Wikipedia talk:WikiProject Medicine/Archive 32

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Veins

Hi. I'm new here and I would like to stay even if I'm Portuguese. Veins, arteries, heart, are my passion. I did an article about a special GSV tributary, the accessory saphenous vein, I did it in a subpage but now I realize that the main page has been redirected to saphenous vein. That vein is really important in varicose vein disease and has a different treatment. It deserves its own page. Is it possible to undo that redirect? This is my subpage: User:Nini00/Acessory saphenous vein so you can check my work, and I wait yet another image. Thank you for your help Nini ^✉ 20:30, 8 February 2013 (UTC)

Welcome. Maybe this template is of use for the page you are writing...Another quick bit of advice is to write in paragraphs instead of bullet points. Thanks for contributions. Lesion (talk) 21:12, 8 February 2013 (UTC)

Thank you. Nini ^✉ 21:49, 8 February 2013 (UTC)

And to kind of answer your question about the redirect, all I see is that, so it doesn't look like it was ever published under that title. Which redirect were you talking about? Biosthmors (talk) 23:32, 8 February 2013 (UTC)

Ok I understand. Sorry for my poor experience in WP. I can publish the article. Thank you for help Nini ^✉ 10:56, 9 February 2013 (UTC)

Name-dropping vs useful lead for more information

What's the WP:MED standard for discussing work related to a drug? In particular, how much discussion and credentialing is appropriate when mentioning a lead researcher? At Pomalidomide and Thalidomide, several IPs (with suspicious geolocation) are insisting that we include name and affiliation in the body (edit-summary: "This lab discovered the drug and still works on such compounds Readers may want to contact this lab and need this info"). User:Edgar181 (who is mostly inactive at the moment) raised a WP:CREDENTIAL concern in part, and I went further with removing it to focus on the actual article topic and not giving essentially sole credit to the one lab's PI (edit-summaries: "no need to name-drop, especially since it's cited to a reliable source and is drifting off-topic for this article", "this is an encyclopedia, not a literature-review"). DMacks (talk) 22:19, 8 February 2013 (UTC)

In the history section it would be okay. In the "medical uses" section no one should be mentioned and it should be based on secondary source. This article is bad Thalidomide Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:25, 8 February 2013 (UTC)

I would avoid entirely statements like this. We don't need articles littered with references to "studies done in Dr So-and-so's lab at Big Hospital". However, it would be fine to include a factual statement about the discovery, like "The first published descriptions of this compound were written by Alice Expert at Big Hospital", if you could find an independent source that directly says that this was the first published description. (It's not good enough to do a PubMed search and decide for yourself that the oldest thing listed there is truly the first published description.)

You might like to read WP:MEDMOS#Writing style as well. WhatamIdoing (talk) 23:42, 8 February 2013 (UTC)

Serious copyright problems at Caring_for_people_with_dementia

All the section (very big section) in Caring_for_people_with_dementia#Environmental_design_and_assistive_technology seems to be a wayyyyyyyyyy to close paraphrase of the cited article in it. Moreover, it is based in wikiuniversity text, so problems with copyright may not end here. To make it even more complicated it seems that the editor that added such content (User:Jtneill) was an experienced one. Since I have not edited for a while I am really not sure how to act. --Garrondo (talk) 22:54, 8 February 2013 (UTC)

Let me look. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:26, 8 February 2013 (UTC)

Okay removed the section in question. Described the concerns on the talk page and left a note on the users talk page. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:39, 8 February 2013 (UTC)

OHSU Project

I have been in talks with some faculty at OHSU School of Medicine for a few months now about a wiki editing pilot project. I just spoke with the students (a total of 8, so it should be quite manageable) about editing the ins and outs of editing wikipedia a bit. It is part of a course on pharmacology, and the "prompt" they were given had something to do with methamphetamine, or perhaps other sympathomimetics or indications for same. And FWIW, I have also spoken a bit with Lane Rasberry and Doc James about this in the past, it's just now getting going.

I just wanted to drop everyone (~~WP:USEP~~ WP:ENB, WP:MED, WP:PHARM) a note who might be interacting with some of these folks over the next month or two (the course runs until April 10). I gave them a rundown on some of the common mistakes students make as part of these projects, e.g. assuming that one's edits have to stay up in order for them to be useful as a grade (which I've seen a number of times). I am confident they will be able to avoid most of these common pitfalls.

As it stands it appears that they will be looking for either stubs to build out that are related to the clinical vignette that is their initial prompt; they might instead/also work on rewriting part of an article that is jargon-laden or otherwise confusing to adhere more closely to WP:MEDMOS. The consensus was that they would try and sandbox everything before putting it in an actual article.

Most of them, as of right now, do not have WP accounts, but should be making them soon. If you see them around, say Hi!

-- UseTheCommandLine (talk) 00:54, 9 February 2013 (UTC)

---Updated links UseTheCommandLine (talk) 01:12, 9 February 2013 (UTC)

JMIR Wiki Medical Reviews

Per Gunther as posted [1] JMIR Publications is currently (Jan 2013) pilot-testing an innovative peer-reviewed journal JMIR Wiki Medical Reviews which sets out to publish Wikipedia (Review) and Wikiversity (Original Works) papers. Authors who have made significant contributions to Wikipedia articles are invited to submit the article to http://wikimedical.jmir.org/author

JMIR Wiki Medical Reviews (JMIR Wiki Med Rev) is an innovative journal which takes the best wikipedia articles in medicine, peer-reviews them, and publishes them as citable scholarly review article, with the goals to 1) Improve Wikipedia articles, 2) enhance public trust in the accuracy of medical Wikipedia articles, 4) improve visibility and indexing of outstanding Wikipedia articles (e.g. by indexing in bibliographic databases and featuring them on JMIR), 5) to acknowledge authors who volunteer their time on wikipedia to improve articles by listing them as authors in a "citable" publication, 6) to add an additional layer of formal peer-review to wikipedia articles (JMIR Wiki Med Rev - About us/Focus and Scope)

JMIR Publications will publish the first 20 articles free of charge, deposit them in PubMed Central, and will apply for PubMed indexing. JMIR Wiki Medical Reviews is hoped to become the first peer-reviewed journal publishing Wikipedia articles.

Dr James Heilman has agreed to serve as Editor-in-chief, other editorial board members are to be recruited (ideally active in Wikipedia Medicine). Editorial board members encourage Wikipedia authors to submit their articles to the journal for peer-review, select external peer-reviewers, and guide articles through the peer-review process. The publisher (JMIR Publications, represented by Dr Gunther Eysenbach) will coordinate production, which includes converting the Wikipedia article into XML, and depositing the articles in various bibliographic databases and full text databases. It is hoped that the journal will be Medline-indexed and will receive an impact factor. For the latter it is important to primarily publish articles which will be highly cited.

Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:07, 22 January 2013 (UTC)

Fantastic. I will be helping with this effort. Biosthmors (talk) 22:29, 22 January 2013 (UTC)

Seriously, Doc James is always making me feel bad with all the wonderful work he does. Yobol (talk) 04:50, 24 January 2013 (UTC)

What can we do to help?Remember (talk) 23:32, 22 January 2013 (UTC)

Awesome! Bagsy a place on the editorial board. Axl ¤ [Talk] 00:19, 23 January 2013 (UTC)

Does bagsy mean you want to be on the editorial board? I hope so, because I think that would be great news! Biosthmors (talk) 19:19, 23 January 2013 (UTC)

_{Yes. Although it may be British schoolboy slang. Axl ¤ [Talk] 12:30, 24 January 2013 (UTC)}

I agree with others. This is obviously great news. Flyer22 (talk) 00:23, 23 January 2013 (UTC)

As far as I am aware, to help this succeed, we need to produce great content for publication and/or serve on the editorial board. Biosthmors (talk) 00:45, 23 January 2013 (UTC)

Yes exactly. I need all of you people to join me :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:54, 23 January 2013 (UTC)

Very interesting, indeed. What a pity that I don't know English --SU ltd. (talk) 16:54, 23 January 2013 (UTC)

You read, write and translate/understand English sufficiently enough, SU ltd. So I don't see why you wouldn't be able to participate, unless you are busy or would rather not. Flyer22 (talk) 19:14, 23 January 2013 (UTC)

Thank you very much, Flyer22. If you, a native speaker of English, consider my English sufficiently enough, then I’ll be glad to take part. I’ll be away about a month or two. As soon as I’m back, I’ll share my opinion on that if you consider it possible. Personally, I can’t agree with 7mike5000. To my mind, Jmh649 undertakes a great thing. --SU ltd. (talk) 17:02, 24 January 2013 (UTC)

LOL, you created Russian versions of those soap opera couple articles I created, SU ltd.? *Blushes* I'm not sure how interested Russian audiences are or would be in those couples, but thank you for spreading the knowledge. Flyer22 (talk) 20:45, 24 January 2013 (UTC)

BTW, Russian audiences use Cyrillic script (unlike the Poles). If you see texts in a Latin alphabet, they can’t be written in Russian. Sometimes I write something in a foreign language just for a change because I neither watch TV nor listen to music. As for the rest of audiences, they don’t matter to me. They have undoubted right to watch TV and go to the cinema if they like. --SU ltd. (talk) 02:38, 25 January 2013 (UTC)

And about the encouragement, you're welcome. Flyer22 (talk) 20:52, 24 January 2013 (UTC)

I was not an author on the article, but Influenza seems like a good article to go through the publication process since it is already a FA and has lots of global public health implications. Remember (talk) 14:08, 23 January 2013 (UTC)

Certainly. Will need a lead person take it on. IMO there is still some work to do. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:27, 23 January 2013 (UTC)

Hmm. Would ketogenic diet be suitable? It needs an update with some recent reviews, though I don't think anything drastic will change as a result. Perhaps I may even get round to writing a decent epilepsy article. -- Colin°^Talk 16:09, 23 January 2013 (UTC)

I sure hope ketogenic diet would fly. I want the journal to also have enough scope to publish fundamental topics to the field of medicine itself, such as blood coagulation and human circulatory system. I think we should use the journal to get topics that are valuable to medical students upgraded in quality. Medical students are a very valuable target audience or "constituency" for WikiProject Medicine. Biosthmors (talk) 19:15, 23 January 2013 (UTC)

Must you keep raising the bar? You're making the rest of us look lazy... Now I'm wondering how Wikipedia:WikiProject Academic Journals is going to address this from secondary sources ;-) LeadSongDog come howl! 20:02, 23 January 2013 (UTC)

I think he's a group account. That's the only possible explanation. --Anthonyhcole (talk) 05:15, 24 January 2013 (UTC)

I've met one of him. My theory is some sort of space-time manipulation where he gets 48hr days and the rest of us struggle on 24. Certainly I don't know anyone who isn't also called James who gives more to Wikipedia. Colin°^Talk 11:40, 24 January 2013 (UTC)

Thanks for the words of encouragement. It has sort of gotten into my head that what we are doing here truly matters. I have been unable to shake this feeling and thus wondering around promoting Wikipedia to whomever I run across. I'm uncertain if I am starting to annoy people yet :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:45, 25 January 2013 (UTC)

My interest is piqued, but I'd appreciate clarification. Having recently signed up with the Wikipedia Education Program where I am getting a crash course in the ways of WP editing, primarily by our terrific Ambassador, Biosthmors. I have just explained to my students how a Wikipedia article should be written in the style of an encyclopedia and not in the style of a review article for a scientific or medical journal. Differences include the emphasis on secondary sources rather than primary sources in WP articles. This is in contrast to professional review articles which (speaking as a scientist, but not an MD) I would expect to include more information about the underlying research. Biolprof (talk) 05:12, 25 January 2013 (UTC)

Yes so these are going to be Wikipedia style literature reviews which will be slightly different than standard literature reviews. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:42, 25 January 2013 (UTC)

I just stopped by to post about another article (see below) and I just happened upon this thread. This is a great idea, and it is exciting! Good luck to all contributors and participants. --- Steve Quinn (talk) 06:03, 25 January 2013 (UTC)

Authorship question

If someone were to support an article for publication as the author, what are the requirements? Do they have to have added a large portion of the text to the article? Do they just have to support it during review and make all the necessary corrections? I may be interested in helping to get an article published, but I don't want to bite off more than I can chew. Remember (talk) 18:20, 24 January 2013 (UTC)

I doubt having to contribute a large portion of text would be a requirement. A current featured article might not need much updating on the prose and sources, but I do think an author should know the level of text–source integrity of the article and the recent literature. Biosthmors (talk) 20:08, 24 January 2013 (UTC)

As an author you need to feel comfortable standing behind the text as your name will be attached to it. Typically I would say this would require having made a fairly substantial contribution to it.

Typically this should apply for any article you have helped bring to GA/FA. I am hoping that this will encourage more people to get involved. Currently less than 1% of our medical articles has passed GA or FA thus there is a lot to chose from.

How we would handle authorship in cases where the submitting author is not one of the top authors I do not know yet. Instinctively I would prefer if this were not the case. If one has never made an edit to the article your name will not be applied. If one has only made minor changes you will be listed as a contributor rather than an author. Where this cut off will be than is the next question. Major journals allow ghost writing but this is not something I am happy with.

There is no perfect way to determine who has made the most contributions. We have this tool that breaks down edits by time and number by editor [2] but of course different people edit in different style. Some people may make a bunch of grammar changes while other may write large amounts in one go. I think part of this will be discussion with the 10 most frequent authors. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:07, 24 January 2013 (UTC)

I think it would be interesting to have full disclosure and transparency -- that the reviewers are listed separately at the end of the article. I think this would increase the buy in from academia. Listing reviewers completely changes the game... but I think the idea is worth experimenting with. Nephron T|C 01:05, 4 February 2013 (UTC)

Editorial board size and responsibilities?

I was thinking of doing some outreach to M.D.s or Ph.D.s without current involvement in Wikipedia to invite them to participate as an editorial board member of JMIR Wiki Medical Reviews. Do we have a theoretical maximum of people for positions on the editorial board? 10? 15? 20? What are the expectations? A certain amount of peer-reviews? Biosthmors (talk) 20:08, 24 January 2013 (UTC)

Probably best to direct this to Gunther. I am not sure how many people he wishes. I am going to ask a few docs at UCLA if they would be interested. A number have expressed interest in Wikipedia before. I have already sent a note to UCSF. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:12, 24 January 2013 (UTC)

If you're still looking for people for the editorial board -- you can put my name into the ring. I started as a staff physician in August -- that's why I haven't been around much lately. I have a university affiliation (clinical professorship) -- as of November. If you're looking for other university types -- I'd suggest Samir (User:Samir). He is at the same institution as Gunther... and I know they know one another already as I sat around a table with both of them. Nephron T|C 01:20, 4 February 2013 (UTC)

Also, just saying, outreach to D.O. physicians should be included as well along with M.D.s and Ph.D.s who are currently involved in Wikipedia.TylerDurden8823 (talk) 01:39, 4 February 2013 (UTC)

I have created a specific page here for all interested Wikipedia:WikiProject Medicine/JMIR Wiki Medical Reviews. Please add your names if interested in being on the editorial board. I assume real names will be required. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:01, 4 February 2013 (UTC)

Another of Gunther's undertakings, WebCite, is currently under discussion at meta:WebCite and at VPT. LeadSongDog come howl! 14:08, 11 February 2013 (UTC)

Veins Ultrasonography

I have 2 questions about this future page:

1 - is COI, because I am very close of this subject, it is my work, is my passion.
2 - is the title, because for lower limbs and to study varicose veins, this examen is really special and it will be more and more as the evolution in treatment will grow. I would like your advice before translate User:Nini00/Lower limbs venous ultrasonography to English (I suppose you have a translator Pt/En). What would be the best title? "Lower limbs venous ultrasonography" is the one I prefer (limb or limbs?).

Thank you for your advice Nini ^✉ 11:34, 9 February 2013 (UTC)

As long as the subject is notable (supported by a number of acceptable sources), and the article contains no original research and is written in a neutral point of view, there is no problem.

The translation task force may be able to help you with that issue.

I would suggest you follow the term most commonly used in the supporting sources.

You may find this guide useful: WP:MEDMOS#Medical tests. Hope this helps... Lesion (talk) 12:37, 9 February 2013 (UTC)

Agree with Lesion. The big thing is sourcing. As long as it is supported by high quality secondary sources there should not be a problem.Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:38, 9 February 2013 (UTC)

Thank you very much. The subject is supported by high quality sources, even WHO. Nini ^✉ 17:21, 9 February 2013 (UTC)

Okay will take a look when you have it translated. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:25, 9 February 2013 (UTC)

You might want to read WP:MEDCOI. Being a healthcare professional is not a conflict of interest. WhatamIdoing (talk) 19:11, 9 February 2013 (UTC)

Now if you were working for a company that sells treatments for the issue in question that would be a different matter :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:36, 9 February 2013 (UTC)

I don't sell anything, thanks God. I'll pay attention mainly to my academic opinions about some subjects. I will be impartial. You can follow the article at User:Nini00/Lower limbs venous ultrasonography. Nini ^✉ 14:01, 10 February 2013 (UTC)

Comments requested

I noticed it has been proposed (by user:coin459) that drooling be merged with hypersalivation. Not sure if this is the best thing to do since hypersalivation is specifically overproductiong of saliva, and whilst this is the main cause of drooling, the latter may also be caused by "inability to retain saliva within the mouth (incontinence of saliva), or problems with swallowing (dysphagia/odynophagia)"...both of which may occur with normal saliva output. On the other hand, I recently reworked xerostomia/hyposalivation, a very similar scenario: 2 very close topics which are almost inseparable, hyposalivation being a topic contained within xerostomia, but xerostomia meaning slightly more. Hyposalivation was a redirect back to xerostomia. I decided in the end to just build the xerostomia page, although it ended up containing much info on hyposalivation. Comments requested for drooling/hypersalivation merge, the consensus of which may lead to changes to xerostomia/hyposalivation... Lesion (talk) 12:16, 10 February 2013 (UTC)

I agree with you. Fusion is not appropriated. They are different things. Hypersalivation can exist without drooling and this one can exist without hypersalivation. Even the synonym is wrong in drooling article. Is not a synonym of hypersalivation. Nini ^✉ 13:53, 10 February 2013 (UTC)

Yes should not be merged. Some people with normal salivation drool due to a stroke. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:54, 10 February 2013 (UTC)

Ptyalism is different from drooling in the same way polyuria is different from enuresis. alteripse (talk) 04:03, 11 February 2013 (UTC)

Chiropractic

Hi guys! I was referred here by Ocaasi who has been providing me with careful guidance in editing Chiropractic. The main issues identified were NPOV and length. The article contained a lot of puffery (both pro/con) and tended the use primary sources in an uneven way when more current secondary sources were available. In order to raise the reliability and quality of the page, WP:MED and WP:MEDRS and WP:PSMED were used to introduce the proper manual of style for the article. I believe it accurately reflects the spirit and intent of WP:MED. This is a sincere attempt to open dialogue for an evidence-based discussion of chiropractic, but also for other traditional/CAM disciplines that have developed a legitimate scientific research base. Too often those articles have strong bias, pro or con, because WP:MED does not enforce WP:PSMED and WP:MEDRS in a consistent way. They should be under the WP:MED project so standards can be raised for editing thereby attracting academics and scholars as opposed to idealogues on both sides. In my opinion the best way to move forward is using a scientific point of view (SPOV) to achieve NPOV. Just offering a critical eye to controversial topics in medicine and how to resolve them in an evidence-based way. Regards, DVMt (talk) 00:27, 11 February 2013 (UTC)

There are a number of us who try to apply WP:MEDRS the best we can. But we of course have been been able to apply it to a limited extend as the number of articles that fall under WP:MED is huge.

Typically if you are using systematic review from the last 3-5 years that are pubmed indexed all should be well. It gets more complicated of course when recent systematic reviews disagree with each other.

Is there a specific issue you wish looked at? Often one has to go RfC by RfC with controversial topics. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:40, 11 February 2013 (UTC)

I'm not comfortable with the wording you use, "legitimate scientific research base" almost implies "evidence base". Complimentary medicine, almost by definition I would say has no evidence base. But I think you meant, "people are researching it" which is not the same as "evidence base"? Due to the nature of these topics, I would also say that using a scientific point of view on these articles would definitely introduce "bias", no? ... Lesion (talk) 00:45, 11 February 2013 (UTC)

Yes one of the difficulties with chiropractics is that there is a great deal of pseudoscience mixed in with some legitimate research. When one looks at the legitimate research however some interpret it as positive and other interpret it as equivalent to conservative care.

