has done neither. Arguments about he said, no you said, no you said, no he said, are beyond tedious, and a waste of my time. I suspect you are making general claims (which I'm arguing against), while in your head think you are making specific claims about some specific point you disagree on and are engaged in a righteous battle for TRUTH against all who may destroy Wikipedia (which I could not care less about, frankly). In order to argue your specific point, you are making claims that are wrong and misleading. I have seen before editors make arguments that may just about get away with on a huge topic like diabetes or cancer, but prove inconvenient to the point of paralysis when working on minor subjects.
 * WP:WEIGHT is about the weight of statements, opinions, viewpoints, etc in article text. But you now claim that deciding sources to include in an article is the subject of WEIGHT. It isn't. That's the job of WP:V and parts of WP:MEDRS. NPOV says "All encyclopedic content on Wikipedia must be written from a neutral point of view (NPOV), which means representing fairly, proportionately, and, as far as possible, without editorial bias, all of the significant views that have been published by reliable sources on a topic." The job of deciding those POV to include and the weight/proportion to give them in articles is completely down to Wikipedians - that's why we are called editors. We make those choices by being familiar with the quality literature on a topic and a deep understanding of the article subject. We are guided in making those choices by policies/guidelines.
 * We in-text attribute viewpoints and recommendations of consensus committees or standards bodies or professional bodies all the time. Whether that's the DSM for psychiatry articles at one end of the scale, or the 'Tuberous Sclerosis Complex Diagnostic Criteria Update: Recommendations of the "2012 International Tuberous Sclerosis Complex Consensus Conference"' at the other end of the scale. The specific point/opinion that you are fighting some battle about isn't my concern here. I don't want to have to face some editor who knows nothing about Tuberous Sclerosis Complex or the literature, demand that I find an independent source that those consensus conference recommendations carry weight (or tediously, that each and any recommendation is explicitly sourced to another independent source verifying its weight) -- because frankly the "2012 International Tuberous Sclerosis Complex Consensus Group" who developed it and is composed of "79 specialists from 14 countries, was organized into 12 subcommittees" probably includes most of the specialists publishing in that field. So I'd be hard pressed to find someone "independent" who wasn't perhaps some maverick. This is my concern. The decision about what to include in various articles is down to Wikipedians who are familiar with the reliable professional literature and article subject. It isn't a simple job that can be done by a drive-by editor who is neither, and considers other editors to be opponents. I am not giving any editors green lights. -- Colin°Talk 15:07, 22 December 2018 (UTC)
 * Give it a rest, . it's blatantly obvious that you're talking nonsense yet again. WP:WEIGHT is about whether to include viewpoints in articles or not, and the extent to which they are covered, as you'd know if you had bothered to read the policy. It's really ridiculous to pretend that it encourages editors to use their own opinions to ascribe importance to one source over another. It simply doesn't. The only criterion for giving prominence to one viewpoint over another – and note that applies to viewpoints, not sources, as you mistakenly believe –  is the extent that they feature in published, reliable sources. There is no article on Wikipedia where it is appropriate for an editor to decide that source A deserves more prominence than source B simply on their own say-so. You really are getting tendentious in your efforts to promote that sort of spin.
 * We've all seen POV-pushers attributing views that they disagree with, rather than stating uncontested views as factual in Wikipedia's voice. The POV-pushers know that by attributing, they imply the possibility that there may be unstated disagreement among other equally valid sources. In this particular case, a new editor who is unaware of WP:ASF thinks that a source titled "Standard of Care" will carry more weight with the reader, and attempts to attribute the conclusions of that source in the belief that it gives their own views more weight. The solution in every case is to apply our normal standards: uncontested statements are simply presented in Wikipedia's voice; and differing statements are attributed as the respective source's opinion.
 * If you could just get your head around the difference between inclusion of a viewpoint (WEIGHT) and attempting to elevate the significance of a particular source on no other grounds than you think it's more important (OR), we wouldn't have to waste our time refuting straw-man arguments that you insist on producing. When it comes to cases like the 'Tuberous Sclerosis Complex Diagnostic Criteria Update: Recommendations of the "2012 International Tuberous Sclerosis Complex Consensus Conference"', it's quite right to argue that their conclusions should be included in a relevant article (WEIGHT). But when you start summarising those conclusions into the article in such a way that you imply they are more important than differing ones found in some other high quality reliable source, solely because of your opinion of the source's importance, then you're going to find your opinion is quite rightly challenged, and others will ask for independent proof. Your insistence that you know better than other editors makes you an enabler of every POV-pusher on the wiki, who will immediately take the same line in order to promote their pet theories. That's the green light you're giving to them all. --RexxS (talk) 18:11, 22 December 2018 (UTC)
 * I would really appreciate if you could argue without all the personal abuse and complete misrepresentation of what I wrote. As I said, I have no wish to spend my evening arguing over what I said vs what you claim I said, or over what you said, vs what you claim you said, particularly when each response only exponentially increases the misrepresentation and misunderstandings. I do wonder if you could perhaps view WP as less of a battleground, and other editors (myself included) as not just opponents to be insulted and swatted at with WP: links. Could you perhaps find a way to reach agreement with others rather than seeking to topple them? My views are far from minority let alone tendentious, but actually reflect those editors who know how to write articles, whole articles, and who approach editing by immersing themselves in the literature of an article subject, and gaining a comprehensive grasp of the topic.
 * Btw, there is much research into low carb diets for diabetes, with dozens of papers on the subject this year, and this is an area where guidelines are in flux and likely to change. A Wikipedian interested in article building, rather than fighting editors with insults, would find much to write about. The best way to ensure a topic is covered properly on Wikipedia is to write a comprehensive and accessible article with great sources. If one is only interested in preventing crappy edits to a crappy article, one fines oneself fighting and reverting rather than being able to say, for example: we already cover that point, better, and with better sources. The LCD diet article is incomplete and crappy, and editors fighting each other at it will only ensure it remains incomplete and crappy. -- Colin°Talk 18:37, 22 December 2018 (UTC)
 * FTR, "attempting to elevate the significance of a particular source on no other grounds than you think it's more important" isn't OR. It's a WP:WEIGHT violation.  WhatamIdoing (talk) 01:25, 24 December 2018 (UTC)
 * Limiting carbohydrate consumption is a traditional treatment for diabetes – indeed, it was the only effective treatment before the development of insulin therapy – and when carefully adhered to, it generally results in improved glucose control, usually without long-term weight loss.
 * A 2018 consensus report on type 2 diabetes by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) found that a low-carbohydrate diet was found to reduce requirements for medication and improve glycemic control while the Mediterranean diet and a low-carb version of the Mediterranean diet were found to have somewhat better glycemic control.
 * The ADA's Standards of Medical Care in Diabetes includes low-carbohydrate diet as a potential Medical Nutrition Therapy option for most patients with type 2 diabetes, along with Mediterranean, DASH and plant based diets. The ADA also noted there is confusion over the definition of what constitutes a low carbohydrate diet and that more longer term studies are needed.
 * CarbShark (talk) 04:16, 22 December 2018 (UTC)
 * Except that loses a lot of information as compared to the current text as tweaked by . Also the ADA is not recommending the diet as a "therapy option for most people", but specifically discuss if for use "in the short term (1–2 years) to achieve weight loss". Alexbrn (talk) 05:15, 22 December 2018 (UTC)
 * This is what I'm referring to when I say ADA is recommending diet in their standard of care. MNT = Diet.
 * In section 5, Lifestyle Management: Nutrition Therapy:
 * "All individuals with diabetes should be offered a referral for individualized MNT provided by a registered dietitian (RD) who is knowledgeable and skilled in providing diabetes-specific MNT (49)."
 * And From Medical nutrition therapy recommendations:
 * "5.6 An individualized medical nutrition therapy program as needed to achieve treatment goals, preferably provided by a registered dietitian, is recommended for all people with type 1 or type 2 diabetes, prediabetes, and gestational diabetes mellitus."
 * "5.10 There is no single ideal dietary distribution of calories among carbohydrates, fats, and proteins for people with diabetes; therefore, meal plans should be individualized while keeping total calorie and metabolic goals in mind."
 * "5.11 A variety of eating patterns are acceptable for the management of type 2 diabetes and prediabetes."
 * CarbShark (talk) 15:56, 22 December 2018 (UTC)
 * I can't make up my mind about whether it's better to call out the ADA and EASD by name, or to present it as an unattributed fact. On the one hand, information from this kind of report normally gets presented without attribution.  On the other hand, this is a significant policy shift for ADA, and the fact of their support might be valuable for some readers.  WhatamIdoing (talk) 05:28, 22 December 2018 (UTC)
 * Perhaps another hard look at WP:ASF: "When a statement is a fact (e.g. information that is accepted as true and about which there is no serious dispute), it should be asserted using Wikipedia's own voice without in-text attribution. " might help make up your mind? After all, the citation is just a click away, the same as it is for any other sourced fact.--RexxS (talk) 13:07, 22 December 2018 (UTC)
 * That's exactly the difficulty. Until the publication of this document, there has been "serious dispute" about this point.  I'm not sure that we should go from (what ought to have been) "Almost everyone except the (hugely influential) ADA accepts low-carb diets for most people with diabetes" directly to "Low-carb diets are acceptable", without an intervening note that "everyone" now, finally, after years of resistance, includes the ADA.  Otherwise, it's possible that some readers will interpret "everyone" as meaning "everyone except those stick-in-the-muds that have resisted this for so long, but who control the practice guidelines in the US".  It's really a question of who we want to educate.  WhatamIdoing (talk) 01:44, 24 December 2018 (UTC)
 * The ADA were recommending low-carb diets for weight loss back in 2008. Has their position really changed that much? Alexbrn (talk) 03:42, 24 December 2018 (UTC)
 * Yes it has Alexbrn. Weight loss and T2D are two different things. There is a lot of academic research on "TOFI" (thin outside fat inside) who are thin people and have T2D, so weight loss is not needed at all. There is also a lot of literature on very obese who have no T2D and are metabolically healthy. Weight loss and T2D have never ever meant the same thing.
 * The fact that the ADA specifically suggests that the LC is now recommended for a particular population, specifically for T2D, is a huge change. Additional points of interest (quotes from 5. Lifestyle, same session as discussed above--I bolded new stuff):
 * "5.12 Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are high in fiber, including vegetables, fruits, legumes, whole grains, as well as dairy products.
 * 5.15 People with diabetes and those at risk are advised to avoid sugar-sweetened beverages (including fruit juices) in order to control glycemia and weight and reduce their risk for cardiovascular disease and fatty liver and should minimize the consumption of foods with added sugar that have the capacity to displace healthier, more nutrient-dense food choices..." (note that this is the first time they suggest that carbs have anything to do with cardiovascular disease)
 * Under Carbohydrates section: "...monitoring carbohydrate intake and considering the blood glucose response to dietary carbohydrate are key for improving postprandial glucose control... For people with type 2 diabetes or prediabetes, low-carbohydrate eating plans show potential to improve glycemia and lipid outcomes for up to 1 year...both children and adults with diabetes are encouraged to minimize intake of refined carbohydrates and added sugars and instead focus on carbohydrates from vegetables, legumes, fruits, dairy (milk and yogurt), and whole grains. The consumption of sugar-sweetened beverages (including fruit juices) and processed “low-fat” or “nonfat” food products with high amounts of refined grains and added sugars is strongly discouraged..." and under Nonnutritive Sweeteners section: "...some research suggests an association with weight gain..."
 * I would say these changes are more than enough to update the LC page to reflect some of the changes. The new guidelines recommend low carbs diet, goes to great details on reducing carbohydrates fr glycemic control, specifically discusses refined carbs, starches and fruit juices. They should be incorporated as the 2019 Standards of Medical Care in Diabetes by the ADA recommends the LC diet short term. Astanton (talk) 23:08, 2 January 2019 (UTC)Astanton
 * I don't think it would be accurate to say the ADA are making a "recommendation" for low-carb diets. They do countenance it as an option, but say "no single approach has been proven to be consistently superior". They make the point that the kind of carbohydrate in a diet should be wholesome, and highly-refined/sugary stuff avoided - but that's not really "low-carb" so much as "right-carb" dieting. Alexbrn (talk) 06:20, 3 January 2019 (UTC)
 * agree w/ Alexbrn--Ozzie10aaaa (talk) 22:13, 4 January 2019 (UTC)
 * Ozzie10aaaa what I wrote above are direct quotes from the DAD and it specifically states: . Best not to make "judgment" over what the ADA "may think" when they clearly write in the new manual what "it is that they are recommending". That is what is in the 20119 reference guideline for diabetes care. Perhaps you should read it before criticizing based on your beliefs. It is in section 5, under "Eating Patterns, Macronutrient Distribution, and Meal Planning" look at the sentence attached to citations 62-64. It is as clear as it gets--and they are citing the very article I wanted to cite originally. This is a secondary source. From what I understand, Wikipedia regulations recommend the use of secondary or review citations. The ADA 2019 dietary guidelines are both. note: they are dietary guidelines for diabetes care and are low carbs. They meet the definition of Wikipedia in every respect. If you still judge it to be not belonging to Wikipedia, that is a clear sign pf complete bias and distortion of information--fake news in effect. It is my understanding that Wikipedia has much such fake news in it. I am hoping to clear those pages up where I have the knowledge to discover them. Cheers Astanton (talk) 07:03, 9 January 2019 (UTC)Astanton
 * it's a bit rich to attack Ozzie for not reading the source and being biased, when on the evidence before us that is exactly what you are doing. The ADA does not "recommend" low-carb diets - their noting of the diet "showing potential" over the short term is not a "recommendation". In fact what they recommend is more the opposite of the POV you are trying to push, since they say people with T2D should be "developing healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods". Alexbrn (talk) 09:10, 9 January 2019 (UTC)
 * it's a bit rich to attack Ozzie for not reading the source and being biased, when on the evidence before us that is exactly what you are doing. The ADA does not "recommend" low-carb diets - their noting of the diet "showing potential" over the short term is not a "recommendation". In fact what they recommend is more the opposite of the POV you are trying to push, since they say people with T2D should be "developing healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods". Alexbrn (talk) 09:10, 9 January 2019 (UTC)

