Wikipedia talk:WikiProject Medicine/Archive 96

Is a picture worth a thousand words, or not
I am reproducing here a discussion begun in 2016, regarding the use of self-created medical diagnostic images in Wikipedia articles. I argued at the time that allowing these to be presented was an end-around WP:OR and WP:VERIFY. While the trainee that generated and uploaded them had reasonable credentials, it set a bad precedent to extend the already problematic process of allowing editors to introduce gigabytes of impactful scholarly information without attribution, just because it was image- rather than text-based.

I re-raise the discussion here, because I wrongly let the matter die after an uninformed, superficial consensus developed there. I should indeed have gone with the trainee's suggestion that the discussion be taken up here. It follows in collapsed form, only followed by my signature. Apologies for the personal diversion taken in the reply, but it is inexcusable to dismiss an editor for "four edits" when the whole of the wiki-universe is linked, and 45 seconds of due diligence would have proved this dismissal to be ridiculous. But the matter at hand is not how I was treated in that discussion.

The matter at hand, rather, is important—Do we begin to reign in the extent to which sophisticated images are used to present ever-increasing amounts of real information, without sources, or do we allow it to continue, and so function as a way to introduce content that is not anchored in the best secondary scientific and medical sources?

I say presenting a self-generated piece of data is WP:OR—whether it is me determining and reporting a melting point or stretching frequency in a chemistry article, or or other trainees presenting medical imaging or other self-generated visual data (which is far more rich, more impactful, and far more prone to misuse); moreover, I say that it is clear use of Wikipedia for the unrefereed self-publication of scientific data. I say that presenting a complicated image (say, a biochemical or regulatory pathway) redrawn from a textbook would violate WP:VERIFY if the source of the original intellectual content is not stated along with the image. What say ye here?

I know this is, to some extent, an argument against the status quo. But if this cannot be addressed as a potentially nefarious trend, in the important and well-edited medical articles, then it is going to continue ever more broadly, and contribute to the eventual failure of WP as an increasingly reliable source of information. Our worlds will not get less visually based, but more. Images are data. Were this a journal, this would not be a matter than for a moment's discussion. The fundamental facts of the matter are clear—that images are data, that they contain information, etc. The question is one of local policy: What say ye, here, about beginning the arduous process of insisting that good articles declare their sources for visual information, and that WP not be a venue for self-publication of data (imaging, or otherwise)? User:Leprof_7272

Regarding which, are Wikiproject Medicine and other users aware that you are generating original content?
 * Regarding your image collection: Ultrasonography and related images are data

Content taken from published sources to create Wikipedia images, that is adapted by relabeling, redrawing, etc., is acceptable if you cite the source when the image is used. In citing the source, such as in the cases of your relabeling the images from the 1918 Gray's, a positive contribution is made to the encyclopedia—improved all the more if in relabeling you take a more modern text, and make sure the nomenclature used 100-years ago is fully, completely the same as in use now (and then, you provide that modern corroborating source).

On the other hand, data-rich content that you generate yourself (for as any anatomist, spectroscopist, cell biologist, or radiologist will tell you, images are data)—or that is generated in your or a colleague's laboratory (rather than being adapted from a published, peer-reviewed source)—and thereafter is interpreted and selected for presentation by you: these images, whether from the imaging laboratory, like the problematic ultrasounds, or otherwise, these images are, in my opinion, entirely unacceptable at Wikipedia, as their distribution amounts to prohibited WP:Original research. Given that such WP:OR is seemingly widespread in certain types of your images, and that errors have been found in that part of your work, post hoc (see below), one has to question any image in your collection that is not sourced to a reliable, scholarly source, per WP:VERIFY. [All the more, for the visual data images, considering American standards and expectations regarding the documentation required to assure permissions and medical privacy standards are met (e.g., of the individuals whose sonograms appear).]

The current limited peer review process in use here (that you have applied), and its results in the case of your ultrasound images, casts a further shadow over your collection: To the contrary, your set of images: Even so, at least 2 interpretive/scientific mistakes were discovered after gallery creation and image dissemination. Viz., in the two image cases that were withdrawn, the images nevertheless were uploaded and available for dissemination until their errors were discovered. The point of WP:OR and WP:VERIFY is to minimise the distribution of inaccurate material, that would be widespread were these policies were not in force.
 * 2-3 independent reviewers are typically involved in refereed publication of visual data by journals, and that occurs after preliminary screening by masthead editorial teams at the publication (e.g., most manuscripts submitted to NPG journals are never sent out for review, as they are judged as not being within scope or up to journal standards).
 * received no pre-review by scholarly individuals in this organization, for baseline acceptability;
 * was reviewed at one point in time (that is now past, meaning that unreviewed images may again be a part of the gallery);
 * was not independently reviewed, insofar as the individual reviewing is apparently a colleague at your institution;
 * was reviewed by a single individual whose scholarly credentials are not in evidence;

Given these observations, in my view, one has to question any image in your collection that is not sourced to a reliable, scholarly source, per WP:VERIFY. As stated above, such self-published data images interpreted only by WP editors are, in my opinion, entirely unacceptable at Wikipedia, as their distribution amounts to prohibited WP:Original research.

I suggest here for discussion, the following two proposals:
 * You commit to state the scholarly, published source of any image you derive and adapt from another publication, asking as well that if the source is out-of-date, and you check content during your adaptation, that you also state the scholarly source against which your adaptation is checked; and
 * You commit to removing any image of yours that violates WP:OR, that is, any image that is your original data and research, whether by data gathering, or by its interpretation.

The fact of the matter is that the rules you are skirting are very commonly ignored at wikipedia, with the result being that there are many cases at WP that violate basic, widely accepted principles of doing honest scholarly work. But you raise this to a new level, by elevating your Medical gallery of Mikael Häggström 2014 to be a collection to a component of a purported peer-reviewed journal of medicine (WJoM). You are therefore setting a precedent, and newly proposed precedents should be closely scrutinised.

I suggest on close scrutiny, that your work violates WP:OR, in part, and when misused, further violates WP:VERIFY. Wikipedia is called on to use content (data and interpretations) from published, peer-reviewed sources of the highest quality. Your gallery does not rise to this level, not even with your colleagues review. We are to be generating images drawn from scholars, from scholarly sources, and not publishing our own data and research (and its interpretation) here.

Even were you to publish your images, they would not be entirely acceptable here, as you would be called to pick the best available images to make an encyclopedic point, and (speaking as a published and publishing scholar), our personally created journal images are most often not best for these encyclopedia articles.

Le Prof Leprof 7272 (discuss) 23:42, 12 April 2016 (UTC)


 * As I understand, the synopsis of this person's entry is: Should we require all images to comply with WP:MEDRS? Mikael Häggström (talk) 06:40, 17 March 2017 (UTC)


 * I agree with you that Wikiversity is not a WP:MEDRS. However, I disagree that pictures by medical imaging (including ultrasonographies, X-rays and MRI images) that are not from WP:MEDRS would be unacceptable in Wikipedia. Text and diagrams can be created with own words and designs, using MEDRS as references, but X-rays etc must be copies from the original sources. Very few pictures by medical imaging on external pages have compatible licenses. Journals often charge between $1,500 and $3,000 for making restricted works open access (PLOS examples), so the cost of permissions to make works even copyleft to be compatible with Wikipedia can be expected to be of similar amount. As a result, almost all pictures by medical imaging that are used in Wikipedia originate from Wikipedia users (as can be seen by analyzing Category:Bone fractures for example) and are thus WP:OR, and would hence have to be removed if it was a requirement to be from MEDRS. Therefore, your suggestion has much broader implications than the ultrasonographies I have added to Wikipedia, so if you still insist on such a requirement, I suggest you bring it to WT:WikiProject Medicine. Mikael Häggström (talk) 19:42, 13 April 2016 (UTC)


 * , your mastery of editing on WikiUniversity with only four edits may indicate your unfamiliarity with this project. I like to assume good faith, but your familiarity with policy and guidelines with only four edits in the Project Wikiuniversity it is easy for me to ignore anything you have written about and his amazing contributions to the encyclopedia. Best Regards, Barbara (WVS) (talk) 00:36, 11 July 2016 (UTC)
 * Thanks, Barbara, for your encouraging note Mikael Häggström (talk) 05:27, 11 July 2016 (UTC)
 * I, also, cannot see any sense to what User:Leprof 7272 is saying.--Guy vandegrift (talk) 16:16, 12 July 2016 (UTC)
 * — I should apologise for not immediately responding, but the earlier set of three responses were so baldly superficial, and free of thought, and untied to WP policy and guideline (not so much Mr Häggström's as the two additional voices that felt the need to create the insubstantial consensus)—that I felt no point at the time to try to reply.
 * But another matter here has brought me back, and so I do reply.
 * Barbara, you argue—amazingly, insultingly, given the ease and connectedness of the wiki-universe—from embarrassingly limited evidence. Had you simply run my numbers at the English Wikipedia, you would have seen that your "four edits" comment was simply ridiculous, and unapologetically self- and status quo-serving. Moreover, note, apart from the hard record of my WP edits, these represent perhaps 20% of all my edits—I make a majority of my edits while not logged in, because I do not care, for the most part, to enter into discussions here. Life is too short. Finally, I am a published university Professor with far more real world scientific research and educational experience than most here—as you might have inferred, had you read my sufficiently informative, if intentionally vague User page. (It is vague, because I experienced harassment because of WP, after being outed here with regard to my University, by a disgruntled fellow WP editor.)
 * With regard to the earlier point, I will simply state, again: Your images, and images at WP in general, are being used as an "end around", to circumvent WP:OR and WP:VERIFY policies, setting up an alternative pathway of "just trust me" content at Wikipedia. While you may be acting within current accepted practice at WP, the practice is wrong, simply wrong, vis-a-vis the spirit of the underlying policies and guidelines of the place.
 * So, in choosing, the three of you, to satisfy the need of this young university editor for self-expression via his scientific image generation (rather than wait until they appear in a published journal, and he has the stature to negotiate with his publisher the right to place them in the public domain), instead, we publish them without the support of an authoritative associated publication. In doing so, we open the door a bit further to the import of unpublished, unsourced, non-peer-reviewed content.
 * So be it. If a picture is worth a thousand words, the trio of you are responsible for many kilobytes of unpublished content.
 * Worse, you punt on the opportunity to be a part of the solution, instead, extending the problem into new, ever more sophisticated arenas. The problem is not when trainees at good universities present unpublished images. The problem is the principles involved—that it opens the door to anyone here to do the same, in any arena (and we fight this daily in chemistry articles); moreover, that it defies the very basis, the very foundation of the place, that our reliability is based on use of published information of the highest quality available.
 * When the estimable Mr Häggström grows disinterested or too busy to keep an eye on his work, it is the accepted policies and practices that will (or in this case, fail) to maintain encyclopedic quality. And the contribution of this trio of you, to fail to engage the substantive deep discussion, to instead respond superficially, and thus to extend the exception and allow the continued use of unpublished images not associated with any scholarly venue—it's simply a shame. On you, and on the place. Nothing more from me, but I will, at every juncture, continue to paste in my objection, whenever a student queries them to me, whenever I happen upon them.
 * This course of denying the information content of images, and thereby excepting them from citation standards is nonsense, and will eventually either change, or contribute to the failure of this place. Le Prof 73.210.155.96 (talk) 03:10, 17 March 2017 (UTC)

Le Prof 73.210.155.96 (talk) 03:49, 17 March 2017 (UTC)

First arbitrary break, Is a picture worth a thousand words, or not
The stuff above is [too long didn't read/tldr]. Can you give an example of the images that concern you? Concisely? Jytdog (talk) 05:01, 17 March 2017 (UTC)


