Wikipedia talk:WikiProject Medicine/Archive 50

Phenotypic heterogeneity
Hello WP:MEDICINE. This article (maybe not exclusively medical topic) needs expert attention. Thanks to anyone willing to check and verify. --Vejvančický (talk / contribs) 07:42, 14 June 2014 (UTC)
 * I very much get the feeling there is a separate term for this phenomnenon, which likely is a larger article. That this is a stub feels very unlikely to me, though this notice would be placed better under WP:Genetics. -- CFCF  (talk · contribs · email) 02:58, 15 June 2014 (UTC)
 * A number of similar articles which could well do with a merge:


 * Genetic heterogeneity


 * Allelic heterogeneity


 * Locus heterogeneity
 * Similar articles:


 * Pleiotropy - only one that could be under WP:MED
 * Homogeneity and heterogeneity (main article on non-medical term)


 * I suggest these articles be merged into a single larger article, possibly: Geneity (medicine) or Heterogeneity (Currently a redirect) . -- CFCF  (talk · contribs · email) 03:07, 15 June 2014 (UTC)
 * Thanks for your help and suggestions, CFCF, I'll notify also WP:Genetics. --Vejvančický (talk / contribs) 06:29, 15 June 2014 (UTC)
 * The first four are not encyclopedia articles on topics. They are dictionary definitions. They should be converted to redirects, and their content grouped together (to make it easier to grasp the differences among them) in some genetics article. I suggest genetics, unless we already have some more specialised article on the relationships between genes, alleles and phenotypes. The fifth is a far more general topic, and the article seems fine to me – anyway, it is of no concern to this project. Maproom (talk) 08:44, 15 June 2014 (UTC)
 * If you do decide to group the first four together into an article, I suggest it should be called "genetic heterogeneity", or "heterogeneity (genetic)". There is nothing specifically medical about the terms. Maproom (talk) 08:57, 15 June 2014 (UTC)
 * As correctly explained at Genetic heterogeneity, "pleiotropy" has a very different meaning to the others, and should not be merged in. Note that this article, linked from Phenotypic heterogeneity, defines phenotypic heterogeneity in essentially the opposite way to our article.  Phenocopy is another somewhat related term. Adrian J. Hunter(talk•contribs) 14:06, 15 June 2014 (UTC)

A phrase for "Bad things in health care"
After some discussion and some prodding from I think there is no word for "bad things in health care" so I made an article called User:Bluerasberry/Undesirable health care outcomes for every bad thing in health care. I derived the subsection titles that article from lists of problematic outcomes described in health care quality evaluations.

I thought that medical harm or iatrogenesis might mean "bad things in health care", but I have come to see literature say that iatrogenesis is the same as medical error so I started a merge proposal at Talk:Medical_error. "Medical harm" is not a term consistently used anywhere, but where it is used, it too means medical error, so started a deletion discussion at Articles for deletion/Medical harm.

There is definitely a concept called "health care quality" and a lot of culture and research about that concept. I think there are no terms for what health care quality tries to produce - good health care? - and now I just made up a phrase for what it tries to eliminate - User:Bluerasberry/Undesirable health care outcomes. If anyone has better ideas for what terms should be used to describe the point of health care management then please share.  Blue Rasberry  (talk)  17:02, 12 June 2014 (UTC)


 * Sometimes the best available treatment still carries unwanted but unavoidable harmful effects (or a risk thereof). Think necessary amputations, for instance, or radiation-induced nausea in cancer therapy. One would not normally call this error, yet it still is harm which one would seek to minimize. The distinction is useful, though I'm not sure about the best terminology. LeadSongDog come howl!  17:55, 12 June 2014 (UTC)


 * On looking at Bluerasberry's "Bad things in health care" page I was surprised not to find a link to Harm (Medicine); then I saw the deletion discussion... All rather unfortunate, imo. There's actually a 2014 MeSH term for 'patient harm' . 'Harm' is also a key concept in risk-benefit analysis. For example, my understanding is that there is no rationale to implement a screening (or treatment) programme unless the health benefits can be shown to outweigh the potential for harm, however inadvertent. 86.181.64.67 (talk) 19:18, 12 June 2014 (UTC)
 * We have morbidity but that is slightly different. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:30, 13 June 2014 (UTC)
 * Or adverse effect perhaps? At least, that's the measure used in the Number needed to harm entry in the Dictionary of Epidemiology (which doesn't contain a separate entry for 'harm'). In its broadest sense I think the term 'harm' may be extended to largely imponderable adverse effects of screening programmes such as anxiety and loss of sleep. (Fwiw, the new 'patient harm' MeSH term currently retrieves only 9 articles: http://www.ncbi.nlm.nih.gov/pubmed/?term=patient+harm[mh]). 86.181.64.67 (talk) 08:29, 13 June 2014 (UTC)


 * Propose creating a redirect for Harm (medicine) to Adverse effects (in the plural). 86.128.169.211 (talk) 13:02, 16 June 2014 (UTC)
 * Hello 86. What you say sounds reasonable to me but for the past few days, I have been unable to find any literature using this kind of terminology. Also I have gotten some pushback about including some things like expected side effects, medical debt, and societal discrimination against certain patients as anything to be related with the terms "health" or "medicine". Also "adverse effects" is a term with a history of usage, and means something more nuanced as a technical term than just the literal meaning of the words "adverse effect" even though literally that is the meaning I want to convey. Thanks for the feedback and thanks for the link. It is helpful to know that "patient harm" is a MeSH, term, and that it is new, and that it is not being used much, and that it seems to not be used as a technical term in that literature to which you linked.  Blue Rasberry   (talk)  13:43, 16 June 2014 (UTC)


 * Hello Blue Rasberry. ... While trying draft a nuanced response, I actually stumbled, via Google, on a page named redirect for "Medical harm" to "Medical error", which I don't think is altogether appropriate . I now think Harm (medicine) should redirect there, and we should add a dab header to the more generic (and somewhat sketchy, imo) page called "Harm". 86.128.169.211 (talk) 15:50, 16 June 2014 (UTC)
 * Hello 86 - just earlier today, "medical harm" was its own article. It was just deleted at Articles for deletion/Medical harm. The major argument for deletion was that no one had identified any source which defined the term "medical harm", and that all sources used in that article were referring to "medical error". While I agree that "harm" is a more general concept, Wikipedia is supposed to be a summary of what has already been published and not what people intuitively believe. If I found a source which used any word to mean all kinds of "harm" in medical contexts, then I might make an article on that concept or apply or combine the term with what I am calling "User:Bluerasberry/Undesirable health care outcomes". I have not found that term or any book or paper which combines the idea of "medical error" with intentional harms, like known side effects or anticipated and chosen harms which go with expected treatment. If the literature uses "medical harm" and "harm" seemingly exclusively to mean "medical error", then Wikipedia guidelines recommend that Wikipedia also use the word in that way. For that reason, it is difficult to make the argument that the "harm" article should be used as you suggest. I initially also wanted to use that article in this way, and that is why I am trying to sort out the correct terminology for these things. I will put up DABs and all the other navigational aids when we are closer to consensus about correct terms. Right now also there is a discussion about the difference, if any, between iatrogenesis and medical error.  Blue Rasberry   (talk)  16:56, 16 June 2014 (UTC)


 * Fwiw, this was the response I was drafting, before I stumbled on that redirect: A synonym for "Bad things in health care"? The standard term, as I understand it at least, is "harm". See various, though not all, of the article titles here (eg     etc). Of course "harm" has other medical usages too, as in "self-harm", which is a separate topic. Nevertheless, given the relevance of the term in the meaning you proposed I feel we should probably have a redirect available for Harm (medicine). Technically, I feel adverse effects would be appropriate, although the scope of the topic may be broader.  86.128.169.211 (talk) 17:14, 16 June 2014 (UTC)
 * Adding: I think the CONSORT extension on reporting of harms in RCT by itself demonstrates the notability of Harm (medicine). In their glossary, the CONSORT group defines "harms" as The totality of possible adverse consequences of an intervention or therapy... 86.128.169.211 (talk) 18:06, 16 June 2014 (UTC)

External links in infobox
Issue: The Template:Infobox disease is a widely used template that contains various important links related to a particular disease to which the page belongs. DiseasesDB, ICD-9, ICD-10, MeSH, OMIM etc. are internationally accepted codes that are used to define the disease. On the contrary MedlinePlus, (proposed) patient.co.uk, (earlier) eMedicine etc. provide links to external sources which might or might not contain data not included in the present Wikipedia article. Since the infobox is right at the top of the page, many people may click on these external links and leave without reading the Wikipedia article. Proposal: I propose moving all such links into the External links section and retaining only the defining codes within the infobox disease. Please sign to support or oppose the proposal or feel free to discuss the issue in greater detail. Please note that there have been multiple earlier discussions about splitting the Infobox.  D ip ta ns hu Talk 07:32, 14 June 2014 (UTC)

Support

 * 1)  D ip ta ns hu Talk 07:32, 14 June 2014 (UTC)
 * 2) WS (talk) 13:48, 14 June 2014 (UTC)
 * 3) A sound proposal, clearly presented to boot, and one I support thoroughly. --LT910001 (talk) 22:31, 14 June 2014 (UTC)
 * 4) A generally good site may not be that good on a particular disease and therefore should not routinely be added to infoboxes (or to External links, of course).  Such sites need to be vetted in each case and, if good, be added to External links.  --Hordaland (talk) 00:55, 17 June 2014 (UTC)

Oppose
Oppose I think the infobox links are a good feature seeing as they add relevant information for professionals and patients alike. ICD/OMIM etc. codes are very useful for a professional and may actually be a driving force for someone to come here, and having these at the bottom of the page defeats much of the purpose of the infobox. I would personally suggest a hidden-by-default section of the infobox with professional information instead, and an open-by-default section for patient information links. We have to think about what our goal is, and it is not to simply have all our content read but to bring the mass of medical knowledge to the world. To provide the best medical knowledge available we need to both link to other high quality sources as well as curate our own content. Default style links in the infobox ensure we link to sources that have been accepted and vetted by the mass of editors here at WP:MED. Having everything under an external links section makes it easy to add a poor source among high quality sources, and it makes it much harder for us to have oversight. -- CFCF  (talk · contribs · email) 06:05, 15 June 2014 (UTC)

Oppose Agree with CFCF's views. From usage I put a lot more trust in info box content than I do in 'external links' which very often contain a lot of dead links anyway. Also I feel info at top of article is a lot more helpful. Iztwoz (talk) 14:46, 16 June 2014 (UTC)
 * Oppose I think having pubmed or at least a couple of links in the infobox is a good idea. Pubmed is a simply overview of the disease. Usually much simpler than us. I would be supportive of adding DMOZ or a DMOZ like site and getting rid of the EL section most of the time. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:16, 17 June 2014 (UTC)

Discuss
Following the Eye-tracking pattern of users, if a Wikipedia article is small i.e. belonging to the Stub or Start class, there might be a greater requirement of going to a suitable external link that might contain some valued resource, the page being short. But if a page is long, leaving an external link at the bottom and not above the fold automatically reduces the probability of it being actually visited unless the user is that desperate to read more.  D ip ta ns hu Talk 07:44, 14 June 2014 (UTC)


 * One of the main reasons that these were moved to the infobox back in the day is that putting the commonest ones in the infobox meant that we could frequently get rid of the ==External links== section altogether, which in turn reduces the amount of spammy links that get added. (If there's no existing section for it, then people don't add external links as often.)  I wonder if people think that risk has gotten better or worse in the intervening years.  WhatamIdoing (talk) 18:23, 14 June 2014 (UTC)
 * External Links sections are a headache I must admit. I have no huge preference on this really otherwise. Cas Liber (talk · contribs) 21:38, 14 June 2014 (UTC)

I'd support linking to a readable, reliable article from the infobox (selected by the article's editors - not mandated by a template parameter) while our article is below featured article quality. Once an article has reached FA we should, per the external links guideline, avoid providing external links to any site that provides no more than we would expect to find in an FA. --Anthonyhcole (talk · contribs · email) 03:24, 17 June 2014 (UTC)

Wikipedia talk:Articles for creation/Pancreatic Cancer Action Network
Hello again, medical experts. Is this old AfC submission something that should be kept and improved? It will likely be deleted as a stale draft unless someone takes an interest in it. &mdash;Anne Delong (talk) 01:46, 17 June 2014 (UTC)
 * Seems ok as it is as a stub. They raised just under $20M last FY. The article no doubt with some COI - only edits of an ISP, in 2012, but neutral. Of course I have some potential COI myself. Wiki CRUK John (talk) 11:05, 17 June 2014 (UTC)

Draft:Natural eggshell membrane
Draft:Natural eggshell membrane needs a beady eye cast over it. It is claimed to be an altmed treatment for arthritis. Roger (Dodger67) (talk) 10:27, 13 June 2014 (UTC)


 * Eggshell membrane has made it to mainspace, but there is no sign n its history indicating that the medical claim has been checked against the relevant standards. There is also a "Did you know" nomination on the Talk page that probably needs to be checked for compliance. Roger (Dodger67) (talk) 20:11, 17 June 2014 (UTC)

FDA Issues Guidance on Pharmaceutical Company Correction of Misinformation on Social Websites
Interesting example from the guidance:

Example 11: A firm finds a webpage about its product that was written by an independent third party on an Internet-based, interactive, collaboratively edited encyclopedia. The firm may choose to contact the author of the webpage and provide corrective information to the author.


 * FDA recognizes that a firm cannot control whether an independent third party refuses to correct 288 the misinformation, or corrects only a portion of the misinformation even though the firm 289 provided complete corrective information, or declines to include the respective required labeling, 290 or declines to remove misinformation, or does not correct all the misinformation in one clearly 291 defined part (if the firm sought to correct more than one piece of misinformation). Accordingly, 292 FDA will not hold a firm accountable for an independent third party’s subsequent actions or lack 293 thereof.

Central theme of the guidance is that any corrective communication must contain corrections to both positive and negative misinformation, and may not be selective toward negative misinformation.


 * When a firm voluntarily undertakes the correction of misinformation in a truthful and non-misleading manner pursuant to the recommendations in this draft guidance, FDA does not intend to object if these voluntary corrections do not satisfy otherwise applicable regulatory requirements, if any. If a firm chooses to provide information outside the scope of this draft guidance, the firm should ensure the information it provides complies with any applicable requirements related to labeling or advertising. Information considered to be outside the scope of this guidance includes information that does not meet criteria listed above.


 * FDA does not expect firms to submit corrections to the Agency when correcting misinformation \pursuant to this draft guidance; however, FDA recommends that firms keep records to assist in \responding to questions that may come from the Agency. The records should include, for \example, the content of the misinformation, where it appeared, the date it appeared or was \located, the corrective information that was provided, and the date the corrective information \was provided.

The USFDA may now be maintaining files on Wikipedia. Interesting thought.

Document is found here. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM401079.pdf

Formerly 98 (talk) 19:49, 17 June 2014 (UTC)
 * Thanks for sharing. This is very helpful to me.  Blue Rasberry   (talk)  20:45, 17 June 2014 (UTC)

Recent Radiosurgery edits
Not my speciality, but I don't think these edits belong --  CFCF  (talk · contribs · email) 11:13, 20 June 2014 (UTC)

Invite review prominently on each medical article
What if we put something like this at the top of each medical article?: This could take them to a brief form where they may identify themselves, if they wish, giving a university or other professional email address (kept confidential), and add comments - maybe with a toggle button so they can easily flip between the article and their comments. Their comments and name would appear as a new thread on the article's talk page and they would receive an email with a link to that thread. --Anthonyhcole (talk · contribs · email) 10:18, 19 June 2014 (UTC)
 * Sounds like a good plan. Would support this.Docsim (talk) 04:07, 20 June 2014 (UTC)
 * Sounds like the Article feedback version 5 that was killed. I thought it was a good idea. Spoke up in its support and was sad to see it go. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:16, 20 June 2014 (UTC)
 * Are there any real technical issues against us setting up such a system for our articles on our own? -- CFCF  (talk · contribs · email) 11:16, 20 June 2014 (UTC)
 * Perhaps not, but I suspect it might get relegated to the talk page, which is really little use, and both the quantity and quality of the feedback received in the general excercise were pretty dire, so much so that people stopped bothering to read it. I think it's more productive to seek out medics on their own ground, as Bluerasberry did with the BMJ, the various Education projects do with medical schools, & I am working on doing through other channels, including online communities. Wiki CRUK John (talk) 13:42, 20 June 2014 (UTC)

Improve readability and information on Desiccated thyroid extract wikipedia page
I would like to make improvements to the desiccated thyroid extract wikipedia page Desiccated_thyroid_extract. From using the product and surface level research, I would like to work on the following: 1) restructuring the page 2) adding additional information, 3) adding/finding citations to support new and existing information and 4) rewriting content for readability and clarification. Since I am new to making these types of edits, I would appreciate any assistance with any of the above. Would anyone be willing to collaborate with the research? Thank you!

Presto808 (talk) 16:36, 19 June 2014 (UTC)
 * We have three main pages to help you get started:
 * WP:MEDHOW
 * WP:MEDMOS
 * WP:MEDRS
 * Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:18, 20 June 2014 (UTC)
 * Have reorganized per WP:MEDMOS. Work is needed on the reference as most of them are not of great quality. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:21, 20 June 2014 (UTC)


 * Hello, Presto. With large projects like this, please don't make a great many changes in one single edit.  Then it will be easier if someone wants to discuss one of your edits.  Good luck.  --Hordaland (talk) 15:36, 20 June 2014 (UTC)

What constitutes a medical article
Could someone tell me what constitutes a medical article or topic. Would physical therapy or podiatry fit the bill.Docsim (talk) 04:10, 20 June 2014 (UTC)
 * Sort of. User:WhatamIdoing may be best to answer. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:23, 20 June 2014 (UTC)
 * There are two typical reasons to ask this question: one is about WP:MEDA and the other about WP:MEDRS.
 * Both of these are "medical" articles in the sense that people here are willing to support the articles. They should therefore be tagged with WPMED (on the talk page) as being within our scope.
 * Some parts of these articles are "medical" in the sense that they make statements about biomedical information. Those particular statements should be supported by reliable sources as described in WP:MEDRS.  However, other statements (for example, about training, licensing, history, etc.) just need normal WP:Reliable sources.
 * Feel free to ask more questions about this if you want more information. WhatamIdoing (talk) 16:04, 20 June 2014 (UTC)

Foot ailment name
Editors are invited to participate at Reference desk/Science (version of 21:15, 20 June 2014). (Also, they are invited to consider watchlisting that page.) —Wavelength (talk) 21:23, 20 June 2014 (UTC)

Ayurveda
On Ayurveda. A view of charity is being over used and overrated. A edit from 1 June adds it on lead that "There is no scientific evidence to prove that Ayurvedic medicine can treat or cure cancer or any other disease", Although many other organizations, ahead of charity view differently.. And this same thing is added on the subsection on subsection but without any quotes, thus violating copyright. Previously, it was only on the subsection as "According to Cancer Research UK, "there is no scientific evidence that Ayurvedic medicine can treat or cure cancer any other disease." Because it is the view of only one "Charity". Discussion has been opened there. To me this whole edit seems like a WP:WEASEL and non-neutral POV, other 2 editors have objected too Talk:Ayurveda. Bladesmulti (talk) 17:10, 20 June 2014 (UTC)
 * This focusses on the use of the quote from CRUK. I've expanded the intro to the Efficacy section to give more of a flavour of what the CRUK statement says and eliminate the over-close paraphrasing. The CRUK source is MEDRS-compliant ("position statements from nationally or internationally recognised expert bodies") and seems to represent the mainstream scientific view, so there cannot be any doubt that its inclusion is justified. In my humble opinion, the quote used in the lead is due weight and needs to be there so that the mainstream view is properly represented. Perhaps a few more eyes on the disagreement would be useful. --RexxS (talk) 19:49, 20 June 2014 (UTC)
 * The American Cancer Society says, "There is no convincing clinical evidence so far to suggest that traditional Ayurvedic treatments can have a substantial impact on the growth and spread of cancer", so it doesn't sound to me like the view of just one charity. (They also outline some of the studies that are being done on drugs derived from Ayurvedic herbal treatments; it looks like an Ayurvedic laxative works [as a laxative, not as a cancer treatment].) WhatamIdoing (talk) 21:30, 20 June 2014 (UTC)

Chuen Yan Cheng
Please would someone check the sourcing and medical claims in Chuen Yan Cheng? Andy Mabbett ( Pigsonthewing ); Talk to Andy; Andy's edits 20:51, 20 June 2014 (UTC)


 * This is a BLP stub about the inventor of a contraceptive drug for men. It claims that there are no side effects.  It may be significantly outdated.  User:Flyer22, do you have an interest in this?  WhatamIdoing (talk) 21:33, 20 June 2014 (UTC)

Helping out with travel-related medical information at Wikivoyage
If you are looking for something a little different to do, then you might have some fun by taking a look at voy:Stay healthy and related pages over at Wikivoyage. Wikivoyage is a travel wiki. I'm just getting started there, but the rules are a bit different (they really are trying to give advice, and nothing gets cited), and it seems to be a bit more low-key and friendly. There's a page at voy:Wikivoyage:Welcome, Wikipedians that outlines some of the differences. Your Wikipedia username and password should work as usual. Feel free to stop by and say hello to me if you decide to look around over there. WhatamIdoing (talk) 02:52, 21 June 2014 (UTC)
 * Great to see you joining. They are a good group and agree it is fun to write about travelling. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:38, 21 June 2014 (UTC)

eMedicine links working again
I had communicated with eMedicine and they have reactivated the links bearing the form subj|ID. Therefore the technical glitch that sparked multiple discussions, has been resolved. As of now, till patient.co.uk links appear in the infoboxes, should the eMedicine links be reactivated in the infobox?  D ip ta ns hu Talk 10:07, 21 June 2014 (UTC)
 * That's okay with me. (If there's a page that we don't like, then we're not required to add the links to the infobox anyway.)  WhatamIdoing (talk) 16:24, 21 June 2014 (UTC)
 * patient.co.uk should be ready in a couple of days. I guess we could. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:15, 22 June 2014 (UTC)

Alcohol (drug) importance
Can someone please take a look at the alcohol (drug) article and tell me where it rates on the importance scale? --David Hedlund (talk) 05:30, 21 June 2014 (UTC)
 * it for you.  Seppi  333  (Insert 2¢ &#124; Maintained) 13:37, 21 June 2014 (UTC)
 * Thank you. Also, which template should be set in articles so I do not have to ask like this? --David Hedlund (talk) 02:28, 22 June 2014 (UTC)
 * If it's a drug, just paste this code at the top of the talkpage.


