Talk:Circumcision/Archive 72

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Archive 65

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Archive 70

If too much skin is removed, the penis may not be able to grow to its full length.

Any particular reason you don't like the source? Rip-Saw (talk) 00:42, 25 April 2012 (UTC)

That fact that it fails WP:MEDRS, for one. Also, the fact that it was written by various leading anti-circumcision activists such as Marilyn Milos (founder of nocirc.org), George C. Denniston (founder of doctorsopposingcircumcision.org), and Frederick Mansfield Hodges, doesn't really inspire much confidence in its neutrality or objectivity. Jayjg ^(talk) 01:07, 25 April 2012 (UTC)

Do you care directly refute the subject matter or are you going to continue to quote policy? Rip-Saw (talk) 01:18, 25 April 2012 (UTC)

I'm going to quote policy, of course, because that's all that matters here. My own opinions on the subject, if I had any, would be irrelevant, and Wikipedia is not a forum. Jayjg ^(talk) 01:22, 25 April 2012 (UTC)

Unless you are able to point out what part of policy is being violated, then how do I know you even understand the policy? You state your opinions are irrelevant; should I take that to mean I should ignore your opinions on the authors of my reference? Rip-Saw (talk) 01:29, 25 April 2012 (UTC)

I noted that it fails WP:MEDRS - did you click on the link there to see what sources are acceptable here? Jayjg ^(talk) 01:31, 25 April 2012 (UTC)

Do you care directly refute the subject matter or are you going to continue to quote policy? Rip-Saw (talk) 01:36, 25 April 2012 (UTC)

Please review my response of 01:22, 25 April 2012 above. Jayjg ^(talk) 01:39, 25 April 2012 (UTC)

I do not respond well to logical fallacy, nor do I respond well thinly veiled threats. If you see a policy violation in anything that I contribute, then you had better directly address precisely how my contribution is in violation of policy, or else you are in the wrong for reverting it. See: WP: Editing policy, WP: EW, and WP: Civility. Rip-Saw (talk) 01:53, 25 April 2012 (UTC)

WP:MEDRS recommends using "general or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies". Your source is the proceedings of an anti-circumcision conference run by nocirc.org. I can't see how it meets any of the qualifications recommended by WP:MEDRS. Jayjg ^(talk) 02:01, 25 April 2012 (UTC)

WP: MEDRS also states "Medical textbooks published by academic publishers are often excellent secondary sources." and "Major academic publishers (e.g., ... Wolters Kluwer, ...)" This book is published by Kluwer, listed in WP: MEDRS specifically as a "major academic publisher". The author, George C. Denniston, is a medical doctor doing research in the field of circumcision, and could be considered an expert. He is an expert, and has a respected publisher. So again, I ask: Do you have a problem with WHAT is being cited? As of right now this article states, "Circumcisions may remove too much or too little skin," then gives no example of the consequences of removing too much skin. Rip-Saw (talk) 03:19, 25 April 2012 (UTC)

It's not a medical textbook, so that doesn't apply. It is actually the "Proceedings of the Sixth International Symposium on Genital Integrity", as you can confirm here. The fact that an anti-circumcision conference presentation is unlikely to have "a reputation for fact-checking and accuracy" should be self-evident. And in any case, conference presentations are specifically identified as unreliable per WP:MEDRS#Other sources. Also, to correct a couple of your erroneous claims above: Denniston wasn't the author of that chapter (it was written by Gillian Bensley and Gregory Boyle, both of whom are psychologists), and the publisher was Springer. Jakew (talk) 10:00, 25 April 2012 (UTC)

We can quote a total non-medical quack, who says things not endorsed by any medical society of any country, as long as the quack is referenced in a secondary study. No matter how distasteful it may be for someone in here, use of an anti-circumcision doctor's primary research is beside the point. It doesn't matter if the source is pro or anti. Unless a doctor like Denniston gets his work into a meta-study, which results in a secondary resource (a resource made from multiple studies of the primary research done by doctors like, say, Denniston or Bailey, or even a layman), their study can't be used. It's not a wikipedia rule. wikipedia allows high quality primary research. It's a rule of the circumcision page...likely because this page is such a hotbed of contention. This leads to a higher hurdle for some. It is harder to prove that a normal body part works, because no one publishes secondary research on it. No philanthropist is throwing millions at the problem of proving that a foreskin works, for instance. Another paragraph was criticised, because the author was a psychologist. While potentially distasteful to some, we have cited references in here written by people who are neither medical doctors, nor psychologists, nor epidemiologists. The key is that it comes from a secondary resource, as I am told. Tftobin (talk) 16:29, 25 April 2012 (UTC)

A peer reviewed medical journal is a reliable source whether specific members of Wikipedia claim the topic is bias or not. There is no reason to believe that medical professionals are untruthful or inaccurate in their submission to this topic except invalid ones such as [[1]].Gsonnenf (talk) 18:36, 28 April 2012 (UTC)

Yes, in general, peer reviewed medical journals are considered reliable sources on medical topics. However, since the source in question was not a "peer reviewed medical journal", it's unclear how your comment is relevant to the discussion here. Jayjg ^(talk) 21:39, 29 April 2012 (UTC)

From the title I deduced it from from a professional conference, "Proceedings of the Sixth International Symposium on Genital Integrity" where one submits papers. For anyone who believes other wise [2]. It appears this is a medical journal/textbook published by an approved publisher, wherein authors aggregate content from a conference. It is absolutely an approved source.

As far as the authors, it is written by medical experts whom, after reviewing evidence, have come to the conclusion circumcision is applied inappropriately. It is bizarre and incorrect that contributors would attempt to disqualify leading medical professionals as bias because they are advocating for their professional conclusion.Gsonnenf (talk) 19:57, 1 May 2012 (UTC)

It is neither a textbook nor a medical journal. It is the proceedings of an anti-circumcision conference. Since these are specifically identified as unreliable by WP:MEDRS, it is baffling that this discussion is still continuing. Jakew (talk) 20:31, 1 May 2012 (UTC)

Sorry, I thought we already came to consensus on this here: Talk:Circumcision/Archive_71#reverted_.22If_too_much_skin_is_removed.2C_the_penis_may_not_be_able_to_grow_to_its_full_length..22. Rip-Saw, the editor who originally opened this question, read the underlying medical report and agreed that it was not suitable for this article. Tom and Gary also added to that thread, and although they did not agree, they did not disagree either. Zad68 (talk) 20:36, 1 May 2012 (UTC)

"Most controversial"

I've again reverted the addition to the lead of "and it has been described as the most controversial procedure of all times" (citing Alanis 2004). While the cited source supports the statement, there are several problems with its inclusion in the lead.

In this particular context, it's not a particularly reliable source. I've just checked the full text of the article and I couldn't find any citations for the claim (hence it appears to be a primary source for it), nor was a methodology described by which the conclusion was reached. It's not a systematic review of procedures and the degree to which they're controversial. It's not a review of controversial procedures or controversy per se. It's not even a comparative study. It's just an off-hand remark made as background in a review that is otherwise primarily about the procedure rather than controversy. As such is merely the opinion of the authors. The fact that it is an opinion is not grounds for exclusion, of course, but is it of sufficient significance to belong in the lead? I don't see any evidence that it is. It's certainly a striking statement: the most controversial procedure of all time. But sensationalism and NPOV are not entirely compatible, and we shouldn't include statements just because they're striking. Jakew (talk) 08:01, 1 May 2012 (UTC)

It doesn't pass your sniff test. I understand that. It is, however, a citeable source. As editors have reminded me multiple times, it doesn't have to be true, it just has to be verifiable. Dr. Morris' claims regarding mandated circumcision for balanitis, etc, don't pass my sniff test. They are a citeable source. Logic dictates that either both stay, or both go. That being said, I don't have a lot invested either way. I just want to see fairness. I don't care which way it goes, as long as both are treated equally. Tftobin (talk) 16:49, 1 May 2012 (UTC)

Well, shall we start by applying WP:PSTS and WP:MEDRS#Definitions? Alanis appears to be a primary source for this issue, as noted above, since the authors don't refer to any primary sources when making the "most controversial" claim. Morris, in contrast, discusses the findings of other sources (his refs 44 and 82-85), and makes an "analytic or evaluative claims about them" (to quote WP:PSTS). Thus, it's a secondary source. (In any case, I'm a little perplexed that you keep complaining about this issue. As noted previously, I'm quite happy to delete the two sentences citing refs 113 and 114.) Jakew (talk) 17:19, 1 May 2012 (UTC)

Only medical descriptions and advice fall under WP:MED. The controversy, though involving medical data, is both political and social in nature. One has to only look at articles such as assistant suicide to see the precedence. We are lucky enough that a quality source that qualifies for wp:medrs also comments on the controversy.Gsonnenf (talk) 18:54, 1 May 2012 (UTC)

Certainly it meets the requirements for MEDRS when commenting on specific aspects of controversy, since in those respects it is acting as a secondary source. But for the "most controversial" claim it seems to fall short of the requirements, as noted above. Jakew (talk) 21:14, 1 May 2012 (UTC)

I disapprove this edit which aggrandizes this single sensational quote in an undue fashion, and employs weasel words for this effect. "Most controversial" is clearly a subjective value statement, and must be widely held to justify this prominent inclusion. If as Gsonnenf states, "The controversy, though involving medical data, is both political and social in nature", this must be made clear when stating this view to ensure compliance with WP:MEDRS. This edit is much more accurate and presents the same information in a considered manner.
Best Wishes Ankh.Morpork 21:39, 1 May 2012 (UTC)

I added "has been characterized as the world's most controversial surgery" to the article last week. The source was already a footnote from the opening paragraph. I disagree that it's a "sensational" characteization. Can you suggest any other operation which has such a level of controversy associated with it? Now we have two sources which characterize it as exceedingly controversial, how is that "sensationalism"? Can you cite a source which makes the claim that circumcision is not controversial? Robert B19 (talk) 23:46, 1 May 2012 (UTC)

Nobody has suggested that the article should state that circumcision isn't controversial, Robert, so there's no need to cite a source for that. As for your first question, I'd think abortion is probably as controversial, and probably more so. But it depends how you judge degree of controversy; as AnkhMorpork correctly notes, it's a very subjective thing. Jakew (talk) 07:53, 2 May 2012 (UTC)

Abortion is quite arguably more controversial, and particularly 'partial-birth abortion', or intact dilation and extraction, which has been the subject of US legislation and Supreme Court rulings. Sterilization procedures also leap to mind when considering controversial, surgical procedures. I agree that calling it the most controversial surgery is not warranted. It's certainly controversial, which is readily apparent and noted. But, as noted, the statement is not supported by a source; as used, it is, as Jakew noted, a rhetorical device, not a scientific or medical fact. Nor is it particularly meaningful even if it was; if there was some methodology to determine how controversial a surgery was, would we note that the second-most controversial procedure as such? The third? Would the least controversial procedure be noted for that position? Noting that it is very controversial, as the page currently does, seems like the best option. Morrowulf (talk) 08:46, 2 May 2012 (UTC)

Worldwide, partial birth abortion isn't even on the radar screen. Circumcision is on everyone's radar screen, worldwide. You have two secondary sources which say it. In wikipedia's rules, it is verifiable, and therefore, all the whining about it doesn't mean it shouldn't be used. I still have not heard a reasonable explanation of why the "most controversial" reference shouldn't be used, and yet Dr. Morris' reference should be used. They are both secondary resources. If "most controversial" is a subjective value judgment, what is "Circumcision of males represents a surgical “vaccine“ against a wide variety of infections, adverse medical conditions and potentially fatal diseases over their lifetime, and also protects their sexual partners." Yet, miraculously, we have no trouble citing that as a reference. The arguments of "subjective value judgment" and "nor was a methodology described by which the conclusion was reached" hold no water. If one can be used, then the other can be used. Period. They may or may not be truthful, but they are both verifiable, in the wikipedia sense. And editors can stop mentioning that an offer was made to remove two references. I never said no. Either they both stay as references, and I am speaking very specifically about references 114 and 20, or they both go. They are both guilty of "subjective value judgment" and "nor was a methodology described by which the conclusion was reached" Tftobin (talk) 16:43, 2 May 2012 (UTC)

Morrowulf, you are exactly right. For example, Charles H. Kellner's 2011 article "Electroconvulsive Therapy: The Second Most Controversial Medical Procedure" (Psychiatric Times. Vol. 28 No. 1) lists abortion as the "most controversial" medical procedure, followed by electroconvulsive therapy. In addition, the authors in question (Alanis and Lucidi (2004)) make a related dubious claim; they describe neonatal circumcision as "the world's oldest and most controversial operation", but reliable sources indicate that trepanation is the oldest operation for which we have evidence. Jayjg ^(talk) 22:47, 2 May 2012 (UTC)

Benagiano and Pera appear to agree with Kellner, stating "Voluntary abortion is the most controversial act in the entire field of medical practice".[3] Jakew (talk) 10:53, 3 May 2012 (UTC)

Comment: I think moving discussion about "most controversial" to the body, and not the lead, and attributing it, seems like a good solution. To include in the lead, we would need to see multiple secondary sources describing it as such, which is not evident here. Yobol (talk) 16:41, 2 May 2012 (UTC)

Agree. Jayjg ^(talk) 22:47, 2 May 2012 (UTC)

Agree as well... although not surprising because what you are describing is exactly the edit I made to the article yesterday. :) Zad68 (talk) 23:57, 2 May 2012 (UTC)

I think it's a good compromise. Jakew (talk) 10:03, 3 May 2012 (UTC)

What compromise? No one has responded to a challenge I made. The ones who agree, pat themselves on the back, and have the gaul to call it a compromise! Tftobin (talk) 11:50, 3 May 2012 (UTC)

Some editors were arguing for including the "most controversial" claim in the lead. Others were arguing for deleting the claim. The compromise is to include it, but in the body rather than the lead, and with attribution. Jakew (talk) 12:10, 3 May 2012 (UTC)

In my opinion, based on my understanding of wiki guidelines and principles and the topic, it would be WP:UNDUE to place it in the lead, just as it would be an WP:UNDUE violation, for example, to place in the lead that according to Orthodox Judaism, for healthy Jewish males to deliberately refuse to become circumcised results in being spiritually excommunicated, prevented from being able to partake in various rituals, and possible excommunication from the hereafter (even though there are probably more verifiable sources over the past 2000 years that state the Jewish religious opinion than those that claim routine neonatal circumcision is the "most controversial surgery"). Yes, I understand that the analogy is somewhat flawed in that we have a separate article focusing on Judaism's circumcision ceremony, Brit_milah, and the consequences are in the Brit_milah#Biblical_references section. The point should be self-evident, though. As for putting it in the body, if properly attributed to the proposer, it would be appropriate to be placed in the Circumcision#Society_and_culture section which lo and behold, it already is. -- Avi (talk) 14:58, 3 May 2012 (UTC)

Lack of relevant surgical images

For some context on the images in Wikipedia articles for other surgeries, please see Cholecystectomy, Tonsillectomy, Cataract surgery, Arthroscopy, Uterine myomectomy, Hysterectomy. Note that in the tonsillectomy article, there is a day-after image, another image taken a few days after. The main image for the article features a 3 day post-operation image following a tonsillectomy. For the cataract surgery article, there is an image of the surgery while it is being performed, in addition to an image of a post-operation eyeball.

As it stands, this article features an image of a neonatal penis receiving an injection prior to circumcision. And a 4-day post Plastibell circumcision photo, where the glans are entirely encapsulated, so the post-operation surgical imagery is also minimal. Why don't we actually chose an image similar with one from the Plastibell article, at least? And the only other image must be years after a circumcision, featuring a photo of a circumcised adult male.

It seems that there is actually no appropriate image for circumcision during the procedure. With this being the article dedicated to circumcision, and with Wikipedia not being censored, the readers of this article deserve to be given fair imagery with respect to what the surgery entails, perhaps also including 1-day and few-day post-circumcision images. The images in this article are surprisingly benign for a surgery that permanently removes removes human specialized nerve endings.

We describe circumcision as a surgical procedure in this article, in the first sentence actually. Let's make this article more consistent with what is shown in other surgical articles. FactoidDroid (talk) 08:21, 28 April 2012 (UTC)

Your statement that "The images in this article are surprisingly benign for a surgery that permanently removes removes human specialized nerve endings" seems to indicate a desire for "shock images". Please note that, per WP:MEDMOS#Images: "Potentially disturbing images should be not be used for their shock value, for decoration, or merely to add an image". Please also note the provisions in that section about use of images for POV pushing. Jakew (talk) 10:26, 28 April 2012 (UTC)

Like I already explained, I only desire for this article to be consistent with other surgical articles, since we describe it as a surgical procedure. Again, the other articles do depict images of the procedure being performed, and additionally contain images post-operation. And again, Jakew, I'm going to have to ask you to refrain from putting words in my mouth going forward. I'm getting really tired of it. FactoidDroid (talk) 20:40, 28 April 2012 (UTC)

What is wrong, or inconsistent, in showing what actually happens? Why would a seasoned editor here be shocked about it? Especially when there are videos which depict it, which have been here forever? FactoidDroid is correct, the pictures are inconsistent with those of other surgeries. Tftobin (talk) 00:33, 29 April 2012 (UTC)

Should it be consistent with surgical procedures that permanently remove human specialized nerve endings, specifically? Jakew (talk) 07:40, 29 April 2012 (UTC)

I don't see why that should cause a distinction. Do you? How does that make it surgically different, from the previously mentioned surgeries, in a way that we should not be allowed to see the process? Is it any more graphic, than, say, a hysterectomy? Tftobin (talk) 16:38, 29 April 2012 (UTC)

Apparently the images are "surprisingly benign for a surgery that permanently removes removes human specialized nerve endings". I'm trying to understand that remark myself, and I'm hoping that Therewillbefact can explain it; perhaps surgeries that remove such nerve endings are expected to have particularly malignant images? Jakew (talk) 17:17, 29 April 2012 (UTC)

I've just taken a sample of surgical procedures (all those beginning with 'A' in Category:Surgical removal procedures). Of these nine, five (55%) contain either diagrams or no images at all, one contains a photo of a man with long-healed amputations, one contains a photograph of an (excised) adrenal tumour, one contains relatively long-distance photos of an appendectomy (and two photos of resulting scars), and one contains some photographs of suturing during an abdominoplasty. So, based on that admittedly small sample, I'd say that the photos in this article (a long-distance photo in the lead image, a 4th day recovery image, an image showing anaesthesia placement, and an image of the healed result) are possibly a little more detailed, but certainly no less detailed than average. Jakew (talk) 18:01, 29 April 2012 (UTC)

To supplement that, of the eight procedures beginning with 'C', one contains detailed photographs, one is this article, and the other six contain no surgical images. Jakew (talk) 18:05, 29 April 2012 (UTC)

What's the nature of your resistance? That people might see what a circumcision looks like, in the same way they can see what tonsillectomy looks like? They can already look on the internet, but why should they have to, when they don't have to go outside wikipedia to see the surgeries listed above. I honestly don't understand your objection. Why not the same objection to the videos? Tftobin (talk) 20:29, 29 April 2012 (UTC)