As WAID says: 'tis the season for increased interest in our diet articles. It appears there is some kind of Facebook group coordinating an effort to change Low-carbohydrate diet, and Jimmy Wales is being petition on twitter in parallel to this. Apparently Wikipedia is controlled by vegans - who knew! More eyes on this and our other diet articles could be helpful over the festive season. Alexbrn (talk) 15:25, 21 December 2018 (UTC)
 * I came here to warn that Skeptic from Britain, briefly MatthewManchester1994, seems like he may actually be more accurately named “Vegan only diet activist from USA” and was manipulating people on-Wiki that he was a sceptic to hide his agenda. Of course I cannot reveal any personally identifying information and won’t. Vegans are posting off-wiki that they will carry on from where Skeptic from Britain left off (after he was outed off-wiki and became a vanished user) and will wage a campaign on-wiki against all diets that involve killing/eating animals. This editor has caused several articles to be deleted and may have seriously biased a wide range of articles, which is why I raise this here.-- Literaturegeek |  T@1k?  18:06, 21 December 2018 (UTC)

Wrt WP:ASF, it is not clear cut, black and white, what is an opinion and what is a fact. The decision to include specific types of diet in a management nutrition therapy is based on opinion. That it is included in ADA's choices of MNT is a fact. That's ADA's report looked at various diets and discussed their efficacy is a fact. That one diet is better than another is an opinion. The efficacy, safety, cost-effectiveness and relative attractiveness (first-line, second-line, etc) are all opinions -- were the trials large/good enough? What is the cost to society/health-service vs treatment (likely varies from country to country). What is the cost of a therapy (e.g. hiring dietitian support, paying for drugs). An "indication for" is just a medical opinion, though if it appears to be universally held, we may not bother with direct attribution and merely state it as a fact in Wikipedia's voice. Sometimes, though, it helps or is necessary to indicate that it is only "indicated"/recommended in some countries or by some bodies or some authors. That's why familiarity with the literature is needed.

Please note that this is the International English version of Wikipedia, read by people globally, so the convenience/popularity of a diet in Western English-speaking countries doesn't necessarily translate to other countries that have different eating patters or even religious restrictions on eating (something noted in the Ketogentic diet article). A quick search finds two examples: "the low carbohydrate diet is not recognized in Czech diabetology"; "All the three randomized controlled trials showed better glucose management with the carbohydrate restricted diet (vs energy restricted). Our study revealed that there is very little evidence on diets, particularly in Japanese patients with diabetes, and that the energy restricted diet, which has been recommended by the Japan Diabetes Society in the sole dietary management approach, is not supported by any scientific evidence.".

I am a bit concerned that the Low-carbohydrate diet article currently says [the ADA report] " found that a low-carbohydrate diet was not as good as a Mediterranean diet at improving glycemic control" [my bold]. I have looked at this report and cannot find any direct comparison between the two diets. Could someone point this out to me?