 * If it's another form of medical article, use


 *  Seppi  333  (Insert 2¢ &#124; Maintained) 12:10, 22 June 2014 (UTC)

AfC submission - 22/06
Should the fibrinogen section be made into a separate article? See Draft:Factor I Deficiency. FoCuSandLeArN (talk) 20:24, 22 June 2014 (UTC)

brevity of sentences in lead....
Right, cervix is undergoing alot of editing and heading towards FAC - and I are having a difference of opinion over prose - see here. Essentially I would say that these two pairs of sentences are too short to flow smoothly whereas he says they should be as short as possible. Opinions invited...if anyone wants to offer opinions on the rest of the article that's fine/great/appreciated but its a looooong page....Cas Liber (talk · contribs) 20:58, 17 June 2014 (UTC)
 * My opinion is that the lead should be written in as simple of English as possible without making the content in question wrong. I beleive that easy understanding is more important than brilliant prose. This requires us using short sentences and simpler words. The body of the text can be more written with more complicated language. We need to keep in mind our readers and that many of our readers do not speak English as a first language. Those who love and excel at complicated language usually have excellent access to high quality medical content / advice and do not need us anyway.
 * I guess this is why I do not write featured articles :-) Doc James  (talk · contribs · email) (if I write on your page reply on mine) 20:33, 17 June 2014 (UTC)
 * James a sentence with two short clauses is not complicated language. Cas Liber (talk · contribs) 21:21, 17 June 2014 (UTC)
 * Not sure about all the differences, but I do agree with this simplification and the accompanying edit summary. Yes, editorial context does matter. Imo, emphasis on the need for "brilliant prose" throughout FA could be contrary to Wikipedia's core values of providing reliable information that is freely available to everyone. Especially so in topics that may be of practical use in the real world to people who aren't native speakers of English. Per James's remarks above, it's hard enough to work up a lead that is both technically correct and comprehensible to our rather broad general readership, without being micromanaged into brilliance. 86.128.169.211 (talk) 22:02, 17 June 2014 (UTC)
 * This is, with all respect, a stupid thing for two such wonderful editors as you (both of you) to get excited about. Since it is purely a stylistic issue with no effect on the validity of the article, both of you should step back and allow other editors to choose which variant to use. Looie496 (talk) 22:50, 17 June 2014 (UTC)
 * I agree that this one sentence is a minor issue as both versions are fairly simple. But the issue of simplification generally I view as exceedingly important, especially with respect to the lead. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:06, 17 June 2014 (UTC)
 * - yes, that's why I have circulated it for additional opinions and am happy to abide by the result. Cas Liber (talk · contribs) 04:05, 18 June 2014 (UTC)

I can't follow who's on which side of the argument, so if I offend either James or Cas Liber - sorry. I'm a strong believer that the articles should be written in simple english with short sentences. I've written articles that I thought were simple only to have my non-medical (university educated) friends tell me they are unreadable. With respect to the opening sentence, the "...and hence..." is cumbersome in my opinion. My preference is for 2 sentences. Ian Furst (talk) 01:07, 18 June 2014 (UTC)
 * I was just about to say I think the "hence" is unnecessary. Personally, I'd contextualise first, thus: "In the female reproductive system, the cervix (neck) or cervix uteri is the lower part of the uterus."  Just my 2c. Adrian J. Hunter(talk•contribs) 01:30, 18 June 2014 (UTC)
 * Yeah I like that. Cas Liber (talk · contribs) 04:05, 18 June 2014 (UTC)

It may be better to think about the entire first paragraph, rather than just trying to rearrange this line as presented as the question here. I would start the introduction with an anatomical statement something like; "The uterus consists of two parts; its lower tubular part is the called the cervix (cervix uteri) and its upper and broader part is called the body of the uterus (corpus uteri)." I think that this first line will orientate readers about the anatomy especially as the cavity of the body of the uterus is included in the introduction after this. There are many right ways of writing a clear line about the anatomy, not only my suggestion, including dividing my suggestion into three sentences. The fact about the cervix being part of the female reproductive system should be easy to write into the introduction elsewhere, and need not be part of an orientating line about the anatomy. Actually, it the cervix is a fascinating medical topic and I am sure that many WP Med editors would find it interesting, even if the peer review page is getting rather long. Snowman (talk) 06:45, 18 June 2014 (UTC)
 * I am of the opinion that the bolded text / topic of the article should usually begin the first sentence to key the reader that they are indeed on the right page. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 07:53, 18 June 2014 (UTC)
 * What about: "The cervix (cervix uteri) is the lower part of the uterus and the body of the uterus (corpus uteri) is the upper part of the uterus. A slight narrowing of the circumference of the uterus at the base of the cervix demarcates the junction of these two parts." Wordsmiths will be able to enhance this. Some extra referenced text would be needed in the article to support this. It is perhaps a little to soon to refine the introduction, at this juncture. Snowman (talk) 08:44, 18 June 2014 (UTC)
 * It takes some WP:COMPETENCE to be able to understand when to step back, instead of offering what biologists call display behavior. I think most of us edit here to relax or rest.  --Ancheta Wis    (talk  &#124; contribs) 13:40, 18 June 2014 (UTC)
 * OMG, I think I'm leaving too...! Just watching this is painful. We really need to consider Wikipedia's core priorities here as an encyclopedia that's open to all. In my understanding at least, that doesn't include systematically obsessing other writers and contributors with "wordsmithing" in homage to certain FA ideals. (And for the record, I speak as someone with a decades-long background in language editing.) 86.128.169.211 (talk) 09:04, 18 June 2014 (UTC)
 * Aaawww, don't sweat it - jus' trying to get a feel for what folks reckon is best. @Snowman, general consensus is that the article should star "The X..." where "X" is the article title. I think I've had this conversation a few times over the years and that is what it's boiled down to. Cas Liber (talk · contribs) 13:21, 18 June 2014 (UTC)
 * I see. Focusing on the issue that User:Casliber raised; personally speaking, I would support User:Casliber's preference a logical joined up sentence at the beginning of the cervix article. Snowman (talk) 07:55, 19 June 2014 (UTC)
 * I don't think that reams of personal preferences for things like "a logical joined up sentence" should be allowed to hamper the development and maintenance of Wikipedia's best work. I suspect this is a flaw in the current FA/PR processes. 86.128.169.211 (talk) 10:15, 19 June 2014 (UTC)
 * I couldn't care less, personally, about FA or GA. Though they matter, compared with accuracy, clarity and completeness, beauty of expression, punctuation, spelling and even the manual of style are utterly inconsequential. Neither GA nor FA is any guarantee of an article's accuracy or completeness. --Anthonyhcole (talk · contribs · email) 10:44, 19 June 2014 (UTC)

Nothing against discreet and judicious copyediting. Everyone likes clean and readable text (and James always invites people to feel free to fix his typos, etc). But surely there's always a delicate relation of respect between editor and writer? James's preference for simple but correct language in the lead is a reasoned editorial choice that is broadly in line with WP:LEAD. And, fwiw, I think Casliber was right to bring the question here in a respectful way. 86.128.169.211 (talk) 11:55, 19 June 2014 (UTC)
 * - almost every single article I've taken to GAN or FAC has been improved in some way by the process (I think maybe one passed GAN without any suggestions). And the way they were improved was by accuracy, clarity and completeness, beauty of expression, punctuation and spelling. Cas Liber (talk · contribs) 13:44, 19 June 2014 (UTC)
 * I could have phrased that better. My only GA was vastly improved by the process. But if the process is toxic, and it can sometimes be toxic at both FA and GA, then I think having a distinct process that just focusses on an article's accuracy and completeness - involving genuine subject-matter experts - may be a useful one for those who feel they are (or actually are) being bullied and harassed over beauty of prose, MOS and other less-critical elements of quality. --Anthonyhcole (talk · contribs · email) 13:54, 19 June 2014 (UTC)
 * I have found GA to be mostly useful but it is variable. Found FA to be too nitpicky. And often one needs to inform the reviewers about WP:MEDMOS and WP:MEDRS. Sometimes not all suggestions are improvements. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:12, 20 June 2014 (UTC)
 * GA I've found far too random, as it's all down to one reviewer (normally), and the criteria are interpreted very variably. FA is super-nitpicky, and often concentrates on MOS & tidiness as the reviewers don't have specialized knowledge. Of course some suggestions need resisting, but I would say the article is always improved by the process. One can always withdraw.  It's important that those who do have expertise post reviews, if only to say the content is ok (or not).  There's an unfortunate tendency, now I think growing, for nominators to insist on all the examples of a general problem being produced by the reviewers, which should be resisted.  The former management used to resist this effectively.  Wiki CRUK John (talk) 09:36, 23 June 2014 (UTC)

Nurse anesthetist
I believe this article should have its name changed to Nurse anesthetist (United States) because of the lack of worldwide view of the subject. A separate article on this would be notable and have sufficient information to have independent from a Nurse anesthetist (if it was made). What do you Wikipedians think? Robert4565 (talk) 01:10, 23 June 2014 (UTC)
 * I think that the title should indicate what belongs on the page, not merely what someone has already added to the page. If you think it needs non-American information (and almost every article about any occupation does), then WP:Be bold and expand it.  WhatamIdoing (talk) 03:39, 23 June 2014 (UTC)
 * The title should remain as it is. I don't think that there are any nurse anaesthetists in the UK, but there are in France and some other countries. Ideally, that information should be added to this article, as WhatamIdoing suggests. If the size of the article eventually becomes unwieldy, it might then be appropriate to split out daughter articles. Axl  ¤  [Talk]  09:40, 23 June 2014 (UTC)

Harm revisited?
A bold proposal on the general topic of how to address medical harm (if I've understood correctly) is under discussion here. 86.128.169.211 (talk) 22:49, 23 June 2014 (UTC)

Svetol
Can someone with the proper background take a look at the clinical research and journals cited in this article? -Lciaccio (talk) 20:29, 23 June 2014 (UTC)
 * Okay trimmed all the primary sources, merged brand name to generic name, added better summary of secondary source. Watch article in question. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:01, 24 June 2014 (UTC)

Agmatine
I saw this message posted on the chemistry wikiproject and thought it might be just as relevant here (the problems noted in the message below involve the "Potential medical uses" section):


 * An editor claiming to be Gad M. Gilad, Ph.D. has recently made substantial changes to Agmatine. Please see my comments on Talk:Agmatine. The editor is a scientist who sells agmatine supplements (neurofencine). I do not assume the edits were made in bad faith; however, after a very brief look, I have found at least one statement that strikes me as questionable (again, see the article's talk page). I would appreciate anyone's efforts to review the recent changes, and remove any that may not have been in good faith. —νημινυλι (talk) 05:33, 21 June 2014 (UTC)  — Preceding unsigned comment added by 72.94.166.117 (talk)
 * Gah so many primary sources Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:09, 24 June 2014 (UTC)

Alcohol flush reaction
Extra eyes needed as issues surrounding images are occurring. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:28, 24 June 2014 (UTC)

Plantar fasciitis eyes needed
Hello all, more eyes are needed here please. Primary sources are being used to support a statement about shin weakness/tibialis anterior weakness. My edits are being reverted when this information is removed since these claims are citing sources out of compliance with WP:MEDRS and the review article references already present in the article state otherwise. I would rather not get into an edit war, so I would rather the Wikipedia community weigh in here. Thanks everyone TylerDurden8823 (talk) 04:41, 24 June 2014 (UTC)

Wikipedia talk:Articles for creation/Seth C. Hawkins
Hello once again, medical experts. This old AfC submission about a doctor has a lot of primary references. I'm not sure where to look to find reviews or citations of his work. Is this a notable person, and should the page be kept and improved, or deleted as a stale draft? &mdash;Anne Delong (talk) 12:24, 24 June 2014 (UTC)

Arnold S. Relman needs/deserves expansion
The article on the recently late Arnold S. Relman (1923-2014) is a stub which is well deserving of expansion. There is a good set of references in the article in the "Further reading" section and more on the article's talk page (formatted for use as references by yours truly). I hope someone has the time to improve this article. - - MrBill3 (talk) 16:19, 24 June 2014 (UTC)

Article on Wikipedia quality
This one is much better than the last as it actually gives enough detail to verify the statements made  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 05:13, 24 June 2014 (UTC)
 * I can't seem to view the whole paper. The Canadian Journal of Information and Library Science isn't listed on PubMed. Axl  ¤  [Talk]  07:40, 24 June 2014 (UTC)
 * But, like the last, it doesn't compare Wikipedia to any other information source, so its utility is for assessing Wikipedia's quality is questionable. The list of errors will be very useful, though. check your email Adrian J. Hunter(talk•contribs) 12:25, 24 June 2014 (UTC)
 * Interesting, I'll read it tonight. If the errors it lists are extensive we should probably make a list of the errors it points to and work them through one by one. Also, if anyone needs a copy, just send me a mail and I can attach it. (Getting hold of it wasn't so straight forward, didn't show up on any searches, had to log in to the journal webside through my library proxy.)  --  CFCF  (talk · contribs · email) 16:25, 24 June 2014 (UTC)
 * The only found two significant errors. It is useful because they tell use the errors that they found. One had already been corrected and I corrected the other one. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 06:06, 25 June 2014 (UTC)

Non-invasive RF cancer treatment
See where that redirect goes. Wiki CRUK John (talk) 16:50, 24 June 2014 (UTC)


 * The discussion resulting in the redirect is here, but the alternative was an AFD, which I admit is still an appealing option. The link to it at Radiofrequency ablation might benefit from a description along the lines suggested by WP:SEEALSO.   WhatamIdoing (talk) 20:09, 24 June 2014 (UTC)
 * There are secondary sources such as this one  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 06:12, 25 June 2014 (UTC)

Rebuttal to Hasty's criticism of Wikipedia
Blog post on the Cochrane website. Axl ¤  [Talk]  12:30, 23 June 2014 (UTC)


 * Excellent! My only concern is that given where the rebuttal was published, the popular press may not notice it.  I assume that this has already been done, but have the "UK’s Daily Mail and BBC News, and the US-based Advisory Board" as well as the Journal of the American Osteopathic Association been alerted to this rebuttal? Also a letter to the JAOA editor would be very appropriate. Boghog (talk) 19:33, 24 June 2014 (UTC)
 * Will be sent. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 06:16, 25 June 2014 (UTC)

I am leaving
There is a toxic atmosphere on WP in which bullying and name-calling are accepted and sanctioned in the name of factual integrity. I have seen too many times instances where editors are willing to disagree instead of compromise, and very few instances where editors themselves intercede when arguments become too heated. In order to defend myself at any instance I am expected to master the hundreds of guidelines and guideline subsections and trawl through hundreds of diffs. WP is biased towards users who have developed relationships outside of article space, including on WPocracy, email, or by meeting in person. These methods circumvent the principles of openness and collaboration and make it hard for users such as myself who just want to 'get by'. WP has an atmosphere built around confrontation and the only groups this suit are young and middle-aged white men. I don't want to be part of this culture, and I certainly wouldn't recommend anybody I know participating on Wikipedia.

Goodbye to WPMED. I have the utmost respect for many members of this project and have had the pleasure of working with some really wonderful Wikipedians. I wish you all well. --LT910001 (talk) 03:43, 17 June 2014 (UTC)
 * LT, I hope you change your mind and perhaps consider not leaving on a permanent basis. I think Wikipedia is better for having you as one of its editors but I can certainly sympathize with your frustration. Whatever you decide to do, I wish you the best (but I hope you come back in time). Know that I'll be here waiting to work with you if you choose to return. TylerDurden8823 (talk) 03:57, 17 June 2014 (UTC)
 * Gah. Unfortunate to see another great editor leaving in less than two months. This being our last editor who left
 * It is unfortunate that one needs such a thick skin to edit Wikipedia. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:21, 17 June 2014 (UTC)
 * Ok, I have tried clearing the air. Cas Liber (talk · contribs) 04:33, 17 June 2014 (UTC)
 * I'm really sorry to hear this, and I feel this is a great loss to WP:ANAT as well as WP:MED. I understand your frustration, although I did not know it was so severe. I'm hoping that you won't give up on Wikipedia indefinitely, and hopefully this can be a wake-up call to those who criticize and condemn without contributing anything major themselves. Not pointing any fingers, but I think we need to work on our attitude, and medical editors may be less accepting of this type of arguing, being used to a professional atmosphere of mutual respect between contributors. -- CFCF  (talk · contribs · email) 07:30, 17 June 2014 (UTC)
 * As James says, "It is unfortunate that one needs such a thick skin to edit Wikipedia." I think WMF needs to take a strong lead in viewing Wikipedia as a real, if in many ways unusual, work environment. Many of the processes can feel like booby traps. Irrespective of innate skin type and all our many contingent life factors, everyone who commits energies here is ultimately vulnerable on an individual level. 86.128.169.211 (talk) 08:07, 17 June 2014 (UTC)
 * The thing is that we are a self governing project. The WMF has little authority over the community. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:36, 17 June 2014 (UTC)
 * I realise that and also realise that the WMF is aware of the issues. I believe our self-governing community needs, collectively, to get the message that occupational health (in the broadest sense of the term) needs to be a priority here. Not easy... But prevention can be more than just cuddly cats and cookies. One thing I feel the WMF might try is to encourage academic OH research groups and peer-review journals to take an interest and start out on independent study of Wikipedia as an online volunteer work environment. 86.128.169.211 (talk) 11:05, 17 June 2014 (UTC)
 * I don't really know anything about it myself, but I've heard that the Dutch Wikipedia made this kind of a cultural change a few years back, I believe it involved a series of conversations, a decision that they wanted to be more welcoming, and a decision to kick out some editors who were unable or unwilling to be kind to other editors, even if they were "good content contributors".  Maintaining that culture requires a lot of community policing:  you can't have that unless people are willing to publicly speak their disapproval of unfriendly comments, and it can't always be the same person. Strangely, this probably is the cause of the dispute over our efforts to improve their articles:  their community norms seem to care more than ours about respecting other people's contributions, even to the point of not replacing someone else's mediocre efforts with a better version overnight.  WhatamIdoing (talk) 15:53, 17 June 2014 (UTC)
 * Interesting. The suggestion I'm trying to make is different though, and is very much geared to the medium-/long-term. Backpedalling a bit... OH research is a multidisciplinary field which looks at many jobs, but may miss some relevant ones (for instance, I haven't encountered anyone who disputes that housework is highly relevant but very little studied). Given broad the social impact of Wikipedia today, I don't see why the voluntary work conducted online by Wikipedia contributors shouldn't be a legitimate, and perhaps even appetizing, topic of study. But looking at PubMed, there appears to be next to no occupational health peer-review publications dedicated to Wikipedia as such. I realise that a lot of work goes on internally on Meta and elsewhere. But I feel that WMF could be encouraging, or even commissioning, research from university groups off-wiki (while of course also providing the appropriate background support in clarifying our many quirky ways). 86.128.169.211 (talk) 16:26, 17 June 2014 (UTC)

+1 to the toxic atmosphere notion. I hope LT910001 has a well earned-break, and then may choose to return as a dynamic IP. This is a most effective measure against WP's bullshit, since activity is reduced to just occasional relaxed editing (a bit like how most editors started perhaps). You are insulated from confrontation by essentially opting out of the bullying culture. If you find as an IP you cannot edit certain pages, well then ask yourself it is worth the stress to work on a controversial topic anyway? You can always keep a manual watchlist (i.e. a list of articles outside wikipedia), and check in on them every once in a while if you feel the need.