Thrown into it an entire profession that makes its livelihood off it "being beneficial" and one has a situation where "It is difficult to get a man to understand something, when his salary depends upon his not understanding it". Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:54, 11 February 2013 (UTC)

Thanks for replying Doc James. Agreed, when possible the most recent systematic reviews have been used and if they disagree; both sides are mentioned. Such as the case regarding spinal manipulation and stroke. I was writing because just to inform the community that to take a peek at the article because NPOV was obtained by simply using a scientific consensus that chiropractors are regarded as MSK specialists. Now that the article reflects that, it is in stable form. Also, it follows the proper MoS for medical specialities. Essentially I'm just trying to be as transparent as possible because I know that article was very unreliable both critical and supportive. This version addresses all the problems that were plaguing the article for years on WP and causing a lot of problems for editors, admins, etc. It reflects chiropractors in 2013 but nonetheless specifically mention its controversies both internally and externally. If we basically agree that chiropractic is appropriate and legitimate for MSK disorders I believe we can achieve consensus on the topic. It would be a major benefit to WP:MED, WP in general and rational skeptics who stick to an evidence-based approach at editing. The pseudoscience and legitimacy are discussed at depth in the article and resolves around MSK specialists vs. subluxation-based doctors. Lesion, that is a common myth that chiropractors don't have an evidence base. Please see evidence-based practice guidelines at the article itself. I was surprised too honestly. It makes it easier to evaluate what a 'good' chiropractor is/does from the fringe in the profession. Defining these elements was key to achieving scientific consensus for appropriate chiropractic interventions which is essentially MSK care with manual and manipulative therapies. DVMt (talk) 00:56, 11 February 2013 (UTC)

Orthopods are MSK specialist. Will need to look.Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:03, 11 February 2013 (UTC)

if there is a scientific evidence base for something, then can it really be called complimentary medicine? Lesion (talk) 01:13, 11 February 2013 (UTC)

Lesion, this is a critical issue you raise. It's up to you, me and others to critically evaluate the research base and make that conclusion. Based on my research I would argue that there is an evidence base for management of spinal and MSK issues. DVMt (talk) 01:34, 11 February 2013 (UTC)

An issue, the article says "Manual and conservative therapies commonly used by chiropractors are effective for the treatment of low back pain," and bases it on this 2011 Cochrane review which states "High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain."[3]. I not convinced the ref supports the text in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:09, 11 February 2013 (UTC)

Well if that's the main issue, specifically chronic low back pain, then that can be mentioned or omitted as effectiveness. I don't think our viewpoints are different here, probably just finding common language. DVMt (talk) 01:31, 11 February 2013 (UTC)

Our article than states without qualifications "Spinal manipulation, commonly used by chiropractors and other manual medicine practitioners are effective for the treatment of spinal pain, including low back pain, neck pain, some forms of headache and a number of extremity joint conditions such as shoulder and hip pain" supported the journal Chiropr Osteopat. Yet we have this more recent systematic review that states "Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management." . PMID 22621391. {{cite journal}}: Cite journal requires |journal= (help); Missing or empty |title= (help) So I think we have a huge problem. It appears that our article just picks up the positive research and presents it while ignoring the research that disagrees. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:44, 11 February 2013 (UTC)

Anyway looks like an attempt to whitewash the article. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:54, 11 February 2013 (UTC)

Disagreed Doc James. However, we can discuss this with other regular editors at the talk page. — Preceding unsigned comment added by DVMt (talk • contribs) 02:00, 11 February 2013 (UTC)

A quick search of reviews for spinal manipulation and headaches reveals multiple systematic reviews like PMID 22621391, PMID 21511952, PMID 21649656, PMID 22460941 have been ignored, while one of the two reviews mentioned, PMID 21298314 was misrepresented in that our article does not mention the caveats the authors of the review felt merited mentioning in the conclusions (no firm conclusions, low quality evidence, etc). That was just looking at one of the outcomes with spinal manipulation, I shudder to think what a more in depth search of other areas will show. It is hard to come to a conclusion other than that there is rampant white washing. Yobol (talk) 02:22, 11 February 2013 (UTC)

I don't see why they can't be inserted in the article, nonetheless there is disagreement. We must also separate manual therapy from spinal manipulation as the two are not synonymous. DVMt (talk) 03:11, 11 February 2013 (UTC)

A recurring theme in articles on CAM methodologies that we really need to clarify hinges on the statistical impossibility of proving the proposition that one specific inert intervention is not more effective than a placebo. Time after time we see reviews look at such results and give a feeble conclusion that larger sample populations are needed (when infinite sample populations would still be "inconclusive") or that better methodology is needed. The simple truth is that placebos are indistinguishable from each other. Hence any attempt to show a CAM methodology's efficacy in a placebo-controlled trial must be regarded as ill-conceived, with a high probability of false "success" at a low confidence level. Rather, the comparison should be against the best known standard of care. With a few exceptions, our CAM articles have failed to clearly convey this problem to readers. We should be able to find a consistent, clear way to convey this. LeadSongDog come howl! 02:43, 11 February 2013 (UTC)

Good point, but I disagree that all placebo effects are equal. You get things happening like larger sugar pills being more effective than smaller ones, or blue sugar pills being more effective for depression than another color... Lesion (talk) 03:43, 11 February 2013 (UTC)

Not possible in a true double blind trial, of course. There is, too, the problem that "individualized" treatment is often an "essential" aspect of CAM methods, effectively saying "who needs scientific method, when we have revealed Truth?" LeadSongDog come howl! 03:58, 11 February 2013 (UTC)

Including more expensive placebos are better than inexpensive placeboes :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:38, 11 February 2013 (UTC)

"Complementary" medicine frequently has an evidence base, but it's things like "research proves that getting a massage is pleasant and relaxing", not "research proves that massage kills cancer cells".

I don't think that chiropractic counts as 'complementary', since its notion is that all you need for a crick in the neck (why is this still a red link?) is a spinal adjustment, rather than a spinal adjustment plus some other treatment. That's the meaning of "complementary": things that go with something else, like complement goods or complementary angles. Chiropractic is likely to be more precisely labeled as an alternative approach, as in "If you wake up with a crick in your neck, you can wait until it goes away on its own, or "alternatively", you can get a spinal adjustment to get rid of it immediately". WhatamIdoing (talk) 16:53, 11 February 2013 (UTC)

Agree fits in more with alternative than complementary within the CAM framework. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:18, 11 February 2013 (UTC)

Some talk about scam (Supplements, Complementary and Alternative Medicine) or (s)cam (supposedly complementary and alternative medicine) (Ok, they do say quite ironically): Nevertheless even in the blog I linked (sciencebasedmedicine), which is as far as anybody can get against cam they say that chiropraxi is a special case since it probably serves for 1 thing (mostly back pain), but the problem is that most chiropractors say it serves for everything.--Garrondo (talk) 20:40, 11 February 2013 (UTC)

Vertebral subluxation

Sadly we appear to have the same problem of down-playing of the mainstream view at Vertebral subluxation as well. If you compare the current version with that of 22 January 2013, you can see how for example the criticism section has now been reduced to a single paragraph. --RexxS (talk) 03:33, 11 February 2013 (UTC)

Have restored the previous version there too. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:38, 11 February 2013 (UTC)

Simplification template

Hello, I was just looking at the reader feedback on the asthma article.

It seems that a fair proportion of the people reading the article were struggling with what they consider complex terminology, but much of the article seems quite correctly encyclopedic to me (I'm not a medical professional - and I can follow the article without much problem, and there are hyperlinks for any tricky bits).

So, it occurred to me that there are two reasons people will be consulting the asthma article (and in general looking at medical/disease type articles), either someone who is looking for some detailed nuance (who will want the article in much the same state as it currently stands), or someone who is looking for the broader overview (symptoms, causes, if they are contagious, treatments, outcome).

I think the people in the second category - especially if they are children may find it easier to look at simple:asthma than asthma, but I think the 'simple english' pages are not well known by those unfamiliar with wikipedia, so... I wondered about whether there ought to be a hatnote at the top of the asthma article saying something like If the medical terminology is too complex, and you just want a broad overview, you might like to check out [[:simple:asthma|this page]].

Then I thought it might be a good idea to have that a generic hatnote template for all medical articles?Though the person adding the template might also then want to check that the simple equivalent was suitably worded.

The other idea I had was just a general attempt to run through existing articles looking for a info box for diseases with a view to spotting whether they listed symptoms, causes, contagious/vector, treatments, treated/untreated outcome. I've added this project to my watchlist for a while, I don't know if this has already been discussed. EdwardLane (talk) 11:03, 11 February 2013 (UTC)

There's certainly an attraction to the idea, though the wording might be improved. Perhaps just "A Simple English version of this article is available at Simple:Asthma." Having that link hidden in the list of interlanguage links has never seemed very satisfactory. LeadSongDog come howl! 17:20, 11 February 2013 (UTC)

I like your wording EdwardLane (talk) 19:10, 11 February 2013 (UTC)

Efforts are currently ongoing to move simple English to the top of the language list. I see this as a good idea. Proposed here [4] Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:30, 11 February 2013 (UTC)

I think anyone writing a article within in this project is aware of a need to provide both an encyclopedic article, and at the same time knows that almost all people accessing the page will be doing so primarily because of questions about their own health, or their family or someone they know. However, as per WP:MEDMOS articles are not supposed to be "patient information leaflets". Personally I try to balance this by writing the lead in a slightly different style to the body of the article. The lead is almost a plain language summary, and avoids unnecessary jargon. The lead is like a summary for the people in the second category you describe, and the rest of the article goes into much greater depth, and does not avoid medical terminology, although these are wikilinked and/or explained in parentheses. Nesting of related articles also allows for even greater detail of subtopics. In this respect, there is a "level of service" depending upon what the readers are after: basic information, encyclopedic and academic.

Lead: synonyms, basic definition, summary of content e.g. symptoms, classification, etc etc

Body of article...

==Classification==

1 or 2 paragraph summary of Classification of syndrome XX.

==Symptoms==

etc.

I think the plain language summary would be great to highlight to readers, and this could certainly be done as some kind of standard template/ hatnote. Great idea. Lesion (talk) 21:09, 11 February 2013 (UTC)

I am hesitant to add another type of hatnote to the lead. Many articles already have a couple of these which begins to push the beginning of the article a fair ways down. That is why I like the language link solution. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:22, 11 February 2013 (UTC)

Rename Glossodynia to Burning mouth syndrome ?

Key words	No. pubmed hits
"Glossodynia"	287
"Burning mouth syndrome"	782
"Oral dysaesthesia"	6
"glossopyrosis"	19
"stomatodynia"	44

ICD-10 uses Glossodynia [5]. The one Cochrane RV of this topic uses the term "Burning mouth syndrome".[6] Lesion (talk) 02:53, 11 February 2013 (UTC)

~~Why not just use a redirect?~~ should have checked before commenting, sorry -- UseTheCommandLine (talk) 12:00, 11 February 2013 (UTC)

And online mainstream tertiary sources (Mayo, NIH) appear to favor burning mouth syndrome, so that's what I say it should be. Biosthmors (talk) 01:07, 12 February 2013 (UTC)

By logic Glossodynia is just a symptom which means pain or dysaesthesia which can be caused by many pathologic issues. Which brings us to the "syndrome" definition. So "Burning mouth syndrome" is by logic the correct term in my humble opinion. DocElisa ^✉ 09:26, 12 February 2013 (UTC)

Even though "glossodynia" could be translated from its root words glossa - tongue odyne - pain ; in publications it is almost universally a term used as a synonym for burning mouth syndrome. If you want to say a painful tongue as a symptom with many possibly causes, not just burning mouth syndrome/glossodynia, then I suggest "glossitis" (although this implies inflammation specifically rather than pain) or just "tongue pain" or even "glossalgia".

Anyway, I feel 3 for and none against is a good enough consensus. Thanks for comments. Lesion (talk) 11:55, 12 February 2013 (UTC)

Empty section template for medical articles

I just added a couple {{empty section}}'s to burning mouth syndrome, and it made me think we should probably have one specific to medical articles that links to WP:MEDRS. I think this would help us keep track of how incomplete articles are and it parallels with User:WhatamIdoing's recent comments about making sure we have prognosis sections, if I remember correctly. Biosthmors (talk) 20:02, 12 February 2013 (UTC)

Good article diff

Is this in any way an improvement? Maybe someone knows off the top of their head. I don't. Biosthmors (talk) 22:07, 11 February 2013 (UTC)

I don't remember if at the 3rd week of fetus development there is a distinction between nasal and oral cavity. I think there is no difference yet so oral cavity is the correct term. If is true it can be an improvement. DocElisa ^✉ 22:32, 11 February 2013 (UTC)

By the way I'm Nini00, I changed my name. The first one has been choosen by my daugther, we were palying at Web. It was too childish so I have asked her permission to change it... DocElisa ^✉ 22:36, 11 February 2013 (UTC)
- We're glad to have you! Welcome. =) Biosthmors (talk) 01:00, 12 February 2013 (UTC)

Thank you DocElisa ^✉ 09:19, 12 February 2013 (UTC)

I did a title error

Yes I did an error: Accessory saphenous vein must be deleted or redirected to Anterior accessory saphenous vein. This is the name in the new terminology and is in accord with the Latin name. I can't do it... yet. And instead to move to the new title I have created the new page (idiot newbie I am ...) Thank you for correction DocElisa ^✉ 09:39, 12 February 2013 (UTC)

I think keep accessory saphenous vein as a redirect in case people search for the older name... Lesion (talk) 11:40, 12 February 2013 (UTC)

Is what I think and is done. Thanks DocElisa ^✉ 14:50, 12 February 2013 (UTC)

Eyes, please

... upon Ted Kaptchuk, Irving Kirsch, and Program in Placebo Studies. There seems to be some first-party editing but some cleanup might rescue the articles. Is it worth the effort? LeadSongDog come howl! 16:29, 12 February 2013 (UTC)

Kirsch and the Program might need to be merged, the only significant media coverage I was able to find was a New Yorker article. i haven't done anything but glance at it, but it isnt immediately clear to me whether it's about the man or the program. I am unclear on how to justify the Kirsch article, it may need to go to AfD (though admittedly i am a bit trigger happy with AfD). -- UseTheCommandLine (talk) 18:00, 12 February 2013 (UTC)

Kirsch is definitely notable. The article doesn't seem too bad to me: not too autobiography/resume. Can't comment about the notability of the other two, but don't see any harm in having both. --Anthonyhcole (talk) 21:59, 12 February 2013 (UTC)

Thanks for the feedback. I'm still concerned at the apparent COI. There's a nasty policy gap around accounts that appear to be real names editing related content. We really need to either require verification of that identity or presume COI for such usernames. I certainly wouldn't want to discourage editors with such expertise from participating, but this runs perilously close to violating wp:NOTWEBHOST. LeadSongDog come howl! 17:37, 13 February 2013 (UTC)

Lower limbs venous ultrasonography

About 50% of the whole article Lower limbs venous ultrasonography is launched. All comments and corrections are welcome. Thank you. DocElisa ^✉ 19:03, 12 February 2013 (UTC)

Great! I should find ways to link this from DVT. One thing I noticed were citations to a 1998 WHO source. Could we get anything more updated, per WP:MEDDATE? Thanks again! Biosthmors (talk) 19:56, 12 February 2013 (UTC)

I'll try. WHO doesn't need to work about this subject nowadays because in USA, Germany, UK, France, Italy and others there are already specialized centers to prepare physicians. So 1998 is too old document for USA but for other countries like Portugal, Brasil, Grece, most of Africa countries that document is not old... unfortunately. DocElisa ^✉ 00:50, 13 February 2013 (UTC)

About DVT I think that's very important to link this article but I don't know very well how to do it because all the directions are about the compression ultrasound (a quick and incomplete examination made in a hurry) and the idea that the lower leg DVT doesn't need to be treated. I don't agree with this because lots of patients will be at risk to have a pulmonary embolism if we generalize this idea on web. So I can't modify nothing without permission. My experience over 25 years treating vein diseases (I'm cardiologist but in 1987 I left the pump and I became "plumber" - unfortunately I'm old) teach me that we must treat DVT even while we wait diagnosis confirmation (it's easy to stop lovenox treatment is hard or impossible to treat a DVT with more than 24 hours evolution due to cloth organization). DocElisa ^✉ 13:17, 13 February 2013 (UTC)

discussion at WT:MEDRS over recommendations against including primary study results

FYI, there is currently an active discussion at WT:MEDRS over a proposal to weaken the current recommendations in WP:MEDRS against the inclusion of primary studies. Participation would be appreciated! Cheers... Zad68 16:00, 13 February 2013 (UTC)

Check of new ventricular dyssynchrony article

Hi All,

I just created a stub article on Ventricular dyssynchrony. It's my first medical article and I am not a medical expert. I am looking for someone more knowledgeable to take a quick look at the content to make sure I haven't said something horribly wrong. If this is not the right venue to ask such a favor, where would be a more appropriate location?

Thanks, --Mark viking (talk) 22:23, 13 February 2013 (UTC)

Welcome. This is a great place to ask for help. I've never heard of that before, so I'll leave the once-over to someone else, but you are in the right place, and I'm sure someone will have a look before long. WhatamIdoing (talk) 22:51, 13 February 2013 (UTC)

After a quick look on your article. There's nothing horribly wrong. Is a good beginning for an article.

Just some ideas to expand the article:

1 - may be good to expand this theme talking about physiology

little atrio-ventricular dyssynchrony is physiologic, atria contracts before ventricles
little dyssynchrony between ventricles is physiologic too and is the reason for the phonographic components of heart sounds

2 - May be better to expand physiopathology too (a little bit)

a bigger dysssynchony is usually secondary to conduction problems with electrical dyssynchrony. I'm not sure if dyssynchrony leads to heart failure or if heart failure leads to dyssynchrony. Any way, what is sure is: dyssynchrony worses a pre-existing heart failure and an appropriate pacing improves these patients

3 - Tell us what it is "resynchronization therapy"

Well done, go ahead. Regards DocElisa ^✉ 23:18, 13 February 2013 (UTC)

Thanks very much, DocElisa, for reviewing the article! And thanks for the suggestions for improvements and a better description of the relation between dyssynchrony and heart failure. Regards, --Mark viking (talk) 18:19, 14 February 2013 (UTC)

Should this be listed under Category:Cardiac dysrhythmia? Under the more general category of Heart diseases? Somewhere else? WhatamIdoing (talk) 19:31, 14 February 2013 (UTC)

I think you're right about Category:Cardiac dysrhythmia. The Pacemaker syndrome article is under that category and also talks about AV dyssynchrony. I've added the category to the article. I've removed Cardiology, because that is implied by Cardiac dysrhythmia and it looks like the Heart diseases category is also implied by it. Thanks, --Mark viking (talk) 21:22, 14 February 2013 (UTC)

Toxoplasmosis#Signs_and_symptoms

Can an expert take a look at Toxoplasmosis#Signs_and_symptoms? It needs a bit of a tweak for readability. -- Alan Liefting (talk - contribs) 21:18, 14 February 2013 (UTC)

CardioNetworks (ECGpedia, echopedia) upload

There is a discussion at commons:Commons:Bots/Requests/Smallbot 8 as to whether the upload is worthwhile.Smallman12q (talk) 22:39, 14 February 2013 (UTC)

Weird article: Homogenized Milk and Atherosclerosis

I ran across Homogenized Milk and Atherosclerosis (edit | talk | history | protect | delete | links | watch | logs | views) today. It's throwing a lot of red flags up in my mind, including an reliance on cherry-picked, predominantly-primary, mostly-decades-old sources, plus extensive use of references to books published by Sunflower Publishing Co. (of Sweden), which seems to just be an outlet for guys marketing a miracle cure (the so-called "ORS Method") for heart disease. Despite the article being extensive and generally well-formatted, and bearing something like 100 footnotes, it seems to be structured primarily as an argument for a fringe theory.

Should this whole thing be redirected to atherosclerosis, accompanied by a merge of whatever small amount of useful content is present to Atherosclerosis#Diet and dietary supplements, or have I totally misread this article? TenOfAllTrades(talk) 23:43, 16 February 2013 (UTC)

This looks like WP:FRINGE content. Time for WP:AFD? --Orlady (talk) 00:34, 17 February 2013 (UTC)

I agree even if the problem is under research. Is WP:NOR. Is not the milk the problem is Xanthine oxidase and we already have the article. Doc Elisa ^✉ 01:57, 17 February 2013 (UTC)

By the way, I don't know what you think about an article which references are all books and journals not online. We can't verify nothing or we must run from a library to another... I would agree about a WP policy like "the number of references not online can't exceed 50% of the totality", for example. Better to verify Doc Elisa ^✉ 02:07, 17 February 2013 (UTC)

See homogenized milk atherosclerosis - Google Scholar (about 8,690 results).