 * As I understand, the synopsis is: Should we require all images to comply with WP:MEDRS? My position is as found in my initial reply:
 * I disagree that pictures by medical imaging (including ultrasonographies, X-rays and MRI images) that are not from WP:MEDRS would be unacceptable in Wikipedia. Text and diagrams can be created with own words and designs, using MEDRS as references, but X-rays etc must be copies from the original sources. Very few pictures by medical imaging on external pages have compatible licenses. Journals often charge between $1,500 and $3,000 for making restricted works open access (PLOS examples), so the cost of permissions to make works even copyleft to be compatible with Wikipedia can be expected to be of similar amount [if possible at all]. As a result, almost all pictures by medical imaging that are used in Wikipedia originate from Wikipedia users (as can be seen by analyzing Category:Bone fractures for example) and are thus WP:OR, and would hence have to be removed if it was a requirement to be from MEDRS.
 * Mikael Häggström (talk) 06:37, 17 March 2017 (UTC)
 * Le Prof is incorrect in claiming that these images violate WP:OR, as that policy explicitly allows previously unpublished images created by Wikipedians; please see No original research. On the broader point, I believe Le Prof is correct that the relaxation of the usual WP:OR requirements makes it easier for errors to creep in through images than through text.  But that's the price we have to pay to have images on Wikipedia.  There just aren't enough peer-reviewed images with Wikipedia-compatible licenses to go around.  Our usual error-checking mechanisms still apply – Le Prof, if you there are particular images you believe are erroneous or misleading, please tell us, and if we agree we'll delete them.  (Commons won't, but that's another story.)  Adrian J. Hunter(talk•contribs) 08:10, 17 March 2017 (UTC)
 * To be precise, this is our current policy: "Original images created by a Wikipedian are not considered original research, so long as they do not illustrate or introduce unpublished ideas or arguments, the core reason behind the NOR policy" and Adrian is right. The consequence is that there exists a presumption that an image is acceptable, unless shown otherwise. If LeProf finds particular images that he believes are erroneous, then we can take steps to remove or correct them. Beyond that though, the question remains "Must the information contained within a medical image be supportable from a MEDRS-compliant source?" I suspect that the answer may be "Preferably yes, but lacking definitive guidelines, we have to examine that issue on a case-by-case basis". What do others think? --RexxS (talk) 11:54, 17 March 2017 (UTC)
 * We have had this discussion before. If someone uploads a picture of a disease or a Xray of a broken bone and uses it to illustrate that disease that is not original research per WP's use of the term.
 * What is proposed would basically disallow WPians to upload their own images. Would we need references to support the claim that pictures people have taken of olympians are actually the people in question? We need to use common sense. Doc James  (talk · contribs · email) 16:53, 17 March 2017 (UTC)
 * In my view, if the image is illustrating some well-sourced textual content in the article it is great (yes, like " an X-ray of a broken femur". If the caption of the image is making some claim like "asparatame causes cancer, as shown in this image" this is not OK  or even more narrowly - "This is a picture of a rat fed aspartame for 90 days; there is a large cancerous mass on its right flank" and the person says "I did that myself, and took this picture myself:"  would not be ok. Jytdog (talk)
 * Yup would agree with that Jytdog. Doc James  (talk · contribs · email) 20:47, 17 March 2017 (UTC)


 * There's a grey area between "an X-ray of a broken femur" and "I did that myself, and took this picture myself", of the "a 30-year-old woman displaying the typical symptoms of rickets" type—at what point does it become OR to state in Wikipedia's voice that the illness/injury being shown is actually what's being described? It's not a problem in the majority of cases, but especially when using historical photographs of conditions which are now rare, it may well be that the subjects were never formally diagnosed, or that the diagnoses didn't even exist during their lifetimes. Take the lead image of Cretinism (a page which probably shouldn't exist, since it's an obvious content fork of Congenital hypothyroidism) for example; the only evidence we have that this guy is suffering congenital hypothyroidism rather than just being short is that the original photo is labelled "Joseph le crétin". &#8209; Iridescent 21:08, 17 March 2017 (UTC)
 * And yes that is absolutely where the shit hits the fan. agreed. Jytdog (talk) 22:12, 17 March 2017 (UTC)
 * We solve that problem by writing a caption that either focuses on the appearance ("This man's height is characteristic of congenital hypothyroidism") or on the history ("This photo from the late 19th century was titled Joseph le crétin"). In this example, a historical treatment might also remember that a diagnosis of cretinism originally covered a lot more territory than just congenital hypothyroidism, due to the aforementioned difficulties of pre-modern diagnostic techniques.  WhatamIdoing (talk) 02:15, 18 March 2017 (UTC)

Cretinism and Congenital hypothyroidism are not exactly the same. One causes the other though. Doc James (talk · contribs · email) 04:52, 18 March 2017 (UTC)
 * No comment on cretinism and congenital hypothyroidism—separate discussion for those article pages.
 * I accept that this has been discussed before, and I accept that there is current policy allowing editor-created images.


 * With all due respect Doc, no, my raising this and the suggestions that follow do not seek to alter the reality that editors can upload images.

It does, however, suggest that in such a place as the sciences, and medicine, where we realize that all data are not tabular/textual, that images can be data, and in such cases, additional scrutiny is required to adhere to the principles of WP:VERIFY and WP:SELFPUBLISH. But Doc, yes, this is a sea change that is proposed here, and I would ask you to focus on principles and not on the dire implications (that could be rolled out slowly over time). For I am indeed suggesting that people should not self-publish X-rays here, that you, as an expert, can tell are fine, but that may escape your attention for a time—or help us, come after you retire—and so may adversely impact readers. Likewise, I see no point to allow people to take their own pictures of rashes, swollen legs, etc., offering them as "just trust me, I was diagnosed thus" content (until such time that mistakes can be caught, again by experts). I would object to these, both for the principle laid out in following, but also because keeping that status quo acceptance puts minds like yours on such corrective work, and off the real work—finding reliable collections of peer-reviewed, published medical and scientific images, whose publishers might be persuaded to allow their images to appear here, with proper attribution. As long sad there is a "user-generated DVT swollen leg image is good enough"" approach, we will generate more problems, and never address the better solutions that might be possible.
 * So, what I am trying to initiate here—among a more learned group of editors than is the norm at WP, on a subject where the ramifications of presentation of image-as-data are clearer—is a discussion on whether we need to begin to scale back allowing visual data and factual assertion, especially in medicine and the sciences, as a means to insert perspective into articles.
 * Three points. (i) The fact that data constitute a form of intellectual content akin to text is clear from every discussion of the matter, from author instruction pages of journals to scientific fraud discussions. If anything, the need for the sourcing and attribution and validity of images is taken as or more seriously than the text (perhaps because it is recognized, pedagogically, that people no longer read top to bottom, but from and around the visuals of any presented piece).
 * (ii) The fact that content is guided by, and sometimes redirected by images is also clear. For instance, the biosynthesis of benzoxazinone, from the perspective of the chemistry and biochemistry, is wholly presented in its article by a figure, the origins of which do not appear in the article or in its description at Wilimedia commons. (As well, the article only presents its title subject through the image; the whole of the text is about the genetics and the cellular localization of the enzymes, and not about the biosynthesis per se. It appears as image only.) This is an example of the many, many cases where images replace text, and represent completely unsourced content. Likewise, the complex biosyntheses remain unsourced, both in image and in text, for paclitaxel and longifolene, both in article and in image (etc., etc.)—that is, failing to source the image makes the generation of unsourced text all the more likely, by editors that simply (and often capably) just summarise what they see in the image. The same issue also presents itself in the synthetic schemes of many chemistry and natural products articles, etc. In these cases, a picture is clearly understood to not only be worth, but to replace a thousand words at Wikipedia, and/or to be the source of further untraceable, unverifiable content.
 * And any time pictures replace words, communicating the intellectual content of the encyclopedia, I argue they deserve a citation ("Pathway based on the presentation of…" or "Synthetic scheme redrawn from…"). Otherwise, in replacing descriptive, textual content, this is just an end around WP:VERIFY. Moreover—and this addresses the green text quoting the NOR policy above—these cases beg the question of how we could possibly know, apart from a drawn out research project, whether in all these cases where the ultimate source of the intellectual content appears neither in article, nor in image, nor at Wikimedia Commons that the material does not "illustrate or introduce unpublished ideas or arguments" as the WP:NOR guideline requires. As in any (sane) intellectual endeavor, the onus to ensure accuracy and truth should lie with the person offering/submitting the material, and not with a followup, ad hoc, catch-as-catch-can volunteer force of readers that may eventually catch errors (that have meanwhile circulated to millions of largely scientifically ignorant readers).
 * (iii) WP policies began in a time when raw scientific data, as images, were not as readily created and presented in Wikipedia. And, unlike particular views of the US Consitution, we do not perceive that the WP policies and guidelines are intended to remain the same, but rather to evolve as technical capabilities and patterns of editor practice evolve. So, I ask again, is it time now, at the medicine and science articles, to initiate change broadly supportive of the spirit of WP:VERIFY, that says:
 * (a) that raw, new scientific data should not be self-published on Wikipedia, and
 * (b) when image content is sophisticated and not common knowledge, that the source from which it is derived should be stated, so the considerable intellectual content of the image is verifiable?
 * Finally, with regard to the question/challenge of my finding specific problems with the self-published ultrsonographic data that we are currently allowing to be presented—first, this issue was already discussed at length, above, in the collapsed discussion, in a bulleted area. There I compare how such data would have been handled in an independent, peer-reviewed setting, versus how they were handled by the submitting author, and in that discussion, I noted that errors were found during a process of self-imposed peer-review (by an unnamed faculty colleague/friend at his institution), and that those errors were only found after the images had appeared at WMC for some time.
 * Second, I would reply that these particulars are immaterial to the general question. For every editor with the smarts and integrity to try some form of self-imposed peer review of their self-published visual data, there will be as many or more others who do not do so (the widely distributed "just trust my experiments" gas discharge data, and its accompanying experimental details, being another ready example).


 * So, I repeat, two direct proposals, as presented in the above bulleted questions. Rephrased, (a) Should we continue to allow superficially supportive images that are only correctable and interpretable by the most well-trained of narrow experts (editors of the sort we do not often attract here), images that have their origins in original research/work of editors, and thus constitute first publication of non-reviewed, unpublished work (being self-published at WP for the first time), do we allow these to continue to be presented as "just trust me" content with the Wikiproject Medicine articles? and, (b) Should we continue allowing complex chemical/biochemical/molecular biology schemes related to Wikiproject Medicine and other sciences to also appear as "just trust me" content, hoping that any errors present will be caught (despite doing so is made into a research project by the failure to attribute the content), knowing that unsourced content begets further unsourced content?


 * Please, argue here not from the undesirable, practical implications you might envision—an articles-remain-pretty end does not justify the means. Argue from the first principles. Are these cases not violations of our core principles of verifiability and independent sourcing? Cheers, reply when convenient. Le Prof Leprof 7272 (talk) 18:42, 20 March 2017 (UTC)


 * We all agree that common sense is needed. Do you have examples that concern you? Doc James  (talk · contribs · email) 22:18, 20 March 2017 (UTC)
 * Two categories under discussion, both thoroughly "exampled": (i) on self-publication of raw data that violates the spirit of WP:VER, ex. are ultrasonography and all other data imagery. (ii) on the matter of information rich figures, the examples given above were the Benzoxazinone biosynthesis (only scheme, no text, so picture worth all words), and paclitaxel and longifolene, where no source of image led to no sourcing of text content. See also below. Le Prof Leprof 7272 (talk) 02:30, 24 March 2017 (UTC)


 * Leprof gave the example of an uncited (he called it "unverifiable" but I'm sure that he meant to say uncited) chemical synthesis as the locus of his concern. When images are uploaded (if you have the right software, it's easy to copy the information out of a textbook), the uploaders don't always cite their sources, and they don't always provide a description of the process in text, either (which is valuable for many purposes, not just for verifiability).  This leaves the article without citations for the content and also incomplete.  I've not seen anything in all of this that suggests Leprof has seen any actual errors.  WhatamIdoing (talk) 18:53, 23 March 2017 (UTC)
 * On the matter of errors, yes, many, see below. ON the matter of unverifiable, separate matter will discuss with you at your Talk. Cheers. Le Prof Leprof 7272 (talk) 02:34, 24 March 2017 (UTC)