A look at this BMJ article suggests to me we should make more use of it in the article, which currently only uses it to highlight the difficulty of how to classify "what is a low carbohydrate diet" (again, another opinion). The paper notes that there's no one low carb diet -- they vary in quality and approach to what fats to include. Its key message says there is controversy over whether to prefer a LCD for type 2 diabetes, but that "there are calls to review this in light of emerging evidence on the potential benefits of low carbohydrate diets for weight management and glycaemic control". There are likely more guidelines and reviews that should be considered, not just the ADA. As WP:WEIGHT guides, a deep understanding how of we, as editors and writers, should include and what proportion to include, comes from familiarity with the body of literature on the topic. It does not come from finding or arguing over just one source or just one other source. -- Colin°Talk 09:30, 23 December 2018 (UTC)

break
They are all conspiracy theories being circulated on social media. The Skeptic from Britain was not a vegan. 82.132.231.126 (talk) —Preceding undated comment added 22:19, 21 December 2018 (UTC)
 * Incorrect IP editor, the last message by now vanished user, formerly Skeptic from Britain, claims the outing was correct - he stated himself that his real life name has been posted on social media and so is leaving Wikipedia, thereby admitting that he is a USA based vegan anti-animal produce activist rather than a British based Sceptic. Why would he suddenly need to change username and then become a vanished user if the outing was false? I think any articles that were deleted should be restored and a second vote/discussion had.-- Literaturegeek |  T@1k?  03:52, 22 December 2018 (UTC)
 * British sceptics spell sceptic with a letter ‘c’ whereas in the USA it is spelt with a K so even his username is a red flag.-- Literaturegeek |  T@1k?  04:41, 22 December 2018 (UTC)

FWIW, the first I heard of any concerted effort to edit or manipulate wiki pages was after this dispute started and I followed links on talk pages. I am not part of any group or team. I used to be a regular contributor to the Medical Research into LC diets page, and stopped when that was being merged here. (although I did mention this dispute in a LC fb group) CarbShark (talk) 04:16, 22 December 2018 (UTC)
 * I am concerned he has Sockpuppet accounts. It does appear, from reading social media from the vegan community, he has meat puppet activists. I am also worried about the damage he has caused by his prolific editing as I saw many established editors backing him up again and again in content disputes (obviously thoroughly taken in by his presentation as a sceptic editor) rather than challenging him.-- Literaturegeek |  T@1k?  04:45, 22 December 2018 (UTC)


 * obviously not from Britain, couldn’t spell sceptic. Roxy, the dog . wooF 16:09, 22 December 2018 (UTC)

Coda
I happened to look at Low-fat diet and what I found was alarming. This is further evidence of how diet nonsense has spilled into our content. The page was emblazoned with a warning that "Recent research has not supported the efficacy of low fat diets in lowering cholesterol and weight" and the second sentence informed readers that low-fat diets "have been shown" to cause obesity (with misrepresented source as a supporting citation). This misinformation has been there for over a year during which time the article had > 100,000 page views. Alexbrn (talk) 10:59, 24 December 2018 (UTC)


 * I believe that's true at some level, though? "Diets don't work" for long-term weight loss seems to be the current mainstream POV.  WhatamIdoing (talk) 16:09, 24 December 2018 (UTC)
 * The level it's true at is kind of the "untrue" level, especially in light of the cited source! But I believe it's right that long-term lifestyle management for weight loss is the current mainstream POV, rather than $diet-with-a-name. Anyway - I'm about to start gorging on some luxurious combination of carbohydrates, fats and proteins (not to mention alcohol). So I shall put my Wiki-despair to one side and bid you all Seasons Greetings! Alexbrn (talk) 16:28, 24 December 2018 (UTC)
 * Diets don't work is the current mainstream POV? And if so, should be be using material supporting the mainstream POV, or the scientific consensus? I haven't heard the claim about diets not working for long term weight loss outside of fat activism. Natureium (talk) 19:57, 24 December 2018 (UTC)
 * The problem is that most low fat diets equal high simple sugar diets. And high simple sugars are linked to health problems per the World Health Organization. But yah the claim that they cause obesity was a little strong. Doc James  (talk · contribs · email) 09:08, 25 December 2018 (UTC)
 * Here's a quote from course materials for a MPH program: "It is important that patients know the truth about dieting, and that we are able to guide their choices.  98% of people who lose weight gain it back within 5 years.  90% of people who lose weight gain back more weight than they originally lost.  Only 5 -10% of dieters maintain weight loss > 10% of baseline weight."  (The same page advocates for low-fat diets.)  Those numbers don't sound too different from what I've seen in other sources.  WhatamIdoing (talk) 23:47, 25 December 2018 (UTC)
 * I think this is quite important. I've been struck from the sources I've been reading for the low-carb article how unremarkable, sane and settled mainstream dietary advice is (weight loss depends on calorie restriction; a healthy diet is balanced - and oh get some exercise). I wish there was some way our plethora of exotic diet articles could be framed to make this clear. There's almost a case for invoking WP:PSCI to let us put mainstream dietary findings prominently in these diet articles. Alexbrn (talk) 16:54, 26 December 2018 (UTC)
 * My diet book, called "Eat Food, Mainly Veg", comes out soon. It has 170 blank pages. -Roxy, the dog . wooF 17:31, 26 December 2018 (UTC)
 * Along these lines, does anybody here think this source is too old? Does it meet WP:MEDRS? Abductive  (reasoning) 22:25, 26 December 2018 (UTC)
 * A 2012 paper is a bit old, but I don't think it's unusable. If a 6.5-year-old high-quality review gets high-quality content into an article, then I recommend using it.  Presumably someone will do something similar again, and we can switch to a newer (or otherwise better) paper whenever we find one.  WhatamIdoing (talk) 10:58, 27 December 2018 (UTC)
 * If anyone's in the mood for cleaning up dietspam, do feel free to take a look at Soylent (meal replacement); I've been trying and failing to work up the enthusiasm to face the fan backlash if I slash-and-burn it (and rival fad "total liquid replacement" schemes like Ambronite and Huel, although they're nowhere near as full of PR guff) for months now. Because the fad for totally synthetic diets (as opposed to long-standing schemes like Slimfast where one is still eating actual food, just consuming filling but nutritionally low products along with it to fill yourself up so you eat less) is too new and too niche for the big medical sites to be covering it yet, Wikipedia is pretty much the only point of call other than advertisers when people search for these things. &#8209; Iridescent 11:18, 27 December 2018 (UTC)
 * Perhaps is what you seek? It explicitly states "We didn’t find any systematic reviews on the long term health effects of other common diets, such as the paleolithic, Atkins, zone, Ornish, South Beach, or a gluten-free diets." It also explicitly points out that "Evidence for the benefits of fruits, vegetables, whole grains, fish, nuts, legumes, vegetable oils, dairy, coffee, and tea—and for a lower intake of red and processed meats and sugar sweetened drinks— comes largely from observational studies, which have multiple limitations." LeadSongDog  come howl!  18:46, 2 January 2019 (UTC)

Erythropoiesis and Reticulocytopenia
Dear medical experts: I was reading the article Erythropoiesis, and when I came to the part about vitamin deficiency I clicked on the link to the article Reticulocytopenia. According to the first article, vitamin deficiency can lead to Reticulocytopenia, but the second article doesn't mention this, instead discussing only scarier causes. I was just being nosy, but if someone whose doctor has actually told them they have this health problem reads the article it might worry them needlessly. Should the Reticulocytopenia article included a sentence or two about vitamins, and if so, can someone who can express it clearly and can find an appropriate reference please make this change? Thanks.&mdash;Anne Delong (talk) 16:20, 8 January 2019 (UTC)


 * Thank you for the interesting question. I took a quick look, and I think that these are actually different.  AFIACT with a quick look, the term (which ought to mean "not many new RBCs for any reason at all" according to its name) is actually used specifically to mean "sudden stop in RBCs production due to infection with Parvovirus B19".
 * And if my impression is wrong (always possible), then we probably ought to have two articles, maybe Aplastic crisis for the Parvovirus B19 thing and Reticulocytopenia for everyday garden-variety reductions in RBC production. WhatamIdoing (talk) 07:45, 9 January 2019 (UTC)


 * I'll take a look at the articles in question when I get a chance, but aplastic crisis is not specific for parvo B19 infection, and can also describe a halt in RBC production associated with sickle cell anemia and other conditions. Similarly, "reticulocytopenia" (relative reduction in RBC production) is descriptive rather than specific to a cause. &mdash; soupvector (talk) 22:53, 9 January 2019 (UTC)

