Wikipedia talk:Manual of Style/Medicine-related articles/Archive 1

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Proposed Manual of Style/Special Article Styles entry

I propose a new part of the Manual of Style, and more specifically of Special Article Styles, about writing medical articles.

It contains a number of topics related to problems that can be encountered while writing such articles. It should give these articles more uniformity and help editors face some challenges in the area, such as writing for the average reader. I long searched for such a guideline, and when I learned it didn't exist yet I started writing it, using existing parts from Wikipedia:WikiProject_Clinical_medicine/Template_for_medical_conditions.

Please discuss below if you think this is a good idea, and give feedback on it's content. --Steven Fruitsmaak | Talk 11:40, 28 July 2006 (UTC)

I think this is a great idea - in fact, I had thought over the last few days that it would be nice to construct something like this. It's nice that someone had already taken steps in the right direction. I'll give it a look! InvictaHOG 15:01, 28 July 2006 (UTC)
As an alternative, it could be an essay on Wikipedia:WikiProject Medicine, since some other projects also have some similar page on their subjects, but none in the MoS (e.g. this one). On the other hand, several other topics have started a MoS entry (like mathematics). I prefer a MoS entry because I think it will create wider exposure and easier access for people looking for it.--Steven Fruitsmaak | Talk 21:02, 3 August 2006 (UTC)

NPOV

Avoid writing from the doctor's point of view, instead use a Neutral Point of View. This wording needs to be looked at more carefully. I've encountered situations where personal websites containing original research were being used as references for medical articles, claiming that these sites counter the view of the "medical establishment". Sandy 16:55, 28 July 2006 (UTC)

I think that the main place I see this is when an article refers to "patients" instead of individuals or people with the disease. NPOV trumps all and verifiable and credible sources are an integral part of Wikipedia. I think that the guideline just means to speak more generally, not as a doctor approaching a patient InvictaHOG 17:36, 28 July 2006 (UTC)
Still, my concern is that this wording be tightened up so that it not be used as a pretext for including non-peer-reviewed or original research in the name of "NPOVing" the article. Causes, treatment and diagnosis were almost entirely removed from the Asperger syndrome article, under the claim that medical information represents an "unbalanced" "medical establishment" POV. Sandy 17:40, 28 July 2006 (UTC)
You should see the smoking-related articles...! Perhaps one way around this would be to include a section on - off the top of my head, and without having looked at the Asperger's article - approaches to the condition among those with the illness, with the requirement that they be large, recognised patient support groups? That needs refinement, and it will probably provoke plenty of "I don't take medicine because my aunty Rita once got a rash from a tablet, and I'm fine" type edits, but it would at least confine the dispute to one section of the template rather than making the template itself a focus of the dispute.
It's patently absurd to remove sections on treatment, diagnosis etc. from articles on recognised medical conditions, incidentally, and I'd hope that asking for mediation on that article and / or going to dispute would see that recognised.Nmg20 11:17, 29 July 2006 (UTC)
Maybe it should read: avoid writing for (other) doctor's, write for the Average Reader?--Steven Fruitsmaak | Talk 18:57, 30 July 2006 (UTC)
I've changed it, please comment.--Steven Fruitsmaak | Talk 21:46, 3 August 2006 (UTC)

scientific names immiscible with the Average Reader

They've got too many letters usually, can't be promnounced by humans (you peopole even use the wrong word for viscous -- it means thickness in a flow sense, not all them organs underneath the diaphraghm!! "Molasses is viscous, the liver is an abdominal organ."), and though there are connections with other medical terminology, the Average Reader will not know them. Since we're wriitng for that Average Reader, article titles should mean something to him/her, not merely be a collection of nonsense syllables.

So in a discussion about which of the technical medical and out of hte Average Reader's ken terms should be used for blood fat problems, the discussion is off the point. The title should be something like, Blood fat disorders. First, it makes immediately clear that we're not talking about thunder thighs (at least not precisely), that it's fat (lipid is a mysterious thing no one amonst the Average populace is too much sure of -- animal, vegetable, or mineral?), and last it's a disorder. Somethings's wrong.

The first sentences of that article should perhaps introduce the term --

lipid (means the same thing, but includes all the various forms of fat it can have in the blood), that some instances are deadly dangerous, some likely a problem, some probably merely a curiosity, and othere entirely mysterious. How does li[pid get into the blood, what are the major forms, how does it leave the blood, why do we even have any (efficiecy of energy storage of course). Absolutely normal stuff most of this. But like most things, it can go awry and we understand some of these and something about how some of them happen. These are the major problems...... And these are a few of the minor problems sometimes seen..... Overall people can reduce their chances of the bad sort by .... But some of this is hereditary (about this much and heres why it's believed to be so) and we don't know how to manage that part yet. ...

Our target reader (the Average One) will be able to take from this sort of thing much more than from an article more precise and terse, having used proper terminology. Use it by all menas, but only after taking care not to drown our Average Reader.

No bricks, please. Just flowers and well wishes. Save that tomato for the sauce. ww 20:09, 20 July 2006 (UTC)

I disagree. Although articles generally need a short section intended for the average reader, replacing scientific terms with descriptions based on popular usage will lead to ambiguity. Anyway, "viscous" and "lipid" are commonplace terms which are taught in introductory secondary-school courses, and simply wiki-linking them allows those unfamiliar with these terms to discover what they mean. Nevertheless, excessively pretentious terms should be avoided. Pcu123456789 19:12, 28 January 2007 (UTC)

Ordering

I'd tend to put "Epidemiology" up alongside "Cause/(a)Etiology" - the two are both to do with how illnesses take root, after all? I might also move "Pathophysiology" above "Diagnosis", as often diagnostic techniques can be easier to understand with the "basic" (I use the term advisedly!) science already discussed.--Nmg20 17:07, 28 July 2006 (UTC)

This list is only a model and should not, in my opinion, always be followed. Pathophysiology is above diagnosis no?--Steven Fruitsmaak | Talk 18:54, 30 July 2006 (UTC)

References

On the references front, we need an agreed format from the off IMHO. I'd suggest we encourage people *not* just to link by pubmed id - the full references aren't hard to get the hang of, and they then let you link books, web sources, and journals etc. properly. I've tried to pull together all the info on them, and basically all people need to do it to have two or three templates (I keep mine on my talk page) which they then copy-and-paste when they want a particular sort of reference. The main ones here are:

  • <ref>{{cite book | last = | first = | authorlink = | coauthors = | title = | publisher = | date = | location = | url = | doi = | id = }}
  • <ref>{{cite journal | author= | title= | journal= | volume= | issue= | pages= | year= | id=PMID }}</ref>
  • <ref>{{cite news | title= | date= | publisher=[[]]| url=}}</ref>
  • <ref>{{cite web | title= | url= | accessdate= }}</ref>

We also need to explain:

  1. how to do repeat references: the first time, you just put:

<ref name="Stone soup"><ref>{{cite web | title=How to cook stone soup | url=http://www.cookingstonesoup.com | accessdate=2006-04-01 }}</ref>

  • The second time you just need: <ref name="Stone soup"/>
  1. that people need to include the following under a "References" heading to make the text appear:

<!--See http://en.wikipedia.org/wiki/Wikipedia:Footnotes for an explanation of how to generate footnotes using the <ref(erences/)> tags--><div class="references-small"><references/></div> Just some thoughts! Nmg20 17:07, 28 July 2006 (UTC)

Please implement!--Steven Fruitsmaak | Talk 18:50, 30 July 2006 (UTC)
I don't use Cite Journal, since it never seems to get it right. I noticed that Cystic fibrosis didn't use it, either. Sandy 19:02, 30 July 2006 (UTC)
Strange - it's worked fine whenever I've used it - Smoking ban, Lung cancer, and Passive smoking are the three I've really used it on, and they all seem to work fine. If you chuck in an example of a page it's not working on, I'll see if I can figure out what's going on if you like? Nmg20 21:31, 30 July 2006 (UTC)
I'm sorry for the confusion, Nmg – I ran two thoughts together into one sentence. First, is diberri's tool to convert PMID numbers to cite journal. As an example, using PMID 9651407:
The ref I want looks like this:
Leckman JF, Zhang H, Vitale A, et al. Course of tic severity in Tourette syndrome: the first two decades. Pediatrics. 1998;102 (1 Pt 1):14-19. PMID 9651407
Using diberri's tool results in:
Leckman J, Zhang H, Vitale A, Lahnin F, Lynch K, Bondi C, Kim Y, Peterson B (1998). "Course of tic severity in Tourette syndrome: the first two decades". Pediatrics. 102 (1 Pt 1): 14–9. PMID 9651407.{{cite journal}}: CS1 maint: multiple names: authors list (link)
Notice the wayward punctuation after the article name, the need to manually shorten the author list, and the need to manually add in the full-text URL.
If I type the info into cite journal myself, I can get the et al in the author list, I can italicize the journal myself, and I can eliminate the wayward punctuation. But, add to all of this manual work the problem that cite journal chunks up so much KB in a highly-referenced article, and the ease of just copying the info direct from PubMed into ref tags, and I just find cite journal not worth the trouble. Hope this explanation helps -- perhaps I'm doing something wrong. My main objection is that cite web, cite book, and cite journal chunk up the size of the article so much that editing becomes difficult, and I just find it easier to copy the info straight from PubMed into the ref tags. I also noticed that cystic fibrosis, a recent FA, didn't use cite journal. Sandy 22:12, 30 July 2006 (UTC)
I personally do not use them either. They end up taking more time than my own method of cutting and pasting, take up more space, and don't really add much. To each his own, but for a MoS I'd leave it out, IMHO. InvictaHOG 23:06, 30 July 2006 (UTC)
I don't use it either, same reason as InvictaHOG. We could explain it, but isn't there already some extensive explanation about referencing at Wikipedia:Citing sources? I think using a uniformous ref system is quite out of range here. However, many other suggestions made by Nmg20 are very useful I think.--Steven Fruitsmaak | Talk 10:29, 31 July 2006 (UTC)
I do use Diberri's tool - only the minority of journals/papers allow online access to the full article. In those cases I manually copy & paste the url. Also in the above example of Leckman et al, I'ld be unhappy to have clicked on the link for the full article as it is to a 162kb PDF file. Notification of non-html formats is useful for those of us with slow dial-up connections. The cite journal template provides nice url and format parameters to do this with. Perhaps more importantly, the use of citation templates also gives greater future functionality as data may be read as xml items rather than free-hand text/formating (if one looks at, e.g. Wikipedia Talk:Footnotes#Quotation marks, there are various suggestions for wikipedia to cache references which would be far easier with citation details defined by parameters of the cite templates). David Ruben Talk 23:57, 5 August 2006 (UTC)
Yes, I gave a bad example on the PDF. This is what I usually do:
Leckman JF, Zhang H, Vitale A, et al. Course of tic severity in Tourette syndrome: the first two decades. Pediatrics. 1998;102 (1 Pt 1):14-19. PMID 9651407 Full-text PDF
(When I'm on a slow connection, I also mouse over first to see if the link is to a PDF.) Sandy 03:37, 9 August 2006 (UTC)
I also use Diberri's tool and have noticed it occasionally getting confused with foreign language names, or not extracting the year/volume bits - but this is rare. I find the templates help you concentrate on what info to provide and not worry about formatting style. The formatting style for journal references can be baffling, especially for a non-academic. If the full text is free online, I like to mention this at the end of the reference.

