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Merged Archive WikiProject Preclinical medicine: 1 Merged Archive WikiProject Clinical medicine: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 WikiProject Medicine Archives: Index, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172

Ideological contributions to articles on sex and gender, including intersex/DSD articles

A small number of editors are making radical changes to a range of articles, including articles within the scope of this project, aligned with views that presuppose that gamete size is the sole determinant of sex. Sex determination is far more complex in cases of intersex/DSD. Changes relevant to this project have been made to intersex, disorders of sex development, 5α-Reductase deficiency‎ and true hermaphroditism. Changes made in other associated pages include hermaphrodite, gynandromorphism, sex, sex and gender distinction, sex differences in humans, and also LGBT-focused pages such as non-binary gender and queer. The modus operandi appears to impose a narrow view of sex determination as uncontested and incontestable, remove all content on social, cultural or human rights aspects, and add material on gender and LGBT issues to make them as contestable and even be perceived as ridiculous as possible (such as an attempt to add 'xenogender' to non-binary gender.

These changes are associated with narrow views about medicine and the diverse global settings where people with relevant traits - and Wikipedia readers - live. For example, recent changes to 5α-Reductase deficiency‎ have been justified on the talk page by an assertion that all infants go through sex chromosome testing that can identify whether or not that infant has the trait. That editor has just proposed a RfC on this little-watched talk page.

I would very much appreciate a wider range of eyes on these articles. Thank you. Trankuility (talk) 00:59, 14 July 2021 (UTC)

That RfC is somewhat confusing. XOR'easter (talk) 01:09, 15 July 2021 (UTC)

The RFC is at Talk:5α-Reductase deficiency#RfC about sex specificity of 5α-Reductase deficiency. It may get re-written/re-started, but if you go into it with the general idea that we're trying to decide whether the article should say something like "5α-Reductase deficiency can result in males having female genitalia at birth" or "5α-Reductase deficiency can result in genetic males having female genitalia at birth", and you actually look for MEDRS sources to see what kind of language they use, then we might still be able to get somewhere with the current question. However, it might prove more effective to shut it down and start over to run as a clear-cut vote, so if you do (please do!) comment, please check back in a few days to see if you need to repeat your comments.

Also, the sourcing in the article is lousy – stuff from the previous century, case reports from developing-world journals, etc. It'd be a real service to the world if anyone found a decent source and did a quick update. WhatamIdoing (talk) 05:02, 15 July 2021 (UTC)

What's the status of "Endotext" [1] vis-à-vis MEDRS? Also, I found this from Application of Clinical Genetics, which is a Dove Medical Press journal; it looks like they were iffy in the past, but the review in question is more recent than the troubles. XOR'easter (talk) 05:21, 15 July 2021 (UTC)

@XOR'easter, sorry that we didn't reply earlier. Endotext is probably okay. Dove Medical Press is ...maybe okay. In particular, since we're talking about a rare disease, it's really important to be practical about sources. You're not going to get a handful of review articles in top-tier journals for every rare disease (there are about 7,000 of them) every year. The hope is that articles will present mainstream views, and a reasonably complete (if sometimes vague or hedged) overview, even if that means citing a less-than-ideal source. WhatamIdoing (talk) 22:26, 24 July 2021 (UTC)

Update: The RFC was re-written, but not with the question that had been discussed. I have started a Talk:5α-Reductase deficiency#Straw poll. WhatamIdoing (talk) 16:19, 25 July 2021 (UTC)

Sex determination is far more complex in cases of intersex/DSD. Changes relevant to this project have been made to intersex, disorders of sex development, 5α-Reductase deficiency‎ and true hermaphroditism. you have no idea how complex it can get. There are species with ZW sex determination and some species don’t even have sex chromosomes.

The modus operandi appears to impose a narrow view of sex determination as uncontested and incontestable, remove all content on social, cultural or human rights aspects, and add material on gender and LGBT issues to make them as contestable and even be perceived as ridiculous as possible (such as an attempt to add 'xenogender' to non-binary gender.

Just to make things clear Wikipedia is not a place to advocate a particular view. Please read on WP:ADVOCACY. Look here on Wikipedia fringe views are looked down upon in general. If a certain view by an group is considered fringe to the scientific community then we shouldn’t include it all. I mean we don’t include fringe views from religious groups in articles about religion so it makes no sense for us to give fringe views by certain groups special treatment.

These changes are associated with narrow views about medicine and the diverse global settings where people with relevant traits - and Wikipedia readers - live. Sure views regarding topics like this are indeed broad but, one view is clearly more reliable than the other.CycoMa (talk) 05:59, 15 July 2021 (UTC)

Per WP:FRINGE, we do write about views and groups that the scientific community considers fringe, if reliable sources indicate that those views or groups are significant and provide us with details we can use to write about them. Fundamentally, it's not the views that we ask to be "reliable", but the sources which document those views. Fringe religious beliefs get their mentions at Noah's Ark, and we have multiple articles on different types of creationism. We simply try to find the best sources available for each aspect of a topic. If the aspect is something that needs to be investigated in a lab, WP:MEDRS guides us on how to find and evaluate sources; for other aspects, we might turn to WP:SCHOLARSHIP, for example. XOR'easter (talk) 06:30, 15 July 2021 (UTC)

Okay but should we treat views from activists groups the same way we treat views from the scientific community?CycoMa (talk) 06:46, 15 July 2021 (UTC)

"The same"? No. "Appropriately?" Yes, absolutely. There was a proposal (years ago now) to elevate the scientific viewpoint above all others, and it was rejected. WhatamIdoing (talk) 15:04, 15 July 2021 (UTC)

And of course, depending on the topic, "activist groups" and "the scientific community" might not diverge so much. Activists can be up-to-date on the science, while those defending the status quo might be a generation or two behind, or have a habit of passing off the oversimplifications taught to schoolchildren as the final word. Furthermore, neither side of that supposed dichotomy is actually monolithic. Geneticists who work with Petri dishes might hold on to terminology that pediatric endocrinologists have learned to move beyond. XOR'easter (talk) 17:15, 15 July 2021 (UTC)