–Wavelength (talk) 02:54, 17 February 2013 (UTC)

Or instead see PubMed, where the same search gets just four results from the scientific literature: three from thirty or more years ago, and one in 2007 from the famous crank-theory outlet, Medical Hypotheses. The Google Scholar search is pulling in a lot of extraneous results. TenOfAllTrades(talk) 20:30, 17 February 2013 (UTC)

Yes I have not only seen it but read it. The problem is: the subject remains in discussion, is not the milk itself but the treatment procedure "homogenization" and remains "hypothetical". bovine milk xanthine oxidase: a critique of the hypothesis relating to plasmalogen depletion and cardiovascular disease.. We can't affirm something when The American Society for Clinical Nutrition did a paper saying NO: The evidence leads to the conclusion that 1) absorption of dietary xanthine oxidase has not been demonstrated; 2) a relationship between intakes of homogenized milk and levels of serum xanthine oxidase activity have not been established; 3) a direct role for xanthine oxidase in plasmalogen depletion has not been established; 4) neither liposome formation during homogenization of milk nor absorption of intact liposomes from the gastrointestinal tract has been demonstrated; and 5) data are lacking to support the claim that large doses of folic acid inhibit xanthine oxidase in vivo and/or are therapeutic in heart disease. Experimental evidence has failed to substantiate, and in many cases has refuted, the xanthine oxidase/plasmalogen depletion hypothesis. We can't have an article about a controversy research which presents the subject as absolutely confirmed. Anyway, is my opinion. Doc Elisa ^✉ 08:52, 17 February 2013 (UTC)

PS: the 8,690 results in scholar.google only justifies our society where the spectacular, the miracle cure or the devil cause of disease are the best notice and can be easily sold. All are trying to verify the devil. We must be aware of this. Doc Elisa ^✉ 09:06, 17 February 2013 (UTC)

More comments needed for proposed rename of aphthous ulcer

Just bumping this issue. Despite 5 different users voting, there is still a tie and no consensus. Proposal is to rename to "recurrent aphthous stomatitis" or "aphthous stomatitis". Please comment if you haven't done so already (or change your mind), thank you...Talk:Aphthous ulcer#Requested move. Lesion (talk) 15:55, 17 February 2013 (UTC)

Good luck for the new version of this article, Lesion. Doc Elisa ^✉ 20:46, 17 February 2013 (UTC)

Interpretation of WP:MEDRS and Aloe vera article

I needed to check something on the article and discovered lots of primary research, claims, promotional language using primary research, etc., so I started a thread on the talk page to draw attention to the issue. (I don't have much time at present to do a good job of fixing the problem myself, which is usually my preferred way of dealing with such issues.) I'd appreciate it if some editors took a look at the thread and addressed the matter there:

http://en.wikipedia.org/wiki/Talk:Aloe_vera#MEDRS_violations

I'm especially concerned about this part of a comment, which, IMHO, would open a Pandora's box for misuse of primary sources:

"...description of research is not subject to WP:MEDRS."

I can see certain situations which are directly about the research itself, not the subject of the research (in this case aloe vera) where it would be okay, but I'm very uncomfortable about this interpretation. -- Brangifer (talk) 18:37, 17 February 2013 (UTC)

Description of medicine-related research is additionally subject to WP:MEDMOS#Writing style, which it sounds like some editors might want to review. WhatamIdoing (talk) 00:04, 18 February 2013 (UTC)

Can you be a bit more specific? I'm not sure exactly what you mean. Maybe some section wikilinks and exact quotes would help. -- Brangifer (talk) 03:11, 18 February 2013 (UTC)

Anything that contains "promotional language using primary research" is likely to need to be edited to conform with the fourth and fifth bullets:

Do not provide a detailed analysis of an individual study unless the analysis itself is taken from a published reliable source. Wikipedia should concisely state facts about a subject. It should not discuss the underlying literature at any length....
Do not hype a study by listing the names, credentials, institutions, or other "qualifications" of their authors.

I haven't looked at the page in question, but WP:MEDMOS#Writing style deals with hype and promotion. WhatamIdoing (talk) 05:04, 18 February 2013 (UTC)

Excellent! Thanks. -- Brangifer (talk) 05:56, 18 February 2013 (UTC)

References

I have used sfn refs to refer pages of some books and web Pdf articles on Lower limbs venous ultrasonography. Clicking over pdf short ref I go to the full ref but not with books. I don't understand what is wrong. Someone has time to help me? Thank you Doc Elisa ^✉ 20:57, 17 February 2013 (UTC)

Done now. If things don't work as expected, it's best to explicitly use the parameter |ref={{sfn|auth-name|year}} inside the {{cite book}} template in exactly the same style as you used in the {{sfn|auth-name|year|p=page}} template to make the references (instead of hoping that |ref=harv will work things out properly). --RexxS (talk) 22:06, 17 February 2013 (UTC)

Thanks a lot RexxS you have saved my life

Doc Elisa ^✉ 23:18, 17 February 2013 (UTC)

Engaging with other language WikiProject Medicines to collaborate on regional effort

Hi all. In relation to my experiment on Regional variation in standards of care, could someone help me with the following. I see that there are different WikiProject Medicines depending on the language version you choose in the left sidebar. While supporting the main disease state article (English version), it will take a collective effort from people within respective regions and language domains to support supplying information on the variations of how diseases are viewed and tackled in those respective regions. My question is:

Is there currently a method in place to alert and communicate with other WikiProject Medicine language domains on a collective effort such as this experiment (e.g. a channel for all WikiProject Medicine languages to view and see)?

Thanks. GT67 (talk) 18:06, 14 February 2013 (UTC)

I'm unaware of such a platform. Biosthmors (talk) 16:30, 18 February 2013 (UTC)

Project's templates

On "Talk:X-rays", I've noticed one to be edited. It's just a bit of grammar - a single bit; but I was advised to come here and — what?
O'k, it's {{WPMED}} – the information is here, and please pipe it up there if you correct that yourself. Lincoln Josh (talk) 10:18, 18 February 2013 (UTC)

Done. Lincoln Josh (talk) 10:27, 18 February 2013 (UTC)

I think the fix could have gone either way. The text now says This article is within the scope of WikiProject Medicine, which recommends that this article follows the Manual of Style for medicine-related articles and uses high-quality medical sources. It seems like the subjunctive ("We recommend that this article follow our advice and use good sources") would also be appropriate. The most important thing is that the two verbs match. WhatamIdoing (talk) 17:08, 18 February 2013 (UTC)

TM and hypertension

We have a new editor with less than 75 edits but with what appears to be a great deal of knowledge regarding the functioning of Wikipedia at this page [7] wanting a further opinion. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:58, 18 February 2013 (UTC)

Reassessments

Requested at Wikipedia:WikiProject_Medicine/Assessment#Requesting_an_assessment_or_re-assessment if anyone wants to take a stab. Biosthmors (talk) 19:03, 18 February 2013 (UTC)

Philosophy of Chiropractic

Hi all,
I'm concerned that Philosophy of Chiropractic is a POV fork of Chiropractic. However, when I asked at Talk:Chiropractic, DVMt said it had been "approved" by this project. Any suggestions/comments from the good people of WikiProject Medicine? bobrayner (talk) 00:03, 19 February 2013 (UTC)

The conversation is being held here [8] for interested parties. Bob disagrees that WP:MEDRS should apply to the article Philosophy of Chiropractic. Regards, DVMt (talk) 00:07, 19 February 2013 (UTC)

Bob, would this be the same as editor at [9]? --Qexigator (talk) 00:38, 19 February 2013 (UTC)

Here is the diff [10] that shows the MEDRS rating on Philosophy of Chiropractic . DVMt (talk) 00:39, 19 February 2013 (UTC)

What do you mean by "MEDRS rating"? There is no such thing. That's an article importance rating and has nothing to do with MEDRS. -- Brangifer (talk) 03:37, 19 February 2013 (UTC)

Uninvolved editors would be welcome over at Talk:Chiropractic.
DVMt, you said "Bob disagrees that WP:MEDRS should apply to the article". This is a lie. Stop putting words in my mouth. Will you strike that out?
There's also a bizarre ownership problem; I raised concerns that Schools of Chiropractic was a copy & paste move, Scottalter added a history merge tag, then DVMt removed it! Apart from the copyright problem, it's going to be harder to clean up the article if we can't get a clear picture of who did what, considering some DVMt's deceptive edit summaries. bobrayner (talk) 06:52, 19 February 2013 (UTC)

Would Polypill qualify under WP:MED?

I have gotten into a talk page discussion on Polypill with someone who both acknowledges a CoI and disagrees with my removal of a link to a vendor of these kinds of products, on the grounds that the company's board of advisors includes the two people who originally coined the term. More eyes would be appreciated, I acknowledge that I could be totally wrong on this.

Also, I note that the article is not currently tagged as being under WP:MED and I wonder if that is deliberate? ~~If it's just an oversight, I will admit I don't actually know how to tag it as such, so help would be appreciated.~~ -- UseTheCommandLine (talk) 08:35, 19 February 2013 (UTC)

Well yes, but I do feel like I'm being painted here as somewhat more evil than I actually am in real life! :) That's quite a paraphrase of a rather longer discussion at Talk:Polypill and one important thing to note is that I, too, have said that I "could be wrong"; indeed, I'm not exactly putting up a spirited fight there. I too would welcome the scrutiny from other editors with knowledge in the field and of policy. If I have a CoI (and please note that I said potential CoI and have not actually edited the article in a very significant way [er, two first names, one name linked, and an object agreeing with its verb]) then it's pretty mild and I do not exactly stand to gain or lose a lot here (just the yacht). Of course that's why I have not resorted to legal action, death threats, picketing Jimbo etc. The previous sentence should be read as <goak here> by the way. Cheers LBN (talk) 09:03, 19 February 2013 (UTC)

An unfortunate late-night (for me) disagreement has been settled, but I think the Polypill article still could use substantial work. -- UseTheCommandLine (talk) 10:00, 19 February 2013 (UTC)

Agreed! :) Best wishes LBN (talk) 10:43, 19 February 2013 (UTC)

Speaking of CoI...

I have had some involvement with AMSA and PharmFree in the past. I recently made some edits on those pages despite this, and I think I was able to keep it NPOV, though I would appreciate some additional eyes. There was some criticism on, iirc, the AMSA page from a blog that i removed as an EL, though I wasnt able to find a RS link to anything similar. That's my main concern, everything else is pretty much updating or copyediting. (I think, please correct me if i'm wrong)

Anyway, more eyes would be appreciated. Given that relatively few people seem to watch/edit these pages, should I edit and then ask for help, or propose on talk page first? -- UseTheCommandLine (talk) 18:48, 19 February 2013 (UTC)

Looking at my edit history, it seems I've only edited at PharmFree, though the other article probably needs more eyes as well. -- UseTheCommandLine (talk) 19:03, 19 February 2013 (UTC)

Thanks. Everything looks fine to me. I just put the links on the talk page of AMSA in case anyone who wants to write an encyclopedia article might want to consider using them. Biosthmors (talk) 23:47, 19 February 2013 (UTC)

Education Program:Marquette University/Neurobiology (Spring 2013)

I was talking with Yunshui (talk · contribs) about Education Program:Marquette University/Neurobiology (Spring 2013) and MEDRS and here are some links to drafts and respective articles (or one redirect target).

User:Isetem13/Distal spinal muscular atrophy type 1 outline (article at Distal spinal muscular atrophy type 1)
User:ThrowTheBar2/SK Channel Outline (article SK channel)
User:Andersonmatt1125/Spastic Quadriplegia Outline (article Spastic quadriplegia)
User:Bzastrow/Tumefactive Multiple sclerosis (article Tumefactive multiple sclerosis, which was an assignment article last semester from Georgia Tech: User:Biosthmors/Intro Neuro)
User:IJWMarq/"ADCA" outline (article Autosomal dominant cerebellar ataxia, created last semester by a student in the same Georgia Tech class and cerebellar ataxia also exists)
User:MACKXIMUS/Alternating hemiplegia (article Alternating hemiplegia)
User:Sammyt21/"electroneuromyography" outline (currently redirects to Electromyography)
User:Alphabetfood/"Grinker myelinopathy"‎ (article Grinker myelinopathy)
User:CK3501/High Functioning Autism outline (article High-functioning autism)

I'll see what I can do to make sure things are as encyclopedic as possible. Biosthmors (talk) 23:39, 19 February 2013 (UTC)

Proposal to define what WP:MEDRS applies to

There is an active discussion of several proposals to define what WP:MEDRS applies to here. If a proposal gains consensus it would provide a clear scope of what the guideline applies to, and also clarify where it does not apply. This would require significant community participation. Your input is appreciated. Thanks... Zad68 23:53, 19 February 2013 (UTC)

bronchitis

Hey guys, some weirdness happened over at Bronchitis and the entire article looks like a mess. Someone who has some time may want to take a look and see if they can fix the damage that's been done. Just thought I'd pass that along since I don't have time to attend to it at the moment. TylerDurden8823 (talk) 02:40, 20 February 2013 (UTC)

Weirdness reverted. Zad68 02:54, 20 February 2013 (UTC)

Thanks. No clue what that was about.TylerDurden8823 (talk) 06:22, 20 February 2013 (UTC)

Psychology education project

I have found this project Education Program:Davidson College/Cognitive Psychology (2013 Q1). Many articles are medicine related. Students have to add or develop a section in the article and include 10 references. However only a reduced emphasis has been made on the use of secondary sources, and as of today students have posted some possible sources to be used in the talk pages of the articles and in most cases are primary. I have indicated the problem to the teacher and embassador (yesterday) but it is still too soon to see the effect. Nevertheless more eyes would be a good idea. --Garrondo (talk) 14:58, 18 February 2013 (UTC)

Thank you for the note. I see some productive discussion at User talk:CogPsyProf for those that are interested. Biosthmors (talk) 16:28, 18 February 2013 (UTC)

Teacher has just assured me that he has emphasized use of secondary sources in class, and that he will change text of course online as soon as possible. I will closely monitor changes in the stroop effect article.--Garrondo (talk) 16:42, 18 February 2013 (UTC)

I kind of doubt that the students will be able to find ten sources that meet all the usual requirements for a 'best' quality source (secondary, independent, recently published, either peer-reviewed or an academic book, etc.). We might get better work with lower requirements. WhatamIdoing (talk) 17:11, 18 February 2013 (UTC)

Probably true... Another problem is that most articles chosen are already in en essay-state, with tons of primary sources but few secondary, and since students are trying to add more content instead of improving what is already there I actually feel that they are going to advance this trend of essay-cism in psychology articles. --Garrondo (talk) 17:25, 18 February 2013 (UTC)

-They've been responsive to feedback as seen by the note at the top of the course page.Smallman12q (talk) 13:42, 20 February 2013 (UTC)

Very good news!!!--Garrondo (talk) 14:24, 20 February 2013 (UTC)

Podoconiosis

Podoconiosis has made it to the main page with a picture in the DYK section if anyone wants to make edits while it is so prominently linked. Biosthmors (talk) 18:27, 20 February 2013 (UTC)

Water fluoridation

More eyes needed at water fluoridation. Editor is trying to change scope to include natural fluoridation and making unsourced edits, removing stuff they don't like, etc, etc. Colin°^Talk 21:49, 20 February 2013 (UTC)

I have posted at WP:AN3, just to get more eyes on it, maybe someone else can fill in details. I have to run. -- UseTheCommandLine (talk) 22:04, 20 February 2013 (UTC)

I would love more eyes on this - it seems clear that the common usage of the term includes both natural and artificial fluoridation, and that any discussion of fluoride levels in water needs to recognize all the potential sources. Tilapidated (talk) 22:17, 20 February 2013 (UTC)

Tonsil cancer

Having observed that tonsil cancer and tonsillar cancer were redlinks, and noticing that tonsil and oral cancer and palatine tonsil didn't mention the subject in depth, I went to WP:RDS and asked if we had any articles covering cancer originating in the tonsils; they pointed me to oropharyngeal cancer, which is what I wanted. My question — would it be reasonable to create tonsil cancer and tonsillar cancer as redirects to the oropharyngeal cancer article? Nyttend (talk) 02:32, 21 February 2013 (UTC)

Yes and done. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:38, 21 February 2013 (UTC)

Injection fraction

I just ran into the article Injection fraction. To my untrained eye it doesn't look like real medicine. I'd like the opinion of those who have more knowledge than me. Thank you. SchreiberBike (talk) 01:59, 13 February 2013 (UTC)

Well... for me this is new... I'm cardiologist since long long time ago. Big confusion! No sources, good imagination! DocElisa ^✉ 02:15, 13 February 2013 (UTC)

Look at editor's UP and Talk too is strange DocElisa ^✉ 02:22, 13 February 2013 (UTC)

OMG! is not only injection fraction he is changing lots of articles in cardiac physiology! and others. Where he(she) edits little things are changed, apparently not wrong but in fact they are here. I´m looking his edits since 1 hour ago and they are all little but changing the sentence meaning. It will be a big work to correct all. DocElisa ^✉ 03:16, 13 February 2013 (UTC)

I'll go ahead and submit Injection fraction to Wikipedia:Articles for deletion. If you're seeing a dangerous pattern, maybe we should get an administrator involved. The idea of somebody changing medical stuff chills me. SchreiberBike (talk) 04:48, 13 February 2013 (UTC)

See Wikipedia:Articles for deletion/Injection fraction. SchreiberBike (talk) 05:56, 13 February 2013 (UTC)

This seems to go back to his earliest edits in 2007. References never seem to be provided. Very troubling! LeadSongDog come howl! 07:14, 13 February 2013 (UTC)

Davidruben (talk · contribs) and myself have been trying to work with this editor for ages. Lacking the time I have not tried to verify the content in articles he started. I agree that AFD seems a good place for this walled garden of weird stuff. JFW | T@lk 07:25, 13 February 2013 (UTC)

Another "Bicholin conflict" but in Medicine, and on many articles!!! very troubling as you say DocElisa ^✉ 08:31, 13 February 2013 (UTC)

With the "translation task force project" this kind of issue is really a danger. I think all medical stuff must be verified. It seems a very hard work is it possible? DocElisa ^✉ 13:24, 13 February 2013 (UTC)

For example in 2007 in multiple sclerosis the blood brain barrier was well described as an "endothelial" system, in 2008 is already twisted to a "capillary system" what is wrong. I noted it when I have verified the Portuguese translation of this article. DocElisa ^✉ 13:44, 13 February 2013 (UTC)

I have taken a red pen to the obtuse turgid English, removed speculation, statements of what can not be described to a mere "lay" encyclopedia readers, and generally trimmed the article to make some sort of readable paragraphs. I've also removed analogies of buckets (idk), ballistic recoil... Hope this edit is an improvement. That editor with probable coi issue on this topic, previously blocked following repeated warnings and discussion. Such technobabble editing is very hard for other editors to rephrase, and so such distruptive contributions are particularly annoying. David Ruben ^Talk 22:19, 16 February 2013 (UTC)

Sorry, but I don't understand your "improvement" about something that doesn't exist. Injection fraction doesn't exist. If you have found this term in 1 or 2 sources is just an orthographic error. The worse is that many articles about cardiac physiology have been modified by this editor: for example the meaning is changed so is "the calcium which contributes to the AV delay conduction" "and maintain valves opened" what is false. Doc Elisa ^✉ 23:32, 16 February 2013 (UTC)

Here is the true reference of the article Eye on diagnostics Measuring ejection fraction with a MUGA scan. As you can see the author wrote about "Ejection fraction" Doc Elisa ^✉ 23:43, 16 February 2013 (UTC)

That the item seems a neologism I left alone, I simply compressed the waffle, and removed all the tangential verbosity to see if there was any meaningful content - there really is little left ! As they misquoted the one reference in support of a made up term, the article is for the chop. David Ruben ^Talk 00:36, 17 February 2013 (UTC)

I have eliminated some false sentences. I don't know why but I don't think about COI or bad faith. The article was 100% science fiction. I need to verify and correct some other editions. Doc Elisa ^✉ 01:35, 17 February 2013 (UTC)

Reply from author. Biosthmors (talk) 19:18, 21 February 2013 (UTC)

Heads up

Wikidata is going live. This will affect the WP:Interwiki links to articles in other languages. See meta:Wikidata/Deployment_Questions for more information. The practical point is this: if you see someone removing all the interlanguage links, please check the article, not just the diff, to see whether the links still appear in the usual place (on the left, in "Languages" underneath the Toolbox and Print/Export sections, if you're using the normal skin). WhatamIdoing (talk) 23:02, 13 February 2013 (UTC)

What is this about? Lesion (talk) 19:59, 21 February 2013 (UTC)

It basically means that when you see Addbot (talk · contribs) make edits like this, they are legitimate edits and don't worry about them. The big list of inter-wiki language links that are in our articles aren't needed any more. Zad68 20:22, 21 February 2013 (UTC)

Choosing Wisely - a model for organizational engagement

Hello. My name is Lane and I am Wikipedian in Residence at the US-based non-profit organization Consumer Reports. Consumer Reports hired me for no other reason than to promote the development of health articles on Wikipedia, and their specific interest is in sharing information from a health education campaign called "Choosing Wisely". One of the problems I have encountered is explaining to people what Choosing Wisely is and why my organization cares about Wikipedia. Choosing Wisely has a particular health focus, but more broadly, it represents a serious outreach effort on the part of top-level medical organizations to begin promoting the integration of health information into the Wikipedia articlespace. To be transparent about what I am doing I feel that the most natural explanation is my creation of a Wikipedia article on the project on which I am working. To compliment that, I also have a project space at WP:Choosing Wisely.