(ec) Graphic images of surgery are informative to medical professionals, but they're often employed as a shock tactic, and in that respect they have NPOV implications. In the case of controversial articles, we need to be particularly careful to ensure that the images do not bias the reader. Wikipedia is not censored, but that doesn't mean that we include offensive material just because we can. I'm deeply concerned by the rationales offered so far in this thread, as they don't seem consistent with that. The only reason for including images should be their educational value; not because (a minority of) other articles about surgical procedures have them, not because of the kinds of nerve endings removed, and not because the images in the article are "surprisingly benign". Jakew (talk) 21:54, 29 April 2012 (UTC)

The videos are not benign, nor are they gentle. That rationale holds no water. If a photo is offensive, the videos certainly are Tftobin (talk) 22:47, 29 April 2012 (UTC)

It appears that this article already has at least as many (and likely more) images than other articles on surgical procedures. I haven't read any policy-based reason for increasing that imbalance. Jayjg ^(talk) 23:11, 29 April 2012 (UTC)

The images in this article do not reflect the reality of circumcision around the world. They are pictures of babies, before the needle goes in, or after the Plastibell has been on for four days. This is not the reality of circumcision around the globe. It is an artificial representation. There is no teenage circumcision in the Philippines or any of the Arab countries, for instance. There is no adult circumcision in a hospital setting, during the surgery. There is no baby at a bris. I am totally stumped why I even have to discuss this here, let alone struggle with it, when no one objected when I posted a video of a real world circumcision in a hospital. There is an utter lack of photos of the way most circumcisions worldwide are performed, such as Khitan, for instance. Tftobin (talk) 16:20, 30 April 2012 (UTC)

These images offer slim educational value Jakew; none of the images actually seem to depict what the article describes as a circumcision, the "surgical removal of some or all of the foreskin (prepuce) from the penis". This is awfully strange. Actually, several images seem to show everything save for the circumcision, including the main image, as well as the image of a bris. They might as well be images to an article dedicated to changing diapers - as the view of the surgery is blocked by a person in both images. This is supposed to be an encyclopedia article dedicated to a surgical procedure, isn't it? The images featured in this article are clearly inconsistent with the images featured in the articles other common surgeries, as I've shown. Of the ten images in the article, no image accurately represents a circumcision in the context of the surgical procedure it is described as. FactoidDroid (talk) 16:58, 30 April 2012 (UTC)

You are entirely right therewillbefact. This article should present photos of the most common form of the surgery.Gsonnenf (talk) 06:22, 1 May 2012 (UTC)

Do we really have to have permission? Doesn't that imply ownership? Tftobin (talk) 16:42, 1 May 2012 (UTC)

Right, lets go ahead and find candidates for appropriate pictures and improve the article with them. I understand that JakeW will likely contest such additions and that's alright.Gsonnenf (talk) 18:57, 1 May 2012 (UTC)

I too favor the inclusion of photos that depict it. Robert B19 (talk) 23:36, 1 May 2012 (UTC)

Rather than bringing up the fact that there are no pictures in such a way that promotes conspiracy theory, you could have simply looked for these pictures yourself from the start and included them. WP: Be bold By making a rant and only now resorting to finding pictures, you have given other people fodder to declare any pictures you find to be POV pushing. Also, the very conspiracy laden intro to this section is borderline personal attack. Rip-Saw (talk) 05:41, 4 May 2012 (UTC)

Phimosis Penis picture

Really. Is it that necessary? A picture actually displaying phimosis would be more informative.
Best Wishes Ankh.Morpork 17:43, 4 May 2012 (UTC)

HIV cost effectiveness

While I dislike the HIV paragragh being in the lead at all and I want to be clear that I'm not endorsing it. However it is there but cost effectiveness is definately not lead worthy. We have varius sources that conflict with it like "Results from three large randomised controlled trials conducted in Africa have shown strong evidence that male circumcision prevents men in the general population from acquiring HIV from heterosexual sex. At a local level, further research will be needed to assess whether implementing the intervention is feasible, appropriate, and cost-effective in different settings." I do not understand what makes this addition lead worthy? "and studies have concluded it is cost effective in sub-Saharan Africa." Garycompugeek (talk) 14:04, 26 April 2012 (UTC)

I'm afraid I can't see the conflict, Gary. First, you're quoting from an April 2009 publication, while the cost-effectiveness review was published a year later, in March 2010. It stands to reason that a statement such as "further research will be needed" is not intended as a permanent statement; that is, the person making the statement does not mean that further research will always be needed, until the end of time. Second, saying that further research is needed to see if it is cost-effective "in different settings" does not mean that further research is needed to see if it is cost-effective in the setting of sub-Saharan Africa. Jakew (talk) 14:58, 26 April 2012 (UTC)

and you feel this is lead worthy because anything to do with circumcision and HIV should be in the lead??? Garycompugeek (talk) 16:40, 26 April 2012 (UTC)

The lead does not mention cost-effectiveness, merely that it is an effective way. We need to include the cost effectiveness for Africa; that information is well-published. However, this article text currently reads "Circumcision has been judged to be a cost-effective method to reduce the spread of HIV in a population,[9][92] though not necessarily more cost-effective than condoms." That text needs to be changed to "African population," and source 92 needs to be removed on the grounds that it states in the abstract "We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime." Assumptions like this are bad practice. That 60% efficacy has not been proven in the American population (the article is on the American population), even if it was, the results still cannot be generalized to the entire world. Rip-Saw (talk) 16:48, 26 April 2012 (UTC)

Just a minute. The last time an editor posted information on circumcision and cervical cancer from 2002, and I posted an update with a contradictory opinion from 2009, there was a battle royale.Tftobin (talk) 16:59, 26 April 2012 (UTC)

Do you have any policy-based arguments for removing ref 92? Your personal opinion of its methodology is original research, I'm afraid. Jakew (talk) 17:10, 26 April 2012 (UTC)

You rely on policy too much, and not good science. The article is JUNK, and should not be included in the references. They don't even give scientific reasons for generalizing the African studies to Americans. They just say "we assumed" about a dozen times. There's tons of policy on Wikipedia for not including junk sources. Another article states "This article discusses major contextual differences between the United States and the three African countries where the clinical trials [in Africa] were conducted, and cautions that the applicability of the scientific data from Africa to this country must be carefully considered before rational policy recommendations regarding routine neonatal circumcision can be made as a strategy to prevent the spread of HIV in the United States." While the authors of 92 basically throw caution to the wind and ignore good scientific practice. One must remember to carefully view scientific literature with skepticism, because a lot of bad science gets practiced. Rip-Saw (talk) 22:29, 26 April 2012 (UTC)

No, actually, all that matters is policy; policy is what allows us to ensure that anonymous Wikipedia editors can't insist that they know better than scientists published in peer-reviewed journals. Jayjg ^(talk) 22:42, 26 April 2012 (UTC)

Wikipedia:Ignore_all_rules Oh really? Rip-Saw (talk) 22:47, 26 April 2012 (UTC)

Really. "Ignore all rules" doesn't mean one can ignore WP:NOR, WP:V, WP:NPOV or WP:MEDRS whenever it suits one to do so. Jayjg ^(talk) 23:26, 26 April 2012 (UTC)

I never implied that. What I am implying it that "Ignore all rules" means that policy is not all that matters, as someone injudiciously stated. No one has, as of yet, to directly argue the point I made. Rip-Saw (talk) 23:54, 26 April 2012 (UTC)

We're not here to debate the article's subject matter, though. See WP:NOTAFORUM. Jayjg ^(talk) 00:00, 27 April 2012 (UTC)

Yes. Actually reading what is being published here, could upset the status quo. Can't have that now, can we? Rip-Saw, I think you'll find that everything you do implies danger. Welcome. It's a pleasure to meet you. Tftobin (talk) 00:24, 27 April 2012 (UTC)

Would it be realistic to write a quality encyclopaedia on the basis of editors' opinions about circumcision when those editors have unpredictable levels of familiarity with the research on the subject, and with medicine, epidemiology and biostatistics, etc? It wouldn't work with Wikipedia's model, because the view of a true expert in the subject carries no more weight than that of one who is utterly clueless. To make it have a chance of working, you'd need to be able to guarantee that editors had a minimum level of competence in the subject (which means either abolishing anonymity and requiring proof of qualifications, or alternatively performing some sort of examination on the subject matter before permitting individuals to edit). Even then I imagine many disputes would be unresolvable because of fundamentally irreconcilable interpretations. Wikipedia's model avoids those problems because we mainly focus on presentation of what reliable sources have said in accordance with Wikipedia's policies. The prohibition against original research frustrates all of us from time to time, but it's not there just to irritate you. Think for a moment, and it may begin to make sense. Jakew (talk) 12:16, 27 April 2012 (UTC)

Jake not one is arguing to use original research. As an editor of this page it is up to us to pick and choose the sources that best describe the section we are documenting. With a polarizing subject like circumcision its easy to find pro and con sources and a little harder to find neutral ones. One could easily abide by WP:MEDRS and write two completely different articles. We have use WP:COMMONSENSE and be careful how information is presented or sources can easily be abused. In this case it's dangerous to try and extrapolate the African HIV data regardless of what the source says or doesn't say. We choose the sources based on verifiability and topic relevance and we decide what is lead worthy from the article, although it really just supposed to be a brief sysnopsis of the article itself. Garycompugeek (talk) 14:59, 27 April 2012 (UTC)

Actually, Gary, if you read the comment you were replying to and those preceding it, you'll find that those comments were actually about changing the body of the article, not the lead. Specifically, Rip-Saw was proposing to remove ref 92, on grounds of Rip-Saw's personal opinion of its methodology, which is original research by definition. Jakew (talk) 15:39, 27 April 2012 (UTC)

So thats what you got out of my last post eh Jake? Yes I know he was not specifically talking about the lead...and I was talking about the article in general however I did start this thread and was initially talking about removing material from the lead that I found unwarranted. Garycompugeek (talk) 16:49, 27 April 2012 (UTC)

WP: NOR applies to wikipedia articles, not talk pages. If an article read "HIV rates are lowered in circumcised people, because we said so" you would not call it OR if I objected to the article being cited. WP: NOR states "Deciding whether primary, secondary or tertiary sources are appropriate on any given occasion is a matter of good editorial judgment and common sense, and should be discussed on article talk pages. Which is what we are doing. Rip-Saw (talk) 19:05, 27 April 2012 (UTC)

WP:NOR applies to talk pages, too. See WP:TALK#Maintain Wikipedia policy. Jakew (talk) 19:08, 27 April 2012 (UTC)

"There is reasonable allowance for speculation, suggestion, and personal knowledge on talk pages, with a view to prompting further investigation, but it is usually a misuse of a talk page to continue to argue any point that has not met policy requirements." Speculation is original research by definition. I am allowed to use my own knowledge to speculate, make suggestions, and generally question the validity of every source that gets cited. Zad68 found the primary source of a dispute, and showed that its use was not appropriate for use in Circumcision. In the light of scientific evidence, I immediately reversed my opinion on the source and supported its removal; you waste energy endlessly quoting policy. If you could find a reliable source that explicitly and conclusively states numbers that apply to everyone, worldwide, then my own resistance to the lead will be gone. Sansom et al. (2009) (formerly source 92, now source 93) is a joke and I would be ashamed to include such irresponsible authors in any of my own papers. They do not even give rationale for applying the African studies to America. Rip-Saw (talk) 19:36, 27 April 2012 (UTC)

Well, since I asked if you had any policy-based arguments for its removal in my edit dated 17:10, 26 April 2012, and you still haven't provided any such arguments, I suggest that now is the time to stop arguing "any point that has not met policy requirements". Jakew (talk) 19:48, 27 April 2012 (UTC)

If authors agree that removing a source makes an article better, that is a policy based decision as wiki policy allows that. I find it bizarre that some authors are demanding their opposition wikilawyer.Gsonnenf (talk) 19:01, 1 May 2012 (UTC)

"Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." — WP:MEDASSESS Jakew (talk) 20:29, 1 May 2012 (UTC)

Regarding the KNMG statement, "Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." — WP:MEDASSESS Tftobin (talk) 22:48, 4 May 2012 (UTC)

Nobody had even mentioned it in this thread. Jakew (talk) 07:24, 5 May 2012 (UTC)

Recent edit warring

Jakew and Zad68 keep making this edit, even though WP:LEAD dictates that we should add a "summary of its most important aspects" of the article. Minor diseases such as balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis clearly do not meet that criteria. Pass a Method talk 17:50, 4 May 2012 (UTC)

Are you really arguing that the medical indications for a surgical procedure aren't important aspects? Jakew (talk) 18:02, 4 May 2012 (UTC)

No, im saying these diseases are not notable enough to be mentioned in the lede, with emphasis on lede. I dont mind them in the article body. Pass a Method talk 18:07, 4 May 2012 (UTC)

So you agree that medical indications for a surgical procedure are important aspects? If so, wouldn't you agree that a "summary of its most important aspects" should include them? Jakew (talk) 18:11, 4 May 2012 (UTC)

I agree that the lead is too specific and I have suggested a more generalised statement. Instead of everyone reverting each other, can we construct a more general sentence that everyone is satisfied with?
Best Wishes Ankh.Morpork 18:18, 4 May 2012 (UTC)

On what basis do you say it's too specific?

My principal concerns about this edit are: a) replacement of a sourced sentence with an unsourced one, and b) changing "Circumcision is used therapeutically" to "Circumcision is curatively used". This is okay in isolation, but the next sentence refers to "Non-therapeutic circumcisions", which is much easier to understand when the therapeutic usage has been defined. Let's restore the previous language. Jakew (talk) 18:36, 4 May 2012 (UTC)

I agree with Ashmork's current wording and he also corrected a typo. Also, not everything in the lede neccessarily has to be sourced if it is already sourced in the body. Pass a Method talk 18:40, 4 May 2012 (UTC)

I like Jake's latest wording, it addresses PassaMethod's concerns about the level of detail, and the language remains connected. Zad68 (talk) 18:57, 4 May 2012 (UTC)

I like it too. Pass a Method talk 19:10, 4 May 2012 (UTC)

Maintain penile hygiene? Like water fails? Do we advocate female circumcision to maintain hygiene of the vulva? It's original research, unsupported by ref 10. Tftobin (talk) 23:20, 4 May 2012 (UTC)

I was concerned that an unsourced sentence would be challenged before long, but I hadn't expected it to be challenged quite so quickly. Jakew (talk) 07:42, 5 May 2012 (UTC)

I'm going to restore the previous, sourced, version, as a temporary measure. Jakew (talk) 17:26, 5 May 2012 (UTC)

Okay, if you self-revert, as a compromise i support keeping it at this version. What do you think? Pass a Method talk 17:49, 5 May 2012 (UTC)

I think it's entirely appropriate to list the conditions for which it is used as treatment, but I am willing to compromise. First, let me explain my position. I think the lead needs to say something about medical indications, since this is after all an article about a surgical procedure. Since Tftobin has challenged the unsourced sentence, we can't retain it per WP:V. I do recognise that some editors think it inappropriate to list specific conditions. I'm therefore suggesting, as a compromise: "Circumcision is used therapeutically, as one of the treatment options for a number of penile conditions", citing the same sources (Bhattacharjee and Holman et al) that we currently cite. Comments? Jakew (talk) 18:00, 5 May 2012 (UTC)

Yes okay, thats good. I support it. Pass a Method talk 18:05, 5 May 2012 (UTC)

I'm OK with this one. I was fine with the compromise one, until I got to the "maintain penile hygiene", before I went ballistic. The compromise without that clause, may just satisfy everyone. Tftobin (talk) 18:32, 5 May 2012 (UTC)

This looks like possible consensus. I've made the change. If anyone disagrees, I'm happy to self-revert; just ask. Jakew (talk) 18:34, 5 May 2012 (UTC)

Thanks, Jakew. Tftobin (talk) 02:25, 6 May 2012 (UTC)

Summarizing opposing views in the lead's controversy paragraph

I recently added a section to the ever-controversial controversy paragraph in the lead, but not surprisingly my changes were reverted, so I guess that means it's discussion time.

Here's the paragraph in question, with my addition in bold:

There is controversy regarding circumcision.^[1] Areas of controversy have included the health benefits and risks of the procedure,^[2]^[1] ethical and legal considerations,^[1] and the application of human rights principles to the practice.^[3]Anti-circumcision groups are active in many countries.^[4] Those opposed to the practice argue that non-therapeutic infant circumcision violates the human right to personal autonomy^[4], impairs sexual function^[5], is comparable to female genital mutilation^[4], and is unethical due to an infant’s inability to consent.^[6] Arguments supporting non-therapeutic infant circumcision include protection against diseases and conditions such as HIV and phimosis, improvement in hygiene^[7], religious freedom protects the practice^[7], and that a parent has the right to make decisions about their children.

Jakew raised a number of objections to the content above in the revert summary: "poorly balanced, inappropriate level of detail, and synthesis of a "controversy" from arguments, rather than citing of sources that discuss a controversy." I'll address them one at a time below.

Balance: I agree that my edit could have been more balanced. I don't feel that I fairly represented the arguments supporting circumcision. Jake, I was hoping that you'd be willing to write a sentence or two about that (you obviously don't need to use anything that I wrote), since you understand that perspective better than I do, and I'm sure that you have the refs for it. Any other suggestions on how to improve the balance would be appreciated.

Level of detail: I feel that the level of detail was appropriate. My addition was very similar to the controversy paragraph that was present in the lead for years, which was replaced with a less informative paragraph a few months ago. Some editors opposed the change, and my edit was intended to address the concerns of all involved, mainly that prominent views are summarized, using recent secondary sources as opposed to older primary sources. My addition did make the paragraph quite large though. Any suggestions on how it could be improved?

Synthesis of a "controversy" from arguments: My edit was reverted very fast - within 14 minutes - so I doubt that the edit was compared with the sources prior to being reverted. Nevertheless, summarization and synthesis are not the same thing. If you look at the wording I used, vs. what is included in the sources, then compare that to the definition of synthesis in WP:SYNTH, you will see that this argument does not hold up. Divisive, controversial subjects have arguments on both sides that support their point of view, and my intention was to summarize the main arguments from both sides. Again, I welcome any input on how the section could be improved. kyledueck (talk) 17:08, 23 April 2012 (UTC)

I believe you are completely correct Kyleduck. Let's take a straw poll. I have added some other !votes for their users convenience, and also as a little joke which I hope is taken in the spirit it is intended

Egg Centri c 17:37, 23 April 2012 (UTC)

Thanks, but I'm not sure if a straw poll is appropriate yet. Jake has raised some legitimate objections that we should resolve first. kyledueck (talk) 19:39, 23 April 2012 (UTC)

(ec) The rewrite of the controversies paragraph took place in order to address the problem that, rather than describing what sources actually said about controversies, they were instead synthesised from primary sources. Your edit reintroduced this problem. For example, the KNMG are cited in support of the assertion that "Those opposed to the practice argue that non-therapeutic infant circumcision violates the human right to personal autonomy". If we consult the source, we see that it's being used as a primary source. It doesn't state that opponents make this argument; rather, it asserts this claim itself ("Non-therapeutic circumcision of male minors conflicts with the child’s right to autonomy and physical integrity"). To interpret this as an argument of those opposed to the practice is original research; to do so repeatedly to produce sets of opposing arguments that, collectively, constitute a "controversy" is synthesis.

Regarding level of detail, there is very little space available in the lead, and it needs to be used effectively. We must always weigh the value of additional information against its bulk. Since the "Areas of controversy have included" sentence already outlines the major areas of controversy, specific arguments are of limited additional value, but including them adds considerable bulk.