Or you will find different perspectives. A scientist might see severe congenital deafness as a disease, and a Deaf person might see it as a difference that confers advantages. The scientist's view should generally be preferred for describing objective/physical situations, but a scientist has no advantage over anyone else when it comes to interpreting it as "good" or "bad" or how facts relate to various human values. WhatamIdoing (talk) 17:49, 15 July 2021 (UTC)

Well here’s the thing tho, sometimes activists groups may have information that’s problematic. For example many intersex articles cited the study that claimed 1.7% of people are intersex. However, I and other found a good amount of reliable sources that pointed out why this statistic was problematic. Like the biggest problem with that 1.7% statistic was that it included LOCAH as intersex however, individuals with this condition have phenotypes that clearly match up with their sex chromosomes and don’t have ambiguous genitalia. Not to many of the conditions Anne Fausto Sterling labeled as intersex were never once considered intersex from a medical perspective.CycoMa (talk) 17:54, 15 July 2021 (UTC)

Scientists, too, may have "information that's problematic". (Just browse Retraction Watch if you want a visceral sense of that.) And when it comes to definitions, things get truly slippery. Anne Fausto-Sterling and coauthors published a peer-reviewed article in a scientific journal laying out a specific definition of "intersex", adding up the percentages while noting how they depend upon the inclusion criteria, and noting that not all conditions "usually call for surgical intervention". They also observe that earlier estimates that intersexual births might run as high as 4% are unwarranted, except in populations in which a particular genetic condition occurs with high frequency. That's all just part of the scientific process: propose a hypothesis or a definition and see what follows. The revision of diagnostic criteria and of the classification of conditions is likewise part of the medical-scientific process. Why shouldn't Klinefelter syndrome, Turner syndrome, and late onset congenital adrenal hyperplasia fall under the general DSD rubric? (After all, they treat Kleinfelter and Turner with hormone replacement therapy, and T blockers are one of the medications for LOCAH.) It's not an easy judgment call to make in either direction. You have all the problems of deciding what counts as a species or as a planet, with the added difficulty that the goal is to provide the best standard of care to actual patients. Activists are, of course, entitled to quote the higher percentages, particularly if they see themselves as representing all those stigmatized by sex/gender abnormality, rather than being an exclusive club for carriers of a specific mutation. Intersex Human Rights Australia takes this line, for example, with substantial and interesting caveats for all their numbers. XOR'easter (talk) 18:52, 15 July 2021 (UTC)

That's fair, I guess that's how the scientific method works. We have scholars debating with each until a consensus emerges.CycoMa (talk) 20:21, 16 July 2021 (UTC)

When is something a review or lit survey, hence secondary?

I was just wondering if the terms literature review or survey which are characteristic of certain types of published papers which can then be used as WP:SECONDARY sources in Wikipedia articles, are well-defined terms or not?

Consider the article Cultural Components of Sex Differences in Color Preference in Child Development by J. Davis, et al. (This question arises in the context of my searching for more secondary sources for the WP article Gendered associations of pink and blue, which has a lot of primary sources in the #Academic research section.) The journal article starts out with a long intro, summarizing and linking dozens of other studies, and anecdotally commenting on their conclusions, and drawing some groups of opinion out of the collection. But about 1/3 of the way down, the article switches gears to describing the study which was carried out by the authors, involving disparate populations in Peru, Congo, Vanuatu, and Australia; the rest of the article is similar to any published study, and clearly WP:PRIMARY in the Wikipedia sense.

But what about that long intro, listing and evaluating all those other studies? Does that make it a "survey" thus WP:SECONDARY as well, and thereofre a better choice for inclusion in Gendered associations of pink and blue than some of the PRIMARY studies already cited there? What qualifies an article as a "survey" or a "literature review"? Is it the absence of any primary study results by the author(s) being reported, and sole attention on other studies, accompanied by an attempt to standardize the disparate data so they can be reanalyzed collectively as a whole? Thanks, (please  mention me on reply; thanks!) Mathglot (talk) 03:02, 21 July 2021 (UTC)

@Mathglot, you won't be surprised to hear that this has come up before. The general conclusion is that this is, indeed, technically secondary content. However, it's usually secondary content that's being selected to prove a particular point. That point, and the selected content, might be perfectly fair (many times it really is), but there is a risk that it's not. Consequently, while that section is technically SECONDARY, if you rely on it, the end result might not be DUE.

Having said that, if that's one of the best sources you can find, then "better" is better than "worse", and we do not want to make perfect be the enemy of the good. If you're using the best sources you can find (more recent, more scholarly, more secondary, more independent, etc.), and you're being careful about how you use them, then that might be the best approach to that rather narrow and culture-dependent subject. WhatamIdoing (talk) 03:34, 21 July 2021 (UTC)

Pierre-Auguste Renoir's son Jean sewing (1900)

@WhatamIdoing:, thanks for the nuanced response. I couldn't help thinking, while reading Davis et al., what went into their choice of narrative, and how they were evaluating results of other researchers' studies, and whether there was cherrypicking going on (or cherry-evaluating?). In the Gendered associations of pink and blue article, I think we're exactly in the situation you describe: we have very little in the way of recent secondary reviews, so we may have to gingerly use some of this one qua secondary, and hope for the best, till something more solid comes along. For this article, the Jo Paoletti book is widely respected, afaict, but it dates to 2012 and a lot has happened since then; but I am also interested in the generalized question, which I think you've addressed as well, so thank you for that. If others want to chime in with their ideas or experiences, I'm all ears. Mathglot (talk) 04:43, 21 July 2021 (UTC)

I haven't taken a look at the article at all. With that caveat, I expect that (if you haven't already) it would be useful to look for sources about non-Anglophone/non-Western/non-Christian countries (non-Christian because Marian blue had gendered connotations in Europe). If you grew up with "pink is for girls", then it might be surprising to discover that most of the world didn't follow that model. WhatamIdoing (talk) 16:00, 21 July 2021 (UTC)

Not surprised. Also, it already has some (non-western Christian), and should have some more, but has to follow the studies that are out there. Mathglot (talk) 08:02, 22 July 2021 (UTC)

Mathglot, do you remember the "research" back in 2007 that claimed women evolved to identify and love pink cause they were out looking for berries or needed to best determine skin flushing as a social signal. Covered by The Guardian, New Scientist, BBC News and Scientific American among many others. The original paper is here. Those were the days when The Guardian's own science journalists lived in fear of being thoroughly mocked by Ben Goldacre, and sure enough he lets rip. -- Colin°^Talk 08:41, 22 July 2021 (UTC)

I've been thinking about precisely this question for a while, thanks for asking it. In some fields, it seems to the the case that you don't have reviews and paper introductions are picking up the slack (I'm thinking about the machine learning field here).