Sandy, when you manually shortened the author list, how did you decide who would become "et al"? I quite like giving everyone some credit. Is "et al" just a throwback to paper and its space restrictions? If PubMed give the full author list, why shouldn't we? Colin°Talk 07:42, 9 August 2006 (UTC)

The convention varies, but a good rule of thumb is if there are more than 5 authors then the list can be shortened to the first 3 + et al - if readers want the rest of the authors they can visit PubMed? --apers0n 10:16, 9 August 2006 (UTC)
What s/he said :-) I don't remember who actually helped me with this when I was first writing the article: one of the Wiki physicians pointed out to me the same thing Aperson said. Sometimes the author lists are overwhelming, and the full list is only a click away on PubMed. Sandy 12:47, 9 August 2006 (UTC)

References/ tagging

When creating the list of references, Wikipedia:Footnotes#Style_recommendations suggests the use of the template:

{{subst:Footnotes|100%}}

...which includes the commented explanation of how to generate footnotes.
RESIZING (to a standard 92%) with the template mentioned above (perhaps for articles with a long list of footnotes):

{{subst:Footnotes|92%}}

--apers0n 06:53, 5 August 2006 (UTC)
Whilst WP:Footnotes does mention this, this is in context of providing help to editors new to the cite.php system, i.e. in Wikipedia:Footnotes#Helping editors unfamiliar with this system of footnotes. The preceeding section, Wikipedia:Footnotes#Style recommendations actually offers the following: <div class="references-small"><references/></div>. Which has the distinct advantage of not specifying the numerical value of 'small'. Using {{subst:Footnotes|92%}} is surely inviting the unwarey, inexperienced or vandal to tinker with that '92%' to some indecipherable lower value. David Ruben Talk 23:57, 5 August 2006 (UTC)
What about {{subst:reference}}, which produces the following code:

!-- ----------------------------------------------------------
See http://en.wikipedia.org/wiki/Wikipedia:Footnotes for a
discussion of different citation methods and how to generate
footnotes using the <ref>, </ref> and <reference /> tags
- ---------------------------------------------------------- -->
<div class="references-small">
<references />
</div>

--apers0n 10:08, 9 August 2006 (UTC)

Slightly different topic

A slightly different topic, but since the page is being worked on: I also left OMIM out of the "disease" box on Tourette syndrome because the OMIM info on TS is woefully inaccurate. Sandy 13:49, 31 July 2006 (UTC)

This doesn't seem to belong here...--Steven Fruitsmaak | Talk 21:06, 3 August 2006 (UTC)
um ... the proposed template includes the infobox, which includes OMIM. No? Sandy 21:09, 3 August 2006 (UTC)
But this discussion is not about the Infobox itself. I don't understand what you are arguing, are you proposing any change to the project page here?--Steven Fruitsmaak | Talk 21:27, 3 August 2006 (UTC)

Help needed

In the beginning of the page I've made some references to other policies and guidelines on wikipedia. If anyone could put more references in the rest of this page, this would be greatly appreciated! After all, we do want to cite our sources, no...?--Steven Fruitsmaak | Talk 00:04, 4 August 2006 (UTC)

Suggestion

It would be great if this particluar MOS could address the trend in some articles to have long lists of notable people with certain medical condition or physical attributes. Perhaps it should give some idea of when lists within the article are OK, when lists should be forked, and what is necessary for inclusion in the list (i.e. all examples should be referenced in order to conform to WP:V). Some examples of these lists are in Eyebrow, Hernia, and Heterochromia. -AED 02:22, 8 August 2006 (UTC)

Ooops... I see that most of my concerns are addressed in the "Notable cases" section. -AED 02:34, 8 August 2006 (UTC)
I updated this section a little. For previous discussions on this topic see here and here.--Steven Fruitsmaak | Talk 09:51, 8 August 2006 (UTC)
TS used to have a long list, no references, and got vandalism and speculative inserts daily. I created a broader daughter article to get it out of the main article. By turning the list into prose, and referencing everything, the speculative edits and vandalism completely ceased. Sociological and cultural aspects of Tourette syndrome. Sandy 02:28, 8 August 2006 (UTC)
Good work! Like what you have done, I think cracking down on WP:V in these articles would force improvements in many of these articles. -AED 02:34, 8 August 2006 (UTC)
Moving it out and turning it into prose was Encephalon's idea :-) Enforcing WP:V was mine. The main article was getting slammed with coprolalia joke inserts: now the vandals can't find the list quickly, and their attention span is probably too short to look for it. Sandy 02:41, 8 August 2006 (UTC)

Previous questions regarding this issue that remained unanswered:

  • Can such lists include fictional characters?
  • Should the persons on the list have lastingly affected the popular perception of a condition (e.g. Stephen Hawking and ALS)? Or could any notable person be included?
  • Starting from what number of items should the list be split off?
  • Are they interesting or Vanispamcruftisement?
  • Does it seem more appropriate to discuss a policy like this on a general Wiki forum?
  • Another suggestions: Perhaps we could devise a policy and make a new tag to go specifically at the top of those lists that would give contributors a certain amount of time to comply with providing a citation, etc.?

I would like to remark that this page is nominated as a guideline, which is not the same as policy and cannot be inforced.--Steven Fruitsmaak | Talk 09:51, 8 August 2006 (UTC)

As the principle editor of List of people with epilepsy, I may be biased. You might be interested in the little essay I wrote in Talk:List of people with epilepsy#Listcruft. This quotes the relevant WP policy and guidelines on lists of people. Everything must meet WP:V and ideally should be deleted (or move to the talk page) in preference to requesting citations. In my essay, I disagree with the idea that all lists of people need the requirement that the people are notable because they are associated with the list topic. In an earlier discussion, JFW requested both WP:V and "evidence that this has lastingly affected the popular perception of a condition (e.g. Stephen Hawking and ALS)". This second test would almost certainly reduce such lists to the point where they could not be separate articles. Indeed, it would be hard to form a "list" at all. I suspect that is what JFW wants :-).
The guidelines for spawning off the list to a separate page would be those for any article: If you enforce WP:V, can the list become long and useful enough to stand on its own? I like the Tourettes page. It is a novel way of dealing with the issue. Colin°Talk 10:09, 8 August 2006 (UTC)
Personally I also think the lasting-influence-criterium is not a good idea, it will lead to more debate than it's worth, because it is not unambiguous to verify. However, I think it should be included because of "Selected lists of people should be selected for importance/notability in that category and should have Wikipedia articles." in the style guideline Wikipedia:Lists_(stand-alone_lists)#Lists_of_people. I think we need consistency therefore I am in favor of the criterium suggested by JFW.--Steven Fruitsmaak | Talk 11:24, 8 August 2006 (UTC)

I will just throw in my two cents as to the unresolved questions. I think that one way to do the notability thing is to say that individuals listed should have their own Wikipedia page. One exception to this could be the children of famous people (such as Boomer Esiason's son or Doug Flutie's son) when the child has dramatically increased awareness of an illness but probably wouldn't make a good article. I think that fictional characters should be included on the list or else the articles may attract a section such as "Multiple sclerosis in fiction." A separate heading can of course accomodate them on the list page. I don't think that lasting influence can be proven or should be required. Most of these articles seem to be there to increase the numbers of people with the disease, not to discuss their impact on the disease. If they are all verified, I don't see any reason to deny people the chance to collect famous people with their disease into one place. It seems to have a therapeutic effect in some way - there are editors who are updating a list on the prostate cancer talk page to this day! I think that setting a number is not as helpful as allowing editors to use their own judgment. If there are three people discussed in a section and they all have well-written prose, then making a separate article might not make sense. If there are five people with no discussion, then an editor can decide as they wish. Obviously long lists (10 people or more) should be strongly considered for a new article. I'm not sure that we can decide whether they are interesting - they seem to be interesting to a certain segment of the Wikipedia editing population. This will never be official policy (IMO) and medical articles will continue to attract these kinds of additions no matter what we say here. IMHO it's best to just be laid-back about it - there is enough bandwidth to go around. As this is a question that seems to only affect medical articles, I'm not sure that it needs a wider audience. We'll never be wrong by seeking a greater consensus, but no one has ever balked at being referred to the medicine recommendation pages when a style issue is being discussed, in my experience. As for asking for references for an article, there is already a policy and tag in place. It's probably best to just conform to the general rules on that one! InvictaHOG 11:46, 8 August 2006 (UTC)

The objection that WP:V and WP:NN requirements would make the lists too short for a separate page can be handled by doing what I did on TS. You roll all of that "trivia" and "social" stuff into a separate article. The people with the condition are intensely interested in that info, but its content detracts from the more "medical" tone of the main article.
Can such lists include fictional characters?
In the case of Tourette syndrome, the fictional characters seriously fuel misrepresentations about the condition, so I believe that subject needs to be treated. Again, you can see how I handled it in the entertainment section. [1] The broader public needs to know these fictional representations are almost always wrong and further stereotypes. Another example: a Quincy episode fueled legions of correct diagnoses of TS in the 1980s. You can still encounter many people with TS who thank a television show for their diagnosis. Again, if you handle this within the prose, rather than just a list, it is helpful to the reader. Have a look at the TS article before I started working on it: IMO this is what we don't want. [2]
Should the persons on the list have lastingly affected the popular perception of a condition (e.g. Stephen Hawking and ALS)? Or could any notable person be included?
If you restrict it to "lastingly affected", conditions with low prevalence rates may have no one to discuss. And, I can argue that any known person with TS lastingly affects the child with TS, who is desperate to know that s/he has a future. There aren't enough role models in TS: I'd not like to see further restrictions than WP:V and WP:NN.
Starting from what number of items should the list be split off?
I'd rephrase the question to, are there other things that could also be split off into an "other aspects" article.
Are they interesting or Vanispamcruftisement?
I'm biased, but I know people in the TS community really care about that list. It gives parents a way to give hope to their children.
Does it seem more appropriate to discuss a policy like this on a general Wiki forum?
No: the level of knowledge about medical conditions is often lacking in general fora discussions.
Another suggestions: Perhaps we could devise a policy and make a new tag to go specifically at the top of those lists that would give contributors a certain amount of time to comply with providing a citation, etc.?
Instruction creep: in terms of policy, simply enforce WP:V and WP:NN. But a tag to remind people of policy, and give them a time limit to clean up, would be helpful.
Also, I would not like to see a requirement that every person on the list had to have a Wiki entry, because in the case of TS, that would mean I'd have to create them all. (Actually, I think I'm only missing one.) WP:NN should cover it.
Sandy 12:39, 8 August 2006 (UTC)
"its content detracts from the more "medical" tone of the main article" is what I mean by elitism: what's wrong with discussing notable cases in the article itself? I think we should not be to hasty to split off content. A cleanup tag indeed already exists. These sections tend to get wider than just people affected, and I like it: that's why I haven't split off Hernias in pop culture.--Steven Fruitsmaak | Talk 15:47, 8 August 2006 (UTC)
How would the MOS deal with "List of fictional characters with Heterochromia"? None of the examples are referenced and I don't think it's really possible to create a proper article with the information in the list. Would a split to a separate article be viewed as an improper fork? Should there be explicit reference that all lists, whether in the article or separate, must conform to WP:V and WP:LIST? (P.S. Regarding this issue, check out some of the recent additions by User:80.200.8.88.) -AED 20:56, 8 August 2006 (UTC)
When I've had an unreferenced list in an article, instead of creating a separate page for the list I've just moved it to the talk page and stated that it should be referenced before going further. Especially something as difficult as verifying dozens of fictional characters! It keeps the information around in case an editor is keen on referencing it and starting a new list article but keeps unreferenced material away from the article in the meantime. InvictaHOG 22:00, 8 August 2006 (UTC)

I think I see a consensus starting to form here, that there is an acceptable (moderate) amount of people-listing in most circumstances. Having just looked through a few such articles, I personally find that I tend to be annoyed by the lists when they are a substantial fraction of the total text of the article. Conversely, I doubt I would be annoyed to find a list split off into a subarticle / related article, except maybe in the case that it's too small to stand alone. So I guess my suggestion would be to split any list that, in the opinion of the editor willing to do the work, is large enough to stand alone.  — JVinocur (talk • contribs) 19:00, 8 August 2006 (UTC)

I'm a bit nervous about folk saying "must conform to (insert guideline here)". It shouldn't be this hard – enforce the policies; use the guidelines as guidelines; be helpful and add some citations; be bold in applying the scythe of verifiability*; use common sense with what remains.

*Moving unreferenced stuff to the talk page is often better – I just didn't want to lose my scythe metaphor :-)

I fear we are trying to read too much into what are after all just a couple of sentences here and there in the vast pages that make up Wikipedia's policy and guidelines. The Wikipedia:What Wikipedia is not page has had over 350 edits since I last looked at it in detail in March 2006! The sentence I quoted then has changed and moved to another section. Next month it may be completely rephrased.