Regarding balance, I was particularly concerned by the choice of arguments. Although you cited four arguments from each viewpoint, two of those ostensibly in favour ("religious freedom protects the practice" and "a parent has the right to make decisions about their children") are not really arguments in favour at all. Since you acknowledge that it was poorly balanced, and since they're primary sources anyway, I won't dwell on that point. Jakew (talk) 17:50, 23 April 2012 (UTC)

Thanks for your feedback Jake. The wording "Those opposed to the practice" does seem to be original research. Replacing it with "Arguments against non-therapeutic infant circumcision include" should correct that problem.

I did not use the word "controversy" anywhere in the content that I added, so I'm not sure where you're getting the idea that synthesis could involve that word. Maybe it's a case of believing that WP:SYNTH applies to different sentences in a paragraph, when in fact that is not true. WP:What SYNTH is not#SYNTH is not mere juxtaposition

The problem with the level of detail might be resolved by shortening the paragraph a bit, removing the redundant statement about human rights, and the statement about anti-circumcision groups:

There is controversy regarding circumcision.[1] Areas of controversy have included the health benefits and risks of the procedure,[2][1] ethical and legal considerations.[1] Arguments against non-therapeutic infant circumcision include that it violates the human right to personal autonomy[4], impairs sexual function[5], is comparable to female genital mutilation[4], and is unethical due to an infant’s inability to consent [6]. Arguments supporting non-therapeutic infant circumcision include protection against diseases and conditions such as HIV and phimosis, improvement in hygiene[7], religious freedom protects the practice[7], and that a parent has the right to make decisions about their children.

That seems to be a more reasonable size. Comments are welcome. kyledueck (talk) 19:36, 23 April 2012 (UTC)

The paragraph in question begins by introducing the subject of controversy, so it is quite obvious that the rest of the paragraph is intended to expand on that and describe these controversies, whether or not the following sentences actually use the word "controversy". I should also point out that your edit summary read "Summarizing circumcision controversy in the lead", which seems to suggest that this was also your intent.

The problem with the "arguments against" phrasing is that it can imply that the arguments have validity (compare with "the arguments against doing X are that... while the arguments for it are... What do you think?").

The shortened version seems to suffer from several of the problems I've discussed above. In fact, it seems somewhat less balanced because, instead of noting that the application of human rights is a subject of controversy, it notes an argument that circumcision violates human rights, completely ignoring the existence of opposing points of view. Jakew (talk) 20:54, 23 April 2012 (UTC)

Synthesis is using multiple sources to advance a position not explicitly stated in the sources. If I'm understanding you correctly, you're saying that by producing sets of opposing arguments from different sources, I have advanced the position that this constitutes a controversy, and this is synthesis because the sources do not use the word controversy. It's worth noting that the dictionary definition of controversy is "A dispute, especially a public one, between sides holding opposing views"[4]. The sources do not need to specifically mention the word "controversy" - the mere presence of differing views in literature constitutes a controversy. Describing a controversy, by the dictionary definition of the word, necessitates summarizing the opposing points of view, even if they're from different sources. Calling this synthesis is a misinterpretation or misapplication of policy, and such an interpretation would make it almost impossible so summarize anything on wikipedia.

Sorry, but I'm not seeing any problem with the "arguments for/against" format, and the words to watch page doesn't list this as being problematic. Explicitly stating that they are arguments rather than facts seems very neutral to me, especially since both sides of the controversy are discussed. Readers are free to decide for themselves if the arguments are valid. However, if anyone would like to suggest wording that would be more neutral, I'm all ears.

"The shortened version seems to suffer from several of the problems I've discussed above. In fact, it seems somewhat less balanced because, instead of noting that the application of human rights is a subject of controversy, it notes an argument that circumcision violates human rights, completely ignoring the existence of opposing points of view." Previously you said that there's too much detail, now that there's not enough detail. This seems to be a no-win situation for me... nevertheless, I'm open to suggestions about improvements that could be made. kyledueck (talk) 01:31, 24 April 2012 (UTC)

Kyle, the sources don't use the word controversy or even a synonym, because they aren't discussing a controversy. That's the fundamental problem. To quote WP:SYNTH: "Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources." Your assertion that the existence of these arguments constitutes a controversy is synthesis. Citing a dictionary definition may mean that the synthesis is correct, but that's not the issue. The issue is that it's synthesis from primary sources. To properly summarise an issue, Wikipedia relies upon secondary sources to document the controversy, identify the important viewpoints, etc. That's what we do with every other issue; there's no reason why controversy should be an exception. Some sources are already cited that do document a controversy. Jakew (talk) 08:16, 24 April 2012 (UTC)

You stated that "there is very little space available in the lead" while I find that the lead for this article is 30% smaller than articles of a similar size. In fact, the lead is smaller than many articles that are not as large as this one. Given the rather small size for the lead, I'd say there's easily room for an entire paragraph. Please consider increasing the size of the lead. Rip-Saw (talk) 20:31, 24 April 2012 (UTC)

One cannot insert WP:SYNTH into a lede regardless of its size (or lack thereof). Jayjg ^(talk) 23:48, 24 April 2012 (UTC)

Quoting opposing sources to show controversy is certainly not WP:SYNTH. On the contrary controversy is supposed to be well documented by showing opposing viewpoints. Garycompugeek (talk) 14:41, 25 April 2012 (UTC)

Perhaps I wasn't clear about the issue of synthesis, let me try again.

The edit mentioned at the top of the thread is not a synthesis. If it had written as "The controversy(a) includes arguments against circumcision such as... etc.(b), etc.(c), etc.(d)" and the statement cited in source (a) was completely unrelated to the statements made in (b), (c), and (d), then you may have an argument that the sentence violated WP:SYNTH. This isn't the case though. It's impossible that I could be using multiple sources to insinuate that there is a controversy when I haven't even used that word, let alone cited sources to support such wording.
To reiterate, synthesis is not mere juxtaposition, and the fact the the word controversy is included elsewhere in the paragraph is not an indication of synthesis.
Even if it were a synthesis, the position supposedly being advanced by the "synthesis" is an indisputable fact. A controversy is defined as dispute between two sides with opposing arguments. There's no reason that someone would misuse sources to advance the position that a controversy has opposing arguments - it's a simple fact. kyledueck (talk) 12:34, 30 April 2012 (UTC)

As explained previously, it was a clear case of synthesis: the paragraph began by discussing controversy, so it is reasonable to expect the rest of the paragraph to discuss the same or a closely related subject. Protesting that you didn't use that particular word is unconvincing at best: if you didn't intend to summarise a controversy than why did your edit summary read "Summarizing circumcision controversy in the lead"? "What SYNTH is not" is an essay, not policy, so I do not understand why you keep citing it. Finally, believing something to be an indisputable fact is not an excuse for synthesis. Jakew (talk) 14:47, 30 April 2012 (UTC)

The edit summary I had originally typed was something like "Summarizing views for/against circumcision in the lead's controversy paragraph," but at the last minute I shortened it to "Summarizing circumcision controversy in the lead." Unfortunately, I can't remember why I decided to change it, and now regret doing so.

So, here we are. I have a flawed edit summary, and you have a flawed argument of synthesis based mainly on an edit summary. The core issue here is whether the content of the edit in question is a synthesis, not whether the edit summary and edit together constitute a synthesis. Arguments for synthesis should be based on the edit itself, rather than on edit summaries, so your argument for synthesis has no merit I'm afraid.

As you mention, the paragraph does begin by discussing a controversy. The views for/against circumcision seem well-suited to that paragraph. I'm not sure why you would disagree, but if you feel that they'd be better off in a new paragraph, I could live with that. kyledueck (talk) 13:42, 2 May 2012 (UTC)

That would still leave the primary source problem, though... Jakew (talk) 14:26, 2 May 2012 (UTC)

I used medical reviews, and circumcision position statements from major medical organizations. Both types are secondary sources, and are high-quality sources according to WP:MEDRS. kyledueck (talk) 14:38, 2 May 2012 (UTC)

They aren't secondary sources for these particular claims. For example, as I pointed out above, 'the KNMG are cited in support of the assertion that "Those opposed to the practice argue that non-therapeutic infant circumcision violates the human right to personal autonomy". If we consult the source, we see that it's being used as a primary source. It doesn't state that opponents make this argument; rather, it asserts this claim itself ("Non-therapeutic circumcision of male minors conflicts with the child’s right to autonomy and physical integrity")".' Jakew (talk) 14:59, 2 May 2012 (UTC)

I think that my suggestion above to change the wording from "Those opposed to the practice argue that" to "Arguments against non-therapeutic infant circumcision include" addresses this problem. kyledueck (talk) 15:29, 2 May 2012 (UTC)

Sorry, I don't understand. How does that address the problem that they're primary sources? Jakew (talk) 15:31, 2 May 2012 (UTC)

I addressed the main premise of your argument, which is that I was using the text "Opponents of circumcision" in my proposed edit when the source did support that wording. I addressed your concern by changing the wording so that the text in the proposed edit fits the text from the sources. So, we can remove this premise from your argument, and then it becomes something like:

'The cited KNMG source is being used as a primary source for the statement "Arguments against non-therapeutic infant circumcision include that it violates the human right to personal autonomy", because it asserts this claim itself ("Non-therapeutic circumcision of male minors conflicts with the child’s right to autonomy and physical integrity")'

I can't make sense of that. I don't see evidence to support the claim that it's being used as a primary source. It seems that you're stating that it is a primary source, without describing how. So I can't disprove your argument that the KNMG source is being used as a primary source, because it appears to be a nonsensical argument. Wikipedia policy clearly states that position statements from medical organizations are secondary sources, so at present I have no reason to assume otherwise. kyledueck (talk) 20:16, 2 May 2012 (UTC)

Kyle, your statement that "Wikipedia policy clearly states that position statements from medical organizations are secondary sources" is incorrect. Position statements are often secondary, but not always. WP:PSTS states: "Whether a source is primary or secondary depends on context. A book by a military historian about the Second World War might be a secondary source about the war, but if it includes details of the author's own war experiences, it would be a primary source about those experiences." In the context of the KNMG's viewpoint that "Non-therapeutic circumcision of male minors conflicts with the child’s right to autonomy and physical integrity", it is a primary source. Jakew (talk) 21:30, 2 May 2012 (UTC)

By that definition, it would be a primary source if it stated "My non-therapeutic circumcision conflicted with my right to autonomy and physical integrity." However, it does not, so it's not a primary source. Also note in WP:PSTS: Secondary sources "rely on primary sources for their material, making analytic or evaluative claims about them." and "Articles may make an analytic or evaluative claim only if that has been published by a reliable secondary source." The statement from the KNMG is making an evaluative claim about circumcision. Position statements from medical organizations are reliable secondary sources, so they can be included in this article. kyledueck (talk) 22:31, 2 May 2012 (UTC)

It's a primary source because you are assessing its contents, and making claims about those contents that the source itself does not explicitly make. Jayjg ^(talk) 22:51, 2 May 2012 (UTC)

Please be more specific. What claim am I making about the contents that the source itself does not explicitly make? Also, what wikipedia policy says that by assessing the contents of a source, one can change the source from a secondary source to primary source? kyledueck (talk) 23:04, 2 May 2012 (UTC)

Where does the KNMG source state "Those opposed to the practice argue that non-therapeutic infant circumcision violates the human right to personal autonomy". Please quote it making this statement, or indeed, any statement at all about "those opposed to the practice". You are interpreting what the source states and its editorial position, therefore you are treating it as a WP:PRIMARY source. Jayjg ^(talk) 23:54, 2 May 2012 (UTC)

If you want to participate in this discussion, please read the whole discussion first. We've already covered this. kyledueck (talk) 00:08, 3 May 2012 (UTC)

Indeed we have. The source makes no statement at all about "those opposed to the practice", and you are therefore using it as a WP:PRIMARY source. Do you have anything new to add? Jayjg ^(talk) 00:21, 3 May 2012 (UTC)

You appear to be getting wikipedia policies confused. The problem you are describing is not a primary source issue, it is original research. I have acknowledged this above, twice actually, and said that I would use the wording "Arguments against non-therapeutic infant circumcision include" instead of "Those opposed to the practice argue" to address this problem. kyledueck (talk) 12:00, 4 May 2012 (UTC)

The primary source issue arises because secondary sources, by definition, "rely on primary sources for their material, making analytic or evaluative claims about them". But, as noted above, if we examine the KNMG source we find that it doesn't cite any primary sources regarding the "autonomy" issue: it appears to be their own assessment, there is no indication that it is based on any primary sources. So, just as an author is a primary source for his own experiences of a war, an author is a primary source for own opinions about circumcision. Similarly, just as an author is a secondary source for analysing and synthesising primary sources about the war, an author is a secondary source for analysis or evaluation of primary sources about circumcision. Jakew (talk) 12:16, 4 May 2012 (UTC)

It appears to be their own assessment, based on the many circumcision-related primary and secondary sources cited in the document. There's no requirement that scientific or medical documents include a citation for every single line in the document. An evaluative claim is the source's own assessment by definition, and those statements are not likely to have citations. kyledueck (talk) 13:12, 4 May 2012 (UTC)

That's not my impression, but perhaps we'd better agree to disagree. Since it's just one of the many problems I listed above, it's not critical that we reach agreement on it. Jakew (talk) 15:09, 4 May 2012 (UTC)

Did Dr. Morris detail the research which went into the statement "The benefits vastly outweigh risks." in ref 114? Or "It has no adverse effect on penile sensitivity, function, or sensation during sexual arousal."? Or "Most women prefer the circumcised penis for appearance, hygiene and sex."? If so, I am curious as to why the medical organizations of most countries which have a medical organization state that the opposite is true,for the first quote? How did scientists measure, and determine that circumcision has no adverse effect on penile sensitivity, function, or sensation? Did Dr. Morris or some other set of researchers interview all the women of the planet, and determine that most prefer the circumcised penis? If not, how was that conclusion derived? I find it peculiar, intriguing, and revealing that one set of rules applies to one set of secondary sources, and another set of rules applies to another set of secondary sources. Tftobin (talk) 16:00, 4 May 2012 (UTC)

He refers in the text to his Table 1 regarding the first claim, and the footnote to that table reads: "Values are based on statistics for USA (see(125) for refs used for source data)." For the second claim, he cites his refs 10 and 115-123. For the third, he cites his refs 120, 122, and 123. We don't actually cite him in support of any of these claims, of course, so it's a moot point anyway, but yes, we could in principle cite him as a secondary source for these points. Jakew (talk) 16:08, 4 May 2012 (UTC)

He cited something. That doesn't exactly answer the question. The problem is the same. Did somebody ask all the women in the world what their preference is? No. Are we using it as a secondary resource? Yes. Did the Dutch ask every medical group in the world? No. Can we use them as a secondary resource, the same way we are using ref 114? Yes. Does it have to be true? No. Does it have to be verifiable? Yes. Tftobin (talk) 17:24, 4 May 2012 (UTC)

The problem, as noted above, is that there's no evidence that the KNMG's assertion is based upon any primary sources, hence it appears to be a primary source itself. Jakew (talk) 17:28, 4 May 2012 (UTC)

Ref 17 in the KNMG source includes Prophylactic interventions on children: balancing human rights with public health. In this document, we find: "Also, the human rights burden to the individual posed by circumcision is severe because it violates the human right to autonomy and bodily integrity, entails the loss of a normal part of the body, alters the appearance of the penis, and impairs sexual, protective, and immunological functions." By relying on obscure technicalities, you are stretching the definition of a primary source beyond what is reasonable. But even by your own definition, it is a secondary source for the statement in question. kyledueck (talk) 18:21, 4 May 2012 (UTC)

Hmm. I guess it's possible that they were referring to that, so I'll concede that it could be a secondary source for this claim. As noted above, though, there are several other problems with the proposed text. Jakew (talk) 07:28, 5 May 2012 (UTC)

The only unaddressed problem with any merit is the issue of balance. The other objections have either been rectified, or are misinterpretations of policy, as explained above. I do intend to correct the issue of balance at some point, but it likely won't be today. kyledueck (talk) 12:08, 5 May 2012 (UTC)

I count three discussed above (balance, level of detail, and lack of neutrality in the proposed "arguments against" phrasing). In addition there's also a problem with lack of cohesion. Without something to tie the arguments together like "Those opposed to the practice argue that" or controversies (neither of which can actually be used due to NOR problems), you're just presenting a heap of apparently unrelated arguments, which is poor writing. Jakew (talk) 12:18, 5 May 2012 (UTC)

As someone with a great deal of experience, what would be your recommendation, to solve the problems you've mentioned? Tftobin (talk) 18:35, 5 May 2012 (UTC)

Actually my recommendation is to leave things as they are. Please understand that I'm not trying to be difficult when I say this. A couple of months ago, when I rewrote the controversy paragraph (I'm sure you remember the discussion that led to it), I thought carefully about many of these problems and tried to work out the best solution. The only truly satisfactory solution that I could find was to rely on sources that describe the controversy. And while I haven't tested it scientifically, my impression is that (ironically) this paragraph has been much less controversial since I made that change. I don't recall anyone expressing indignation about something that is included but shouldn't be, or vice versa, whereas that was a regular occurrence with the old paragraph. The only objection has been (as in this discussion) a concern that it doesn't contain enough detail. I still believe this approach is the only workable solution, and if anything I'm more certain of it as a result of this discussion. Jakew (talk) 18:49, 5 May 2012 (UTC)

As I continue to edit less-controversial Wiki entries, I'm still trying to figure out why the discussion of HIV is the circ-related topic which contains such details in the lede. Given that the rest of the article goes into detail on the topics touched on in the lede, wouldn't it make the most sense simply to change paragraphs 4 & 5? The controversy over the Sub-Saharan studies seems to warrant it's being relegated to the section under HIV where more specific details can be applied. As the lede reads now, the HIV information seems unrelated to the general definition of circumcision and its uses, going suddenly into detail which the rest of the lede avoids. I recommend this change (moving the specific information about the Sub-Saharan studies to the HIV section of the article.)

Circumcision is used therapeutically, as one of the treatment options for a number of penile conditions[10][11]. In addition, non-therapeutic circumcisions are commonly performed for social, cultural, religious, or prophylactic reasons.[12] Summaries of the views of professional associations of physicians state that none currently recommend routine (i.e. universal) circumcision,[13][14] and that none recommend prohibiting the practice.[14] The WHO currently recommends circumcision be recognised as an intervention as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV.[17]

Some bodies have discussed under what circumstances circumcision is ethical.[18][19]TGTommyrocket (talk) 03:40, 6 May 2012 (UTC)

Please see WP:LEAD, which states "The lead should be able to stand alone as a concise overview. It should define the topic, establish context, explain why the topic is interesting or notable, and summarize the most important points" Jakew (talk) 07:29, 6 May 2012 (UTC)

Swap one of the opposition external links

I would like to swap http://www.doctorsopposingcircumcision.org/ with http://sexasnatureintendedit.com/. My reason is that docs opposing circ contains nothing really that http://www.cirp.org/ does not. I think http://sexasnatureintendedit.com/ is a great site that encapsulates circumcision opposition due to the sexual effects. I would also like to add http://circumstitions.com/ because it contains more recent regularly updated anti-circ news stories. This would then bring the total number of links to 5. I disagree with anyone who says that this is excessive. This whole article is excessive - particularly on the medical aspects - making it very pro-circ. Obviously we would have to add another pro-circ site. In light of the founder's recent infamy 1 2 3, how about http://www.gilgalsoc.org/? Obviously that is a joke but I am sure Jake knows of another pro-circ site. So, Jake do you or anyone else object to this? Tremello (talk) 08:03, 9 May 2012 (UTC)

I disagree with both proposals.