The other thing I was thinking about at the same time as thinking about this was large epidemiological studies and whether these actually show up in reviews and whether they constitute a different kind of paper Talpedia (talk) 09:12, 22 July 2021 (UTC)

10 most-viewed stubby articles in this Wikiproject

• Rapid antigen test
• Microdeletion syndrome
• Degloving
• Inactivated vaccine
• Christine Grady
• SARS-CoV-2 lineage B.1.617
• Hematoma
• Folliculitis
• Tizanidine
• National Doctors' Day

Wikipedia:WikiProject Medicine/Popular pages, FYI--Coin945 (talk) 13:27, 21 July 2021 (UTC)

I wish all stubs on Wikipedia were as good as those articles! Dr. Vogel (talk) 23:38, 21 July 2021 (UTC)

Degloving doesn't have the image I expected it to have...not sure if that's for the better or the worse... Vaticidalprophet 23:57, 21 July 2021 (UTC)

Microdeletion syndrome has more sources than sentences. WhatamIdoing (talk) 16:49, 22 July 2021 (UTC)

That's not unusual for a list article. -- Colin°^Talk 17:20, 22 July 2021 (UTC)

It almost certainly shouldn't be a list article -- there's at least more that you can say about it than is said here. It's pretty much in my area, so I'll consider trying to expand it. Vaticidalprophet 20:32, 22 July 2021 (UTC)

Ivermectin and COVID-19

A request was inserted on my talk page to add a review paper about the use of ivermectin for COVID-19. The journal is American Journal of Therapeutics and appears to be a valid medical reliable secondary source. Thoughts?

Cc'ing some folks who have edited relevant pages: Alexbrn, DMacks, WhatamIdoing

--Whywhenwhohow (talk) 04:55, 23 July 2021 (UTC)

References

It's been discussed at length, multiple times, on the article Talk page, and above here too. Bottom line, it's a suspicious paper[2] with undisclosed COIs, based in part apparently on fraudulent research[3] and which makes WP:EXCEPTIONAL claims that would undercut what all the major medical bodies (EMA, WHO, FDA etc) are saying. So it's not being used. Higher-quality research is underway so decent sources should be available before long. Alexbrn (talk) 05:26, 23 July 2021 (UTC)

Medical genetics of Jews

Since it also concerns medicine input at WP:FTN § Medical genetics of Jews is welcome, —PaleoNeonate – 17:55, 23 July 2021 (UTC)

thank you for posting--Ozzie10aaaa (talk) 12:24, 29 July 2021 (UTC)

Calculus (medicine)

I'm tempted to delete the text in the infobox of Calculus (medicine) (recently added by an IP), keeping only the photo and legend, as misleading; but not being a medic would welcome an (ahem) second opinion. 07:08, 24 July 2021 (UTC)

Thanks. I've shortened it. The article in general needs some work (especially the ==Treatment== section). WhatamIdoing (talk) 17:12, 24 July 2021 (UTC)

Thanks in return. So far as treatment goes, I can report that in the early 1980s, treatment for bladder stone might involve the surgical equivalent of a straightened-out paperclip. Narky Blert (talk) 17:20, 24 July 2021 (UTC)

Hopefully it also involved a good deal of anesthesia. *wince* WhatamIdoing (talk) 22:16, 24 July 2021 (UTC)

Manipulative surgery and faradism

Hi, I have just created a biography of Morton Smart (died 1956), a Scottish physician who is generally described as a "manipulative surgeon" and practised "manipulative surgery" (according to all of his obituaries). He was also an expert in faradism, which was the "use of induced rapidly alternating electric currents to stimulate nerve and muscle activity" [4]. None of these terms have Wikipedia articles. I have literally no medical or scientific training, but from what I can gather they are no longer used in the medical profession; manipulative surgery seems to have been a specific form of orthopedic medicine which entailed fixing injuries by using the hands, and faradism was apparently used to treat muscle conditions. Morton himself did not like to be called an orthopedic surgeon. Should we have articles on these topics? —Noswall59 (talk) 15:26, 24 July 2021 (UTC).

@Noswall59, this old source says that "manipulative surgeon" is the same thing as a bonesetter. This 1932 book says "Manipulative surgery may be defined simply as the art and practice of moving joints for therapeutic purposes".

You might also double-check that he was a physician and not a surgeon. WhatamIdoing (talk) 17:35, 24 July 2021 (UTC)

Search for "Smart-Bristow coil" CV9933 (talk) 19:55, 24 July 2021 (UTC)

I am unsure if it is technically considered the same thing or not, but there is electrotherapy. Jebbles (talk) 20:17, 24 July 2021 (UTC)

Thanks all for these responses. His entry in the Oxford Dictionary of National Biography calls him a "manipulative surgeon" and that was his title in the Royal Household, but then the ODNB also mentions that he "did not regard himself as an orthopaedic surgeon ... [and] practised essentially as an orthopaedic physician", so I'll add that to the article. I imagine, based on this book review in Nature (which says "the practice of manipulative surgery is almost a monopoly of the bone-setter"), that this was a sub-practice of bone-setting, in which case it might be worth a brief mention there? As for faradism, yes, he did invent the Smart-Bristow coil – I'll mention that too. —Noswall59 (talk) 07:50, 26 July 2021 (UTC).

I have added a short section at Bonesetter if anyone wishes to review it. Thanks, —Noswall59 (talk) 08:04, 26 July 2021 (UTC).