What are 'primary sources' and why are they unacceptable?
I've noticed that 'primary sources' are being frowned upon. I'm trying to write a stub of Cerebral folate deficiency. As far as I understand, the majority of research into cases of CFD (allegedly) caused by antibodies to the folate receptor has been carried out (and was pioneered) by a group led by Ramaekers et al. Would the inclusion of their papers as references be incorrect? Do I need instead rely on reviews written by other scientists? -- C opper K ettle  13:06, 7 January 2019 (UTC)
 * Read WP:MEDRS for acceptable sources on medically related topics. -Roxy, the dog . wooF 13:10, 7 January 2019 (UTC)
 * As well as WP:MEDRS, WP:WHYMEDRS gives some useful background. There's a (draft) attempt to describe when primary sources are useful at WP:MEDFAQ. Alexbrn (talk) 13:11, 7 January 2019 (UTC)
 * Thank you! -- C opper K ettle  14:21, 7 January 2019 (UTC)
 * For this situation, I think the key sentence in MEDRS is going to be "These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or where few reviews are published."
 * MEDRS has a blind spot for rare diseases. WP:N declares something with just a few journal articles to be worthy of a separate article, but a strict reading of MEDRS won't let you put anything in that article.  So keep in mind that while primary sources are generally discouraged, they're not outright prohibited.  MEDRS is written so that a new editor can find out what to do when updating an article like Hypercholesterolemia.  It is not written to help you find out how to update Oculodentodigital dysplasia (which has ~100 patients worldwide, which is five times as many known cases as CFD).  If you're working with a rare disease, please get as close to the ideal as you can – but you also need to write an encyclopedia article with the sources that actually exist, and we need to back off and let you do that.  Blanking apparently accurate and sourced information "per MEDRS" in such a situation harms the project.  WhatamIdoing (talk) 17:38, 7 January 2019 (UTC)
 * Remember also that "secondary source" is not the same thing as "MEDRS compliant". There are a lot of people who use "primary source" as "not MEDRS source" among many other incorrect interpretations, too, so be careful what they are actually referring to. Jo-Jo Eumerus (talk, contributions) 17:47, 7 January 2019 (UTC)
 * An excellent and important point, Jo-Jo. If something like Men's Health (British magazine) were to run an article telling readers how to decide if they should discuss CFD with their doctors, it would be secondary, independent, and completely unusable for any medical claims whatsoever.  WhatamIdoing (talk) 17:59, 7 January 2019 (UTC)
 * Thank you for all the explanations! The problem with CFD is that in some studies (autism, depression, even schizophrenia) a sizeable proportion of treatment-refractory patients have been found to meet the "low CSF 5MTHF\anti-FRa antibodies" criterion for CFD, which might make it much more common, if confirmed. However, as the history of psychiatric research tells us, this may turn out a dud. I'll look for secondary sources on that count then - but here again, what if a review is written by the same Ramaekers who pioneered the majority of studies? Will such a review be acceptable per MEDR? Less controversially, CFD has been reported in mitochondrial diseases, especially in the Kearns–Sayre syndrome, which alone increases its prevalence beyond 20 persons/world. -- C opper K ettle  18:50, 7 January 2019 (UTC)
 * It may be that the same or a closely related topic is discussed by a different name in the literature. Reviews such as https://www.mdpi.com/1422-0067/19/12/4068 or may be helpful to some extent to confirm individual, though we must be careful to avoid wp:SYN.LeadSongDog  come howl!  22:48, 7 January 2019 (UTC)


 * And I'd be very weary of using an MDPI journal for a review... Headbomb {t · c · p · b} 01:47, 8 January 2019 (UTC)
 * Why might an MDPI journal be not up to the task? -- C opper K ettle  16:09, 8 January 2019 (UTC)
 * Read MDPI. Also (another draft) WP:CRAPWATCH is under construction. Alexbrn (talk) 16:27, 8 January 2019 (UTC)
 * Do books dedicated to some topic and written by a doctor count as good secondary sources? I want to add a mention of the possible role of auto-antibodies in the development of symptoms to the Cerebral folate deficiency article. There is a 2012 book written by Phillip L. Pearl and titled Inherited Metabolic Epilepsies, page 3:
 * "Cerebral folate deficiency has been associated both with auto-antibodies and gene mutations of the folate FR1 receptor.[..] This disorder is covered in more detail in Chapter 22 by Dr Fernando Scaglia"
 * Would this serve as a reputable source? -- C opper K ettle  19:07, 9 January 2019 (UTC)
 * This looks like a reference work by Demos Medical Publishing, which should be reliable for most purposes. A book written by a physician specifically patients can be a weaker source (unless you're writing patient-centered content, in which case it may be stronger than an academic paper).  BTW, the cite journal template will let you cite the author and title of a specific chapter, plus the editor for the whole book, and this is sometimes appropriate, especially in reference books. WhatamIdoing (talk) 07:54, 10 January 2019 (UTC)

Lateral motor column neuron
Hello, looking for advice about Lateral motor column neuron - should it be merged to motor neuron, or does it belong as its own article? &spades;PMC&spades; (talk) 22:19, 10 January 2019 (UTC)
 * And on the topic of neurons, any thoughts about Medullary inspiratory neuron? &spades;PMC&spades; (talk) 22:55, 10 January 2019 (UTC)
 * Both are stubs. I would support merging User:Premeditated Chaos Doc James  (talk · contribs · email) 02:44, 11 January 2019 (UTC)
 * The lateral motor column neurons article is unsourced, and I'm not finding much in the way of sources on a search. There's nothing on PubMed, and what's on Google Books/Google Scholar seems...not explanatory? I redirected that one to motor neuron for now.


 * I also redirected medullary inspiratory neuron to respiratory center, which contains information about the topic as a whole - it's one of those cases where it doesn't seem helpful to expand the narrow topic in the absence of context. Since the medullary inspiratory neuron article doesn't make it clear if it refers to the dorsal or ventral respiratory group, I redirected it to the topic that covers the whole. While we're here, looks like the sub-topics Dorsal respiratory group and Ventral respiratory group have been proposed for merge into respiratory center for over a year now with no one commenting. Could some MED people possibly give their thoughts just so that can either get done, or declined? &spades;PMC&spades; (talk) 15:51, 11 January 2019 (UTC)
 * Dorsal respiratory group and Ventral respiratory group should not be merged...IMO--Ozzie10aaaa (talk) 11:53, 12 January 2019 (UTC)
 * Both the DRG and VRG are small articles and already mostly covered at RG. I am generally supportive of merging in such cases. Doc James  (talk · contribs · email) 17:15, 12 January 2019 (UTC)
 * they are small articles, however per and could remain separate...IMO--Ozzie10aaaa (talk) 19:09, 12 January 2019 (UTC)
 * Just to say that I have just merged these before reading this. See no reason for opposing merge.? --Iztwoz (talk) 21:17, 12 January 2019 (UTC)
 * Have just had a look at the articles Ozzie linked - these are good and I would be happy to go through these sometime to make additions to the page. If the items became top heavy then a split could be possible. But I cannot download them (subscription needed) can the links be left somewere.--Iztwoz (talk) 21:27, 12 January 2019 (UTC)
 * Downloads not a problem - just needed to make an account.--Iztwoz (talk) 21:34, 12 January 2019 (UTC)
 * thanks Iztwoz--Ozzie10aaaa (talk) 21:42, 12 January 2019 (UTC)

Proposed merge
There is a discussion on the talk page. See Talk:Electronic cigarette aerosol and liquid. QuackGuru ( talk ) 22:06, 8 January 2019 (UTC)

Proposed change
See Talk:Electric smoking system. QuackGuru ( talk ) 00:07, 13 January 2019 (UTC)

Digital dependencies and global mental health
Hi wikiproject medicine. I need some help with how we get the very neutral very reliable sources on either this page, or social media addiction. At the moment, medicine is completely out of it. I need to develop consensus, or the articles as they stand, appear to be quite medically useless. Thanks! I know we can do it, it just involves careful thought, and we all need to consider own own cognitive bias, myself especially. E.3 (talk) 12:56, 12 January 2019 (UTC)
 * might help--Ozzie10aaaa (talk) 11:08, 13 January 2019 (UTC)

Adding an educational video on 3 rare diseases
I tried adding an educational video link on creatine deficiencies (a group of three rare diseases) to the pages relevant with the reference and everything. I am told I cannot add the same video to multiple pages because it is considered spam. The video covers the symptoms, signs, and diagnostic of all three diseases. These diseases are massively under diagnosed and most of the times it takes years until families find a doctor that knows what they are so the video reference is very important for families and for medical professionals.