With regards the whole "wikipedia is broken" thing, IMO, the bureaucracy needs to be rigorously de-bloated, and there needs to be much condensing of the 100s of rules into a realistic, approachable and unified editing rulebook. Not to mention getting rid of those admins who really should not be admins, etc. 92.40.91.103 (talk) 13:28, 17 June 2014 (UTC)
 * Some pages are protected due to issues around sockpuppetry, others are protected due to issues around school children rather than being particularly controversial. If it is the latter (like STIs) and you wish to work on them drop me a note and I can unprotect them for you. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:33, 17 June 2014 (UTC)
 * Just to clarify, when pointing to the relevance of studying the "work environment" here from an occupational health perspective I'm not sure I was specifically intending any prior restriction to "toxic atmosphere" notions. OH research that is ultimately geared to prevention has a big methodological toolkit, but takes time, specialist knowledge, human resources, and, perhaps ultimately, funding. Adverse outcomes can happen even when, as in this case I think, committed editors with varying backgrounds and individual characteristics are all striving to improve Wikipedia content in what they each believe is the most appropriate way, doing their best to follow due process. I suspect FA and GA nominations are particularly susceptible venues for such grief, but there are many other at-risk processes too, including ANI (as in the recent loss to the project James mentioned above)... Or even, as you imply just working on controversial topics. Fwiw, I too have found an IP strategy to be a useful expedient to survive in the environment. And, damn it, what was that essay called about bloat? Oh, and btw, you can tell I don't really belong or I would have found that WP:CREEP link immediately... and known the best ANI tactics... and how to survive GAN/FAN... and a whole load of other esoteric WP:LORE. ...ranting away into the distance... 86.128.169.211 (talk) 14:55, 17 June 2014 (UTC)
 * (You've established a clear identity and good reputation here, 86, without having to assume a nom de plume. --Anthonyhcole (talk · contribs · email) 16:44, 17 June 2014 (UTC))
 * Thanks Anthony. I think you've actually provided a rather nice illustration of how the Wikipedia environment is far from just "toxic". Are there real issues for those who try to do gf work within this environment, though...? I think it's clear to pretty much all of us here that the answer is yes. (And I'm just trying to suggest that OH may provide relevant tools for the study and, ultimately, the prevention of undesirable outcomes in our work environment.) 86.128.169.211 (talk) 17:09, 17 June 2014 (UTC)
 * I think taking advice from good expert OH consultants would be money well-spent. If you have the competence, time and energy to drive a project like this, you would have my 100% moral support, but I have no time, energy or expertise to contribute. WhatamIdoing, James and Bluerasberry all have a good grasp of the grant-making process at WMF, and WMF is very keen to throw money at worthy projects. If you're in the UK (or even if you're not) Wikimedia UK has a budget for supporting worthy projects - and this looks like something they'd consider. --Anthonyhcole (talk · contribs · email) 17:37, 17 June 2014 (UTC)
 * Gosh, that wasn't really quite what I was intending to suggest... Rather, perhaps for WMF to put the word around to academic OH research groups that we and our work environment are here to be studied from various inter/disciplinary perspectives (e.g. epidemiological, social, psychological, engineering, etc). That despite the apparent dearth of outside academic interest hitherto, we do actually constitute a legitimate and potentially worthwhile area of study. For example, information (including that already accrued) on "who we are" may be highly relevant. And how about our processes, culture, etc, etc? What sort of interventions might be identified acceptable and feasible within the context of our self-governing community? Which interventions are effective? I realise that people within the WMF are probably addressing some of these questions already in their own ways, and I certainly wouldn't want to belittle their work. But I can't see any reason not to encourage outside research with an occupational focus (as distinct, for example from study primarily focused on content/quality). My thought was that WMF might eventually want to commission specific work, as and when the Foundation identifies particular areas for specific in-depth study. But a first step might be to invite interest more generally.  86.128.169.211 (talk) 18:41, 17 June 2014 (UTC)


 * I just proposed meta:Grants:IdeaLab/Victim_support_services - I will be talking with others about what other nonprofit organizations do when their volunteers are harassed. I think I would like to have professional counseling services available for Wikipedians because too many people are helpless to respond meaningfully to their attackers. Also, someone should document these problems so that we can address them more fully.  Blue Rasberry   (talk)  18:07, 17 June 2014 (UTC)
 * I hate the word "victim". Just because someone is being totally unacceptable does not mean that one have been "victimized". How about "Editor support services" Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:23, 17 June 2014 (UTC)
 * I agree with James that victim is not an ideal word in this context (and for that matter, tend to think it's not the best word in most contexts where it's used.) Sumana's keynote from Wikiconference USA is relevant to a good chunk of this discussion - and although practices from either organization would be hard to directly adapt to ENWP, the practices of both Hacker School and the Ada Initiative are probably worth examining.  WMDE's community grant program had a proposal accepted a couple of years ago to hire professional facilitators to handle some of the emotional labor involved in settling on-wiki disputes - it ended up falling through when the volunteer involved had to pull out, but struck me as quite interesting. As mentioned by Whatamidoing someone above, this is an area that would likely not be hard to find WMF grant funding for useful ideas for - I know I'd endorse pretty much any well thought out grant in this area proposed to the project and events grants program.  Best, Kevin Gorman (talk) 22:42, 17 June 2014 (UTC)
 * First, I want to say that no one ever wants to see a good productive editor leave the project because of an unfriendly environment, and I would love to see the problematic editors removed as much as the rest of you. I acknowledge I don't edit much in the way of the sciences (although I did minor in and get a foundation scholarship for astronomy in college) because of the obvious difficulties I see in the more subjective humanities articles. The support services project strikes me as a great idea and to the degree I can be useful there (which probably isn't much) I will try to help. Specifically regarding OH, WorlCat has several reference books here dealing with the subject and I think at least a few of them might be available to me. I will try to get together some listing of what they cover in the next few months, which I think might be as useful in getting a sort of prospectus for OH content together. It might take a few months though, and the lists of articles and subarticles will almost certainly be somewhat outdated, but it might be at least a point to start from. John Carter (talk) 22:58, 17 June 2014 (UTC)
 * While putting in another (perhaps superfluous) voice in favour of replacing "victim support" with "editor support", "contributor support" or somesuch, I'd also like to say that this seems to me to be an interesting proposal. On a somewhat related topic, I've always been a bit perplexed by the quasi-disciplinary associations that mentoring seems to acquire on Wikipedia. Imo, most of us here may stand to benefit at some time from thoughtful informal mentoring, at least in particular areas we find more tricky... as well as from some plain Jane human support. Best, 86.128.169.211 (talk) 23:09, 17 June 2014 (UTC)
 * It is unfortunate to work hard to attract / develop high quality editors just to have someone make their work here unfun and have them leave.
 * To get our organization to change direction will be hard. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:11, 17 June 2014 (UTC)
 * While this is an interesting and worthwhile conversation to have, I think perhaps we have strayed from the original topic of this section. TylerDurden8823 (talk) 06:09, 18 June 2014 (UTC)
 * On the contrary, I think this discussion has been attempting to address some (though admittedly not all) of the deeply felt complaints made in the initial post. 86.128.169.211 (talk) 08:34, 18 June 2014 (UTC)
 * I changed it to "community support services" because I love that word. I did not mean to go astray. I like the idea of connecting this to Occupational medicine or Occupational safety and health, and maybe we can find some precedent in business practices and research for retaining people in any position prone to high stress.  Blue Rasberry   (talk)  11:57, 18 June 2014 (UTC)

In the novel Food of the Gods HGWells describes the appearance of a nest of giant wasps outside a small English countryside town. The villagers are terrorized by the wasps, and after some weeks send a message to the Royal Society requesting help. The society sends out a team of scientists who spend the next several months documenting various aspects of the wasps' physiology and behavior while they continue to terrorize the village. Frustrated, the mayor requests assistance from the Royal Academy of Engineers. The engineers pile wood around the nest, set the wood on fire, and return to London the same day with the problem solved. Similarly, I wonder if we need to study this problem further, or simply enforce the rules. Formerly 98 (talk) 12:23, 18 June 2014 (UTC)
 * Err, enforce which rules? Cas Liber (talk · contribs) 13:19, 18 June 2014 (UTC)
 * Well, I thought we had some rules on civility, if we don't, maybe we should. There are editors here that have long track records of responding to nearly every disagreement with personal attacks, accusations of bad faith editing, etc. They wouldn't last a month with that sort of behavior in a corporate environment. I realize I'm oversimplifying the situation a bit, but as a relative newcomer, I don't understand the extent to which the senior people here tolerate that sort of behavior while wringing their hands about the low female participation and general exodus of editors.  I wouldn't work at a company that tolerated such behavior. Formerly 98 (talk) 13:38, 18 June 2014 (UTC)
 * The line between uncivil and just rough around the edges is like the one that divides tadpoles and frogs. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 17:36, 18 June 2014 (UTC)
 * Absolutely, but we clearly have a healthy population of fully differentiated versions of both phenotypes. Why is it so difficult to deal with those who are clearly frogs?  I was involved in a discussion on the Admin's notice board a few weeks back in which the subject was engaging in clear cut personal attacks of a very personal sort right there on the board and daring the admins to block him.  Outcome: no consensus for any action.  Sometimes its like a party that anyone can attend, and no one can be asked to leave no matter how obnoxiously they behave.  You end up with beer cans all over the neighbor's years, broken furniture, and fistfights breaking out in the back yard.  Having rules and enforcing them just makes a better environment for everyone. Formerly 98 (talk) 18:43, 18 June 2014 (UTC)
 * Yup. I had someone threatening legal action against me yesterday. This was after calling another editor a psychopath. Sometimes this place just seems too dangerous to edit openly. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:47, 19 June 2014 (UTC)

@LT910001: sad to hear that. I haven't really worked with you all that much, but it still feels like a friend is leaving. May you find peace, wherever you go. I do believe these cases constitute very real cyberbullying that has gone unchecked for far too long. I hope someone comes up with a good solution to fix this toxic work environment, and that they implement the solution soon. meteor_sandwich_yum (talk) 06:01, 19 June 2014 (UTC)

WPMED A-class article?
My 2 cents is that GAN/FAN process creates significant conflict. I know that I've found it an unpleasant side of WP - not sure what others think. Few medical editors seem to take issue with having academic debates or building consensus around content. But you can put tens or hundreds of hours into an article to have it sit for months on the list, only to be reviewed by someone that is largely disengaged with the actual content of the article. If we're to make a change in the near term, my suggestion would be in the GAN/FAN process (which seems unlikely) or to de-emphasize it's importance to the medical community. Ian Furst (talk) 00:55, 18 June 2014 (UTC)
 * We are about providing high quality medical content to the world. The GA and FA process are not that important in doing this. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:07, 18 June 2014 (UTC)
 * I completely agree. However, many of us look for validation of the effort, and quality assurance.  How do you systematically recognize effort and provide feedback when requested?  It seems that the quality of the articles has increased over the years (e.g. FA articles from years ago that would never make it now), what (if anything) could the community replace it with? Peer review? Ian Furst (talk) 01:15, 18 June 2014 (UTC)
 * FWIW, WP:MILHIST makes extensive use of its pretty much exclusively internal A-Class rating. I suppose it would be possible for the medicine projects to develop a similar system. John Carter (talk) 01:31, 18 June 2014 (UTC)
 * A scale for the project alone, judged by the people of the project. Imo, it might be worth transitioning to that. For those who like the challenge of FA/GA, it looks like they can still do it. There project page has some good ideas Ian Furst (talk) 02:14, 18 June 2014 (UTC)
 * How do MilHist's A-class criteria and process differ from GA and FA? Ah. I see WikiProject Military history/Assessment and WikiProject Military history/Assessment/A-Class review. This proposal makes a lot of sense to me. --Anthonyhcole (talk · contribs · email) 02:41, 18 June 2014 (UTC)
 * We got rid of A class a while ago as we did not really feel like we were active enough to manage it. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:13, 18 June 2014 (UTC)
 * We have existing processes of Peer Review and FAC - both are helpful and complement each other. FA status can be used as a consensus/stable version to refer back to after articles undergo (inevitable) article erosion. GA is pot luck - if an article is reviewed by an inexperienced reviewer then articles with glaring errors or gaps can easily be listed. My preference in the first instance is use existing processes and (1) be on the watch for GA nominations of medical articles at WP:GAN, (2) make generous use of Peer Review - it has been very fruitful for cervix, (3) this then maximises chance of success at a rigorous review place like FAC, which then gives us a stable version. I agree that we don't have enough activity to warrant A-class review, which seems to be bureaucracy-creep anyway. Cas Liber (talk · contribs) 04:18, 18 June 2014 (UTC)


 * Creating an "A" class has been discussed in the past. Most recently, and  discussed this at WikiProject_Medicine/Good_article_review, which could be converted to "A-class review". Other related information is at WikiProject Medicine/Assessment and WikiProject Medicine/Featured articles review. Category:A-Class medicine articles is empty and intentionally unused. WikiProject Medicine has never had a regular community of sufficient size to do assessment.
 * No one is maintaining all these assessment projects. It could happen that all WP:MED assessment could be condensed from considering GA and FA and only do in-house assessments of A with judgments on quality of health information and supporting our community of editors rather than sending people into GA and FA reviews where there could be more conflict. Even if we did this, it is not certain that we have enough people on hand to give reviews when requested. I do not know what the solution is to this except that it would be nice if there were same way that WikiProject Medicine contributors could get their content reviewed for medical accuracy on request.  Blue Rasberry   (talk)  16:29, 18 June 2014 (UTC)
 * What about scheduling volunteers for a month at a time (or 1 week or 2 weeks, depending on workload/number of volunteers) to do the reviews? If you know you're only on for a week or two at a time, the workload seems less daunting. How many active editors participate at WP:MED projects?  30 or so? Ian Furst (talk) 18:48, 18 June 2014 (UTC)
 * Part of my pitch to mid-career scientists and medics, too busy to get in to serious editing (or that's what they think, heh heh) is to encourage them to keep an eye on here (or their appropriate project talk - eg molecular biology) and to do FA & GA reviews from a content point of view. I haven't done this sort of presentation to medics yet. Wiki CRUK John (talk) 19:05, 18 June 2014 (UTC)
 * Back in the old stone knives and bearskins days of the project I used to do some Biography A-class review although I acknowledge that I know damn little about medicine and almost certainly wouldn't be useful here. One thing that might be useful though might be trying to get together some lists of recent specialist reference books like I've started for some of the humanities projects at Category:WikiProject lists of encyclopedic articles and what topics are covered substantially in which books to use as a baseline indicator for which content types to include in which articles here. Those sources might tyhen be used by even someone like me in the "first stage of A-class review" or rough review and then maybe getting someone other than the article writers/developers who knows the field in for a "second stage of A-class review" to determine how current the specific details included in the articles are? John Carter (talk) 19:10, 18 June 2014 (UTC)

Since it's not being used for anything, perhaps we could use A-class to denote articles that have passed review for accuracy and completeness by named subject-matter experts (with a prominent link to the version that passed review) - sort of Wiki CRUK John's suggestion, above, but without having to meet the other criteria for FA. This way, interested experts could comment on (and hopefully eventually pass) any article that takes their fancy and not be limited to just the tiny few that make their way to FA nomination ... more like John Carter's second stage. --Anthonyhcole (talk · contribs · email) 09:42, 19 June 2014 (UTC)
 * I think this is an excellent suggestion, and it might be easier to get reviewers than editors (as for reviewers of publications many see it as an obligation, and rarely say no). And once word gets out there we have high quality content more reviewers might start editing? Thoughts?-- CFCF  (talk · contribs · email) 14:21, 21 June 2014 (UTC)
 * Hmm, I suspect there is no harm in it.....so part of me thinks why not.... Cas Liber (talk · contribs) 14:54, 21 June 2014 (UTC)


 * Actually the more I think about it the more I think it is a good idea - it could be a platform that we can invite medical experts to opine in/on when articles are nominated there. Looking at the milhist process though, it looks like we'll need a WP:MED coordinator.....Cas Liber (talk · contribs) 23:45, 21 June 2014 (UTC)


 * As an update, I've started a page at WikiProject_Medicine/Assessment/A-Class_review borrowing from WikiProject Military history/Assessment/A-Class review, though I doubt we need quite so many templates. It is sort of bold except that (1) A-class review is an existing process so we're not doing anything not covered by existing policy and (2) it isn't compusory, so folks can ignore if they wish. The more I think about it the more I think that this creates or facilitates some platform for medical experts to engage with content here. Cas Liber (talk · contribs) 01:52, 23 June 2014 (UTC)

Progress and subpages
Right folks, have now copied: Feel free to add/edit/tweak/discuss....I guess we have to figure out some coordinators too......Cas Liber (talk · contribs) 09:38, 25 June 2014 (UTC)
 * WikiProject Medicine/Assessment/A-Class
 * WikiProject Medicine/Assessment/A-Class FAQ
 * WikiProject Medicine/Assessment/A-Class review
 * I've made a suggestion to include an accessibility criterion at Wikipedia talk:WikiProject Medicine/Assessment/A-Class. --RexxS (talk) 16:02, 25 June 2014 (UTC)

Alternative cancer treatments
There is discussion about the section heading "Ineffective treatments" as not being NPOV in the article Alternative cancer treatments. I think some input from knowledgeable experienced editors could be helpful. - - MrBill3 (talk) 03:19, 25 June 2014 (UTC)
 * I can pretty much say it is impossible for that heading to be NPOV. It can be correct or incorrect, but claiming that it is NPOV is pretty much grasping at straws when you know they are quackery. I'll see if I can help. -- CFCF  (talk · contribs · email) 04:46, 25 June 2014 (UTC)
 * It can be NPOV if it reflects the sources. Neutral Point of View does not mean neutral content, it means the content reflects the published sources as due, see WP:NPOV. If the sources describe the treatments as ineffective or as not actually being treatment the section header should clearly reflect that. - - MrBill3 (talk) 04:51, 25 June 2014 (UTC)
 * I think you misunderstood me, and I myself. I should have written: there is no way that heading can be in breach of WP:NPOV. As you say, if it reflects the sources then we are free to call the treatments ineffective. -- CFCF  (talk · contribs · email) 05:00, 25 June 2014 (UTC)
 * As I understand the OP, it's not entirely clear that all of them are actually "ineffective". For a few, the efficacy may be unknown (but implausible); for at least one, it may work in a small number of minor cases, but with a much lower efficacy rate than modern conventional medicine and much worse side effects.  (That one, by the way, was considered "conventional medicine" back in the day.)
 * I don't oppose ==Ineffective== (the OP proposed ==Ineffective and unproven==), because IMO it's accurate to a first approximation. But I don't think the OP is unreasonable to suggest improvements.  WhatamIdoing (talk) 16:36, 25 June 2014 (UTC)

No wonder we have problems with fringe theories
I was idly reviewing the materials at Training/For students and I watched the video Verifiability and Neutral point of view on the Verifiability page. I was interested to hear the following: So far so good, although I would have hoped that the authors had heard of MEDRS and either avoided a medical claim as an example, or explained that for medical claims, a "reputable source" is not sufficient in itself. The BMJ is a reputable source, but still publishes primary research that falls short of MEDRS.
 * Lets say you are an advocate for vaccinations, and you write, "Every parent should get their children vaccinated". Unfortunately, this is biased and certain to cause disagreement. It can't be in Wikipedia. However, published opinions of experts can be included. And if these opinions differ, the article should present all the major opinions without endorsing one over the other. For example, writing that "Vaccinating all US children saves an estimated 33,000 lives" and citing a reputable source is a statement of fact that can be verified.