Consumer Reports and the other participating health organizations care about Wikipedia because Wikipedia is one of the most consulted sources of health information in the world in all places, and it is probably actually the most popular source of health information. I feel that anyone who is serious about providing free health information to the public is obligated to develop Wikipedia articles in their field in a way that is in accord with community guidelines.

The Wikipedia community has extensive policies on WP:conflict of interest editing. I made a Choosing Wisely article as a paid staff member for my organization, so this article would fall under paid editing community regulations. The article is currently at Wikipedia talk:Articles for creation/Choosing Wisely and it is in queue for anyone to review it and make it go live, which I think it deserves because I feel that it meets Wikipedia inclusion criteria. There are not clear community guidelines on how I can propose this article for review, but I posted it to WP:AFC and am posting it here on the WikiProject Medicine board because it is most relevant to this project. Guidelines are clear that I should not make it live myself because I was paid to write it. Further discussion about the article or what it represents could go on the talk page of the article if it were to go live.

I would like for this article and the Choosing Wisely health campaign to be an example for all health organizations that when they conduct educational outreach efforts, they need to consider whether they are sharing the kind of information which people try to get from Wikipedia, and if so, then that organization needs to work with the Wikipedia community to develop practices for doing long-term collaboration to maintain the quality of Wikipedia health articles. I can talk more about this here on this talk page, on my own talk page, in the WP:Choosing Wisely project space, on the Choosing Wisely article talk page if it goes live, or by phone or Skype if you email me your contact details. It is my hope that Choosing Wisely will set a precedent that anyone doing health education of any kind - including all governments, non-profit organizations, hospitals, public health efforts, medical libraries, and anyone else - should recognize the role of Wikipedia in educating the public on basic health topics. Thanks for your attention. Blue Rasberry (talk) 14:20, 20 February 2013 (UTC)

Hey Lane. Thanks for starting this discussion! I'm not sure we have real "paid editing community regulations", but thanks so much for making your potential COI clear. Because you've been around here a while, and we've met before, I assume you want to produce reliable and WP:NPOV content, so I WP:AGF that a real COI is not present. Since you've already declared it, I say skip AfC and post it as an article. Maybe your goal, though, is to develop a cautious model for others with COI or potential COIs. That's respectable. I am thinking about that too.

Because editors here may want to do outreach, and those interested in m:WikiProject Med signal a desire for outreach, maybe we could have simple system at WikiProject Medicine to have our own "ambassadors" to help manage outreach, incoming edits, and potential COIs. (WP:MILHIST has named people to "lead" their Wikiproject, for example.) Those unaffiliated with m:WikiProject Med could serve as a representative of WikiProject Medicine, while affiliated individuals could represent both groups. Lane, both of us already participate in WMF outreach/support, as that kind of WP:Ambassador. I think this concept should be extended to all of Wikipedia, so that editors can serve as volunteer representatives of the Wikipedia community to local organizations and online. It's already happening in classrooms, so why not expand it to the organizations you mention? But posting here at WP:MED and on one's user page about a potential COI seem to always be sufficient in declaring potential "medical" COI. There is also the Wikipedia:Conflict of interest/Noticeboard, and maybe posting there should be part of the process. Perhaps a "WikiProject Medicine ambassador" could be used to "clear" drafts like this, instead of using AfC. Biosthmors (talk) 17:03, 20 February 2013 (UTC)

Maybe I have an unfair bias against AfC, but I've seen it be absolutely useless as Wikipedia:Articles for deletion/Goldilocks Mastectomy came out of it. It just seems like an unnecessary hurdle or hoop to jump through. Biosthmors (talk) 17:03, 20 February 2013 (UTC)

I agree with what you are saying, but since this case is close to me, I do not think that right now I should suggest policies or best practices. I would like to participate in conversations on this topic externally to this request as I am sure many other health organizations also would like a well-defined guide to engaging the Wikimedia community. Just as you described, I also would like access to volunteers serving unofficial leadership roles modeled after outreach positions, because as you pointed out, campus ambassadors are volunteers who speak with a kind of authority at universities, and I feel that chapters like the medicine project or even existing regional chapters have the potential to be analogous contact points for people like me who want to both get a check that I am following policy and to avoid potential harm to the community. The UK Wikimedia chapter, for example, recently instituted new policies on how they interact with people doing outreach as reported in last week's Signpost, and I hope that this starts a trend that when people do outreach that they can use existing chapters and projects to get quick preliminary review before the perpetual and slow process of getting community review begins.

I posted to the Conflict of Interest noticeboard as you suggested. Right now, the article is still not live and anyone other than me can review it and make it live or suggest a reason why it should not be live. I would appreciate anyone doing this review. I think that it is best that I not skip AfC but I would appreciate anyone else making the judgment call on whether this article meets inclusion criteria. Thanks. Blue Rasberry (talk) 04:08, 21 February 2013 (UTC)

Should we leave comments at Wikipedia:Articles for creation/Choosing Wisely (the draft is at Wikipedia talk:Articles for creation/Choosing Wisely)? I just edited the draft and left a comment on the draft. It appears like it could stand some improvement. Biosthmors (talk) 19:04, 21 February 2013 (UTC)

I do not know. The situation is that Articles at AfC go into talk space, which means that there is no obvious place to put comments. You put the comments into the vacant project space. I have no idea why the "article for creation" is not in the project space and why the talk space is not for comments in the system there. I followed your lead and answered the comments you posted in the project space. Blue Rasberry (talk) 03:57, 22 February 2013 (UTC)

Obvious self-promotion

This looks like just another PR campaign - the top Google links are self-published and the rest are the result of a press releases. Clearly Wikipedia is just another link in the self-promotion chain. In short, all I see is a lot of effort at self-promotion and very little indication that this campaign has any notability apart from its promoters. Rklawton (talk) 15:16, 21 February 2013 (UTC)

Notability isn't defined by the order of Google hits, and editors' personal opinions about whether the news articles in bona fide sources are "real articles" or "just the result of a press release" are irrelevant. WhatamIdoing (talk) 18:06, 21 February 2013 (UTC)

I do agree that it is part of a PR campaign. I also think that it demonstrates WP:N and WP:RS, as I would expect it to with a community member working on it. I expect that the potential for increased scrutiny would, over time, undermine its usefulness as a PR vehicle per se, whether through atrophy or through edits to the article. I think that the specific criticism of self-promotion is not particularly useful in determining whether it fits the guidelines, as it suggests that Lane is promoting himself, or that his allegiance is first and foremost to the organization that pays him. While I agree that these are concerns, I think that if this is representative of how the community feels about these issues, then perhaps the idea of the wikipedian-in-residence program should be re-examined and modified; I think that if Lane were not as active as he is in the WP community, those assumptions might be more justified, either on their face or as default positions. Furthermore, as I understand it, the idea of a WiR is to try and avoid some of bigger pitfalls with paid editing and PR by having editors be primarily representatives of the community.

Setting aside concerns about the interests of the person(s) who helped to produce the article, I do agree that the article has a slight promotional tone, though there are any number of reasons I might feel that way (such as being involved in this discussion, for instance), and it seems less obviously promotional than many, many other articles on WP. I am also pleased that criticism of the campaign has been included, and even is contained within the article itself rather than being consigned to a criticism section, as happens so often. I do not think I would be inclined to tag this article, if I saw it while browsing, with "advert".

While I do support the addition of this article, I do not think I should be the one to add it to WP from its current home at AfC, at least not right now. I will take a stab at helping to edit it over the next few days. -- UseTheCommandLine (talk) 19:50, 21 February 2013 (UTC)

William C. Rader

Can someone have a look at this article on an "offshore stem cell practitioner". As best I can make out it has been something of a battleground between those who want to promote and those say the subject is a con artist, and the content reads that way. Some expertise with the underlying topic would help.--Fuhghettaboutit (talk) 13:26, 21 February 2013 (UTC)

Nomination of Hyperia (epilepsy) for deletion

A discussion is taking place as to whether the article Hyperia (epilepsy) is suitable for inclusion in Wikipedia according to Wikipedia's policies and guidelines or whether it should be deleted.

The article will be discussed at Wikipedia:Articles for deletion/Hyperia (epilepsy) until a consensus is reached, and anyone is welcome to contribute to the discussion. The nomination will explain the policies and guidelines which are of concern. The discussion focuses on high-quality evidence and our policies and guidelines.

Users may edit the article during the discussion, including to improve the article to address concerns raised in the discussion. However, do not remove the article-for-deletion template from the top of the article. Maralia (talk) 15:23, 21 February 2013 (UTC)

On a related note, since we've got some new people on board, there are two main ways to keep up with medicine-related deletion discussions: Wikipedia:WikiProject Deletion sorting/Medicine and Wikipedia:WikiProject Medicine/Article alerts. Most of them aren't listed here, so we always need a few people to keep an eye on these pages. WhatamIdoing (talk) 19:34, 21 February 2013 (UTC)

WP:KIS label

Your WP:Keep It Simple label, {{User label WPMedicine}} is in danger of being deleted. See (Wikipedia:Templates for discussion/Log/2013 February 6#Template:User_label.) If you still want it, you may wish to move it to project space, perhaps a redirect page Template:Label_WPMedicine or Template:Label_WikiProject_Medicine by placing {{db-move|Template:User label WPMedicine|[[Wikipedia:Templates for discussion/Log/2013 February 6#Template:User_label]]}} above the redirect. Also see {{user label}} for technical details. Feel free to review my planning page, User:PC-XT/KIS, and talk there if you have questions. PC-XT (talk) 01:35, 13 February 2013 (UTC)

The result of the discussion was move. The label is now {{WP:KIS/WPMedicine}} PC-XT (talk) 05:08, 23 February 2013 (UTC)

Cochrane reviews and "updates" published elsewhere

Hi. I have a quick question. If a study has been published in the Cochrane Database of Systematic Reviews and, shortly thereafter, the same authors publish an update of their findings in a different publication, which study, for Wikipedia, should be given precedence? Example of two studies provided below:

Rubinstein, S. M.; Van Middelkoop, M.; Assendelft, W. J.; De Boer, M. R.; Van Tulder, M. W. (2011). Rubinstein, Sidney M (ed.). "Spinal manipulative therapy for chronic low-back pain". The Cochrane Library (2): CD008112. doi:10.1002/14651858.CD008112.pub2. PMID 21328304. - original review
Rubinstein, S. M.; Van Middelkoop, M.; Assendelft, W. J. J.; De Boer, M. R.; Van Tulder, M. W. (2011). "Spinal Manipulative Therapy for Chronic Low-Back Pain". Spine. 36 (13): E825–E846. doi:10.1097/BRS.0b013e3182197fe1. PMID 21593658. - update

Thanks. FiachraByrne (talk) 20:58, 21 February 2013 (UTC)

In such cases it's important to look closely at the dates. That Cochrane review was up to date back in 2009, but work in the interim clearly would not be included. The newer review by the same authors should be seen as a reliable update. We'd expect the next issue from Cochrane to reflect it.LeadSongDog come howl! 22:29, 21 February 2013 (UTC)

Both come to the same conclusion so it is not that much of an issue. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:49, 21 February 2013 (UTC)

Indeed, the conclusions are similar, just wasn't sure which should be given preference for a citation. Thanks to you both. FiachraByrne (talk) 23:28, 21 February 2013 (UTC)

Both have the same authors, review the same articles, and reach the same conclusions so apart of the ethical issues of publishing twice almost the same thing I would say that there is no evidence to say that any of the two is better than the other. --Garrondo (talk) 07:50, 22 February 2013 (UTC)

This is purely hypothetical and for future reference but what if, assuming the same methodology and rigor, they had enlarged their dataset and come to different, possibly controversial conclusions contradicting their earlier findings? Which study would be preferred? FiachraByrne (talk) 12:42, 22 February 2013 (UTC)

In that case I would either cite the last one or describe the evolution in the conclusions.--Garrondo (talk) 13:31, 22 February 2013 (UTC)

Systematic review vs. Cochrane review

What's the process for weighing a systematic review which completely disagrees with the majority of literature including Cochrane reviews. Would such a paper be considered an "outlier" as it falls outside of mainstream consensus?DVMt (talk) 22:17, 23 February 2013 (UTC)

We would need an example where this is the case. Do you have one? Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:50, 23 February 2013 (UTC)

Yes. This source [11] from a journal with an impact factor of 0.7 is being used to disagree with [12] this Cochrane source with an impact factor of 5.715. DVMt (talk) 19:34, 24 February 2013 (UTC)

RFC on U.S. single payer polling data

Please consider weighing in on this RFC about whether the United States National Health Care Act (the "single payer" bill, H.R. 676) article should include this polling data or not. Thank you! Neo Poz (talk) 06:26, 24 February 2013 (UTC)

Class editing

Hi! I'm daniela

I'm Daniela del Río and I'm working on a project at school for my Medical English Class.

Welcome! Could you post here again and provide a signature for your talk page posts per WP:CHEAT? Thanks so much. What article (or articles) do you plan to edit? Biosthmors (talk) 19:08, 18 February 2013 (UTC)

User:Rorras

Hi Im working on a school project :). Im Rodrigo Rafael Flores Mariñelarena from the Tec CCM.

Holaaaaa :D! I'm Xime!

Hi, I'm a medical student studying in Mexico. I'm doing a project for a medical english class and I'll be using WikiProject Medicine. — Preceding unsigned comment added by Nindasofia24601 (talk • contribs) 18:24, 18 February 2013 (UTC)

Hi there! I'm Israel Collado and I'm working in a Medical Project. — Preceding unsigned comment added by Israel Collado (talk • contribs) 18:26, 18 February 2013 (UTC)

Welcome all! Next time please remember to sign your talk page posts per WP:CHEAT. Thanks! What is your assignment? Does your professor have an account here? Do you have a WP:Course page? Thanks! Biosthmors (talk) 19:08, 18 February 2013 (UTC)

The assignment is Medical English our teacher is User:Thelmadatter no we doesn't have WP:Course page , but that could be a good idea . See you. — Preceding unsigned comment added by Rorras (talk • contribs) 17:58, 25 February 2013 (UTC)

Helloooooooo

Hi! My name is Carolina. I'm working on an English Project and I ll be glad to help on the wikiproject of Medicine. — Preceding unsigned comment added by Carolinapercas (talk • contribs) 18:28, 18 February 2013 (UTC)

Thanks so much. Welcome! Have you seen the five goals we have listed? Also please remember to sign your talk page posts per WP:CHEAT. Thanks! Biosthmors (talk) 19:08, 18 February 2013 (UTC)

Hi! my name is Juan and i'am a student from Mexico sing in here for an English project, if someone could explain me the basic rules of behavoir and what things can i post in here i will be very greatfull :D — Preceding unsigned comment added by JhonnyDuffman (talk • contribs) 17:51, 25 February 2013 (UTC)

Welcome

Welcome to all of you. If you want to see what a great article looks like, then please look over the ones at Wikipedia:WikiProject Medicine#Showcase. If you want some basic advice, see Wikipedia:WikiProject Medicine/How to edit or the links at {{MedWelcome-reg}}. Good luck, WhatamIdoing (talk) 18:01, 25 February 2013 (UTC)

How to translate into Wikipedian: "statistically significant but clinically irrelevant"

Another query I'm afraid. If a therapy has measurable efficacy but is not, in clinical terms, demonstrably more effective than other therapies, what formulation of words might best be used to communicate that in a wikipedian article? I'm think of findings that report, as per the section heading, a therapy that provides a benefit which is statistically significant but not clinically relevant. FiachraByrne (talk) 12:50, 22 February 2013 (UTC)

Before determining this, make sure the study you are citing is even appropriate for inclusion into Wikipedia. By the policies at WP:MEDRS, review articles and other secondary sources are most appropriate for Wikipedia, whereas the kind of result you are referencing is most likely to be found in a primary source. I do not think there there is a better way to say "statistically significant but not clinically relevant", but make sure that this information is notable in the context of the article. In a section on research about a therapy, this information would be useful. Otherwise, it might be better just to say that the therapy is not clinically relevant and let the reader review the source if that person wants more details about how this was determined. Blue Rasberry (talk) 12:56, 22 February 2013 (UTC)

Assuming that both the statistical and clinical significance are both stated in a secondary source, and that that secondary source "believes" that there is truly an effect albeit without clinical singinificancy (and does not propose that such statistical significance is due to other factors such as chance or some kind of bias) I would translate it as "had a slight/small/some effect".--Garrondo (talk) 13:36, 22 February 2013 (UTC)

The statement "a benefit which is statistically significant but not clinically relevant" sounds self-contradictory. A change which has no clinical effect by definition cannot be described as a "benefit". If there's no demonstrable difference to a person's health, it is not a benefit. I would probably argue to exclude such a finding from the article per WP:UNDUE. Zad68 13:46, 22 February 2013 (UTC)

@Zad: Sorry, you're correct of course. Substitute "effect" for benefit. The text reads: "has a small, significant, but not clinically relevant, short-term effect". I won't be adding it to any article myself (although it will be added if not already). It is secondary source and the article is on a therapeutic discipline rather than a condition (and hence must be included as the best source on the efficacy of one of the main treatment modalities of that discipline (which shall remain nameless)).

@Bluerasberry: why would the finding of a marginal effect for a therapy be more likely from a primary than a secondary study? I would have assumed that that was a reflection of the quality of the therapy, in the first instance, rather the form of the study. [edit: allowing for the fact that a bigger sample size is likely to be more accurate I would have thought it was also more likely to find small effects than a small primary study. FiachraByrne (talk) 14:11, 22 February 2013 (UTC)]

@Garrondo: that form of wording seems to reflect the wider medical press reporting the study (which, however, contained more than this single statement of course). FiachraByrne (talk) 14:04, 22 February 2013 (UTC)

A marginal effect for a therapy is more likely to come from a primary source because most medical research returns a null result and most research is primary. Secondary sources generally report what has worked, and give less prominence to what does not. Could you share the paper, the Wikipedia article, and the proposed change you want to make? It is easier to talk about things specifically then make the general case rather than start with the general case and apply it specifically. Blue Rasberry (talk) 14:11, 22 February 2013 (UTC)

But we were having such a rational discussion now I'm afraid my horns will show. It's from the update to the latest Cochrane review on spinal manipulation cited in the section above – I got dragged (or dragged myself) into the alt med morass due to User:ParkSehJik and can't quite seem to disengage. An editor asked me to look at his proposed changes to the Chiropractic article before he submitted them for ~~rejection by~~ consideration to the wider community (defined as the 500+ watchers of that article). FiachraByrne (talk) 14:31, 22 February 2013 (UTC)

Re "a benefit which is statistically significant but not clinically relevant", no this is not "self-contradictory". A bullet to the brain as treatment for chronic back pain is consistently highly effective, but that does not make it a clinically relevant treatment modality - the side effects are too severe. To be clinically relevant a treatment should work and it should be preferrable in some regard to the best treatment available for some population of patients. The "more effective than placebo in a (statistically insignificant/methodically deficient/biased sample-pick any) population" or worse the "not statistically less effective than placebo" sort of comparisons are as valueless as they are common. Such meaningless statements should be ignored on principle. LeadSongDog come howl! 16:12, 22 February 2013 (UTC)

Clinical relevance is of greater importance than statistical significance thus one want to give greater weight to it. Statistical significance is a mathematical concept. Clinical relevance is a person centered concept.Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:47, 22 February 2013 (UTC)

One could say "has a small but not clinically important effort" or simply "made no clinically important difference" Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:48, 22 February 2013 (UTC)

(edit conflict)The latter seems clearer, or just "was clinically unimportant". Any related comments on Talk:Evidence-based medicine#Source? LeadSongDog come howl! 19:00, 22 February 2013 (UTC)

Statistical significance without clinical releavnce is actually not uncommon. All statistical significance means (if done properly) is that a result or difference observed is unlikely to be due to chance. It doesn't tell you if that difference is actually large enough to be useful or cost-effective (or if, as in the bullet-to-the-head example offered by LeadSongDog, it isn't accompanied by other undesirable costs or consequences). I like the way it was described in this Wall Street Journal column: "...a very large sample size reduces the effects of statistical noise, so it can yield very high levels of significance for fairly minor relationships — or, roughly speaking, a large degree of confidence in the existence of a very small effect." (My emphasis added.) TenOfAllTrades(talk) 18:40, 22 February 2013 (UTC)

Wikipedia:Manual of Style/Medicine-related articles#Not_using_careful_language suggests linking to the relevant articles:

The term "significant" can refer to either statistical significance or clinical significance. Statistical significance means that the results are unlikely to be due to chance. Clinical significance means that the results are large enough to be noticed by the patient and will make a difference in the effect of the disease or condition on the patient. For example, a reduction of one ounce of body weight may be statistically significant in a large population, but has no clinical significance for the individual. Linking to statistical significance may be useful.