Autism

Autism is one of WP:MED’s highest viewed articles, and is a Featured article. This will require considerable collaboration; please watchlist. SandyGeorgia (Talk) 22:06, 25 July 2021 (UTC)

PS, while I am glad to see the long-needed rewrite underway, I am quite concerned that User:Kilopylae might not be familiar with FA standards, and is adding uncited text, and very old sources, so some guidance will be helpful. I am traveling all week, and unlikely to have time to pitch in here. The article is LONG overdue for a trip to WP:FAR, which I have held off on because WP:MED has so many other articles in need of FAR. Perhaps someone else has time to guide Kilopylae in FA standards and high quality sourcing. Tackling a medical article of this scope, and one which is so outdated, requires considerable experience, and unfortunately the main author, User:Eubulides has been long gone for many years now. SandyGeorgia (Talk) 22:13, 25 July 2021 (UTC)

Kilopylae this kind of bold move, with respect to a Featured article, might be better reviewed with WP:MED regulars. SandyGeorgia (Talk) 22:18, 25 July 2021 (UTC)

Template:COVID-19 treatments (current consensus)

coronavirus

Hi all. I recently created a consensus template on COVID-19 treatments, because I (and many others) have become frustrated at the endlessly repetitive discussions on relevant talk pages. See, for example: Talk:Bret Weinstein, Talk:Ivermectin, Talk:Didier Raoult, Talk:Pierre Kory, Talk:Hydroxychloroquine. My hope is that writing all of this down in a template could be helpful as a place to direct new and inexperienced users who have repeatedly come to these talk pages to push a POV. Much like it has worked for Template:Origins of COVID-19 (current consensus), Talk:Donald Trump, Talk:Joe Biden#Current consensus, Talk:Sushant Singh Rajput. (credit to ProcrastinatingReader on those prior templates).

However, I would appreciate your feedback. Overall, of course, but also on the following specific issues:

1. Too long? I'm an academic and I'm verbose as hell. They teach us to be this way in graduate and medical school. :) Help me trim the fat.
2. Represents actual consensus? I want it to be rock solid so please steel-man my claims. These templates only work if they are pretty indefensible. Of course nothing is 100%, and bad faith editors will disagree no matter what... but I appreciate criticism on this nonetheless.
3. What else should be included here? I'm sure there are other topics I'm missing, like maybe Vitamin D? ...Forsythia? (kidding, kidding)
4. Which articles would this be good to include on? So far, I'm thinking Talk:Ivermectin, Talk:Hydroxychloroquine, Talk:Bret Weinstein, Talk:Didier Raoult, Talk:Pierre Kory. Any other suggestions?

Thank you for any help you can provide.--Shibbolethink ^{(♔ ♕)} 16:00, 2 August 2021 (UTC)

I feel like we've played around with new concepts as a result of the COVID-19 disruption and there's currently not too much evidence on which approaches are most effective. There are only so many of these templates so it's difficult to assess exactly what effects they've had and how different variables (e.g. length/style) affect their usefulness. I think it's fine to change it up a bit as appropriate, or to experiment with a different approach.

With the origins of COVID-19 one I wanted to be as uncontentious as possible - to the point of blandness - to help with documenting a moderate position everyone could get behind. I think in that topic area many of the disputes were on major issues (should this article exist, should this group of sources making exceptional claims be used, etc.) and less on specific content presentation, and the former sets of issues were usually discussed at XfD, which made the resource have less points on 'the big issues' than I expected. I also realised that sometimes it's the case that outcomes are so obvious to everyone and only some IP/non-confirmed users are debating the issue, hence it's never really subject to a 'consensus discussion', which limited the amount of things that could go on that template. Mostly I was concerned that opening the scope too wide would introduce more contentious bullets and thus make it a dubious resource. Perhaps I was too paranoid on that aspect.

As it applies here, some of the discussions of point #3 only had one editor participating saying the sources were unreliable (Alexbrn). I'm pretty sure he was/is right, but I'm not sure "current consensus" is the right word to use (it's then more of a FAQ). I do think something like "Treatments for COVID-19: Important [information/notes]" may be more correct, but I think it's only me who sees a distinction. Either way, I personally wouldn't cut it down; that would lose high quality information in exchange for a perceived increase in trustworthiness that may not even exist.

I like the bolding to make it more readable and make the main points stand out. It certainly seems like there are more relevant points for those articles (e.g. on specific sources, on specific outcomes by authoritative bodies, plenty of discussions about the issue), which makes it a good candidate for a template like this. ProcrastinatingReader (talk) 17:22, 2 August 2021 (UTC)

ProcrastinatingReader, thank you for your thoughts, as always.

I think maybe the saving grace of a template like this is that it's for an extremely narrow, obviously inarguably WP:MEDRS-relevant topic. So we don't necessarily need as robust discussion-linking as a topic like viral origins, which is much more grey and debatable! I totally buy that it's as you say. These things are so uncontroversial that it's only IPs and brand new folks showing up to disagree!

Maybe what would help with point 3 is a clarifying RfC at RSN about these sites? But, as soon as I type that, I realize how annoying and tedious that would be to everyone involved! I think it's okay to fall back on the fact that it's pretty uncontroversial that these sites don't meet MEDRS. And thus this template just serves as a place to hold all the reasons why that is, as expressed in article and talk space.

I think if someone comes along and challenges 3, then we can do an RfC. Doesn't consensus default to the status quo in situations like this? I just don't want to make RSN mad, lol.--Shibbolethink ^{(♔ ♕)} 17:46, 2 August 2021 (UTC)

I personally don't think it needs an RSN. There's no active dispute, and it seems fairly obvious what the outcome would be. I meant that the difficulty with respect to the template just arises in that I dunno if those discussions can accurately be called a "consensus" per se. But I find it very difficult to imagine someone coming along and disputing it, and being able to introduce those sources, without having to go to RSN and show consensus for their position. In that sense, actually, I suppose it is accurately described as a consensus (but more of the WP:IMPLICITCONSENSUS variety, which IMO is the weakest variety but valid nevertheless). ProcrastinatingReader (talk) 17:52, 2 August 2021 (UTC)

Are we (still) having problems with those websites? The Wikipedia:Spam blacklist is an option to consider if it looks like there might be any effort to promote them. WhatamIdoing (talk) 04:25, 3 August 2021 (UTC)