Second arbitrary break, Is a picture worth a thousand words, or not
For a specific example, see discussion here: Talk:Dental_fluorosis where 2 IPs are arguing whether an image shows an example of a given condition (one of the IPs says he/she took the image of his/her patient and uploaded it the image is of his/her own teeth ) Jytdog (talk) 02:07, 22 March 2017 (UTC) (corrected Jytdog (talk) 16:46, 27 March 2017 (UTC))
 * First thought: We need more dentists around here. Second thought:  There's no reason why this photo couldn't be both.  But a trip to Google Images produces many sources that look the same, such as http://www.eurjdent.com/viewimage.asp?img=EurJDent_2013_7_4_504_120661_u1.jpg (from ).  Another notes that problems such as chipping and cracking also happens in severe cases.  I think that the uploader is correct:  this probably is a case of severe dental fluorosis.  WhatamIdoing (talk) 00:16, 23 March 2017 (UTC)
 * I hear all that but it goes to the OR question that was raised above. You just did OR yourself to try to validate the picture (and wished we had an editor who could validate based on their personal knowledge....).  If the picture doesn't show what is described by sourced content in the article it seems we have a problem.  Jytdog (talk) 00:25, 23 March 2017 (UTC)
 * Bravo Jytdog. Bravo. Leprof 7272 (talk) 05:03, 24 March 2017 (UTC)
 * Determining that a picture looks like something that's in a reliable source is not "original research". And, it's important to remember, the requirement for photos isn't that the image actually is the relevant subject; it only has to look like the relevant subject (which means that actual-but-atypical appearances can't be used).  This image, for example, is completely useless to illustrate Cake, even though it is actually a decorated layer cake, but it could be considered for illustrating Turkey meat (if it had a free license and no better options were available).   WhatamIdoing (talk) 18:07, 23 March 2017 (UTC)
 * To the contrary, comparing two ultrasonography data sets, and determining that the two are interchangeable is indeed WP:OR, and very expert OR. And that is where we began—asking whether it is acceptable for WP to allow self-publication of medical imaging data. But it does not stop there. When an individual has a systemic bacterial intection, the capillaries in the nail beds change in appearance such that an expert at physical exam can often detect such an infection that approaches septicemia, before it is too late. We going to allow editors to send in pictures of their finger nails to illustrate this, letting Doc sit in judgment over real versus errant or fraudulent submissions? Why not get an out-of-print, classic textbook or two ID'd, and begin the process of negotiation for their images to appear here? Instead of farming out example image generation to non-experts, and creating a non-sustainable "someone will surely catch it" quality system... Leprof 7272 (talk) 05:03, 24 March 2017 (UTC)
 * Yes and no. For most articles, even medical articles, "near enough" is fine. (Nobody is going to complain that this image on Biddenden Maids is biologically impossible, since it's specifically illustrating the public perception of conjoined twins rather than actually claiming to be medically accurate). However, when it comes to (some) medical articles there's an extra need to ensure images are as representative as possible, since no matter how many disclaimers we plaster over everything some people will be using Wikipedia articles for diagnosis. (Not only is there the "my child has a spotty rash on his abdomen and legs, I thought it was just an allergic reaction to his new trousers but someone told me it could be meningitis, what do the two different rashes look like?" issue, but in some parts of the developing world the Wikipedia Zero scheme means Wikipedia is the only freely available source of healthcare information). There are some photos of psoriasis that could perfectly well be used to illustrate dermatitis and vice versa, but it wouldn't be appropriate or ethical to do so since it would have the potential to mislead readers (and could open WP to adverse publicity and even legal challenges if someone misdiagnosed on the basis of our images.) &#8209; Iridescent 18:33, 23 March 2017 (UTC)
 * Note that you guys have sailed past the core point. You have two images, one labeled "condition X" and the other labeled "condition Y," and are discussing how similar they look, whether it is appropriate to show them side by side, etc. But you argue, assuming facts not in evidence. You simply do not, cannot know, absent direct, authoritative sourcing ("It came from Gray's Anatomy...") or WP:OR ("It looks the same to me as what I saw in..."), that the first truly is "condition X", and the second "Y". That you perceive the first to truly be "condition X" because you have done the research to convince yourself of it—how can this not be OR? And how is this not substituting one "just trust me" scenario (asked by the submitter) with another (asked by an editor)? This is utterly nonsensical, vis-à-vis creating a process that gives some assurance of quality, independent of specific gifted individuals doing an extraordinary job. We begin with "just trust me" from the person submitting the diagnostic image—simple or complex—and the whole formal process just goes south from there. Stand back from this—can you not see that we would never allow such arguments, about text-based content? That this is so much slight of hand logic, to avoid an obvious conclusion, that informational (content-rich) medical and other scientific images are a real and fundamentally unavoidable content problem? Le Prof Leprof 7272 (talk) 05:37, 24 March 2017 (UTC)
 * I've answered this point repeatedly. We don't care whether it "truly is" the condition.  We care whether it looks like the condition.  The sole purpose of an image in an article is to illustrate the subject.  If the image looks like it, then it is capable of illustrating it.  If it doesn't look like it – even if it truly is it – then it is not capable of illustrating it.
 * Of course, it's nice to have an image that actually is the subject, looks like the subject, and is backed by a reliable source, but the trifecta isn't required. The absolute minimum requirement is only that the appearance be consistent with it.
 * And the way that you determine whether something is sufficiently representive is...well, it's exactly what I did with this image (looking in reliable sources to see what they used and how they described them), and which Jytdog worried might be a policy violation rather than what the policy used to explicitly authorize under the name of "source-based research". This isn't the first time that this has come up.  It might be useful to document how to determine whether any given visual representation is representative. WhatamIdoing (talk) 17:11, 24 March 2017 (UTC)
 * Understood, and your presenting your perspective as this stark dichotomy is helpful (even to the extent of the highlight). My response: We share the second half of your conviction (I concur with the pedagogic imperative that an image illustrate a principle of the article), but we part company on the first. I would argue that not caring whether an image "truly is" what it purports to be, while possibly acceptable in expert hands (I'm not even sure about it being acceptable from experts) is a dangerous extension of the images-as-end-around-WP:VERIFY to images as addition of knowling presented inaccurate content. So, I fundamentally disagree that this should be accepted. I think it very unwise, as I extrapolate from Doc James doing it, to everyone, everywhere, in English-speaking humanity, being allowed to express their expert judgment, that what looks like symptom/condition X is fine to be misrepresented as symptom/condition Y. Cheers, Le Prof 73.210.155.96 (talk) 15:13, 25 March 2017 (UTC)
 * (I might be inclined to include psoriasis and dermatitis images in the other articles – side by side, to illustrate how similar they look.) WhatamIdoing (talk) 18:58, 23 March 2017 (UTC)
 * Before interspersing last comments (for I am likely tossing in the towel), let me reply to a "so what" theme that began developing, even before the last "arbitrary break" (I will reiterate two general points), and then I'll share today's time-wasting unsourced image example, and sign off.
 * WhatamIdoing suggested that the failure to source images does not result in mistakes. It indeed results both in mistakes, and in much wasted time on the part of those of us who distrust the process, in catching them. Two "for instances". [1] As noted, the ultrasonographic images had (I believe I recall correctly) two medically important mistakes that led to changes in the posted content. Notably, these changes were made (a) only after the images had been Wiki-posted for some time, and (b) were only caught, post hoc, because the submitter, a medical trainee, had a faculty colleague perform a sort of "peer review." That faculty colleague, as an expert in the medical specialty, caught the mistakes. I note above that even this limited form of peer review is not practiced by most medical image submitters, and that we lack the broad medical expertise in the various specialties that will ensure we catch all of such mistakes. Mistakes cannot be avoided in this place, but establishing general practices that ensure a steady stream, sans a mechanism to correct them, is like DNA damage in living systems without DNA repair. It will kill us (muck all our efforts, even if only after we are gone) eventually. [2] In terms of the chemistry and biochemistry errors I can be more brief. I come upon them daily, without looking for them. Errors in nomenclature are common, as are errors in stereochemistry, and representations of molecule as something other than they are. Most often, these are dealt with, via bold edit, replacing an incorrect image with a correct one, or at least deleting the errant one. Very often, these edits are reverted. But many I do not bother with, either from the start, or after reversion (simply because I will not argue with the untrained over possibly subtle matters of correctness, e.g., presenting only one enantiomer of a molecule, where the common name/article name is stereochemically non-descript, thus referring to a racemate). Bottom line, the inference that this is not a matter of containing content errors is simply wrong. A conclusion above was that a picture was worth a thousand words, and unsourced images replace text, and spawn further unsourced content (text descriptions that follow suit—unsourced image-describing text following unsourced image). Conclusion here is that there are many problem images here, sometimes subtly so, sometimes overtly, but we lack the time and expertise (and commitment to be persistent and fight), and so it is simply a case of "garbage in... garbage out stays in...".
 * Today's further example. Responding to an request from a student reader, who noted a nomenclature discrepancy between Table and Scheme at the Non-mevalonate pathway, now ✅ (fixed). To begin, I checked the Commons for the image description (negative, no source given), and examined all near-dozen cited sources in the article for a comparable scheme (negative, image not in any cited source). So, per the need expressed by a student, I concluded [1] the problem raised was indeed real (discrepancies within and between articles), but [2] it was, for lack of sourcing, now a research problem, rather than a reasonable editorial/scholarly fix. (Conclusion about the issue here was clear, and simple, because the image presented "creative" [de novo made up, nonstandard] abbreviations for enzymes, which stood out from all the immediately available sources.) I gave up on helping, until a separate matter led me to stumble across the source of the image—which, it turns out, was copied absolutely verbatim (shape, layout, non-standard abbreviations and all), from a second/third-tier review source, Qidwai et al.. See also here for the scheme-table fix, if interested. Bottom line, the failure to provide the source of that important biosynthetic pathway almost lead to "no action" on the student's request to fix a confusing article, and in any case wasted valuable expert editorial time, see link just provided.
 * For the rest of the replies, I will intersperse brief messages to those making points above.

Otherwise, I sense there is no spirit for this fight—to go medical with my allusion, I sense that we are unready for the drastic surgery that is needed. I sense that people here are going to follow the lead of, who thinks it fine for a person to take a picture of their swollen leg, and post it, "just trust me", as visual record of of the symptoms of Deep vein thrombosis. Or of teeth. Or of X-rays. Or of ultrasonographs, MRIs... (NMR spectra, EKGs, JPEGs of medical charts, or of notebook-recorded measured melting points, there is no end to the creativity that might be expressed.) The naivete of the notion that images are not significant intellectual content, on par with text, astounds me, and its being ignored leaves me feeling completely flummoxed (even leaving aside our complete lack of concern over consent). [You think all these images are selfies, or made available thorugh informed consent?]

Perhaps this is because, as a physician, Doc is sure he can spot unreasonable submissions, and cull them. Well, to this I say, policy is not built around one person. It is bad policy to establish a practice over a long period, because we have one or a very few individuals that will intervene to maintain quality. (Perhaps this is one benefit of having been both in private sector and public, that I understand the meaning and requirements of a quality system, and I know a good one never relies on a single, unique individual, but rather on the system, and its fungible elements.)

So, I've all but given up here. It is absolutely clear to me that that all pictures are data, but that some, in some areas, rise above the innocuous, to being the self-publication of medical and scientific data. If Wikipedia is remaining in the business of doing that, because no one wants to do the work of negotiating quality images to appear from a reputable published source—well, we will eventually become what we would be if we could redact all of Docs' (and other reliable editors') edits—reduced to a least common denominator of our editorial expertise. We are barely, among my colleagues, a trustworthy encyclopedia now. Absent Doc and a few of you, this would be a sorrier place. If you cannot see the system needs to be independent of you—which is what a policy of sourcing complex images would do—then I am done arguing. You can decide why the hypocrisy of an "end-around" is acceptable here, but not with med content referenced to primary sources (any decent primary source being orders of magnitude better then a self-submitted, "just trust me" X-ray or patho-voyeuristic/selfie photo).

No, having run this by some of my tech, philosophy, medicine, journalism, pharma, and legal colleagues for feedback, the only dissents to the obvious I've experienced are here, seemingly because we don't want to face the work required to right the ship. And I am out of breath arguing it. All pictures are data. Some are more egregious violations of our core principles than others. Le Prof Leprof 7272 (talk) 05:00, 24 March 2017 (UTC)
 * My position is that we cannot let perfection paralyze us from doing anything. Wikipedia is a work in progress.
 * I will ask dental folks what they think of the image. Doc James  (talk · contribs · email) 08:09, 24 March 2017 (UTC)
 * Okay our Wiki Dentist has replied that it is a mix of both severe fluorosis and dental caries. He is going to add arrows. Doc James  (talk · contribs · email) 12:38, 24 March 2017 (UTC)
 * Picture and caption updated. Doc James  (talk · contribs · email) 12:43, 24 March 2017 (UTC)
 * With all due respect, this dental image that we now conclude as a mix of both sever[e] fluorosis and dental caries is both case in point, and beside the point. It is a case study, in that the image was originally incorporated with incomplete, and therefore incorrect information into an article despite expertise of the contributor (it represented a partial misdiagnosis until corrected), and that both the selection of the image, and the correction of the accompanying text represent clearly exercised WP:OR (!). Were this not coming from you, Doc, I would be appalled. Extrapolating this to the general practice of editors here, from every point on the curve of medical expertise, and from every English-speaking access point to the web, I am absolutely appalled.
 * It is immaterial, in that it is a specific case, and does not encompass the fullness of the issues, which include the policy questions of whether we are violating WP:SELFPUBLISH and WP:OR with this practice (as these medical diagnositc images, such as the original ultrasonograms, are clearly data, and self-published, here, at Wikpedia for the first time). In the original ultrasonography case, as well, the image set at first contained medical errors.
 * Hence, we appear to be on the track of formalising an understanding that ensures, at every moment in time, a significant static percentage of inaccurate medical information here at WP (in the images absent sources, that are outside of Docs expertise, that no one has happened upon yet to correct, and—allowing WhatAm...'s deeply flawed "does it look like" test, see below—that no one easily can, for the lack of sources). I say "every" and "static," because there will always be a portion of material that is dynamically inaccurate. Sourced text, if wrong, will be wrong until corrected. But it is the presence of a source that allows correction. This additional commitment to allow inaccurate content without sources that would allow for correction, and allow it from "all comers"—see also the yellow highlighted discussion with WhatAm... above—this is numbing, appalling, unbelievable. Le Prof 73.210.155.96 (talk) 15:13, 25 March 2017 (UTC)
 * I'm not sure that the dental image was actually "incomplete", so much as "insufficiently detailed for some people's tastes". Severe fluorosis causes chipping, cracking, and pitting – and therefore dental caries.  WhatamIdoing (talk) 15:01, 26 March 2017 (UTC)


 * just want to note that i mischaracterized the discussion about this fluorosis image. The IP writing is not a dentist, but is saying that the image is of his/her own teeth.  They have also mentioned "malpractice" of the dentist who gave them high doses of fluoride as a kid and that they have had difficulties with insurance.  Don't know if uploading the image is serving some RW purpose for the IP -- a whole other angle.  Hm.  Jytdog (talk) 16:46, 27 March 2017 (UTC)

Fourth arbitrary break, Is a picture worth a thousand words, or not
This is in essence a cost-benefit problem. Our main objective per WP:IAR is always to improve the enyclopedia. I think many editors (myself included) believe that having images, even if they constitute OR, is generally better than not having these images. Thus, to these editors, culling these images is a net negative for the project. That said, yes we should improve our image sourcing. If we can obtain appropriately licensed images from reputable sources we should absolutely use them. I don't think we are at the point yet that we can remove all OR images though. The community might be more amenable to raising our standards if we have these image sources lined up first, rather than deleting first and then looking for reputable sources. Sizeofint (talk) 17:37, 24 March 2017 (UTC)
 * OK, one area of agreement is that we should improve our image sourcing, and that we if we could obtain appropriately licensed images from reputable sources we should absolutely use them. Also, opinion that we should not remove all OR images. What of stemming the influx of images, by restricting them only to images that have an accompanying acceptable medical reference source?  Le Prof 73.210.155.96 (talk) 15:28, 25 March 2017 (UTC)

Identifying the contents of an image
What do you think? Are these pictures of the White House? And how did you figure it out?