Regarding your first proposal, I disagree partly because sexasnatureintendedit.com is a promotional site, intended to promote the author's book of the same name. Second, it merely contains the theories of one woman, which is hardly encyclopaedic material. Thirdly, judging by the number of Google News results, DOC is more notable than SANII — there are about four times as many results.

Regarding your second proposal, I disagree for several reasons. Firstly, it's an amateurish site that (again) represents the opinions of one person. Secondly, we already have 4 links for each point of view, which is really too many as it is. Remember that Wikipedia is not a collection of links. Finally, adding it without adding a balancing link would imbalance the external links. Jakew (talk) 08:23, 9 May 2012 (UTC)

The external links do not need to be encyclopaedic material. They are not encyclopaedias. You cannot deny that they are anti-circ sites (which is what we say they are) so we are deceiving nobody. These sites are not just the opinions of one person. Most, if not all, anti-circ people will agree with the information on these sites. Given that they are under the heading Opposition links, again we are decieving nobody here. You point to the policy Wikipedia is not a collection of links. What that policy says is "Wikipedia should not be a "mere collections of external links or Internet directories". With the emphasis on mere. Because this article is so long and so biased in favour of circumcising, there is no danger of it just being a mere collection of links. Adding 1 or 2 more links is not going to make any noticeable difference. The sexasnatureintended site does not exist solely to promote the book. That is the key point. It provides a unique graphical perspective which the other sites do not. Having looked at the doctors opposing circumcision site I notice it is quite informative though badly designed. I am in favour of keeping that site and adding the 2 I mentioned. We would have to find 2 more pro-circ sites, but that shouldn't be hard. Tremello (talk) 09:43, 9 May 2012 (UTC)

External links are supposed to contain material with encyclopaedic value, though that doesn't mean that they're expected to be encyclopaedias. It is not about "deceiving" people; it is because we normally include "Sites that contain neutral and accurate material that is relevant to an encyclopedic understanding of the subject and cannot be integrated into the Wikipedia article due to copyright issues". You've apparently missed the key point of WP:NOTREPOSITORY, which is: "There is nothing wrong with adding one or more useful content-relevant links to an article; however, excessive lists can dwarf articles and detract from the purpose of Wikipedia." WP:EL makes a similar point, stating: "it is not Wikipedia's purpose to include a lengthy or comprehensive list of external links related to each topic". At the moment we include thirteen external links. That is already excessive; increasing it to seventeen would exacerbate the problem. Jakew (talk) 10:12, 9 May 2012 (UTC)

Because this article is so long and so biased in favour of circumcising - please review begging the question. Jayjg ^(talk) 11:18, 9 May 2012 (UTC)

I take by that you mean I have not provided a reason for why it is pro-circ. If you read my previous post where I say "This whole article is excessive - particularly on the medical aspects - making it very pro-circ." I do provide a reason for my statement that it is pro-circ. Jayjg, you do have a habit of ignoring the central theme of a person's post and focusing on something minor to score cheap points and derail the discussion away from the issue that is contentious. This is not the kind of attitude that makes wikipedia a welcoming place and it is not conducive to progress in debate. Tremello (talk) 17:16, 9 May 2012 (UTC)

Please remember to comment on content, not the contributor, Tremello. Jakew (talk) 17:18, 9 May 2012 (UTC)

Where were the other editors, when someone was taking a cheap shot at me above? Was that editor commenting on content, and not the contributor? It's amazing to watch the rules fly up, when an editor disagrees, and watch them relax again, when the editor agrees. This creates the impression, if not the actuality, of a double standard. Tftobin (talk) 00:13, 10 May 2012 (UTC)

Even if we assume, for the sake of argument, that your summary is correct, wouldn't your argument be an example of the fallacy of tu quoque? Jakew (talk) 08:21, 10 May 2012 (UTC)

Sort of like the hypothetical editor who plays like they don't know what is being referred to, about an editor possibly writing a brochure for the Gilgal Society? What a tremendous strain it must be to maintain the outward impression of neutrality for people in that situation. It's interesting that people who've had no previous connection with the article can somehow sense the tremendous imbalances. There isn't a fig leaf of neutrality to be found in these parts, in the opinion of many who come here. There are some people who were simply born to be disingenuous, it would seem. Also interesting that when I comment that seasoned editors get away with taking shots, and still crying foul, someone takes a shot, and cries foul. Tftobin (talk) 20:06, 10 May 2012 (UTC)

Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." Jayjg ^(talk) 02:02, 11 May 2012 (UTC)

"Firstly, it's an amateurish site that (again) represents the opinions of one person. ". This statement couldn't possibly be applied to http://www.circinfo.net/, could it? I am simply asking in the interest of fairness. Tftobin (talk) 13:27, 9 May 2012 (UTC)

It's the work of one person, certainly, but I'm not sure you could describe it as "amateurish" — certainly not to a comparable degree. Circinfo.net is probably more comparable to Robert Darby's historyofcircumcision.net, in the sense that both constitute detailed academic literature reviews. (Please note that I'm deliberately setting aside my own evaluation of the merits of the content.) Jakew (talk) 15:45, 9 May 2012 (UTC)

Yeah, the banana adds a much needed touch of class. I'm certain I could describe it as amateurish, or even deceptive, if I were allowed by the rules to do so. How could someone who publicly contributed to and until recently affiliated themselves with the Gilgal Society seem more factual, and yet makes statements that fly in the face of so many other medical societies, than someone who was merely amateurish, but brought up valid points? People may also be setting aside more than just evaluation. They could be setting aside actual involvement, like writing brochures, or something like that. Or, perhaps, even more. Tftobin (talk) 00:14, 10 May 2012 (UTC)

Since you mention it, both sites differ from the views of most medical organisations, because they're arguing that the neutral mainstream views should change (Morris arguing for circumcision, Young arguing against it). That's the case for the majority of our external links, and it doesn't seem to be an argument against any of them. It's unproductive to debate whose points are valid, so I won't waste time doing so. Finally, I'm struggling to see how writing a brochure — of all things — could make the author's website inappropriate. Jakew (talk) 08:15, 10 May 2012 (UTC)

Let's suspend NPA on this talk page

New rule: Anyone who invokes NPA on this talk page is assumed to have lost the argument. Exception for vicious genuinely personal attacks, or anything against new editors. Anyone with a personalised signature can be assumed to have a thick enough skin that they can take their username being used by another editor. Of course speaking purely logically the identity or known predilections of an author shouldn't matter. But this page is also a page for rhetoric, and the constant invocation of NPA is spoiling that. Not to mention that pure NPA citation is neither logic nor rhetoric.

Who's with me? Egg Centri c 12:49, 11 May 2012 (UTC)

This would be in direction violation of WP:TPNO, in reference to WP:NPA, which is policy. Even if you could get a consensus of editors here to agree to override Wikipedia-wide policy per your suggestion, it would still be in violation of WP:LOCALCONSENSUS, discussed under WP:CONSENSUS, which is also policy. You would have to get Wikipedia community-wide support for the suggestion. Regardless, this entire discussion on this article's Talk page is not in accordance with WP:TPNO, and so is inappropriate here. Perhaps you should start by taking this suggestion to the Village Pump. In the meantime, WP:NPA still applies here. Zad68 (talk) 12:58, 11 May 2012 (UTC) edited to add: Also, Egg, please review how Wikipedia is not a battleground and Wikipedia is not about winning. Zad68 (talk) 13:06, 11 May 2012 (UTC)

To avoid more editors going to the effort you went to to compose the above, perhaps I should clarify that was a joke

- of course the fact that wasn't immediately apparent says a lot about this talk page! Egg Centri c 14:25, 11 May 2012 (UTC)

Wikipedia is SERIOUS BUSINESS. Please refrain from: making any jokes, making sarcastic comments, using metaphors, talking about Hitler, and making logically sound arguments unless you can quote Wikipedia policy. Rip-Saw (talk) 17:16, 11 May 2012 (UTC)

Worry not. All my future statements will have the sincerity of this one

Egg Centri c 23:01, 11 May 2012 (UTC)

RFC

Since no consensus could be reached in Wikipedia:Dispute resolution noticeboard, I am submitting an RFC (request for comments, from uninvolved editors Results from a metanalysis are being generalized to the entire world population. Clarity on Wikipedia policy needs to be offered, as well as help on how to summarize research data while keeping context. Should research clearly done in Africa only, with specific high risk populations, be extrapolated and applied to the world's population? Tftobin (talk) 01:37, 4 May 2012 (UTC)

Tftobin, an RFC is a good idea, thanks for opening it. Tom--as a procedural note, a new Talk page entry like this (even an RFC notice) normally goes at the bottom of the page, not the top. Having the RFC at the top might confuse experienced editors who expect to see the RFC at the bottom, where the newest entry is normally found, and would look up the page to review the previous discussion. Also, I don't think the RFC discussion description is stated quite accurately, but I am sure the details under discussion will be made clear soon. Zad68 (talk) 02:19, 4 May 2012 (UTC)

Hi Zad68, I put the RFC at the top of the page, because I was instructed to by Wikipedia:Requests for comment. "Place one of the templates shown in the table on the right at the beginning of the talk page section which you would like to promote." I don't care personally where it goes. Perhaps, if nobody is following it, Wikipedia:Requests for comment should be changed? Tftobin (talk) 14:24, 4 May 2012 (UTC)

Tom, I hope you don't mind, but I think the confusion that could be caused by having the RFC at the top of the Talk page is serious enough that I took the liberty of moving it to the bottom. Zad68 (talk) 02:22, 4 May 2012 (UTC)

Note for people who are here as a result of the RFC listing, additional background about this discussion can be found from this DRN discussion: Wikipedia:Dispute_resolution_noticeboard#Circumcision. The clerk there has posted notice that the discussion will be closed within a day due to incivility. No consensus was reached. 02:26, 4 May 2012 (UTC)

Comment: We should be saying what the source says, not what you or I think it should say. If the source makes the extrapolation, we are not in a position to qualify it because we want to, that is classic WP:OR. Yobol (talk) 02:35, 4 May 2012 (UTC)

Yobol, please let's see what new, uninvolved editors have to say. Zad68 (talk) 02:52, 4 May 2012 (UTC)

As far as I can remember, I did not participate in the DRN discussion, nor any discussion recently with regards to how this study can be generalized. As such, I am an uninvolved editor with regards to this discussion. Also, my experience has been that anyone can comment in an RfC, not just "uninvolved" editors. If you could point to me which policy says only "uninvolved" editors can participate in an RfC, that might help to clarify things. Thanks. Yobol (talk) 03:03, 4 May 2012 (UTC)

You're right, my bad, I see you haven't talked about this area of the article before. Thank you for your input! Zad68 (talk) 13:06, 4 May 2012 (UTC)

My argument so far -- I’d like to preface by stating the authors work for the South African Cochrane Center, so it is reasonable to assume their research was done with Africa in mind. Being in Africa, it is easy to see why they might not have thought to mention their results only apply to Africa, and thus used general langue instead of being specific. My argument breaks down into two parts:
A: The studies were only done in Africa. To say the results apply to African men is certainly true, no one can deny this. No one is saying the results apply to ONLY African men. Saying the results apply to African men is not the same as declaring the results null and void for other populations. It merely gives a bit of specificity to the interpretation of the authors’ work, and puts the work in the geographic context it was done in.
B: The authors never give any rationale for applying their research to any other geographic region, nor do they explicitly state their research applies to any other region. The abstract is ambiguous, but that does not give the lead the right to be ambiguous as well. The authors merely say “general population.” In the same paper, they refer to the general population of Africa. Since these researchers are in Africa, doing research on African people, for the sake of Africa, it is not unreasonable to assume when they say "general population," they mean the general population of Africa.
Thought experiment -- If I did an obesity study in America, I’d certainly not declare the entire world has a problem with obesity, even lacking any studies from the rest of the world to contradict me. Just because a medical study holds true in one culture does not mean it holds true in ALL cultures. Significant reasoning or evidence must be brought forth in order to make such claims. I’d be arguing this point even had the authors explicitly stated their results are universal. Rip-Saw (talk) 04:24, 4 May 2012 (UTC)

"Evidence continues to suggest that the results from the randomized trials lack external validity when extrapolated to general populations in Africa" Author Response (Lawrence W. Green, DrPH)
"This article discusses major contextual differences between the United States and the three African countries where the clinical trials were conducted, and cautions that the applicability of the scientific data from Africa to this country must be carefully considered before rational policy recommendations regarding routine neonatal circumcision can be made as a strategy to prevent the spread of HIV in the United States" Can routine neonatal circumcision help prevent human immunodeficiency virus transmission in the United States? Rip-Saw (talk) 04:46, 4 May 2012 (UTC)
"Therefore, although the efficacy of using male circumcision in reducing HIV infections was significant within the strict circumstances of the three trials, taken to scale under the very different prevailing circumstances of Africa, their effectiveness cannot be generalized" Male Circumcision and HIV Prevention: Insufficient Evidence and Neglected External Validity

I just did a quick search for articles that cite the study in question and came up with those three links. That first and last link (both by Dr. Green) seriously question the external validity of the results. I am going to look into it more. It may turn out the entire concept of circumcision in Africa is wrong and needs to be removed. Rip-Saw (talk) 04:58, 4 May 2012 (UTC)

The RfC is confusingly and non-neutrally put. It is not our place to judge whether research should "be extrapolated and applied to the world's population", and opening the RfC by stating that "are being generalized" misleadingly implies that Wikipedia editors are doing so. The real question is, should the sentence in the lead ("Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%") be altered to read "in heterosexual African men"? This needs to be corrected as a matter of some urgency: it is essential that RfCs are phrased neutrally.
The most important question that we should address is: does the source limit the results to African men? Looking at the source, it concludes: "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." Clearly, it does not. If we were to add such a qualifier, then, it would violate Wikipedia's no original research policy.
A follow-up question is: is this the best source for this type of information? WP:MEDASSESS gives the following guidance: "The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs)." So, clearly it (a Cochrane review and meta-analysis of RCT data) is the best type of source for this piece of information.
Another follow-up question: is this source representative of this type of source? There are three other meta-analyses of RCT data. Mills et al conclude "Male circumcision is an effective strategy for reducing new male HIV infections." Byakika-Tusiime concludes: "These results provide unequivocal evidence that circumcision plays a causal role in reducing the risk of HIV infection among men." and Weiss et al conclude: "In conclusion, randomized controlled trials have provided final conclusive evidence that male circumcision provides approximately 60% protection against the heterosexual acquisition of HIV in men." None of these sources include an "African" qualifier, indicating that we cannot cite an an alternative source of similar quality that includes it.
Finally, if other sources (not meta-analyses) express alternative views, then we need to consider how much WP:WEIGHT those sources should be given. I would suggest that fringe viewpoints, such as that of Green et al, should be given very little. More mainstream views, such as that of Xu et al, should be given some weight, but we must careful of US-centricism. Jakew (talk) 07:38, 4 May 2012 (UTC)

Argumentum ad ignorantiam. The fact that the authors do not explicitly limit the results to African men is not evidence that they generalize the results to the population of the world. Adding the qualifier cannot violate WP:NOR because adding the qualifier does not add any knowledge or data about the research to the lead.

Your final source uses terms like "Potential population-level impact of male circumcision in sub-Saharan Africa" and "Cost-effectiveness of male circumcision for HIV prevention in sub-Saharan Africa." It is quite apparent that these authors are only applying their results to Africa. I could not find any place in the other two articles where the authors mentioned the results applying to any specific geographic region. Rip-Saw (talk) 08:18, 4 May 2012 (UTC)

"Even with well-sourced material, if you use it out of context, or to advance a position not directly and explicitly supported by the source, you are engaging in original research" — WP:NOR. Do the authors explicitly limit the results to African men? Jakew (talk) 08:24, 4 May 2012 (UTC)

You are confused, and the policy you just quoted refutes your own arguments. First of all, adding the qualifier "African" is not adding any geographic groups to the article. It does not RESTRICT the findings to only African men, it merely limits the generalization of the findings to everyone. Secondly, the policy says "if you use it out of context," and the abstract is certainly out of context with the rest of the article. The context is, this is an African study, reviewed by scientists living in Africa, written for their African peers. You are engaging in Sub-Saharan Africa focus. Xu et al states the results do not necessarily apply to Americans, so why are Americans being included in the lead under the broad statement "heterosexual men"? Why are Japanese men being included when the study never once mentions Japan? I don't see Germans or Brazilians mentioned either, yet they both fall under the broad statement "heterosexual men". Rip-Saw (talk) 08:42, 4 May 2012 (UTC)

Adding the qualifier "African" imposes a limit on the scope of the statement. The source does not state this qualifier; you do. Nor does it limit the context; again, this is your interpretation. Hence, it is original research. Jakew (talk) 08:54, 4 May 2012 (UTC)

Gentlemen, I think it's important that we pull apart the two different findings of the Cochrane review, and discuss each one separately--Rip-Saw, please go with me on this: The Cochrane review results says two things: 1) "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." 2) "Inclusion of male circumcision into current HIV prevention measures guidelines is warranted, with further research required to assess the feasibility, desirability, and cost-effectiveness of implementing the procedure within local contexts." I think the problem is you're conflating the two findings. Finding 1) is a finding of fact about human biology (without a qualifier), and 2) is a recommendation for pursuing circumcision to address an epidemic "within local contexts." Let's say the rate of new female to male acquisition of HIV in an area is 50% (over the same study period as Cochrane), and to keep the math simple, let's say MC (male circumcision) reduces the rate of acquisition by 60%. In a population of 1,000 heterosexual men without HIV in this high-risk area, you'd expect to end up with 500 HIV+ men if they weren't MC'd, and 200 (60% fewer) if they were. Let's move to an area with a much lower infection rate, let's say 5%. Wouldn't you still expect to end up with 50 HIV+ non-MC men, and 20 (60% fewer) HIV+ MC men? The question of extrapolating the results from a high HIV+ area to a low HIV+ area isn't a difference in the biological makeup of the men, but other, outside cultural factors--how expensive is it, how expensive are other treatments, cultural differences in willingness to be on a long-term drug protocol vs. getting circumcised once, marginal cost per case averted, etc. So let's not confuse the two: The Cochrane result being quoted in the lead is a paraphrase of finding 1) about human biology, and it is NOT a statement about 2) or any kind of recommendation that MC should be pursued by any individual locality. The reports you bring up seem to be addressing topic 2) with a warning against extrapolating the results to make an argument for MC as a sensible part of an HIV management program just anywhere in the world. The particular factors of Africa's high infection rate and poverty make looking at MC sensible there, and probably not elsewhere. But that's not the finding being discussed in the lead, which is a paraphrase of 1), a statement about human biology. Does this address your concern? Zad68 (talk) 13:38, 4 May 2012 (UTC)