I agree that there is a consensus developing but a sticking point is the "lastingly affected the popular perception of a condition" criterion that I'd like dropped. It introduces a value judgement (which as editors we mustn't make), is very hard to verify, and isn't IMO a logical conclusion of any existing rule or guideline. The existing guidelines request that editors of a list page (or section) should agree and describe a clear set of entry criteria for the list. I favour leaving those editors to decide amongst themselves how broad or strict they want to be. Sorry for rambling. Colin°Talk 22:21, 8 August 2006 (UTC)

Rune.welsh has pointed out to me that WP:LIVING applies to such lists if they include living people. Whilst the colour of someone's eyes seems pretty harmless and unlikely to be libelous, a wrong inclusion in another medical list might well upset somebody. I've added some futher thoughts at Talk:List of people with epilepsy#Biographies of living persons Colin°Talk 15:34, 9 August 2006 (UTC)

The color of someone's eyes may be harmless, but this is an issue with Tourette syndrome. Between WP:V and WP:BLP, I can delete any addition that is not well referenced. I really think WP:V covers it all, anyway. Sandy 15:43, 9 August 2006 (UTC)

I've made some changes to the Notable cases header as an attempt to formulate a consensus. Please comment.--Steven Fruitsmaak | Talk 07:51, 10 August 2006 (UTC)

Layout

WP:LAYOUT specifies the order of sections as:

  • See also
  • Notes
  • References
  • Further reading
  • External links

The Medicine-related guidelines contradict the Wiki guidelines, calling for:

  • References
  • Footnotes
  • See also
  • External links

Is there a reason medical articles should deviate form Wiki guidelines? Sandy 01:16, 30 September 2006 (UTC)

Though there are many exceptions, in general, I believe the reason is that in many paper-based medical journals, the "references" are not tied to specific assertions, while in Wikipedia, they are. So, some people coming from a medical background make a distinction between links that support a specific fact and links that support the article as a whole, and include an extra header, "Footnotes". Perhaps this thread would be a good opportunity for the community to define more precisely what we mean on Wikipedia when we say "References", "Footnotes", and "External links". --Arcadian 02:06, 30 September 2006 (UTC)
I'm clear on how those sections are defined throughout Wiki and in medical articles: I just don't understand why medical articles have changed the order of those sections. Why should notes/references come before See also in medical articles, when they come after See also throughout Wiki? It looks like it was probably just a mistake here. Sandy 02:10, 30 September 2006 (UTC)
I agree with Sandy. WP:CITE covers this in detail. There are several styles in use in Wikipedia. Generally, the Notes section contains numbered notes referred to at points throughout the text. The References section is a bullet list, usually applicable for the article as a whole. Both Notes and Footnotes are mentioned as possible headings, but Notes seems to be the most popular and the one used in WP:LAYOUT. Therefore, I suggest we rename/reorder to match WP:LAYOUT. Other styles can be seen:
Colin°Talk 10:59, 30 September 2006 (UTC)
  • I just want to get See also in the right place, since I've noticed I keep having to change it on medical articles. I had no problem sorting out Notes from References from Further Reading on Tourette syndrome; Notes are inline citations, References were a summary of the main sources used in building the inline cites (not relisting every PMID, only important book and other general sources), and Further Reading was other hardprint sources not used as references, but excellent reading nonetheless to gain a better knowledge of the condition. External links are reliable websites not used as refs. Sandy 16:17, 30 September 2006 (UTC)

I've changed it, thanks for bringing it up. Now that I have you listening, I was planning to move some more content here later (hopefully soon), and I hope to hold a straw pole to ensure consensus on this proposal somewhere in December.--Steven Fruitsmaak (Reply) 01:57, 1 October 2006 (UTC)

This is a related but more general question from a less-experienced user. It seems to me that, given the length of the reference section in a well-cited medical article, the external links get buried. The reference section is not of general interest and the specific items can be accessed by people who want to see a given reference using the embedded intra-article links between contention and citation. By contrast, the external links are of general interest and, if done well, are a significant addition to the article (i.e. Alzheimer's disease). It therefore makes sense to me to place these above the references. --Ipeltan 19:36, 1 October 2006 (UTC)
The Wiki-wide thinking is that anything that is in an External link that is important enough to be mentioned on Wiki should be Wikified: that's why they're last. Wiki content takes precedence: external links should be minimized or the content should be Wikified. Have a look at WP:EL and WP:NOT. Sandy 20:37, 1 October 2006 (UTC)
"in a well-cited medical article, the external links get buried". Couldn't have said it better myself. We should make that a guideline. Policy even :-). Seriously, the benefits of external links are overestimated by the well-meaning (we all have Google) and overexploited by the devious (Google loves Wikipedia). Of the links in the Alzheimer's article, two are already mentioned by the info box at the top. One is a scientific journal, unavailable to the general public (Wikipedia's target audience, in case we forget). The single charity mentioned is US-based and comes at the top of any Google search anyway. I see you've done some serious pruning here – good job, keep going ;-) The reference section should be of general interest, even if you don't follow the links. It is what separates a quality Wikipedia article from one that we are ashamed of. Even a general reader can get a feel for whether the sources are reliable or iffy just by their descriptions. Colin°Talk 22:38, 1 October 2006 (UTC)

Reliable sources

There has been a movement to un-do reliable sources as a guideline, and it now has a disputed tag. (For disclosure, I am in favor of keeping WP:RS). I believe the section of RS which applies to medical articles is very helpful, particularly in distinguishing information published in the popular press without the benefit of good peer review or medical consensus, and pseudoscience, from good, peer-reviewed sources. Should we consider including any of the verbiage from there in MEDMOS? (Copied below). Sandy (Talk) 16:09, 26 October 2006 (UTC)

I've copied parts of it: don't think arvix is very relevant (as compared to PubMed), and that last section was also not very relevant. I guess now the entire thing needs a good rewrite or review?--Steven Fruitsmaak (Reply) 21:16, 26 October 2006 (UTC)

Physical sciences, mathematics and medicine

Cite peer-reviewed scientific publications and check community consensus

Scientific journals are the best place to find primary source articles about experiments, including medical studies. Any serious scientific journal is peer-reviewed. Many articles are excluded from peer-reviewed journals because they report what is in the opinion of the editors unimportant or questionable research. In particular be careful of material in a journal that is not peer-reviewed reporting material in a different field. (See the Marty Rimm and Sokal affairs.)

The fact that a statement is published in a refereed journal does not make it true. Even a well-designed experiment or study can produce flawed results or fall victim to deliberate fraud. (See the Retracted article on neurotoxicity of ecstasy and the Schön affair.)

Honesty and the policies of neutrality and No original research demand that we present the prevailing "scientific consensus". Polling a group of experts in the field wouldn't be practical for many editors but fortunately there is an easier way. The scientific consensus can be found in recent, authoritative review articles or textbooks and some forms of monographs.

There is sometimes no single prevailing view because the available evidence does not yet point to a single answer. Because Wikipedia not only aims to be accurate, but also useful, it tries to explain the theories and empirical justification for each school of thought, with reference to published sources. Editors must not, however, create arguments themselves in favor of, or against, any particular theory or position. See Wikipedia:No original research, which is policy. Although significant-minority views are welcome in Wikipedia, the views of tiny minorities need not be reported. (See Wikipedia:Neutral Point of View.)

Make readers aware of any uncertainty or controversy. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers.

In science, avoid citing the popular press

The popular press generally does not cover science well. Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease. Also, newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. They also tend not to report adequately on the methodology of scientific work, or the degree of experimental error. Thus, popular newspaper and magazine sources are generally not reliable sources for science and medicine articles.

What can a popular-press article on scientific research provide? Often, the most useful thing is the name of the head researcher involved in a project, and the name of his or her institution. For instance, a newspaper article quoting Joe Smith of the Woods Hole Oceanographic Institution regarding whales' response to sonar gives you a strong suggestion of where to go to find more: look up his work on the subject. Rather than citing the newspaper article, cite his published papers.

Which science journals are reputable?

One method to determine which journals are held in high esteem by scientists is to look at impact factor ratings, which track how many times a given journal is cited by articles in other publications. Be aware, however, that these impact factors are not necessarily valid for all academic fields and specialties.

In general, journals published by prominent scientific societies are of better quality than those produced by commercial publishers. The American Association for the Advancement of Science's journal Science is among the most highly regarded; the journals Nature and Cell are notable non-society publications.

Keep in mind that even a reputable journal may occasionally post a retraction of an experimental result. Articles may be selected on the grounds that they are interesting or highly promising, not merely because they seem reliable.

arXiv preprints and conference abstracts

There are a growing number of sources on the web that publish preprints of articles and conference abstracts, the most popular of these being arXiv. Such websites exercise no editorial control over papers published there. For this reason, arXiv (or similar) preprints and conference abstracts should be considered to be self-published, as they have not been published by a third-party source, and should be treated in the same way as other self-published material. See the section above on self-published sources. Most of them are also primary sources, to be treated with the caution as described in various sections of this guideline.

Researchers may publish on arXiv for different reasons: to establish priority in a competitive field, to make available newly developed methods to the scientific community while the publication is undergoing peer-review (a specially lengthy process in mathematics), and sometimes to publish a paper that has been rejected from several journals or to bypass peer-review for publications of dubious quality. Editors should be aware that preprints in such collections, like those in the arXiv collection, may or may not be accepted by the journal for which they were written — in some cases they are written solely for the arXiv and are never submitted for publication. Similarly, material presented at a conference may not merit publication in a scientific journal.

Evaluating experiments and studies

There are techniques that scientists use to prevent common errors, and to help others replicate results. Some characteristics to look for are experimental control (such as placebo controls), and double-blind methods for medical studies. Detail about the design and implementation of the experiment should be available, as well as raw data. Reliable studies don't just present conclusions.

Sections

The "Quick list of sections" for use in medication articles seems a bit strange to me, particularly the presence of "Diagnosis", "Treatment" and "Prognosis" headings, and the lack of a "Indications" heading (although this can often be covered in the lead). Were these intentional or did they slip past? (I am, however, adding my support below – to me this is a minor glitch, not something I "take issue with" or find incompatible with MEDMOS becoming a guideline.) Fvasconcellos 00:09, 27 October 2006 (UTC)

Proposal or guideline

This proposal has been floating about, under different names, for quite a while. Is it time to develop consensus as to whether it should become a guideline, rather than a proposal? Are there any members of the Medical Projects who oppose this as a guideline? Sandy (Talk) 15:34, 26 October 2006 (UTC)

I've alerted some projects I considered related, hopefully people will come to express consensus. Please discuss below.--Steven Fruitsmaak (Reply) 21:41, 26 October 2006 (UTC)

Questions

Comments and suggestions

  • My compliments to Steven for his hard work on this, something I vaguely remember starting off in 2004 but never quite completing. It offers sensible advice and a reasonable standard. Of course I take issue with the eponym thing - but as an avowed eponymophiliac I could do no different :-). JFW | T@lk 23:53, 26 October 2006 (UTC)
    • I don't think the article opposes to eponyms, it just summarizes previous discussions about it.--Steven Fruitsmaak (Reply) 16:21, 27 October 2006 (UTC)
  • I don't think this article is named in accordance with the Manual of Style. Perhaps it should be moved to Wikipedia:Manual of Style (medicine-related articles). Aside from that, in my brief look at it, it looks like a great proposal. –Joke 15:45, 27 October 2006 (UTC)
Looking at other articles in the sidebar at WP:MOS, it appears that Joke is correct. Sandy (Talk) 16:00, 27 October 2006 (UTC)
Yes, and so it was moved. Thanks.--Steven Fruitsmaak (Reply) 16:18, 27 October 2006 (UTC)

Support

  1. Steven Fruitsmaak (Reply) 21:41, 26 October 2006 (UTC)
  2. JFW | T@lk 23:52, 26 October 2006 (UTC)
  3. Sandy (Talk) 23:54, 26 October 2006 (UTC)
  4. Fvasconcellos 00:09, 27 October 2006 (UTC)
  5. Arcadian 00:18, 27 October 2006 (UTC)
  6. Davidruben - but I do quite like eponyms, and think 'References' sections should come before 'Footnotes' (on basis same principle as general to more specific information when writing articles). 03:42, 27 October 2006 (UTC)
    1. I like the current order, and it conforms to WP:LAYOUT. Sandy (Talk) 16:05, 27 October 2006 (UTC)
  7. Kyoko 15:59, 27 October 2006 (UTC)

Neutral

Oppose

The proposal contains much useful information, but I am against making it a guideline in its current state. It needs major cleanup, specifically:

  • Resources need to be separated out from the rest of the article instead of being scattered throughout. You've got some useful tips like "don't use disclaimers" and "avoid citing the popular press", but in between there's these huge lists of sections & templates which break up the text and make it impossible to follow. All the do's and don'ts should be together, and the resources (infobox templates, resource templates, drug article sections, disease articles sections) should be in one place, ideally on another page.
  • Redundant information from other guidelines should be removed unless there's a specific reason why it applies to medical articles. For example, the top ten tips should not include "be bold" and "look for the appropriate category". On the other hand, I have no problem with the disclaimer tip, since that addresses a problem which is particularly common in medical articles.
  • Unnecessary detail should be removed. Does it matter if disease naming was discussed at some NIH conference in 1975? I've read that section several times and I still don't know if a Wikipedia policy on disease names exists.
  • Less of a wish-list, more of a practical guide. Is anyone going to completely re-organize a perfectly good medical article just so that the top level headers conform to the list given in this guideline? If not, is the list anything more than a wish-list that's cluttering up the page? What we need is a practical guide for the editors of medical articles, which will be used by them because they find it useful.