Don't bother telling me that Science Is Special™: WP:Original research doesn't have any special "it's okay to do this for BLPs (fact:  individual Wikipedia editors have had to defend themselves from noticeably more libel lawsuits than medical malpractice ones) and geography and artwork and everything else, but it's not okay to do this for science" rules. (Leprof's main point appears to be changing that.) The process for identifying the contents of an image is exactly the same, no matter what the contents are.

I say this: if editors can follow the normal, reasonable process, and editors can determine to a reasonable level that those photos are actually the White House – or, more precisely, that those photos look enough like the actual White House that they're usable for the educational purpose of illustrating the article, (NB:  not the purpose of "proving that this image really is an actual photograph of the actual thing", but merely the purpose of "showing people what it looks like", which is something you can accomplish even if you discover later that the image in question is trick photography or one of the several replicas of the White House), then editors are probably capable of determining whether an image purporting to show severe fluorosis looks like an image showing severe fluorosis.

It's nice to have good images, and it's nice to have a reliable source to blame if the image is misidentified. But I do not agree that editors are incapable of, or should be prohibited from, looking at a bunch of images in reliable sources and deciding whether the image that they could use from Commons looks like the images in the reliable sources. I also trust editors to know when they need to get a second opinion. Some conditions are difficult to tell apart from images, just like some people are difficult to tell apart in images.

This type of discussion always reminds me of the hepatitis C skeptic back in 2010. He kept removing an electron micrograph from the hep C virus article because he didn't want what he perceived as photographic proof of the virus' existence in Wikipedia. His main line of attack was that we needed a third-party reliable source to attest that this exact image was an accurate and true micrograph of the Hep C virus (it's a small enveloped virus. It looks like a featureless blob, and there's no way for even an expert to differentiate a micrograph of Hep C from a micrograph of, say, West Nile virus or the yellow fever virus, which are also small enveloped viruses.  Their exterior appearances are identical). As we explained repeatedly, the purpose of the image wasn't prove the virus' existence, or even to prove that Wikipedia had an image of it. The purpose was only to show people what the virus looked like. To that extent, images of those viruses are actually interchangeable (although I don't recommend spamming the same photo into all of the articles): they are different viruses, but the only parts of them that are micrographically visible are identical. It has always been my POV that readers benefited from that illustration (it was certainly sufficient to illustrate "Look! Small enveloped virus!  Not the fancy bacteriophage that you remember from your school days!"), even before Tim Vickers talked a reliable source into donating a much better one.


 * Sorry, mate, the hep C image debate is a red herring of an example, completely unrelated, and with distinct nefarious motivations. (Working hard to supress feeling offended.) Also un-rooted in WP principles, where I have clearly stated mine (WP:SELFPUBLISH, WP:ORIGINAL RESEARCH, etc.).
 * Otherwise,, the "looks like" argument that keeps rearing its angry head continues to leave me at a loss. You want us to not declare that medicine and science are different, and that just as anyone can compare images of the White House (length of training required to approach expertise, perhaps an hour, at a intelligence agency-level, if, as here, time is not a variable, and full photographic perspectives at elevation are given), they can compare medical images (length of time required to approach expertise—I don't know Doc, how long does a consulting radiologist train these days, before being board certified? 6 years after undergraduate? More?) So, this is so much nonsense, and you guys know it. (Otherwise, next time you have a major test, ask someone here to read it for you.)
 * Bottom line, you cannot possibly argue in the presence of physicians and scientists that it is not true, that the less trained and experienced you are, the more that complex things look similar. Have you never had a cellular path experience/lab? Or done any spectroscopy or imaging? Or, forget these; I married an art historian. How about the provenance of Dutch paintings from the Northern European Renaissance? "Looks like a duck, quacks like a duck..." is not scholarship, its comedy. (In my experience, when its practicality has made its way into business practice, it has been led to bad outcomes there as well.) There is a reason why a technician—who is trained and generally more knowledgable than anyone here—acquires medical images, but that the health care delivery systems in place preclude the techncian from interpreting the medical images, toward the diagnosis, which must instead be done by a radiologist—an MD, with board-certified training in their specific area of imaging. But no, here at WP, anyone can take two medical images, and say "A looks like B," and we are fine with it. Sorry, utter nonsense.
 * Finally, the continuing argument that "looks like" is ethically valid falls flat, emphatically, as well. The "Who would know?" ... "I would know." ethical conundrum (linked explanation chosen for accessibility, not philosophical rigour) is as old as the hills, and there is no question where scietists and physicians have always in past, planted the flag. Do as you will, but consensus can be wrong, and it this proceeds as it seems it will, it will be wrong. Le Prof Leprof 7272 (talk) 23:09, 25 March 2017 (UTC)
 * If you need a medical degree to determine that this image, uploaded by someone else (with the probably correct answer already provided to you), looks like these other images (from reliable sources), then the image is not actually useful for our educational purpose.
 * The task for editors isn't to find a new, unidentified medical image and figure out what it represents. The task for editors is to take an image that a radiologist has already evaluated and see whether it looks like images that other radiologists have identified as having the same condition.  To use your analogy, the task isn't proving the provenance of a new, unknown Dutch painting; the task is much more similar to deciding whether this photo, which claims to be a picture of Hans Multscher's altarpiece at Sterzing, is sufficiently similar to the photos of that famous sculpture as represented at reliable sources that it could/should be included in his article.  WhatamIdoing (talk) 15:17, 26 March 2017 (UTC)
 * Sorry mate, but this is so much connerie. See previous comments on the undeniable pedagogical understanding that greater degrees of training are required to differentiate histological, radiological, and other such complex images. You are the one that is arguing that we should perform such A-looks-like-B comparisons. (I say nonsense.) But if we are, then you cannot escape (a) that complex images have pedagogical value, and (b) that it takes proper training to fully, correctly assign which of a pair of images is, and is not, an invasive variant of squamous cell carcinoma (or even, to differential between simple dental image interpretations). Le Prof Leprof 7272 (talk) 06:57, 3 April 2017 (UTC)

I still don't see any compelling reason to change our rules. WhatamIdoing (talk) 17:11, 24 March 2017 (UTC)
 * but do readers know that the images are only supposed to look like the relevant subject rather than actually be of it? The problem is that what "look like" means can change; a revised set of diagnostic criteria may mean that what was once sufficiently similar isn't any longer. I do understand the thrust of your argument, but we are applying two standards: for text we require sourcing that reasonably competent readers can check for themselves; for images we do not. Peter coxhead (talk) 17:30, 24 March 2017 (UTC)
 * I don't think we have two standards. I expect that reasonably competent readers can check for themselves – exactly the same way that the reasonably competent editors checked the image, and exactly the same way that reasonably competent readers and editors check that material is verifiABLE even when not followed by a reliable source that is cited in the article.  "VerifiABLE" includes verification through the mechanism of asking your favorite web search engine for help checking the contents.
 * (This method won't work for a first-ever image, of course. If you've got the first-ever image of something, then there's no way for us to compare yours against the images in reliable sources.  But when there are several, and you've got one that's free, both readers and editors can compare the image that we have against the images in reliable sources.)  WhatamIdoing (talk) 19:14, 24 March 2017 (UTC)
 * but we don't normally expect textual medical information to be verifiABLE even when not followed by a reliable source that is cited in the article. Since medical information must be based on "reliable, third-party published secondary sources", we can, and do, explicitly cite in the article in almost all cases. This is where the example of an image of the White House is misleading. Higher standards are applied to medical information, as per WP:MEDRS.
 * You say both readers and editors can compare the image that we have against the images in reliable sources, but there's a crucial difference. For textual medical information, we can compare the text in the article with the text in the cited reliable sources. So if we are expected to compare an image in a Wikipedia medical article with an image in reliable source[s], then those sources should be cited, e.g. by saying something like "compare to Fig. 12 in Jones (2012)", where Jones (2012) meets the standards of WP:MEDRS. Peter coxhead (talk) 19:41, 24 March 2017 (UTC)
 * You'll find that your assertion about explicit cites in "almost all cases" doesn't stand up to scrutiny. I just looked at the week's most popular article on a medical condition, 48, XXXX (see Special:Permalink/771047827). Sure enough, you don't have to go past the lead to find a citation needed tag on the statement relating the number of cases reported. The fact is that we accept that not every medical article will cite every fact, but we have procedures to deal with cases where we feel that a lack of citation is a concern. So it is with images. If I've seen many images and multiple cases of a skin bend, then I would likely challenge an image claiming to show a skin bend that didn't resemble what I'd previously seen. That system seems to work acceptably, given that if I didn't spot it, I know there are several other editors who would – and that's in a fairly niche topic. Of course it's not foolproof, but I still believe it's adequate for our purposes.
 * Nevertheless I find the idea of a {cite image} facility attractive. Why not have a citation that points to the external url of a copyrighted image published by a reliable source, which verifies what our free image is illustrating? We could have url, title, date, publisher, accessdate, etc. Looking at it, we could re-use cite web to do the job. What do others think? --RexxS (talk) 20:28, 24 March 2017 (UTC)
 * Paraphrasing text is easier than paraphrasing an image. We have text that "look like" the text in the reliable source. We have pictures that "look like" the pictures of the disease on Google. Doc James  (talk · contribs · email) 05:38, 25 March 2017 (UTC)
 * the correct analogy for "paraphrasing text" is constructing an illustration based on real life observation or an image taken from real life. What we are talking about here is quite different, namely whether to accept an image that may not be of the right object or phenomenon but "looks like it". This is like accepting text that may or may not be correct but "seems right". Peter coxhead (talk) 09:23, 26 March 2017 (UTC)
 * If there are concerns such as the one raised regarding the image of fluorosis we can deal with it by discussion and consensus. I am simple not seeing a huge problem here. We are not filling up with fake images. Doc James  (talk · contribs · email) 09:28, 26 March 2017 (UTC)
 * Cite image already exists. We could use it (e.g., on the File: description page) by adding "Compare to images in..." as Peter suggested.  (Also, one might not always be comparing it against an online image.)   WhatamIdoing (talk) 15:17, 26 March 2017 (UTC)

Matter of consent for medical images
, to add to the foregoing, I would have you look in on— but to continue comment only here —the further relevant discussion of patient consent, [ https://commons.wikimedia.org/wiki/User_talk:Doc_James#Consent appearing here]. That closes with my summary questions, reproduced here as a starting point: How can what is being done by the best (you, regarding your consent practices), that ought to be done by all, be institutionalised into policy, at WP, where our contributors are not restricted to experts, and where we draw editors from many tens of English-speaking nations, each with their own HIPAA-type legal requirements? How do we hope to allow medical images representing patients, not sifted through automatically by any consent and release process (as would take place if we import images from a published textbook, or other formal source)? What policies guide this now, at WP, and are they sufficient—would our policies have directed you to do what you did, with your consent forms and process, so that it directs others to do the same? Comments here. Le Prof 73.210.155.96 (talk) 15:28, 25 March 2017 (UTC)
 * Journals are often not verifying consents either. They ask the author if they got appropriate consent but do not go into the details. If issues occur redress for a patient is through the physician's college. Doc James  (talk · contribs · email) 15:35, 25 March 2017 (UTC)
 * This would be good enough for us as well, except that journals have some confidence of the credentials of submitting individuals. How would you adapt journal practice, given the lack of identified, credentialed, institution-associated submitters here? I think a further form/statement of the type that accompanies all image uploads (currently only covering copyright), an additional step that makes clear what we expect regarding patient consent for medical images/information, to which the uploader agrees through a check box, might suffice. Thoughts? Le Prof 73.210.155.96 (talk) 16:27, 25 March 2017 (UTC)
 * Reminding people that appropriate consent may be required is reasonable. Could say something like "If you are a health professional who took this image in your workplace, we advise you to get appropriate consent. While we do not need to see it, your licensing body at some point in time may." Doc James  (talk · contribs · email) 16:33, 25 March 2017 (UTC)
 * I suspect that most images that contain personally identifiable information (e.g., pictures of people with a medical condition) aren't being uploaded by health professionals. Also, I think this whole tangent is based on the idea that patients are "not experts" (even though expert patients are a thing), and that expertise as a result of formal training is required to add health-related images to Wikipedia, is wrong.  In practice, expertise is not required for statements like "Here's a picture of my kid, who has Down syndrome" or "Here's my X-ray, showing that I broke my leg" or "I had chickenpox; it sucked".  Most of our medicine-related images run in that range.  Expertise is rarely required.  WhatamIdoing (talk) 15:36, 26 March 2017 (UTC)
 * Of course I concur. The individuals taking pictures of DVT legs are likely not physicians, just as Doc is not a dentist. All the more reason (a) to make sure we relieve the organisation of culpability for negligence in non-compliance (e.g., in the US, for HIPAA-related violations of privacy) via consent policy and practices in place, and (b) that we rein this who-can-upload-what mess in, before the watching world catches wind… that we take the matter of fully reliable medical information (as communicated by crucial images) so lackadaisically. Compared to the error-containing Google snippet box controversy of the week of 9 March, this one is truly big news. Le Prof Leprof 7272 (talk) 06:57, 3 April 2017 (UTC)