Depending on what you're trying to say, that might be useful. WhatamIdoing (talk) 23:48, 22 February 2013 (UTC)

Who defines clinical significance and is this usage consistent in any given intervention? For example this review which reviewed the Rubenstein et al. 2011 CLBP Cochrane review criticizes the use of the term clinical significance. To wit, "Based on pooled results from numerous trials, the authors report that spinal manipulative therapy on average has a small advantage compared with other therapies, but that this difference is not clinically important. Unfortunately, there is no standard method for determining what constitutes a clinically important treatment group difference in patient-rated outcomes. It depends on the perspective used. Small group differences may be considered unimportant from the clinician and patient's perspective, but may be important when the proportions of responders are compared and from a societal perspective when cost and risk of adverse events are factored in." PMID 22028377. I don't think we need to split hairs that bad and use the KISS principle. Also, given the pre-determined outcome (as alluded to by Fiachara above) why is it that WP:COMPETENCE does not apply to matters in which a scientific consensus is being developed? The current system is too biased where skeptics/critics of any given intervention (or profession) can vote-stack and thereby nullifying a perfectly reasonable and accurate edit. If, as Fiachra sarcastically suggested, this is likely then the outcome is 'rigged'. Not particular fair when we are dealing with a whole category of medicine (manual and manipulative therapy) practiced by severeal professions including osteopathic physicians, chiropractors, physical therapists, veterinarians, and even selected medical physicians. DVMt (talk) 00:21, 23 February 2013 (UTC)

The conclusions of this review are clear "Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management." Posadzki, P (2012 Jun). "Is spinal manipulation effective for pain? An overview of systematic reviews". Pain medicine (Malden, Mass.). 13 (6): 754–61. PMID 22621391. {{cite journal}}: Check date values in: |date= (help)

Yes there are efforts to state that "Manual and manipulative therapies may be effective for the treatment of low back pain" among many other pain conditions partly based on this Cochrane review [13] which states "High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain"

Efforts to say it is useful for headaches while ignoring this review [14] in preference to this one [15] when the real point they both agree on is the evidence is poor so that we do not know.

And now there are concerns leveled at those who disagree with this overly optimistic view on manipulation as us lacking competence? Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:13, 23 February 2013 (UTC)

It's more complicated than that: "it doesn't work any better than anything else for chronic low back pain" doesn't mean that it doesn't work at all (just that it's no better than the other options) or that it doesn't work for acute low back pain, or that it doesn't work for pain in other areas. So "it may be effective for the treatment of low back pain"— and the other options (like physical therapy and not taking back pain lying down) "may be effective", too. WhatamIdoing (talk) 05:02, 23 February 2013 (UTC)

Agree which is why we current state "The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain" Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:45, 23 February 2013 (UTC)

Doc James, your whole premise rests on an outlier paper done by the hair apparent to Edzard Ernst. Do you realize his paper contradicts Cochrane. It is a fringe paper in itself, since it goes against mainstream consensus on SMT. Furthermore, Doc James is rehashing an issue that was resolved 2 weeks ago in that the statement was qualified and specifically stated "may be effective for certain type of headaches. Note again, the outlier paper by Posadski being used to challenge the mainstream evidence. A clear trend which suggests that it is indeed his research that is fringe as it is not in accordance with the majority of the literature. Furthermore, asserting that there is no good evidence on neck pain is ridiculous. An evidence-based physician know about [16] this report which was funded by the World Health Organization. It is the most exhaustive and comprehensive study of neck pain ever produced. Doc James mischaracterizes low-level evidence as "poor" , NPOV language that inserts words not stated in the review. This bias changes the tone of the material inserting doubt when the actual words "there is low level evidence spinal manipulation is effective for..." I'm going to cut to the chase, having a personal disdain for chiropractic and equating it strictly with pseudoscience shouldn't be used to obscure what the evidence says about manual and manipulative therapy. Too often this red herring is tossed in and emotions take over. Also please note how Doc James omitted this part of the paragraph which closes the lead of chiropractic "The ideas of innate intelligence and the chiropractic subluxation are regarded as pseudoscience.". Yet again, a a critical source Edzard Ernst is used to to make a point by stating that spinal manipulation is unsafe (2008) when a 2012 Cochrane reviews conclude it's "relatively safe". There's a reality distortion field that is going on here which is not based on mainstream consensus regarding manipulative therapy. Doc James wanted a RfC, and he shall have it here on WP:MEDRS when the proposed draft is revised. DVMt (talk) 06:29, 23 February 2013 (UTC)

DVMt, please try to keep your comments focused on the text and sources and not about other editors; also remember to WP:AGF. Puhlaa (talk) 08:41, 23 February 2013 (UTC)

I agree with the point made by WhatamIdoing in that "it doesn't work any better than anything else for chronic low back pain" doesn't mean the same as "it doesn't work at all". This cochrane review concludes that "High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions...in patients with chronic low-back pain." and the plain language summary expands to say: "...spine manipulation appears to be as effective as other common therapies prescribed for chronic low-back pain, such as, exercise therapy, standard medical care or physiotherapy." Similarly, this secondary source concludes that spine manipulation achieves "equivalent or superior improvement in pain and function when compared with other commonly used interventions, such as physical modalities, medication, education, or exercise, for short, intermediate, and long-term follow-up." In fact, most secondary sources conclude that manipulation is 'as effective as other therapies', or that it is just simply 'effective' for back pain; for example [17][18][19]. Doc James has presented one source by one author that says spine manipulation is not effective for pain, but IMO this is a fringe view when discussing back pain specifically. The current text at the chiropractic article is "The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain", but the bulk of mainstream sources seem to indicate that manipulation is equally as effective as all other treatments, including standard medical care, for back pain.Puhlaa (talk) 08:41, 23 February 2013 (UTC)

Yes, I agree with WhatamIdoing as well in this regard. But I strongly disagree with the statement " scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain". Chiropractic ≠ SMT and vice-versa. A more precise description would "Scientific consensus is that manual and manipulative therapies are equivalent to other therapies such as exercise, standard medical or physiotherapy for mechanical musculoskeletal disorders such as low back pain.". Given that LBP is now the leading cause of disability worldwide disability in people under age 45 [20] it's important we don't give manipulation the short shrift. DVMt (talk) 17:49, 23 February 2013 (UTC)

Sorry if I created a minor shit-storm and sincere thanks to everyone who offered an opinion. It's been highly informative for me. It's probably best to restrict any further discussion to the relevant article talk pages. FiachraByrne (talk) 20:37, 23 February 2013 (UTC)

To the contrary Fiachra, this is exactly what is needed is discussion regarding a) effectiveness of manual manipulative therapy b) safety of manual and manipulative therapy and c) cost-effectiveness. These are the central themes which edit wars are based on, and it's primarily because we're not achieving a true scientific consensus which has led us to this point. Ergo, the RfC on manual and manipulative therapy. DVMt (talk) 20:58, 23 February 2013 (UTC)

Sure let us know when you have the RfC drafted. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:24, 23 February 2013 (UTC)

Truth lies in science Doc James, not in beliefs. Using fringe, outlier papers from Ernst and Posadzki, that disagrees with recent Cochrane reviews is the crux of your argument. The RfC will be enlightening I'm sure. We're going to see why you single handedly deleted 100 new research papers, many of them systematic reviews on basic sciences of spinal manipulation, and joint dysfunction, history and research. This is troubling by any standard. We simply cannot white-wash articles by scrubbing them free of new sources that date from 2005-2013. The science is there but there's obfuscation going on. This has somehow turned personal when it simply is a question of in depth scientific investigation of manual and manipulative therapy. DVMt (talk) 21:52, 23 February 2013 (UTC)

You mean "single handedly" with the help of 5 others? [21] and that the "science is there" except for the difficulty with "fringe" groups like the Cochrane collaboration and a few others like Ernst and Podsadzki who manage to get published in "fringe" journals like Cephalalgia (journal) [22] (impact factor 3.4), and Pain Medicine (impact factor 2.3) [23] among many others

By "basic science" do you mean references from the Journal of Manipulative and Physiological Therapeutics with its impact factor of 1.3 from the American Chiropractic Association such as this paper [24] in edits like this [25]? Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:45, 23 February 2013 (UTC)

Actually, what's the impact factor of Spine? Cherry picking isn't very nice. DVMt (talk) 00:49, 24 February 2013 (UTC)

RfC: Effectiveness of SMT for LBP

What's the process for weighing a systematic review which completely disagrees with the majority of literature including Cochrane reviews. Would such a paper be considered an "outlier" as it falls outside of mainstream consensus?DVMt (talk) 22:17, 23 February 2013 (UTC)

So to be clear you are trying to say that

This 2008 Cochrane review [26] which concludes "High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain" and this 2012 Cochrane review[27] which states "SMT is no more effective in participants with acute low-back pain than inert interventions, sham SMT, or when added to another intervention. SMT also appears to be no better than other recommended therapies."

disagrees with

This 2011 review [28] "Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition." and this 2012 review[29] which states "Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management."

IMO they all seem to agree more or less. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:25, 23 February 2013 (UTC)

Doc James, I believe that what DVMt is saying is that there are 2 clusters of sources that are saying different things and I agree with him/her. The following 6 mainstream reviews, collectively written by about 25 authors, say that say spine manipulation is equal or greater than all other interventions for back pain:

This cochrane source "High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions...in patients with chronic low-back pain." and the plain language summary expands to say: "...spine manipulation appears to be as effective as other common therapies prescribed for chronic low-back pain, such as, exercise therapy, standard medical care or physiotherapy."
This secondary source concludes that spine manipulation achieves "equivalent or superior improvement in pain and function when compared with other commonly used interventions, such as physical modalities, medication, education, or exercise, for short, intermediate, and long-term follow-up."
This cochrane review concludes "Combined chiropractic interventions slightly improved pain and disability in the short-term and pain in the medium-term for acute and subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions."
This cochrane review cautiously concludes "SMT is no more effective in participants with acute low-back pain than inert interventions, sham SMT, or when added to another intervention. SMT also appears to be no better than other recommended therapies. Our evaluation is limited by the small number of studies per comparison, outcome, and time interval."
This secondary source concludes "Therapies with good evidence of moderate efficacy for chronic or subacute low back pain are cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation."
This secondary source found that manipulation is similar in effect to medical care with exercise.

And these 6 conclusions are in contrast with these other 2 papers, written by 2 authors, which claim that manipulation is good for nothing:

This source written by Posadzki P, Ernst E. say "Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition."
This source, also by Posadzki P. states "Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management."

To me there is a clear difference in conclusions between the first 6 papers and the last 2 papers. As such, DVM is asking "What's the process for weighing a systematic review which completely disagrees with the majority of literature including Cochrane reviews". Is this an accurate representation of what you are asking DVMt? Puhlaa (talk) 23:07, 23 February 2013 (UTC)

Yes, I would agree with that interpretation. Thank you for collecting the sources in question in an organized matter. DVMt (talk) 23:12, 23 February 2013 (UTC)

In other words, there are 27 authors investigating spinal manipulation effectiveness. 25 are in agreement and 2 dissent. If this doesn't clearly delineate the fringe and mainstream views, nothing can.

Section move

Doc, please don't move the section. This is meant for a question to a wide audience, not just pertained to those who are interested in manual and manipulative therapy. Also, I did not state anything of the sort. Please do not assume my argument and speculate. I will comment here for your specific question but after I get to post my question to the broad audience. Please do not censor my question. We all have to abide by WP rules, whether we are admins or not. DVMt (talk) 22:45, 23 February 2013 (UTC)

Have just looked through your edits and they all more or less related to chiropractics. Let see what others think.Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:49, 23 February 2013 (UTC)

To address the question. My argument is this: you are using two Ernst/Posadzki articles [30], [31] which are fringe/outliers papers to have equal weight with the mainstream consensus (i.e. Cochrane reviews 2011, 2012, 2013). Clearly SMT is considered to be equivalent to other interventions for low back pain management, as effective specifically as "standard medical care, exercise therapy and phsyiotherapy. Yet, there is a push to give undue weight the Posadzki review which incredibly states "these data fails to demonstrate convincingly that spinal manipulation is an effective intervention for any condition." Clearly this is an outlier opinion that is not in agreement with the scientific consensus, yet you argue for the fringe side. This is rather astonishing. The mainstream consensus, as I understand, gets more weight than fringe views. DVMt (talk) 22:55, 23 February 2013 (UTC)

Thanks so your position is that the Cochrane papers I have mentioned above say something different from the Ernst/Posadzki paper. Let see what others think as IMO they say basically the same thing (SMT is equivalent to the control). Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:04, 23 February 2013 (UTC)

Doc James, I think that the 6 'positive' sources (thus NOT Ernst's) are saying manipulation is no better than control. However, you are skipping over the fact that the 'control' group in most of the systematic reviews included usual medical care. The Ernst paper is saying that manipulation is not effective, the others are saying manipulation is no more effective than usual care. This is a different conclusion IMO. Puhlaa (talk) 23:14, 23 February 2013 (UTC)

Agreed. IMO the argument Doc James is making is "manipulating" (haha) the conclusions by attempting to subterfuge the argument of equivalence with standard medical care. Also, as SMT is by and large equal to standard medical and physical therapy interventions for LBP, this would mean that the SMT is seen as a complementary therapy (i.e. research that demonstrates effectiveness and safety) which goes against the fringe views of Ernst and Posadzki. SMT has gone mainstream, more or less, for treatment of spinal pain disorders. We need to acknowledge this. It was accepted more or less in the 1980s as an intervention for LBP. DVMt (talk) 23:40, 23 February 2013 (UTC)

Yes so SMT is equivalent to control. It is fine at that point to say either SMT is more or less the same as other conservative measures or that it is simply not effective. When acupuncture was shown to be equivalent to sham acupuncture for migraines that was not deemed to be a success for acupuncture.[32] When a medication equals a sugar pill we do not say the medication "works" because we know placebos "work". The difficult with chiro, acupuncture, and transcendental meditation among others is that an active control is required. People feel better when you pay attention to them. For these methods to be claimed to "work" they need to be better than control which the majority of the literature does not support. I spend much of my life distracting people until they get better on their own and I am happy to admit it :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:30, 23 February 2013 (UTC)

Please do not talk about other therapies. So you are suggesting the benefits of SMT are entirely placebo? If this your argument then? So standard medical care, exercise therapy and physiotherapy work by way of placebo too for LBP? DVMt (talk) 23:40, 23 February 2013 (UTC)

Why not talk about other therapies, we are discussing how to address these issues generally. Comparing exercise to no exercise is reasonable. Typically expensive and complicated therapies such as chiro and transcendental meditation would need to beat more conservative therapies like "simply exercise" not just match them to be deemed a success in most peoples minds. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:01, 24 February 2013 (UTC)

I agree with the idea that cost-effectiveness is a major determining factor when efficacy is equivalent. After concluding that "SMT appears to be as effective as other common therapies prescribed for chronic low-back pain, such as, exercise therapy, standard medical care or physiotherapy." the authors of the cochrane review state that "Determining cost-effectiveness of care has high priority." So far, reliable secondary sources currently suggest that manipulation is a cost-effective therapy for back pain [33][34], however, comparative cost analysis between all of the equally efficacious (or not) therapies has yet to be done. As such, I feel that part of Doc Jame's last comment (that chiro is expensive relative to other treatments) is more of your personal opinion than fact. As I said, I do agree that cost-effectiveness is important, but we don't have that data yet. Puhlaa (talk) 00:47, 24 February 2013 (UTC)

No. The purpose of this RfC specifically pertains to manual and manipulative therapy. Let's focus on this issue, shall we? You are going on tangents without providing any evidence to your arguments. Repeatedly doing could be viewed as tendentious editing. Typically expensive and complicated? The research demonstrates cost-effectiveness and the 'complicated' comment is a WP:COATRACK argument. It doesn't pertain the matter at hand. Please do stay on topic. Scientific consensus depends on it. DVMt (talk) 00:34, 24 February 2013 (UTC)

you keep mentioning RfC would you be so kind as to provide a link to the RfC Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:06, 24 February 2013 (UTC)

Evidence against SMT as a therapeutic intervention for LBP

SMT is not effective for LBP and it is a placebo. Authors: 2. Edzard Ernst, Paul Posadzki.
Journals: New Zealand Journal of Medicine (IF 0.6-0.7) and Pain Medicine (IF 2.346).

This source written by Posadzki P, Ernst E. say "Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition."
This source, also by Posadzki P. states "Collectively, these data fail to demonstrate that spinal manipulation is an effective intervention for pain management."

Represents the minority/outlier viewpoint.

Evidence for SMT as a therapeutic intervention for LBP

SMT is equivalent to standard medical care, exercise therapy and physiotherapy, for LBP. Authors: 41. Rubenstein et al.
Journals cited: Spine (IF 3.290), Cochrane review (IF 5.715), Annals of Internal Medicine (IF 16.7), Journal of Electromyography and Kinesiology (IF 1.969), European Spine Journal (IF 1.96), Clinical Orthopaedics and Related Research (IF 2.533).

This cochrane source "High quality evidence suggests that there is no clinically relevant difference between SMT and other interventions...in patients with chronic low-back pain." and the plain language summary expands to say: "...spine manipulation appears to be as effective as other common therapies prescribed for chronic low-back pain, such as, exercise therapy, standard medical care or physiotherapy."
This secondary source concludes that spine manipulation achieves "equivalent or superior improvement in pain and function when compared with other commonly used interventions, such as physical modalities, medication, education, or exercise, for short, intermediate, and long-term follow-up."
This cochrane review concludes "Combined chiropractic interventions slightly improved pain and disability in the short-term and pain in the medium-term for acute and subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions."
This cochrane review cautiously concludes "SMT is no more effective in participants with acute low-back pain than inert interventions, sham SMT, or when added to another intervention. SMT also appears to be no better than other recommended therapies. Our evaluation is limited by the small number of studies per comparison, outcome, and time interval."
This secondary source concludes "Therapies with good evidence of moderate efficacy for chronic or subacute low back pain are cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation."
This secondary source found that manipulation is similar in effect to medical care with exercise.
This 2012 systematic review supports the use of SMT in clinical practice as a cost-effective treatment when used alone or in combination with other treatment approaches.
[35] Combining spinal manipulative therapy with other interventions (multi-modal) are more beneficial than unimodal therapeutic approaches.
[36] There is evidence supporting the cost-effectiveness of the guideline-endorsed treatments of interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation and cognitive-behavioural therapy for sub-acute or chronic LBP.
[37]. Studies of nonoperative treatments demonstrated greater value for graded activity over physical therapy and pain management; spinal manipulation over exercise; behavioral therapy and physiotherapy over advice; and acupuncture and exercise over usual general practitioner care.
[38] Therapies with good evidence of moderate efficacy for chronic or subacute low back pain are cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation. From the American College of Physicians.

Represents the mainstream, majority viewpoint. Note the interdisciplinary consensus with 39 of 41 authors agreeing with a common , mainstream, majority viewpoint.

Comments

Yup, this reached WP:TLDR for me about three subsections ago. You might want to draft this stuff in your userspace and try again. If you want to have a back-and-forth kind of thing, then consider using a table, with each "side" getting one column. You can see an example of this style at Talk:Special education/Archive 5#Planning (an RFC that we didn't need to have, once everyone figured out what the actual question was).