But then the video continues: WTF?? No wonder we have problems with fringe theories. The training material intended for students is telling them to stuff articles with views diametrically opposed to the mainstream view because it "helps to balance the article". The authors of that video should be kept in detention and made to write out 100 times: Sometimes my mind boggles. --RexxS (talk) 18:06, 25 June 2014 (UTC)
 * And if there is an opposing view, it should also be included. For example, a quote from a reputable source like "Critics claim that vaccinations have never benefited public health" helps to balance the article and keep it neutral.
 * Fringe theory in a nutshell: To maintain a neutral point of view, an idea that is not broadly supported by scholarship in its field must not be given undue weight in an article about a mainstream idea. More extensive treatment should be reserved for an article about the idea, which must meet the test of notability. Additionally, when the subject of an article is the minority viewpoint itself, the proper contextual relationship between minority and majority viewpoints must be clear. - Fringe theories
 * The video includes the caveats "major opinions" and "reputable source". Also, it is supposed to be a short, generic overview of the principles of editing. It is not intended to be an in-depth analysis of the application of WP:NPOV. Axl  ¤  [Talk]  18:28, 25 June 2014 (UTC)


 * But presenting "all the major opinions without endorsing one over the other" surely doesn't mean giving each equal weight if the one 'major opinion' has 90% support in the scientific community while the other has (up to) 10%. --Hordaland (talk) 19:06, 25 June 2014 (UTC)


 * I endorse RexxS and Hordaland's concerns. Per Okrent's Law: "The pursuit of balance can create imbalance because sometimes something is true."  Implying that we should always Teach the controversy rather than evaluating the quality of sources is an abdication of our responsibility as editors.
 * While I agree with the principle of offering a 'short, generic overview' accompanied by real-world examples, when we do so it is important to choose examples that are amenable to an abbreviated presentation. There's no need to choose a politically-charged, emotionally-fraught example.  Pity it's part of a video presentation; compared to text, video is extremely difficult to edit. TenOfAllTrades(talk) 19:20, 25 June 2014 (UTC)
 * To follow up on Hordaland's clear statement, see WP:FRINGE: "In general, Wikipedia should always give prominence to established lines of research found in reliable sources and present neutral descriptions of other claims with respect to their historical, scientific, and cultural prominence." --Ancheta Wis   (talk  &#124; contribs) 19:28, 25 June 2014 (UTC)


 * I agree the existing wording is problematical. --Anthonyhcole (talk · contribs · email) 00:24, 26 June 2014 (UTC)

Svetol is a brand name of green coffee extract
Have tried to merging one to the other. Creator of article has reverted. Discussion is here Talk:Green coffee extract Appreciate further opinions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:14, 25 June 2014 (UTC)
 * The Svetol page was a . I've taken a, but I expect to be reverted. I'd appreciate other eyes to double-check that I didn't accidentally remove some MEDRS-compliant content. --RexxS (talk) 00:09, 26 June 2014 (UTC)
 * Yes I was also reverted a bunch of times. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:19, 26 June 2014 (UTC)

Diabetes mellitus type 2
New user repeatedly attempting to add a bunch of old primary sources to the article. Additional comments appreciated. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:37, 27 June 2014 (UTC)

CRUK review of Esophageal cancer
As at Talk:Pancreatic_cancer (see above) I've written up as best I can the results of an initial review of Esophageal cancer at Talk:Esophageal_cancer. This is by the internal person who recently reviewed and revised the CRUK (cancerhelp section) pages on this, with the most useful recent papers, which I have her working copies of. The idea is to sort these points out in the article before sending the article for review by other outside specialists. I don't want to waste the time of a top expert by sending them the article as it is. It is basicly accurate but some of the refs are over 5 y.o. (actually its better than Pancreatic in this respect). I'm hoping this is enough to go on for one of the medics here to revise the article, with me helping as I can. Please say at that section (Discussion bit) if you would like to take this on, or otherwise comment. All the main recent papers are open access. Lung and brain next, after the reviewer comes back from holiday.... Thanks to those who have chipped in at Pancreatic. Wiki CRUK John (talk) 14:20, 27 June 2014 (UTC)

Leaflet needs work
The last paragraph of your Wikimania leaflet says that "Personal physicians will always be invaluable, but everyone has the right to learn enough to make their own informed health choices and ask their doctor questions." I think that this is a terrible, terrible, peasant focus that undersells Wikipedia and your project, and seems to focus right at the one area - medical advice - that you can't or won't really give.

I would suggest replacing it with:

"Wikipedia should do the best it can to help patients, students, and medical professionals find information with a solid scientific basis that can better their understanding at every level of technical detail. We can provide a neutral and productive basis for people to make better-informed decisions in everything from personal behavior to political action by making these matters easier for anyone to learn about for themselves."

Wnt (talk) 23:31, 26 June 2014 (UTC)


 * Agree. Particularly removing "personal physicians", whatever that is.  There are many other health workers who also are "invaluable".  Midwives, for example, in most countries.
 * I'd pare down your suggestion some, by removing these words: "of technical detail", "and productive", "better-", and maybe "for themselves".
 * In fact I think the last sentence could be made stronger by shortening it to "We can provide a neutral basis for people to make informed decisions in everything from personal behavior to political action."
 * --Hordaland (talk) 02:47, 27 June 2014 (UTC)
 * The "pretty" version is just a sample of what it will look like. The actual text is supposed to be updated to match what's given (in plain text) in the table:  We aim for a future in which all health information on Wikipedia is accurate in every language version and backed by authoritative sources. Globally, Wikipedia is already one of the most-used sources of freely available health information. Participants from all backgrounds are invited to join us by writing, translating, reviewing and joining our discussions.
 * I'd rather say that we're trying to help "people" instead of "patients", because we seem to help a lot of people who are not patients. Also, we're supposed to provide more than just "information with a solid scientific basis", because we're supposed to include social, cultural, and historical information, too.  WhatamIdoing (talk) 04:35, 27 June 2014 (UTC)
 * Hordaland's suggestions seem reasonable. I am not that knowledgeable of WP:MED's goals, whether the WikiProject per se aims to improve only scientific aspects or the others also; I do not mean to suggest that social/cultural/historical information in these articles isn't important but didn't know it was in your purview. Wnt (talk) 05:08, 27 June 2014 (UTC)
 * I know none of you are shy. Wnt, you say "your leaflet", but this leaflet is as much yours as anyone else's. All of you, make changes first, then if you want to talk, come here and propose something. For whatever reason, a lot of people like talking about this leaflet without making changes to the master version of the text on the Wikimania website. Please change it however you like as you normally would with anything else. WP:BB.  Blue Rasberry   (talk)  13:27, 27 June 2014 (UTC)
 * Related projects in other languages are now also linked, broadly per an earlier discussion. 86.128.169.211 (talk) 14:10, 27 June 2014 (UTC)
 * I've been there and done that already, but not for a few weeks. It's the same username/password, for anyone else who wants to have a go.  WhatamIdoing (talk) 15:46, 27 June 2014 (UTC)
 * Well, I don't think of myself as an actual member of the project; while I encounter some overlap on the content my interest and goals are often different since I'm often more interested in research or traditional practices. Also, the editing now would have to be done to, I think, which is aggravating to do piecemeal, so it'd be better to have agreement. Wnt (talk) 16:26, 27 June 2014 (UTC)

Surrogate endpoint article
Could use some help reaching consensus. Thanks.Formerly 98 (talk) 17:00, 27 June 2014 (UTC)

Account stuff
Hi everyone,

I know that a lot of you read this page but none of the drama boards, so I'd like to give you a little personal heads-up that there's some possibly disruptive changes in account management coming down the pike (date unknown, but this year). I've officially got nothing to do with this, but I would like you all to do a quick check: Please click on Special:Preferences. Look under "Basic information" (the first section), at the "Global account status" item. If it doesn't say "All in order!", please squawk so we can get your account sorted before the deluge. WhatamIdoing (talk) 17:48, 26 June 2014 (UTC)
 * Hmm, mine says: "In migration. Your account is active on 18 project sites. Unconfirmed accounts with your name remain on 23 projects." Axl  ¤  [Talk]  18:59, 26 June 2014 (UTC)


 * Thanks for the heads-up. If someone finds their accounts are not in order, who might they squawk to?  CBHA (talk) 20:28, 26 June 2014 (UTC)
 * It depends a bit on what the problem is, CBHA. Renames require bureaucrats (I don't suppose that any of you have been contemplating an RFB?  Now would be a good time for us to have a lot more bureaucrats around).
 * Axl, are all of those unconfirmed accounts you (to the best of your knowledge)? commons:User:Axl says that they might not be.  Does anything useful happen if you go to Special:MergeAccount?  WhatamIdoing (talk) 22:22, 26 June 2014 (UTC)
 * The Wikimedia Commons account is not me. Actually I asked the owner to let me have the account five years ago. I also poked him here. Axl  ¤  [Talk]  23:08, 26 June 2014 (UTC)
 * There are numerous accounts in other languages; those accounts belong to other editors. Axl  ¤  [Talk]  23:14, 26 June 2014 (UTC)
 * Hi Axl, as far as I can tell, you have the global account, and all of those others will be automagically renamed (to things like "Axl-itwiki") and you'll be "Axl" everywhere. I'll ask around and make sure I'm right, though.  I don't know exactly when this will happen (no date has been set), but September might be the earliest.
 * Does anyone else have any odd messages in their account status? WhatamIdoing (talk) 15:52, 27 June 2014 (UTC)
 * Okay, thanks. Axl  ¤  [Talk]  17:36, 27 June 2014 (UTC)

toxic
I agree with LT. Wp has full of bullies, some are not admins and a few are. WP is dangerous because its medical articles are unregulated and people are even opposed to disclaimers because they want to pretend WP is a medical textbook even though people could die as a result.

This is really bad.

Stephanie Bowman (talk) 03:05, 23 June 2014 (UTC)


 * Have you seen this RFC? 39 editors opposed a banner. A large number of editors (at least 32&mdash;it is somewhat awkward to count exactly how many separate individuals) supported a banner. I doubt that there will be a consensus on this matter. Axl  ¤  [Talk]  11:32, 26 June 2014 (UTC)


 * I don't agree with Axl there, Stephanie. The RfC closed as uncertain - there were eventually so many options on the table that the closers recommended calling another RfC with a more focussed question. I expect that to happen sometime in the next 12 months. --Anthonyhcole (talk · contribs · email) 03:17, 28 June 2014 (UTC)

Draft FDA guidelines for social media
I'm reposting parts of a section of the WP:COI talk page here, as it seems even more relevant here. Smallbones( smalltalk ) 17:49, 25 June 2014 (UTC)

A piece by Ed Silverman on the Wall Street Journal website Tweet This: FDA Finally Proposes Social Media Guidelines (17 June 2014) contains relevant advice for manufacturers of prescription drugs and medical devices from the US Food and Drug Administration. According to Silverman,

"For third-party websites, such as Wikipedia, the draft guidance suggests that companies should feel free to correct misinformation, but that any correction must include balanced information and the source of the revision or update must be noted, Abrams explains. This means a company or company employee or contractor should be credited with any additions.

“The information should not be promotional and should be factually correct. This is not an opportunity for a company to tout its drugs,” he says. “The information [being added or revised] should be consistent with the FDA-approved [product] labeling and for it to be effective, you want it posted right by the misinformation.”"

The draft guidance itself is here. Wikipedia is not mentioned by name, but there are references to "an interactive website" and "an Internet-based, interactive, collaboratively edited encyclopedia".

I think this is the first time I have seen a US government authority advise companies to go on interactive websites like Wikipedia to correct user-generated content related to their products. As an alternative to companies editing the information themselves, it mentions the possibility of contacting the author of the user-generated content (cf. examples 7 and 11 in the draft guidance). Andreas JN 466 09:59, 25 June 2014 (UTC)
 * It's along the same vein as the FTC requirements, that it be done in a transparent way. The subtext there is that if they do take control of the content directly, they'll be subject to the full FDA requirements for advertising communication, which are extensive. Gigs (talk) 17:10, 25 June 2014 (UTC)


 * This is indeed an interesting and timely development. First it should be noted that prescription drugs and FDA approved medical devises are one of only a couple exceptions to FTC regulation of ads in the US.  FDA ad regulation was, and still would be, done on a case-by-case basis; the FDC consulting with the potential advertiser. Note that the proposed guideline are more or less similar to the FTC rules, e.g. the paid edits would have to be disclosed.


 * The only other exception I know of to FTC regulation of ads in the US is for *some* financial firms, e.g. all communication re: newly registered stock offerings (sales) is strictly regulated by the SEC.


 * Note that there is a 90-day comment period on this (until Sept. 17, 2014?). It would be useful if Wikipedia editors got together and make their own comments to the FDA. I'll suggest this be coordinated by WP:Medicine, but there may be conflicting views, so I'll suggest that folks with different views just send in their own comments.


 * It may even be the case that the WMF board or WMF legal might want to send in their own comment - after all they do possess better legal knowledge, and do speak for the the entire movement. Even so, I think they'd like to hear from Wikipedia editors with the comments made in some organized fashion. (that's up to them of course)


 * I'll repost this in several places, but will probably concentrate my efforts at WP:Medicine.


 * Smallbones( smalltalk ) 17:28, 25 June 2014 (UTC)
 * If we are going to send a message to the FDA it should be to point out that due to the collaborative and open source nature of Wikipedia, there is no one "author" for a page that can be contacted in most cases. We should educate them on how our talk pages work. Gigs (talk) 17:32, 25 June 2014 (UTC)
 * And I'd generally like the pharmas be limited to the talk pages, except to remove dangerous information, perhaps identify "off-label" uses with a simple sentence and ref. Make it clear that disclosure is required -but the draft guideline already does that - and probably indicate that the "promotional labeling" information shouldn't be included anywhere (I think the draft guideline does that but it wasn't entirely clear). Education about Wikipedia, via our comments, via the final guidelines would be the strategy. Smallbones( smalltalk ) 17:40, 25 June 2014 (UTC)
 * With respect to "off label use", this is an USA legal thing. We are a global encyclopedia. We want what the best available literature says. The position of regulators can go in the section on society and culture.
 * With respect to replying I am not sure what we should say. Having had some very negative runs in with industry here on Wikipedia I am inclined to see those being paid to promote a product limited to the talk pages. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 19:54, 25 June 2014 (UTC)


 * I'm not sure its that much to worry about. My read of the Guidance was that it was more about requesting changes than about doing actual editing. I'm not privy to the details of Doc's experience with pharma interference with Wikipedia, or and how much of it was official vs. lone wolf activity by a small percentage of the million or so pharmaceutical industry employees worldwide, but I certainly didn't get the impression that the Guidance would start any sort of stampede to edit Wikipedia articles.  BP simply assigned someone the task of "coordinating" with Wikipedia, and we've all seen how that played out in the press.  The Guidance does not require social network sites to make requested changes nor to change their rules about who can actively edit, nor does the FDA have statutory power to pass those sorts of rules.


 * Like Cochrane, NICE, the Institute for Safe Medication Practices, Public Citizen, the CDC, the major medical professional societies, and scores of other groups, the FDA is a nominally disinterested third party that independently evaluates medical data and attempts to draw some sorts of conclusions. Like the aforementioned organization, their independence and neutrality is never absolute.  And their decisions are sometimes constrained by the Agency's enabling legislation.  But if you look through a couple of recent approval summaries on the Agency website, they dig into the clinical and preclinical data on new drugs to an extent that is far beyond the capabilities of most organizations.  I don't understand why their opinions would be limited to the Society and Culture section.  They've made some bad calls, but so has everyone else. Formerly 98 (talk) 22:19, 25 June 2014 (UTC)
 * I guess I should clarify. IMO we should not organize the "medical uses" section into FDA approved uses and "off label uses". While I agree that the FDA is a good source, it is not the only source. If one wants to create a list of "approved" versus "off label" uses as this is a US legal definition it should be in the society and culture section. Other ways of presenting stuff from the FDA can go in the "medical uses" or other sections. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:29, 25 June 2014 (UTC)

Actually, this is not about including information from the FDA. It's about the FDA's ability to regulate what pharma companies can say on social media, and incidentally on Wikipedia. So the draft guidance says that a pharma company's employees must disclose if they make an edit here. It even says somethings about people that they just have some influence on. So we might send the FDA a comment on their proposed guidance that educates them about how Wikipedia works (it's pretty obvious they only have a vague idea) and then say we recommend that employees of pharma and the people they influence should, e.g.;
 * disclose their employer, client, and affiliation for each edit
 * Only edit on talk pages
 * disclose if they have been paid for specific research that they cite.

Or whatever else we want paid pharma editors to do or not do. This will likely be our only chance to send in this info to them for a decade or so.

Smallbones( smalltalk ) 00:54, 26 June 2014 (UTC)


 * On our end, I think that there is some danger of assuming that the COI-related rules for the English Wikipedia are the rules for every wiki. Our rules here don't even apply to other languages of Wikipedia, much less to the smaller, non-Wikipedia "interactive, collaborative encyclopedias" out there.
 * About the pharma companies editing, my main concern is that they might believe that this requires them to remove off-label information, which we don't want them to do anyway, but which could also be a nightmare if they decide that the EU requires them to add X and the US requires them to remove X. WhatamIdoing (talk) 16:10, 26 June 2014 (UTC)


 * Having them stay on the talk page and off the article page should be very safe for everybody involved. I think allowing companies to remove dangerous information on drugs in articles is a real good idea.  Focusing on en:WP doesn't seem like a bad idea for US FDA regulation.  Smallbones( smalltalk ) 18:01, 26 June 2014 (UTC)

Drug Safety in the Digital Age, NEJM


 Blue Rasberry  (talk)  13:46, 27 June 2014 (UTC)


 * From just a quick reading of a brief article on this paper, it looks ok and actually reflects reasonably well on Wikipedia. The only thing I would have preferred is some sort of alternative considered, e.g. is there another site that updates the info more quickly? another form of media that gives detailed info to more people more quickly?
 * As far as the above section on FDA guidelines, I'd think that we can recommend that drug firms bring this information asap to the talk pages, and remove any information in the article that has been shown by the FDA announcement to be dangerous. Smallbones( smalltalk ) 14:31, 27 June 2014 (UTC)
 * , talk pages of minor articles languish and posts there are frequently ignored. Meanwhile, CNN reports that "More than 1/3 of Wikipedia pages have out-of-date drug info a year after a new US FDA warning". If you really wanted to keep drug companies from editing articles directly (personally I think that preventing potential damage to readers' health is a pretty good case for the application of WP:IAR policy), you'd have to have a well-oiled central noticeboard that promptly responds to input. Until such time, I would prefer it if companies (disclosing their affiliation per ToU) corrected harmful misinformation in article space on sight, as envisaged in the FDA draft guidance. (If I read your comment correctly, we agree on that latter point.) Andreas JN 466 10:31, 28 June 2014 (UTC)
 * is there another site that updates the info more quickly? Quoting the CNN article, "So where should you go to get the latest drug safety information? Report author John Seeger recommends consumers be “cautious about information that comes up when you do searches online" and "cross-reference it with the more authoritative source.”
 * “As a public health and regulatory agency, it is a priority for the FDA to provide consumers with clear and accurate information about the safety of the drugs they take," FDA spokesperson Tara Goodin said. "While there are a number of useful websites that contain information about FDA-approved products, ultimately, FDA.gov remains the best resource to find accurate and timely information about the safety and effectiveness of approved drug products.” Andreas JN 466 10:39, 28 June 2014 (UTC)

CRUK review of Pancreatic cancer
At Talk:Pancreatic_cancer I've written up as best I can the results of an initial review of Pancreatic cancer by the internal person who recently reviewed and revised the CRUK (cancerhelp section) pages on this, and listed the most useful papers, which I have her working copies of. The idea is to sort these points out in the article before sending the article for review by other outside specialists. I don't want to waste the time of a top expert by sending them the article as it is. It is basicly accurate but many if not most of the refs, except the recently added World Cancer Report, are over 5 y.o.. I'm hoping this is enough to go on for one of the medics here to revise the article, with me helping as I can. Please say at that section (Discussion bit) if you would like to take this on, or otherwise comment. Access to the sources will be key I think. Esophageal next - see a few down. Wiki CRUK John (talk) 17:20, 26 June 2014 (UTC)


 * I have access to Dynamed and/or Uptodate at work, so if I get a chance will try and compare the summary there with what we have at this article and the one below. Have had a busy few weeks, but will see how the week coming goes. Cas Liber (talk · contribs) 15:10, 28 June 2014 (UTC)

Opinions on a request for reader feedback?
Recently, I added this box to the article Cancer pain. It did link to a special page, Cancer pain/Comment, where it said, "We're particularly interested in hearing what's missing or wrong and whether the article is clear and readable, but your thoughts on anything would be very welcome. Click here to leave your comment. You can find your comment (and others' comments) and any replies by clicking the "talk" tab at the top of the article."