All of the research has shown that the efficacy of circumcision is less in certain populations than others. Were it not for the overwhelming evidence that goes against what you just said, I might have believed mother nature worked that way. But do a thought experiment: If condoms were 100% effective against stopping HIV, and you had a population that used condoms 100% of the time, you'd have a 0% efficacy for circumcision. it would not matter because you would have a 0% HIV transmission rate either way. Since condom use and effectiveness are not 100%, you will always have a small efficacy for circumcision, but that value is going to be smaller than for high-risk populations. Most of North America, Europe, most of South America, the Middle East, and Asia are low-risk populations. Rip-Saw (talk) 17:56, 4 May 2012 (UTC)

Rip-Saw, I 100% understand the math of what you are saying, but isn't what you are describing a "confounding factor"? This is accounted for using statistical methods, and the Cochrane review says specifically they did analysis for confounding factors. The populations that were included in the Cochrane study were large enough and diverse enough such that confounding factors could be well accounted for, right? Zad68 (talk) 22:13, 7 May 2012 (UTC)

You ask very good questions that have actually made me stop and think, and I just realized I never responded to your statement "However, if you did a study on obesity in America,... and you found, after accounting for confounding factors, that Drug X reduces the acquisition of new weight by 60%, I would expect that Drug X would work that way on humans in Japan and Australia too." I wouldn't expect that. It may or may not, it depends on how the drug works. (Thinking time!) Lets say drug X works by stopping 80% of fat in red meat from being digested, cutting out a large number of calories from our fatty diets. In Asia, where they eat a lot of rice and fish, this drug may not have nearly any impact at all. Removing confounds (I'm going to answer your most recent post here) would, in this case, mean taking diets into consideration. "Well Drug X would work on Asians if they ate as much red meat as Americans do" and it would if they did. However, to then state "This drug is equally effective on Asians, if you remove confounds" is akin to saying it's equally effective on Asians who aren't Asians. If North Americans and Asians and Europeans had similar sexual habits (confounding variables) as Africans do, then I'm sure circumcision would be just as effective, but we don't have similar sexual habits at all. Rip-Saw (talk) 23:21, 7 May 2012 (UTC)

Reply to Rip-Saw's thought experiment: Rip-Saw, you write: "If I did an obesity study in America, I’d certainly not declare the entire world has a problem with obesity, even lacking any studies from the rest of the world to contradict me. Just because a medical study holds true in one culture does not mean it holds true in ALL cultures." However, if you did a study on obesity in America, and you did an RCT on several thousand people, some who got Drug X and some who didn't, and you found, after accounting for confounding factors, that Drug X reduces the acquisition of new weight by 60%, I would expect that Drug X would work that way on humans in Japan and Australia too. In America, the people in the study group may have only gained 4 lbs. instead of 10 lbs. In Japan, where the normal acquisition of weight is 1 lb. (for example), I'd expect people who take Drug X there to gain only 0.4 lbs. It may make sense to promote the use of Drug X in America but not Japan because of this. But in both cases, Drug X reduces acquisition of new weight in humans (whether American or Japanese) by 60%. Zad68 (talk) 13:45, 4 May 2012 (UTC)

You might expect that, but such is not the case in the outside world. 80% to 85% of adult Americans are circumcised, and yet the American HIV infection rate is high. The circumcision rate in Ethiopia is 93%, and the rate of HIV infection is also high. The circumcision rates of Japan, Finland, and New Zealand are tiny. Their rates of HIV infection are also tiny...Finland's is .03% of the population. The studies don't extrapolate well. Tftobin (talk) 14:20, 4 May 2012 (UTC)

Tom, are you conflating the general HIV infection rates with female-to-male infection rates? The Cochrane finding we are discussing is only related to female-to-male infection rates. And are you confusing infection rates with prevalence? According to the CDC, the HIV prevalence rate in America among 13 years and up is 0.4%, is that "high?" And the new infection rate in America is 0.016%. I'm not buying your numbers, I'd have to see the underlying studies you're basing these claims on. Either way, this is kind of getting off topic from the discussion of Rip-Saw's thought experiment. Zad68 (talk) 14:56, 4 May 2012 (UTC)

I am not sure that we need evidence for the commonality of men. Is there indication that what is applicable to African men is not applicable to men of other continents, as concerns circumcision and its bearing on HIV infection in heterosexual men? The present wording is already indicating that the "evidence" derives from Africa: "Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%,[15] and studies have concluded it is cost effective in sub-Saharan Africa.[16]" Bus stop (talk) 15:44, 4 May 2012 (UTC)

Indeed, there is evidence that what is applicable to African men is not applicable elsewhere. The same authors being referenced in the lead did a meta-analysis BEFORE the random controlled trials and found that the efficacy of circumcision is much lower in low-risk populations than in high-risk ones. They, however, couldn't come up with any solid numbers due to variation in the different studies. The graphs they made speak for themselves, though. The source is HIV and male circumcision--a systematic review with assessment of the quality of studies. Furthermore, another, independent study by Weiss et al. actually did assign numbers: "The association was stronger among men at high risk of HIV (crude RR = 0.27; adjusted RR = 0.29, CI 0.20-0.41) than among men in general populations (crude RR = 0.93; adjusted RR = 0.56, CI 0.44-0.70)" The adjusted RR is the number to look at here, with the general populations receiving only half the benefit from circumcision. Obviously, more research needs to be done on low-risk groups before we apply numbers from high-risk groups to them. Rip-Saw (talk) 21:51, 4 May 2012 (UTC)

Technical stuff -- The confidence intervals do not even overlap in the Weiss et al. study. This study gives the efficacy in high-risk groups at 71% and the general population at 44%. So if the African trials found an efficacy of 38-66% in their general population, which is high-risk relative to the rest of the world, then the efficacy for the rest of the world would be around 24-41%. Obviously we cannot draw any conclusions from the numbers I spit out here, but the problem is that NO RESEARCHERS have done what I just did, therefore we cannot include ANYTHING about the general world population. Rip-Saw (talk) 23:27, 4 May 2012 (UTC)

So, just to review, you're taking data from African studies of high-risk men and those in the general population, and from the difference between the two you're somehow drawing a conclusion about African and non-African populations. And you're using this as supporting evidence to argue that one cannot extrapolate relative risk. Not only is your argument pure original research, it's nonsensical as well. Jakew (talk) 08:06, 5 May 2012 (UTC)

I already cited this hypothesis as original research, since there is no research that exists on the topic of the efficacy of circumcision in low-risk countries. That is why I stated the numbers I came up with cannot be put into the article. I only gave this example because some people need examples to understand concepts. Do you still fail to understand that the efficacy of circumcision could be lower in some countries than others? Have you even looked at the data? You have a habit of citing policy as soon as you can, rather than directly address what I said, which leads me to believe you aren't even thinking about what I say and just trying to poke policy holes in everything, despite the fact that nearly every time you try to use policy against me, I turn it right back around and throw it in your face. Allow me to, once again, throw policy in your face: There is reasonable allowance for speculation, suggestion, and personal knowledge on talk pages, with a view to prompting further investigation. I encourage others to "investigate further" and discover the verified truth. Rip-Saw (talk) 17:00, 5 May 2012 (UTC)

To complete the quotation "...but it is usually a misuse of a talk page to continue to argue any point that has not met policy requirements." Jakew (talk) 17:13, 5 May 2012 (UTC)

Can we stay on topic? Rip-Saw (talk) 21:34, 5 May 2012 (UTC)

comment, the above is too much to read hence im not sure what this RfC is about. Can somebody simplify it in short for me please? Pass a Method talk 16:56, 4 May 2012 (UTC)

The source being quoted in the lead makes a statement that may or may not have been intended to apply to all male heterosexual populations. Some contend that the authors intended the research apply to only the populations they were studying, while others feel that the abstract and conclusion are referring to heterosexual men in general, and thus the research applies to all heterosexual men. It is a question of ambiguity that I feel is resolved by using a bit of commonsense and by doing a bit of background reading. Rip-Saw (talk) 21:57, 4 May 2012 (UTC)

Please don't misrepresent the dispute. It isn't accurate to label the two sides as "they mean African populations" vs "they mean all populations". Yobol, Jayjg, Curb Chain, Paul Barlow, and I have essentially pointed out that we don't need to decide what the authors intended, since "heterosexual men" has the same meaning in a Wikipedia article as it has in the source. In any case, we cannot "resolve ambiguity" by inserting a qualifier not present in the source, since that would violate WP:NOR. Jakew (talk) 08:06, 5 May 2012 (UTC)

Yobol hasn't decided anything yet, nor did Curb Chain express much of an opinion either way. You see to see other people's rather neutral comments a fuel to your own opinions. In fact, Yabol's comment "If the source makes the extrapolation, we are not in a position to qualify it because we want to" can easily be interpreted as backing up my own assertions. Rip-Saw (talk) 21:33, 7 May 2012 (UTC)

The authors of the Kenyan RCT had this to say: "Male circumcision significantly reduces the risk of HIV acquisition in young men in Africa," and "Generalisability of our study results to other populations could be restricted by several factors." Followed by an entire paragraph of why their results cannot be generalized.
The authors of the South African RCT concluded, "This study has some limitations. It was conducted in one area in sub-Saharan Africa and, therefore, may not be generalizable to other places. Nevertheless, because of the similar route of transmission of HIV in sub-Saharan Africa and because observational studies from various areas of sub-Saharan Africa have shown an association between HIV status and MC, the result of this trial is applicable to all of sub-Saharan Africa with some degree of confidence."
The authors of the Ugandan trial made no comment on applicable populations, giving a similarly ambiguous conclusion as the meta-analysis: "Circumcision can be recommended for HIV prevention in men."

Two out of three RCTs explicitly state their results cannot be generalized, yet right here in the lead, we are doing so. Rip-Saw (talk) 22:52, 7 May 2012 (UTC)

I do not think my comments back up your assertion. I see nothing in the secondary source used to say it is limited only to Africa, or that it cannot be generalized. I see a lot of personal research to try to convince everyone that the secondary source should not have said that, however.Yobol (talk) 01:40, 8 May 2012 (UTC)

There is nothing in the secondary source saying it applies to Americans, and I have listed a half-dozen sources saying it cannot. Some would qualify the results to the entire world. I prefer to err on the side of scientific caution. At any rate, I feel like it no longer matters what the authors of that source actually meant in their abstract, the amount of evidence I have mounted against the lead is now significant enough that it must be changed whether or not it is an accurate reflection of its source. Rip-Saw (talk) 02:26, 8 May 2012 (UTC)

And, here we will have to agree to disagree. I'm an old-school kind of Wikipedian that actually cares about accurately reflecting the high quality sources I use. Yobol (talk) 02:31, 8 May 2012 (UTC)

And all I care about is what the research says, which just so happens to go along with a certain policy on Wikipedia. I have yet to see anyone produce any document which lays claim that circumcision is 38-66% effective in Americans, Asians, or Europeans. I have 3 documents that say otherwise. Rip-Saw (talk) 02:42, 8 May 2012 (UTC)

It doesn't really matter what the individual RCTs conclude, because they're primary sources and hence can't be cited. For the statement about the effect of circumcision against female-to-male transmission of HIV, we need to cite a high-quality secondary source and, since they're available and WP:MEDASSESS regards them as the best quality, this should be a meta-analysis of RCTs. When citing such a source, we can't insert the qualifier "African" because other sources make that conclusion; that's WP:SYNTH by definition. So we need to look at RCT meta-analyses, and look at what they conclude. Jakew (talk) 07:55, 8 May 2012 (UTC)

Actually it does matter what they conclude, because 2/3 of the RCTs said the results are not generalizable to populations other than those being tested, and the meta-analysis is ambiguous at best in its conclusions. Nowhere in WP:MEDASSESS does it forbid primary sources. Wikipedia does not ban primary sources. I have a half dozen sources refuting your interpretation of the abstract of the meta-analysis. A half dozen researchers agree with me, not you. Open your eyes and look at this from a neutral point of view for once. Or find evidence that supports the view that 38-66% applies to other continents. If you have no research to back you up, then you lose the right to participate in a consensus discussion of this nature. Rip-Saw (talk) 17:13, 8 May 2012 (UTC)

Since I'm not proposing to say that "38-66% applies to other continents", there's no reason why I should find evidence in support of that view. Since I'm saying that we should follow the source in not applying the "African" qualifier, I need provide no further evidence. Jakew (talk) 17:19, 8 May 2012 (UTC)

Your own version of the lead currently says heterosexual men, and 38-66% effective. Not applying the qualifier "African" is the exact same thing as applying the qualifier "all" when taken so grossly out of context. The lead, in fact, suggests that the 38-66% rate applies to all continents. Rip-Saw (talk) 17:37, 8 May 2012 (UTC)

Jakew says: " ..."heterosexual men" has the same meaning in a Wikipedia article as it has in the source. In any case, we cannot "resolve ambiguity" by inserting a qualifier not present in the source, since that would violate WP:NOR."

He is referring to the Cochrane authors' conclusion here

This it seems is the basis of his argument. He then conveniently draws on the wikipedia policy to use meta analysis of RCTs to determine the majority view. This is stated here: WP:MEDASSESS. But this Cochrane RCT metanalysis does not in fact determine the majority view on the question: "Does male circumcision reduce female to male transmission of HIV in general, not just in Africa?" I will accept that it does determine the majority view on the question "Does male circumcision reduce female to male transmission of HIV in Africa?"

Jakew, you might say that the Cochrane review does in fact show that the majority view is that circumcision reduces acquisition of HIV by heterosexual men by between 38% and 66% in general, not just in Africa. That is what you are currently saying. You point to other meta analyses of the RCT trials. I'd like to point out that what you are using is the authors conclusions. We should have some common sense here. The reason WP:MEDASSESS says that meta analyses of RCT's are the most accurate and reliable way to determine the consensus view on a particular question of debate is because the more data you collect, the more confident you can be in your conclusions. Note that the meta analyses are on the same 3 RCT experiments. In terms of what we put into the lead, the particular question of debate, the question we are concerned with, is "do the results of the RCTs apply in general or just to the African settings?" On this particular question, there are no meta analysis of RCTs to determine the answer. Because of this, you cannot point to WP:MEDASSESS and use it as justification including a sentence that implies that circumcision reduces HIV in general.

The main way we influence the article is that we the editors decide what to include. The WP:MEDASSESS policy does not guide on what to include. All it shows is that once you have decided the topic of what to include, how much weight you should give to either side of the debate on that particular topic, within the more general topic of circumcision. So I repeat it does not guide on what topic to include, for instance, in the lead. You Jakew, have decided that. It is you who has decided to create a sentence that gives the lay reader the impression that circumcision reduces HIV in general, rather than a sentence that simply states the results of some African trials. It is also you who has decided the structure of this article. It is you who has decided to focus so much on the medical aspects. You like to display your strict adherence to the wiki policy, Wikipedia:No original research to show that you are holding this article together and preventing it from turning into a bad article. No original research is a good policy because it means that wiki articles are reliable and give a balanced view of the subject. But if you influence the article and put your stamp on it in other ways, your holier than thou attitude and image as this bastion of wikipedia principles appears unjustified. Tremello (talk) 10:48, 8 May 2012 (UTC)

Tremello, you say "I'd like to point out that what you are using is the authors conclusions." That is quite correct, and thank you for acknowledging it.

Regarding the remainder of your argument, you seem to have misunderstood. The question "do the results of the RCTs apply in general or just to the African settings?" is not one that we can answer, nor should we try (per WP:NOR). The question we do need to address is, what is the best source to summarise the effect of circumcision on female-to-male HIV transmission? And the follow-up question to that is, how does that source characterise the population to which it applies: African heterosexual men or heterosexual men? Jakew (talk) 11:34, 8 May 2012 (UTC)

Jakew, you say, "The question we do need to address is, what is the best source to summarise the effect of circumcision on female-to-male HIV transmission?" This is what I am saying about you showing bias - which is just as bad as including original research. You have just decided what is to be included in the lead. You have just decided that that is the question that must be answered in the lead. We could put the answer to the question above in the lead, or we could instead talk about something else such as the more general issue of circumcision as a preventative measure for HIV. It is you who has decided that the issue of circumcision in the lead should be based solely on the results of the RCTs rather than a more general and equally balanced discussion of circumcision as a preventative measure against HIV. You might say that we should not give equal weight to the the opposing view that circumcision should not be used as preventative measure against HIV. But I don't see how if we did it would violate WP:MEDASSESS.

Currently we have: Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%,[15] and studies have concluded it is cost effective in sub-Saharan Africa.[16] The WHO currently recommends circumcision be recognised as an intervention as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV.[17] Some bodies have discussed under what circumstances circumcision is ethical.[18][19]

I agree that we must talk about the circumcision trials in Africa. I disagree with you that we should not provide context. Currently it is all very clinical: The results of studies and the recommendations of organisations. Alternatively we could report on what has actually happened and what is currently happening. I feel we should talk about the efforts to scale up circumcision in Africa. So I would put something like this: Some studies in Africa concluded that circumcision reduces the risk of female to male transmission of HIV.(ref) Currently the WHO are scaling up circumcision in Africa in a bid to reduce HIV.(ref) This is controversial.(ref) There is a dispute as to whether circumcision should be used as a preventative measure against HIV in developed countries such as the USA.(ref)" To me that is a lot less biased and a lot more balanced because we are talking about the issue in a more general sense. Your decision not to talk about the issue in a more general sense is where you have shown bias. Tremello (talk) 17:45, 8 May 2012 (UTC)

Wikipedia articles can only "provide context" that is explicitly found in cited sources; adding an editor's personal bias, mixing unrelated sources to create an argument, or attempting to counter general or systematic reviews with specific individual studies, is WP:NOR. Jayjg ^(talk) 23:01, 8 May 2012 (UTC)

All we can use are the author's conclusions, Tremello. The fact that researchers conducted numerous meta-analyses on the RCTs only suggests that the RCTs are a very reliable source of information on the topic. The majority view is certainly that circumcision reduces the likelihood of getting HIV from a woman, and that in the populations tested that effectiveness is at around 60%. Those are indisputable facts of the research that no one can argue against without random controlled trials that dispute these facts. The problem lies in assuming the authors mean 38-66% applies to all heterosexual men, not African heterosexual men. Had they intended that to be the case, they would have to at least make a case in the paper for that conclusion, which they did not. The very fact that we are having this discussion is proof that the authors did not intend their numbers apply to men universally. Rip-Saw (talk) 17:33, 8 May 2012 (UTC)

Dispute amongst Wikipedia editors is not evidence of dispute amongst reliable sources, or problems with reliable sources. Jayjg ^(talk) 00:00, 11 May 2012 (UTC)

We are really not allowed to make any assumptions about what authors' meant or implied—that would be WP:OR. The best we can do is quote the statements verbatim, and let the interested reader follow the links, read the source, and make their own decision. For Wikipedia to enshrine one interpretation over the other would be improper. -- Avi (talk) 22:26, 10 May 2012 (UTC)

That is such a load of horse crap. It is NOT appropriate to quote out of context to push your own viewpoints. And this is not a dispute that has anything to do with a dispute in the medical community. This is a dispute about the meaning of what the authors said. If this RFC fails to work, then I will just take it a step further. Rip-Saw (talk) 07:03, 11 May 2012 (UTC)

"This is a dispute about the meaning of what the authors said." This is exactly what is not allowed on Wikipedia—for it is original research on our part to make any interpretation. I direct to to Wikipedia:No original research#Using sources (bold exists in original text; italics are my own for emphasis):

Research that consists of collecting and organizing material from existing sources within the provisions of this and other content policies is fundamental to writing an encyclopedia. Best practice is to research the most reliable sources on the topic and summarize what they say in your own words, with each statement in the article attributable to a source that makes that statement explicitly. Source material should be carefully summarized or rephrased without changing its meaning or implication. Take care not to go beyond what is expressed in the sources, or to use them in ways inconsistent with the intention of the source, such as using material out of context. In short, stick to the sources.