 * Agree with WAID. Here we have a great video. Is it what the parent says it is? Of course. We can use common sense most of the time. Doc James  (talk · contribs · email) 08:20, 27 March 2017 (UTC)

may be interested in this topic. If anyone is interested, I drafted a basic consent form for medical images, e.g. as seen on File:Buccal exostosis.jpg feel free to use/adapt. Matthew Ferguson (talk) 15:48, 26 March 2017 (UTC)

Question—Figures published in PLoS and the like
It is my understanding that every article in the PLoS journals is published under the Creative Commons Attribution (CC BY) license and those images can all be used in WP if they are cited appropriately. So too of any journal that published with CC BY licenses. This is correct? Jytdog (talk) 17:27, 25 March 2017 (UTC)
 * if you look at the terms of use on the PLoS website, yes, it does link to CC BY 4.0, so all images can be uploaded to Commons with the appropriate indication of the source and the author and then used in articles. Peter coxhead (talk) 18:02, 25 March 2017 (UTC)
 * Thanks! Jytdog (talk) 18:14, 25 March 2017 (UTC)
 * So this provides one such source for good, peer-reviewed, published images that require no further organisational/legal work from us, to be able to incorporate them. Good catch, M. Jytdog. And I would note, the policy for use of these images, even with their better provenance (than non-reviewed images), is consistent with the notion of including sources so follow-op editors can verify. Cheers. Le Prof Leprof 7272 (talk) 18:58, 25 March 2017 (UTC)
 * I looked at the current issue of PLoS Medicine. There were no usable medical images.  Most "images" were tables and graphs, which could be re-created from the data (and, in the case of tables, shouldn't be presented as images for reasons of accessibility).  The only photograph or drawing in the entire issue was the cover art, which is originally from Pixabay, which is a CC-0 site.  (Please use c:Template:Pixabay if you upload from there.)  WhatamIdoing (talk) 16:20, 26 March 2017 (UTC)

Proposals
In the following, I am trying to bring this to a decision. I am willing to have these four proposals fully deleted and replaced by related ones, as long as the proposals take into account the strong and reasonable concerns of Jytdog, RexxS, Peter coxhead, Sizeofint and myself. [Per objection, please note, listing of individuals here does not mean that they agree with me, only that they have expressed concerns during the course of the foregoing discussion.]

In crafting these, I have read all the comments top to bottom, and am trying to initiate change that is conservative—allowing Doc and others to continue to put in reliable, accurate images—but that otherwise makes images from others that may not be credentialed likewise subject to verification, by requiring a medical/scientific reference. This may slow down Doc's work, but only a bit, since he is savvy with his med refs. Others, it will be a new discipline, and a good one.

Please, vote and comment (or replace with better proposal, if necessary, in which case, retain my content as collapsed content). No change is the only thing that the foregoing discussion does not fully support. Note, I understand that much of this implies changes at WM Commons. But if an important end-user like WikiProject Medicine goes to Commons with an agreed upon proposal, then change at Commons will be all the more possible. This Project is an important, dedicated end-user of some types of Commons images. Cheers, Le Prof 73.210.155.96 (talk) 16:19, 25 March 2017 (UTC)
 * Stop misrepresenting me. Please also stop WP:BLUDGEONing this discussion. Jytdog (talk) 17:07, 25 March 2017 (UTC)
 * With all due respect, asking that your concerns be addressed is not a misrepresntation. For the types of things said which led me to list you, see In my view, if the image is illustrating... and I hear all that but it goes to the OR question..., and the text following each of these, and others of your very well informed, reasonable comments. And it is not bludgeoning to try to bring a discussion to a close, and to fully express ones perspective. Cheers, Le Prof 73.210.155.96 (talk) 17:17, 25 March 2017 (UTC)

[1] Initiate effort to identify published sources for agreements to in-license quality images

 * Agree. In both in-print and out-of-print cases, the assistance of the umbrella Wiki organisation should be sought, so that further in-licensing of images relevant to WikiProject Medicine can take place, so that self-published information is no longer needed to the extent it currently appears to be. This has already been done with some medical image sources, so we know this is possible. Le Prof 73.210.155.96 (talk) 16:19, 25 March 2017 (UTC)
 * Since you are very passionate about this issue, I suggest that you simply do this yourself, speaking for yourself when you reach out to folks. In general nobody objects when higher-quality, better sourced content replaces lower-quality, worse-sourced content. And as discussed below images from PLoS  and other journals that use Creative Commons Attribution (CC BY) license can be used in WP without talking to anybody.
 * So just WP:FIXIT, image by image. If you do good work, peacefully and simply, others will start doing it too. Jytdog (talk) 18:17, 25 March 2017 (UTC)
 * Again, with all due respect, the problem is bigger than just FIXIT by one individual. The point of WP policy is in part, to stem the flow of the bad, so that those trying to create or improve the place ares not wasted on maintenance, non? This FIXIT suggestion is akin to the child moving the content of the sea, thimble by thimble, into a nearby hole in the beach's sand (a famous story about Augustine of Hippo), and is what the Dutch refer to as asking to dweilen met de kraan open. As well it contains insinuations, response to which I will not indulge here. See you at your Talk page. Le Prof Leprof 7272 (talk) 19:53, 25 March 2017 (UTC)
 * Agree we have lots and lots of issues that need fixing. For one our medical content could be written in simpler language and this effort is supported by policy. There are a few of use who have been slowly working to improve this. Another is that our medical content could be better referenced and provide a clearer overview. Also being slowly worked on. Providing higher quality images is a noble effort aswell. Doc James  (talk · contribs · email) 02:30, 26 March 2017 (UTC)
 * I agree this is something we are gradually working on already, and Leprof is very welcome to join in the effort. Mikael Häggström (talk) 11:52, 27 March 2017 (UTC)
 * The actions of one individual might not be enough to solve everything, but it would be an excellent place for any concerned editor to start. If nothing else, as a practical matter, it would be far easier to push through a policy change if you could start that discussion with "I've been doing this myself for the last few years, and I've had excellent results..."  WhatamIdoing (talk) 15:40, 26 March 2017 (UTC)
 * With all due respect, this is simply insulting, and diversionary. I've been correcting and adding to images—both those replacing text, and those incorrectly asserting scientific fact—for years (as already mentioned, in various places above). Cast aspersions as you will, I have wasted a great deal of time on this, seeing many knee-jerk reversions (logic, incorrect image being better than no image at all); moreover, have witnessed the continuing steady influx of unsourced images (making checking and correction all the more implausible of a path to argue). The futility communicated by the Augustine of Hippo seaside story—not superficially chosen—was intended to make a point. With the added impetus of the privacy issue, and the clear example of self-published radiology (ultrasonograms), I'll not be settling for the purposeless thimble-only approach, any longer. Le Prof Leprof 7272 (talk) 06:57, 3 April 2017 (UTC)

[2] Allow sophisticated scientific/medical images only when accompanied by suitable source

 * Conditional agree. Allowing only such future sourced images in WP Medicine, and retroactively moving appearing images in this direction, solves the problem of WP:VER and resolves the strong WP:OR objection to WhatAmIDoings's "looks like is good enough" argument. Hence the "Agree." But it does not ensure patient consent when images/information are not drawings, schemes, etc. When the images are photographs of patients, HIPAA-relevant diagnostic images, etc., compliance with a further "patient consent" policy is necessary (cf. Doc's practices at the Commons). Le Prof 73.210.155.96 (talk) 16:19, 25 March 2017 (UTC)
 * Oppose What would be a suitable source? Doc James  (talk · contribs · email) 16:27, 25 March 2017 (UTC)
 * Please, Doc. WP:MEDRS in the case of medical sources. The biosynthetic journal source from which a pathway was redrawn, as in the case of the Non-mevalonate pathway example presented (which otherwise took hours to find). A medical image of an ultrasonogram, affected patient skin area, etc., to which the uploaded image was judged comparable by the individual uploading. (And so on, obviously.) The point is to [a] allow verification, and [b] streamline error correction. Le Prof 73.210.155.96 (talk) 16:56, 25 March 2017 (UTC)


 * Oppose per common sense. Images are meant to support, not replace text. Per WP:V, text must be supported by reliable sources.  Per long standing consensus, WP:V does not extend to images. The only requirement for images is that they are obvious do not contradict the text. I agree as a general principle, image sources should be documented when ever possible. But it is not always possible to do so. Boghog (talk) 19:01, 25 March 2017 (UTC)
 * Just praying for you today,, glad to see you seemingly well, and in usual form. If you take the time to relax the knee, and skim the content above, you will see that the point of these proposals are the exceptions you acknowledge. Above are given examples [a] where images do indeed replace text, [b] where images spawn further unsourced text (when unsourced images are described by conscientious editors solving problem a., absent a source), and [c] where a lack of sourcing of an image made reconciling a student reader's request for clarification into an arduous rather than simple process.
 * Otherwise, I am glad you agree that image sources should be documented when ever possible, but disagree as to the impossibility of achieving this; a person uploading an image, in the first place, always knows its origin. The work created by existing unsourced images is indeed enormous, but you have the wrong end of the stick if you conclude these proposals to be anything other than prospective in nature—to stem future actions that lead to inaccuracies and unsourced text. And, please note, the point of the discussion here is to create a basis for possible changes at WikiMedia Commons, and clarifications at WP:VERIFY, based in the specific observations and needs of this Project. So, what things say right now is largely immaterial to the analysis/question.
 * Finally, no strictures from me on where you land with your conclusions, after proper consideration, but perhaps try uncommon grace to start [strict theological meaning, unmerited favour], instead of gut impulse and what strikes you in the moment as common sense. Cheers, glad to see you. Le Prof Leprof 7272 (talk) 20:19, 25 March 2017 (UTC)
 * Oppose. I've no objection to people doing this voluntarily, nor to us encouraging people to do it optionally. However, requiring it (aside from the impossibility of requiring, at this Wikipedia, that a behavior take place over a Commons) would probably spawn disputes about about what it means to verify an image.  We have a small group of editors who believe that if it's not plagiarism (due to close paraphrasing), then it's not verifiable, and that group will find it impossible to "verify" any photograph that isn't an exact copy.  WhatamIdoing (talk) 15:45, 26 March 2017 (UTC)
 * Oppose. The multitude of necessary criteria (published in a WP:MEDRS, WP:Compatible license as well as general WP:Inclusion criteria) would leave the vast majority of medical articles without any image. As per the previous section, we should continue our efforts in replacing existing images with ones of better standard, and when we have an acceptable coverage with such images, I am willing to change my mind. However, we are far from that point. Mikael Häggström (talk) 12:03, 27 March 2017 (UTC)
 * Please see my final message at the close of this overall section, also of this date, and the related final message in a new section at the end of this Talk page. And note, there is nothing personal here, and I wish you all the best in your training and medical endeavours. But as I note below, this matter will not end here, and in this regard, I am thankful for your images, because they are so egregiously representative of the problem, and the nonsensical corner into which we have painted ourselves, that I am happy such a clear-cut example exists, as we move forward. (It is, in a sense, the test case (law) needed, for higher level review of the issues involved.) Meanwhile, for your protection, I would recommend engaging with Doc at his Talk page, to find out what he does to comply with Canadian patient consent laws, when he self-publishes his unique medical images here, then go to your legal department at your university, to make sure you are doing the same (complying with the applicable privacy and consent laws in your jurisdiction). The first, and absolutely most critical matter that will be attended to here, is the likely lack of patient consent for some self-published medical images here. After that, I return to the broader issue of lack of true professional peer review in representative and comparable image cases. Cheers, Le Prof Leprof 7272 (talk) 06:57, 3 April 2017 (UTC)

[3] Require formal patient-consent documentation when presenting original medical information