An admin has deleted Cancer pain/Comment and removed the box from the article.

I've rewritten the box, linking directly to the talk page "New section" window, and restored it.

I'd appreciate guidance from my peers here. Is there anything in Wikipedia's rules or norms that says the article can't invite comments from readers? If so, is this an instance where the rule should be modified or ignored? Comments at Talk:Cancer pain --Anthonyhcole (talk · contribs · email) 00:42, 26 June 2014 (UTC)


 * It seems strange to use a text that refers to the next fortnight but is dated 3 years ago. --Hordaland (talk) 01:51, 26 June 2014 (UTC)


 * Hi. Hordaland. I don't understand you there. --Anthonyhcole (talk · contribs · email) 03:27, 26 June 2014 (UTC)
 * I think that this is a good example of what WP:PGCHANGE is talking about: "To update best practices, you may change the practice directly (you are permitted to deviate from practice for the purposes of such change)..."  If you think that this is a good idea, then it's good to test such a change on a small number of pages ("one" being the smallest possible number) and get some information about how well it works.  That said, it's a WP:SELFREF, so it should probably be encapsulated inside selfref (so it will disappear if someone makes a pdf of the page).  WhatamIdoing (talk) 16:38, 26 June 2014 (UTC)
 * Hello Anthony. When I point at the box at the top of this section I see a text.  I click on "more" to see all of it.  It's (apparently) signed in 2011.  --Hordaland (talk) 21:23, 26 June 2014 (UTC)
 * P.S. I see now that it's the first posting on Talk:Cancer pain; that was in 2011.  --Hordaland (talk) 21:28, 26 June 2014 (UTC)
 * Am I mistaken in saying that as this was a speedy delete you can just recreate the page? The motivation for the delete is not any policy, but that it is a test-page, something which is not true. I personally think this box is an excellent idea, and would support it being reinstated. -- CFCF  (talk · contribs · email) 06:25, 27 June 2014 (UTC)
 * Sorry, CFCF, I haven't checked WT:MED for a few days. It looks like we'll be replacing the deleted subpage with an edit notice, if I can find an admin to do it. --Anthonyhcole (talk · contribs · email)  13:51, 29 June 2014 (UTC)

PACT and ACT merger
There is a proposed merger for the stub Program of Assertive Community Treatment into the larger article Assertive community treatment. An IP anon is opposed to a redirect. I would like some comments / third opinion from WikiProject Psychology regarding the proposal at Talk:Assertive community treatment. NAMI describes the two terms saying, "There is no difference between the PACT (Program of Assertive Community Treatment) model and the ACT (Assertive Community Treatment) model. Not only does NAMI use PACT and ACT interchangeably, but PACT or ACT is also known by other names across the country." The other point of view is that they are not the same, but different enough to require separate articles. --Dual Freq (talk) 23:01, 29 June 2014 (UTC)

Issues with alt med articles
We are having issues with editors using "review articles" from journals with low impact factors to contradict or instead of reviews from high impact journals at the acupuncture article among others.

For example in this edit this review  from a journal with an impact factor of 1  was added instead of this Cochrane review  which has an impact factor of 5.78.

Do we need more methods to exclude poor quality sources? Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:53, 27 June 2014 (UTC)


 * If a journal has been found to be by consensus faulty or unreliable and reported, we should make a note of that on one of our sourcing pages. Next best thing is when material is added, try our best to find other higher-quality sources (like Cochrane etc.) Cas Liber (talk · contribs) 00:09, 28 June 2014 (UTC)
 * Should we work on creating a list of journals that should not be used? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:22, 28 June 2014 (UTC)
 * That sounds like the most reasonable approach to me. I do not think we should necessarily label all journals with lower impact factors as unreliable or faulty, but a list of journals that are regarded as such would be useful for medical editors IMO. However, I do think it is important that we discuss what criteria will be used to consider a journal unreliable prior to establishing this list. TylerDurden8823 (talk) 01:26, 28 June 2014 (UTC)
 * Sometimes these fringe journals can be used for mundane claims. For strong claims it is best avoided. Part of the problem at the acu page was pointed out here. QuackGuru  ( talk ) 01:27, 28 June 2014 (UTC)
 * Yes agree criteria are needed. And it partly depends on what the content is in question. We need high quality sources to support unlikely statements. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:29, 28 June 2014 (UTC)
 * I also think it's important that this list not be fixed. The quality of any given journal can improve or worsen over time. TylerDurden8823 (talk) 02:54, 28 June 2014 (UTC)
 * This source from Med. Acupuncture is not a systematic review. See Acupuncture. There is a long history of using poor sources at the acu page. Almost every time someone deletes an unreliable source another unreliable source is added to the page.  QuackGuru  ( talk ) 03:04, 28 June 2014 (UTC)
 * Agree the list should not be fixed - essentially a list discussing the strengths and caveats of certain journals. Cas Liber (talk · contribs) 03:19, 28 June 2014 (UTC)
 * That sounds like a Sisyphean task. Shouldn't this be covered by WP:REDFLAG?  If it isn't, or if it's not clear whether it is, perhaps a section in WP:MEDRS about how REDFLAG applies to medicine would be more transparent and simpler to implement. Adrian J. Hunter(talk•contribs) 05:15, 28 June 2014 (UTC)
 * That's true, the number of journals out there is immense and perhaps this would be simpler. TylerDurden8823 (talk) 05:22, 28 June 2014 (UTC)
 * To give a rough idea of what generating and maintaining such a list would involve, Beall's List of Predatory Publishers has more than doubled in size in the last year to 477, and each of those publishers has "a few to hundreds of individual journal titles". Adrian J. Hunter(talk•contribs) 05:39, 28 June 2014 (UTC)
 * This is the sort of reason I call this "your project". I am not at all pleased with people going off into a huddle and coming up with an ever-flexible list of journals to exclude based in no small part on their POV.  I want to see the pro-acupuncture people have the freedom to present their view of things.  Prestigious sources should be given a little halo of explanation, but I find the way that the article chants the mantra "systematic review" literally seventy-one times (though 41 of those are in the references) to be absolutely ridiculous.  I remain skeptical of this whole fad of claiming that you can review a broad field accurately by following a rote procedure.  But when you then deliberately depart from the "systematic" approach by picking and choosing the journals you like ... what do I call that?  Wikipedia should allow more than just the most powerful opinion-makers to have a say. Wnt (talk) 04:17, 28 June 2014 (UTC)
 * As regards use of systematic reviews and meta-analyses of randomized comparative trials as the highest level of evidence for clinical efficacy, this is not a "fad" and the acceptance of this approach within the scientific community is in no way influenced by Wikipedia or any POV of this project. Of course, a homespun alternative for Wikipedia might be to leave the doors wide open for claims by the most powerful opinion-makers (rather than collaborate with a highly scrupulous non-profit organization like Cochrane). Regarding traditional medicine in general, when the best available evidence from systematic reviews etc supports claims of efficacy, we need to say that. When it doesn't we need to say that too. As to the question of grading journals (by impact factor or in other ways), while recognizing the practical issues I share the concerns raised in the past by  (eg ). Fortunately, such questions do not affect our recognition of the general reliability of Cochrane reviews. 86.128.169.211 (talk) 08:39, 28 June 2014 (UTC)
 * That second source includes some important caveats: "Systematic review (with homogeneity) of Level 1 diagnostic studies; or a clinical decision rule with 1b studies from different clinical centers." It has to be Level 1, there has to be homogeneity... my feeling is that if you have a lot of great data that all agrees there's not going to be an argument anyway.  But the magic words "systematic review" can be spotted as low as 3a on their chart, and even then with the caveat that it has to be with homogeneity and of 3b-grade studies, i.e. even with no systematic review any one such study would be nearly as good evidence.  That's not the same kind of fetishism as I'm seeing here.  Documents like  emphasize that systematic reviews can be done badly, and that they may conflict with large single studies.  But I feel like that paper is still too credulous, because even if a single review of a particular issue (clot busters in 1992) would have come to a better conclusion and saved lives, the statistical power of such 20/20 hindsight is really very poor, and it's pretty much impossible to do a proper control for it where an independent expert goes back and does a narrative review of the old literature to see if just having any other person take a crack at it would have got it right. Wnt (talk) 12:22, 28 June 2014 (UTC)
 * To be honest, I have no idea where you're getting this idea that WikiProject Medicine sees the phrase "systematic review" in a paper and doesn't bother to evaluate whether it is a systematic review of a handful of case-control studies or several dozen prospective studies / randomized controlled trials. From my read of what you're saying, which isn't very clear at least to me, it seems that you're trying to describe a problem that just doesn't seem to exist. Yes, MEDRS is written broadly and I too think that there are places where it can be overspecific. But I'm not seeing what you want changed. Are you saying that you want editors to be able to use other Level 1 evidence to refute systematic reviews? As an aside, systematic reviews are a huge pain for researchers and clinicians to do properly, and at least in the area of my professional interest, simply do not exist for a number of rather important clinical issues. Individual research groups can try to remedy that, but it comes at a time and financial cost of doing more interesting research elsewhere and I can guarantee there is no way we would have started on what we are working on now if it weren't absolutely necessary for another project. We would have gone with using other evidence that has been published in journals&mdash;prospective, longitudinal studies or large RCTs. But that would have been the suboptimal option. NW ( Talk ) 15:00, 28 June 2014 (UTC)
 * Yes, agree with NW. And it is true that the specific wording of MEDRS needs more work. For instance, we really do need to specify that for efficacy studies, we're looking for good systematic reviews and/or meta-analyses of randomized-controlled trials, not of cohort or case-control studies. The precise wording needs work (though that can sometimes be difficult in the presence of destructive critiques). 86.128.169.211 (talk) 21:09, 28 June 2014 (UTC)
 * The levels of evidence page might be expanded and we can simply directly users to use the highest quality evidence available. For example, let's take the Journal of Bone and Joint Surgery, which I admittedly I know little about, has this nice table detailing levels of evidence stratified by type of study (RCT, prognostic, diagnostic, economic). It isn't perfect, as a level 2 systematic review will many a time beat level 1 studies for our purposes, but it's a nice way to start. NW ( Talk ) 23:37, 28 June 2014 (UTC)

I'm ambivalent to creating such a list, because as mentioned above, it would be a herculean task. An alternative is to simply create a list of journals that aren't up to scratch?

The difficulty with going purely on impact factor is that many smaller field-specific journals have low impact factors, not because they aren't high quality, but because they are so specific in their focus. There are numerous cancer, immunology, physiology etc. journals that have an impact factor under 2, but are still very relevant to the field.

Could the solution be to make impact factor ratings the go-to solution for WP:REDFLAG? Any disputed statement needs to come from a journal with a high impact factor? To be frank this issue isn't only relevant for alt-med, but has been up on Electronic cigarette, where Cochrane's reviews were being replaced by some lower quality ones, and where we had nothing in WP:MEDRS to lean on when disputing the edits. -- CFCF  (talk · contribs · email) 09:18, 28 June 2014 (UTC)
 * I don't think we should use impact factor as the sole criterion to determine what journal should be used as a reference for a disputed statement. TylerDurden8823 (talk) 15:51, 28 June 2014 (UTC)
 * I'm not sure that we should use impact factor at all. It systematically disadvantages specialist journals and rewards journals that publish popular things rather than good work.
 * I think that a better solution is for editors on both sides of these disputes to accept that there really are multiple POVs, and that we're supposed to include all of the significant POVs. If you can find actual reliable sources (not just blog postings) saying that a journal is dubious (see Medical Hypotheses for an example), then certainly skip it, but otherwise, I think that you should accept both the pro-acupuncture and anti-acupuncture review articles, without playing the game about "my journal is better than your journal".  There's room in that article for more than one POV, and we can even say things like "Reviews have come to opposite conclusions about..." when there is disagreement. WhatamIdoing (talk) 23:14, 28 June 2014 (UTC)
 * Yes we do have issues with journals which do everything they can to increase their "impact factor". And thus would agree it is far from a perfect measure. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:36, 29 June 2014 (UTC)

Real evidence levels versus Wikipedia cultism
Above I was directed at, and thinking about it ... without putting it in particular on a pedestal, that list illustrates what is wrong with Wikipedia's overbearing policies on medical articles. Specifically, what's not on the list:


 * Five years. That number, however deeply enshrined in the Wikimedical faith, still smells to me of the ass some editor pulled it out of.  Nothing in the third party list suggests that a properly done experiment or systematic review just goes away after a little while.
 * Secondary sources. Even a systematic review, with significant caveats, ranks only a little better than the underlying studies that went into it.

I need not add that impact factors and homemade lists of "good" journals aren't even a cloud on their horizon!

So here's my question: can Wikipedia obtain third-party opinions about, or directly assess, levels of evidence according to some standard similar to this one I was pointed at? And can we agree to blow a hole in our policy that allows editors to ignore the made-up Wikipedia special rules and include data from high-level sources? Wnt (talk) 12:43, 28 June 2014 (UTC)

The 5 year thing (MEDDATE), is pretty much ignored presently. There are very many source on medical articles > 5 years old. If there is a good secondary/tertiary source older than 5 years, use it imo. It's probably going to be better than the previous source anyway (some health information website often). But it's nice to be up to date in an ideal world. Would suggest replacing the old and terrible sources with at least not terrible sources (but maybe old) as a priority first however.

With regards your ranking of systematic reviews "only a little better" than primary sources, I think you are missing the whole idea and point of systematic reviews. If the underlying sources are full of flawed methodology, all kinds of bias, etc., a good systematic review will conclude this rather than perhaps following the same petri dish conclusions of each individual primary source. It might conclude "there is not enough evidence until someone does some proper research" whereas the primary sources are saying "Our results suggest this this and this". In this respect a systematic review is far more reliable than primary sources. Anyway, the whole secondary source thing is encyclopedia-wide (RS not just MedRS), so you would have to convince more people than just this wikiproject.

Here are more examples of external "evidence levels", Evidence-based_medicine. It might be interesting to see such things formerly laid out in MedRS, although to be honest, it is largely the same in spirit already. 188.29.81.1 (talk) 16:53, 28 June 2014 (UTC)


 * The problem with meta analysis is that the complexity and sheer volume of information and decision-making involved in deciding which trials to include and how to process the data greatly undercuts the ability of readers to make their own assessment of the author's decisions. In criticizing the recent Cochrane review on neuramidase inhibitors in the BMJ, I was recently challenged by Trish Groves to review and publish my own analysis of the Roche clinical study reports.  Its a nice rhetorical challenge (which she has offered to virtually everyone who criticized the study), but the problem is that to do so would take 6 months, and unlike the Cochrane researchers, I'm not being paid a salary while I do it. To my mind,this lack of transperancy and the "accept our conclusions or quit your job and spend 6 months doing your own analysis" attitude is the core of the problem.


 * The opportunity for the authors to incorporate their own personal biases is made clear by the stream of industry-sponsored meta analysese comparing their own new drugs to older ones (which consistently find for their own drug). That this is not just an industry problem is shown by the consistency with which those on both sides of the statins-in-primary-prevention issue are able to continue to publish meta analyses upholding their long-held and opposing viewpoints as more and more trial data becomes available.


 * The rules here are that the meta analysese are the most reliable sources, and if you find one that claims to have examined data that others didn't include, its pretty much a trump card irrespective of the readily apparent biases of the authors. Given that the biases of the investigators shine through the analysis, one can usually find one that agrees with one's own position on any controversial topic. It's not really that different than cherry picking primary research papers, and to an extent, I'd argue that most meta analyses ARE primary research.  I don't like it, but that's how things are done here.


 * The intrinsic lack of transperancy of the process flies in the face of traditional scientific publishing, and results in publications that are little more than carefully reasoned editorials. Formerly 98 (talk) 18:48, 28 June 2014 (UTC)


 * The "5 year thing (MEDDATE)" was introduced in this "Revision as of 18:00, 14 July 2008" by Eubulides, after a discussion. It is actually rather mildly phrased "Here are some rules of thumb for keeping an article up-to-date while maintaining the more-important goal of reliability. These guidelines 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 and few reviews are being published. ... Look for reviews published in the last five years or so, preferably in the last two or three years." I expect a good deal of current medical content predates it, and another large % met it when the passage was written, but has not been revised, and now does not merely because of the efluxion of time, as the lawyers call it. It is not so much ignored, in many articles, as very hard to keep up with with present resources. User:Wiki CRUK John/Johnbod (talk) 02:18, 29 June 2014 (UTC)


 * A key phrase in the wording there is "rule of thumb" (no Mozartean quips invited!). Yes, the 5-year cut-off is arbitrary, but it's not rigidly enforced, especially when recent updates are not available. That duration is cited to encourage inclusion of up-to-date information—a major issue for us, as John notes. 86.128.169.211 (talk) 10:54, 29 June 2014 (UTC)


 * The problem I have with your claim that a good systematic review will exclude a bad primary study is that ... how do you know it's a good systematic review? Personally I feel more confident looking at a primary publication and seeing that it's a major lab with good public funding coming out in a solid research journal publishing experiments that make sense, than trying to tell whether a systematic review covered all the sources fairly.  I understand that's a personal bias, but the bottom line is that I don't like the implication that it's OK to pick up just about any self-described systematic review and trust that it points to good studies, but not to point to the research result directly trusting that.  And indeed that's not far from where the discussion began above, by casting aspersions on a pro-acupuncture systematic review.  Now my preferred ugly solution to the conundrum is simply to cast a wide net, allow a lot of stuff in even knowing that some of it may be a little dodgy, on the basis that it's better for the reader to sort through too much data than too little.  But it may be that we can come up with another solution that includes cross-checking between systematic reviews and primary research they acknowledge, so that we can make a greater range of opinion known by citing all the articles that pass the filter you suggest of a systematic review recognizing them.  Definitely though I don't want ad hoc solutions that chuck out whole library stacks full of articles based on a couple of people going "hmmm" at the name of the journal. Wnt (talk) 23:47, 28 June 2014 (UTC)
 * We simply don't have the ability to do that. We can't have the accountable expertise. NOR plus ANYONECANEDIT means we need someone else to decide what primary sources matter, we can't trust the judgement of pseudonymous wiki editors. LeadSongDog come howl!  03:25, 29 June 2014 (UTC)
 * Is it really that much easier for editors to assess whether a source is "secondary" or a "systematic review" than it is to have them decide if a study was controlled, prospective, was a cohort study, used a good reference standard? (not all of these things would have to be determined either)  We're telling editors that they don't have the independent judgment to apply the real standards used in the industry, then turn them loose into endless plastic-toy debates over the more irrelevant terms they are allowed to judge. Wnt (talk) 05:20, 29 June 2014 (UTC)


 * Considering how few know how to distinguish 1o, 2o and 3o sources currently, I would say asking people to be able to recognize other details of the study methodology would be asking too much. For most people on Wikipedia, any source which is presented as a scientific publication will appear very reliable, whether it is a primary source, original research in vtiro study or a meta analysis.188.29.89.177 (talk) 11:16, 29 June 2014 (UTC)
 * Agreed, the likelihood a secondary source is low quality is much lower than a primary source is. It is far from an ideal solution, but we cannot enforce anything else. We aren't speaking of "allowing a few sub-standard sources in" but about opening the flood-gates completely if we get rid of this clause. There are times when it isn't enough, but being able to rely on this significantly decreases the amount of work needed to argue against poor edits. The whole Wikiproject will fall if we were to allow primary sources indiscriminately, as each single shoddy statement would need to be analyzed in full, and each single source would need to be read in full. It just isn't viable.
 * Additionally, just as 188 says, the simple fact that a user can find a secondary source implies a form of understanding of both what WP:MEDRS aims for, and that they are sufficiently knowledgeable in the field. -- CFCF  (talk · contribs · email) 11:36, 29 June 2014 (UTC)