It's normal to have content RFCs on the talk page of the article that will be affected by the outcome. I really think that you ought to consider the effect on the regular editors at that article of having a bunch of "outsiders" make decisions over here about an article that 90% of us haven't ever read or edited. It's not generally a way to keep the article's regular editors feeling like you want their participation. WhatamIdoing (talk) 05:56, 24 February 2013 (UTC)

As this issue pertains to a specific question involving scientific evaluation of manual and manipulative therapy, and because WP:COMPETENCE applies, I brought it to WP:MEDRS. The arguments have been condensed above. There's basically 2 dissenting sources against 11. The dissenting sources are fringe and outlier since they completely contradict with the existing body of literature including Cochrane reviews. In terms of having "regular editors participate" I agree completely for other material not pertaining to medical matters. I don't anticipate there being another RfC such as this since we are finally dealing with this issue which was way past its due date! :) DVMt (talk) 16:21, 24 February 2013 (UTC)

I see it as 13 sources that more or less agree with each other. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:05, 24 February 2013 (UTC)

The 13 sources are not in agreement. 11 specifically refute the 2 that you're in agreement with. I would caution against such obfuscation of the matter. DVMt (talk) 19:26, 24 February 2013 (UTC)

Move this to the article Talk page - this very deep content-specific argumentation doesn't belong here at WT:MED. Please move it to the article Talk page. If you're keen on getting WP:MED input you should leave a note here about the discussion there. Zad68 18:34, 24 February 2013 (UTC)

We are in the middle of the RfC however. Based on the evidence provided above, do you not have a comment? Also, this is not specific to any talk page, as it involves manual and manipulative therapies, which is not specific to chiropractic, but also pertains to osteopathic manipulative medicine and physical therapy.DVMt (talk) 18:43, 24 February 2013 (UTC)

You state "We are in the middle of the RfC" but I see no RfC on the page Talk:Chiropractic. Is the RfC taking place somewhere else? Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:03, 24 February 2013 (UTC)

Welcome back, James! How about we deal with the primary issue at hand, which is regarding the Effectiveness of SMT for LBP. So far you've produced two sources which are a) not in accordance with the majority of the literature on SMT and LBP including one with an impact factor of 0.7. And b) you've incorrectly asserted that SMT was not cost-effective, and that that any results were based on placebo. Do you have any other sources, other than Ernst and Pozadski, preferably from secondary sources in high impact journal that agree with these authors? DVMt (talk) 19:12, 24 February 2013 (UTC)

I'd be happy to comment on an RFC if there's an actual RFC at an article Talk page that you can point me to. This is not the place to hold an RFC. I think there is a consensus now that this conversation should be moved to an article Talk page, and if you are unwilling to make that move happen yourself, I'm sure someone else here will be willing to do that for you. Zad68 19:30, 24 February 2013 (UTC)

Doc James requested an RfC and I requested WP:MED takes a look at the sources in questions. Also, my previous concern was not adressed, specifically that it is not appropriate to hold the RfC at any talk page given that manual and manipulative therapies is not specific chiropractors, but to osteopathic physicians, physical therapists and specialist MDs who work in sports med or orthopaedics. DVMt (talk) 19:37, 24 February 2013 (UTC)

This isn't an RFC. Is this just an unfamiliarity with what an "RFC" is? Take a look at WP:RFC, follow the instructions there. You appear to be proposing article content changes so this should be held at an article Talk page. You should identify one article Talk page and start a new section there with a proposal of the form "Consider changing article content from X to Y using source(s) Z." If there might be more than one article affected, I suggest you start by picking one article, let the RFC run its course there, and then maybe you can apply the outcome of that RFC discussion at other articles. The reason you are putting forward here isn't strong enough to avoid holding the RFC at a particular article talk page, pick one and start there. Zad68 19:43, 24 February 2013 (UTC)

Ok, fair enough. A RfC was opened at spinal manipulation as it is the most appropriate article talk page, IMO. I ask Doc James, again, do you have any other sources, other than Ernst and Pozadski, preferably from secondary sources in high impact journals, that agree with the conclusions of these authors?m DVMt (talk) 20:31, 24 February 2013 (UTC)

Sure, there are these secondary sources in high impact journals:

PMC 1420782 "Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment." (J R Soc Med)
PMID 20642715 "Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit." (Int J Clin Pract)
PMID 18280103 "With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition." (J Pain Symptom Manage)

You need to learn that the reliability of sources in Wikipedia is determined first of all by the reputation of the journal, not your biases against authors who reach conclusions that you don't like. There's insufficient difference between the conclusions drawn through all of the sources that have been mentioned to sustain your attacks on the mainstream view that chiropractic spinal manipulation offers nothing that isn't achievable in many other ways - with the exception of chronic back pain where it does seem to have an advantage over competing therapies. No matter how often you try to smear Ernst by calling his conclusions "fringe" and "outliers", they are not. The Lancet doesn't publish reviews that are "fringe" and "outliers", nor does the Journal of the Royal Society of Medicine, nor the other distinguished journals that have a reputation for fact-finding and accuracy where these conclusions are published. Have a read of WP:NPOV: "Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in the published, reliable sources." That's prominence in the sources, regardless of the authors, and you're going to have to learn to count the sources, not the authors, to determine what is prominence. --RexxS (talk) 22:04, 24 February 2013 (UTC)

RexxS, I disagree with your statement "count the sources not the authors". I think that, in general, 5 papers from 5 independent groups of authors that reach similar conclusions would get more weight than a contradictory conclusion from 100 papers by one author. IMO, it is the weight of the entire scientific community that determines consensus, not the sheer number of papers one author can publish. Perhaps this topic would make a good topic for discussion here? I am curious what the consensus would be on this issue in general?Puhlaa (talk) 00:40, 25 February 2013 (UTC)

I understand your view, Puhlaa, because it seems rational that one author published 100 times should carry less weight than 100 authors published once. But that's a fallacy, because it ignores the publishing process of respected journals: one author published 100 times carries the weight of 100 peer reviews and 100 editorial decisions which oversaw the publication process, just as the other case does. It is a common misconception on Wikipedia that it is the author themselves who carries weight: their contributions are actually granted their weight by all of the trusted process surrounding their publication - and it is that trust that we rely on to establish a reliable source. It is clear therefore when we are asked by WP:NPOV to represent "in proportion to the prominence of each viewpoint in the published, reliable sources", that we cannot discount papers in judging a viewpoint's prominence simply because they happen to have the same author - indeed the request to find sources not by author X is precisely the sort of selection bias that we must guard against (and was the reason why I deliberately chose differing reviews by Ernst to make the point). Of course, I would be happy to debate the issue again here if I haven't explained my reasoning clearly enough. Cheers --RexxS (talk) 15:56, 25 February 2013 (UTC)

Well said. Perhaps this should be incorporated into WP:MEDRS. -- Scray (talk) 16:39, 25 February 2013 (UTC)

I'll save others the trip - at this point there's still no RFC (just a link on Talk:Chiropractic back to this discussion, which is not productive). I think DVMt has been directed to WP:RFC before, so I don't understand why any confusion about the process would continue. -- Scray (talk) 00:26, 25 February 2013 (UTC)

He made one here: Talk:Spinal_manipulation#RfC_Effectiveness_of_SMT_for_LBP — raeky t 00:28, 25 February 2013 (UTC)

it should probably be noted here that DVMt was blocked 3 days for edit warring. Zad68 02:25, 25 February 2013 (UTC)

Google Scholar versus PubMed

In a recent discussion on this talk page (#Weird article: Homogenized Milk and Atherosclerosis), it was apparent that other editors gave more credence to four search results on PubMed than to 8,690 search results on Google Scholar, implying that PubMed has higher quality as a reference source than does Google Scholar. I have been accustomed to believing that Google Scholar delivers results of high quality, at least in comparison with regular Google Search results. PubMed is hosted by the United States government. What is the policy of this WikiProject in regard to the relative credibility of these two search options, and on what is that policy based?
—Wavelength (talk) 00:35, 24 February 2013 (UTC)

Both contain very much the same content. The key is that we prefer secondary source per WP:MEDRS Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:21, 24 February 2013 (UTC)

See also Index medicus, the historical precursor of PubMed et al. As noted, there have been competing indices, but as I understand it this is the core upon which all English-language medical librarianship is based. I'm unsure what your (Wavelength) comment about it being hosted by the US government is supposed to mean, please clarify. -- [ UseTheCommandLine ~/talk ] #_ 03:02, 24 February 2013 (UTC)

Some readers might perceive government sources as being more credible than other sources because of their access to extensive amounts of information. Some other readers might distrust government sources as possibly being unduly influenced by corporate interests.

—Wavelength (talk) 03:17, 24 February 2013 (UTC)

You seem to be using the term "source" in a way I do not understand. PubMed is an index (and PubMed Central is a repository). They are not the source of the information contained in most of the cited medical journal articles, in the sense that they neither publish, nor produce articles. -- [ UseTheCommandLine ~/talk ] #_ 03:29, 24 February 2013 (UTC)

I mean that PubMed chooses which published information to index, just as Google Scholar (algorithmically) chooses which published information to index.

—Wavelength (talk) 03:39, 24 February 2013 (UTC)

at some level there will be a human making decisions either way, either in the decision to include or exclude journals, or in deciding whether to adjust or replace the algorithm. there is also a way to request your papers be indexed by Scholar, so long as they conform to Google's standards. So I guess what I'm still puzzled about is the reason for the the distinction you appear to be making. -- [ UseTheCommandLine ~/talk ] #_ 04:52, 24 February 2013 (UTC)

Additional information about inclusion criteria etc can be found at the NLM's Bibliographic Services Division website. -- [ UseTheCommandLine ~/talk ] #_ 03:05, 24 February 2013 (UTC)

Thank you, Doc James, for the link to WP:MEDRS, which explains why secondary sources are preferred.

—Wavelength (talk) 16:17, 24 February 2013 (UTC)

WP:MEDRS has a link to Wikipedia:Identifying and using primary and secondary sources, which I have started to read.

—Wavelength (talk) 17:09, 25 February 2013 (UTC)

Alternapedia

Alternapedia describes itself as "the online encyclopedia where researchers, educators and practitioners in naturopathic and other forms of integrative medicine edit and create the encyclopedia entries." I am not suggesting this as a source for Wikipedia articles, but its information might give editors ideas for improving Wikipedia's coverage of some topics.
—Wavelength (talk) 21:47, 25 February 2013 (UTC)

Just looked at it and much appears to be simply copy and pasted from Wikipedia. Thankfully it gives us credit at the bottom so all is cool. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:20, 25 February 2013 (UTC)

WikiProject administrative work, not for admins

Does anybody have a bad case of editcountitis at the moment? A whole bunch of biographies and organizations have been incorrectly rated as "Mid" importance on our tags. I've cleared out almost a hundred, but if someone else wants to take over, then please start at the letter D. Basically all articles about people and organizations are low importance for this project (by which we really mean low priority for us to work on, not exactly "importance") per WP:MEDA.

Fixing this just means going to the talk page of any person- or organization-sounding article and changing the |importance=Mid to its correct setting, which is |importance=Low. There are probably a couple hundred to be done, and it only takes a few seconds each. WhatamIdoing (talk) 01:04, 19 February 2013 (UTC)

this would be a very good job for a script if it were allowed. If I write a script to do this will I get in trouble for using it? Zad68 01:17, 19 February 2013 (UTC)

I would caution against it, for stubs I can see, but for developed articles it wouldn't be fair not to have a human take a look at it. DVMt (talk) 02:25, 19 February 2013 (UTC)

Per WPMED these are all low importance. Other projects of course can set them differently. Would support a script. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:47, 19 February 2013 (UTC)

I'm not suggesting that a script determine which articles need updating and with what assessment value, just that a script can apply the updates. If a human can put together a list of article titles and WP:MED assessments, I could probably run a script to apply the updates. Zad68 03:07, 19 February 2013 (UTC)

Sounds good to me! DVMt (talk) 03:32, 19 February 2013 (UTC)

A request at Wikipedia:AutoWikiBrowser/Tasks might to the trick. Biosthmors (talk) 03:35, 19 February 2013 (UTC)

We used to have one. A copy is at User:WhatamIdoing/Temp.js. It broke a couple of years ago, with the switch to Vector. WhatamIdoing (talk) 00:43, 20 February 2013 (UTC)

Not too bad - I just finished (I think) Z, Y, W, and V. -- Scray (talk) 06:34, 20 February 2013 (UTC)

I've gotten the next couple of letters done, so someone else can start with the letter H. It's pretty easy: find anything in this list that looks like a person's name (check the article if you're not sure), and change the WPMED template from "Mid" to "Low". WhatamIdoing (talk) 02:03, 26 February 2013 (UTC)

It is easy. Up to the letter J now. Biosthmors (talk) 02:14, 26 February 2013 (UTC)

Up to the letter M. Biosthmors (talk) 21:16, 26 February 2013 (UTC)

It's done. Biosthmors (talk) 01:33, 27 February 2013 (UTC)

Stem cell educator

I think is yet a research subject. It will be wonderful if we can educate stem cells, but is just a trial. Doc Elisa ^✉ 08:41, 25 February 2013 (UTC)

I'm not a medical researcher, but would point out that references have been removed, so consideration should be based on all the evidence. The subject is certainly quite early but appears to be moving from pure research towards application. Removed materials include a 'reception' section which truthfully reported non-medical press reception, to which surely MEDRS cannot be expected to be applied. I will accept whatever is decided here, and have neither edited the article lately nor will do so unless asked. If any further input from me is desired, please ask on my talk page. Chiswick Chap (talk) 09:27, 25 February 2013 (UTC)

Red Pen - I don't think your edits are appropriate, you should go back and search for better sources for the content you removed. It is good practice to search for secondary sources to support content currently supported by primary sources, or failing this use the tag {{primary source-inline}} to highlight the need for better sources to a future editor who may perform this search, if you are too busy. Some editors prefer to delete content immediately. In time, editors non familiar with MEDRS will add back the removed material referencing more primary sources and the cycle begins again. The best way to improve an article is to preserve content where ever possible, and substitute less favorable sources with better ones. This is responsible editing. Lesion (talk) 13:14, 25 February 2013 (UTC)

Lesion, I understand your point, and I can see where some of those edits might be seen as a little aggressive. My view is that given the paucity of secondary sources, the article should be limited almost entirely to media attention. It seems also like there might be a WP:COI issue lurking here too, as I mention on the talk page. all the cited articles have the same primary author, which is a little strange to me; it's not like this is a new field or anything, and I would have thought most editors would want to cite multiple people. And it would not be outside the realm of possibility for someone to coin a neologism and make up a wikipedia page to support that term ahead of publication of, say, a book. Or an article. Not that I am accusing anyone of anything, just saying that my impression from watching AfD discussions is that that sort of thing has happened before, so there is likely to be a precedent. I will also note that the diagram posted on commons has the "source" as being from http://tianhecell.com.

FWIW, my institution does not get Autoimmune Reviews So I am unable to evaluate the sole listed secondary source, though I would very much like to. -- [UseTheCommandLine ~/talk] #_ 16:46, 25 February 2013 (UTC)

The specific instance is complicated, but in general I'm with Lesion: we have a bit too much "Rv, you didn't name a secondary source" and not nearly enough "Here's a better source for what you just added". It's not a game of Mother, May I? or Simon Says, so that failing to provide a secondary source on the first try gives you free pass to remove whatever someone else added.

On the other hand, if the content is inappropriate or just plain wrong, then it needs to be removed no matter what (where "no matter what" includes "even if it was added by WhatamIdoing": none of us are perfect, and we're all counting on the rest of you to fix our occasional mistakes). WhatamIdoing (talk) 17:50, 25 February 2013 (UTC)

Would it be possible for you to provide more detail on the talk page? I do see some removal of journalism-type references removed, and one commercial one. I'd appreciate more discussion over there (and if I can persuade you to, diffs). -- [UseTheCommandLine ~/talk] #_ 18:22, 25 February 2013 (UTC)

Searches for "Stem cell educator" led to hits of "Dr. Smith, a stem cell educator, ..." If you think there are lots of secondary sources that are just laying out there waiting to be added to the article, you should be able to find them with no effort as well. -- TRPoD aka The Red Pen of Doom 01:46, 28 February 2013 (UTC)

You miss the point entirely. The duty of performing this search and if appropriate substituting with secondary sources lies with the person who wants to delete the primary sourced content. Lesion (talk) 01:55, 28 February 2013 (UTC)

Really? Which policy says that? WP:V says "The burden of evidence lies with the editor who adds or restores material". bobrayner (talk) 02:48, 28 February 2013 (UTC)

It would be difficult to stop people adding unsourced content or content based on unreliable sources. Editors will not learn the policy unless they become more involved with the encyclopedia. We are talking here about what to do with an article that already contains such content. Just because someone decided to bold the text of that guideline does not devalue the other guidelines that promote responsible editing, nor does it over-rule them. Anyone can go through policy and bold certain ones they like =). I believe consensus is against lazy deletion of content with no effort made to search for better sources. It just creates extra work for more serious editors, and is probably a waste of time anyway in the longer term. If readers find "missing content" they will just re-add it, based on whatever sources they find. It is much better to replace content based on poor refs with more desirable refs. Lesion (talk) 03:05, 28 February 2013 (UTC)

Regardless, there do not seem to be any secondary sources on the subject of the device. And I should also point out that the fact that it is a device, rather than a drug or a biological is of substantial interest, because the regulations for devices, at least in the US where the Phase I/II trial is listed (performed in China), are far more lax. Particularly when it comes to things like efficacy.

Now, I cannot access either the primary source article to evaluate the basis for this invention, nor can I access the review that is supposed to pertain to it (by the same primary author). I would welcome your assistance, Lesion or WhatamIdoing, in figuring out what sort of articles would be most appropriate to include references to. While I admit I am a little skeptical of the claims that appear to be made (or suggested, anyway), particularly given the fact that every snake-oil salesman and their mother is shilling "stem cell" treatments of some variety or another, I am certainly open to the possibility that this is completely above board. I just need some direction in beginning to evaluate the claims, which is why I asked for help. -- [UseTheCommandLine ~/talk] #_ 03:07, 28 February 2013 (UTC)

Infant

see talk:Infant where the title of the article is in question -- 65.92.180.137 (talk) 15:10, 26 February 2013 (UTC)

In my opinion, enough input is here now. Blue Rasberry (talk) 16:29, 26 February 2013 (UTC)

Medcyclopaedia

It seems to have been taken down or moved and their articles were used as sources. see Template:Medcyclopaedia. Feral mage (talk) 21:49, 26 February 2013 (UTC)

Infobox disease ICD code

I thought I understood this but apparently not. I want to enter K04.8 [39] this is what I think it should be...{{ICD10||K|04|8|k|04}}. Help? Lesion (talk) 17:16, 27 February 2013 (UTC)

Try this: {{ICD10|K|04|8|k|04}}

Which gives K04.8. You had an extra vertical bar ("|") there. —Fvasconcellos (t·c) 17:43, 27 February 2013 (UTC)

Oh yeah... thanks. Lesion (talk) 18:12, 27 February 2013 (UTC)

Female genital mutilation article

An editor, User:YvelinesFrance, has added the words "Female circumcision" to the infobox of the Female genital mutilation article as the primary title, as well as to the beginning of the lead as the primary title,[40][41] despite (whether YvelinesFrance knows it or not) the fact that "female genital mutilation" is the WP:COMMONNAME and the WP:COMMON MEDICAL NAME for these procedures. Not to mention that having "Female circumcision" listed as the first name doesn't conform to the title of the article, and the Terminology section mentions that "female genital mutilation" is the more common name for the procedures. Having looked at the current discussions on the article's talk page about the title, it has been mentioned there that the title has been discussed/debated extensively times before...and that the WP:CONSENSUS is to leave the article titled Female genital mutilation. So because of that, and because the topic of the procedures is so sensitive, I feel that more eyes from this project are needed on that article.

Looking at YvelinesFrance's contributions, which show extensive blanking/removal of things he does not like, even when those things are reliably sourced, his conduct is something suited for discussion at Wikipedia:Administrators' noticeboard/Incidents. Flyer22 (talk) 18:40, 23 February 2013 (UTC)

Have restored previous text. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:28, 23 February 2013 (UTC)

Not only was reverting YvelinesFrance the right move, obviously, but protecting the article from being edited by IPs/non-WP:Autoconfirmed users and from being moved by any non-administrator was as well. This and this was very likely WP:Socking.