All we should do is bring the exact quote, the source, and let the interested reader find the original and make their own decision. If that is something with which you feel you cannot comply, then Wikipedia is not the project in which you should be focusing your efforts, as WP:NOR is, for better or for worse, non-negotiable. -- Avi (talk) 14:26, 11 May 2012 (UTC)

Avi, I think there is a misunderstanding. From what Rip-Saw had said previously, two of the three studies questioned whether their results were applicable outside of Africa. I don't believe Rip-Saw intended any original research, just a thorough review of what is already here. Tftobin (talk) 15:45, 11 May 2012 (UTC)

But we don't cite the individual RCTs, Tom, as they're primary sources. We cite the meta-analyses (currently the Cochrane review), which don't qualify their conclusions in such a way (perhaps because one can extrapolate with more confidence from three RCTs in different environments than one can extrapolate from one). You can't say something and attribute it to source A unless source A explicitly states it. It doesn't make any difference whether sources B and C support it, unless those are the sources cited. Jakew (talk) 16:18, 11 May 2012 (UTC)

Is it really your assertion that we IGNORE the body of an article and cherry pick quotes from the abstract and conclusion? You basically just supported the position that no Wikipedian should use the brain inside their head! That is completely ridiculous and I refuse to take anything you say seriously. Rip-Saw (talk) 16:32, 11 May 2012 (UTC)

The body of the article doesn't support the qualifier you wish to add, though. Incidentally, please review WP:CIVIL. Jakew (talk) 17:03, 11 May 2012 (UTC)

(edit conflict) No, RipSaw, the assertion is we do not ADD anything that is not explicitly stated and then we LET the readers USE the brain in their heads without us deciding what the interpretation should be. Your suggestion causes Wikipedia to espouse something not explicitly stated in the source, something that policy forbids. -- Avi (talk) 17:05, 11 May 2012 (UTC)

I have actually read the article in question. It is clear that the authors intended that their own study apply to the very populations they were studying. To think otherwise would be pure foolishness. I am not attempting to add anything to what the authors said, I am, in fact, attempting to take away the generalization of what the authors said. While it may be OK to directly quote the abstract after context is given in the body of Circumcision, to do so in the lead, out of context, is grossly irresponsible scientific reporting. Perhaps some people feel Wikipedia should not be held to such high standards, but last time I checked, Wikipedia wishes to be held to the highest of standards. Rip-Saw (talk) 17:26, 11 May 2012 (UTC)

The conclusion from the abstract reads: "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months."
The 'plain language summary' from the body reads: "Results from three large randomised controlled trials conducted in Africa have shown strong evidence that male circumcision prevents men in the general population from acquiring HIV from heterosexual sex."
The beginning of the 'Discussion' section reads: "Three large African RCTs assessing the effectiveness of male circumcision in preventing HIV acquisition in sexually active men in the general population were conducted between 2002 and 2006. The results indicate compelling evidence that male circumcision, when conducted using a medical procedure, reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months."
The beginning of the 'Implications for practice' section reads: "Male circumcision can be considered as an effective measure to partly prevent HIV acquisition in heterosexual men."
The beginning of the 'Implications for research' section reads: "Research on the effectiveness of male circumcision for preventing HIV acquisition in heterosexual men is complete. No further trials are required to establish this fact."

I could not find anything in the article that supports your assertion that their conclusions only "apply to the very populations they were studying". Jakew (talk) 17:51, 11 May 2012 (UTC)

Having also read the article, I agree with Jakew and am confused as to how anyone could say the sentence in question is "out of context." Perhaps Rip-Saw could explain which context he is referring to, quoting from the article. Yobol (talk) 21:58, 11 May 2012 (UTC)

Having read the introduction to the article, including the "Main results" and "Plain Language Summary" I too am confused how anyone can say the sentence we have is out of context. -- Avi (talk) 00:28, 14 May 2012 (UTC)

It would be quite difficult to disagree with Jakew, Yobol, or Avi on this point; how could this possibly be "out of context", given the source's contents? Jayjg ^(talk) 00:32, 15 May 2012 (UTC)

It's not really so difficult to disagree. That's why RFCs exist. That's why there is one here. A man a hair away from a medical degree has an issue with the way the studies are being presented. Tftobin (talk) 11:10, 15 May 2012 (UTC)

It may not be difficult to literally write "I disagree" on the talk page (anyone can do that), but it is probably in the best interest of the person disagreeing to explain how they came to that decision in order to have any credibility. Yobol (talk) 13:09, 15 May 2012 (UTC)

Comment

No point in an RFC. Too (or two) many "wiki-pros" involved - they're on the wrong side of history and I interpret their tactics as reflecting that. But I can't be bothered without thinking that the rationalists could get somewhere, and that will only come with arbcom OR massive community involvement - but basically no one cares apart from either well organised, and rather sinister, pro-circumcision lot, or deranged anti-circumcision loonies. There are a lot of anti-circumcision - which is the only rational position - editors, including most of the people above, but ultimately they don't *actually* care enough because they don't have either a religion or a fetish driving them. They get worn down. Anyhow - let me know when someone has the balls (or foreskin) to take this to RFA and I'll get involved. Egg Centri c 00:53, 11 May 2012 (UTC)

You are right. I am very frustrated that there are two RFCs on this one page, and nobody at wikipedia central seems to be too anxious to resolve them. The editors who have been controlling the flow of information have been cited in disputes so many times, it is like kids who don't care what the punishment is, they are going to do it anyway. There is no punishment for flagrant violations, of WP:Etiquette, WP:NPOV, or much of anything else. I am rapidly losing patience, and it is showing. I will not give in to the sinister, though, even if it kills me. That is to allow lies to become truth, and manipulation to cause perception to become the new reality. The next generation deserves better. Why aren't you going for an RFA? What would be the point, anyway? Just because one has admin powers, doesn't mean one can use them. Tftobin (talk) 01:18, 11 May 2012 (UTC)

Egg Centric, Tftobin, your comments included statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." Jayjg ^(talk) 01:46, 11 May 2012 (UTC)

Jayjg, your comment "Thank you for that amusingly ironic statement; it certainly helps lighten what is sometimes an otherwise rather tense Talk: page. Much appreciated!" included statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." It's time all the editors started playing by the rules, all the time, and not just when it suits their purpose. Tftobin (talk) 12:04, 11 May 2012 (UTC)

Please stop making irrelevant, off-topic comments that have nothing to do with issues or comments in this section. Also, do not delete or otherwise modify other editors comments, as you did here. Jakew (talk) 12:08, 11 May 2012 (UTC)

My edit of another editor's entry was a cut and paste mistake. My apologies. I tried to correct it, and was not allowed. If other editors can feel free to comment on the editors, then all editors can feel free to comment on the editors. This pick and choose selective enforcement of wikipedia policy is going to stop, whether some editors like it, or not. Tftobin (talk) 12:11, 11 May 2012 (UTC)

Given that you also had to copy and paste the comment which you referenced, did it have any relevance whatsoever to this section? If not, this is not the place for it. If you have an issue with Jayjg, it is not appropriate to raise that issue everywhere Jayjg comments. Take it to User talk:Jayjg, if you wish. It doesn't belong here. Jakew (talk) 12:28, 11 May 2012 (UTC)

The point was that seasoned editors get away with doing whatever they want. The enforcement of WP:NPA and WP:TPYES is extremely selective, and not limited to any one editor. It is also used to suppress opposition. Should I post it on the page of every editor who does it? What would be the benefit, or the point, when it is so easy to ignore? I could say what the other editor says, if you don't like it, don't do it. Tftobin (talk) 15:35, 11 May 2012 (UTC)

Every single editor on this page (or indeed any page) has the right to be free of personal attacks and insinuations, Tom. That applies to everyone, whether or not they've made personal attacks themselves. We all share responsibility for enforcing the applicable policies, so if you think something needs to be said about a particular comment (and you're sure it's a violation), you can and should say something in direct response to it. But bringing it up later on, in an unrelated thread, is inappropriate. I like to think I'm reasonably fair when I cite policies, but having said that I'm quite sure that I'm not as fair as I could (and should) be. I'm sure that's the case for all of us, too. We're human, and we have human failings. That doesn't mean that we should have to tolerate personal attacks. Wouldn't you agree with that? Jakew (talk) 16:11, 11 May 2012 (UTC)

I would agree with that, Jakew. In return, I would ask that the rules be applied consistently, applicable to everyone. Wouldn't you agree to that? Tftobin (talk) 17:37, 11 May 2012 (UTC)

Certainly I'd agree, Tom. Jakew (talk) 18:20, 11 May 2012 (UTC)

Then I extend you a handshake, Jakew. Tftobin (talk) 19:59, 11 May 2012 (UTC)

This is going to MEDCAB tomorrow. I just aced my last 2 finals and I have time to thoroughly research this topic now. By the time I am done with this article, the entire thing will have been gone over with a fine-tooth comb. I am going to fully read every single source, and if anything smells fishy at all, it's out. Rip-Saw (talk) 07:18, 11 May 2012 (UTC)

Sorry Mr Tobin, by RFA I meant request for arbitration. This issue needs arbcom I'm afraid. Although they like to see that people have tried everything else first so... Egg Centri c 12:39, 11 May 2012 (UTC)

ArbCom is unlikely to be interested, since they "will not make editorial statements or decisions about how articles should read ("content decisions"), so users should not ask the Committee to make these kinds of decisions. It will not do so." Wikipedia:Arbitration Jakew (talk) 15:30, 11 May 2012 (UTC)

Which begs the question, what would be effective? Pretty obviously, two open RFCs are not having the desired effect. Is there a next step? If so, what is it? Thanks. By the way, I would like to thank the editor who was brave enough to plough through, and then offer RFC advice. It is very much appreciated, I would wager, by everyone. Tftobin (talk) 15:39, 11 May 2012 (UTC)

The previous RfC was on a different, unrelated subject, so really we've just had a WP:DRN thread and one RfC. As for the "desired effect", what actually is that? From my point of view, a good result would be acceptance of the fact that NOR prohibits writing what we think the source ought to have concluded. Jakew (talk) 16:11, 11 May 2012 (UTC)

This has nothing to do with what the source ought to have concluded, but rather what the source actually concluded. Rip-Saw (talk) 17:32, 11 May 2012 (UTC)

Agreed. Jakew (talk) 17:35, 11 May 2012 (UTC)

You cannot agree with me, having just said "what we think the source ought to have concluded." You seem to think this debate is about the quality of the source, when it is in fact about the quality of the interpretation of the source. Rip-Saw (talk) 17:54, 11 May 2012 (UTC)

Everything the human mind comes across, it interprets. Nothing can be written about and not have been interpreted. Rip-Saw (talk) 18:00, 11 May 2012 (UTC)

Very philosophical, but I'm afraid WP:NOR is still policy. There shouldn't be a debate about the quality of interpretation, because we shouldn't be trying to interpret the source. We should just paraphrase what it explicitly states. As you said (and I agreed), what the source ought to have concluded is irrelevant, and the key question is what it actually concluded. Jakew (talk) 18:10, 11 May 2012 (UTC)

You continue to cite policy in talking to me, as if I do not already have a through understanding of all policy on Wikipedia already, having read every policy ever referenced on this talk page in its entirety. The authors never give any reason that their results would apply out-side of the investigated populations. No rationale is given for such a conclusion. Assuming the authors are reasonable, it must be concluded that their conclusion applies to the populations they were testing. It is, in fact, a weakness of their study that they do not discuss which populations their data applies to. It is likely they leave this up to the scientists that read such studies to determine. You are not a scientist, and for you to interpret their conclusions that 38-66% applies to all men is not likely what the authors had in mind. Rip-Saw (talk) 18:51, 11 May 2012 (UTC)

When you say "Assuming the authors are reasonable", you seem to mean "Assuming the authors agree with Rip-Saw", and I'm afraid your conclusion is still your conclusion, at the end of the day. I agree that it would be inappropriate to insert the words "all men" in the article. However, since nobody has done so, it seems a moot point. You're actually objecting to using the same language as the source, and to describe that as an "interpretation" seems creative at best. Jakew (talk) 18:58, 11 May 2012 (UTC)

Jakew, this statement above is the exact kind of personal attack I never want to see again. This is what I see, as the seasoned editors getting away with a response, for which they would slap a less seasoned editor if the tables were reversed. Please, abide by the guidelines, if you don't want to be attacked by others. Considering the speech you gave above, and I believe it was sincere, this is conduct unbecoming. Tftobin (talk) 20:11, 11 May 2012 (UTC)

Reasonable is a defined term. Reasonable scientists do not draw conclusions without explicitly reasoning to those conclusions. That is not my opinion, but the fact of the entire scientific process. Yes, I object to using the same language as the source uses, since it is being taken out of context. An abstract is hardly the thing to put into the lead, and there is not enough room in the lead to place the results in context. The lead is not the place to cite research that has had the external validity of its conclusions substantially questioned. The numbers should be taken out of the lead, and left in the body of the article, where their external and internal validity can be properly discussed. Rip-Saw (talk) 19:57, 11 May 2012 (UTC)

It seems entirely reasonable to take several studies of heterosexual men and draw a conclusion about heterosexual men. Not is it taken out of context: we explicitly state that the evidence is from Africa. Finally, questioning of external validity seems confined to fringe sources, and doesn't belong in the lead. Jakew (talk) 20:17, 11 May 2012 (UTC)

There are considerably more sources that state the external validity is not there than state that it is. You can't simply label relevant, well-sourced data you don't like as fringe. Especially when it is in the majority. Rip-Saw (talk) 22:51, 11 May 2012 (UTC)

That's not a valid comparison. Few sources will state that there is external validity unless that issue is seriously questioned. By analogy (to quote Pirsig), "no one is fanatically shouting that the sun is going to rise tomorrow", but it would be an error to conclude from the few fanatically shouting that it won't that theirs is a majority point of view. A more valid question is, of the secondary sources that comment on the trials, what proportion question the external validity. I think you'll find that it's an extreme minority, justifying my use of the "fringe" label which, incidentally, has nothing to do with my personal likes and dislikes. Jakew (talk) 10:01, 12 May 2012 (UTC)

Please explain one more time, how no medical association of any country advocates routine circumcision for medical or health reasons, and yet, when a molecular biologist exhorts that "circumcision is a biomedical imperative for the 21st century", this is somehow not a fringe view? Tftobin (talk) 20:39, 12 May 2012 (UTC)

This section is about the HIV sentence in the lead, Tom. Jakew (talk) 20:51, 12 May 2012 (UTC)

More comment

Though I agree with the previous comment (and congrats to Ripsaw), I think that this is another example of the worst kind of RFC situation: rwar in a teacup with WLawyers circling overhead. I actually have read the discussion (once only!) and my profit on't is, That I know better than to read it again.

Clearly the two sides will not come to agreement.
As far (ha!) as I can see, there is sufficient material on which to base adequate and uncontroversial statements, though that is unlikely to sate the controversialists among us. Something like:
- Some people in Africa have investigated the effect of male circumcision on the transmission of HIV infection (mainly or only in Africa, where of course, preputia...)
- They came to the conclusion that there was a significant effect, arguably worthwhile in epidemiological terms, though not overwhelming.
- Currently it is not clear to me to what extent the research sources took the drastically varied styles of circumcision into consideration, or whether the mortality or morbidity rates justified special consideration, but no doubt someone who cares can document that appropriately with the full approval of other concerned editors.
- At least some sources have expressed caution about extrapolation to other countries. (They might well have added caution about extrapolation to other African populations as well; I don't know, but I think they should.)
- Nothing that anyone has found so far suggests that the effect is so marked as to justify any reduction of other precautions or protection in engaging in activities tending to the transmission of infection.
- And no doubt a job lot of similar points that are explicit or a priori obvious, such as that Africa has been a continent since 1869 or so.
Argument on the matter of HIV/circumcision, whether for or against any points other than these, such as whether the chop is equally valuable or deplorable in other continents or ethnic groups, would no doubt be justified and pleasurable as ever, but should be omitted from the article until fully and verifiably cited, no matter with what passion it might be supported. Having seen what I have seen so far, it might be best to omit most of it from the Talk page as well.

Not very original I fear, but that is the best I see as worth offering at this point. For the rest, have fun, those who think this sort of thing is fun. JonRichfield (talk) 08:41, 11 May 2012 (UTC)

On the contrary, this is the best feedback the page has received during the RFC. The review can't have been easy. At the risk of speaking for everyone, thank you for your service, and your willingness to put a helmet and an asbestos suit on, and walk into a conflagration. Tftobin (talk) 15:48, 11 May 2012 (UTC)

Thanks TFT, for a most unexpected response. I'll now go and cool my blushes in a bucket of iced water :-) JonRichfield (talk) 18:14, 11 May 2012 (UTC)

"At least some sources have expressed caution about extrapolation to other countries. (They might well have added caution about extrapolation to other African populations as well; I don't know, but I think they should.)" Yet we continue to state, in the lead, that circumcision is 38-66% for heterosexual males, making no distinction and offering no warning that the results may not apply outside of Africa. Rip-Saw (talk) 19:17, 11 May 2012 (UTC)

Except that now you have an opinion, by an editor normally outside of the circumcision page, saying it. This is part of what an RFC is for, another set of uninvolved eyes offering a clearer view. Tftobin (talk) 20:14, 11 May 2012 (UTC)

Many editors have glanced at the discussion and left an opinion. Most of them are not relevant to the discussion, or they don't clearly take a stance. No one want to read the wall of text. I am grateful for people who do get involved, but the level of involvement needs to be high to accomplish anything. Rip-Saw (talk) 23:27, 11 May 2012 (UTC)

Comment

For some context, it wasn't until this discussion that Jakew made an edit to the lead that prompted this RFC. The lead actually stated for over half a year that circumcision has been shown to reduce the risk of acquiring HIV in "heterosexual populations that are at high risk", and that "evidence among heterosexual men in sub-Saharan Africa shows a decreased risk of between 38 and 66% over 2 years" (emphasis mine). FactoidDroid (talk) 18:58, 14 May 2012 (UTC)

Archiving

I have once again tweaked the archive bot to 10 days that Jayjg recently set to 4. I'm tired of searching the archives for relevant threads that keep disappeering. After Jayjg changed it to 4 days I went to Wikipedia talk:Talk page guidelines and petitioned to change talk pages from 50k to 200k to reflect modern day internet speeds. After a week of silence I made the change to the guideline and nobody commented. Yesterday Jayjg reverted that change and I became aware that he is doing the same thing to other contentious articles he edits. I feel this is done on purpose to maintain the status quo and limit discussion, something completely contrary to the spirit of the wiki. Garycompugeek (talk) 14:20, 3 May 2012 (UTC)

Please see Talk:Circumcision/Archive 69#Archiving rate and, rather urgently, WP:AGF. Jakew (talk) 14:29, 3 May 2012 (UTC)

Gary, It is unbelievably outrageous that you would go ahead and quietly change a Wikipedia-wide recommendation for everyone for your own, personal viewpoint and convenience. Zad68 (talk) 18:31, 3 May 2012 (UTC)