WhatamIdoing, I think it's mostly died down, now it's just people pushing individual meta-analyses in off-topic journals more than anything. But if it becomes an issue again, I think that's definitely what we should do. The edit warning alone would probably be a big deterrent. As far as I can tell, nobody is citing them in article space, probably because these articles are all SP or ECP after persistent abuse. I will say that I have been filing google search complaints whenever I can, because these sites are still some of the top 2 or 3 results for things like "ivermectin meta analysis" or "ivermectin data." Which is really disappointing.--Shibbolethink ^{(♔ ♕)} 04:32, 3 August 2021 (UTC)

Speaking of search results, if you search "COVID-19" (and some related terms) you get no link to Wikipedia; I think Google are manually setting the results for that page as I don't think the first page is an SEO thing. Of course, it's interesting because we've probably maintained one of the most consistently reliable sources throughout the pandemic, but I can understand why an encyclopaedia everyone can edit isn't first page for pandemic results. ProcrastinatingReader (talk) 11:12, 3 August 2021 (UTC)

Google has historically avoided intervening in the search results, although they are customized per person (and their guess at your identity, if you aren't logged into one of their accounts). For COVID-19 I get a link to the COVID-19 article as sixth in the list. For longer phrases, such as COVID-19 treatment and COVID-19 vaccine, it's not in the top 10, but Wikipedia was sometimes linked in the sidebar as a source of information about the number of cases. WhatamIdoing (talk) 15:29, 4 August 2021 (UTC)

Draft:The British Society for Allergy and Clinical Immunology

The notability of this subject is unclear, some advice would be appreciated. Roger (Dodger67) (talk) 17:39, 2 August 2021 (UTC)

its been declined three timesDraft:British_Society_for_Allergy_and_Clinical_Immunology and IMO there has been no improvement (including notability)--Ozzie10aaaa (talk) 12:06, 4 August 2021 (UTC)

I just saw this, as well, during AfC reviewing and decided neither to decline nor approve. It seems like it could be on the edge notability but barely. I don't think anyone will fault your decision either way (or at least I won't). Chetsford (talk) 19:47, 4 August 2021 (UTC)

Concerns with dropping Cochrane sources in lots of articles

Greetings User:Harrisonnelson1205 and others. (I'm tired, so I'm sorry if this is excessively grumpy.) For what it's worth, I am not a fan of the recent contributions I see from this editor. In general, I dislike it when contributors think there's 1 journal that's so great that they then go along dropping sentences in random articles to cite a single publication. I dislike the flow of the prose that results from this approach, and I find it a myopic approach to editing. I recently reverted one contribution at deep vein thrombosis that was added in this manner, and I explained my rationale on the talk page and the edit summary. (There are other gripes I state there, and they relate to the source, but I won't repeat them here.) Maybe others would like to review these contributions. Unfortunately, I do not have the time to do so myself. I have been concerned for a long time about conflicts of interest in these cases. I fear that editors who adopt this style of contributing are blinded by the desire to cite 1 specific journal or publisher and that they do not consider the rest of the medical literature and the totality of Wikipedia's policies and guidelines so that the net effect is that they aren't really here to help build an encyclopedia. I'm concerned that editors who contribute in this style are instead actually here to promote a publisher to Wikipedia's detriment. Biosthmors (talk) 02:39, 4 August 2021 (UTC)

I suppose Cochrane is an unusual case in that its content is (nearly) always representative of the kind of WP:BESTSOURCES Wikipedia likes to use. I haven't reviewed any of these specific edits but suppose one factor is how well-developed the articles are to which Cochrane material is being added. Adding it a some poorly-sourced raggedy article is always going to be a win; dumping it disjointedly into a well-sourced, well-developed article ... not so much. Appropriate care should be taken to ensure this is taken into account. Alexbrn (talk) 04:25, 4 August 2021 (UTC)

I don't think that Cochrane sources should be put on such a pedestal. Sure, they are a reliable source for biomedical information. Sure, I think some citations are appropriate and helpful for readers. But let's take for example the recent seminar on VTE that was published in the Lancet [5]. Only 4 out of 164 references are to Cochrane sources. I also cite Cochrane sparingly at deep vein thrombosis (an article that is currently up for peer review and one I've tried to maintain over the years). I have repeatedly had to clean up what I consider to be "Cochrane clutter" from people dropping in Cochrane sources in an unwise manner. Personally, I don't find Cochrane sources to be particularly useful for article development. For example, deep vein thrombosis uses 4 Cochrane-published articles out of 199, and none of them are highly-cited within the article. (Contrast this with the Mazzolai et al. source, which is cited over 20 times there.) In other words, I think a well-developed article will cite Cochrane sources only very sparingly. Therefore, I hold a negative view towards single-purpose accounts whose goal it is to tilt the balance of an article towards Cochrane sources in a haphazard manner, as was the pattern of edits I see with Harrisonnelson1205. Wikipedia citations are something Cochrane keeps track of, as you can see here. Clearly there is the potential for conflict of interest editing. Because I think Cochrane should only be cited occasionally in a well-written article, I don't agree with the assertion that adding Cochrane-sourced content to a "poorly-sourced raggedy article is always going to be a win." Such use of sources could be wp:undue and mislead readers about what subtopics are actually of import to an encyclopedic summary. Biosthmors (talk) 22:51, 5 August 2021 (UTC)

Kindling (sedative–hypnotic withdrawal)

A request from a user using an IP address about the article Kindling (sedative–hypnotic withdrawal) was posted on my talk page. It seems like it would be better handled here. Whywhenwhohow (talk) 04:27, 4 August 2021 (UTC)

• I'm unable to really effectively improve the article at this time, but I'm not going to nominate it for deletion - there's plenty of MEDRS sources: [6] [7] [8]... and that's just on the first page of Google results for the term "gaba kindling". It's definitely a real thing - from personal experience I can say that it's even significant enough to be flagged as a drug utilization program in medical information systems - people who've potentially repeatedly gone through periods without a GABAergic drug are flagged for potential review for increased effects from new withdrawals for counseling and education. I'll throw it on my to do list for if I get some time soon to improve. It is a real phenomenon, and while I can't say whether sources in the article now use the term, it can certainly be improved to cite the term itself. The user seems to be trying to form policy based reasons they object to the article (such as "the lead has no citations") and they're making vast misinterpretation of the MEDRS in the article now. Seems to be a case of an ulterior motive, especially given their post on the talk page where they talk about their personal experience trying to convince people this isn't a thing (I presume when they were told it was a thing by a professional). If anyone wants to use the sources I found to add in the meantime while I find time to improve it, please do feel free to do so. -bɜ:ʳkənhɪmez (User/say hi!) 04:37, 4 August 2021 (UTC)

  @Literaturegeek worked on that article years ago, and might be able to take a look, if he's on wiki again some time. WhatamIdoing (talk) 15:36, 4 August 2021 (UTC)

Wikimania is a free virtual conference this year

Please sign up. It won't be the same as the in-person experience, but it'll include a lot more of us than usual.