 * Agree. When images brought into WP Medicine constitute presentations of HIPAA-relevant (add the relevant Canadian, British, Australian, South African, etc. agencies) diagnostic images, photographs, etc., the images we use must present evidence of compliance with a further "patient consent" policy that protects patient rights and medical information. Le Prof 73.210.155.96 (talk) 16:19, 25 March 2017 (UTC)
 * Oppose We are not set up to handle this. There are dozens of organizations full of lawyers with budgets in the 100s of millions that take care of it in each jurisdiction. We should not make Wikipedia harder to contribute to than PLOS medicine, the NEJM, or the BMJ. Doc James  (talk · contribs · email) 16:25, 25 March 2017 (UTC)
 * Please, Doc. Opposition is fine, straw men are not. How is it significantly harder, on upload of a medical image involving patient information, to check a box that says patient consent was obtained within the relevant legal jurisdictions? Above you said, Reminding people that appropriate consent may be required is reasonable. (See also that discussion above for elaboration on the check box notion.) This is clearly not at all harder than the requirements of your listed journals. Since we are going into the business of first-publications of medical information, how can this protection of patient information and rights not be a concern? You clearly take care of this yourself; if not a concern for others, why for yourself? Again, as stated at your Talk page, I appreciate your training, expertise, integrity, etc. The issue is extrapolating from you, to what we allow any medically untrained individual with an iPhone. Le Prof 73.210.155.96 (talk) 16:56, 25 March 2017 (UTC)
 * agree w/ Doc James, fail to see what benefits this would bring?--Ozzie10aaaa (talk) 17:14, 25 March 2017 (UTC)
 * Please see Doc's comments above, e.g., Reminding people that appropriate consent may be required is reasonable., above. Thank you for your comments. Le Prof 73.210.155.96 (talk) 17:19, 25 March 2017 (UTC)
 * yes I had seen it--Ozzie10aaaa (talk) 12:03, 14 April 2017 (UTC)


 * Oppose Per what Doc James said directly above and what I said in section #2. Boghog (talk) 19:34, 25 March 2017 (UTC)
 * Any adjustment, since you had the wrong end of the stick, above? Cheers, Le Prof Leprof 7272 (talk) 20:21, 25 March 2017 (UTC)
 * Nope. Also disagree who has the wrong end of the stick. Boghog (talk) 20:59, 25 March 2017 (UTC)
 * Can only know what you think based on what you say, and since you misunderstood that the emphasis here is on the examples given (of image replacing text, image leading to unsourced text, etc.), said opposed, but then agreed with the need for an increased degree to which images have sources, then missed the fact that this is a prospective discussion (so that if changes are needed at WikiMedia Commons or in WP:VERIFY, we could approach them as a project), I could only conclude that you looked superficially at the discussion, made a snap decision to support Doc's position right or wrong (since it was me arguing, and I clearly must be wrong). Seemed like ol' "snap-call" Bog to me. But maybe, for historic reasons, the poker player in me has read you wrongly this time. Le Prof Leprof 7272 (talk) 23:22, 25 March 2017 (UTC)


 * Oppose anything that requires patients to "out" themselves. I don't see any method of actually "presenting evidence of compliance" without disclosing the real names of patients to someone associated with Wikipedia.  Also:
 * "Must present evidence of compliance" (from the proposal) is far stronger statement than "check a box that says patient consent was obtained" (from the comments). We actually don't want evidence of compliance, because that would mean that we need to secure that sensitive information.  Medical consent forms (mostly) belong on paper in a filing cabinet, not in a database that could get hacked.
 * Have you ever heard of this thing called "lying"? That's what people do when you tell them that they can't upload naked pictures of their ex-girlfriends unless they first tick a box to claim that she agreed to it.  If you can't trust people to get consent in the first place, then you can't trust them to be truthful when you demand that they claim to have done so.
 * Rhe English Wikipedia can't tell Commons what to do. If they don't want an extra tickbox on their already-overcomplicated upload forms, then there won't be one.   WhatamIdoing (talk) 15:54, 26 March 2017 (UTC)
 * Doc has already suggested a reminder at upload, and I have suggested a stop-and-think commitment/button akin to what people select regarding copyright, e.g.,
 * "Does your uploaded image present any a person, especially with regard to dental, medical, or related imagery of human subject? [If yes…] Please indicate your assent that you have obtained, and maintain on file, patient consent permissions in compliance with all legally applicable jurisdictions relevant to where the image was obtained (e.g., if in an urban area of the U.S., city, county, state, and federal HIPAA patient privacy requirements)…"
 * and so your "I don't see" and other objections are not persuasive, when the issue is so fundamental and important. Ask yourself, if it is not, why does Doc already do it, for his images? (I.e., get signed patient consent forms, and keep them on file at his institution, see discussion at his Talk page.) Otherwise, you know as well as I, that had Doc taken the lead on this, WikiMedia Commons (a) would have likely been persuaded, and (b) if not, we would have a strengthened basis for promoting the change, top down, if need be. Bottom line, when it comes to legal compliance, all the separate Wiki venues ultimately toe the line that the wikipedia equivalent of "central command" (Foundation) lays out, because only the umbrella organisation has the resources to review and make lasting decisions about legal matters.
 * Otherwise, note, surely, people will dissemble, fudge, and outright lie. But those in responsibility move into legal negligence if no good faith effort is made to encourage/facilitate user compliance with applicable law. The ultimate historic legal culpability of sites sharing copyrighted information, despite claims of their having been the innocent operators of sites not intended for illegal activities, makes this abundantly clear. Cheers, see close of this section below. Le Prof Leprof 7272 (talk) 06:57, 3 April 2017 (UTC)

[4] Disallow self-published (first appearance) medical data absent expert corroboration

 * Agree. It is beyond any expectation of our capabilities here, that in all specialties of medicine, BMCB, etc., that we will have the continuing expertise to evaluate original data as is done in a journal peer-review process. The onus that the data being self-published are valid must fall on the submitter. What would be needed here is an additional discussion of what this corroboration might look like. I do not believe that having a look by a faculty colleague at same institution suffices. Le Prof 73.210.155.96 (talk) 16:19, 25 March 2017 (UTC)
 * Comment We do not allow this here now. The Wiki Journal of Medicine however will publish it on Wikiversity. Doc James (talk · contribs · email) 16:26, 25 March 2017 (UTC)
 * Comment We clearly do allow this here now. For instance, both oral images appearing in this Are Pictures Worth... discussion here are self-published (first appearances) of medical data. Again, images are data. There is no question about this, anywhere in the authoritative med.sci publishing discussions. Le Prof 73.210.155.96 (talk) 17:01, 25 March 2017 (UTC)
 * It's a complete strawman argument to claim that image uploads constitute original research; the origins of an image are only potentially problematic in the very few cases where there's potential doubt over what's portrayed and Wikipedia states authoritatively in Wikipedia's voice that the image depicts a specific thing. If I upload a picture of a set of lesions and claim without confirmation from a medical professional that it depicts cowpox, that's potentially original research; if I upload a picture of a knee and claim that it depicts a typical human knee, that's not OR regardless of where the image came from. Even within the constraints of WP:MEDRS, the fifth pillar still applies, and as with every other article editors are expected to apply common sense rather than complete and slavish adherence to guidelines to the the point of absurdity. 73.210.155.96, don't take this the wrong way, but your walls-of-text style of discussion is going to lose you whatever potential support you might have. Everyone on this page is busy and has better things they could be doing, and consistently using 200 words to do the job of five is wasting a lot of time of a lot of people. &#8209; Iridescent 18:18, 25 March 2017 (UTC)
 * You are correct in refuting the "uploads = OR" equality, but this is not my contention. I do not argue that image uploads constitute WP:OR. And I agree with much of the rest of your first paragraph. So can we as a Project deal with the cases you acknowledge, please?
 * In particular, per earlier arguments, I contend [a] deciding that a self-published image uploaded by an editor and claimed as an accurate example of diagnostic data (in the case of the ultrasonograms) or as a valid representation of a pathology (in the case of patho-selfies and patient images)—these are applications of a level of interpretation that is considered WP:OR (see discussions of use of primary sources in WP:VER and elsewhere), an argument with which you appear to agree and [b] deciding that an image for condition X looks like condition Y, as argued above by is likewise grossly interpretive, clearly invoking expertise, and so again, at the level of WP:OR.
 * Regarding, your WOT comment, see this from Pascal, and this by Nicholas Carr. Warning, while the jest is ~20, the substance of Carr's argument is >4000 words. Chose this over arguments appearing in law and other contexts. Le Prof Leprof 7272 (talk) 19:41, 25 March 2017 (UTC)
 * Deciding that an image can be used to illustrate a (previously published) concept might be "original research" as some conceive of that concept in the real world, but I assure you that it is not a violation of No original research. It is compliant with the letter of the policy:  " Original images created by a Wikipedian are not considered original research, so long as they do not illustrate or introduce unpublished ideas or arguments".  To give a specific application, the "ideas or arguments" of severe fluorosis are previously published, and the act of deciding (through consensus and use of best editorial judgment) that a particular image illustrates that previously published "idea or argument" is explicitly not a violation of the Wikipedia policy.  WhatamIdoing (talk) 16:02, 26 March 2017 (UTC)
 * Were anyone to extrapolate the fundamental argument being made about information contained in images, any more broadly, it would simply be laughable, it is so astounding. If we describe, in 600 words, Benzoxazinone biosynthesis, with no sources, it is a violation of WP:VER, but if we present the identical information in an unsourced image, it is no problem? Really? Saying this with a straight face?


 * As for the real world OR versus WP:OR argument, you miss the forest for trees. The point of this discussion was to deal with on the ground realities at this project—first-time, self-publication of medical diagnostic information, non-expert evaluation of A-like-B circumstances at medical articles, non-traceability/non-verifiability of information-rich scientific and medical images, likely lack of patient consent in self-published medical images, etc.—and to arrive at a consensus so WP policy loopholes could be changed. So when you say as some conceive of that concept in the real world, you are skirting the point. WP exists in the real world. Paitents whose images might appear without consent are real patients. The jurisdictions they live in have real laws. The individuals we confuse with medical and scientific mistakes in images (for instance, the non-mevalonate pathway example I gave above) are real readers, with real confusion.


 * Through adherence to loopholes in WP:VER and WP:OR that skirt concepts fundamental to wikipedia's veracity—all information verifiable, no first, self-publishing purported factual information here, etc.—you are further painting us into a corner. This position is increasingly nonsensical, as an independent review of this discussion will surely find. The very point is that process needs to change, so that this end around ceases to be used to introduce new, unpublished information into the encyclopedia. Best had this come as a groundswell effort from one of the best run projects here. But the implications of failing to encourage privacy compliance, and failing to stop WP self-publication of diagnostic information—if bottom up does not work, then there are other approaches to follow to get important matters considered. (And I'm not wasting further time on futile, lengthy persuasive arguing that people do not ingest. Examples were repeatedly given, and ignored, here. If ultrasonograms as data, benzoxazinone and non-mevalonate biosynthesis images as real intellectual content—if these are passed over without deep consideration here, there is no point in trying this again, with this group plus a larger group of even less sophisticated participants.) As I say below, lets call this chapter to a close, see next. Le Prof Leprof 7272 (talk) 06:57, 3 April 2017 (UTC)

Proposing to close discussion at WikiProject Medicine
I propose we call this discussion closed, and box it—the whole bloody lot of it, as a whole, together—as there is no continuing productive engagement, and as as Jyt has demonstrated such boxing and closures are a norm, here. As far as I am concerned, the lot of it can be condensed, as well.

Please note, I have neither lost interest or flagged in conviction regarding this—I continue to maintain, despite that we nevertheless are violating basic (foundational) tenets of WP design and intent, and, moreover, are headed for serious product and brand quality-related trouble, long term, whether we wish to face it and wrestle with change, or not. (The core issues are WP:VERIFY and WP:SELFPUBLISH, and WP:OR, as well as the legal privacy matters that I have tried to raise. I believe the end-around that exists allowing people to skirt fundamental WP quality commitments, via image uploads and uses at articles—even if within the letter of existing "law"—must come to an end.) And so participants should expect further contact regarding these matters, as this discussion moves to other venues. It was my commitment to try to start from the bottom and persuade here, but it is worth no more of anyone's time to continue.
 * respected Doc's commitment to the original, self-publication of his and others radiographic, photographic, etc. images here, and his trust that everything will turn out fine with regard to patient consent (absent any change in WP policy), and
 * respected WhatamI's and others' conviction that the degree of WP:OR required for the cases of just-trust-me-even-though-I'm-not-a-radiologist uploads and rash-A-looks-enough-like-rash-B-to-call-A-as-B conclusions

I hope, however, as you move to condense and box, you might look, for instance, to the idea of a {cite image} facility [suggested by RexxS] Where he said"Why not have a citation that points to the external url of a copyrighted image published by a reliable source, which verifies what our free image is illustrating? We could have url, title, date, publisher, accessdate, etc. Looking at it, we could re-use cite web to do the job. What do others think?" and other such suggestions, by individuals other than myself, for instance,"…it goes to the OR question that was raised above. You just did OR yourself to try to validate the picture (and wished we had an editor who could validate based on their personal knowledge....). If the picture doesn't show what is described by sourced content in the article it seems we have a problem" (which, despite our agreement on this point, was stated by an editor that does not wish to he associated with my conclusions).