 * Agree that MEDRS facilitates more focused dialogue on talk pages. I don't think anyone's claiming that the wording of the guideline can't be improved. But despite it's technical limitations it's a valid defence against pov (or simply naive) editing. And it also provides a useful starting point for informed gf editorial reasoning. In short, yes it can be polished, but it basically works. 86.128.169.211 (talk) 12:00, 29 June 2014 (UTC)
 * "Is it really that much easier for editors to assess whether a source is "secondary" or a "systematic review"..."
 * Yes: You tell them to find it on PubMed, click the "Publication Types and MeSH Terms" heading, and see whether the word "Review" is there.  In most cases, it requires zero judgement and much less skill than writing the wikitext formatting for the citation.  WhatamIdoing (talk) 16:42, 29 June 2014 (UTC)
 * Ugh. I've seen this kind of decision making... the problem is that on one hand, a "review" is not uncommonly a professor writing an overview of four or five papers by himself and his collaborators, with some sympathetic citations; on the other, a "primary article" often contains useful review in its introduction and discussion.  If we're going to have a no-thought criterion, the best such criterion to have is to include everything. Wnt (talk) 21:52, 29 June 2014 (UTC)
 * I agree it isn't perfect, but it is primarily about applying quality control. What suggestions do you have Wnt? We need something that is easy to: comply with, enforce & understand, etc. ; and which does not rely on third party judgement. Any ideas off the top of you head?-- CFCF  (talk · contribs · email) 22:07, 29 June 2014 (UTC)
 * "Include everything" is simply not possible. There are over a million academic journal articles published each year.  WhatamIdoing (talk) 23:35, 29 June 2014 (UTC)
 * Start with the fundamental inclusionist principle. Wikipedia is an encyclopedia without any looming limit on what it can hold.  I like to think of it like my image of the Smithsonian, filing away practically any serious submission of material in a drawer somewhere for future generations to examine.  So generally speaking, any editor who can find WP:reliable sources (a low standard) and accurately summarize the information they provides should have a right to house that information somewhere on Wikipedia.  I know people will point at some exceptions, but this is the principle toward which we should strive.
 * Now you can say it's impossible to summarize a million articles a year. To begin with, I doubt that's true.  We have three million articles, most of which have many references.  They're not all science, of course, but we're not that many orders of magnitude away from doing it.  But the other thing is that ... if we can't do it, we don't have to worry about preventing it from happening.  The editors will, by virtue of not doing everything, apply a filter that promotes the more important articles more often than the less important articles.  Now that's a subjective decision, but when subjective decisions are made by tens of thousands of editors they are fairer than when they are made in a star chamber where a few people decide what is OK to use.  The more hierarchy and power in the process, the easier it is for a biased group to take control of it.
 * Dealing with WP:FRINGE does not involve suppressing material, but properly filing it. We have a place for the Flat Earth Society.  But we must not confuse "fringe" with merely "wrong".  It is useful for Wikipedia to refute wrong ideas, and suppressing material makes that impossible.  To make a parallel, when a famous person is wrongly accused of a crime in the papers, it is better for us to cover their exoneration than to delete all mention of the incident, because people would forever be asking after it in the talk page.  We'd be giving the impression we were covering up the crime when instead we could be delivering compelling evidence of innocence.  We should only exile fringe material from an article when there's not much reason people would take it seriously to begin with.
 * We do have an obligation to make it clear when one point of view is winning the battle for scientific opinion. We can do that by describing reasons to take one point of view more seriously, i.e. large studies, systematic reviews, prestigious journals, supporting opinions.  We could figure out many different kinds of things for editors to look for, which are straightforward and verifiable, which give indications of quality; use them not as rules to have the editors decide who is right behind the scenes but rather ways to cue the reader in on who is winning.  For example, one criterion I've seen published is that studies with public support are more reliable than those funded by the company whose product is being tested - obvious, but WP:MEDRS still specifically bans discrimination against those studies and certainly doesn't encourage it, despite my attempt to get that changed.  Systematic reviews are indeed one way of signifying quality but there are many others.
 * To me people here seem to assume that Wikipedia should provide "information for patients". There are sites that provide information for patients, meant to be used alongside medical treatment, but Wikipedia should strive to the higher goal of simply providing information -- for high school students, medical students, reporters, political activists, officials, and scientists - and yes, of course patients too, but regarding them as our equals, not our wards.  Fundamentally, an encyclopedia by its nature expresses a belief that any reader should have the right to know everything - not filtered by occupation, caste, or social role, but purely for the love of knowledge itself.  This perspective is why I generally feel we need to cast a very broad net for all the possible ideas out there, rather than intentionally suppressing all but those judged most likely to deliver effective treatment. I should add that I suspect the utility of our articles follows a sort of Zipf's law, where the impact of a single reader (perhaps a researcher or activist) may form a significant fraction of the total benefit an article can have. Wnt (talk) 00:53, 30 June 2014 (UTC)

Sarcasm doesn't do well on the internet, I'm sorry. The guideline is not going to be changed in this regard, and I will not waste more time on this discussion. I suggest you go read Jytdog's essay User:Jytdog/Why MEDRS? -- -- CFCF  (talk · contribs · email) 06:29, 30 June 2014 (UTC)
 * Point 1 & 2 have essentially the same problems. Editors who concentrate on medical articles here on Wikipedia are counted in the tens, and you suggest we should be able to summarize 1,000,000 articles. That amounts to, even very optimistically: 10.000 articles per editor, or ~27+ articles a day.
 * Yes, indeed sometimes there is need to suppress fringe ideas. There aren't enough editors to go around to check each and every last homeopathy article so that it doesn't state anything about a miracle cure.
 * These are often murky waters, and you aren't always going to immediately tell who supports a study. Do you suggest we only cite publicly funded sources? The shit-storm there is bound to be even greater.
 * Wikipedia does not assume that. What we assume is that a patient reading the content should not be subject to missinformation, or information that is largely dubious for whatever reason.
 * The model of "add whatever interests you, because then only (mostly) important papers will get added" is a nice idea, but it doesn't work in practice. How about I add whatever interests me, which happens to be my own publications about my grand new theory?  I believe we had a case of that related to complications of vasectomies a while back.  How about I add whatever interests me, which happens to be anything saying that this one surgery is worthless?  I ran into a case of that on a sympathectomy:  the only editor interested in that subject "just happened" to be someone who ran a website trying to get the surgery legally banned.  If we were all just innocently interested in information, then this might work, but in practice, "add wahtever interests you" is a boon to POV pushers.  WhatamIdoing (talk) 15:51, 30 June 2014 (UTC)
 * That can be disturbing, yes; but someone bent on a biased agenda can break the rules no matter what they are. I think the key is that we take the inclusionist approach to disputes where you fix biased/limited viewpoints by adding and covering the better-supported ones more.  This is not a special thing for medicine - any other kind of politics can be just as heated.  It isn't uncommon for people with strong political views to edit political articles - and if people can only be inclusionist and add stuff instead of constantly reverting the last person's work, that can be a quite productive way to write an article.  (and in this case, honestly I don't think someone critical of a procedure not so different in concept from a lobotomy should really be regarded as supporting a fringe point of view)  The bias produced by the filter of individual editors is not random, since of course companies can be prowling around pushing their POV, but it is relatively easily opposed by editors (as yourself) who get offended when an editor is not being neutral.  It is harder to fix systematic bias that emerges when, say, a group of people in a special wikiproject come up an arbitrary list of journals that shall not be used.  Individual bias is more usually flagrant, unsophisticated, heartfelt, honest; that's why I prefer it so much to the alternative. Wnt (talk) 20:23, 30 June 2014 (UTC)

Alcohol (drug) vs alcoholic beverage
I'm not sure if we don't need more medical eyes in this ANI thread. It is about alcohol. JFW &#124; T@lk  20:19, 30 June 2014 (UTC)


 * Regarding this comment: Fwiw, I've found this split perplexing too. It made me wonder what "general" readers make of this distinction. 109.156.204.159 (talk) 22:05, 30 June 2014 (UTC)


 * Link is here  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:39, 30 June 2014 (UTC)

Assistance with 2014 West Africa Ebola outbreak article on main page
Someone with medical / public health background needs to keep track of the 2014 West Africa Ebola outbreak article, which is currently on the main page. -- Djembayz (talk) 17:16, 30 June 2014 (UTC)
 * Have recently updated the lead of Ebola virus disease Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:04, 1 July 2014 (UTC)

Synthetic routes in drug articles - style guide?
I've noted the recent addition of detailed chemical synthetic routes to many of the drug articles in Wikipedia. I don't see this as a positive thing, as it is difficult for me to imagine that more than 1-2% of our readers is able to understand and appreciate this content. In most cases the synthetic route provided is a randomly selected procedure from among many published in the literature, and there is no citation showing that the particular route illustrated is used for production.

Also, without meaning to be a prude, I note that the proliferation of synthetic routes and references to detailed synthetic procedures has been particularly rapid for drugs of recreational interest. We have detailed synthetic routes and literature references now for many drugs that are rarely if ever used therapeutically, including Fencamfamine, bromadol, metenolone, MDMA, methamphetamine, and mescaline among many, many others.

I would like to propose adding to both the medicine and pharmacology style guides a statement along the line of "Detailed information regarding the method of chemical synthesis of pharmacologically active substances should not normally be included in articles, as it is outside the scope of a general interest encyclopedia. The inclusion of references and detailed schemes for the synthesis of psychotropic drugs with high abuse potential is particularly discouraged".

Most importantly, I think the inclusion of synthetic routes is out of scope and too specialized. Secondarily, while the synthetic routes for drugs of abuse are widely available on the web, I don't see any reason for Wikipedia to participate in its dissemination. The routes are really outside our usual scope in any case.

Just my POV. Any thoughts from others? Formerly 98 (talk) 22:02, 21 June 2014 (UTC)


 * I doubt that the community will agree to this. The first objection will be that Wikipedia is not meant to be an encyclopedia solely for general interest.  WhatamIdoing (talk) 22:19, 21 June 2014 (UTC)


 * Hmm, off to a poor start. By "general interest" I'm referring to non-specialist.  I see a lot of articles with commentary pointing out that the level of technical detail should be reduced to an appropriate level for a general audience. Formerly 98 (talk) 23:12, 21 June 2014 (UTC)
 * were these added recently? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:12, 22 June 2014 (UTC)


 * Maybe its this template; Technical, which says "This article may be too technical for most readers to understand. Please help improve this page to make it understandable to non-experts, without removing the technical details.", without removing. We do not know what people are looking for. Most peoplemy postulate have no idea what H, O, Yb, pH, Ph are. The lead should be readable for "everybody". This is the medicine wikiproject and I have no interest in medicine and skip all the "nonsense" when I am reading about chemical compounds (but I do not delete it, because maybe it has interest to others). Christian75 (talk) 08:58, 1 July 2014 (UTC)

Summary style might help here. 194.42.240.60 (talk) 08:11, 22 June 2014 (UTC)


 * I have mixed feelings about this. I agree that including an arbitrarily chosen synthesis of a drug is not appropriate.  If included, the synthesis should be how it is produced industrially or perhaps how it was first synthesized, but certainly not the 10th "novel route to drug X" synthesis. In these cases, a separate article on "synthetic routes to drug X" might be appropriate.  Concerning illicit synthesis, Wikipedia is neither a how to guide nor is it censored.  Furthermore if the illicit synthesis of a drug is wide spread, that increases the notability and therefore the justification for its inclusion.  IMHO including a general description of the synthesis is fair game, but regardless if the synthesis were ethical or illicit, it would not be appropriate to include experimental details. Finally, wouldn't it be more appropriate to have this discussion here? Boghog (talk) 08:45, 22 June 2014 (UTC)


 * If a compound article is tagged with WP:MED+WP:PHARM and WP:CHEMS, then the MOS layout for that page needs to include all relevant sections laid out in the MOS for those projects. MOS:CHEM indicates including a synthesis section.  Seppi  333  (Insert 2¢ &#124; Maintained) 12:07, 22 June 2014 (UTC)
 * I think I'm supportive of this - WP:UNDUE is one applicable policy, perhaps the main one. Johnbod (talk) 12:42, 22 June 2014 (UTC)


 * Seppi333 makes an interesting point about the chemistry style guide. But I wonder if the synthesis section is intended to include the detailed synthetic schemes becoming commonplace in these articles.  I'm a PhD chemist, and I routinely blow past these detailed synthetic schemes.  Which makes me wonder how many of our readers find them of interest (or comprehensible). Formerly 98 (talk) 13:04, 22 June 2014 (UTC)
 * BogHog, I agree that probably should have been posted over at Pharmacology, but in the summer its hard to get eyes on things over there. Formerly 98 (talk) 13:04, 22 June 2014 (UTC)

@ Formerly, just because yourself or even the vast majority of other readers do not find some info useful is no credible reason to delete it. Just put it into a sub article which is linked from the main page if you don't think it is part of the main topic. WP:Summary style lays this concept out exactly. 194.42.240.60 (talk) 22:51, 22 June 2014 (UTC)
 * I welcome the inclusion of information on synthesis. Wikipedia has thousands of articles on very specialised topics and even if only a few readers find them of interest that is okay. Wikipedia is not a general interest encyclopedia. Accept that specialized content exists. We are talking of pages dedicated to a single compound. That is already very specialized. The "adverse effects" section in Fencamfamine is all jargon that I do not understand and is of no interest to me but a understand that other people do find it interesting to read. If the topic is published synthetic methods then it is irrelevant if any of the methods have commercial value. State it as a fact: such and such methods have been reported. Valuable information to me. Move the section to the bottom of the page if you have to. Synthetic routes are within scope especially when it comes to recreational drugs. Wikipedia should not censor this information. A meth cook is only interested in concentrations used, cook time and crystallisation method, the sort of detailed information that does not belong in Wikipedia. V8rik (talk) 18:59, 26 June 2014 (UTC)

Rushing Woman's Syndrome
This is a self-help book by a woman with a PhD in biochemistry that "examined the biochemical and nutritional factors in children with autism." The strongest sources are reliable sources that debunk the theory after it was relied on in public by a minor celebrity. I'm not sure that the book is notable. Stuartyeates (talk) 20:59, 30 June 2014 (UTC)
 * It is not notable medically. But is it notable as a book? I do not know. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:35, 30 June 2014 (UTC)

Okay - we need to think on how to approach this - the author has a new page at Libby Weaver, which was written by this role account, while this role account wrote the book. I think merging is the best idea - the book I'd say is covering medical material unsupported by secondary/reliable sources. Also - the accounts I suspect are the same and are paid editors, hence is this worth a sockpuppet investigation? Will post at WP:AN/I. Cas Liber (talk · contribs) 07:02, 1 July 2014 (UTC)
 * Yes likely. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 09:09, 1 July 2014 (UTC)
 * It gets better: all the books by this author are published by http://www.littlegreenfrogpublishing.com/ and she appears to be their only author, so they're all self-published. Stuartyeates (talk) 09:18, 1 July 2014 (UTC)
 * Okay then, that clinches it - have nominated at Articles for deletion/Rushing Woman's Syndrome Cas Liber (talk · contribs) 10:14, 1 July 2014 (UTC)

Template:DailyMed
They don't use old url and id type at Dailymed website: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=1687. The new url and id should look like: http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=11086b35-760b-460d-b1b6-e20ad6baf764. Shoud we change the template? — Preceding unsigned comment added by Username-alexander (talk • contribs) 12:09, 1 July 2014 (UTC)

Prescrire
What are peoples thoughts on Prescrire? Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:40, 29 June 2014 (UTC)
 * They are European which provides some balance to much of the American perspective in the literature.
 * They produce systematic reviews
 * Each is peer reviewed by 20-40 experts
 * It is a not for profit
 * They do not allow advertising
 * They do not allow the buying of large number of reprints
 * They are independent of industry
 * They have an English version that is pubmed indexed but there main version is in French.
 * They have a fairly large number of subscribers and have content reprinted by a number of English journals including Canadian Family Physician


 * Sounds good by your description, James. It costs €140/year for a non-professional individual in Europe.  I tried several search terms (circadian, chrono..., etc.) with no result.  Finally got hits on "melatonin".  Two of eight hits were not of interest (major depression and sexual dissatisfaction).  The other six were all more than five years old, half of them from before 2000.  I didn't check any other, perhaps more popular, topics.  Besides being expensive, it appears to me to be out-of-date.  --Hordaland (talk) 13:45, 29 June 2014 (UTC)


 * They publish 11 editions in English a year. There are a 123 articles listed from the last 5 years on pubmed that are listed as reviews  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:27, 30 June 2014 (UTC)
 * It was my criticism that prompted JMH649's query. My prior remarks were unnecessarily confrontational, and I apologize for this.  But my concerns are as follows:


 * This is not a traditional journal that accepts submitted manuscripts from independent authors, sends them to independent referees, and then makes publication decisions based on the input of those referees. As described below, it is a self-published product by a group with non-mainstream views.
 * In part because of the above, it is not a widely accepted source. According to this website, the average Prescrire article gets cited only 0.18 times, and half of these are self-citations.  Put another way, only one in every 11 Prescrire articles ever gets even a single citation in the mainstream medical literature. This puts it neck-and-neck with the following journals:
 * Homeopathy
 * Alabama Nurse
 * The Australian Journal of Medical Herbalism


 * For comparison, respected specialty journals such as the Journal of Clinical Gastroenterology get about 3.5 cites per manuscript, and minor generalist journals such as Southern Medical Journal get about 1.2 external citations per article, about a 10-fold difference.


 * Prescrire's home page is full of troubling, dismissive references to other journals such as the Lancet. Quotations marks are placed around phrases like "medical journal" and "referee" to express skepticism about the processes of these sources, along with adjectives such as "so called". In recent years it has written moderately to highly negative reviews of many drugs that are mainstays of professional medical association treatment guidelines, including thalidomide for multiple myeloma and most of the anti-MRSA, anti-VRE antibacterials that have been approved since 1990.


 * Prescrire's own description of its review preparation protocols makes it clear that the selection of editors to write articles, the writing of the articles themselves, the selection of the "referees", the decisions regarding which referee comments will be incorporated, and approval and publication of the final draft are all conducted tightly under the control of a single person, the journal's excecutive editor. There are no independent authors, editors, or referees.


 * Respectfully, this is not a source that should be used to support broad statements about the safety and efficacy of any medical intervention. It is not mainstream, is not truly peer reviewed, and the lack of citations of its content after 20 years of existence shows that it is not widely respected.  It is WP:selfpublished and probably can be considered WP:fringe.  It is not a scientific journal in the usual sense of the term, nor does its editorial processes incorporate the usual quality control and peer review processes that are normally associated with reliable sources.Formerly 98 (talk) 13:50, 29 June 2014 (UTC)
 * I'd never heard of this journal before about ten minutes ago........ Cas Liber (talk · contribs) 13:59, 29 June 2014 (UTC)


 * Just to add one more point, my understanding is that our emphasis on secondary sources is to show mainstream acceptance of medical ideas and conclusions. How can one do that by citing a journal that gets only 0.09 citations per published article?  I believe this flies in the face of the principles underlying MEDRS. Formerly 98 (talk) 14:16, 29 June 2014 (UTC)
 * We need to present all the (significant) POVs, not just the mainstream one. Using secondary sources helps us figure out what is important enough to include in a concise summary.  Using them in DUE proportion helps us present the mainstream view as being mainstream (not as being the only one that exists).  WhatamIdoing (talk) 16:48, 29 June 2014 (UTC)
 * I'm in full agreement. In the present case, however, this source was used to make a summary statement about the risk/benefit ratio of the drug, not to present a minority viewpoint that was identified as such. And with respect to signficance, Prescrire is less cited than the journals Reanimation, Gastroenterologia del Peru, The Nebraska Symposium on Motivation, and the Journal of the Tennessee Dental Association. I'm just having trouble seeing this. Formerly 98 (talk) 18:05, 29 June 2014 (UTC)
 * I've got no opinion on this journal, but the "statistics" approach is troubling. What drives citations is often things like the age of the journal, the proportion of articles that are open-access (which means, in part, the proportion of articles reporting work funded by the US government), and media attention/marketing savvy.  I don't have the citation, but I've read that the most effective way to reach American doctors and researchers is to get your study mentioned in The New York Times, not to get it published in a good journal.  WhatamIdoing (talk) 19:08, 29 June 2014 (UTC)
 * In general I agree with you its a pretty limited approach. But when a journal has been around for 20 years publishing reviews on topics of broad interest, and no one is citing those reviews, there has to be some explanation.  Mine is that the journal is not highly regarded. I'm open to hearing others. Formerly 98 (talk) 19:29, 29 June 2014 (UTC)
 * Do you know of other publications that style themselves as "continuing education" journals that are widely cited? There are some, I think, but perhaps not that many; the Current Opinion series has a somewhat similar editorial role, I think. Perhaps it's worth noting that although this (originally government-sponsored) journal also publishes an English edition, there's a major editorial need for continuing-education medical literature in other languages for the benefit of the many medics who have difficulty reading the scientific lingua franca of English. 86.128.169.211 (talk) 08:32, 30 June 2014 (UTC)

Prescrire international is pubmed indexed and to be indexed it must be peer reviewed from what I gather. Many of its conclusions are inline with other reviews such as this 2014 review on treating mildly elevated BP

With respect to the effectiveness of peer review, we all know that it is far from a panacea. While I am very supporting of using reviews from the Lancet, their financial structure does leave them open to concerns. For example this review states with respect to tPA in stroke "although some patients might benefit up to 6 h after stroke" in the interpretation yet if you read the paper in full the data only support up to 3 to 4.5 hours. Journals that rely on advertising and reprints must be exceedingly careful regarding what they publish. Critical position can go missing due to financial concerns.