From my perspective it seems to make sense then to have the video linked in the independent conditions (AGAT, GAMT, CTD) and the main creatine deficiency article. I had added it to the main creatine page under the creatine deficiency section and I can see how that might be too much to list it there. What about the rests? I am the parent of child with one of the rare diseases so yes I do want this information to be available to other parents like myself who looked on wikipedia when they got a diagnostic. What is your suggestion on how to best include this information? --Auract (talk) 23:52, 7 January 2019 (UTC)
 * Is it possible to get the videos released under an open license User:Auract? Doc James  (talk · contribs · email) 01:43, 8 January 2019 (UTC)
 * User:Natureium, what makes you think that using the same (relevant) external link on multiple articles is spam? WP:LINKSPAM needs a thorough re-write (which I'll get to someday... probably...), but it doesn't say anything about that, and I'm not aware of any rule elsewhere against using the same link on three articles, either.  WhatamIdoing (talk) 10:59, 8 January 2019 (UTC)
 * I had moved the videos from the body text to the See also section, which maybe should have been renamed external links. The video should probably be on the three disease specific pages and cerebral creatine deficiency. It is directly relevant to each of those articles.  Canada Hky (talk) 13:41, 8 January 2019 (UTC)
 * When I removed the videos, they had been posted to 7 different articles. I find it hard to believe that the same video is directly relevant to seven different topics. I am not opposed to them being attached to three articles, provided all three conditions are discussed in detail in the video. Natureium (talk) 14:38, 8 January 2019 (UTC)
 * It would be great if editors on the project were able to expand the articles to clearly include the points made in the video, where appropriate. I'm not clear why Doc James thinks an open licence is relevant to whether we should link to it. -- Colin°Talk 15:37, 8 January 2019 (UTC)
 * I am working on expanding the set of four articles (slowly), and can use the video as a source when needed. The video itself is a good avenue for people who prefer watching to reading though.  Canada Hky (talk) 15:45, 8 January 2019 (UTC)
 * A good video can be appropriate in the ==External links== section. We don't usually favor them for refs that support medical information.  WhatamIdoing (talk) 16:17, 8 January 2019 (UTC)
 * That's fine. This all could have been avoided by renaming the "See also" section to "External links" - which was my initial error.  Canada Hky (talk) 16:23, 8 January 2019 (UTC)
 * I wouldn't say "this all could have been avoided", because my problem with this initially was having it added to 7 different articles. Natureium (talk) 16:33, 8 January 2019 (UTC)
 * Thanks everyone for the very healthy conversation here and for clarifying some points. User:Canada Hky it sounds like your suggestion to make them external links (rather than see also) is the way to go and has everyone's blessing.Auract (talk) 20:34, 8 January 2019 (UTC)
 * To address User:Natureium point, there's the umbrella diseases called creating deficiencies, the three rare diseases it represents, and the three genes + creatine itself. Now, what I am seeing on other gene pages (and the creatine page itself actually) is that they have sections that talk about the clinical significance or pathology of the gene, and thus the deficiency. Is the video too much there? Regardless of the answer, perhaps we can then get some help to improve the gene pages (like SLC6A8) for creatine deficiencies too to be more complete and include information for pathology and function? I am happy to try to make some edits because I do have a very personal motivation to make sure we know a lot more about these genes and rare diseases. I'll need some help and support since I am not a versed wiki user. Who volunteers to help me?--Auract (talk) 20:34, 8 January 2019 (UTC)
 * Annotating the link with the name of the organization, its tax status, and other chatter pushes this well over the line for me into the realm of spam regardless of the content of the videos. I cannot view the video, but is it actually high-quality content (in terms of WP:RS)? Advocacy groups can have vested-interest/NPOV problems. DMacks (talk) 07:36, 9 January 2019 (UTC)
 * DMacks Annotating the video with the name of the org is my bad. I do not know the wiki conventions and I thought that is the reasonable way to show that this video is coming from a reasonable source. I assume from this conversation it is not. To your point and Colin point, the video provides diagnosis criteria and describes signs and symptoms including showing these in real children. As someone else in this thread pointed out (perhaps User:Canada Hky, different individuals digest information in different ways so a video description is valuable. Colin, can you please explain your position of why you think this is not a reliable source? Do you have any medical background? Auract (talk) 14:47, 9 January 2019 (UTC)
 * I have watched the video. It follows the TV documentary approach of having several parent's vignettes about their sick children, and several talking heads of doctors who presumably are specialists in this condition giving some information about it. It concludes with a short advocacy section encouraging the adoption of testing babies around birth to identify those affected. I don't think it counts as a reliable source. Btw the master and child articles are:
 * Cerebral creatine deficiency
 * Creatine transporter defect
 * Arginine:glycine amidinotransferase deficiency
 * Guanidinoacetate methyltransferase deficiency
 * The master article (and the above discussion) wrongly links to Arginine:glycine amidinotransferase which has a sub-section on the deficiency that arguably could be trimmed to be a short summary and link to the deficiency article. The three child articles seem quite well developed, if a bit technical and non-parent-friendly. The merit of including the external link seems lowish, perhaps for the master article at present while it remains stubby. If there is anything the doctors mention that isn't in the article, I don't think it would take someone long (with access to sources) to remedy that. If there is comprehensive information created by a charity, I'd rather link to that bit of the website, than directly to you YouTube video. Less likely to go stale too. -- Talk 11:44, 9 January 2019 (UTC)
 * User:Colin Are gene articles supposed to have links on the pathology? I see pages that do and one of my points above is that we can perhaps try to bring the three creatine deficiency genes to the same standards. Do you agree? Auract (talk) 14:47, 9 January 2019 (UTC)
 * I'm not sure what you mean by "gene articles" here. Did you mean Arginine:glycine amidinotransferase, which is on the enzyme? There isn't a problem discussing some aspects of deficiency in that article, but really the Arginine:glycine amidinotransferase deficiency article is where to go into detail. Wrt the video, I'd have to watch again but I don't recall video being a vital component of showing signs and symptoms in real children -- some children featured but to be honest they could have any number of conditions, which I guess is why it was hard to diagnose. Wikipedia is a text-based encyclopaedia at heart, so we really want to explain all these things in text. Pictures of visible things like MRI scans or physical visible symptoms can be useful if appropriate. A short video clip of a feature of the disease, such as a seizure, can be useful. But while I agree "different individuals digest information in different ways" the way you're going to get information from Wikipedia is mainly by text. That's what we do best, and what we can all collaborate on to improve and cite our sources. It isn't really part of our external links policy to link to an audio-visual version of the same information, even if you think some people prefer the video format. I suggest you read WP:MEDRS, WP:RS and WP:V about what makes a reliable source. -- Colin°Talk 09:22, 10 January 2019 (UTC)
 * Colin, yes I meant the pages about the 2 enzymes and 1 transporter protein (which are named after their encoding genes) that in other examples seem to mention the deficiency. Compare this page SLC6A8 or this one Guanidinoacetate N-methyltransferase with NGLY1. Prompted by this conversation about the completeness of these articles, I am arguing the gene pages (2 enzymes and transporter) should have more details, including a section on function and pathology. Will you Colin help me improve these pages? Auract (talk) 20:31, 11 January 2019 (UTC)
 * I will try to summarize the discussion here so we move forward. WhatamIdoing,DMacks, and Canada Hky you seemed to think the video information is relevant correct? Natureium thinks it's useful but does not need to be on 7 articles (which I agree and I hope we improve the other three page that discuss the protein&enzymes without having to link to the video). Colin is skeptical that the video adds anything. Doc James made the point I should let others add the video since I volunteer for the parent advocacy group. As the parent of a kid with this rare disease I will be very persistent to get these pages to be as informative as they can so please do help me out to improve them. Teach me about wikipedia editing etiquette and I'll teach you about creatine deficiencies.Auract (talk) 20:31, 11 January 2019 (UTC)
 * I very clearly stated I did not view the video and was therefore taking no position on if it was appropriate (I did not comment on "relevant"). Based on those who have commented on the content, I now oppose linking in WP:EL or similar, but obviously no objection to someone using the content to find WP:RS for writing article content. DMacks (talk) 23:25, 11 January 2019 (UTC)
 * I don't think it is right to take a stance one way or the other on a specific video that you haven't watched. I think it is appropriate and relevant to the three specific disease pages and the overall CCD article.  My personal plan for the year is to get those articles to GA status, due to increasing interest as GAMT deficiency starts being included in routine newborn screening around the world.  Since Wikipedia is usually the first google hit, we are providing a service by having the encyclopedia be accurate and up to date.  However, given that the video is also accurate and up to date, providing the opportunity for likely worried families to absorb the information in a different media seems appropriate.  I'm open to holding off on adding the video until the pages have been further expanded, so it doesn't appear to have undue weight on articles which are right now somewhat short.  Canada Hky (talk) 15:31, 12 January 2019 (UTC)
 * Canada Hky, the relevant policy for whether to include the video is WP:EL. I think if you get those articles to GA status (comprehensive, well sourced, etc) then the video will as a consequence clearly fail WP:EL. That's my opinion and others may disagree. I think there is a stronger argument for the video while it contains relevant information an article lacks. Sorry, but there are specific rules about links from WP and they go beyond being "educational" and meeting preferences of people who like videos vs text, etc. There is simply too much of the internet that could be linked to, and we have Google and relevant charities/health bodies who can do that job. DMacks was clearly originally only commenting on the text that appeared on the article alongside the link, but I agree that I don't think he should "vote" oppose the link based on secondhand comments (even if mine). -- Colin°Talk 10:57, 13 January 2019 (UTC)
 * Agree to disagree. I see nothing on the External Links policy that would forbid the video in question.  Canada Hky (talk) 13:54, 14 January 2019 (UTC)
 * Canada Hky, I believe he meant that (in his opinion), the video "merely repeat[s] information that is already or should be in the article", which according to WP:ELNO is exactly the kind of link that isn't normally wanted.
 * If I may make a more procedural (and optional) suggestion, at this point, it might be more appropriate to continue these conversations on the article talk pages with anyone who is interested enough to watch those pages, or to take it to the External links/Noticeboard if normal talk-page discussions aren't able to resolve the question. WhatamIdoing (talk) 14:17, 14 January 2019 (UTC)
 * Auract, I'm glad you are keen to work on improving the articles, and hope you can work with Canada Hky on that. I would like to be in a position to help you but my circumstances make it hard/unfair for me to promise you anything. I have very limited free time for article work, already have a commitment to work on Tuberous sclerosis, and don't have direct access to the medical research/review papers and books you will need. I suggest that this section has got bogged down discussing the video and you'd be better starting a new section on article improvement. You could start by reading the main and related articles on these conditions, and noting down issues you find on the article talk pages. For example, if there is information missing, note that what is missing. You can mention stuff on the talk page without having to find WP:MEDRS sources -- then someone can help with that bit. And if you think the text is too hard for a parent to read (which is the "general reader" Wikipedia is aimed at) then mention that too and make suggestions. Keep doing that as you get braver to edit the article itself. If there are disagreements, discuss on the talk page rather than reverting. As for searching for sources and getting access to papers from journals, there's a whole WP:Medicine project here who can help. Books are harder, as I know professional books can be very expensive, but if you or someone here has access to a university or medical library, then they might be able to help with specific requests. So, I think you should start with the article talk pages and then create a new section here to request help from WP:MED members to help with the improvements you seek. Btw, Auract, if you put something on your user page, it will no longer be a "red link" and you may find that gets a better response -- it make it look like you are here to stay. No need to reveal any personal stuff, just perhaps your interests on WP. -- Colin°Talk 10:57, 13 January 2019 (UTC)