Anything that can be done, allowing this esteemed Project to lead the way, avoiding WP:OR and doing a better job of indicating sources of the intellectual information in images—how can this not but help, regardless of what I achieve in the further discussions elsewhere?

And I will be working, alongside those outside communications, toward a tag that will indicate (a) current article status when an image is replacing text, and (b) that an unsourced image contains considerable intellectual content that is not sourced at the WikiMedia page for the image (or with the image's application at individual articles). These will make the examples I pointed to more visible, and easier to attend to. Regardless of whether I accomplish that tag, or top-down reviews I am seeking, the encyclopedia would be better off if the various general problems I raised began to receive the concerted attention of the dedicated editors that engaged in this discussion.

Mikael, Whatami, Doc, please skim to make sure you saw my final replies. Pinged, but who knows if you were brought you to the place of those last entries. Search this date stamp to save time. Cheers. With regard, Le Prof Leprof 7272 (talk) 06:57, 3 April 2017 (UTC)

Formal close of earlier discussion requested
See the subsection above, entitled, "Proposing to close discussion at WikiProject Medicine," which asks to close-out an extensive foregoing general discussion and its proposals. These sought to initiate Project action to address the lack of formal requirements in image upload to protect patient consent, and to close the loop holes that currently allow self-publication of first, new, unpublished radiographic, photographic and other medical data here, and that allow use of complex, information-rich scientific images (e.g., biosynthetic schemes, cell regulatory pathways, etc.) even if they are un-sourced at the Commons or in the article in which they appear.

That discussion should be closed, with acknowledgment that the Project is committed, with a minority of dissenting voices, to maintaining the status quo. I note for the record that I dissent from this conclusion, and that I am pursuing other routes to see these matters clarified. Cheers, Le Prof Leprof 7272 (talk) 07:30, 3 April 2017 (UTC)


 * I think it inaccurate to claim that "the Project is committed" to anything, much less specifically to maintaining the status quo. I agree with you that none of your individual proposals gained much support.
 * If you decide to try another forum, then I have a thought for you to consider: Editors are unlikely to support any proposal if they feel like you're asking them to say that they're too stupid to figure out that this "first, new, [previously] unpublished radiographic" X-ray image shows a broken bone, or any of the many (many) variations on that theme.  If you can come up with a way to write a clear guideline that doesn't burden the majority of "obvious" images, while reining in the ones that could create good-faith disputes even among editors who are perfectly willing to count the number of Oxygen atoms in each molecular diagram in the synthetic pathway and compare Commons' drawings against the drawings in multiple published reliable sources, then you might get some support.  But that kind of WP:Policy writing is hard; I'm not entirely convinced that it can be achieved.  WhatamIdoing (talk) 23:47, 3 April 2017 (UTC)
 * And yes, I argue that an image such as this self-published radiograph is problematic for two of the many reasons raised above, namely that there is no evidence of patient consent in the disclosure of the medical information, and because there is no expert statement of what the content is contended to convey, and so it is left to any wikipedia participant to affix it to any article, and thereafter to claim it represents / supports any factual claim they might wish. This is not in keeping with fundamental tenets of good encyclopedic writing, Doc's and your views notwithstanding. Cheers, Le Prof 73.210.155.96 (talk) 06:20, 4 April 2017 (UTC)
 * The carte blanche rejection of all proposals, and the failure of participating editors to accept the invitation to create any alternative proposals (thus recognizing a need for some change), clearly constitutes a commitment to the status quo. The measure of a "burden on the majority" is an improper test; if at some point we had a clear test for plagiarism, and it became absolutely clear that 30% of the encyclopedia is plagiarised content, burdening the majority is the last thing with which we should be worrying ourselves. Likewise with the appearance of self-published data, with potential for flouting prevailing standards of patient consent. (The real issue is with our commitment to quality, and how the watching world will come to perceive the encyclopedia, if these skeleta make their way out of our carefully locked up editorial closets.) Otherwise, I note that you continue to denigrate the importance of the issues that exist, so I'll leave you to continue to perceive and argue about counting oxygen atoms (though you clearly need a lesson in the history of drug discovery). The fundamental issues here (that I will not again repeat), are plain and clear, for any without a strong, personal vested interest in resisting change. The discussion is ended, please have it boxed and closed. Le Prof 73.210.155.96 (talk) 06:15, 4 April 2017 (UTC)

Helping scientists learn to edit Wikipedia
This (and their edit-a-thon guide) may interest several of you: https://www.simonsfoundation.org/education-outreach/crowdsourcing-expertise/

WhatamIdoing (talk) 20:00, 23 April 2017 (UTC)
 * good info, thanks WAID--Ozzie10aaaa (talk) 10:52, 24 April 2017 (UTC)

Impella
This user is likely an undisclosed paid editor User:Skire913. Clean up their work a fair bit including Acute cardiac unloading. Others thoughts? Doc James (talk · contribs · email) 22:22, 18 April 2017 (UTC)
 * Acute cardiac unloading needs better refs(seems to be from)--Ozzie10aaaa (talk) 00:23, 19 April 2017 (UTC)
 * Are you seeing copyright issues? Doc James  (talk · contribs · email) 06:45, 19 April 2017 (UTC)
 * no..i meant the editor per seems to be from ...IMO--Ozzie10aaaa (talk) 11:09, 19 April 2017 (UTC)

I am not a paid editor for this article, Doc James. I work in close collaboration with many of the scientists mentioned in this article (or at least mentioned in the article as originally accepted), and also in close collaboration with. I get asked very often to educate people on acute cardiac unloading, and the best solution (I thought) would be to create a wikipedia article on the subject. You have made many assumptions in the edits of this article, and have almost completed gutted it of any useful scientific or educational content. The vast majority of the article was well-supported with numerous peer-reviewed scientific references from very high quality journals. I am not sure how the original article didn't serve the purpose of educating the general public. And for your information, the appearance that this article reads like "an Impella advertisement" only stems from the fact that this particular medical device is currently the only one that can actually do what is written about in this article. If/when more devices become available, I will gladly incorporate them into this article. Until then, I would appreciate it if you undid your over-reaching edits of the article. Everything in the originally accepted article was completely fact-based, peer-reviewed, and presented without prejudice. — Preceding unsigned comment added by Skire913 (talk • contribs) 20:04, 24 April 2017 (UTC)
 * User:Skire913 You need to use sources per WP:MEDRS. The ones you used mostly did not. Also many of the images did not have appropriate license release.
 * You say you work withe the scientists. Are you paid at all by any of the companies making these products? Doc James  (talk · contribs · email) 20:50, 24 April 2017 (UTC)
 * We don't actually need that question answered.
 * Skire913, if you're paid to edit, then there are legal requirements to disclose this on wiki. If you happen to work for a related company, or otherwise have the kind of relationship that an ethical scientist or journalist would disclose, then you may have a conflict of interest that you should disclose, too, even if you are just editing on your own time and without your employer knowing or caring.
 * We have some rules about sourcing that surprise a lot of scientists. For example, we prefer review articles to original peer-reviewed research papers.  And – well, we get so many people who try to add "Herb of the week cures cancer" based on a cherry-picked case study, or "Expensive proprietary thing-a-ma-bob stops heart attacks" that we sometimes get a little jumpy about primary sources.  So if there are any review articles, please help us out and cite them, and if there aren't, then let's talk about what's the best we can do.  WhatamIdoing (talk) 23:35, 24 April 2017 (UTC)

Alpins method
This is a technique developed by a gentleman who wants to spread these details via WP. Bunches of it is based on primary sources. What are peoples thoughts about this? Doc James (talk · contribs · email) 21:38, 24 April 2017 (UTC)
 * ...thereforeArticles_for_deletion...IMO--Ozzie10aaaa (talk) 23:56, 24 April 2017 (UTC)

RfC on the WP:ANDOR guideline
Hi, all. Opinions are needed on the following: Wikipedia talk:Manual of Style. A WP:Permalink for it is here. Flyer22 Reborn (talk) 22:39, 17 April 2017 (UTC)
 * I am happy with either. Just not interested in seeing battles occur over it. Doc James  (talk · contribs · email) 23:01, 17 April 2017 (UTC)


 * It appears the proposal will "soften" policy. Everyone knows where I stand on policy. I support indef blocks for violating V policy. QuackGuru  ( talk ) 23:51, 17 April 2017 (UTC)


 * An indefinite block for violating a policy? Policies are violated all the time on this site without indefinite blocks. And per WP:Ignore all rules, they are sometimes violated for good reasons. By "V policy," do you mean the WP:Verifiability policy? Or was the V a typo? Flyer22 Reborn (talk) 06:51, 18 April 2017 (UTC)


 * Also, the WP:ANDOR rule is a guideline, not a policy. Guidelines have more leeway. Or least should when it seems they don't. Flyer22 Reborn (talk) 06:53, 18 April 2017 (UTC)
 * Editors continue to replace sourced content with original research. There is no good reason to blatantly violate policy. There was no typo. I noticed editors are continuing to add "some" against V policy. If these problems persist then I will be forced to take greater measures and support bans and indef blocks. They know who they are and they are following my contributions and they will probably be reading this. QuackGuru  ( talk ) 22:37, 18 April 2017 (UTC)
 * Quack, that might all be true, but I cannot see how it is relevant. The question in this section is about whether editors should always write "apples or oranges or both", or if they could sometimes write "apples and/or oranges" instead.  WhatamIdoing (talk) 01:30, 19 April 2017 (UTC)
 * The question is why always avoid writing "and/or"? I do not know. Maybe the rules are wrong and should be tightened rather than softened. QuackGuru  ( talk ) 01:55, 19 April 2017 (UTC)
 * Yes, that is the question. WhatamIdoing (talk) 03:34, 19 April 2017 (UTC)


 * QuackGuru, as you know, I've argued with you on your interpretation of avoiding "some." But like WhatamIdoing stated, that matter is not about this one. Flyer22 Reborn (talk) 03:44, 25 April 2017 (UTC)

Further opinions here
Talk:Multisystemic_therapy. Has been worked on by a bunch of connected editors. Doc James (talk · contribs · email) 20:16, 25 April 2017 (UTC)
 * One of the editors is engaging very positively on the talk page and has provided several sources that look quite good. I've done a quick copyedit and tried to get back to the sources as far as possible, but having read the sources used so far, I'm sure there's still room for improvement. --RexxS (talk) 22:28, 25 April 2017 (UTC)
 * Yup agree. Good discussion ongoing. Simply further opinions wanted. Doc James  (talk · contribs · email) 00:26, 26 April 2017 (UTC)
 * Yup agree. Good discussion ongoing. Simply further opinions wanted. Doc James  (talk · contribs · email) 00:26, 26 April 2017 (UTC)

Editing medicine pages to include information on authorisation by European Medicines Agency
I would like to ask for advice about editing pages about medicines to include information about their marketing authorisation in Europe. I work in communications for the European Medicines Agency. It could be useful to readers of a page about a medicine to include the information that it has been centrally authorised (by EMA) with the date of authorisation and a link to the medicine's page on the EMA website. (For each medicine, the EMA website has a summary page describing the medicine, indications, mechanism of action, the main clinical studies that led to authorisation and the main points of the benefit-risk analysis. There are also links to the 'summary of product characteristics' and the EMA's assessment report.) However, Im not sure if it is acceptable to edit the pages myself, as I work for EMA. So my questions are 1: do you think edits to include information about the European authorisation would be useful? 2: if yes, what would be the best way to achieve this, should I go onto every medicine's talk page an request an edit? Thank you in advance for any feedback EUMedcomm (talk) 21:44, 22 April 2017 (UTC)
 * In my view this would be awesome.  You should check in with WP:GLAM about how to proceed but I do not view this as any kind of real COI.  Regulators are one of the view truly unbiased players in the world of drugs and it would be amazing to have more thorough content based on EMA evaluations.  Welcome!! Jytdog (talk) 22:01, 22 April 2017 (UTC)
 * Sounds reasonable User:EUMedcomm.
 * You would just need to go about it the right way.
 * Are the EMA documents under an open license? If not you will need to make sure you paraphrase.
 * Our articles on medications generally follow the layout at WP:PHARMMOS. Approval in different jurisdictions would go under "Society and culture" typically.
 * Make some proposals. We will provide feedback. And than after a few you can likely continue. Doc James  (talk · contribs · email) 01:54, 23 April 2017 (UTC)
 * A few thoughts:
 * User:Biosthmors (who worked with WHO on getting ICD information on the English Wikipedia) could probably provide some good general advice to you, if he's got some time available.
 * You probably need to request a (slightly) different your username. The English Wikipedia (unlike, say, the German Wikipedia or Commons) worries that a generic username will be used by multiple people (e.g., you this year, and then you get a different job, and this account goes to a new employee), so some admins get nervous about generic usernames like "Marketing Division, Sirius Cybernetics". We'd rather see a specific human identified, such as "Hurtenflirst from Dolmansaxlil Shoe Corporation".
 * URLs could perhaps be included in infobox drug.
 * Wikidata would probably like a lot of the EMA's data. WhatamIdoing (talk) 01:58, 23 April 2017 (UTC)
 * I gave them a heads up about their username too, here. When i edit about drugs i rely lots on the UK Electronic Medicines Compendium which summarizes the EMA  Summary of Product Characteristics (SPCs) really well, and also on the FDA label.  I sometimes use the EMA authorization stuff... but generally the UK EMC is plenty.
 * But for instance our article on Alipogene tiparvovec sucks; it has only been approved by the EMA so there is no FDA label and there is no UK EMC page on it. But the EMA's index page is here and their detailed Summary of Product Characteristics is here which is great.  I have been meaning to use that to make a normal drug article per PHARMMOS.  This is a place where having the EMA do that kind of work would be so, so helpful.  Must places it would be gravy but some places, meeting real unmet needs. Jytdog (talk) 02:22, 23 April 2017 (UTC)
 * Yup for meds not approved in the USA it is very hard to find information Doc James  (talk · contribs · email) 14:04, 23 April 2017 (UTC)
 * I would suggest a route, if the community agrees, that allows (all) other editors to easily see your edits of this sort, but you make them first, without waiting for pre-clearance. You could set up a sub-page to your user page where you list all the articles concerned, and invite comments. We ran a system rather like this (though in fact requiring pre-clerarance) at pages like User:Csldigicol/Working page 2015, on a project with the Metropolitan Museum Library, in New York.  Also see this blog.  But I think in your case it should be simpler; presumably the info to add is pretty standard. Johnbod (talk) 01:40, 26 April 2017 (UTC)