In short, I propose some ruthless pruning before making this a guideline. KonradG 16:53, 27 October 2006 (UTC)

I oppose the cookie-cutter sections listed. It was developed for clinical articles, and seems to fit that quite nicely. I am not convinced it works for other types of articles. For example, is the term "epidemiology" always appropriate for genetic traits? Does it make sense to talk about an "epidemic of Turner syndrome", for example? In clinical medicine, the emphasis is on symptoms as a way of obtaining the correct diagnosis, then on to treatment, and prognosis. Is that the same for chromosomal disorders, such as Down syndrome? What about general health articles, where there is no diagnosis at all? I know that Sandy found it useful to use the template when working on TS. I found it awkward for Down syndrome. TedTalk/Contributions 13:41, 1 November 2006 (UTC)

Sadly, I must agree with the above two comments. It is too much of a rag-bag at present to be worthy of officialdom. One way of trimming the size would be to move some of the useful-info to project pages (such as Diberri's tool for PMIDs). There is repetition of stuff covered elsewhere (e.g. Cite.php system). The "Other resource templates" are rarely used since many are now handled by the info box. The "Which science journals are reputable?" section is (as written) of no practical value.

  • I see someone's just removed this section. I do think there is some merit in covering how one discerns which articles to use, the types of articles there are (e.g. large scale studies, case notes, reviews), why review articles are often better than the more basic research papers as a source for Wikipedia, whether to cite the papers/books you actually read or to cite the seminal paper you've only read about, etc. Some of this overlaps the science-related articles MoS. Colin°Talk 18:00, 1 November 2006 (UTC)

I also agree the section title guidelines are still too prescriptive. What suits an infectious disease will differ to a genetic disease which differs to an minor ailment (e.g. headache). Similarly, many short drug articles couldn't possibly fill in all the sections required and may be better off not trying. The current focus encourages an RxList/Drugs.com clone rather than writing something of encyclopaedic interest to a general reader. BTW: epidemiology is fine for genetic/chromosomal disorders and does not imply an epidemic. The word encapsulates discussions of incidence (a section in Down syndrome), prevalence and risk.

If a few people want to get together to improve this proposal, then I'd be happy to muck in. Colin°Talk 16:31, 1 November 2006 (UTC)

I am not totally clueless. I do understand the use of epidemiology in some circles for genetic disorders (mostly from the clinical side). I see both uses in the medical/research literature, although mostly "incidence" for the journals I scan. It may not be the best example. The question was, "should clinical terms be used in all cases, in particular with all genetic disorders?" Is a "clinical bias" always the best way? What happens for articles that span interests? Remember, medical genetics and human genetics do not have the same viewpoints. I tried looking at Down syndrome and how it could written with the clinical medicine format, but it simply didn't work. Of course, that could also simply be my own inadequacies. TedTalk/Contributions 20:24, 2 November 2006 (UTC)
Appologies to Ted. I misunderstood your example. Colin°Talk 23:12, 2 November 2006 (UTC)

Oppose in current state per above, needs cleanup. In particular, I disagree with the "Ensure your language does not cause offence" section. It currently advocates avoiding certain standard English constructions; it smells of political correctness. People can be epileptic, contrary to what it claims. Pcu123456789 19:33, 28 January 2007 (UTC)

It is worth pointing out that the article has changed considerably since this guideline was first "put to the vote". It would certainly need a new round of opinion-seeking and the more views put forward, the better. Colin°Talk 22:30, 28 January 2007 (UTC)
It does still need some work - I reverted some massive changes earlier today - some of them were good, but the changes went too far without talk page consensus on several issues. SandyGeorgia (Talk) 22:40, 28 January 2007 (UTC)

eMedicine/PubMed References

Hi there; been editing several articles within medical fields, but there's some strange happenings with some articles with regards to PubMed and eMedicine articles. The majority of information that can be gotten publicly through these resources is not enough to get a rounded article on such a matter, due to the lack of figures attained during a study or experiment, aims and soforth.

While eMedicine does provide full figures and analysis, some features require an eMedicine subscription, as well as the majority of articles having information which has not been updated for several years; making verifiability somewhat more difficult. I admit that the current situation on Journals makes it difficult to get detailed information, particularly for people who are researching outside the confines of doctor-hood or medical school.

I think there should be a guideline section for eMedicine/PubMed/Public Journal site which encourages people to use the full data and results if possible, particularly avoiding some PubMed articles if the only information is a summary, albeit somewhat vague. This would make it much easier.. particularly in rapidly improving fields to mark both the validity and change of results over months, years and so on. JCraw 16:21, 2 November 2006 (UTC)

Reformatting this article

At the risk causing further trouble, I've had a go at reformatting this article at Wikipedia talk:Manual of Style (medicine-related articles)/temp. I've examined the other MoS articles and attempted to follow their example in terms of style and scope. This is a style guide, so, for example, discussions of verifability, choosing reliable sources, and notes on "how we got here" don't belong. Such details should either be included in existing policy and guideline articles or incorporated into other Project guidelines and essays. I've removed stuff that is repeated or covered in greated depth elsewhere. I've condensed the big tables and removed the cookie-cutter text. Naturally, I've taken the opportunity of introducing my own opinions and don't expect everyone to agree. I welcome your opinions. Steven Fruitsmaak is apparently enjoying a holiday so I'd certainly like to wait for him to return before making any substantial changes to the article proper. Colin°Talk 23:12, 2 November 2006 (UTC)

There was no need to wait, this should be improved and edited by any one of us. I appreciate the efforts but I feel that to much valuable information was left out in that new version. I'll look at the concerns outed (thanks for that feedback btw!) and try to address some of them.--Steven Fruitsmaak (Reply) 20:49, 6 November 2006 (UTC)
I've had a go at it. Could someone fix the nutshell layout? Please comment.--Steven Fruitsmaak (Reply) 22:23, 6 November 2006 (UTC)
I've removed "Diagnosis", "Treatment" and "Prognosis" from the quick list of sections for drug articles, and added "Indications" as per my comment above. Fvasconcellos 23:59, 6 November 2006 (UTC)

New edition

The new edition has dealt with some comments:

  • Do's-dont's and resources have been sorted
  • Huge lists and boxes reduced and some content moved
  • The nuance of "clinical articles" was introduced for the sections. Anyway, the sections are not ment as a straight jacket but as a guide for users who seek advice.
  • Parts of Colin's version were added and edited.

A major point for me remains the "sections for drug articles", because there seems to be no consensus -Colin's version looked totally different from the original. I think we can do 2 things: (a) mention that this is just a suggestion and should not be inforced too hard, or (b) move this to WP:DRUGS and let them discuss about it.

Comments please, and please, just go ahead and edit the thing to make it better!--Steven Fruitsmaak (Reply) 20:38, 7 November 2006 (UTC)

You've been busy! I am pleased my suggestion didn't end up a complete waste of time. I'm afraid I don't have time today to have a thorough look. I'm not sure about the top level split into "Issues for medical articles" and "Resources". I think the split we need is between style (goes here) and other guidance (goes into a new article). One obvious topic for other guidance is the choice and usage of sources for medical articles.
The drugs section list in the alternative version is pretty close to Wikipedia:WikiProject Drugs/General/Main sections of drug page and I think is more widely used. Some of the sections in the cookie-cutter example aren't actually used widely (a couple appear as lower-level headings only on paracetamol). I'm not sure WP:DRUGS is active enough just to dump it on them - and there is a lot of overlap on membership anyway.
I ask those who have written lots of medical articles, to have a look at the collections in your braglists and compare them to the section headings we're proposing as guidelines. Many articles are < a screenful of paragraphs with only a few sections. I'm really not convinced that the best way to start an article is with the skeleton of a Featured Article. It can take months to get enough material or contributors to fill in all those sections. Also, I'm not aware of other WProjects that mandate a set of headings. It's like the biography project insisting you have a "School Years" section. I'd like to downplay them as just suggestions, and also for us (as a project) to highlight some of our better articles so people can learn by example.
When I get some time, I'll have a fiddle with it. I was put off making significant changes since a bunch of folk I highly respect said they were happy with the current version (plus doing it whilst you were on your hols seemed improper). Colin°Talk 21:59, 7 November 2006 (UTC)
I understand that the resources are not a typical part of a MOS: should we move them to an essay elsewhere then? Or a WikiProject Subpage? On the other hand I feel reluctant because the use of the templates can be promoted this way, which is a way of promoting uniformity, which is a genuine MOS-activity.
I totally agree that we don't need to emphasise on the headings: I don't think that, for example, articles should be kept from FA-status because they have other headings: if this isn't stressed enough in the current version, feel free to change it! I wasn't aware of that subpage of WP:DRUGS, the current edition shows my personal interpretation, but indeed for most articles this is over the top, and we shouldn't introduce things that aren't used out there: I'll refrain from further editing, this should be left to people who have more experience with drug articles, like you Colin.
--Steven Fruitsmaak (Reply) 13:16, 9 November 2006 (UTC)
I've had a fiddle now. I've shifted the stuff on reliable sources to Wikipedia:WikiProject Medicine/Reliable sources but kept the templates, which I agree are useful here. This new project guideline article is currently very much just a dump of the text I removed – there is a lot that can be done to that. Basically a rewrite and major expansion.
I think I've got a compromise wording on the sections and the notable cases sections. I've moved the order of sections to match the order of a real article. I've trimmed the nutshell so that it really is a nutshell. I truely don't think I've thrown anything important away (that isn't covered elsewhere - and there are plenty pointers as to where else to look). Off to bed now ;-) Colin°Talk 00:29, 10 November 2006 (UTC)

Dramatic changes without discussion

Practically abandoned? What is that about? If a guideline is working, why would we expect a lot of edits? A huge amount of changes out of nowhere. Back in November, we had a nice chart of sections, and some very good info - the guidelines have lost most of their substance, and this one took away even more. Time to get moving to fixing this. There are some good changes in the above revision, but some very bad ones which go against consensus. Unless there's disagreement, I'll revert it again, based on no discussion or consensus, and would like to bring back the helpful description of sections lost back in November. SandyGeorgia (Talk) 17:40, 30 January 2007 (UTC)