In particular, I think many editors here will be interested in this presentation:

wikimania:2021:Submissions/Preventing misinformation during the COVID-19 pandemic: How Wikipedia, public health experts, and news media can collaborate to share trustworthy knowledge in times of crisis

Daniel Mietchen and User:Netha Hussain also have a COVID-related talk scheduled.

If you see other sessions that might interest this group, please share links. WhatamIdoing (talk) 18:49, 4 August 2021 (UTC)

Thanks for sharing this. JenOttawa (talk) 16:30, 5 August 2021 (UTC)

There will be a session titled "Attracting experts to contribute to Wikimedia movement", but there's no page to link to it yet. Wikimania:2021:Program has the schedule. Different days will be more convenient for some timezones than other days. WhatamIdoing (talk) 17:58, 5 August 2021 (UTC)

Creat - herbal treatment for COVID-19

• Andrographis paniculata (edit | visual edit | history) · Article talk (edit | history) · Watch

Creat (Andrographis paniculata) is a herb which has been touted in Thailand as a COVID-19 treatment. Phyzome is repeatedly[9][10][11] adding text to the article saying that a PLOS ONE review of the herb's use for ARTIs "concluded that it was likely safe and beneficial but ...". Even if PLOS ONE is a usable source for this striking claim (maybe doubtful), I don't think it says this. Rather it says,

Paniculata appears beneficial and safe for relieving ARTI symptoms and shortening time to symptom resolution. However, these findings should be interpreted cautiously owing to poor study quality and heterogeneity.

I do not like the leap from something merely "appearing to" do something to it being "likely", especially given thw weak nature of the evidence. Since this has devolved into a bit of an edit war, newer eyes would be helpful. Alexbrn (talk) 18:59, 4 August 2021 (UTC)

• I think the content added by Phyzome —

-A 2017 meta-analysis evaluating Andrographis paniculata to treat acute respiratory tract infections concluded that it was likely safe and beneficial but that the studies reviewed were of poor quality, and better-designed studies should be performed.

—is a more accurate representation of the source material than the alternate text proposed —

-A 2017 meta-analysis evaluating Andrographis paniculata to treat respiratory tract infections was inconclusive because the trials reviewed were of poor quality.

Changing "was likely" to "it appeared to be" would be a relevant point of discussion but wordsmithing that should occur on the Talk page; slash and burn reverts seem very unproductive over a two to three word passage. Chetsford (talk) 19:48, 4 August 2021 (UTC)

• I don't typically delve into medical discussions but I respect Alex and I respect experienced editors like Phyzome, as well. Alex works hard to push back against non-neutral points of view in regards to, primarily but not completely, the COVID crisis that has gripped the world. I have and will continue to commend them for that. That being said, the current wording of the article seems to suggest the findings were inconclusive. The word "inconclusive" was never used in the official findings. At the same time, neither is the word "likely" used. In my opinion both instances represent slightly opposite views of the actual findings of the study, one not giving it enough weight while the other gives it too much. Regardless this is nothing to be having an edit war over. Why not try to find middle ground and simply state what the findings were? In this case it can be placed in the article as a simple direct quote with proper attribution or summed up in a way other than using "inconclusive" or "likely". --ARoseWolf 19:51, 4 August 2021 (UTC)
  • From the source's conclusion: "The evidence is inconclusive due to limited methodological quality of included trials and study heterogeneity". Alexbrn (talk) 20:00, 4 August 2021 (UTC)

    Alexbrn, yeah that's pretty damning. I would support the "inconclusive" wording based on this.--Shibbolethink ^{(♔ ♕)} 20:03, 4 August 2021 (UTC)

    • Also from the source's conclusion: "A. Paniculata appears to be beneficial and safe for relieving ARTI symptoms and reducing time to symptom resolution." While leaving room for improvement with respect to "was likely" versus "it appeared to be", Phyzome's version seems to better and more holistically summarize the contents of the study's conclusion. The alternate version [12] cherry picks one sentence. Chetsford (talk) 20:09, 4 August 2021 (UTC)
      • It only "appears" to be because it is an appearance (not a reality); elevating this into some kind of probability is OR/misreading. The underlying data is too poor to conclude anything, as is stated. Alexbrn (talk) 20:13, 4 August 2021 (UTC)
        • It only "appears" to be because it is an appearance (not a reality) While a social constructionist argument is a ... novel ... one to advance in a content discussion, I don't think it's for us to reimagine the content of any source. With some room for improvement, Phyzome's version is a better and more holistic summary of the study's conclusion. The alternate version, in cherry picking a single sentence, deceives readers as to the content of the source. That said, I do appreciate what I think your intent is here; to guard the dullest of our readers from irrational conclusions. Chetsford (talk) 20:30, 4 August 2021 (UTC)

I stand corrected with the fact "inconclusive" was used later in the study, twice no less. --ARoseWolf 20:28, 4 August 2021 (UTC)

The full conclusions section reads:

A. Paniculata appears to be beneficial and safe for relieving ARTI symptoms and reducing time to symptom resolution. The evidence is inconclusive due to limited methodological quality of included trials and study heterogeneity. Well-designed trials evaluating effectiveness, efficacy and safety of A. Paniculata as a monotherapy, or as an herbal mixture, as well as exploring its potential to reduce antibiotic prescribing in primary care, are warranted.