What exactly do you find quiet about it Zad68? As mentioned above and per instruction at the top of its page I commented on the talk page and waited a week, when there were no objections I made the change. Should I have posted at the village pump and emailed all wikipedia editors? How exactly do you think guidelines get changed? Furthermore who's viewpoint should I be using? Garycompugeek (talk) 18:43, 3 May 2012 (UTC)

I agree with Gary. The current rate of archiving is quicker than most other wikipedia pages. Pass a Method talk 19:03, 3 May 2012 (UTC)

PassaMethod, I think it's quicker than most pages because this Talk page gets more edits to it than most other Talk pages. It gets more Talk threads, and each thread grows larger than threads on most other pages. This page is already pretty big, currently approaching 50k. I think the current setting is good. Zad68 (talk) 19:18, 3 May 2012 (UTC)

Gary, it is "quiet" because Wikipedia talk:Talk page guidelines gets hardly any views, see here, so the notification of your intent to change the Wikipedia-wide recommendation was like shouting in the desert at night. Your thought to post at WP:PUMP was a good one (even if you were being facetious), that gets at least an order of magnitude more views, and I would have put out an WP:RFC as well. Situational awareness of a change like this is sorely needed. You really needed to be aware that this sort of change doesn't just affect the recommendations for the few articles you watch. It affects the recommendation for all millions of Wikipedia articles and you need to go out of your way to expand the discussion to respect that. Anyway, following the WP:BRD path, you were bold, you got reverted, and if you are still interested in following through on the proposed change, WP:PUMP and WP:RFC would be two good areas to take your change to. Zad68 (talk) 19:14, 3 May 2012 (UTC)

Regardless of how much traffic any page gets, us laymen have no idea how many editors watch the page. As a rule I watch many Wikipedia policy and guideline pages and you can be sure that others do also. I have no problem with RFC's and/or the village pump but have not yet come to the point where I feel the need enter into dispute resolutions. I am also not so secular as to be unaware that this change would effect wikipedia in it's entirety and not just the pages I watch. (Do I really seem that naive? Rhetorical, please no smart ass replies.) Garycompugeek (talk) 19:33, 3 May 2012 (UTC)

Dispute resolution? Is that in reference to my mention of WP:BRD? Sorry if I used an unfamiliar acronym there, WP:BRD is "be bold, revert, discuss" and it describes an approach to making article changes, it doesn't have anything to do with WP:DRN dispute resolution noticeboard. By the way, you are involved in a WP:DRN dispute resolution, here: Wikipedia:Dispute_resolution_noticeboard#Circumcision. (If this is all stuff you know already, honestly I'm not trying to be patronizing! I just can't tell from your response if my use of acronyms is confusing--if it is, I apologize.) Anyway, I think we're off-topic long enough for Talk:Circumcision. Let me know if you open a RFC for the proposed change to the Wikipedia-wide Talk-page archiving recommendation, I'd like participate. Thanks... Zad68 (talk) 19:52, 3 May 2012 (UTC)

Thank you for the disclaimer Zad68, I did for a moment think you were patronizing me. I was refering to WP:DISPUTE and its methodology not the WP:DRN but its easy to see your confusion and I apologize for not being clearer and yes I'm aware of that DRN thread, thanks. Garycompugeek (talk) 20:06, 3 May 2012 (UTC)

No prob and likewise. Zad68 (talk) 20:09, 3 May 2012 (UTC)

You can always bring a topic back up for discussion, and look over the most recent archive to see what was brought up. I've noticed this talk page tends to load slowly. It's not really a question of internet speeds but wikipedia server speeds. Four days may be a tad short, but I don't think it is annoyingly short. As far as I am concerned, once it's archived, it's gone forever. I think the FAQ could use some loving. Rip-Saw (talk) 04:15, 4 May 2012 (UTC)

Theoretically true, but that doesn't mean there are no tactical advantages to it. We should not allow users to gain such advantages through unilateral decisions. Archiving changes should require consensus if disputed. See discussion here: Talk:Pogrom#Archiving. Oncenawhile (talk) 08:08, 4 May 2012 (UTC)

Actually, we've had archiving set at 4 days for some time now (months, I believe). The most recently attempted change was Garycompugeek's attempt to lengthen the archiving period. Even at 4 days the page is prone to becoming overly long and, hence, slow to load. And could we please stop these nonsensical bad-faith assumptions about "tactical advantages"? Jakew (talk) 19:41, 4 May 2012 (UTC)

3 weeks Jake. Wikipedia servers and internet traffic are the main causes of slow page loads... to test this the next time this page loads slow go to a tiny page and you will usually find yourself experiencing the same issue. I have never seen anyone argue over when to archive a page except here and a few other contentious article that jayjg edits. Typically if anyone wants to raise the archive limit or do it manually nobody usually cares. I find it hard to believe some are so concerned with the size of the page they edit war over it and more realistic that some editors merely wish to maintain the status quo by archiving threads as quickly as possible. If this is not an issue then why are we talking about it? Oh right... the page is way to big because the guideline says 50k. I am lobbying to change this guideline from 50k to 200k right here. I encourage those interested to participate. Garycompugeek (talk) 20:06, 4 May 2012 (UTC)

Even with the setting at 4 days, the Talk: page has 10 threads and is over 150k. Editors may possibly be confusing practical archiving with tactical archiving - which is somewhat surprising, since there actually is no such thing as "tactical archiving", a phrase that combines equal parts conspiracism and bad faith. Jayjg ^(talk) 16:59, 6 May 2012 (UTC)

I did not coin the term...another editor with concerns on two other contentious articles suggested it, consequently you were also the editor increasing the archive rate on those articles as well. The fact that you deny over active archiving can be used tactically to maintain the status quo and your the main protagonist in each case holds little weight. Garycompugeek (talk) 18:07, 7 May 2012 (UTC)

It may be theoretically possible that "over active" archiving can be used tactically; however, that does not justify claiming that archiving is being used tactically. The latter is a blatant assertion, without evidence, of bad faith. I urge you, as a matter of urgency, to review WP:AGF. Jakew (talk) 18:11, 7 May 2012 (UTC)

I wouldn't get too bent out of shape about it. Many of the entries here are in bad faith, and some who complain the loudest are some of the worst offenders. To those, I would urge, look in the mirror. Tftobin (talk) 01:37, 8 May 2012 (UTC)

Thank you for that amusingly ironic statement; it certainly helps lighten what is sometimes an otherwise rather tense Talk: page. Much appreciated! Jayjg ^(talk) 23:28, 8 May 2012 (UTC)

It's not every editor who has been the subject of so many disputes, who could find humor in that statement. Also much appreciated! Tftobin (talk) 13:15, 9 May 2012 (UTC)

There is no WP:AGF issue here. Amendments to the archiving rate could be used tactically, so when an editor involved in an unresolved discussion starts changing the archiving parameters to file away some of the arguments, it raises natural "questions" about that editor's motives. None of us can know the answer to those "questions", so we Assume Good Faith, but it would be much better if the "questions" weren't raised at all. And they don't need to be raised - an editor who is involved in a heated debate does not need to also deal with the "administrative tasks" on the same page. Oncenawhile (talk) 10:22, 9 May 2012 (UTC)

I should point out that if there is a tactical advantage to decreasing the archiving rate, there must logically be a tactical advantage to increasing it. Thus, if you question one set of motives you must also, to be consistent, question those of the editors who disagree. However, questioning an editor's motives is fundamentally incompatible with assuming good faith. Hence, it seems fairly obvious that there is an AGF issue here. Jakew (talk) 10:31, 9 May 2012 (UTC)

Please stop using logic in your responses, it gives you an unfair advantage. Jayjg ^(talk) 11:09, 9 May 2012 (UTC)

Jakew, I agree with you on your first point - it works both ways. That's why WP:STATUSQUO exists. On your second point, if such behaviour is raising temperatures we should think carefully about it. Unless I have misread the comments, I don't think anyone is accusing anyone of any motive here - only that the behaviour "could be suggestive" of a motive. Let's not hide away from this, but instead work together to try to find a thoughtful way of going about this to keep temperatures cool on all sides.

To that end, I have formalised an RFC at Wikipedia_talk:Talk_page_guidelines#Archiving_talk_pages. Oncenawhile (talk) 11:29, 9 May 2012 (UTC)

Meanwhile, back in reality-land, this Talk: page is still over 140k. As far as I can tell, it is the third-longest Talk: page on all of Wikipedia, and is consistently in the top 10. The page has had almost 2,500 edits so far this year - that's around 20 a day! Claims that it should archived more slowly, or that the motive for keeping a moderately high archiving rate is anything other than purely practical, are, at best, ridiculous. Jayjg ^(talk) 23:51, 10 May 2012 (UTC)

"Tactical" update: The article's Talk: page has now grown to 173k! I think it's now the second longest Talk: page on Wikipedia. Jayjg ^(talk) 00:35, 15 May 2012 (UTC)

Is there perhaps a toolserver that measures these things? It would be helpful to see what the largest talk pages are on Wikipedia. It does make sense that controversial articles have the largest talk pages. Garycompugeek (talk) 14:38, 15 May 2012 (UTC)

It makes sense to more rapidly archive fast-growing Talk: pages; in fact, that is the general, common-sense practice. What doesn't make sense is to resist such common-sense with specious bad faith accusations of "tactical archiving". And despite all the automated archiving, this Talk: page is still 173k, and likely the second longest on Wikipedia. Jayjg ^(talk) 06:11, 18 May 2012 (UTC)

Recent revert

I reverted addition of recent article to the "sexual effects" section as it appears to be citing only one article for that statement. What we need to use are secondary sources such as systematic reviews (which we do cite in that section) that look at the literature as a whole and come to a conclusion after looking at the totality of the evidence, rather than give undue weight to one article that mentions circumcision exactly once. Yobol (talk) 18:23, 17 May 2012 (UTC)

This section needs to be completly rewritten. As it stands right now both paragraphs completly contradict each other with contradicting studies. It would be best to trim it down and not quote sections that are disproven in the same section. We need to illustrate the conflict between studies and leave it at that. More pro and con detail can go into Sexual effects of circumcision. Garycompugeek (talk) 18:40, 17 May 2012 (UTC)

If the reviews hold contradicting views, then that section will have contradicting views as well. We only report what the reliable secondary sources conclude, and if they contradict, so be it. Yobol (talk) 18:53, 17 May 2012 (UTC)

I agree with you completely and never said otherwise. I did say "We need to illustrate the conflict between studies and leave it at that." and "not quote sections that are disproven in the same section". Seems silly to pick a quote out of a source like The effect of circumcision on penile sensation or sexual satisfaction is unknown. When we give detailed analysis in the preceding paragraph or No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction. When we give evidence in the preceding paragraph. Obviously these studies are at odds with each and I'm not saying not to use them as sources. They illustrate a controversy well. I am saying the section can be better written to use the sources, show the controversy, while still documenting sexual effects. Garycompugeek (talk) 19:41, 17 May 2012 (UTC)

How about inserting "On the other hand," at the beginning of the 2nd paragraph, just before "In January 2007, the American Academy of Family Physicians (AAFP) stated..."? ☺Coppertwig (talk) 00:07, 21 May 2012 (UTC)

Statistic removal

I am removing the statistics from the 4th paragraph for the following reasons:

The source [[5]] qualifies as a WP:Primary by definition of a primary source
The source is not an original study in and of itself, but is instead a "meta-study" based on the "RCTs". The underlying RCTs were not random or controlled as I indicated earlier by the Gregory Boyle and George Hill research; my previous posts here linked to their research which is a reliable source.
The sentence I'm removing is an opinion of the researchers themselves and is not directly supported by the results. See [[6]]. The actual reduction is not statistically significant. See Statistical_significance. The "gold standard" is ~5%.
I cannot obtain the source article in question without paying for it, but it really doesn't matter since we're not supposed to be using primary sources directly anyway. Both the monitor.co.ug and the aforementioned research goes to discredit the research
Prostitution, when taken into account, nullifies the "benefits": [[7]]
Additional secondary source finding no benefit of MGM: [[8]]
Another secondary source discrediting the research based on non-sexual HIV acquisition. See citations at the following link: [[9]]
See citations here; male-female transmission increased: [[10]]
Commentary that RCTs were not random at all (this is a fact as participants were paid): [[11]]
No relationship between MGM & HIV in Kenya: [[12]]

Unlike the primary source in question, I've posted numerous links to reliable sources here. It would be easy to justify removing additional statements based on the source in question, but let's start with this one. Erikvcl (talk) 04:26, 27 April 2012 (UTC)

Many of your points constitute arguing about the subject, so I'll respond only briefly to those.

The source is a meta-analysis and systematic review. Hence it is a secondary source by definition: "Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations." — WP:MEDRS Also from that page: "The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs). [...] Cochrane Library reviews are generally of high-quality and are routinely maintained even if their initial publication dates fall outside the above window."
Erroneous claims that demonstrate a misunderstanding of what constitutes a randomised controlled trial are irrelevant.
Per WP:PSTS, secondary sources "rely on primary sources for their material, making analytic or evaluative claims about them". So your observation that the researchers have made evaluative claims about the primary sources is not a problem. Your claims about statistical significance are incorrect, and the news source you cite is a good example of why news sources are not considered reliable for medical claims.
As noted above, it's a secondary source.
This is the claim of a single primary source (and an ecological study at that).
This is an earlier version of the Cochrane review, pre-dating the randomised controlled trials. The authors concluded, essentially, that there was evidence of benefit, but RCTs would be needed to be certain. Or to quote: "The results from existing observational studies show a strong epidemiological association between male circumcision and prevention of HIV, especially among high-risk groups. However, observational studies are inherently limited by confounding which is unlikely to be fully adjusted for. In the light of forthcoming results from RCTs, the value of IPD analysis of the included studies is doubtful."
Here you cite three e-letters that didn't even have the benefit of peer review and don't even appear to have been selected for print.
And a primary source (an observational study). Jakew (talk) 09:15, 27 April 2012 (UTC)

All of my points go to arguing about the validity of sources and claims. My responses follow:

It is not clear to me in any way how this 38-66% reduction is calculated. Can you please clarify?
According to the definition of randomised controlled trial, the RCTs here do not qualify. I have provided numerous reliable secondary sources showing why this is true.
Please show me how my claims about statistical insignificance are incorrect. Wikipedia states that news sources are OK. It is not up to you to say that the source is not reliable: Wikipedia's policies dictate that. If you can say that the bogus RCTs and meta-studies are reliable, then the news sources are in too! You can't have your cake and eat it too.
Please go back and read my bullet points. I never mentioned that the e-letters were a source. My words were "see citations".

All I see here are straw man arguments. Please justify your claims with sources. I have provided numerous sources above. Erikvcl (talk) 06:05, 28 April 2012 (UTC)

Certainly, I'm happy to explain. Different figures come from different studies (and may vary slightly depending on how they are calculated). I'll use Auvert et al as an example. In this study 1,620 were circumcised, and 1,654 were not. 20 of the circumcised men became HIV+, vs 49 of the control group. So first, let's calculate the relative risk, which is the ratio between the two fractions. That is, (20/1620) / (49/1654), or 0.42. Expressed as a reduction, that's 1-0.42 = 0.58, and as a percentage, 58%.
Sorry, you're incorrect. A controlled trial, by definition, is a trial in which participants are divided into (as a minimum) two groups, one of which receives the intervention, and the other does not. The latter is called a control group, and is the source of the term "controlled". A controlled trial is "randomised" if participants are assigned randomly to the groups (for example, by flipping a coin); the alternative is non-random assignment, for example comparing volunteers for an intervention with those who did not volunteer and did not receive it.
Regarding statistical significance, each trial reported statistical significance, often in the form of a p value (a value less than 0.05 is usually considered statistically significant in medicine). The Auvert study, for example, reported "p < 0.001", while Gray et al reported "p=0·006" in the least significant analysis and "p=0·002" in the most. If you want, you can analyse the figures for yourself; here is an online calculator. (Please note: I'm supplying this information as background information only; Wikipedia editors should never attempt to perform their own statistical analysis of study data.) As for the news source, I've already cited the relevant part of MEDRS that says that news sources aren't reliable. Frankly, I'm perplexed that you're still arguing to the contrary.

Finally, it's not reasonable to expect me to somehow intuit which references you think might be appropriate. Jakew (talk) 08:22, 28 April 2012 (UTC)

The trials were not true RCTs because participants were paid, they targeted areas where the results would be favorable, etc. etc. I've already posted sources to this. You said my sources were junk. I'm getting weary of you saying that my sources are junk. The African studies are junk -- it's a fact and sources prove it -- we've discussed that at length. As it stands, I give up. Erikvcl (talk) 01:52, 29 April 2012 (UTC)

Score, status quo. Desired results achieved. Tftobin (talk) 16:34, 29 April 2012 (UTC)

When a proposed change would make an article worse, the status quo is obviously Wikipedia's preferred outcome. Jayjg ^(talk) 23:13, 29 April 2012 (UTC)

I agree we need to get rid of the junk sources. Erikvcl, thank you for fixing them with reliable sources. hopefully your changes won't be reverted by those who choose to ignore them.Gsonnenf (talk) 06:18, 1 May 2012 (UTC)

Gsonnenf, which "junk sources" did Erikcvl "get rid of" and "fix" with reliable sources? Please list the sources, and show the edit. Jayjg ^(talk) 22:50, 2 May 2012 (UTC)

What I did was remove the 38-66% statistic and justified why I removed it by citing over half a dozen sources. I did not replace any sources but rather cited numerous sources justifying my removal of this statement on this talk page. The sources I cited were from journal articles, studies, and news articles. All of which were deemed unacceptable by Jakew. One point I will make is that even if we leave this statistic in, the wording of it must change. The current wording states that 38-66% represents the reduction of risk. Not even the source makes this claim. What that number represents is the relative reduction in HIV transmission rate between circ/intact men. This is completely different than reduction of risk. The wording must change even if we have to leave this statement there. What I cannot understand is why my sources are never good enough. In particular, http://xa.yimg.com/kq/groups/23477339/1441224426/name/JLM_boyle_hill.pdf, is particularly significant. This source, apparently, is "fringe". It's certainly not any more fringe than the conflict-of-interest-riddled RCTs, meta-studies, and WHO conclusions. Once again, I will state this link: http://www.cirp.org/library/disease/HIV/ . Now I now you're going to say that's a biased page and all that. But look at the SOURCES not the conclusions and you'll find a tremendous body of medical evidence disproving the RCTs and meta-studies. In order to maintain WP:UNDUE, we need to start vetting these sources and bringing them in. According to WP:UNDUE, we should not give undue weight to any one source. We have obsessively relied on the RCTs and meta-studies (including WHO, etc.) in this article. We must balance this inequity to reduce the bias in the article. Erikvcl (talk) 04:02, 3 May 2012 (UTC)

Actually, no, you won't find a "tremendous body of medical evidence disproving the RCTs and meta-studies". First of all, of the 98 references cited, only approx. 14 postdate the RCTs, and only a fraction of those comment on them at all. The rest is a mixture of sources that don't even mention HIV, sources that don't mention circumcision, a handful of non-representative primary sources, and some outdated secondary sources such as the 2003 Cochrane review (which, in any case, we already cite in the article). Put bluntly, it only looks impressive until you examine the details.