I was traveling during a big chunk of November - can anyone tell me why we lost the helpful section descriptions we had a while back? SandyGeorgia (Talk) 18:14, 30 January 2007 (UTC)
The section descriptions got lost in this edit. They were replaced by a list of headings and a link to boilerplate text. Neither contain the comments or example column text from the old table. I don't know why Steve removed them but I don't particularly mourn their loss. However, I've no objection to (re)adding comments if they are useful. I'd be interested to know which ones were. I think some of the guidance was obvious to anyone competent enough to populate a section, or repeated standard MOS stuff.
Some of the non-style content concerning choosing medical sources has been moved here: Wikipedia:WikiProject Medicine/Reliable sources and is linked to within this guideline (but probably too in too subtle a fashion). I'm not sure whether that page could be expanded in its new position, or folded back here. I think it deserves to be a project guideline but isn't strictly speaking a MOS issue.
The above talk page descriptions + studying the history should explain what went on last November and the rationale behind the changes. Most of the edits were by Steven and I. Despite several requests at the time, nobody else joined in, which was disappointing. I'd very much welcome further discussion and work on this, to bring it towards being an accepted guideline. Please bear in mind that many medical articles will be short and never reach featured status. In addition, there is huge range of topics covered by this project, not all of which fit a particular model. Colin°Talk 20:17, 30 January 2007 (UTC)
Yes, I'm sorry I was traveling, Colin, as I cared a lot about this page. OK - my perspective, and why I found the earlier version invaluable. When I first came to Wiki, I pestered the Medicine Project for help, and with a few exceptions, I got little. I knew what needed to be said, and I knew how to reference it, but I didn't know how to structure it and I didn't know the medical lingo. I'm a layperson - the guide was utterly invaluable in helping me churn out an FA, with little other guidance. My concern is that by losing so much of it, we make it harder for laypersons to contribute to good medical articles. Thoughts? Maybe I'm the only layperson fool who tried to write an article on a medical topic, but a lot of what was there wasn't obvious to me when I started out :-) (PS - we don't seem to mention the PMID template?) SandyGeorgia (Talk) 20:49, 30 January 2007 (UTC)
What I was trying to achieve was a professional MOS-style guideline page in keeping with other formal WP guidelines. If we want this to be accepted by WP, then we will have to alert a wider circle of reviewers, who I think would criticise any informal untidy bits. Other Wikiprojects have project pages that don't try to be a formal MOS guideline. For example, WikiProject Biography has a step-by-step guide on their homepage and also a separate Manual of Style. The WikiProject Medicine/Reliable sources page was an attempt at such a "useful" project page. It hasn't had any support, despite "choosing and using reliable sources for medical articles" being a common project issue. How about starting a project page for informal guidance in medical article creation? We could all muck in without worrying about changing an approved guideline. The WikiProject Medicine homepage could be reformatted to point at these project pages more directly.
Re: PMID. Do you mean PMID 15199035 rather than PMID 15199035? I prefer the latter since the ID is actually useful (like an ISBN or DOI) compared with many of the numbers you see in the Disease Infobox. It is also the format produced by diberri's excellent template filling tool. I've added it to the page anyway. Colin°Talk 21:55, 30 January 2007 (UTC)
I prefer the latter as well - I was just coming to ask why we don't link to Diberri's tool? I'm not really following wrt the informal bits - were the descriptions of Section headings we had before too informal? SandyGeorgia (Talk) 21:58, 30 January 2007 (UTC)
The tool is mentioned four times (DrugBank, HUGO, PMID and ISBN)! See the "Info boxes" and "Citing medical sources" sections where it says "enter the ID in this page". Regarding content of the MEDMOS, I can only suggest you look at other examples on WP, as I did, to see the sort of thing they contain. For example, the Biography MOS page doesn't mandate you have a "School years" section, nor does it suggest what might go in it. BTW, of course you are are not the "only layperson fool who tried to write an article on a medical topic". There's at least two of them. :-) Colin°Talk 22:17, 30 January 2007 (UTC)
Well, maybe I'm the one with the oldest eyes :-) Looks like I'd better do my usual - print it out to read it carefully, 'cuz I miss too much on the computer screen. And, I'll go back to the older versions to see what was there that I'm really missing now. How do we feel about the deletions of our info about Notables? I thought we'd nailed that down by consensus, and were doing a good job in that area. SandyGeorgia (Talk) 22:31, 30 January 2007 (UTC)
Erm. The "Notable cases" section is longer, not deleted. It contains "see also" rather than repeating or trying to explain other guidelines. The old text was a good example of inappropriate text for a guideline: "An option that might satisfy everyone..." and "Maybe ... is a better header." Colin°Talk 22:53, 30 January 2007 (UTC)
No, I'm referring to the deletions/reverts in the last two days - someone has been changing to NO notable cases should be mentioned.[3] SandyGeorgia (Talk) 22:56, 30 January 2007 (UTC)

(Unindent). The diff you mention is a rvrv of the one by Wryspy here. It looks remarkably like a revert back to the Revision as of 22:10, 9 November 2006, with the line "Ensure your language does not cause offence." removed. See this diff. I'm not sure if the author intended to revert that far back, or actually just wanted to remove that one line. Colin°Talk 23:32, 30 January 2007 (UTC)

What I'm asking about is the proposal in the new edits that mention of notable cases should be completely absent, and the removal of our guidelines on notables - I thought we had consensus on that? SandyGeorgia (Talk) 23:38, 30 January 2007 (UTC)
You've lost me a bit. I'm not particularly concerned about the edit two days ago since that appears to be either a mistake or a (more or less) revert back to an older version the editor preferred the look of. The current version is identical to the 19th Nov (apart from my recent PMID edit). I don't see any significant removal wrt notables. The one thing I have now spotted is the Nutshell line saying "Avoid trivia sections such as lists of notable cases." which has been there since my edit of Nov 9th. It previously said "A notable cases section should be absent in most articles and is sometimes hard to deal with.", the first half of which is the text from the original guideline. Do you think the nutshell line is too hard? It probably is. Could "avoid" be reduced in strength? The existing guideline: Avoid trivia sections in articles applies, I think, to notables sections in articles. They fall into all the same traps. Unless you're prepared to keep the article in a watchlist and delete all the George Bush and my mate Kevin entries, it becomes a mess. Colin°Talk 00:22, 31 January 2007 (UTC)
I'm getting frustrated here :-) I'm looking at an edit history of two substantial rewrites to the guideline in the last two days, both of which were reverted and need to be discussed to develop consensus. It seems like we're not talking about the same thing at all - don't know what else to do other than wait to see if the same editor(s) again make the changes, and discuss it then. SandyGeorgia (Talk) 00:43, 31 January 2007 (UTC)
There were no substantial rewrites in the last two days, only reverts. I don't see anything worth discussing.:
  • 19:57, 19 November 2006 Stevenfruitsmaak – Minor edit made at end of November's changes.
  • 08:19, 28 January 2007 Wryspy – Massive revert back to 22:10 9th Nov (with one line removed also).
  • 13:58, 28 January 2007 SandyGeorgia – Revert of above.
  • 17:34, 30 January 2007 KonradG – Revert of above (hence identical to Wryspy)
  • 18:05, 30 January 2007 Arcadian – Revert of above (hence identical to SandyGeorgia, and also 19th Nov).
Let's move on. Colin°Talk 09:13, 31 January 2007 (UTC)

Comment. I can't comment on all of Wryspry's changes, but I very much agree with some of them, especially the removing of the line "Ensure your language does not cause offence." That line is at variance with one of Wikipedia's core policies, that Wikipedia is not censored. Heck, if we went by, say, Christian Science standards, lots of medicine related articles could potentially be offensive and false. Obviously, language shouldn't gratuitously cause offense... but I'd call that more common sense, and specified in the general Manual of Style. On the subject, I know that Colin's already posted there, but at Wikipedia:Categories for discussion/Log/2007 January 27#Category:Diabetics, there was a reasonably strong consensus that standard English should be used and not necessarily "person first" terminology. I'm not saying that "person first" won't be right sometimes, too; just that the standard term should be used (notably, some deaf people strongly defend being "deaf" rather than "a person who can't hear"). Unlike most other parts of science, precision is not normally an issue here; "diabetic" does in fact mean "being affected by diabetes" (and so on for other conditions), so there's no loss of accuracy by using the common term.

Anyway, I'd propose that the section in question be rewritten to say something like "Choose language with care." rather than "don't cause offense." I'd also be in favor of removing/replacing the claim that diabetic, epileptic, etc. "define a person by their medical condition." I guess it could be replaced with "use precise terms" or "different conditions are referred to in different ways," but those both seem like truisms.

Comments? SnowFire 03:35, 8 February 2007 (UTC)

Can I just repeat: Wryspry's "changes" were not carefully crafted edits. It was a revert back to the Revision as of 22:10, 9 November 2006, also with the line "Ensure your language does not cause offence." removed. Other than that line, I don't regard the other changes as worth discussing, especially since there was no edit summary.
I have no problem with rewording that phrase if it upsets certain editors. I think the above-mentioned debate on "diabetics" is worth reading. A few points here:
  • The censorship argument is irrelevant. See the guideline on Wikipedia:Profanity (clearly this isn't profanity), which says "Words and images that would be considered offensive ... by typical Wikipedia readers should be used if and only if their omission would cause the article to be less informative, relevant, or accurate, and no equally suitable alternatives are available." It goes on to day (wrt to discussions) "Words like ... "censorship" tend to inflame the discussion and should be avoided."
  • There was no "consensus that standard English should be used". The notion that an encyclopaedia should use "standard English" is something I find quite baffling. I expect it to use "professional English".
  • The debate ended on no consensus to change. That discussion focussed on one term and only proved that there was no appetite to force a rename for that term only. It failed to provide guidance on what phrase you would use if you were creating something new. To be honest, I think asking editors with no experience (either as patient, caregiver or profession) to give an opinion is somewhat pointless. It is like asking me when the word "Eskimo" should be used. We should emulate the style guides and recommendations used by charities, medical journals, quality newspapers, etc. I quoted some of those in the above debate.
Colin°Talk 09:59, 8 February 2007 (UTC)
Glad to hear you have no objection to rewording the offense phrase (assuming that's what you're referring to). Didn't realize Wryspry just reverted; I assumed it was a long set of changes. As for the other comments:
  • I mentioned this in the previous debate, but by "standard English" I am not in any way implying "low" or even "middle" English; I do mean "professional English" or whatever nice adjective you want to stick next to it. However, even among professional/cultured/high/etc. English, there is not always agreement on what terms to use- heck, famously there's the bevy of UK/US differences, not to mention random other regional variations and clashing style guides. So by "standard," I mean "the clearest and most commonly used terminology among formal English" and not "slang." (Although that said, I also agree with the style guide that given two equally precise terms, the one that the general audience would understand should be used in preference to the "medical" term, or else both terms should be used.)
  • I don't find the analogy to the Profanity guideline particularly relevant since as you say this issue "clearly isn't profanity."
  • If the issue was proper medical treatment for a disease or why a disease would occur, I'd agree with you in a heartbeat. However, one of the very rare issues where a poll of random educated people is exactly what you want rather than an "expert" is language usage, since language usage is inherently socially defined. Pretty much all of the opposes said things like "The current names are normal English" or "is standard English" (quotes from users other than me); such rationales would imply that the normal English should be used for any condition, not just diabetes, as no specific claim was made (again, except when precision would be lost). That's pretty much the guideline that Wikipedia has used; note that the article on opposition to Judaism is at anti-Semitism, not the more "correct" anti-Judaism (well, actually they both have articles, though the anti-Judaism is from a more scholarly and religious perspective). And that's a case where the article's term flagrantly implies the wrong thing.
Again, I'm not asking for the style guideline to prescribe the reverse position (never use person-first teminology! Bwahahaha!), but merely to be neutral on the issue and let each case be decided on its own merits and usage. SnowFire 23:02, 8 February 2007 (UTC)
SnowFire's suggestion seems reasonable to me. There's no clear benefit to getting involved in this mess. These style guides exists to make Wikipedia more effective in its main goal, which is communicating information to the reader. If a style issue doesn't concern that effectiveness, it's moot. KonradG 17:33, 9 February 2007 (UTC)

Turning practical and specific pointers to vague

I've noticed there's a tendency to take practical tips and rephrase them until they become so vague that they're no longer helpful. Sometimes the intent is to make the example more general, and other times it's just to rephrase instructions so they don't sound like orders. There's nothing wrong with having clear instructions in a guideline. In fact, if it only contains a bunch of definitions, but doesn't tell you what to do, then what use is it? People can look up words in a dictionary. Nobody is forced to follow the guideline, but removing clear terms like "do this" and "don't do that" means we end up with sentences so vague that they simply end up being removed in subsequent edits.

I know that the original edits were overly long, but you gotta at least explain what and why. Compare the versions on the left and the right:

Many common words or phrases have one meaning in general use, but a different meaning when used in a medical context. (...) As a general rule, easily confused terms should be eliminated altogether when they can be rephrased in clearer words. Some examples of such terms include:

Some terms can be are open to misinterpretation and should be wikilinked, avoided or carefully explained. Medical usage can sometimes differ to that of the general public.

Approved/Indicated - Approval is a legal issue, indications are a medical one. A drug can be approved for one use but be indicated for several others. These two words are often confused by editors, and even if used correctly, are likely to confuse the reader. Unless specifically discussing regulatory issues, there is little value in using either term over a plain-English description like "common uses".

"Off-label" refers to the use of a drug for a purpose other than which it was a approved for. Unless there is something unusually significant about a drug's regulatory status, such information is of little encyclopedic value and is often copied from the package insert.

Drug usage can be "approved", "indicated" and "off-label". Approval is a legal issue, indications are a medical one. A drug can be approved for one use but be indicated for several others. Off-label use is not an illegal activity.
Drug abuse - The legal view of drug abuse includes any illegal drug use (...) Needless to say, that does not match the DSM definition of drug abuse, nor the intent of the term as it's used in popular culture.