That's a pretty clear conclusion that tells me, in no uncertain terms, that we should not be reporting this herb as beneficial for COVID-19 until we have more conclusive evidence. If this is enough, we should also be reporting Ivermectin, Vitamin D, and energy healing as beneficial for COVID-19.--Shibbolethink ^{(♔ ♕)} 20:36, 4 August 2021 (UTC)

I think Phyzome's suggested edit is consistent with that view: "A 2017 meta-analysis evaluating Andrographis paniculata to treat acute respiratory tract infections concluded that it was likely safe and beneficial but that the studies reviewed were of poor quality, and better-designed studies should be performed." I would never include Phyzome's suggested edit in a patient treatment pamphlet, but a WP article is an accurate summary of RS and has no role in public safety. "we should not be reporting this herb as beneficial for COVID-19" We should not "report" anything as beneficial for anything. WP is not a journalistic endeavor or a public health campaign. We provide encyclopedic treatments of information gleaned from reliable sources and nothing else. Chetsford (talk) 20:48, 4 August 2021 (UTC)

Chetsford, listen I have great respect for you as an editor and admin. I think your judgment is usually extremely level-headed and sound. (such sentences always come with a "but", don't they?) However, I have to disagree with you here: I would never include Phyzome's suggested edit in a patient treatment pamphlet, but a WP article is an accurate summary of RS and has no role in public safety.

As a medical professional, I am extremely uncomfortable with the notion that we should abrogate responsibility for the impact of our medical content simply because WP shouldn't play a role in anyone's medical decisions. What should and shouldn't be is less important to me than what is, and we have reason to believe that individuals come here to research their health. That's the point of WP:MEDRS, right? To make sure we aren't delivering inaccurate or poorly contextualized material that misleads readers about these extremely important ideas.

MEDRS tells us that we should be following the treatment recommendations of government bodies, treatment recommendations, etc. We should be essentially mirroring that patient pamphlet you've described. Where such information is not available, we should be more cautious about the sources we use. WP:MEDASSESS tells us that unpublished RCTs are less reliable than published ones. From the methods of the 2017 article: This review included published and unpublished randomised controlled trials (RCTs).. MEDASSESS also says: To prevent misunderstanding, the text should clearly identify the level of research cited.

We should be reporting what is said in the RSes, but in particular the fact that Phyzome's edit does not have the word "inconclusive" anywhere in it is extremely troubling in that regard. When the source isn't willing to say that a treatment actually has any benefit, or even that it likely has benefit, then we probably should not be saying it either. "appears to be" is the same sort of hedging that we do on attributed quotes. It's the equivalent of a newspaper saying "alleged." --Shibbolethink ^{(♔ ♕)} 20:54, 4 August 2021 (UTC)

"As a medical professional, I am extremely uncomfortable with the notion that we should abrogate responsibility for the impact of our medical content simply because WP shouldn't play a role in anyone's medical decisions." I appreciate and empathize with your professional discomfort. The correct way to resolve this would be to advance a change in our policies or guidelines at the Village Pump. Unfortunately, we can't simply ride rough over our policies and guidelines when we feel either personal or professional discomfort with content we read on WP. "We should be reporting what is said in the RSes, but in particular the fact that Phyzome's edit does not have the word "inconclusive" anywhere in it is extremely troubling in that regard." I have no problem, in fact I would support, modifying Phyzome's suggested phrasing to include the fact this is inconclusive. What I don't support is obliterating information that accurately represents the content of a reliable source to resolve individual feelings of personal or professional discomfort. If your objective is to curate information for laypeople to help them make decisions that will lead to the best possible personal health outcomes, there are projects for that [13]. This, however, isn't one of them. "MEDRS tells us that we should be following the treatment recommendations of government bodies, treatment recommendations, etc. We should be essentially mirroring that patient pamphlet you've described. I don't find anything in Phyzome's suggested text that conflicts with the guidance of MEDRS. That said, I disagree with your reading of MEDRS; I don't believe it suggests we should be mirroring a treatment pamphlet. Chetsford (talk) 21:25, 4 August 2021 (UTC)

MEDRS tells us that we should be following the treatment recommendations of government bodies -- surely you don't believe that, as stated. Several government bodies have strongly recommended Andrographis paniculata for COVID-19 (in the absence of any sufficient evidence, in my opinion!) I have never seen anything indicating that Wikipedia has decided to follow the guidance of any one government except where failing to would actually break laws in specific jurisdictions. This is of course tangential to the issue at hand, but this stood out to me enough that I had to ask. -- Phyzome (talk) 22:20, 4 August 2021 (UTC)

Phyzome, I mean that we should be following the consensus of such recommendations. But you're right that just because the Indian public health agency says Ivermectin works, doesn't mean we say it. I should clarify to say "Government bodies and professional organizations help us clarify the scientific and medical consensus." Fair? --Shibbolethink ^{(♔ ♕)} 22:36, 4 August 2021 (UTC)

Yes, I think we're more in alignment, then. My trust in my own government on medical issues has gone through a pretty turbulent year and a half, but I suppose I agree that when there's a broad consensus there, it's not something to ignore. :-) -- Phyzome (talk) 22:41, 4 August 2021 (UTC)

Hmm! Thanks for highlighting "inconclusive". It's troubling that a handful of smart people (here in this discussion) are having difficulty in ascertaining the intent of the authors of this review—the purpose of preferring reviews is to make sure the science is understood, but that's apparently not happening here (one way or another). Taking a closer look, « The evidence is inconclusive » in the Conclusions might be mirroring « Our safety findings are inconclusive » in the Safety discussion, whereas the part on efficacy under Summary of Evidence is more boldly stated. I'm no longer happy with either phrasing, and would be happy to do some further wordsmithing. It seems correct to say that there is evidence of efficacy, but no conclusive evidence of safety (despite the phrase I picked up from the Conclusions.) Maybe also throw in something about how COVID-19 was not included in the RTIs that were studied, just to be sure people understand it may not be relevant for this virus. Or... perhaps this source should be removed entirely. Bleagh. -- Phyzome (talk) 21:40, 4 August 2021 (UTC)