Anyway, sometimes I forget that you are an administrator, James, because you help out with editing so extensively and don't exercise your administrative role as much as the typical administrator. So besides being a great editor, thanks for being a down-to-earth administrator. Flyer22 (talk) 23:03, 24 February 2013 (UTC)

Thanks for the words of support. These are hard areas to edit to the real heroes are those who tackle them.Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:56, 2 March 2013 (UTC)

Ice-cream headache article -- title

Any of you willing to weigh in on the title of this article? After getting a brain freeze some minutes ago, I decided to check out Wikipedia's article on the subject and was surprised to see it titled Ice-cream headache. I'm not the only one who is surprised by that, considering that the talk page discussions about the title are mostly in support of having the article titled Brian freeze. The latest discussion about the title is Talk:Ice-cream headache#Brain Freeze, where I've already commented. I'm not sure if I ever visited this article before, despite this being a common effect and my having been at Wikipedia for years. Flyer22 (talk) 06:52, 27 February 2013 (UTC)

Added my input.Peter.C • talk • contribs 04:50, 2 March 2013 (UTC)

History

I have been working on the History of medicine article and note that for most articles on diseases there is little in the way of history. Historians in recent decades have been using a social history approach that has generated a solid scholarly literature. Unless people object, I propose adding a few (usually one or two) citations in the "Further reading" section to history sources on the specific topic of the article that will be of use to the general reader (say, undergraduates). These resources are hard for beginners to find. This approach is explicitly authorized as Wikipedia policy by WP:Further which states Further reading: "An optional bulleted list, usually alphabetized, of a reasonable number of editor-recommended publications that would help interested readers learn more about the article subject. Editors may include brief annotations." Rjensen (talk) 08:52, 27 February 2013 (UTC)

Thanks for bringing this here. The addition is typically this book "McGrew, Roderick. Encyclopedia of Medical History (1985), brief history pp 87-90" such as added here. When one puts it into Google books it comes up as the fourth hit where I am [42] There is no preview for it unlike "The Cambridge Illustrated History of Medicine". And this book is not avaliable for sale on Amazon where it is ranked about 3 millionth. Many other books come up on this topic though. So my question is why this one?Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:20, 27 February 2013 (UTC)

I start with McGrew because it is among the 3 or 4 best for beginners, and is widely available in over 1100 libraries (says WorldCat) (and used copies are for sale cheap--eg multiple copes at ABE.COM for under $5, shipping included). The McGrew volume is one of 3 most highly recommended by Roy Porter a leading historian of medicine at Roy Porter (1999). The Greatest Benefit to Mankind: A Medical History of Humanity. W. W. Norton. p. 719. What McGrew does is assemble a series of standard histories and a few specialized monographs and distill the history down to 2-5 pages of very clear text; and he gives the sources. This seems very similar to the Wikipedia formula, except that few of our medical articles have a history section. McGrew covers the history of scientific discoveries as well as the social history, so his coverage is broad. I have been using some other good sources-- the Companion Encyclopedia of the History of medicine series has good articles but they run 20 to 40 pages, and are far more complex than most beginners can readily handle. Other very good resources I have been using are Kiple Cambridge Historical Dictionary of Disease (also short & good but no citations); and The Oxford Illustrated Companion to Medicine. Historical material does not change very rapidly--it's not like medicine itself in that regard, and an item 20 years old may be just right for the historian. Rjensen (talk) 09:46, 27 February 2013 (UTC)

So why not use it as a reference to improve the article in question rather than adding it as an item to a list? Should probably use a more modern ref (from the last 10 year) though. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:04, 27 February 2013 (UTC)

I'm busy writing history of medicine and find it annoying that useful material gets erased for no good reason. Historiography moves rather slowly--solid books are 5 to 10 years in gestation and even short articles wait in queues for six to 36 months. (I was astonished at the speed last year when an article I wrote in June was published in October.) Most of the history actually is pre 1945 or even pre-1800, so new material does not turn up every day & date of publication is not a good indicator of quality of usefulness. Quite unlike experimental science.Rjensen (talk) 10:17, 27 February 2013 (UTC)

This seems fine to me. Ultimately, when someone has the time and interest, the history can be summarised in the article but, until then, a "Further reading" link to a good source is a definite improvement. --Anthonyhcole (talk · contribs · email) 10:57, 27 February 2013 (UTC)

Moreover I do not think that recent references are as as important for history sections as compared to other medical sections since history is obviously in the past and therefore does not change as much.--Garrondo (talk) 12:27, 27 February 2013 (UTC)

The rationale for the inclusion of this source - based on its availability and readability - seems fine. Historians of medicine are not so interested in clinical medicine these days and individual disease pathographies outside of conditions with huge social, cultural or political significance are few and far between. I could be mistaken, but the likelihood of an up-to-date and detailed treatment by a medical historian of dengue fever is remote; it's more probable that you might get something by a clinician-historian published within a relevant medical journal - some of these types of histories are excellent, but they're a mixed bunch. FiachraByrne (talk) 13:04, 27 February 2013 (UTC)

I appreciate and encourage Rjensen's locating appropriate source materials. To make it work for Wikipedia, could these rules be followed: 1) If the sources aren't actually used and referenced in the article when added, add them to "Further reading" and not to the list of References. 2) Do not add them to GA or FA articles without actually using them as references, and instead post a note on the Talk page for those articles mentioning the source. GA and FA articles make up a pretty small proportion of articles overall, and generally the editors who brought the articles to GA or FA are still actively maintaining them, and so should be motivated to actually use the new source in the article as appropriate. Zad68 16:23, 27 February 2013 (UTC)

I am not familiar with this book, but if it is indeed a good source, I see no harm at all in adding it as Further reading (perhaps to articles that have not gone through GAN/FAC "quality assurance" as suggested by Zad). I would also use this opportunity to very gently remind Doc James that using rollback to revert constructive edits (or even nonconstructive edits made in good faith) can be very off-putting and, when done by an admin, could be construed as misuse of the tools. Fvasconcellos (t·c) 16:42, 27 February 2013 (UTC)

I'm also not familiar with the book, but it sounds interesting. I wonder if my library has it. It is 28 years old, which might be a little elderly even for history, but overall I think that adding such sources probably constitutes an improvement, since such sections are normally so incomplete. WhatamIdoing (talk) 21:17, 27 February 2013 (UTC)

I could see adding this to the sub articles that specifically pertain to history of medicine. We could put all sorts of things in the "further reading" section, key primary research papers, recent systematic reviews, textbooks etc but we do not. I would rather people use references to write encyclopedic content. If one finds good refs place it on the talk page if you do not wish to use it yourself. The sections at the end are not places to part sources for others to add to the article. Typically I see this as a section for a couple of books that cover the condition generally (which if they do would also cover the history of the condition). With respect to the history of medicine this is more recent source which has gone through a couple of editions[43] but which amazon does not sell either.

The issue I have encountered is that we get authors, there publisher, or there family adding their book to dozens of articles in this section as a method of promotion. Whenever I see the exact same book adding to more than half a dozen articles IMO their should be consensus. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:30, 27 February 2013 (UTC)

items that go on the talk page will not be found by most users. The question here is whether Wikipedia is written for the benefit of 2000 editors or for a general audience of many millions of people. (I have in mind some 30-50+ million university and advanced high school students around the world.) There is a very strong tendency among senior editors to lapse into the former approach--that happens to me too--but it should not result in automatic deletion of one line bibliographic entries for poorly thought-out reasons. Rjensen (talk) 23:46, 27 February 2013 (UTC)

Incidentally, just came across this source which is available online and may be useful to download for the history sections of articles on infectious diseases [44].

Rjensen is not an anonymous editor. If there were any danger of promotion in favouring this source, and I don't believe there is, it should be easy enough to elucidate.

The Companion encyclopedia to the history of medicine is a superior source but it is considerably less accessible for an uninitiated readership, its coverage in libraries in the UK and US, while good, is not as good as the McGrew text and its cost second-hand at about $500 is 100 times more expensive than McGrew's volume.

Rjensen can speak for himself, but I think his intent is to direct an interested readership to a cheap, readily available and good quality secondary source that combines clinical and social history. FiachraByrne (talk) 00:18, 28 February 2013 (UTC)

The 2008 source you link Fiachra looks excellent and is still in print, plus there is a copy available online (wonder how long?). Both "Encyclopedia of Medical History" and the Companion encyclopedia are out of print by the looks of it. With respect to us being here to recommend books I would say no. If the majority feel we should be and that this is a book we should list I am happy with people rolling back my edits. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:57, 28 February 2013 (UTC)

No idea how long it will remain up. The same website (an academia.dk profile) also hosts this source: Kiple, Kenneth F. (2 June 2003). The Cambridge Historical Dictionary of Disease (PDF). Cambridge University Press. ISBN 978-0-521-53026-2. A worthwhile download. FiachraByrne (talk) 17:26, 28 February 2013 (UTC)

Seminars in Dialysis article on WP

http://www.ncbi.nlm.nih.gov/pubmed/23432369

From the abstract:

"Nephrology articles on Wikipedia were relatively comprehensive, with 70.5% of ICD-10 codes being represented. The articles were fairly reliable, with 7.1 ± 9.8 (mean ± SD) references per article, of which 59.7 ± 35.0% were substantiated references. Finally, all three readability indices determined that nephrology articles are written at a college level. Wikipedia is a comprehensive and fairly reliable medical resource for nephrology patients that is written at a college reading level. Accessibility of this information for the general public may be improved by hosting it at alternative Wikipedias targeted at a lower reading level, such as the Simple English Wikipedia."

That's quite a variability in substantiated references. -- [UseTheCommandLine ~/talk] #_ 12:36, 27 February 2013 (UTC)

The statistics in the article is a little bizarre, in that all the uncertainties in the paper were quoted in terms of standard error of the mean (SEM), but the abstract was in terms of standard deviation over the population. In terms of SEM, there were overall 7.1 ± 1.2 refs per article and 58.5 ± 4.2 substantiated references, which they define as peer-reviewed papers or textbooks with an ISBN. The most interesting result IMO was the heterogeneity in both numbers of references and percentages of substantiated references as a function of ICD-10 code class. --Mark viking (talk) 22:01, 27 February 2013 (UTC)

Well the thing that sticks out about the study to me is the third author. ;-) Biosthmors (talk) 04:40, 28 February 2013 (UTC)

I hadnt actually put that together. I mainly posted it because i thought it was neat seeing an article about WP on pubmed. the statistics, not nearly as important, but i had to say something ABOUT the article to justify posting it. anyway, yay. -- [UseTheCommandLine ~/talk] #_ 05:18, 28 February 2013 (UTC)

I would guess that a referee might have asked for use of standard deviation, and the abstract is always the most visible place to fix it. SEM is not a descriptive statistic for the distribution of data around a mean, as illustrated by the discrepancies noted above (SEM always looks "nicer", but represents the likelihood distribution for the location of the population mean based on sampling means). My impression is that the text of that article should have used SD, too, given the context (SEM will get smaller with larger sample sizes, even when the variability is high). Probably a simple oversight. -- Scray (talk) 06:18, 28 February 2013 (UTC)

" That's quite a variability in substantiated references. "
— UseTheCommandLine

The statistical analysis is flawed. "Substantiated references" is a binary, qualitative variable. Each reference either is substantiated, or it is not. Standard distribution can only be applied to continuous variables, not qualitative variables. I suspect that an author dropped the data into a spreadsheet, perhaps assigning "0" for unsubstantiated and "1" for substantiated.

Regarding the references per article, the SD is unusually large compared to the mean. One SD distance lower than the mean is less than zero. The explanation here is that the data is not normally distributed. Indeed this is what I would expect. The data is probably positively skewed. The vast majority of articles have only a few references each, while a handful of well-developed articles (such as featured articles and good articles) have a large number of references each, bringing the mean value (of references per article) much higher than the median.

I have read only the abstract, not the full paper, so I am unable to comment on the use of SEM here. All too often though, I have seen SEM (mis)used to reduce the apparent value of the SD, giving a visually more appealing result than the SD, lending greater credibility to a result, especially to a less discerning reader. Axl ¤ [Talk] 10:26, 1 March 2013 (UTC)

Notice and reminder

The above discussion is about a published article discussing Wikipedia and health information. It was even written by user:Jfdwolff, one of our own and the person who founded WikiProject Medicine. Whenever anyone here finds such a paper, please list it at Wikipedia:WikiProject Medicine/Wikipedia and medicine. We should keep a log of these things and that link is the most central place we have yet. Blue Rasberry (talk) 15:48, 1 March 2013 (UTC)

Assignment in "treatment of..." and similiar articles?

In the last several days I have found recently registered users doing important additions to treatment of multiple sclerosis, a featured article, (User:Wonglilian), Pathophysiology of multiple sclerosis (user: Desolateflame) and management of Parkinson's disease‎ (User:Przemyslaw.kosinski). Editions are of quite good quality, although have typical mistakes of newcomers including occasional use of primary sources. I have contacted Wonglilian and he is part of an assigment (educational I suppose) which does not seem to be registered. Moreover, I suspect that the other 2 users are also in the same assigment per the type of articles and additions and that there are probably others out of my radar. Has anybody noticed this pattern in other articles? I am going to treat with Wonglilian, but taking into account the extensive additions they are making, it would be great if others contacted the other editors. I see quite a lot of potential but guidance would still be needed.--Garrondo (talk) 15:51, 28 February 2013 (UTC)

It would be a good idea to find the instructor and talk to them, instead of separate piecemeal engagement with every student we find. Feel free to point the instructor towards the Education Program. I'm happy to play the online ambassador role if you don't want to take it on. bobrayner (talk) 15:54, 28 February 2013 (UTC)

I have asked Wonglilian if there is a teacher, but have not received answer yet. I'll contact as soon as I have any news.--Garrondo (talk) 16:34, 28 February 2013 (UTC)

You can use {{MedWelcome}} to give a few medicine-specific links to help pages to new people, if they haven't been welcomed by someone else. WP:Twinkle knows about this welcome, for those who like to use that script. WhatamIdoing (talk) 07:48, 1 March 2013 (UTC)

Fibromyalgia

I regret to say that this article is currently experiencing a flareup of its chronic disease and might benefit from medical attention. Looie496 (talk) 00:01, 1 March 2013 (UTC)

I tried to fix the POV issues but I have just had my edit quickly undone by a brand new account - I suspect multiple account abuse but I have been wrong in the past. Definitely more eyes are needed on this article. I have previously edited this article and spent a bit of time reading up on it for a close friend I have so have a little knowledge of the condition. Basically this editor pedromd appears to want the article to declare the condition as psychosomatic even though reliable sources describe the neurobiology of the condition and the condition responds to drugs that block or reduce sodium ion channel activity or reduce pro-inflammatory cytokines the latter being similar to the neurobiology of major depressive disorder which is often co-morbid. The article does document the controversy in that some healthcare professionals and experts do indeed believe the condition is psychological in origin rather than neurobiological in origin but what appears to be anti-neuroscience strong POV edits keep being made to describe the expert consensus as declaring it to be a psychosomatic disorder which is just not true and not how it is treated. Previous disputes have involved the use of opiates in the treatment of fibromyalgia. Come sojourn on this article and enjoy the fun!--MrADHD | T@1k? 02:39, 1 March 2013 (UTC)

Strange, normally people try to push a particular organic cause instead of a psychosomatic one for things like this. Lesion (talk) 15:16, 1 March 2013 (UTC)

No one is using the talk page. I am a little unsure why? Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:33, 2 March 2013 (UTC)

Medical outbreaks?

Category:Medical outbreaks and subcats needs to be renamed to something a bit better. It is a bit like an outbreak of peace! -- Alan Liefting (talk - contribs) 04:29, 1 March 2013 (UTC)

This should be renamed. Most of the items in these categories are articles on infectious disease outbreaks. Either "Infectious disease outbreaks" or "Disease outbreaks" could be the category name.

One article, Zamfara State lead poisoning epidemic, is not covering a disease outbreak. Lots of articles cover infectious disease epidemics, but I am not sure that this category should exclude non-infectious epidemics, such as poisoning or conditions like obesity or malnutrition if those are epidemics. Also, perhaps seasonal flu articles should be in this category, but that may not be an epidemic and may only be an outbreak.

What is the best name here? Blue Rasberry (talk) 16:11, 1 March 2013 (UTC)

Peer review

I did a request for Lower limbs venous ultrasonography to be peer reviewed to receive a broader perspective on how it may be improved. I would like to improve this article to a class A. Thank you all for your collaboration. Doc Elisa ^✉ 09:04, 2 March 2013 (UTC)

Well, we don't formally have A class within WikiProject Medicine, but surely others can try to help it reach that description (given at WP:Grades). Might you want to reach the formal status of GA and sign up at WP:MEDGA2013? =) Biosthmors (talk) 19:35, 2 March 2013 (UTC)

Yes I would like to sign up to WP:MEDGA2013 but I don't know if the article deserves it at this moment. If I expand much more it becomes too technique or hard to understand. I need some advice. Thank you. Doc Elisa ^✉ 01:28, 4 March 2013 (UTC)

The project talk header

Right now, {{MedTalkheader}} says "We are not able to provide any medical advice; please see your local health professional. Questions about medical subjects in general should be asked at the reference desk." It also says "This page is a place to discuss issues related to Wikipedia's medical articles and related policies..." and then it asks for questions to be placed at the reference desk.

I think these two points should be merged to say "This page is a place to discuss things related to improving Wikipedia's medical content. We do not provide medical advice; please see your local health professional. If you are trying to learn something from a Wikipedia medical article that you think should be there per this and this, feel free to point out that perceived omission below for consideration."

I'll go ahead and make that edit and some others. Biosthmors (talk) 19:32, 2 March 2013 (UTC)

It looks better. Minor suggestions: "this and this" - replace with a phrase each like [[WP:MEDRS|acceptable sources for medical content on wikipedia]]. Also suggest "be respectful" → "be respectful of others", users here are entitled to no more or less respect than on other talk pages... Did the "don't shout" link used to be bold, or my imagination? I feel it would be better to bold it again. Lesion (talk) 22:45, 2 March 2013 (UTC)

I'm glad you think it's an improvement! I've reworded some things again. Thanks to Doc James for making the picture look better! We should put that picture on our project page too, I think. I'm not sure if the don't shout link was bold or not, but I think it's better plain (unless, of course, it becomes a problem). =) Biosthmors (talk) 01:02, 3 March 2013 (UTC)

If the logo is meant to be the logo for the Wiki Project Med Foundation, Inc., then it should not be used here. WPMED ≠ Wiki Project Med Foundation, Inc. WhatamIdoing (talk) 03:11, 3 March 2013 (UTC)

That logo is this one, as far as I'm aware. Biosthmors (talk) 05:51, 3 March 2013 (UTC)

The discussion thread on the meta-wiki talk page for said organization is here. Biosthmors (talk) 19:35, 3 March 2013 (UTC)

Yes it is the logo for Wiki Project Med Foundation, Inc and yes the corporation is different than WPMED. All the Wikimedia chapters however use the same logo as the Wikimedia Foundation (ie many organization using the same logo). I have no strong feeling either way. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:58, 3 March 2013 (UTC)

User:DVMt at Talk:Migraine

Wondering if anyone else can comment? There appears to be efforts to remove the conclusion of this systematic review [45] in this edit [46] by User:DVMt Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:58, 2 March 2013 (UTC)

That's misleading readers, I was proposing the language wasn't NPOV and should state SMT may be as effective for... Thanks for singling be out again. I hope this isn't personal. DVMt (talk) 23:07, 2 March 2013 (UTC)

minor point: the "N" in NPOV stands for neutral. Biosthmors (talk) 00:39, 3 March 2013 (UTC)

Sarcasm aside, do you have anything to add to the ongoing discussion? DVMt (talk) 00:43, 3 March 2013 (UTC)

I was trying to help you communicate on Wikipedia better. I can try to take a look tomorrow, but I don't know if I'll be able to get around to it. Thanks for commenting here though; it should draw in attention. Biosthmors (talk) 01:05, 3 March 2013 (UTC)

Have stated an rfc based on the comments provided. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:27, 3 March 2013 (UTC)

Does my communication really suck that bad Biosmorths? Sorry, if that's the case. I'm so used to getting attacked by skeptics, I may have inherently be predisposed to being "defensive" here at WP. My only "agenda" is to reinforce the CAM articles with high quality evidence and systematic reviews. That being said, there will be research that supports some CAM interventions and some that doesn't. Right now, all the research I've inserted that demonstrates effectiveness is being deleted because of "controversy". At least I would like the material in section added to the talk page so we can discuss it properly. I'm not averse to discussion, as demonstrated by my contribution history. I just think that I'm getting a personal shake-down for merely presenting scientific evidence that supports some CAM. It's 2013 and the evidence is growing in favour of some CAM interventions. That doesn't mean we need to equate yoga with Q-Ray bracelets. There's a big difference and the research overwhelmingly states that not all CAM is equal in effectiveness, safety, cost-effectiveness nor biological plausibility. We must acknowledge the evidence even if it challenges our personal beliefs. DVMt (talk) 01:49, 3 March 2013 (UTC)

White-washing of all evidence of effectiveness at Alt. Med.