(blanked)

Notice that the original contains specific examples, and each one tells you what should be done and why. It's intended to clearly state, "DO NOT USE THESE TERMS BECAUSE THEY ARE GUARANTEED TO BE MISUNDERSTOOD". Saying, "medical usage can sometimes differ to that of the general public" is perfectly true, but misses the point. The second example is shortened down to the definitions of some words, but omits the reason why those words are being defined. If you read the sentence, "Off-label use is not an illegal activity", your likely response is "so what?". The point is, if you see this term, it's probably because it was copied from a package insert, which was written by a committee of lawyers. KonradG 04:21, 14 February 2007 (UTC)

Examples can be helpful, but these examples aren't IMO. I don't see how one can have a serious article on drugs without using the terms "licensed", "approved", "indicated" and "off-label". You don't offer alternatives. These are words I see in my newspaper. They are not obscure jargon. Where words are genuinely ambiguous, and alternatives exist, then yes they should be avoided. If readers might not understand words, they should be wikilinked.
I don't understand the comment about "off-label" being copied from a package insert. In fact, "off-label" usage is the one thing you won't find on a package insert (UK perspective here). Discussing whether something is of "encyclopedic value" isn't relevant to this section in MEDMOS. The section on Drugs already warns against just copying data from drug formulary web sites, for example. Colin°Talk 09:19, 14 February 2007 (UTC)
These words, (apart from the word 'indicated', for which I offered an alternative) are always ambiguous in the context of a drug's medical use. They are all legal terms which are only meaningful in the very narrow context of drug regulation in a specific country. You say they're not obscure jargon, but that's exactly my point -- they are common words which also happen to have obscure meanings when used in a certain context. Consider a statement such as, "Prozac is not approved for the treatment of OCD". Is there any doubt that the word 'approved' will be misunderstood by most readers? How about you show me an article or two where you think these words are necessary, so I can give you an example of how misleading they are even when used correctly. KonradG 19:45, 15 February 2007 (UTC)
Your example of Prozac is fine. In what way would the word be misunderstood? The dict def of approved: officially acknowledged as satisfactory". Colin°Talk 22:01, 15 February 2007 (UTC)
Exactly. "Prozac is not officially acknowledged as satisfactory for OCD", clearly sounds like a statement about what the drug does, while the approval in question concerns how the drug may be marketed. How many people would guess that the statement is about an advertising restriction? KonradG 02:36, 16 February 2007 (UTC)
A drug cannot be "approved" to be marketed for something unless there are studies that show it is "satisfactory for" treatment and that those studies have been "officially acknowledged". You know this. I know this. Where's the problem? "Approved for" is clearly a subset of "indicated for" where the standards are higher and regulation/cost/etc are factors.
I don't think the MEDMOS should limit encyclopaedic mention to just say "commonly used for". The fact that certain drugs are used outside of their licence is of interest. Perhaps someone else can share in this discussion, since we seem to read different things into those words. Colin°Talk 08:57, 16 February 2007 (UTC)
Before I get to that, let me be extra clear on meaning of the terms we're using here. Drugs cannot be "used outside their license", because FDA approval is not a license for drug use, but for drug manufacture. A drug is said to be approved for a use, because the license happens to include restrictions on how that manufacturer may advertise it. It covers only production, since the FDA does not have the authority to regulate the practice of medicine.
So that's the problem with stating that, before Prozac was approved for that use in 2003, it was "not officially acknowledged as satisfactory for OCD". It's plainly not true as a statement about *medical* officials in general. All it really means is that when the original patent expired, the manufacturer expanded its marketing campaign by getting official acknowledgement from the agency responsible for regulating marketing by drug manufacturers. But it sounds plain silly when you write it like that, because it makes it obvious that you're describing something fairly trivial. KonradG 20:45, 16 February 2007 (UTC)
(unindent) Well maybe this is a US/UK thing? In the UK, the licence affects prescription practice, not just marketing. As such, one may find a hospital consultant/specialist will prescribe a drug that the patient is, one month later, unable to get on prescription from their GP – because the GP is not prepared to go outside of the licensed indications. In addition there is NICE, who appear in the newspapers when their guidelines affect whether healthcare trusts will prescribe the latest unproven medications, or expensive medications that have yet to prove themselves superior to established ones. I imagine there is something similar in the US with insurance companies not paying for some medicines.
I agree there is a gap where drugs probably are (and may be widely regarded as) effective and yet are not (yet) licensed. There are also many such drugs being used for which there is actually no solid evidence. I'm sure the UK WikiDocs can explain this better than me. It is not "something fairly trivial". Colin°Talk 21:29, 16 February 2007 (UTC)
I'm not saying the whole issue trivial, just the amount of useful information the reader gets from it. If you need a doctor to explain it, how can you expect the average reader to learn anything non-trivial from a statement that X is not approved for Y? It's far more likely that "not approved for" will be interpreted to mean that a certain use is illegal. And for all I know, that could be what it means in some countries. Which is exactly why medical articles should avoid country-specific regulatory terms which look exactly like common English words. And that's why I provided a small list of such words, and why it's a bad idea to keep the list but remove the part that says what it's a list of and why those terms appear in it. KonradG 01:12, 17 February 2007 (UTC)

Removal of guidelines careful language

The following lines were removed by Snowfire:

I don't see why the second guideline was removed. It wasn't discussed. It contains much standard advise on careful language when writing about medical conditions.

As for removing the first guideline, I'm extremely disappointed at the lack of participation in discussing MEDMOS. Perhaps the talk-page section title didn't help? The first guidelines is overwhelmingly supported by professional and charitable bodies (I can supply refs if required). I don't believe MEDMOS should be "neutral on the issue". Snowfire - you've just come from a discussion on "Diabetic" where I accept there isn't strong felling against the term (though both Diabetes charities and journals disapprove of the term as a noun). However, there is no strong feeling for the term. If it is possible to write articles in a clear and no-clumsy way without causing offence to people-groups then that should be done. One way of doing that is to advocate person-first as a preferred writing style. Colin°Talk 09:09, 14 February 2007 (UTC)

Update: I've reintroduced the above, in a slightly different form, and supplied some contrasting views too. Colin°Talk 18:55, 8 March 2007 (UTC)

Naming conventions

I'm not sure why this proposal requires the exact opposite of Wikipedia:Naming conventions and Wikipedia:Naming conventions (common names). By advocating the technical rather than the common name for articles, this proposal makes it more difficult for the lay reader to find information and makes it virtually certain that most links to a page will be via redirects rather than direct linking. For example, I would guess that linking to [[heart attack]] would be much more common than linking to the obscurely named myocardial infarction. The average Wikipedia editor (let alone reader) probably has no idea what an infarction is, let alone a mycardian one! In my opinion, this section of the proposal seriously needs to be rethought. There is no reason the page shouldn't be at [[heart attack]] with a lead sentence such as, "A heart attack, technically known as a myocardial infarction, is a medical condition blah blah blah . . . ." In situations where there is little or no chance of ambiguity, the common name should trump the technical one. — Brian (talk) 22:31, 18 March 2007 (UTC)

Thanks for your contribution. It isn't the complete opposite. See Wikipedia:Naming conventions (common names)#Do not overdo it. It is an attempt at precision because the lay term is often inadequate or varies for different readers. You may be interested in Wikipedia talk:Naming conventions (common names)/Archive 01#Naming conventions for medicine and Talk:Myocardial infarction/Archive 2#A mass-redirect question. Both discussions occurred when the page was [[heart attack]]. It was moved shortly afterwards.
The "Common names" convention isn't as absolute as it sounds. Drugs are named after the generic International Nonproprietary Name rather than a brand name you may be familiar with. You'd expect an encyclopaedia to be somewhat erudite – I wouldn't want articles called flu or plook. Colin°Talk 23:10, 18 March 2007 (UTC)

This is of relevance only to diseases that have lay terms associated with them. There is no lay term for POEMS syndrome, and some lay terms are simply unencyclopedic (flesh-eating bacteria for starters). In some instances, lay terminology is so precise that it was thought to be the appropriate title (see stroke).

The problem of accuracy was felt particularly on [[heart attack]], which is used by the public for anything between an acute coronary syndrome, sudden cardiac death, cardiac arrest due to secondary causes etc etc and so on. I see no reason to reverse this pattern. JFW | T@lk 23:21, 18 March 2007 (UTC)

If "heart attack" can mean all of those things, then [[heart attack]] should be a disambiguation page. In other words, I don't see that as an argument against using lay terms; I support the use of more technical terms where the lay term is ambiguous, provided appropriate disambiguation practices are followed. — Brian (talk) 01:20, 19 March 2007 (UTC)

Historical ?

Goodness, Radiant, just because we all got busy elsewhere and failed to finish up something that's almost there? OK, what else do we need to do? List—anyone? I'll add my comments later tonight or tomorrow as I have time. How about if we discuss, finish, then poll for support again? SandyGeorgia (Talk) 15:12, 5 April 2007 (UTC)

Well, I must say consensus may not have been reached, but discussion is certainly ongoing, and this (proposed) guideline is frequently cited. I say let's revive, discuss any points of contention, and finish this already! Fvasconcellos 15:21, 5 April 2007 (UTC)
Well, I don't want to irritate Radiant :-) Should we revive then discuss, or discuss then revive ? I feel badly that I dropped the ball several months ago due to travel, while Colin had done lots of work. SandyGeorgia (Talk) 15:23, 5 April 2007 (UTC)
I think we're OK to revert back to a proposal as long as activity resumes and also quickly seek "broader input via a forum such as the village pump". I'd rather we had some indication of project consensus before going that public. Colin°Talk 15:32, 5 April 2007 (UTC)

Forget the village pump. I think there is broad consensus about the general way in which medical articles should be organised. They should be inclusive yet easily readable by someone who bothers to check cross-referenced terminology. They should take the patient as the starting point (hence my insistence on using "Signs and symptoms" as the first section) followed by diagnosis, pathophysiology, treatment, prognosis, epidemiology and historical facts. I'm quite happy voting this into a guideline. JFW | T@lk 16:00, 5 April 2007 (UTC)

If others agree, I'm OK with reviving it while we discuss; I agree it did enjoy consensus, even though we dropped the ball on the final push and poll. SandyGeorgia (Talk) 16:05, 5 April 2007 (UTC)
I've just bumbled in here: to understand the issues, it would be appropriate to display the ongoing discussion here, in one body. Is that possible? Tony 03:08, 6 April 2007 (UTC)
Sorry, you lost me—I archived the talk page today, is that what you're referring to? SandyGeorgia (Talk) 03:36, 6 April 2007 (UTC)

Reliable sources, dmoz and forums

I'd also like us to decide what to do about Wikipedia:WikiProject Medicine/Reliable sources. Is this useful? If so, should it remain where it is and be better linked to from project pages? Or should be fold it into MEDMOS even though, strictly speaking, it isn't a "style guide" issue? Colin°Talk 15:32, 5 April 2007 (UTC)

Whatever we decide, I'd like it to be more prominent. We can't have medical articles written based on AnyJoeBloeWebsite.com or SupportGroupforConditionX.com; also, I need to review if we've said something about {{dmoz}} because I get so tired of pruning EveryDarnSupportGroupInTheWorld from External links. SandyGeorgia (Talk) 15:35, 5 April 2007 (UTC)
Agree, though some organisations do have high quality patient/professional resources that I do think meet WP:EL. They should be linked directly rather than just to the home page. BTW, the Reliable Sources page has a shortcut from WP:MEDRS but this isn't obvious since the "historical" header removed that info. Colin°Talk 15:42, 5 April 2007 (UTC)
My thought is that, if they're already in the DMOZ link, we don't need them. If it meets EL and isn't at dmoz, we can include them, but someone should really submit the link to DMOZ. Example: Tourette Syndrome Association meets RS and EL, and is an organization recognized worldwide, but I don't include its link at Tourette syndrome. If an org is that important, it should have its own article—Tourette Syndrome Association—in which case, it's a See also and not an External link. SandyGeorgia (Talk) 15:46, 5 April 2007 (UTC)
Where are we on forums? I've seen a few over time and usually nuke them on sight, but I'm always afraid of incurring the wrath of a well-intentioned editor... Do we have a definitive position on this? I don't believe WP:EL mandates avoiding them. Fvasconcellos 15:52, 5 April 2007 (UTC)
I nuke on sight; don't meet WP:RS, and should be at the dmoz link. SandyGeorgia (Talk) 15:57, 5 April 2007 (UTC)
Excellent, then; if you and JFW agree that's more than enough. Fingers will remain poised on Large Red Button. Fvasconcellos 16:04, 5 April 2007 (UTC)
Do we mention it in our RS? I'll read everything again and catch up tonight. SandyGeorgia (Talk) 16:06, 5 April 2007 (UTC)