Those all seem like great ideas and outcomes that would satisfy everyone (I think, if I'm reading this correctly). Minor wording disagreements are best handled on article Talk pages and this is definitely a valuable lesson of the need to utilize a collaborative and discursive approach versus aggressive reverting. Chetsford (talk) 21:55, 4 August 2021 (UTC)

As a general rule of thumb, when a (good) source is using words like "inconclusive" or "poor quality", you should handle the subject gently. Think about "under-promising" as a model, or even sidestep the question of efficacy entirely. "It's been researched for ARTIs" is verifiable, encyclopedic content, and it remains verifiable, encyclopedic content regardless of whether you understand the source as saying "the authors would definitely give this to their beloved family members" or "nobody actually knows, and we wish people would stop running poorly designed studies". Sidestepping efficacy also has the advantage that if the next paper says the opposite, then the statement that research had previously happened continues to be true and verifiable. (The 0.3% of readers who actually want to know more will be able to read the cited source.) WhatamIdoing (talk) 03:17, 5 August 2021 (UTC)

I disagree a bit with Alexbrn and Shibbolethink wrt the "appears" statement. That 'It only "appears" to be because it is an appearance (not a reality)' or '"appears to be" is the same sort of hedging that we do on attributed quotes. It's the equivalent of a newspaper saying "alleged."'. The "Summary of evidence" section is quite solidly pointing towards efficacy based on the available trial results, though there is no such conclusion that safety has been demonstrated. The problem with jumping from "in the trials, patients got better" to simply "it works" or even "it is likely to work", is summarised in the conclusion, that the trials are of "limited methodological quality" and "heterogeneity" prevents us doing any serious meta analysis. The result is much more of a "we don't really know for sure" and not "but we think the trials results are probably wrong" or "we have reason to be suspicious and want to distance ourselves". I'm not sure that WAID's suggestion of merely saying "It's been researched for ARTIs" is going to satisfy the reader, because our failure to offer a conclusion will encourage a reader to make their own conclusions. Those are likely to be "well the doctors wouldn't research it if there wasn't something promising here".

The (current) text seems reasonable, but I would change "the trials reviewed were of poor quality" to something like "the trials conducted and published at that time". The review is systematic, but the existing text might suggest to some readers that the meta-analysis cherry picked low quality trials. -- Colin°^Talk 11:38, 5 August 2021 (UTC)

Readers who read the original and make their own conclusions from those originals are not our problem.

And if people think that everything researched is promising, then they need to head over to clinical trials, which, if memory serves, has numbers on just how few (cancer?) patients receive a significant medical benefit from trying out the latest, greatest experimental treatment in trials. In practice, while few are significantly harmed, the trial drugs don't usually perform better than standard treatment, either. WhatamIdoing (talk) 15:42, 5 August 2021 (UTC)

I don't know what you mean by "read the original". I don't think that an argument that "saying X is likely to mislead a lot of readers" is successfully countered by "well those readers are ignorant and should go educate themselves". We can avoid misleading readers by accurately and fairly summarising the conclusions of the analysis paper, which is presumably the best source we have currently on the state of research wrt that treatment. The doctors who do trials are not stupid and don't want to waste their time and money. They think there is a chance the treatement is helpful. Unlike novel cancer therapies, this is the sort of treatment where people do trials because there is already anecdotal evidence of help, or longstanding use in folk medicine. So the mere fact that there are larger trials is suggestive, and if those trials have failed to provide good evidence of efficacy/safety/consistency then we ned to say that, rather than leaving the suggestion hanging. -- Colin°^Talk 09:06, 6 August 2021 (UTC)

If the Wikipedia article says "There was research", and the readers read the original sources themselves and they decide that the original source says "I should drink a liter of this stuff every day", then the Wikipedia article has not misled them at all. What they decide the sources say is not our problem. We have not misled them in that case. WhatamIdoing (talk) 16:17, 6 August 2021 (UTC)

Wikipedian in Residence for ILAE Wikipedia Epilepsy Project

Dear members of WikiProject Medicine

I am a long term Wikipedian contributing primarily to articles under WikiProject Medicine. I am the Editor in Chief of the ILAE Wikipedia Epilepsy Project. The aim of the project is to bring scientifically accurate information on epilepsy subjects to the masses through Wikipedia. We have tagged under WikiProject Epilepsy more than 200 articles which come under the scope of the project. A lot of lacunae have been identified and the updates need scientific acumen. We have been unable to get adequate number of volunteers involved and therefore are considering involving a paid contributor who can carry out the necessary activities. The required activities are:

• To compile a list of important ILAE articles, communicate with the authors about change in license, if felt necessary, get that done.
• To work with the collaborators and identify the key aspects of ILAE publications that need to be incorporated in the articles on Wikipedia.
• To learn the intricacies of Wikipedia editing, and to execute the changes directly on Wikipedia.
• To communicate with peer reviewers and get the existing articles assessed and get a to-do list for the articles worked out. Thereafter they can carry out the changes as needed.

Their official contributions will come from a username tagged with the project. They can directly receive emoluments for the efforts they put in and this would be openly declared on their userpage. The funds could come from the ILAE and a part can come from Wikimedia grants that can be applied for.

Reason a paid position is felt to be needed

There is a paucity of Wikipedians who are academicians/experts in the field who can check the scientific content and verify validity of the information. We have tried to get volunteers but failed to get them adequately involved in structured and systematic contributions. This is leaving gaps that need to be filled and a paid post seems to be the only way out.

Seeking your inputs and checking whether anyone has any objections to this or if you have suggestions about how else this could be done. Diptanshu 💬 15:20, 6 August 2021 (UTC)

@Diptanshu Das, can you get the page created for your Wikimania session? Some editors here might be interested in attending. WhatamIdoing (talk) 16:19, 6 August 2021 (UTC)

@WhatamIdoing: How and where do I create a page for the same? Can you please guide? Otherwise, any specific inputs on the issue particularly discussed here? Diptanshu 💬 16:26, 6 August 2021 (UTC)

 Done here. Thanks for pointing out. @WhatamIdoing: Diptanshu 💬 16:51, 6 August 2021 (UTC)