New editor motivations
If you are interested in the subject of new editors and their motivations, please see Wikimedia Research/Showcase for Wednesday's Research Showcase. The YouTube version will be at https://www.youtube.com/watch?v=Fc51jE_KNTc WhatamIdoing (talk) 17:36, 14 January 2019 (UTC)
 * good info, thanks WAID--Ozzie10aaaa (talk) 13:15, 15 January 2019 (UTC)
 * Thanks for sharing. I will do my best to catch this! JenOttawa (talk) 14:53, 15 January 2019 (UTC)

"Vital" rating of 2 medical articles
Your input is welcome: WT:Vital articles/Level/4.  Seppi  333  (Insert 2¢) 23:45, 30 December 2018 (UTC)


 * more opinions(gave mine)--Ozzie10aaaa (talk) 11:52, 1 January 2019 (UTC)

This still needs additional input to generate consensus (a proposal like this needs a minimum of 5 support/0 oppose to pass).  Seppi  333  (Insert 2¢) 01:18, 17 January 2019 (UTC)
 * Good catch - I've given my support. That should meet the consensus guidelines now. --Atcovi (Talk - Contribs) 02:47, 17 January 2019 (UTC)

Does Cerebral folate deficiency merit a separate article?
I've read several dozen research articles and reviews on Cerebral folate deficiency. I'm thinking of starting a separate article with that name. Do you think it's worth it, or is it better to add first a section in Folate deficiency? --- C opper K ettle  06:03, 6 January 2019 (UTC)
 * P.S. I've read the Folate deficiency article and I'm now certain that Cerebral folate deficiency should have a separate page. I quote: "Cerebral folate deficiency (CFD) may be defined as any neurological syndrome associated with a low cerebrospinal fluid (CSF) concentration of 5-methyltetrahydrofolate (5MTHF) in the presence of normal peripheral folate metabolism (Ramaekers and Blau 2004)." --- Hence it's better not to muddle the issue by heaping them together. -- C opper K ettle  13:32, 6 January 2019 (UTC)
 * Be_bold--Ozzie10aaaa (talk) 13:43, 6 January 2019 (UTC)
 * I think not - those authors seem to be alone in their assertion of this as a separate entity. Perhaps FWIW (not a MEDRS) this exchange of letters in the NEJM regarding primary vs secondary. It appears that the deficiency described by the Ramaekers and Blau responds to folinic acid supplementation. Absent secondary MEDRS from other authors, I would add some material to the existing folate deficiency article. &mdash; soupvector (talk) 14:44, 6 January 2019 (UTC)
 * But there are other authors. When I started reading about the syndrome, I started two MS Word documents, in one of which were only articles by Ramaekers et al., in the other, papers published by other groups. And I have quite a lot of them by now (by other groups). I've started the page, you can take a look. -- C opper K ettle  15:21, 6 January 2019 (UTC)
 * I've also been doing further reading and have amended my earlier objection. This quotation embedded in the text of a systematic review may be helpful (and possibly support a separate article, though I think it's better incorporated into the current one): 5-methyltetrahydrofolate (5-MTHF) is an essential cofactor for methylation reactions in the brain and other organs via S-adenosylmethionine. It participates, for example, in the catabolism of dopamine to its final metabolite HVA. Cerebral folate deficiency (defined as low CSF 5-MTHF values with normal blood folate status) has been described as associated with different neurogenetic and environmental conditions (Pérez-Dueñas et al. 2011) and specifically to some mitochondrial disorders (Garcia-Cazorla et al. 2008a).
 * Note that peripheral blood folate levels can be challenging to interpret - I encounter this often in clinical practice and teaching - because they fluctuate significantly with changes in dietary intake and often don't represent tissue levels. RBC folate measurement can be more useful if done carefully, but has specific demands for sample handling and analysis that may be challenging in settings where these issues often arise. Our current folate deficiency article could benefit from expansion on this topic. Here's a relevant quote: When combined with a clinical picture of megaloblastic anemia and additional results of cobalamin levels, the serum folate concentration is the cheapest and most useful initial biochemical test to diagnose folate deficiency (see Table 39.2 ). The serum folate level is highly sensitive to folate intake, and a single hospital meal may normalize it in a patient with true folate deficiency. Rapidly developing nutritional folate deficiency first leads to a decline in the serum folate level below normal (less than 2 ng/mL) in about 3 weeks; it is a sensitive indicator of negative folate balance. However, isolated reduction of serum folate level in the absence of megaloblastosis (i.e., false-positive result) occurs in one-third of hospitalized patients with anorexia, after acute alcohol consumption, during normal pregnancy, and in patients on anticonvulsants  ; unfortunately, these are the very groups at high risk for folate deficiency and the people who exhibit low serum folate levels when they become folate deficient.  Conversely, in 25% to 50% of cases (predominantly alcoholics) with folate-deficient megaloblastosis, the serum folate levels may be below normal or borderline (2 to 4 ng/mL).  The serum folate level alone should never dictate therapy. It is important to consider the clinical picture, peripheral smear, and bone marrow morphology and also to rule out underlying cobalamin deficiency.
 * Thank you for the links! I've read that cerebrospinal 5-MTHF levels can be also hard to interpret, because the normal range is a "moving target" - in one study the authors write that in normal persons the levels decrease with age, so they adopted several normal ranges for several different age groups. And 5-MTHF can variate with time in persons with anti-FOLR1 antibodies. I'll make a stubby version, and will try to read up later. --15:44, 6 January 2019 (UTC)
 * The article doesn't seem neutral with respect to mechanism, e.g. the sources I cited above note that: (i) serum folate levels aren't a reliable measure of total-body folate stores due to wild fluctuations, (ii) response to supplementation suggests that the purported block in transport is at most a relative block. The problem is pervasive in the article, starting with this sentence in the lede, The numerous causes of the syndrome disrupt folate transport via the choroid plexus. Good luck with this! &mdash; soupvector (talk) 19:17, 6 January 2019 (UTC)

Looking at the literature we have https://ghr.nlm.nih.gov/condition/cerebral-folate-transport-deficiency aswell as a bunch of review articles. So yes I think it deserves its own article. Only 20 cases described so not common. Doc James (talk · contribs · email) 14:24, 7 January 2019 (UTC)


 * But it is observed in Kearns–Sayre syndrome and other mitochondrial diseases, and antibodies may cause it in adults, so it might turn out quite common if the research is replicated. And the FOLR1 gene is not the only gene whose mutations lead to the deficiency, there's SLC46A1 too. --- C opper K ettle  15:00, 7 January 2019 (UTC)
 * for the time being...it deserves its own article--Ozzie10aaaa (talk) 11:45, 17 January 2019 (UTC)

Conscious breathing
The Conscious breathing article clearly touches on medical topics, and could do with a review. The AfD for coherent breathing might also be of interest. -- The Anome (talk) 15:40, 7 January 2019 (UTC)


 * It's always tempting to look at something like this (especially considering the present state of the article) and shout "pseudoscience!" and "altmed!", but it seems to be mainstream medicine in addition to a traditional meditation practice. This paper says that it's helpful for "patients whose asthma continues to cause symptoms and quality-of-life impairment, despite adequate pharmacological treatment, or who have high bronchodilator use, should be offered access to an effective breathing training programme as a part of holistic, integrated asthma care", and Cochrane then says that they can't actually figure out whether it works in children, because it's impossible to separate the effect of the breathing exercises from the effects of the rest of that "holistic, integrated asthma care" program.
 * This article is going to be best handled by someone who is comfortable working in both the "science" and "spiritual" subject areas. WhatamIdoing (talk) 17:54, 7 January 2019 (UTC)


 * concur Ozzie10aaaa (talk) 12:02, 17 January 2019 (UTC)

Might've wasted 30 minutes forming this small "symptoms" section...
Hey. Sorry -- I'm relatively new to editing Wikipedia and I have a very huge interest in medicine. I saw West Nile virus and was eager to add a symptoms section to a seemingly under-developed article. Little did I know, there was a West Nile fever article, which contains an extremely thorough section explaining the symptoms of the WN Fever...