Reliable sources extends to the sources we use for articles. I usually rely on a recent review from a high-impact factor journal to give the article body, then add additional references of particular relevance as I go along. I never use textbooks, as they tend to be unnecessarily concise. For the scientific content, newspaper and magazine sources are rubbish. For popular/historical sections this may be better. JFW | T@lk 16:00, 5 April 2007 (UTC)

With respect to forums, I shoot them on sight unless there is overwhelming evidence that it is the only place on the web where the vast majority of online patients tends to congregate. So far, none have met these criteria. Forums serve to perpetuate WP:CB about DCA and stuff. JFW | T@lk 16:00, 5 April 2007 (UTC)

Fvasconcellos – did you ask wrt EL or RS? Forums are Number 10 on "Links normally to be avoided" at WP:EL. However, the guidelines on what External links to provide is perhaps a separate issue from what Reliable sources to draw on. And again, this isn't a style issue. Where should our EL guidelines go? If you look at Category:Wikipedia guidelines there are other guidelines than just style. For example, Wikipedia:WikiProject Video games/Article guidelines. Should we have a more general Wikipedia:WikiProject Medicine/Guidelines (MEDGUIDE?) that contains MEDRS and/or links to MEDMOS? The Wikipedia:WikiProject Biography have loads of separate guidelines. Colin°Talk 16:12, 5 April 2007 (UTC)

I was asking specifically with regard to EL, and, man, do I need to catch up on my guidelines; sorry about that. I do think they are separate issues, but it would be nice if this guide could cover ELs and RSs as applied to medicine articles, even if that is not a stylistic issue. Do you think this would stray from the guideline's purpose too much? Fvasconcellos 16:35, 5 April 2007 (UTC)
Pros and cons of including that kind of info here or elsewhere; if we add it here, we need guideline consensus on one page, if we place it elsewhere, we have to reach consensus on several pages. Not sure which process will be better, easier. IF any one point is holding us up here, I guess we could make it a separate page, so we can get this done ? I'm trying to think in terms of expediency now. SandyGeorgia (Talk) 16:15, 5 April 2007 (UTC)

Top level headings

See Wikipedia talk:Manual of Style (medicine-related articles)/Quick lists for table showing the usage of top-level headings on 16 of our featured articles on diseases. Colin°Talk 17:10, 5 April 2007 (UTC)

Hey, I tried my best on the Asperger FAR; they resisted :/ SandyGeorgia (Talk) 17:14, 5 April 2007 (UTC)
(PS, Colin, can you restructure the table in any way that is more printable?)
Done. Two tables of 8. Should fit landscape? Colin°Talk 17:34, 5 April 2007 (UTC)
((PPS, oh my, Prostate cancer needs WP:MSH help, MEDMOS notwithstanding!)) SandyGeorgia (Talk) 17:19, 5 April 2007 (UTC)
Oh yes. Noticed and on it. Fvasconcellos 17:21, 5 April 2007 (UTC)
So, WP:EL WP:NOT prune while you're in there—I'll go see if I can dig up a dmoz link :-) SandyGeorgia (Talk) 17:23, 5 April 2007 (UTC)
Heh. Reference mech consistency as well, the lead is full of external jumps... Work calls unfortunately, I'll rejoin the discussion later this evening. Fvasconcellos 17:24, 5 April 2007 (UTC)
I fixed, but one's a dead link. (Do I sense a Medical FA surveillance and improvement committee in the works—or can we get MCOTW to spend a few weeks cleaning up FAs :-) SandyGeorgia (Talk) 17:45, 5 April 2007 (UTC)
Dead link verified for accuracy and "fixed" courtesy of the Wayback Machine. Fvasconcellos 23:47, 5 April 2007 (UTC)
Re-thinking, I don't want to get distracted onto individual articles when we need to get consensus on these guidelines. We've (I've) put it off too long already. But when we do, maybe we can use the MCOTW (Medical Collaboration of the Week) to focus on FA cleanup. SandyGeorgia (Talk) 23:58, 5 April 2007 (UTC)

Drugs

I've had a look at the headings for drugs and there is very little consistency amongst articles. Also there are differences between this style guide, the boiler-plate text and WikiProject Pharmacology's Style guide. I suggest that for now, there is no consensus as to the best top-level-headings and their order. Any listing in the style guide should therefore be purely suggestive rather than enforcing. Here's an alternative, shorter list. The headings are wikilinked here for convenience but should not be linked in any actual article:

Alternatives for the "big words" would be good, but I haven't found any that satisfactorily replace them. A recent discussion on WikiProject Medicine on "Rx Dosage Instructions in Wikipedia" indicated that we should not give the dosage. I agree with this. It is not encyclopaedic or relevant to the general reader, and is subject to vandalism by anons. It is straying into giving medical advice. Some aspects of dosage may be notable. For example if one drug is much more effective than another so can be taken in a lower dose. Another example is where a drug must be taken three or four times a day and compliance then becomes an issue. These examples may find a place in the History section when discussing why this drug is an improvement or has been replaced. Colin°Talk 13:01, 10 April 2007 (UTC)

I wholeheartedly agree—in fact, I've cited this as guideline more than once :) Fvasconcellos 16:39, 12 April 2007 (UTC)
OK, I've been bold and updated the list with the above. The previous longer list didn't enjoy any actual usage. There's still plenty room to tweak this both pre and post guideline status. I've also made the "no dosage" bit a little stronger. Colin°Talk 18:00, 12 April 2007 (UTC)

Diseases/disorders

Classification

I'm wondering about whether to keep "Classification" as the first top level heading, or whether it should be there at all. Older text in the guide clarified this section: "Describe the varieties of the condition, and explain how they are differentiated." However, I'm struggling to find an article that has this section, other than Tourette syndrome. And in that article, I'd argue that the classification was more for where TS fits within tic disorders as well as a place to explain a few terms (a glossary). It doesn't describe varieties of TS, other than to say there is a range of severity. Some conditions do have significant varieties but I don't know whether this is the best place to distinguish them before you've even described the symptoms. It might vary depending on whether the varieties are extreme or subtle. Colin°Talk 16:35, 12 April 2007 (UTC)

Not sure what to do about that; it certainly provided a handy place for me to park that info (what other section would I put that info in?). If you're following the current dilemma at Fetal alcohol syndrome and Fetal Alcohol Spectrum Disorder, that might be another example worth considering. SandyGeorgia (Talk) 16:40, 12 April 2007 (UTC)
I've just found an article that uses Classification as described: Epilepsy. Clearly for some conditions, the classification and varieties are important. For others it is a total non issue. The headings we list should be useful for most articles on disease/disorders. I'm only wondering at this stage. But clearly if it is rarely used, that's a good sign it shouldn't be in this list. That doesn't preclude its use - we aren't forcing a limited set. Colin°Talk 17:00, 12 April 2007 (UTC)
What if we leave it, with a note that not all sections apply to all conditions? SandyGeorgia (Talk) 17:07, 12 April 2007 (UTC)

To Do

Starting list, pls add to it:

  • Careful language section; can someone add an entry about the use of the word "significant" in a statistical sense (as opposed to a layperson sense), as used in reporting studies? If no one can do it, I think Leslie Packer has something somewhere on http://www.tourettesyndrome.net No, it's gone from there—need a discussion of "statistical significance" vs. layterm "significant". Is Statistical significance good enough? SandyGeorgia (Talk) 18:08, 5 April 2007 (UTC)
  • Sections section has a link to Quick lists; if we make any changes to Sections here, we need to make sure they sync at the end. (In fact, having them in two places creates a maintenance problem, as we'll always have to make sure they're in sync—should we bring that over here or not?) SandyGeorgia (Talk) 18:12, 5 April 2007 (UTC)
    • I'm not a big fan of the boilerplate text. I just don't see how someone could start with nothing and instantly create an FA sized article in one go. Better to take it step by step, picking the key headings and fleshing it out as you work on it. To add to this, many disease/disorders already have some text so you'd be adapting what was there. So IMO the "quick lists" could go. Has anyone used them or think they would use them? The Drugs list is out-of-sync but I can't be bothered to sync until we've reviewed what sections are really important. I think the drugs list is currently too large and doesn't reflect any drug article's actual usage. Colin°Talk 20:05, 5 April 2007 (UTC)
      • hmmm, you're right. When I adapted TS, I was too far into the work to just use a quicklist, and when I started a new article (Stereotypic movement disorder), I didn't have enough content to use the list. SandyGeorgia (Talk) 21:32, 5 April 2007 (UTC)
        • I've removed it:
Boilerplate text with appropriate headings and infoboxes can be found here. Copying these can help provide a skeleton upon which to structure your article.
As you noted, this was diverging from the main section text and also the info boxes diverged from their own help pages, which are linked earlier in the guide. All in all, a maintenance headache. Colin°Talk 16:52, 12 April 2007 (UTC)
  • Wikipedia:Manual of Style (medicine-related articles)/Quick lists violates WP:MSH, no special characters in headings. Where did the slashes come from? If it's intended to be either or we should clarify. SandyGeorgia (Talk) 18:21, 5 April 2007 (UTC)
    • Clarified. Please restyle/rephrase if you want. Colin°Talk 18:55, 5 April 2007 (UTC)
      • Confused, we still have slashes, like Causes/Genetics, Pathophysiology/Mechanism, Treatment/Management, Prevention/Screening . What did I miss ? SandyGeorgia (Talk) 19:03, 5 April 2007 (UTC)
        • The words "where a heading contains a slash (/) choose only one from the choice" Colin°Talk 19:50, 5 April 2007 (UTC)
  • Under Section headings, reason the Asperger's people resisted these headings: Signs and symptoms implies "illness" according to them; on Tourette syndrome, I substituted it with "Characteristics". Can we find a way to be more inclusive here, for those articles who (correctly or not) want to avoid the word "symptoms"? I don't mind symptoms personally, but it does stick with some editors, for example, autism spectrum disorders. (First time I've noticed "Cultural references"; nice term, I switched TS to that.) SandyGeorgia (Talk) 18:19, 5 April 2007 (UTC)
    • What makes you think we can pick/suggest headings that will please or be most suited to all articles/editors? Yes, if there are alternatives that would be widely used, then we should offer them. We do point out some of the concerns in the Careful language section and also in the lead for this section. I'm not sure we need to repeat that some section headings may deviate for good reason – these are just guidelines not policy. If editors can justify their deviance, then that's fine. This is a wiki, not a corporate text. Colin°Talk 20:12, 5 April 2007 (UTC)
      • So how about possibilities that include Signs, Symptoms and Characteristics ? Or something to give an alternate choice to get away from "symptoms"? SandyGeorgia (Talk) 21:34, 5 April 2007 (UTC)
        • Actually, I think we make it quite clear that these sections are suggestions. I don't really have a problem with this section. Fvasconcellos 14:04, 7 April 2007 (UTC)
  • Can someone clarify that this is right: AMA citation guidelines suggest that if there are more than six authors, include only the first three, followed by et al. Are the periods and italicization correct? SandyGeorgia (Talk) 18:28, 5 April 2007 (UTC)
    • I've included a ref and also one for URM guidelines. I've rewritten the example to follow AMA/URM style rather than the {{cite journal}} home-grown style. Colin°Talk 21:23, 5 April 2007 (UTC)
  • If the full text is freely available online, add this to the "url" parameter in the template (or hyperlink your article title, if doing it by hand). We need to make mention here of when to add Retrieved on <date>. I'm not a prose person, so I'll leave it to someone else. I believe that past consensus has been that we do NOT need a last access date on PMIDs, but if we also include a courtesy link to a full-text article or PDF, we should add Retrieved on <date>. SandyGeorgia (Talk) 18:30, 5 April 2007 (UTC)
    • I'm sure I've recently read the opposite on that last point. The online editions come in three flavours: (1) a PDF of the scanned article (historical papers - this format is least likely to deviate from the original); (2) a PDF of the article laid out similarly to the print edition (probably quite close to the original); (3) an HTML version (radically different formatting but hopefully no typos or deviations from the original). In addition to this complexity, there is the issue of what the editor actually read. The editor may only have read an online edition that required a paid subscription. In that case, we discourage the URL but don't request a "Retrieved on". Wikipedia:Convenience links is just an essay. I've made one POV explicit in the text. Discuss.... Colin°Talk 21:23, 5 April 2007 (UTC)
      • The general points I'm getting at are that 1) PMID templates don't need last access dates, while 2) URL links do. Not sure if we're saying something different? SandyGeorgia (Talk) 21:36, 5 April 2007 (UTC)
        • Yes I see your point but think it is inconsistent. IMO "retrieved on date" should, strictly speaking, be added where the editor consulted an online source. However, this should be true whether this source is free or subscription only. How many medical editors read all their journals in paper form? I think we can trust the journals (and Pubmed Central) to create verbatim copies of the paper articles online, and that these won't deviate over time. Should journals start moving to a more dynamic publishing system, then perhaps this may no longer apply. So, I think the standard citation is enough and the URL link is just a bonus. No further regulations required. Colin°Talk 21:55, 5 April 2007 (UTC)
  • Categories section: do we need to add any of the following? Genetic disorders | Neurological disorders | Syndromes Again, the autism spectrum folk get bugged about disease and such labeling. SandyGeorgia (Talk) 18:32, 5 April 2007 (UTC)
  • I think we don't need as those are all sub-categories of Category:Diseases. We list there the top-level categories. NCurse work 15:59, 6 April 2007 (UTC)
  • I'm trying to forestall any criticism from other conditions when we try for consensus on the guidelines, along the lines of the problems Ted had (see archive). For example, Asperger, Tourette, Down are not "diseases", and that has been a hangup in the past. Can we figure out how to address it lest it become a sticking point? SandyGeorgia (Talk) 19:18, 7 April 2007 (UTC)
  • Good idea; and one we should follow in general. Wherever we can eliminate potential sources of contention, let's do it. SandyGeorgia (Talk) 20:05, 7 April 2007 (UTC)
  • Old opposes to check: Ted is hardly active anymore. Can someone check if we've addressed his concerns here. I think Colin had the same objection, and I think some of the changes I mention above should help. Other issues were raised by me; I have no further concerns with what we have up now, and want to get it guideline-ified. Does anyone see any other concerns in archive we haven't addressed ? SandyGeorgia (Talk) 18:38, 5 April 2007 (UTC)
  • In a few days, I'm going to ask (I mean beg) Tony1 (talk · contribs) to copyedit to ward off any potential criticsm. [4]SandyGeorgia (Talk) 18:41, 5 April 2007 (UTC)
    • I think we're close enough to ask Tony to copyedit. Does anyone disagree? SandyGeorgia (Talk) 17:32, 12 April 2007 (UTC)
  • Something that comes up time and again the issue of the importance of X (either on its own or compared with Y) Should WP mention it, give it an article, a paragraph, a sentence? This applies somewhat to the above FAS/FASD, but also when considering some study that might be too insignificant or premature or treatment that doesn't hold widespread acceptance, etc. Perhaps these are things that a MEDGUIDE could include along with RS and EL. It may be that they can be dealt with by a project essay rather than a formal guideline. Colin°Talk 22:09, 9 April 2007 (UTC)
    • Where do we stand on this? I'm not clear if we need to add something. SandyGeorgia (Talk) 13:19, 13 April 2007 (UTC)
      • Potentially starting a bigger discussion, which we don't need right now. Lets leave it for inclusion in some other project essay or guideline (MEDGUIDE?) Colin°Talk 14:06, 13 April 2007 (UTC)
  • Review the section headings against good/featured articles. Anticipate minor tweaks to the disease list but an overhaul of the drug one. Colin°Talk 22:20, 9 April 2007 (UTC)
  • Notable cases seem to (slightly) contradict the nutshell. SandyGeorgia (Talk) 17:20, 12 April 2007 (UTC)
  • External links needs work; after we come to consensus (above), we should rewrite it, and mention the dmoz template. SandyGeorgia (Talk) 18:25, 5 April 2007 (UTC)
    • IMHO, any consensus we come to on this issue should be mentioned in the nutshell. If we can discourage linkfarms as early on as possible, this will save trouble later on in an article's progress. Fvasconcellos 22:17, 5 April 2007 (UTC)
      • Can we do more in this area (Colin, you're the better writer)? Can we specifically discourage Usenet, message boards, support forums, and listings of every org in the world, trying to confine it to major national or international orgs, and dmoz link? Also, I've never been clear on this, but it seems to me that anything that is linked in the infobox should not also be linked in External links. Can we point to WP:EL, WP:NOT and WP:RS for external link pruning? SandyGeorgia (Talk) 17:39, 12 April 2007 (UTC)
        • Hey flattery will get you far but I'm sure your friend Tony will have no trouble finding examples of poor writing. I've added a comment about dmoz and repeating the infobox stuff. Sandy added the link farm to the nutshell. Both WP:EL and WP:NOT are covered by the See also at the start. Not sure that WP:RS is relevant for the EL section. Colin°Talk 13:01, 13 April 2007 (UTC)
          • Colin, I'm a terrible writer (but you already knew that :-) Feel free to tweak, delete, or otherwise change anything I write. I'm not sure what this new sentence means: Large disease-related organisations and government health departments sometimes produce web pages containing substantial information that would be of interest to readers wishing to further study the topic. These information pages should be linked directly, rather than to the homepage of the organisation. What is "directly" vis-a-vis "homepage"? SandyGeorgia (Talk) 13:17, 13 April 2007 (UTC)
  • Goodness! Radiant also marked Wikipedia:WikiProject Medicine/Reliable sources Historical !! Busy little bee he was while we were sleeping :-) SandyGeorgia (Talk) 18:26, 5 April 2007 (UTC)
    • I moved it back to a proposal, so let's finish it up (over there). SandyGeorgia (Talk) 17:39, 12 April 2007 (UTC)
  • Decide if we want to bring Reliable sources back to here or keep it separate. SandyGeorgia (Talk) 18:38, 5 April 2007 (UTC)
    • I'm liking the idea of leaving that info in its own article, so we can be sure and gain consensus on this article, while continuing to work on that one. SandyGeorgia (Talk) 17:53, 12 April 2007 (UTC)
      • OK. We'll return to that later. Colin°Talk 18:03, 12 April 2007 (UTC)
  • I can't word this well, but in "Careful language" section, can we add something about not calling conditions and neurological disorders "diseases" (they aren't). SandyGeorgia (Talk) 17:45, 12 April 2007 (UTC)
    • I've tried to find some external guidelines on this but haven't found any yet. It doesn't help that category:neurological disorders contains several "diseases" such as motor neurone disease. The article disease has quite a bit to say about disease, syndrome, condition and there appears to be some cultural variation. I've added another clause to the section on careful language. Is that enough? Colin°Talk 16:17, 13 April 2007 (UTC)
      • Looks good. Marked done, unless someone disagrees (if so, remove my check). Good change on the statistical significance wording, too. SandyGeorgia (Talk) 16:33, 13 April 2007 (UTC)

Article naming

I continue to raise the problem about the two articles, Fetal Alcohol Spectrum Disorder and Fetal Alcohol Syndrome (see my comments on the talk page at FASD). FAS is the current correct medical term. Are our naming conventions strong enough, and do we adequately cover a case like this (FAS is the currently-recognized medical condition)? I'm not saying FASD shouldn't be an article; just that almost all of the content belongs in FAS, with FASD getting a side mention. This is a problem; have we covered it? SandyGeorgia (Talk) 18:56, 5 April 2007 (UTC)

Perhaps we can add a line mentioning that titles of articles are subject to the same sourcing standards as the article content. Most of the references on the FASD page don't use the word "spectrum". I've frequently seen pages state that the name of a condition has recently changed, without stating what organization is making the claim that the name has changed. While newer names are usually more precise, they often don't catch on among researchers for political reasons, and it isn't Wikipedia's place to get ahead of the preponderance of the current literature. I think we should give overwhelming priority to ICD10 as our naming standard whenever possible. In this specific case, I think that FAS should be a full article, with FASD being a header in that article. If the FASD article remains, it shouldn't contain material redundant to FAS, except for a brief summary. --Arcadian 22:12, 7 April 2007 (UTC)
That article is troubling me more and more; I left long talk page discussions that have been ignored. Need to do something; time to clean out the article. Yes, it references statements about FASD to articles about FAS. Is this a are exception, or do we need to say something in MEDMOS? SandyGeorgia (Talk) 22:30, 7 April 2007 (UTC)
I think the Naming conventions section is currently pretty clear about where to go for name mediation, and IDC10 is mentioned for "diseases". If you think an extra sentence or two is needed, could you (Arcadian) give some more examples where the name has been disputed. It might help to spot a pattern that can be guarded against. Colin°Talk 22:09, 9 April 2007 (UTC)
I know I'm blurring a few different issues together here, but some examples of name disputes (on and off Wikipedia) include Klippel Trenaunay syndrome, Interstitial lung disease, Human granulocytic ehrlichiosis, Reactive arthritis, Amyotrophic lateral sclerosis, and Mental retardation. Another case where the situation has been discussed is at Talk:Myocardial_infarction#Acute_Coronary_Syndromes. --Arcadian 17:18, 12 April 2007 (UTC)
Some of the discussion on some of those articles may be something we can clear up. It's not "what people are most familiar with", rather what is the "official" or medically-recognized name of the condition. (There's definitely some disagreement there on the Kleppel Trenaunay syndrome.) Google hits aren't always a good indication; looking at published sources may be. Google scholar is better than Google. Not sure how else we can clear this up. SandyGeorgia (Talk) 17:51, 12 April 2007 (UTC)
oh, my, oh my. Had by myself :-) The "official" DSM name of the condition is Tourette's disorder. The TS community *hates* that term ("disordered") and Tourette syndrome is the far more commonly-used term. Google scholar returns 10 times more hits on Tourette syndrome than on Tourette's disorder. Pubmed returns 10 times more hits on Tourette syndrome than on Tourette's disorder. All the links in our Disease Infobox call it Tourette syndrome. Google returns more than 10 times more hits on Tourette syndrome than on Tourette's disorder. But the DSM calls it Tourette's disorder. So I'm a good example of our naming problem. We'll encounter the same problem when we try to get Down syndrome and Asperger syndrome on board, as they oppose the official possessive eponym. (ICD-10 calls it Asperger's syndrome, even though possessive eponyms are discouraged.) We're going to have a problem here when we try to bring in other groups, and from Radiant's original Historical tagging, it sounds like we've got to consult WikiProject Psychology as well. We need to iron this out. I don't want to go to Tourette's disorder :-( I will if I have to, but it may start a revert war when people in the community see it. SandyGeorgia (Talk) 18:19, 12 April 2007 (UTC)
(crazy idea) Why not follow a somewhat "homegrown" solution—e.g. ICD10 (when available), modified to get rid of possessive eponyms? Fvasconcellos 18:24, 12 April 2007 (UTC)
OK, forget I said that. I'd rather rename to "Tourette's disorder" than "Combined vocal and multiple motor tic disorder"... Fvasconcellos 18:26, 12 April 2007 (UTC)
Right :-) TS is a problem. Not sure if it's unique in that sense or not. SandyGeorgia (Talk) 18:30, 12 April 2007 (UTC)
The current guidelines recommend using an international standard if there are differences between English speakers. For example, if everyone in the UK said "Tourette's disorder". If the world is in harmony but a few bods making the standards have chosen a name nobody uses (DSM) or couldn't agree on a name (ICD) then that's their problem, not ours. The guidelines don't (yet) say that all names must come from ICD/DSM.
The naming of articles is complex and simple rules may fail. Arcadian's idea that "titles of articles are subject to the same sourcing standards as the article content" is reasonable. It forces editors to find reliable sources to justify the name and to explain why they think those sources speak with authority. I'm comfortable with editors debating the merits of different names from different reliable sources. Perhaps we should give more examples of those sources? What we need to discourage is Original Research when arguing for a name. Colin°Talk 23:22, 12 April 2007 (UTC)
Sounds good; thought I'd shot myself in the foot there. Do we need any text adjustments? SandyGeorgia (Talk) 23:31, 12 April 2007 (UTC)
I've tweaked it a bit. Colin°Talk 12:47, 13 April 2007 (UTC)

This looks done to me; if anyone disagrees, pls remove the check and continue discussion. SandyGeorgia (Talk) 13:29, 13 April 2007 (UTC)

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