WP:MEDRS and reports of self-experimentators
According to WP:MEDRS all biomedical information (in any kind of article and including information whether a treatment works, and to what degree) must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge.

I think this is a necessary and very important policy.

However today I created the article Brian Hanley (biohacker) whose section "Results" was removed by User:Jytdog, saying none of these refs are MEDRS.

Here I'd like to discuss whether this information could still be included in some form.

Wouldn't it be okay if it's made very clear that this is just the report of the person self-experimenting? For instance the section could be renamed "Results according to Hanley" or "Report of the results" or "Alleged results".

And if so would this require some change to WP:MEDRS or would you say that it's already covered under it? Also if this is not the right place to discuss this please forward me to whatever page is.

Please comment, thank you.

--Fixuture (talk) 21:18, 23 April 2017 (UTC)
 * Looking at what was removed. I agree we should not use the popular press or reddit to says whether or not a person thinks the med they are using is "working".
 * We should wait until the trial he is in is published and than incorporated into a suitable review article. Doc James  (talk · contribs · email) 21:39, 23 April 2017 (UTC)
 * The deleted content here is the definition of WP:PRIMARY and is far too preliminary to be used, as is the whole section on self-experimentation. This information is nearly as disallowable for an encyclopedia as we're likely to see per WP:V. --Zefr (talk) 23:08, 23 April 2017 (UTC)
 * Lol, biohackers... Carl Fredrik  talk 23:11, 23 April 2017 (UTC)
 * Totally unacceptable for Wikipedia. Unless and until a peer-reviewed independent assessment is published, his self-reported results have no more validity than an "eating onions cured my cancer" interview in a tabloid. &#8209; Iridescent 23:21, 23 April 2017 (UTC)
 * Well... I don't know about that. I think Fixuture's actually on the right track with the idea of being clear that this is a self-report by an individual with a serious COI, rather than a scientific fact.  "Bob said that he personally believes that his treatment is helpful" isn't actually a MEDRS matter because "Bob said something" is not WP:Biomedical information.  What people say about their beliefs – including their beliefs about their medical conditions – is a BLP matter.  The scientific accuracy of the BLP's POV is irrelevant.  It truly doesn't matter whether the content is more like "Alice Expert rejected altmed options for her incurable hangnail, because she says that altmed is a crock of fertilizer and it stinketh" or more like "Whatsherface Actress said that vaccines cause climate change and cellulite".  The statement isn't talking about what happened biomedically.  The statement is talking about what some human said.  We don't need a peer-reviewed primary source ("independent assessment") to accurately summarize his claims for readers.
 * Speaking more broadly, the goal here is "write a biography". The goal is not "defend the world against still-unproven scientific claims being promoted by a guy whose business is making money by selling gene therapy".  If we don't include any information about the alleged results, then we've got an incomplete biography, and we've failed at the main goal.  We need to write a proper biography.  That means including his claims about whether his actions had any effect.
 * (Are we absolutely sure that this guy is notable?) WhatamIdoing (talk) 05:47, 25 April 2017 (UTC)
 * Basically in agreement. "X cured Joe's condition" requires a MEDRS reference.  "Joe claimed that X cured his condition" only requires an ordinary RS. Looie496 (talk) 14:09, 25 April 2017 (UTC)
 * No. You'll find that 99% of the time "Joe claimed that X cured his condition" needs to be removed as WP:UNDUE. The other 1% is probably a hoax. --RexxS (talk) 16:30, 25 April 2017 (UTC)
 * That's a problematic formulation, Looie; it's how news outlets give themselves a free pass on fact-checking and would run afoul, as RexxS notes, of WP:WEIGHT. It provides a framework to present anecdotes and testimonials in support of (explicit or implied) medical claims; Wikipedia should be very reluctant to post this sort of implicit or tacit endorsement, especially without suitable independent analysis. (We well know that a lot of people make dumb medical decisions based on Dr Oz. says... or Gwyneth Paltrow says....)  If we are unable to locate reliable sources containing appropriate expert commentary and analysis of the claims, we should seriously question whether the treatment is notable enough for coverage.  TenOfAllTrades(talk) 17:14, 25 April 2017 (UTC)

We are an encyclopedia. We should not include "celebrity endorsements". That is a level of evidence much below even that of a case report. Doc James (talk · contribs · email) 18:52, 25 April 2017 (UTC)


 * The purpose of MEDRS is to ensure that article do not present inaccurate or not generally accepted information that readers may rely on to the detriment of their health. It is not designed to stop information about beliefs or opinions, no matter how speculative or dubious, provided they are reliably sourced and relevant to the article in which they are published.  The New Yorker and the MIT Technology Review are perfectly acceptable sources.  However, while policy does allow self-published comments to some extent, I would not use the subject's comments on reddit in the article.
 * Many readers want to read about fringe theories, and policy allows coverage of these subjects. The only restriction is that we cannot state them as fact or present them as having greater mainstream support than they actually do.
 * TFD (talk) 19:07, 25 April 2017 (UTC)
 * WP:MEDRS is also to help support WP:DUE.
 * Looking at the text in question further. It appears to be closely paraphrased aswell from the New Yorker article.
 * We reported his self claimed benefits (which are not results) and missed others opinions "George Church, a Harvard geneticist whose lab collaborates with Hanley, heard about his injuries, he told me, “It sounds like it affected his mind more than his muscles.” Basically a polite way of saying this is likely just a placebo effect.
 * The goal of the popular press is to create sensational stories to sell copy. Our goal as an encyclopedia is to be more fact based and less sensational, especially when it comes to healthcare. Doc James  (talk · contribs · email) 19:21, 25 April 2017 (UTC)
 * The issue isn't whether the text accurately reflected the nuance in the source or whether it was too closely worded but whether the source could be used at all. If you think that news media should not be used as sources then we might as well delete the article about the U.S. president, Donald Trump.  The article is not about medicine but about a person who has made controversial claims and therefore the nature of those claims is central to the the topic.  I don't know why you would think that readers are so stupid that they will believe a claim just because an article says that someone made it or that they will start injecting themselves with DNA.  There are articles about Norse mythology but it hasn't lead to mass worship of Odin and Thor.  TFD (talk) 20:38, 25 April 2017 (UTC)
 * We need to be very careful making medical claims based on the popular press. Doc James  (talk · contribs · email) 20:51, 25 April 2017 (UTC)
 * James, how would you tell readers that Hanley made these claims? It's an undeniable fact that he did make these claims, and making these claims seems to be why the article exists.
 * (I could expand upon George Church's polite placebo comment to add both self-deception [if you're going through that much pain to do this, you might not be able to see the evidence that it's not working] and willful deception [it looks like his financial future depends upon convincing other people that this works] to the list possible explanations, but none of those change the fact that he did say these words.) WhatamIdoing (talk) 06:05, 26 April 2017 (UTC)
 * "Hanley claimed that the treatment has helped him. One of his collaborators has suggested any changes are due to the placebo effect." Our job unless the press is not to hype it. We are to be boring and of course we should paraphrase. Doc James  (talk · contribs · email) 17:56, 26 April 2017 (UTC)
 * Sounds like a great place to start. How about you add that to the article now?  WhatamIdoing (talk) 19:46, 26 April 2017 (UTC)
 * Done Doc James  (talk · contribs · email) 19:50, 26 April 2017 (UTC)

It said "Hanley believes that the treatment is working." What was the treatment? QuackGuru ( talk ) 19:31, 25 April 2017 (UTC)
 * According to the article, he injected himself with some plasmid DNA in an effort to produce more growth hormone–releasing hormone. He owns a company that's trying to sell this technology.  He claims to feel better, and he claims that the results on some basic medical tests (e.g., his lipid profile) have improved.  The dispute is over whether the Wikipedia article can report his claims.  Everyone agrees that it's an accurate statement (i.e., he really did make these claims), but some editors don't want readers to know what he claims.  WhatamIdoing (talk) 05:59, 26 April 2017 (UTC)
 * It is fishy Hanley would allow himself to be injected with a potentially dangerous treatment. QuackGuru  ( talk ) 18:10, 26 April 2017 (UTC)
 * It's not actually unusual among researchers with a certain personality. They're thinking something closer to "If I don't believe it's safe enough to use on myself – the person in the world who best understands the evidence and risks – then how could I ethically test it in anyone else?"   WhatamIdoing (talk) 19:46, 26 April 2017 (UTC)

Comment - We have had a similar discussion about whether beliefs about medical claims fall under MEDRS at Wikipedia_talk:WikiProject_Medicine/Archive_85. There the consensus was they do. Sizeofint (talk) 04:22, 26 April 2017 (UTC)
 * I think that some editors were concerned specifically because that was a case of surveying medical experts for their perceptions, which is a little different from "the subject of the article said these words". (The blanked text in the Hanley article include a direct quotation from the subject, and there can be no more authoritative source for a direct quotation than the original source itself.) There's more room for worry about "experts say this" being taken as a scientifically proven fact, than "the CEO of a company that's trying to tell this said this".
 * That said, I think that the criticism there was overblown, and I don't recall a single editor disagreeing with any individual fact taken from that source. The actual question of verifiability or even accuracy did not seem to matter to the editors who opposed that material.  WhatamIdoing (talk) 06:12, 26 April 2017 (UTC)

Article for Deletion discussion
Greetings all. There is an Articles for Deletion discussion taking place here that may be of interest to members of this Wikiproject. Regards Exemplo347 (talk) 23:48, 26 April 2017 (UTC)
 * The article is Perturbation training Sizeofint (talk) 04:45, 27 April 2017 (UTC)
 * I merged it away to other things, but most of it was primary sources. Jytdog (talk) 06:10, 27 April 2017 (UTC)

....While the AfD discussion is still ongoing? The article author would be justified in complaining about that or just boldly reverting your action. The AfD notice - the part that says "this page must not be blanked" - applies to everyone. Exemplo347 (talk) 07:03, 27 April 2017‎ (UTC)
 * totally missed the AfD tag not to mention the obvious calling attention to it here. Have self-reverted the clearing and redirect and added my !vote at the AfD. Jytdog (talk) 08:04, 27 April 2017 (UTC)

Dropping the "'s" in titles
This appears to be the current practice. We have discussions:


 * Talk:Parkinson%27s_disease
 * Talk:Alzheimer%27s_disease

Doc James (talk · contribs · email) 18:31, 26 April 2017 (UTC)


 * An interesting observation of disease vs syndrome has been made by . —  kashmiri  TALK  10:51, 27 April 2017 (UTC)

Phakomatosis redux
So we had this discussion. Wikipedia_talk:WikiProject_Medicine/Archive_95

The students went ahead and did it, and pretty well done content is now sitting in a sandbox, and they are done with it.

What if anything shall we do with it? Jytdog (talk) 05:25, 27 April 2017 (UTC)


 * IMO we should replace the existing stub with their improved content. WhatamIdoing (talk) 15:50, 27 April 2017 (UTC)
 * Yes much better formatted than last time. I am fine with seeing that version go up. Lots of caps still need fixing but that is a fairly minor issue.
 * We need to put together an infobox for disease classes similar to how we have one for medication classes. We also need to put together a section order / outline recommendation. Doc James  (talk · contribs · email) 16:58, 27 April 2017 (UTC)