Though I personally believe my section on symptoms for the WNV shouldn't really be removed because it seems to be a simpler explanation of the symptoms (such as the prevention section on the WNV page) and the WNV page receives a lot more views than the WN Fever page (so, people wanting to find symptoms on the West Nile virus can easily fulfill their need by checking the symptom section I wrote).

But alas, I'm new to this whole "Wikipedia-editing" business, so, I'm asking the WikiProject Medicine community on this. Thanks for the comments. --Atcovi (Talk - Contribs) 18:30, 15 January 2019 (UTC)
 * Both those sections should really be merged into the other article and removed from the virus one. Doc James  (talk · contribs · email) 02:44, 16 January 2019 (UTC)
 * Understandable. When time permits, I will work on merging both sections into the "fever" article (unless someone else it before me). --Atcovi (Talk - Contribs) 02:46, 16 January 2019 (UTC)
 * Don't you think that an article about a pathogen ought to have a section on diseases that it creates (whether human or otherwise), beginning with a link, and providing a quick summary (common vs rare, basic symptoms, prognosis, etc.)?  WhatamIdoing (talk) 15:17, 16 January 2019 (UTC)

Well, yes, now that I've looked through this and several other virus pages. --Atcovi (Talk - Contribs) 16:06, 16 January 2019 (UTC)
 * Yes a couple paragraph summary of the disease would be useful. Just needs to be labeled as such and kept to a summary. Doc James  (talk · contribs · email) 16:32, 16 January 2019 (UTC)
 * WP:VIRUS recommends a section called ==Diseases==. Atcovi, would you like to try doing that?  In between the == Diseases == section heading and the paragraph(s) you write, paste this code:    to get a fancy link to the main article on the disease.   WhatamIdoing (talk) 02:22, 17 January 2019 (UTC)
 * I'm delighted to go ahead and work on this when my already-existing workload has been diminished. Thank you. --Atcovi (Talk - Contribs) 02:46, 17 January 2019 (UTC)
 * I have started a section. Feel free to adjust further. Doc James  (talk · contribs · email) 02:49, 18 January 2019 (UTC)

Category:Case reports journals
I just created this. If you know of journals that would belong in that category, please add them. Headbomb {t · c · p · b} 19:54, 18 January 2019 (UTC)
 * Do we need to be categorizing redirects? Natureium (talk) 20:00, 18 January 2019 (UTC)


 * Don't see why not. I excluded the predatory ones like Clinical & Medical Case Reports and Case Reports in Clinical Medicine though. Headbomb {t · c · p · b} 20:06, 18 January 2019 (UTC)

Moving "Hymenorrhaphy" to "Hymen reconstruction surgery"
Opinions are needed on the following: Talk:Hymen reconstruction surgery. A WP:Permalink for it is here. Flyer22 Reborn (talk) 08:33, 15 January 2019 (UTC)


 * give opinion{gave mine}--Ozzie10aaaa (talk) 11:32, 19 January 2019 (UTC)

New User -- Edit to Management of Parkinson's disease
Hello! I'm new to the Wiki community. I saw there was no info on telemedicine/remote heath on the Management of Parkinson's Disease page, so I added some information about teleneurology research. Would someone mind taking a look at my addition? — Preceding unsigned comment added by Spreadsheetz (talk • contribs) 16:31, 17 January 2019 (UTC)
 * , both sources are reviews--Ozzie10aaaa (talk) 00:13, 20 January 2019 (UTC)

The Global Burden of Disease is a massive database of diseases with epidemiological figures: Should it be on Wikipedia?
From the GDB website you can get an enormous set of data for diseases where you can get their prevalence, incidence, sex ratio, age distribution for almost all countries in the world. You can have a visualization tool to get the scale of the project: https://vizhub.healthdata.org/gbd-compare/

And best of all, all these data are under the Open Data Commons Attribution License (http://www.healthdata.org/about/terms-and-conditions).

In fact, most of these data are already inside Wikipedia, because links to this site are often found in the "epidemiology" section for a great number of disease pages on Wikipedia. But I'm asking myself about a more complete use of these data. What about a massive table with all the prevalence for each country for example, with sex ratio? or one about incidence?

Thanks for your opinon about this! Linuxo (talk) 20:20, 4 January 2019 (UTC)
 * I'm rather dubious about simply replicating an outside source, if it provides the information in a way that is easy to find. Many pitfalls there. Better to have links on our articles, and some smaller tables at places. There are also many notorious problems about interpreting such international data. Johnbod (talk) 20:34, 4 January 2019 (UTC)
 * good points! The thing is it's not so "easy to find" on GDB. I've found this site by chance for example (Google robots are at lost: try "Appendicitis prevalence" and you never will get this site) and in addition, there's no API to SPARQL to it. It would be so great if there was some "Wikidabase" where to put all this massive amount of data. Wikidata extracts data from wikipedia but doesn't store itself that's why I was thinking about storing it in wikipedia pages.Linuxo (talk) 05:24, 5 January 2019 (UTC)

They are not using an open license "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" User:Linuxo

The license issues would need to be figured out first. Doc James (talk · contribs · email) 10:54, 5 January 2019 (UTC)
 * It's an Open Database License. We can't use it? Linuxo (talk) 11:18, 5 January 2019 (UTC)
 * It is not clear. It says "by non-commercial users via the Open Data Commons Attribution License."
 * No one knows what "non-commercial" means and therefore the community has decided not to allow it. Doc James  (talk · contribs · email) 15:02, 6 January 2019 (UTC)
 * agree w/ Doc James--Ozzie10aaaa (talk) 11:56, 20 January 2019 (UTC)
 * As a rough guide to whether we can use something on Wikipedia, "If I reprinted this entire work myself and sold in on Amazon, crediting it to the author but keeping all the money for myself, would they complain?" is the thought experiment you need to be performing. &#8209; Iridescent 15:26, 6 January 2019 (UTC)
 * If you wanted to copy the database, or to come up with an automated way to extract specific bits of information from it for use, citing the GDB as the source, then you probably need to be talking to Wikidata. (Why, oh, why don't they have a well-documented API?)
 * But I don't think that databases belong here in Wikipedia. We want sentences like "n people develop appendicitis each year" (followed by a citation).  We don't want raw data.  WhatamIdoing (talk) 20:45, 6 January 2019 (UTC)


 * The Open Database License does not impose a non-commercial condition. It's an BY-SA sort of license. The Global Burden of Disease database licensing as described does not make sense. I could use graphs derived from this data in multiple articles, and if they were linked to the data, they would be much easier to update. HLHJ (talk) 05:48, 13 January 2019 (UTC)


 * I like the data and want it in Wikipedia. It would take a series of activities over time to make this happen.
 * Data like this starts in Wikidata, not here in English Wikipedia. The Wikidata community has expertise in accepting, curating, and reusing data, including making it available for presentation here in English Wikipedia. For your project to go forward first share ~5 datapoints here in English Wikipedia, then upload a test dataset into Wikidata, then seek community conversation with all these example cases. There is no replacement for a live example in conversation.
 * The Open Data Commons license from Open Knowledge International is incompatible with Wikidata for not being open enough. License incompatibility typically halts projects until and unless you can persuade the rights holder to release the content under a more open license.  Blue Rasberry   (talk)  19:27, 15 January 2019 (UTC)

Marketing of electronic cigarettes
See Talk:Marketing of electronic cigarettes for discussion. QuackGuru ( talk ) 18:54, 20 January 2019 (UTC)

RfC on moving MMR vaccine controversy article
The word "controversy" in the title is problematic for a number of reasons, it seems plausible that a better title could be found. Please weigh in with suggestions. Guy (Help!) 14:49, 20 January 2019 (UTC)


 * more opinions(gave mine)--Ozzie10aaaa (talk) 23:12, 20 January 2019 (UTC)

Talk:Osgood–Schlatter_disease
I don't want to pester James for his reply, so I'm going here to ask for opinions. Thoughts? --Atcovi (Talk - Contribs) 23:17, 20 January 2019 (UTC)
 * commented--Ozzie10aaaa (talk) 11:12, 21 January 2019 (UTC)

Conflict improves articles
I'd like to post an interesting article about Wikipedia interactions (preprint):

In summary, it says that conflict is adversive, but it makes article content better. I hope some of you will find this cheering. The authors welcome feedback. HLHJ (talk) 22:37, 20 January 2019 (UTC)
 * thanks for posting its interesting--Ozzie10aaaa (talk) 19:25, 21 January 2019 (UTC)