The Prescrire funding model is based on subscriptions rather than advertising or reprints. It is also mostly French and presents the evidence within the context of France. It is just one position I agree and it is an opinion that is not tied to the pharmaceutical industry. It is a member of the International Society of Drug Bulletins an organization support by the World Health Organization. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:15, 30 June 2014 (UTC)


 * I can't see any strong a priori reason why content from this French journal shouldn't be considered potential MEDRS. I find the arguments put forward here regarding impact factor / citation index unconvincing, especially in view of the editorial characteristics of the journal. 86.128.169.211 (talk) 09:11, 30 June 2014 (UTC)
 * Medical Hypotheses is Pubmed indexed but not peer-reviewed, so I think there is an incorrect assumption here. Looie496 (talk) 15:00, 30 June 2014 (UTC)
 * (Not sure what "assumption" Looie is referring to here.) Good quality textbooks are considered potential MEDRS, even though they're not usually peer-reviewed in the conventional sense. Prescrire outlines the peer-review procedure it follows, which incorporates a somewhat unusual process for reviewer selection. (Fwiw, my experience with submissions to Current Opinion suggests to me that their peer-review process focuses primarily on formal concerns.) I suppose a more substantial concern might be the way Prescrire entrusts the writing of articles is entrusted to "editors" rather to outside experts in the particular field. 109.156.204.159 (talk) 16:35, 30 June 2014 (UTC) [previously  86.128.169.211]
 * From the indentation level, Looie was responding to Doc James, so it's probably safe to assume that James' comment "to be indexed it must be peer reviewed" was Looie's target. As for concerns that editors rather than outside experts write our articles, the proof is in the pudding. Britannica and Nupedia both used variations on that model and there's no evidence that they've produced better content than Wikipedia (with the possible exception of readability of the text). I wouldn't lose much sleep over concerns like that. --RexxS (talk) 17:28, 30 June 2014 (UTC)
 * Actually, I was referring to Prescrire's editorial system. Sorry RexxS if that wasn't clear. 109.156.204.159 (talk) 18:14, 30 June 2014 (UTC)
 * From the indentation level, Looie was responding to Doc James, so it's probably safe to assume that James' comment "to be indexed it must be peer reviewed" was Looie's target. As for concerns that editors rather than outside experts write our articles, the proof is in the pudding. Britannica and Nupedia both used variations on that model and there's no evidence that they've produced better content than Wikipedia (with the possible exception of readability of the text). I wouldn't lose much sleep over concerns like that. --RexxS (talk) 17:28, 30 June 2014 (UTC)
 * Actually, I was referring to Prescrire's editorial system. Sorry RexxS if that wasn't clear. 109.156.204.159 (talk) 18:14, 30 June 2014 (UTC)

Prescrire is an interesting one. It is quite unconventional and a bit iconoclastic, perhaps more so than other European counterparts such as the Drugs and Therapeutics Bulletin (UK) and the Geneesmiddelenbulletin (NL). My intuition is that I would not use it alone because of concerns about WP:WEIGHT, but I would be happy to support it as a source where there are corroborating sources available. JFW &#124; T@lk  19:23, 30 June 2014 (UTC)
 * Yes it was used in this edit and its conclusions are in line with other sources.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:38, 30 June 2014 (UTC)


 * So the Prescrire summary is that it is a "drug to avoid". What Cochrane said in 2014 is "the NNTB of 8 in fibromyalgia and depression is not an indication of substantial efficacy. More trials (preferably independent investigator led studies) in these indications are required to reach an optimal information size to make convincing determinations of efficacy. Minor side effects are common and more common with duloxetine 60 mg and particularly with 120 mg daily, than 20 mg daily, but serious side effects are rare" This is certainly less that a ringing endorsement, but I'd hardly call it supportive of "drug to avoid".


 * In essence, the precedent being set here is that I can hire some people who share or are willing to defer to my opinions to write articles about medical subjects, pick some like-minded referees to review the articles that my hand picked employees have written, make decisions about which referee's comments to incorporate, and publish articles expressing opinions that have not had any truly independent input or evaluation from anyone. And when the world shows its opinion by completely ignoring my self-published journal, it can still be used a "reliable source" in Wikiipedia. Formerly 98 (talk) 01:28, 1 July 2014 (UTC)
 * It is a number of French academics who are financially independent from the stuff they are studying, at least somewhat endorsed by the World Health Organization and have convinced nearly 35,000 people to buy a subscription that funds the efforts, looking at the available treatments and considering that this one has some concerns compared to others available.
 * I agree it is different than the usual situation where a multi billion dollar company pays a couple of staff members to do a "trial", than pays a scientific article writing firm to write it up, then pays some "well respected experts" to donate their name to the article in question without having any involvement in its production, than promising a journal that they will buy 10,000 re-prints if they publish it / send it out to people they know will be lenient for peer review. Plus of course the journal needs to ignore the fact that the primary end points changed halfway through the trial. And if the journal does not tow the line without putting up a fuse they do not need to threaten to pull their advertising from said journal as this is just understood. This then continues with misinterpretation of said trial in the advertising material produced and giving lavishly to guideline producer to make sure those are favorable. Not to mention doing half a dozen of these trials and burying the one they do not like before the publication process with journals is even started.
 * The company then finishes this with having their head of marketing activity edit Wikipedia along with half a dozen of the docs / meat puppets in the companies pay. Followed by send threatening emails to a Wikipedian with 60 or so of their colleagues cc'ed implying that they are killing people.
 * I think there's room for both these perspectives. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 09:12, 1 July 2014 (UTC)
 * Has anyone asked the French Medical Wikiproject what they think? Wiki CRUK John (talk) 10:07, 1 July 2014 (UTC)
 * (Cited here.) 109.156.204.159 (talk) 13:56, 1 July 2014 (UTC)


 * Doc, I am very familiar with the problem of conflict of interest in publishing. But I disagree both with both of your implicit conclusions: 1) That conflict of interest problems in publishing justify lowering standards in other areas, and 2) That the pharmaceutical industry is the main source of publishing COI.


 * Physicians control every aspect of the medical publishing process, including most of the manuscript preparation, the referee process, and editorial decisions. Physicians and physician-controlled enterprises form the vast majority of the subscriber base. It is inevitable that the content of these publications consistently reflects their financial and political interests. Empirical support for this this observation is provided by the following:


 * In-hospital deaths from medical error, estimated by the IOM at 100k per year, and more recently in two other publications estimating the rate at over 300K. Upon checking into a US hospital in 2014, one's risk of dying from medical error is nearly 1%, but you won't see much discussion of this in the literature. This ongoing issue gets less coverage than the decade old Vioxx story.
 * In the late 1980s and early 1990s, multiple studies estimated that up to 30% of US surgeries (which US surgeons recommend and then perform on a "per service rendered" basis) were unnecessary, resulting in another 10-15,000 deaths per year. A relative handful of more recent publications show vast differences in procedural rates depending on physician ownership of ASCs, private vs. public insurance coverage, and other issues that reflect provider financial interests rather than medical considerations.  Are these deaths less important than those caused by pharmaceutical company malfeasance, or is there another issue in play?
 * 100,000 deaths per year from HAI, but most studies indicate that only 50% of physicians routinely wash their hands between patients. When publications occur, instead of talking about criminal responsibility for patient deaths, they benignly discuss how to "persuade" physicians to stop killing their patients.


 * So yes, I am very familiar with the role of COI in controlling what is published by medical journals. You cant' put a stop to it, but independent review is a minimal first step to keeping some sort of a lid on it.
 * I've blanked my user page and will not trouble you further. Formerly 98 (talk) 14:13, 1 July 2014 (UTC)
 * Oh dear... Sorry to see this. This is one of the pitfalls of the Wikipedia (i.e. internet forum) environment. A single difference, like this, can so easily get to threaten a broader gf collaboration. As someone who prefers to edit as an ip you have my moral support, fwiw, regardless of the question in hand. 109.156.204.159 (talk) 14:32, 1 July 2014 (UTC)
 * Also sorry to see it, and I hope you will reconsider. Wiki CRUK John (talk) 15:08, 1 July 2014 (UTC)

On the article on osteoarthritis we state "Arthroscopic surgical intervention for OA of the knee however has been found to be no better than placebo at relieving symptoms" yup agree that there is a lot of unneeded surgery. And yes I agree the issues around handwashing need to be addressed. And there are tools to address it. Why they have not been adopted I do not know. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:29, 1 July 2014 (UTC)
 * With respect to medical errors we have this paper links them to "increased complexity of medical practice and technology, the increased incidence of antibiotic-resistant bacteria, overuse/misuse of medications, an aging population, and the movement of the medical industry toward higher productivity and expensive technology, which encourages rapid patient flow and overuse of risky, invasive, revenue-generating procedures" among others The United States spends more on health care than any other country in the world yet has outcomes that are at the lower end for OECD countries. It is evidence that more health care is not necessarily better.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 17:53, 1 July 2014 (UTC)


 * Per "That conflict of interest problems in publishing justify lowering standards in other areas". I do not consider this lowering standards. I consider much of what the produce to be decent review articles. Their method of production has some pluses and minuses like all methods do.
 * Per "That the pharmaceutical industry is the main source of publishing COI." They have an obvious financial conflict of interest to produce positive results with respect to medications. Similar to how those who perform arthroscopy for osteoarthritis have a financial incentives to believe it works.
 * Per "You cant' put a stop to it" you can definitely try to minimise it. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:12, 1 July 2014 (UTC)

Meeting up at Wikimania
If you will be in London in early August, and would like some sort of medical meetup, please let's have your views on what to do, and when, at Wiki Project Med/Wikimania 2014 meetup. I would be very grateful if people could post this to other language equivalents. Of course this is for all medical editors not just members of the Wiki Project Med thorg or local projects. Wiki CRUK John (talk) 11:53, 2 July 2014 (UTC)


 * Italian project notified here. 109.156.204.159 (talk) 16:15, 2 July 2014 (UTC)
 * Tante grazie! Johnbod (talk) 22:03, 2 July 2014 (UTC)
 * Prego. 109.156.204.159 (talk) 22:33, 2 July 2014 (UTC)


 * Thanks for taking on organizing this. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 16:46, 2 July 2014 (UTC)

AfC submission - 03/06
Draft:Male accessory gland infection. FoCuSandLeArN (talk) 13:05, 3 July 2014 (UTC)

July 2014 WikiProject Medicine newsletter - The Pulse WP:PULSE
Hello. Before quit Wikipedia, he founded a WikiProject newsletter and was executive editor, president, and chief officer of the publication for about two weeks. At the time of LT's departure I was serving as a copyedit intern for the operation. Even though the publication is without an editor, I put together an issue with help from some others. The paper is intend to be documentation of what WikiProject Medicine members do, and it is intended to help guests of WikiProject Medicine understand what happens here.

Anyone who wants to read the current issue can do so at WP:PULSE. In perhaps a week, a link to it will be mass-messaged to all people who are on the WikiProject Medicine subscriber list. Your perspective would be welcome in this publication now! Please write what you like and just put it in! I hope that it can continue to be a monthly thing.  Blue Rasberry  (talk)  15:29, 3 July 2014 (UTC)

Butter versus margarine
Wikipedia can have information about the advantages of butter and the disadvantages of margarine. —Wavelength (talk) 22:46, 2 July 2014 (UTC)
 * Butter Is Back: Processed Foods Are Culprits in Heart Disease—by Joseph Mercola (June 23, 2014)
 * We need a proper source per WP:MEDRS. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 02:12, 3 July 2014 (UTC)

Low-fat diet could use review and expansion
The question of whether low-fat really is or is not such an important thing to focus on for weight loss does seem to be very much in the Zeitgeist at the moment -- for example The Times (London) ran a long cover-piece in its features section yesterday, "The full-fat diet — why it’s not as unhealthy as you think" (paywalled) reviewing the history of low-fat diet advice contrasted with some more recent research, and Time magazine ran a cover story ten days ago, "Ending the war on fat"  (paywalled).

Our article Low-fat diet is pretty limited at the moment, and reflects none of this discussion. Considering that this is a major lifestyle issue for so many people, it could use some review and expansion by qualified folks from appropriate sources. Jheald (talk) 11:34, 3 July 2014 (UTC)
 * Yes there is lots of great sources on low-fat diet versus other type of diet. There is no significant difference between low fat and high fat. We sum it up here Management_of_obesity. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:15, 4 July 2014 (UTC)

Copy and pasting
We have a new editor User:Torreano61 who has been copy and pasting up a storm. Very similar to a previous editor called User:DrMicro. Both editing extensively in the microbiology topic area. Have blocked this new editor. And dealt with most of the copy and past issues. :-( Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:03, 4 July 2014 (UTC)
 * Am in discussion with user in question. Trying to determine if they understand how Wikipedia works. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 17:13, 4 July 2014 (UTC)

Jay W. Friedman and wisdom teeth
Wikipedia can have information about Dr. Jay W. Friedman and his views on the prophylactic extraction of third molars. —Wavelength (talk) 22:47, 2 July 2014 (UTC)
 * The Prophylactic Extraction of Third Molars: A Public Health Hazard
 * Thank you for the link. This is a non-systemic review article against the removal of asymptomatic, disease free wisdom teeth.  The debate has been discussed in the articles, and careful equal weighting of each side of the argument has been given in the treatment controversy section.  There is a Cochrane study on the subject that is included, with wording largely crafted by Hildabast.  Ian Furst (talk) 02:09, 3 July 2014 (UTC)
 * Friedman source could be used to support the cochrane review, it seems reliable. 188.29.87.125 (talk) 22:02, 3 July 2014 (UTC)


 * Ian Furst, which Wikipedia articles discuss the debate?
 * —Wavelength (talk) 17:06, 4 July 2014 (UTC)
 * I think he's talking about Impacted wisdom teeth. See also wisdom tooth and pericoronitis, articles which could potentially benefit from this source. 188.29.86.105 (talk) 17:52, 4 July 2014 (UTC)
 * Thank you. I could try editing those articles, but I prefer that it be done by members of this WikiProject.
 * —Wavelength (talk) 18:04, 4 July 2014 (UTC)
 * the controversy's discussed in the Impacted wisdom teeth article. I'll post the article on the talk page. Thx. Ian Furst (talk) 18:21, 4 July 2014 (UTC)

Action T4
The article Action T4 recently got a section about language and the euphemisms used by the Nazis to sweeten the truth. That section gave me an uneasy feeling. Now somebody else adds a hidden comment that absolutely horrifies me.

Could somebody take a look and join the discussion at Talk:Action T4? The Banner talk 19:39, 4 July 2014 (UTC)

Calorie restriction
This article makes tons of health claims with primary sources. Please jump in. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:10, 4 July 2014 (UTC)

Sourcing for List of the Presidents of the American Association of Immunologists
This should be an article on the organization, not just a list. Could someone who knows the medical literature add a few more 3rd party sources, so we can turn this into an article on the organization? Djembayz (talk) 14:07, 5 July 2014 (UTC)
 * Organizations are typically of low importance to many of those within this project. Google books might be a good place for sources. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 16:00, 5 July 2014 (UTC)

A statement on Alternative medicine and Wikipedia editing
As Project Medicine has recently lost two valuable editors from an unfortunately small pool, I am heartened to see a considerate and polite discussion occurring on the talk page of the Alternative medicine article. It has helped me develop some thoughts on WP editing and attitudes towards alternative medicine topics. Some key points are: 1) There is a strong policy position in support of evidence based medicine and mainstream medicine. 2) I feel this is echoed and reinforced by the editorial position of many members of this project. 3) This means emerging support for alternative ideas face a staunch wall of resistance. 4) This also means ideas from the alternative community are subject to a higher level of scrutiny/opposition than those from the mainstream community.

An important point to consider is the amount of accepted mainstream medical practice that is not supported by evidence. I certainly understand the arguments based on plausibility and long term unmeasured success (and common sense). Still it is of interest to think, "What if every practice of 'modern medicine' was subjected to the level of scrutiny and the bar of evidence was raised to the level required on WP to make statements about alternative medicine?" and "What if every avenue of exploration endorsed by the mainstream was subjected to the level of hostility exhibited towards ideas from those who lack that endorsement?"

At this point I will own my personal position. I consider Ernst, Barrett, Sampson and Hall heroes. I strongly object to quackery on deep ethical grounds. I have and will work hard to prevent WP from being a vehicle for the promotion for those who profit by the exploitation of those who suffer illness. That said some honesty regarding Bad Pharma and the fact that mainstream medicine is a profit driven industry that uses many unproven treatments is also in order.

While I think WP's policies and guidelines are excellent and promote encyclopedic validity in the presentation of biomedical information, I also think there is room for improvement in our community. I propose we temper our participation with consideration that some alternative medicine advocates are sincere and some honesty in recognizing the high ground we hold is not as lofty as we might think. I propose we present our positions (POV albeit with sound basis) with compassion, consideration and respect. I think we should balance our frustration (RTFM MEDRS etc) with an understanding of a potential underlying motive to benefit suffering human beings, likewise our outrage at support for "predators". I think some humility at the modesty of the measure of success (per some IOM and WHO reports) that modern western maintstream medicine has achieved is in order.

Again I own my POV that skepticism and a high bar of evidence is the way to make progress. I hope that in my drive towards that I conduct myself honestly, ethically and compassionately with respect for the dignity and worth of all who would improve the lot of humanity.

In conclusion I would like to remind everyone that editing WP should be a rewarding experience to all who seek to improve the encyclopedia. Two aspects of participation in WP I hold as ideals are fun and camaraderie. I hope the members of this project can help foster these ideals.

With a deep sense of loss for those editors driven away by feelings of alienation and a sincere hope that diversity of opinion can be encouraged and engaged, I offer the traditional closing,

Best wishes and happy editing.