All the evidence of efficacy for CAM interventions has been deleted and removed here [47] and again here [48]. All material that was deleted was systematic reviews and Cochrane reviews from 2011-2013. I'm afraid there has been a loss of editorial objectivity. DVMt (talk) 22:27, 2 March 2013 (UTC)

And there is a clear explanation on the talk page here Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:34, 2 March 2013 (UTC)

No there is not. There is only a suggestion of 'co-tract' which is not even explained in any details. You are at 2RR there and Migraine today (I'm at 1RR) so I will take the high road and not edit-war with you. Why did you delete all the systematic reviews and Cochrane reviews I added on effectiveness of acupuncture, yoga, mind-body medicine and body-manipulation? It's not in good taste for an admin who is a head-honcho at WP:MED no less,to delete over 30 reviews of efficacy from 2011-2013. You shouldn't let your personal skepticism reach such levels where you delete everything you disagree with on CAM. DVMt (talk) 22:41, 2 March 2013 (UTC)

DVMt, Doc James is right. This has been explained to you several times, but you just don't want to accept it. The edit warring and solo editing needs to stop. Start collaborating by doing anything potentially controversial through the talk page. Don't use the article as a battle zone. You're just messing things up and making lots of work for others.

The alternative medicine article is not the place to add cherry picked refs in support of each and every form of alternative medicine you wish to think is effective. Their individual articles are the place to deal with the nitty gritty of their (lack of) evidence base. When the NCCAM, a very pro-alternative medicine organization, using large sums to perform research, can't even demonstrate efficacy for alternative methods, then who are you to use OR/cherry picked refs to contradict them?: "NCCAM and its predecessor, the Office of Alternative Medicine, have spent more than $2.5 billion on such research since 1992; this research has largely not demonstrated the efficacy of alternative treatments."

Be patient and stop accusing other editors. The problem is not with them, since they are following our policies by requiring content here to follow (IOW "afterwards") RS elsewhere. When any alternative method becomes unequivocally proven efficacious, it will then (IOW "afterwards") become part of mainstream medicine and the NCCAM will then (IOW "afterwards") notify us of that fact. We are required to be behind the curve because we follow the later interpretation of sources. Cherry picking those sources before that happens won't do. "What do you call alternative medicine that works? 'Medicine'." Once a method has been proven to be efficacious, it is no longer classified as alternative medicine and is adopted by mainstream physicians. When that happens we won't even be discussing the method in the alternative medicine article! -- Brangifer (talk) 23:08, 2 March 2013 (UTC)

Brangifer you and Doc James support the deletion of all supportive material at the alt-med page. I added 20 systematic reviews of effectiveness of certain CAM interventions and it was deleted so the page still reads that all research into CAM is a) ineffective b) poor quality c) diversion of real research dollars away from mainstream interventions. This is blatant bias which leads to neutrality issues. The article was also tagged of having too many primary sources (which I replaced with secondary sources from Cochrane and systematic reviews) but you both can justify to the community why you favour the white-wash of any evidence that demonstrates effectiveness of any CAM intervention (yoga, meditation, acupuncture, body manipulaton, etc..) DVMt (talk) 23:17, 2 March 2013 (UTC)

You're not listening. YOU did all that, often dubious, tagging, tagging things that shouldn't be tagged, and refusing to deal with those issues on the talk page. Tags don't provide the necessary information, so do as suggested to you several times and we'll be fine. Bring the issues to the talk page where we can discuss, and possibly improve the situation. We'd love to meet and solve your issues with those spots. Maybe revision would be good, but we don't know yet. Let's talk about the specific quotes and sources on the talk page.

As to your cherry picked refs, anyone can cherry pick double blind research to support any agenda. Yours happens to seek to make alternative medicine look like (effective) "medicine" when it's not. Talk to the NCCAM. If you can get them to reclassify some methods (like homeopathy, for example) and provide positive research evidence that is effective and now accepted by mainstream medicine, then I'll be happen to include the earth shattering news in the Homeopathy article that it is now proven to work, and I'll be happy to remove every single mention of it from the alternative medicine article, excepting possibly a note that it used to be considered alternative, but is now officially not alternative. Heck, I might even do as Tim Minchin quips: "I will take a compass and carve 'Fancy That' on the side of my cock." (Nah, probably not.. ;) You'll get a good laugh from his beat poem Storm. Needless to say, he rips alt med a new one.... -- Brangifer (talk) 23:46, 2 March 2013 (UTC)

No, I get it quite well. Ernst and Quackwatch rule at Alt-med. No evidence of effectiveness can be included as you called it "bloat" and Doc James calls it "co-tract". Stating I am not talking at the talk page? Check my contribution history. I added reviews that did not support any evidence of homeopathy what any condition whatsoever but that's been ignored. The point remains: you both do not support the inclusion of any Cochrane and recent systematic reviews (2013) that demonstrates the effectiveness of any CAM intervention for any medical condition at the alt-med article. No need for any confabulation. My argument is short and specific. why do you support the purging of evidence (secondary sources and Cochrane reviews) which suggest effectiveness? Doc James did the purging but you support him (clear given the COI conflict you have with ties to Stephen Barrett and Quackwatch). Let's get it all out in the open. DVMt (talk) 23:55, 2 March 2013 (UTC)

Your sarcasm and false accusations aren't going to help you. I don't have a COI, but just like anyone else here I do have well-known opinions and interests with no hidden agenda, and I've been here long enough to know better than to fight against our policies in attempts to force them on this encyclopedia. I follow policy, and when it's conveniently on my side, well, that's just dandy. Nothing wrong with that. When it's not, I'll usually remain silent, but I usually change my POV to bring it into line with policy, which, in case you hadn't noticed, often aligns with the scientific method. If you have a gripe with me, then you will have to use policy instead of attacking me and misinterpreting my motives. Just because I support the attempts by Barrett and Quackwatch to expose healthfraud and quackery (I really don't see why you object to that since it's a noble endeavor and he's been awarded for it on numerous occasions) doesn't mean I have any "ties" to them. I have exchanged emails with Barrett a few times many years ago, and the response was nearly always unpleasant and uncooperative, yet I still support his intentions in spite of his brusque manner. I also defend him when he's lied about. As the world's foremost authority on quackery he is a lightning rod for the attacks of scammers, quacks, and their ilk. Having an interest or opinion is not the same as having a COI, so drop the accusations. I have not only survived vicious attacks nearly exactly like yours, with the same charges, in a very nasty ArbCom proceeding, I was also vindicated and my opposer blocked for one year (the maximum allowed) by the Arbitration Committee, and indefinitely by the Wikipedia community. If you're not going to become a collaborative editor, then find another hobby. That's all this is to me. I learn much from it and I don't need the grief of dealing with attacks from you. If you're willing to see that we are not your enemy, we can work together. Demands and edit warring will get you nowhere fast here. Cooperation and a positive learning curve will get you some good friends. I'm open. -- Brangifer (talk) 02:04, 3 March 2013 (UTC)

Wikipedia:Coatrack? Biosthmors (talk) 01:06, 3 March 2013 (UTC)

Yes, and that's not the first time I've seen that error. I wonder if perhaps some autocorrect spilling chucker is at fault. WhatamIdoing (talk) 03:26, 3 March 2013 (UTC)

It looks to me like there's a whole lot of non-AGFing going on here. Can we maybe nip that in the bud? -- [UseTheCommandLine ~/talk] #_ 01:13, 3 March 2013 (UTC)

Agreed. I would like to get an opinion why the alternative medicine page ~~refuses to include evidence~~ of effectiveness for certain CAM interventions for specific medical diagnoses. DVMt (talk) 02:25, 3 March 2013 (UTC)

I'm not sure that framing ("...page refuses to include evidence...") is particularly helpful. It seems a bit hostile to me, which tends, in my experience, to forestall attempts at collaboration. If it's a simple content dispute, then maybe WP:DRN could be more helpful (disclosure: I help out there from time to time, and would probably stay out of this one, if you brought it, because of this interaction) -- [UseTheCommandLine ~/talk] #_ 02:32, 3 March 2013 (UTC)

I'm not experienced WP:DRN. Do you mind explaining to me, briefly, how it works? DVMt (talk) 02:36, 3 March 2013 (UTC) Edit: took a peek. This is a great source. Thanks for recommending it! DVMt (talk) 02:37, 3 March 2013 (UTC)

it's explained in some detail at WP:DR. I will say though, that they only handle content disputes. Your assertions here and, I assume, elsewhere, seem to me like they are a bit accusatory, so some conduct issues may be intertwined here, and they don't handle those. It would behoove you to keep this kind of behavior in check, if for no other reason than because it will reflect poorly on you in disputes such as at DRN, et al. It also creates a hostile climate for other editors, which again keeps people from being as collaborative as they might otherwise be. And while I do see some other editors responding to you sometimes curtly, I don't see the sort of hostility from them that I see coming from you. Please, if you need to step away from editing for a couple days for a breather, do so -- whatever it takes for you to assume good faith and avoid personal attacks. -- [UseTheCommandLine ~/talk] #_ 03:14, 3 March 2013 (UTC)

Thanks for replying. Ironically, I'm the one being accused of being a white-washer which has tainted my whole WP editing experience. I have merely informed readers that a different body of literature, on CAM, exists which demonstrates efficacy, safety, biological plausibility, etc. Also, my argument is that the skeptical side shouldn't equate homeopathy which has 0 evidence to support its use with established complementary medicines (acupuncture, yoga, meditation, body manipulation). Thank you for the good advice. DVMt (talk) 03:46, 3 March 2013 (UTC)

Books as ELs

This user is adding lots of books such as master thesis [49] and this 10 page pamphlet [50] which contains no content our article doesn't already as ELs. Thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:57, 4 March 2013 (UTC)

All the links added this year are to the library at Iowa State University. Not really suggestive of great objectivity or subject-matter insight, but likely is just someone trying to share sources they think might be useful. LeadSongDog come howl! 20:21, 4 March 2013 (UTC)

Speaking of class assignments

I am teaching a Medical English class this semester and my students have started working on Wikipedia. We put some photos up on Commons and now are translating articles from en.wiki to es.wiki. You can see what we are up to here User:Thelmadatter#Medical_English_Spring_2013 If any of you are active on es.wiki as well, we can use your help! We may put articles in en.wiki, depending on how things go.Thelmadatter (talk) 20:14, 28 February 2013 (UTC)

That sounds great. I'm sorry I don't speak Spanish but thanks for posting here! We currently have over 1900 articles in the Category:Wikipedia requested photographs of medical subjects. There is also an essay at WP:Pictures for medical articles. If you or your students see ways to improve upon the essay, or if you want to placing articles into or out of that category (at least for en wiki), please feel free, thanks! Biosthmors (talk) 16:59, 5 March 2013 (UTC)

How does a Whitlow differ from Felon (skin)?

Very curious. The seem the same to me. LCS check (talk) 16:29, 5 March 2013 (UTC)

Doesn't seem to be much difference between the two, especially with whitlow also refering to a felon. Perhaps these two articles should be merged? Peter.C • talk • contribs 18:46, 5 March 2013 (UTC)

And with Felon (skin) being one vague line, which seems to describe exactly the same condition. LCS check (talk) 19:07, 5 March 2013 (UTC)

I've merged and edited Felon (disambiguation) too. Biosthmors (talk) 19:16, 5 March 2013 (UTC)

Per Dorlands 29th, a whitlow is a felon however there are subtypes of whitlows (heptetic and melanotic) that are not felons. The definition of a felon is an "extremely painful abscess on the palmar aspect of the fingertip" But yes merge. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:22, 5 March 2013 (UTC)

Ditto, Schwartz's Principles of Surgery. Concur.Novangelis (talk) 19:36, 5 March 2013 (UTC)

Edit made. Biosthmors (talk) 19:59, 5 March 2013 (UTC)

Anti-psychotics and brain volumes

Hello. Some time ago I added some content to the article Antipsychotic from a primary source. It was from a then fairly recent study by Nancy Andreasen on the impact of antipsychotic dosage on brain volumes over time. There are superior secondary sources that look at this issue but I really don't feel competent at summarising their contents. If another editor or editors competent in this area would consider revising the text to match current research I'd be extremely grateful. You'll find more details - including some relevant secondary sources - at the relevant talk page discussion: Talk:Antipsychotic#Side effects vs structural effects; primary vs secondary sources; unsourced section. Thank you. FiachraByrne (talk) 22:14, 5 March 2013 (UTC)

Requested page move: "Alternative medicine" → "Complementary and alternative medicine"

No doubt you'll all be delighted to hear of this requested page move which I've initiated. Relevant talk page discussion can be found here. Apologies in advance. FiachraByrne (talk) 02:22, 6 March 2013 (UTC)

G'day, I'm Pete

G'day everyone, my name's Pete. I'd like to ask for your assistance, if you're a medical professional.

I suffer from severe anomic aphasia and loss of lip motor control. These are the undocumented side-effects of long-term use of dextropropoxyphene and (very recently) Lyrica (as adjunct treatment for chronic neuropathy due to a 30-year-old stabilising thoracic laminectomy, with sufentanyl supplied intrathecally by an implanted programmable pump) . Unfortunately, while I'd like to get these effects documented and investigated, I've run into a brick wall at every turn, and continue to suffer from these effects socially.

My physician and all the specialists I've worked with have laughed it off (gently, they do respect me) or shrugged their shoulders. The manufacturers don't appear to be interested - I've contacted both Pfizer and Eli Lily, and when I get to speak to someone, they refer me back to my physician!

Please understand, I am NOT seeking treatment per se : I'm trying to get an extremely severe and completely repeatable side-effect that's been completely undocumented documented (if that sentence makes sense!). Anomia is apparently of high interest to various investigative neurologists, and the lip control thing is (as far as I can tell) completely unknown as a complication!

So I'm a target, looking for hunters, but I can't be seen. I think that about overs it.

I understand I can't document these issues here, even on the appropriate pages - after all, there's only one (not widely respected enough) referent!

So is anyone able to offer any suggestions here?

As a smalltime editor and contributor here, I sincerely apologise for asking this kind of thing here, but I've run out of alternatives, and you all seem like reasonable, intelligent, good-looking, sophisticated....

Thanks for your understanding, and feel completely free to delete or report this! -pete Cephas Atheos (talk) 00:53, 2 March 2013 (UTC)

I sympathise with your plight and I hope that you find the answers that you seek and resolution of your health problems but we don't here offer medical advice for a range of reasons. I am sure though if anyone here has a solution to your predicament they will be a Good Samaritan and drop you a private email or talk page message to point you in the right direction. You really are best seeing a medical practitioner in person who can evaluate you face to face and review your medical history. Good luck!--MrADHD | T@1k? 01:10, 2 March 2013 (UTC)

Technically, this is not a request for medical advice. It is a request for assistance in documenting a potential new side-effect. The question is not related to WikiProject Medicine. According to the text at the top of this page, the question should have been directed to the reference desk. But since you have asked here, I'll give you an answer.

It sounds like the best form of documentation for your clinical findings would be a case report. Of course this would need to be done in conjunction with one or more doctors. You state "My physician and all the specialists I've worked with have laughed it off (gently, they do respect me) or shrugged their shoulders." The fact that several specialists (I presume including neurologists?) have assessed your case with all the relevant clinical data and decided that it is not worth writing up, suggests that from the greater medical community's viewpoint, this effect is unrelated or otherwise not important or significant. Sorry. Axl ¤ [Talk] 01:45, 2 March 2013 (UTC)

See http://blog.ted.com/2013/02/28/infographic-its-rare-disease-day/.

—Wavelength (talk) 01:49, 2 March 2013 (UTC)

Wikipedia has articles on anomic aphasia and dextropropoxyphene and Lyrica and chronic and neuropathy and thoracic and laminectomy and sufentanyl and intrathecal and intrathecal pump and Pfizer and Eli Lily. Also, there is a category Category:Rare diseases.

—Wavelength (talk) 04:09, 2 March 2013 (UTC)

The US FDA has an adverse event reporting system that might be along the lines of what you're looking for. If you're not in the US, I imagine your country has something similar, or you may still be able to use the FDA's. good luck. -- [UseTheCommandLine ~/talk] #_ 04:17, 2 March 2013 (UTC)

My thanks to everyone who read or responded. From the documented responses, I can agree with most or all of you - this ain't the place to ask, but having asked, it's almost certainly a side-effect affecting a very small population, and there are some reporting schemes that I was unaware of. I'll investigate those options. My sincere thanks for understanding my position. Now, back to some real work... Cephas Atheos (talk) 01:28, 7 March 2013 (UTC)

Aoki Mariko phenomenon

Aoki Mariko phenomenon is based off several Japanese sources. I can't find anything in the English literature. Could someone confirm the terminology/the existence of this in the literature? (Also asked at Wikipedia:Reliable_sources/Noticeboard#Aoki_Mariko_phenomenon).Smallman12q (talk) 23:47, 2 March 2013 (UTC)

I can personally confirm the existence of the phenomenon. I always attributed it to a combination of typically relaxing in a bookstore after a meal and the normal gastrocolic reflex. Didnt know it had a name in japan. I am certain it is not a chemically mediated phenomenon. alteripse (talk) 02:30, 3 March 2013 (UTC)

userSmallman12q you are asking whether there are any recent, reliable english language sources for this supposed phenomenon? I think if you carried out a search and found nothing, it would be appropriate to remove this content until someone does find suitable sources (especially when this content is being added to pages like laxative...even if reliable sources could be found, it could be argued that it does not belong on pages like this). Lesion (talk) 16:12, 3 March 2013 (UTC)

The Japanese version of the article, ja:青木まりこ現象 is fairly long with what appears to be a lot of references. I don't read Japanese so I don't know what these sources are and whether they're reliable. Just because there's a dearth of source in english, doesn't mean that the phenomenon isn't present, at least in japan. Before I take it to AFD/redirect it...I'd like to know whether there are legit sources for this.Smallman12q (talk) 16:33, 3 March 2013 (UTC)

I see someone already removed that content from laxative, then a user re-added a link to the external links. I am certain that if it is to be included in the laxative page, it falls under MEDRS, for which english publications are needed. It was also added to defecation, but to the section "Mythology and tradition", so MEDRS probably doesn't apply. The question of the main article is whether it is being presented as a physiologic phenomenon, or more of a cultural thing. I would say the latter, so unsure if MEDRS applies to the main article... Lesion (talk) 19:00, 3 March 2013 (UTC)

Wow! I suggest asking for assistance at WikiProject Japan. Axl ¤ [Talk] 00:57, 4 March 2013 (UTC)

The chatroom entries are of no use, I removed them from the article. Each language edition of WP has its own content policies. I don't know what .jp calls for, but .en will need wp:RS discussing the phenomenon. LeadSongDog come howl! 06:05, 4 March 2013 (UTC)

Wikipedia:Babel has a bold link to Category:Wikipedians by language but it wasn't immediately apparent how that can be narrowed down to Japanese speakers. Biosthmors (talk) 16:51, 5 March 2013 (UTC)

Wikipedia:Translators available#Japanese-to-English is probsbly what you want. WhatamIdoing (talk) 17:46, 5 March 2013 (UTC)

As far as I can tell, WP:MEDRS does not require sources to be in English (and if it did, it would conflict with several other guidelines that explicitly state that non-English sources are perfectly acceptable). Looking through the sources in the Japanese article (ja:青木まりこ現象), it doesn't seem to be a standard medical phenomenon, per se. It almost seems to be an extensively documented anecdotal occurrence. Some of the sources are pretty decent (Asahi Shimbun, NHK, TBS, Kadokawa Shoten, and so on, including what appear to be several articles and books translated from English into Japanese). I would recommend Oda Mari as a good one to look things over as I don't have time to figure out that page and she (being native) can read through it much faster than I can. I will post a note on her talk page pointing her here. No guarantees she'll have time, but I'll see. ···日本穣^? · 投稿 · Talk to Nihonjoe · Join WP Japan! 05:47, 6 March 2013 (UTC)

According to the ja article, the phenomenon is mentioned in this book. See also [51]. ja:笠原敏雄 tried to find mentions at en sites, but could not find any. As Nihonjoe said above, the phenomenon has not been scientifically studied. Oda Mari (talk) 09:13, 6 March 2013 (UTC)