Has Cochrane lost its way?
Interesting piece. I was struck by one ex-board member's criticism that Cochrane SRs are "largely synthesised information from industry sponsored studies". Not sure what (if any) implications these ructions have for how we use Cochrane content as a source. Alexbrn (talk) 17:50, 19 January 2019 (UTC)
 * Shouldn't have any effect on our use of Cochrane reviews. One bad apple, who appears to be an antivaxxer, blah blah. -Roxy, the dog . wooF 17:59, 19 January 2019 (UTC)
 * Studies on recently developed drugs are almost all "industry sponsored studies" in one way or another. In some fields, "synthesised...from industry sponsored studies" is synonymous with "using the only evidence that anyone actually has".  WhatamIdoing (talk) 02:59, 20 January 2019 (UTC)
 * I have met Peter Gøtzsche. He is a man of very deep principles and there is little doubt that he is morally outraged by what he sees as fraud in these studies. However, this has led him to form a point of view on the actual scientific question that is well out of line with mainstream thought (it's a lot closer when he is talking about psychotropic drugs, by the way, where he is also courageously outspoken). Gøtzsche is given to... robust statements of his opinion. His statements on psychiatric drug trials and the effects of these drugs on patients speak of anger and disgust, which are not the usual currencies of scientific discourse. I can see why a body that guards a reputation for measured and dispassionate analysis would be likely to fall out with Gøtzsche. I do not think this will be a big deal for them in the long term, but then, I thought Trump would lose in 2016 and Britain would vote Remain. Sometimes obvious stupidity happens anyway. Guy (Help!) 14:58, 20 January 2019 (UTC)
 * There is a response in the current BMJ by Cochrane's Editor in Chief and Deputy Editor in Chief, which sets out their response to the initial allegations. The summary is one page, and the full response is 27 pages! I agee with previous contributors: in 5 years we will probably look back at this as a 'storm in a teacup'; Cochrane sets out, and works to, pretty rigorous and open standards; Peter Gøtzsche is indeed impressive on a personal level, and is not afraid to speak truth to power, sometimes more passionately than most, and we can all be wrong about some things (I am not judging this particular statement, but making a general observation)! Kitb (talk) 18:10, 21 January 2019 (UTC)
 * In many situations the only RCTs are industry funded. When one does a review one needs to use what is avaliable.
 * The world very much needs more independently conducted trials without industry involvement. But that is not a problem either we or Cochrane are going to fix. Doc James  (talk · contribs · email) 19:41, 21 January 2019 (UTC)
 * Agree, and although I am absolutely no apologist for the pharma industry, it's interesting that the top 21 of organisations publishing completed trials registered on Clinicaltrials.gov, are all pharma. Out of the next 10, only 2 are not - VA at 22 and National Institute of Allergy and Infectious Diseases at 33. The highest academic institute was Johns Hopkins, at #37, with nearly 25% of registered trials unpublished. The highest UK institute was London School of Hygiene & Tropical Medicine, at #67, with one third of their registered studies unpublished , whereas Oxford, at #157, has just over 50% of their registered trials unpublished! . By comparison, only 2 out of the bottom 24 were pharma companies. Kitb (talk)

Orangelioncat and penile articles
is a new account. Some here might want to review Orangelioncat's edits to articles like Venous leak and ‎Erectile dysfunction. Looking at images and sources he's used, there appears to be a WP:Conflict of interest aspect to the editing. Since Orangelioncat is also editing anatomy articles about the penis, I'll drop WP:Anatomy a line about this as well. I've already welcomed Orangelioncat with a WP:Med template. Flyer22 Reborn (talk) 01:20, 21 January 2019 (UTC)   ‎
 * Penile Reconstructive Surgery was moved to draft space(thanks Brtishfinance)--Ozzie10aaaa (talk) 13:04, 22 January 2019 (UTC)
 * Yes, I've looked at Draft:Penile Reconstructive Surgery.


 * I noted on my talk page that, as we know, newer research can conflict with older research. It can also be incorrect. So this is where WP:Due weight comes in. In cases where the anatomical research is in conflict or is inconsistent, we report both or all sides...unless the other side or one of the sides is too much of a minority view to mention. For example, we give different reports on the urogenital diaphragm in the Urogenital diaphragm article because the literature is not consistent on it. We mention the dispute regarding the limbic system in the Limbic system article. For penile articles, I am concerned that Orangelioncat will prioritize Geng Long Hsu's and his colleagues' work over what the literature generally states. Flyer22 Reborn (talk) 00:41, 23 January 2019 (UTC)

World Hearing Day is March 3rd
We have an edit-a-thon planned in collaboration with a bunch of folks. Please see HERE for further details. Doc James (talk · contribs · email) 21:37, 22 January 2019 (UTC)
 * Thanks for sharing this! JenOttawa (talk) 00:45, 23 January 2019 (UTC)

Update to Retracted
Instead of using, the new code is. It also supports bibcode, doi, pmid, and pmc. Thanks. Headbomb {t · c · p · b} 18:03, 22 January 2019 (UTC)
 * thank you for posting--Ozzie10aaaa (talk) 21:25, 23 January 2019 (UTC)
 * Adding to this discussion as he is working on a retraction bot. JenOttawa (talk) 22:27, 23 January 2019 (UTC)

Relevant merge discussion, please join
Talk:Dental implant Staszek Lem (talk) 21:14, 23 January 2019 (UTC)
 * commented--Ozzie10aaaa (talk) 11:41, 24 January 2019 (UTC)

Cardiac allograft vasculopathy
New article created on Cardiac allograft vasculopathy. Please feel free to add or amend...anyone. Whispyhistory (talk) 19:17, 26 January 2019 (UTC)
 * Looks really good. Doc James  (talk · contribs · email) 19:53, 26 January 2019 (UTC)
 * Thanks....the ISHLT nomencalture needs adding I think..but I don't know how to do it. The ISHLT devised a nomenclature to define the presence and severity of CAV, ISHLT CAV0 not significant, ISHLT CAV1   mild, ISHLT CAV2    moderate, ISHLT CAV3  severe. Whispyhistory (talk) 20:04, 26 January 2019 (UTC)

Orphan medical stubs
Hello friends, once again I'm looking for help with some medical stubs that are also orphans.

Can Myocytolysis be merged somewhere, perhaps to Myocardial infarction or Myocyte? Or should it remain its own article? Like a lot of the medical stubs I've found, it feels like the kind of thing that would work better as a paragraph in a larger article that can give it more context.

In a similar vein, Malleolar canal looks like a it could possibly be merged to Flexor retinaculum of foot or Malleolus.

As always, I'm happy to do the legwork, I just like to be pointed in the proper direction. &spades;PMC&spades; (talk) 05:59, 22 January 2019 (UTC)
 * Malleolar canal looks like it might be a synonym for tarsal tunnel. Though I'd suggest waiting for a couple more (anatomically minded) opinions. Little pob (talk) 17:41, 22 January 2019 (UTC)
 * I've redirected malleolar canal to tarsal tunnel, but still need input on Myocytolysis. &spades;PMC&spades; (talk) 15:13, 27 January 2019 (UTC)
 * Eh, myocytolisis could probably be merged into cardiac myocyte, but I also think it's fine as is. Natureium (talk) 15:32, 27 January 2019 (UTC)
 * I rewrote it a bit and added some refs, then linked it from cardiac myocyte. Thanks for the suggestion, it's de-orphaned now so I'm happy. &spades;PMC&spades; (talk) 16:14, 27 January 2019 (UTC)

WP:CLOP?
I was approached by an administrator on my talk page for apparently copying licensed material in Alkhurma_virus (the paragraph which describes Saudi Arabia's process to combatting the Alkhurma virus). This admin added an attribute statement, which I removed since I didn't copy word-from-word but rather I tried my best to put it into my own words. I asked the admin for her response/review, but no response was given. So, I'm going here to simply double check to make sure my section in this article is acceptable to WP guidelines and policies. I'd like to make it clear that I did my best to put it in my own words by changing the sentence structure and substituting a lot of words with synonyms.

Thanks for your time. --Atcovi (Talk - Contribs) 02:52, 22 January 2019 (UTC)


 * Diannaa is an absolute expert on copyright matters. If she says that you have a problem, then you may safely assume that you do.
 * This kind of thing isn't easy for all of us, but one "trick" that might be helpful is starting with two or three sources, and combining them, rather than trying to re-arrange one. This makes it easier to get out of the mindset of the one source and avoid close paraphrasing problems.  WhatamIdoing (talk) 16:45, 22 January 2019 (UTC)
 * I find it a bit disappointing that she didn't reply to my comment. I was hoping for more clarification to my paragraph, but alas, I won't bug her for a response. Thank you, also, for the tip, but what shall we do with the paragraph now? Should we leave it as it is? Atcovi (Talk - Contribs) 17:04, 22 January 2019 (UTC)
 * Atcovi, if Diannaa fixed it for you, then I'd leave it however she changed it. WhatamIdoing (talk) 16:49, 27 January 2019 (UTC)