- - MrBill3 (talk) 14:11, 5 July 2014 (UTC)


 * See Flexner Report (version of 16:29, 14 May 2014).
 * —Wavelength (talk) 14:58, 5 July 2014 (UTC)


 * See The Flexner Report ― 100 Years Later (September 2011). Under the heading "THE FLEXNER REPORT ― THE PATH NOT TAKEN", paragraph 2 contains this statement: "Patients were primarily viewed as serving the academic purposes of the professor."
 * —Wavelength (talk) 15:23, 5 July 2014 (UTC)
 * Per "higher level of scrutiny/opposition than those from the mainstream community". I give all an equal level of scrutiny. Agree we are not about opposition just about writing an encyclopedia using the best available sources. Just because vertebroplasty is performed by interventional radiologists does not mean that when they compare their treatment against sham control and find it to not better we at Wikipedia will give them a free pass. Or that we will allow them to highlight the comparison against a wait list control. Some for acupuncture. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 15:58, 5 July 2014 (UTC)
 * Thanks, Mr Bill. I'm often frustrated by the effort that some people make to exclude acceptable sources because the primary author is a chiropractor or the journal is dedicated to evidence-based reviews of altmed—even when the source is saying that there's no evidence for the altmed treatment!  It's especially bad to tell new people that they need to find a review article, and then when they do, tell them that their review article doesn't "count".  If we could get some of that scrutiny turned towards common conventional practices (which are far more widely used), that would be helpful.  It would also be helpful for people to remember that WP:There is no deadline for getting WP:The Truth about quackery in the encyclopedia, and that those "POV pushing quacks" are good-faith humans who are usually trying their best, just like the "POV pushing anti-altmed" editors are also good-faith humans who are usually trying their best.  Even simple steps like being "too busy" with Real Editing™ to reply instantly can help calm down difficult discussions.
 * Also, I've been meaning to post one of my occasional reminders about wikilife, and this is probably as good (or bad) as time as any other: Everyone gets frustrated on occasion.  Everyone, unfortunately, feels disrespected on occasion.  Ask for help here.  If that's not helpful (because sometimes we drop the ball), then take a break.  Work on something else—on your real life, on completely unrelated articles, on another project.  ( probably needs help with information about your hometown, and Category:Unassessed medicine articles always needs attention.)  But if you're tempted to post a resignation manifesto (which is pretty rare in our group), please read GoodBye first, and sleep on it.  WhatamIdoing (talk) 18:46, 5 July 2014 (UTC)

Read the Medical Translation Newsletter
 

Medical Translation Newsletter Issue 1, June/July 2014 by CFCF, Doc James sign up for monthly delivery

Hey, this is the new Medical Translation Newsletter, a part of an IEG supporting our Translation Taskforce. Pop over and give it a read, or drop some comments.-- CFCF  🍌 (email) 09:28, 7 July 2014 (UTC)

Acupuncture and pseudoscience
see also: RSN

At Talk:Acupuncture, I'm engaged in a debate with another editor over the sentence "TCM is largely pseudoscience, with no valid mechanism of action for the majority of its treatments." and whether it needs to be attributed (TCM=traditional Chinese medicine). We seem to have no likelihood of consensus, so I'd be grateful if any other editors would be willing to contribute their opinions on the issue. Thanks --RexxS (talk) 20:07, 5 July 2014 (UTC)


 * For context, there was previous consensus to include the text in question, but only with in-text attribution. Multiple editors rejected presenting the text as fact (without attribution) because 1. It came from an editorial, and was an off-hand dismissive remark in that editorial rather than the thesis statement of a paper focused on answering a question like "what is TCM?" and 2. TCM does not present itself as a science, but rather a 2000 year old traditional medicine, rendering the pejorative label "pseudoscience" inaccurate. Now, recognizing that the opinion that TCM is a pseudoscience is a notable and popular one, I and others agreed to compromise and include the text as long as there is in-text attribution ("An editorial in Nature characterized TCM as pseudoscience, with no valid mechanism…" I support sticking with the previously agreed upon consensus version.Herbxue (talk) 06:13, 6 July 2014 (UTC)
 * When I make a neutral request for other editors to look at a debate, I don't expect to have you arrive to deliver a mendacious one-sided presentation of your biased view of the discussion. But if you insist on re-opening the debate here, I'll oblige. The fact is that there was no previous consensus to attribute the text. That is simply untrue.
 * Editors don't get to change policy at a whim, and WP:NPOV is clear about attribution:
 * Avoid stating facts as opinions. Uncontested and uncontroversial factual assertions made by reliable sources should normally be directly stated in Wikipedia's voice. Unless a topic specifically deals with a disagreement over otherwise uncontested information, there is no need for specific attribution for the assertion, although it is helpful to add a reference link to the source in support of verifiability. Further, the passage should not be worded in any way that makes it appear to be contested.
 * But you think it shouldn't apply to articles where you edit - which is effectively two as over 100 of your 138 edits to articles are on acupuncture or TCM. You simply want to attribute any statement you disagree with in an attempt to weaken its conclusion and cast acupuncture/TCM in a more favourable light. We don't make amateur analysis of reliable sources - that's the job of secondary sources, not Wikipedia editors. The rest is just your opinion with its obvious bias and carries no weight at all.
 * This is the sort of problem we find ourselves dealing with every day from SPAs on alt med topics, so if any WPMED editors can find a few minutes to make an neutral judgement on the issue at Talk:Acupuncture, we could at least lay this one to rest. --RexxS (talk) 12:50, 6 July 2014 (UTC)
 * On the other hand, the statement that traditional medicine is "pseudoscience" (rather than, e.g., not modern science at all) is neither uncontested nor uncontroversial, so your quotation from the policy doesn't apply. WhatamIdoing (talk) 23:22, 6 July 2014 (UTC)
 * Well, the "Uncontested and uncontroversial" actually means uncontested and uncontroversial in reliable sources, not uncontested and uncontroversial by Wikipedia editors, so I think it might be reasonable to expect to see these dissenting reliable sources, don't you? If they exist, let's summarise and attribute the opinions as we always do; but in their absence, surely we should be asserting the sourced statement as simple fact. --RexxS (talk) 15:24, 7 July 2014 (UTC)

Barnstar
Template:The WikiProject Medicine Barnstar

I have just discovered that the WikiProject Medicine barnstar has been changed from the Rod of Asclepius to the caduceus. Can we have the Rod of Asclepius back please? Axl ¤  [Talk]  11:45, 7 July 2014 (UTC)
 * By pure coincidence I was the one who changed it, and I've reverted it. Looking for a Rod of Asclepius svg alternative, the old image is a bit fuzzy. P.S. Thanks for the barnstart :) -- CFCF  🍌 (email) 12:24, 7 July 2014 (UTC)
 * I also do realize it is incorrect, even though it is widely used in association with medicine. -- CFCF  🍌 (email) 12:27, 7 July 2014 (UTC)
 * Lol, adopting the Caduceus as a symbol of medicine might act as a calling card to critics here ;) 109.156.204.159 (talk) 13:28, 7 July 2014 (UTC)
 * CFCF, thank you for changing the image back. Axl  ¤  [Talk]  17:37, 7 July 2014 (UTC)

Help reviewing “Editing psychology articles” handout for student editors?
(Apologies for the cross-post.) Introducing myself for those of you I haven’t interacted with before — I’m LiAnna Davis, and I’m in charge of communications for the Wiki Education Foundation, the nonprofit that runs the Wikipedia Education Program in the United States and Canada. One of my goals this year is to create a series of discipline-specific support materials for students and instructors participating in our program. Given the challenges some psychology students have had in the past, I’m starting with psychology, and I need some help. I’ve created a page in my userspace explaining more about what I’m trying to do, and then added an outline of the preliminary content I’d like to include.

Since psychology is not my specialty, I would really like to get feedback from experienced content contributors in psychology to make sure I’m providing accurate advice to students. I’m looking for several people who’ve contributed content to psychology articles to review the advice and offer feedback — please help if you can! I need all comments by Monday, July 14. Please leave comments on the talk page rather than here so they’re all in the same place. Thanks! --LiAnna (Wiki Ed) (talk) 22:08, 7 July 2014 (UTC)

Wikimania event
The Wikimania event is now booked for the eve of the conference on Thursday, August 7th 2014at 3.30-6.30 p.m.. The page is at https://wikimania2014.wikimedia.org/wiki/Pre-Conference:_Medical_Wikipedians; please sign-up there. In brief, Cancer Research UK, will be hosting the event at their HQ at The Angel Building in Islington. There will be a presentation and discussion on issues around accessible language, followed by a move to a nearby pub. At 6.30 we move off to cover the 1.5 miles (2.3 km) to the Barbican to catch the Wikimania Opening Ceremony and drinks, starting at 7pm.

Please publicize this to any medics attending Wikimania, or medical wikiprojects! Thanks Wiki CRUK John (talk) 18:02, 8 July 2014 (UTC)


 * Spreading the word, thank you! NCurse work 05:43, 9 July 2014 (UTC)
 * Posted on various international WPMED pages. -- CFCF  🍌 (email) 08:23, 9 July 2014 (UTC)

User:Muffinator
Is changing text from We have unfortunately lost the person who has written much of our autism content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:30, 7 July 2014 (UTC)
 * "200 children without autism." to "200 allistic children"
 * "normal individuals" to "neurotypical individuals"
 * "matched controls" to "matched neurotypicals"
 * They are also changing ASD to autism.
 * If you know a more appropriate alternative to "allistic", please add it, because "without autism" doesn't make any sense and we have already determined consensus on person-first language.
 * "Normal" is not a diagnosis and is frankly presumptuous. There is no reliable source to say those individuals were normal. Neurotypical is an accurate medical term whose inclusion makes the article more informative. Replacing "controls" with "neurotypicals" similarly clarifies who we are talking about. If there's a strong reason to keep the word control, call them neurotypical controls to differentiate from a possible control group of more autistic people.
 * A person on the autism spectrum is autistic. That's why it's called the autism spectrum. "Person with ASD" should be replaced with "autistic person", as per the consensus determined on Talk:Autism. Muffinator (talk) 06:40, 7 July 2014 (UTC)
 * Lets gets other opinions on these word changes.
 * ASD includes both autism and Aspergers syndrome thus changing it to just autism is not exactly correct. Yes the DSM 5 have merged these diagnosis into autism spectrum disorder but that is still not simply autism.
 * There was weak support for changing "person with autism" to "autistic person" and I am fine with that. However that was not the only thing you have been changing in your edits thus the reverts. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 06:55, 7 July 2014 (UTC)
 * In this context, by "autism" you mean "classic autism". ASD, classic autism, and Asperger Syndrome are all forms of autism. The fact that old references use outdated terminology is not a good reason to prevent Wikipedia from updating. Wikipedia has its own style guide and does not latch onto references like a chameleon. If I see something wrong while working on a different issue, I'm inclined to correct both of them. If you have a problem with only one part of an edit, you can change that part, or revert and reintroduce the "good" changes. Just reverting is disruptive. At the very least you could provide an explanation of which parts were problematic, I'll check my notifications and put the "good" parts back.Muffinator (talk) 07:02, 7 July 2014 (UTC)
 * Can you direct me to the Wikipedia guideline page that mentions "private language"? Given that articles on Deaf culture use "hearing person", "allistic" is not unprecedented. Muffinator (talk) 07:02, 7 July 2014 (UTC)
 * Have changed the article on Deaf culture. Hearing person is poor English but at least a person can figure it out. Allistic gah.
 * If you are planning on more controversial changes best to get consensus before hand. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 07:22, 7 July 2014 (UTC)
 * That response did not answer the question. Is there a guideline page explaining "private language" or did you just make the controversial change from "hearing person" to "person with normal hearing" without getting consensus first? Muffinator (talk) 07:44, 7 July 2014 (UTC)

Use of the term 'neurotypicals' without wikilinking it is very hard to justify as it's against Use plain English and in the context of an experimental design 'control' is a much better description of their role. The Andrew_Wakefield example should use the same terminology as Wakefield does, because it's talking about a person's beliefs and the further we take it from their terminology the more OR it is. The Autism changes just look wrong --- I still have no idea what the "ability to demonstrate" change is about. Stuartyeates (talk) 07:12, 7 July 2014 (UTC)
 * I believe you are referring to an example in which the word neurotypical was wikilinked earlier in the article. I figured there was no need to link it twice. "Ability to demonstrate comprehension" is a more accurate description as comprehension itself is immeasurable except through self-reporting; this applies in more contexts than just autism. Do we really need to have disputes and consensus over every minute change in wording? If that's the case, we should set up a lock an all articles so that all edits need administrator approval. Muffinator (talk) 07:30, 7 July 2014 (UTC)

Added RFC tag because an interest in "other opinions" was expressed. Muffinator (talk) 07:30, 7 July 2014 (UTC)
 * My opinion is that the Talk:Autism dicussion, which didn't mention other pages and was closed with a "a relatively weak consensus" is no basis to change a the language in a large number of articles. Stuartyeates (talk) 08:04, 7 July 2014 (UTC)
 * Muffinator has also brought this to ANI  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 08:29, 7 July 2014 (UTC)
 * Autism is at the very least the most popular article about autism. More importantly, consensus is consensus. If you have an issue with the discussion being deemed a consensus, take it up with the user who closed the discussion. Muffinator (talk) 08:41, 7 July 2014 (UTC)


 * Re: RFC: Could it be clarified what exactly opinions are being sought for? The four items at the top of the discussion, or more/other than that? In terms of "allism/allistic", that is clearly inappropriate -- it's a confusing, very obscure neologism with no widespread official acceptance at all; it wasn't even "added" to WP or Wiktionary till a few days ago, and even then without a single source. The neurotypical vs. normal debate has more basis in definitive usage, but even then, Stuartyeates' recommendation that WP use the terminology of the cited articles makes a good degree of sense; I don't personally see any real basis for confusion what "normal" or "control" means here. "Autism" is not the same as ASD, that much should be clear to anybody -- one is a spectrum, the other is a specific (autism is always classic autism unless otherwise noted). Softlavender (talk) 08:01, 7 July 2014 (UTC)
 * That was what I was wishing people to weight in on. Thanks. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 08:32, 7 July 2014 (UTC)
 * Strongly agree with Softlavender, and even if it wasn't for those strong arguments there is no consensus for such a broad change. -- CFCF  🍌 (email) 10:07, 7 July 2014 (UTC)
 * "Allistic" is clearly a neologism without clear definition or wide linguistic acceptance in the English language. It would be inappropriate to insert the word into wide use on Wikipedia without significant discussion and broad community consensus. NorthBySouthBaranof (talk) 10:17, 7 July 2014 (UTC)

Having written extensively on ASD: So in short, the changes are mostly wrong, but one might just be right the panda ɛˢˡ”  11:32, 7 July 2014 (UTC)
 * 1) "allistic" is an inappropriate term and should not be used
 * 2) "neurotypical" is the most correct term in lieu of "normal" (because normal cannot be defined)
 * 3) "ASD" is more correct than "autism", unless you're talking the rare cases of full-bore, far end of the spectrum Autistic
 * 4) "matched controls" is a scientific term, and must be kept for scientific consistency
 * Or simply " matched controls" (the matching is an aspect of the study design). 109.156.204.159 (talk) 13:40, 7 July 2014 (UTC)
 * Allistic is POV jargon. Neurotypical is unhelpful to people who are unfamiliar with the subject.  Non-autistic or people without an autism diagnosis (because not all allegedly neurotypical people actually are neurotypical) is a better choice.
 * One other reason for avoiding neurotypical is that it's based on a false dichotomy: a person can have neurological problems that are not ASD-related.  A person with schizophrenia or multiple sclerosis is, as a matter of physical facts, neurologically atypical, even if that person has no significant ASD-related symptoms at all.  WhatamIdoing (talk) 15:29, 7 July 2014 (UTC)
 * Support for 'non-autistic'. --Hordaland (talk) 16:26, 7 July 2014 (UTC)
 * Agreed, 'non-autistic' seems like the correct phrasing, which neither places value judgments nor assumes. NorthBySouthBaranof (talk) 18:59, 7 July 2014 (UTC)

If you are going to use a word like "neurotypical" on wikipedia, you will need to define it at the first instance in the article using brackets. Since that definition will probably use the word "normal" it seems a bit pedantic to me, but I am unfamiliar with the topic. If hte literature uses the term then support. 92.40.94.138 (talk) 17:59, 7 July 2014 (UTC)
 * We should be using plain English as much as possible. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:28, 7 July 2014 (UTC)
 * I agree with Doc James on this one. Dbrodbeck (talk) 19:00, 7 July 2014 (UTC)


 * Writing as a layman, ie., an editor without any medical credentials, the first three of the four changes mentioned above (from "children without autism." to "allistic children", from "normal individuals" to "neurotypical individuals", and from "matched controls" to "matched neurotypicals") confuse the sentences they appear in. If it is important for precision of language to distinguish (eg) between "normal" and "neurotypical", an extra sentence or two should be added to make the distinction.  Wanderer57 (talk) 20:59, 7 July 2014 (UTC)


 * Has any organization which advocates for the autism community every published a manual of style for journalists? Has any such manual of style been identified or sought?, do you know anything about this? Can you recommend any organization which might have published guidance on this that we could copy instead of developing it ourselves?  Blue Rasberry   (talk)  14:36, 8 July 2014 (UTC)
 * The Autistic Self Advocacy Network and the Autism Women's Network are prominent advocacy groups which advocate for Autistic-first language. Muffinator (talk) 14:43, 8 July 2014 (UTC)
 * In my view that doesn't justify it as the de facto terminology for Wikipedia. Just as the National Stroke Association pushed for brain attack, a patient group organization can not simply change our vocabulary. Wikipedia should use terminology used by the most prominent sources, and not that of patient groups, however noble their motives. Wikipedia is not the place to drive a crusade for or against use of any terminology. At best we could state that portions of the autistic community choose to use this terminology.-- CFCF  🍌 (email) 07:35, 9 July 2014 (UTC)
 * The fact that certain terminology is used by the relevant groups may not necessarily be a reason for Wikipedia to adopt it, but the fact that certain terminology is more accurate and more neutral than what was previously used is a reason for Wikipedia to adopt it. I offer these two groups as sources for what User:Bluerasberry requested. Muffinator (talk) 08:05, 9 July 2014 (UTC)
 * {u|Muffinator}} I wrote to ASAN asking if they had a manual of style for journalists. They publish a statement on why they use "Identity-first language", but at the bottom of that statement, they list other activists in the field who use "people-first language". Regardless of what scientific sources say, I would rather use what the community itself uses if we can establish that this community has consensus among the people who talk about such things. Because of the diversity in viewpoints on this topic, it seems undecided. I will see how they reply to my email about their recommendations for writing. If there is a recommended way in the ASD community, then I think we should follow that, but if there is a lot of controversy in the community, then I would say that Wikipedia cannot take a strong position., it is my opinion that the strongest argument that you could make is listing which organizations use language you suggest. I see no such list anywhere, but such a list would be the evidence that Wikipedians would want to see. Whatever ASAN says I will share also.  Blue Rasberry   (talk)  10:28, 9 July 2014 (UTC)

X with autism or autistic X?
There's a discussion at Talk:Autism about whether to use "child with autism", "autistic child" or both. The former appears in PubMed about 25 times as often as the latter. --Anthonyhcole (talk · contribs · email) 13:51, 8 July 2014 (UTC)
 * I suggest we use whatever is most commonly used in the professional literature. -- CFCF  🍌 (email) 07:35, 9 July 2014 (UTC)

Crick after DNA
After Crick's success in understanding the secret of life (see his autobiography What Mad Pursuit), he naturally turned to the next open problem: consciousness, which he worked on for the rest of his life. His collaborator, Christof Koch, completed their last paper together Now, 10 years later, Mohamad Z. Koubeissi MD, et al. (2014), Journal of Epilepsy and Behavior, while seeking to cure a woman's epilepsy, have learned that electrical stimulation of the claustrum reversibly turns off her consciousness, while leaving her wakefulness intact. Turning off the electrical stimulation returned her consciousness. Crick and Koch point out that the claustrum enjoys reciprocal connections to the rest of the brain, including V1, in the visual system.

From the viewpoint of scientific method, the Crick & Koch 2005 paper contains a cautiously worded hypothesis, while Koubeissi, et al. 2014 constitute a crucial experiment, because the Koubeissi experiment describes a reversible method, while Crick & Koch describe a theory which will likely prove fertile for decades, just as the DNA story has proven. The length of the fertile period exemplifies the Lakatos criterion for the 'strength of a scientific programme'.

My question for the MED project is: although Crick & Koch 2005 is labelled a 'review', and therefore a secondary source, does it qualify as MEDRS? What is needed for the concepts which are implicit in Koubeissi, et al. 2014 to qualify? --Ancheta Wis   (talk  &#124; contribs) 09:51, 8 July 2014 (UTC)
 * Crick's hypothesis seems to be noteworthy enough to be covered, though the hypothesis itself is primary material so is best approached through secondary sources. The current claustrum article is not in the best shape. Alexbrn talk 10:20, 8 July 2014 (UTC)
 * The cautious observation I refer to (p.6 of the 10 page pdf) is "There are remarkably few microelectrode investigations of claustral receptive-field properties and almost none in awake animals." -- Crick and Koch 2005, which Koubeissi 2014 has kindly supplied. --Ancheta Wis   (talk  &#124; contribs) 10:42, 8 July 2014 (UTC)


 * In my view, the Crick & Koch paper meets MEDRS, but the views in it are admittedly speculative, so if they are referred to in Wikipedia, it should always be with wording such as "Francis Crick and Christof Koch proposed that ...". In other words, it should be made clear that these are the views of specific people rather than mainstream ideas.  As a source of background information about the claustrum the paper can definitely be used, although in a few respects it is already out of date. A better source for background info is http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983483/. The Koubeissi paper is absolutely a primary source.  My personal opinion is that their findings are not nearly as important as some people make them out to be, and in any case they were obtained from a single human subject and certainly need to be replicated. Looie496 (talk) 13:04, 8 July 2014 (UTC)


 * Note: I've commented more extensively on this on my personal web site, see Comments on Koubessi et al.: Have we learned anything new about the role of the claustrum in consciousness? if you are interested. Looie496 (talk) 15:11, 8 July 2014 (UTC)


 * Nice. Thanks. --Anthonyhcole (talk · contribs · email) 14:26, 9 July 2014 (UTC)