Regarding weight, there are (at present) 942 results when searching PubMed for "circumcision hiv" and, as can be seen by browsing the results, the overwhelming majority of authors are in agreement that circumcision reduces the risk of female-to-male transmission. Yes, there are a few exceptions to that, just as there are still a few who claim that HIV doesn't cause AIDS, or that vaccines cause autism, etc. And there are fairly mixed views regarding male-to-female and male-to-male transmission, though of course those are separate subjects. We do document the opposing minority viewpoint in the fourth paragraph of the HIV section, but to give them greater weight than that found in sources would clearly violate WP:UNDUE. Jakew (talk) 07:55, 3 May 2012 (UTC)

This sounds very much like the "some oppose vaccination" speech. There are responsible adults with scientific and medical backgrounds, who don't believe that the circumcision/hiv connection is what some editors would like to believe it is. Just like headcounting the popular vote in here holds no water, headcounting the PubMed circumcision/hiv connection doesn't make it right. It's like polling the pre-Civil War United States states, to see if slavery is ethical. While I don't disagree that secondary resources are needed, the lecture is getting tiresome and heavy handed. Tftobin (talk) 16:15, 3 May 2012 (UTC)

Per WP:UNDUE, Tom, "Wikipedia aims to present competing views in proportion to their representation in reliable sources on the subject" (emph in original). Jakew (talk) 16:20, 3 May 2012 (UTC)

Reliable, and WHO, are not synonymous. Reliable, and PubMed are not synonymous. When, say, for example, a programmer can get his work published, and become a secondary resource, this tells me that these systems are not fail safe. When the money flows from a large benevolent organization to people with preconceived notions which happen to coincide with their benefactor, this system is not fail safe. Reliable may mean something different to me, than it does to you. Some people are so quick to throw away the concept that sometimes HIV and circumcision have nothing to do with one another. Coming as I do from a country which has been both ravaged by AIDS, and heavily circumcised, perhaps I am not so quick to be convinced. And perhaps others don't want to be convinced, and simply are not open to the very real possibility that much of the research they hold dear does not hold up to higher scientific scrutiny. There is the puzzle of countries with extremely low rates of both circumcision and HIV infection.Tftobin (talk) 01:18, 4 May 2012 (UTC)

"Reliable" in Wikipedia's sense means a source that conforms to WP:RS (and, in appropriate contexts, WP:MEDRS), Tom. In these senses, articles indexed by PubMed usually are reliable. Sometimes it can feel rather surreal to use the term "reliable" in reference to a source which one personally regards as complete garbage, but at the end of the day we have to remember that our personal views are irrelevant to Wikipedia. Jakew (talk) 09:56, 4 May 2012 (UTC)

As is truth. Which brings us back to the RFC. Kind of makes one wonder, if these organizations in which complete trust is being placed, and that trust is somehow being placed inappropriately, what wikipedia will look like in 10 years? Tftobin (talk) 16:05, 4 May 2012 (UTC)

Tom, as your last 5 comments to this thread have been your own generally-stated but obviously pointed opinions, including such musings as "Score, status quo. Desired results achieved," "It's like polling the pre-Civil War United States states, to see if slavery is ethical," and casting doubts on the reliability of the WHO and PubMed with "this tells me that these systems are not fail safe" and "what wikipedia will look like in 10 years?" I am concluding that you do not have any policy-based, specific suggestions on how to improve this article regarding "Statistic removal." Zad68 (talk) 17:05, 4 May 2012 (UTC)

Pretty obviously, there is no sense in including ref 16. Circumcision can't possibly be more cost effective than condoms, because there is no one advocating that circumcised men don't need to use a condom to be safe. I disagree with the sentence, "The WHO currently recommends circumcision be recognised as an intervention as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV", not because the WHO hasn't said it, but also on the grounds that it makes no sense. Condoms, when used regularly and correctly, are 98% effective in preventing HIV. Circumcision, at best, is around 30 something to 60 something percent effective. If one is using a condom, then there is no need for circumcision. I find both statements somewhat misleading as a result. This is another conflict...common sense and good judgment, versus verifiability of the words of someone who defies logic and reason. Tftobin (talk) 17:36, 4 May 2012 (UTC)

"Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." — WP:MEDASSESS Jakew (talk) 17:56, 4 May 2012 (UTC)

Once again, regarding the KNMG statement, "Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." — WP:MEDASSESS Tftobin (talk) 22:51, 4 May 2012 (UTC)

Wikipedia's policy is quite strange on this point. How do we know if it's a "high quality study" without looking into the details? Also, if conflict of interest, lack of peer review, and references are a problem it is, by definition NOT a reliable source by the English definition of the word reliable. Erikvcl (talk) 03:22, 5 May 2012 (UTC)

WP:MEDASSESS quite clearly indicates that the only thing that matters is the type of study. For example, we should assess whether it is a meta-analysis of RCTs or a case-control study (for example), but we shouldn't perform our own assessment of its merits. Jakew (talk) 07:15, 5 May 2012 (UTC)

This is an interesting argument that you make, Jakew. Can you cite a reliable secondary source that shows this is a valid way to determine medical consensus? It seems that if there were consensus, the CDC study you cited would back the Circ for HIV reduction as a great solution. It does not, but instead, cautiously says there's a "possibility". Furthermore, not a single medical organization in the world outside of the (arguably corrupt) WHO supports Circ as an HIV reduction method. All of the meta-studies are built on the same deeply-flawed so-called "RCTs" and have no more validity than the RCTs themselves do. You have failed to cite a source that confirms the African studies. Of course, there will be lots of studies in areas of up-and-coming research! This is far from consensus. Also, doesn't Wiki policy state that we're not supposed to do our own research and draw our own conclusions? It seems like this is exactly what you're doing. If there were a medical consensus, pro-circ organizations like the CDC would endorse it. But they don't. Your arguments are straw man all the way down. Erikvcl (talk) 03:05, 4 May 2012 (UTC)

I presume you mean this CDC factsheet, Erik. It doesn't use the word "possibility", but based on your previous comments I suspect you're referring to the sentence, "it is possible, but not yet adequately assessed, that male circumcision could reduce male-to-female transmission of HIV, although probably to a lesser extent than female-to-male transmission." However, since we're discussing female-to-male transmission, it is unclear why this sentence is relevant. Jakew (talk) 07:02, 4 May 2012 (UTC)

We were talking about medical consensus. Are you saying the CDC report shows medical consensus? Have you confirmed that your method for determining consensus is accurate? My point stands: there is no medical consensus on this issue. And when we have, in effect, one source (RCTs & meta-studies are effectively one source since they're all drawn from the same corrupt data sets) we need corroboration from another source. This is Wiki guideline to comply with WP:UNDUE Erikvcl (talk) 14:22, 4 May 2012 (UTC)

Of course I'm not saying that the CDC report shows medical consensus; it can only show the viewpoint of one body (the CDC). To assess scientific consensus, one has to look at a representative sample of reasonably recent papers, and see what they say. If you've any serious doubts about the scientific consensus, PubMed searches are a good place to start. Jakew (talk) 15:01, 4 May 2012 (UTC)

PubMed searches are a good place to start, for whom? You pay your approximately $1945 and get an article published. This is one method by which non-medical people get their articles published. If it were me, I would not personally be holding them up as a high standard. Tftobin (talk) 16:11, 4 May 2012 (UTC)

Open access journals (that is, the publication model in which authors pay a publication fee rather than readers paying a subscription fee) are included in Wikipedia's definition of a reliable source, Tom. Jakew (talk) 17:18, 4 May 2012 (UTC)

I am wondering whether that is really a prudent policy. When one considers the level of fact versus conjecture, I wonder if wikipedia is leaving itself open to a poor level of quality. Tftobin (talk) 17:40, 4 May 2012 (UTC)

It is not a prudent policy. Jakew says pubmed sources are "generally reliable". What does this mean? When are/aren't they reliable? From my limited experience here on Wikipedia, the decision on reliability seems to have less to do with the accuracy of a particular source and more to do with the viewpoints of editors who have the most edits. Erikvcl (talk) 03:22, 5 May 2012 (UTC)

Tftobin is right. It's a very poor policy. I am learning very quickly that Wikipedia's definition of "reliable source" has NOTHING to do with the English definition of reliable. In English, reliable means trustworthy, sound, and dependable. On Wikipedia, its definition is quite nebulous and doesn't seem to have anything to do with accuracy. Paying a fee to get published without any peer review IS NOT a reliable secondary source. Erikvcl (talk) 03:22, 5 May 2012 (UTC)

If a source isn't peer-reviewed, that does affect Wikipedia's assessment of reliability. Jakew (talk) 07:15, 5 May 2012 (UTC)

No one is disagreeing with you, and saying that sources shouldn't be peer-reviewed. What we are saying, is that peer-review is not an iron clad guarantee that the source will be a reasonable one. If it is peer-reviewed, and a secondary resource, but still manages to defy common sense, perhaps, by total consensus, wikipedia could skip it, and move on to the next peer-reviewed, secondary resource which does not rape our logic. Does this seem unreasonable? In my belief, it could lead to a better encyclopedia. If you are looking for an example of what I would leave out, you can think about what I said about the study of the cost of circumcision versus the cost of condoms. I personally would pass on that one. That is one I would present to other editors, as an example of one that we might pass on. Tftobin (talk) 18:44, 5 May 2012 (UTC)

As I've already stated, I don't believe counting up articles in journals is not a valid way to determine consensus. Unless you can prove consensus and/or show me that your method for determining consensus is valid, I will continue to assert that there is none. Without consensus, we may use WP:UNDUE to provide counter arguments to the HIV-Africa claims. Erikvcl (talk) 15:12, 4 May 2012 (UTC)

WP:UNDUE states: "Wikipedia aims to present competing views in proportion to their representation in reliable sources on the subject". Are you seriously claiming that, when attempting to comply with this, it is invalid to assess the proportion of sources asserting different viewpoints? Jakew (talk) 15:16, 4 May 2012 (UTC)

So we have agreement then. It's great to see that we've made progress. I'll draft up some text to counter the HIV-Africa statement in the lead and I will cite it with reliable secondary sources. Erikvcl (talk) 03:22, 5 May 2012 (UTC)

I'm afraid you've misunderstood. I've reverted your addition, as it gave undue weight to the views of a fringe minority. Remember, we aim to present views "in proportion to their representation in reliable sources". Taking the views of a small minority and giving them comparable weight to mainstream viewpoints doesn't do this; it gives far too much weight to the minority view.

In addition, it even managed to misrepresent that source: you added the text "In particular, the relative reduction in female-male transmission has been shown to be 1.3% rather than the 60% claimed by other studies." That contradicts the source you cited, which clearly states that the absolute risk reduction was 1.3%: "While the absolute reduction in HIV transmission associated with male circumcision across the three female-to-male trials was only about 1.3%, relative reduction was reported as 60%". Jakew (talk) 07:15, 5 May 2012 (UTC)

I have not misunderstood anything. We were discussing the validity of the claim in the lead. You said that we couldn't add a counterpoint because of WP:UNDUE claiming that medical consensus showed that the Africa-HIV conclusion was valid. You claimed this by counting up the number of sources in journals making this claim as well. Not only could you not show me that this is a valid way of determining medical consensus, but all of the HIV-African sources draw from the same studies. There is no medical consensus. No medical organization in the world finds the HIV-Africa studies valid (outside of the WHO). Brazil, in particular, has a high rate of HIV and rejected the studies. I asked you to provide non-African studies that confirm the results. You could not. As there is no medical consensus, it is completely valid to challenge the 38-66% number (which is incorrectly stated in the sources). The 38-66% statement needs a counterpoint. Since you agreed that the content should reflect the weight of the medical evidence, I made my change. You were wrong to revert it. I see your point where I used relative incorrectly, but you could have easily helped me out by switching that to 'absolute'. And please do not call the Boyle/Hill study fringe again. It is a lot less fringe than the bullcrap African studies that are about as close to a scientific joke as it gets. I have cited lots and lots of other studies besides Boyle/Hill, but, alas, you reject them all. We have all cited sources from medical organizations around the world questioning this HIV-Africa nonsense and you reject it. It's time to stop the bias and start working to making this article accurate and correct. It's time to stop quoting Wikipedia policy like a broken record and start looking at the evidence we have. If you honestly and truly think the Africa-HIV studies are accurate and correct, then you have failed consider a wide body of evidence and science. Additionally, it is improper of you to bandy about WP:UNDUE like a weapon. It is NOT a tool to suppress points of view that you don't like. You have, in no way, shown medical consensus on this issue and there is no reason outside of your own personal bias to reject the valid change I made (with the exception of a single-word error I made). I know I'm supposed to focus on the content and not the contributor. Maybe if you would make an effort to keep your own personal bias out of the issue so we can focus on the sources, the evidence, and the facts, we could make better progress. Erikvcl (talk) 04:40, 6 May 2012 (UTC)

Let me address this point-by-point:

"Not only could you not show me that this is a valid way of determining medical consensus" — as pointed out above, Wikipedia is concerned with the proportion to which views are represented in reliable sources. For practical purposes, scientific consensus means a viewpoint held by the vast majority of sources. Consequently, it's difficult to imagine how assessing the proportion of sources holding a viewpoint could be anything but valid.
"but all of the HIV-African sources draw from the same studies" — similarly, all Relativity sources draw from Einstein's work. All sources on the Christian faith draw from the Christian Bible. All sources on the LISP programming language draw from the work of John McCarthy. Sometimes secondary sources all cite the same sources because they've collectively agreed that those are the most important sources. It's difficult to see what your point is here.
"There is no medical consensus" — Yes, there is. When the World Health Organisation, the Cochrane Collaboration, the governments of multiple countries, every published meta-analysis, and virtually every published review agree on something, it's a consensus for all practical purposes.
"No medical organization in the world finds the HIV-Africa studies valid (outside of the WHO)" — medical organisations generally don't make pronouncements about the validity of studies.
"Brazil, in particular, has a high rate of HIV and rejected the studies." — presumably you're referring to headlines such as "Brazil: Circumcision not an HIV prevention tool for gay men", which (at the risk of stating the painfully obvious) aren't about female-to-male transmission and hence aren't even about the same subject.
"I asked you to provide non-African studies that confirm the results. You could not." — repeating this claim won't make it any less false. I've cited studies in this edit. For example, this Indian study reported "Male circumcision was associated with lower HIV prevalence (AOR=0.33,95%CI:0.13-0.81)." As did this, which reported "Taking into account the relative risk and prevalence of risk factors, the highest impact on reducing the HIV number per unit population was for male circumcision." (The AOR associated with the presence of a foreskin was 2.08, 95%CI [1.10–3.94].) And this, "In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, we noted that circumcision was strongly protective against HIV-1 infection (adjusted relative risk 0.15; 95% CI 0.04-0.62; p=0.0089)". (Expressed as percentage risk reductions, the corresponding figures for those three studies are 67%, 52%, and 85%, respectively.) Here is a study from Azerbaijan. It reported: "Additional risk factors include ... no circumcision". Here is a study from Baltimore, US. It concluded: "Circumcision was associated with substantially reduced HIV risk in patients with known HIV exposure, suggesting that results of other studies demonstrating reduced HIV risk for circumcision among heterosexual men likely can be generalized to the US context."
"Since you agreed that the content should reflect the weight of the medical evidence, I made my change." — which gave undue weight to a fringe viewpoint.
"And please do not call the Boyle/Hill study fringe again." — Wikipedia defines WP:FRINGE as: "We use the term fringe theory in a very broad sense to describe ideas that depart significantly from the prevailing or mainstream view in its particular field".
"It is a lot less fringe than the bullcrap African studies that are about as close to a scientific joke as it gets." — please note that "fringe" is not defined in terms of our personal evaluation of the merits of sources.
"I have cited lots and lots of other studies besides Boyle/Hill" — there are a handful of sources out there, but that doesn't necessarily mean that they should be cited. By analogy, here is a list of studies compiled by an anti-vaccination activist to show that vaccines are hazardous. Here is a list compiled by an HIV-AIDS denialist to show that HIV doesn't cause AIDS. The fact that a number of sources can be found does not mean that they deserve comparable weight to the mainstream view. This is fundamental to WP:UNDUE.
"If you honestly and truly think the Africa-HIV studies are accurate and correct, then you have failed consider a wide body of evidence and science." — my opinion regarding whether the studies are accurate and correct is no more relevant than yours. Hypothetically speaking, if you were to convince every single editor, including myself, that the studies were completely and utterly wrong, it wouldn't make the slightest bit of difference. As WP:UNDUE clearly states: "Keep in mind that, in determining proper weight, we consider a viewpoint's prevalence in reliable sources, not its prevalence among Wikipedia editors or the general public."

Finally, please remember to comment on content, not the contributor. Don't speculate about personal biases. Focus on arguments that have actually been made. Jakew (talk) 09:54, 6 May 2012 (UTC)

There is medical consensus that circ has no significant medical benefits. This is why no medical organization recommends routine infant circ. Yet these benefits are featured in the lead. Doesn't this completely fly in the face of what you just said about WP:UNDUE? Erikvcl (talk) 21:17, 6 May 2012 (UTC)

I'm afraid you're incorrect. There are two separate issues: whether there are benefits, and whether circumcision should be recommended for all newborn boys. The second issue involves weighing benefits against risks, financial costs, etc. The mistake you're making is to draw a conclusion about the first issue from non-recommendation about the second. Medical organisations generally agree that there are benefits. For example, as the American Academy of Pediatrics put it in "Circumcision: Information for parents": "Scientific studies show some medical benefits of circumcision. However, these benefits are not sufficient for the American Academy of Pediatrics to recommend that all infant boys be circumcised. [...] Since circumcision is not essential to a child's health, parents should choose what is best for their child by looking at the benefits and risks." Jakew (talk) 07:59, 7 May 2012 (UTC)

So, Jakew, by your quote of wikipedia's definition of [[WP:FRINGE], the work "Why circumcision is a biomedical imperative for the 21st century" would qualify, since circumcision is definitely not accepted as a surgical vaccine, no one agrees that having a foreskin is potentially fatal any more than having a nose is potentially fatal, and because of the statement "The benefits vastly outweigh risks.}, which flies in the face of the AAP, AMA, Canadian Paediatric Society, the British Medical Association, and the Swedish Paediatric Society, etc. Tftobin (talk) 13:18, 7 May 2012 (UTC)

We don't actually document any of those claims in the article, Tom, so it's irrelevant. Please try to stay on topic. Jakew (talk) 14:49, 7 May 2012 (UTC)

Why is it never off topic when other editors dismiss something offhandedly as fringe, as they so frequently do to devalue anything they don't want to hear, and always off topic when I say that something may be fringe? Tftobin (talk) 01:46, 8 May 2012 (UTC)

Tom, this section is about the HIV sentence in the lead. On-topic statements are, therefore, those about the HIV sentence in the lead. Off-topic statements are those which are about some other subject. Which do you suppose is the case for statements that aren't mentioned in the article at all, aren't about HIV, and are in a source that isn't cited in the lead? Jakew (talk) 07:40, 8 May 2012 (UTC)

Tom is quite on topic. We are both questioning your decision-making process in what goes in and what is kept out of this article. Your behavior in not addressing Tom's concern is pedantic and annoying. By dismissing Tom's point, you are attempting to deflect the issue that ultimately comes down to your bias. I'm sure that I don't have to remind you that the English Wikipedia is the only one in which the Circumcision article has a pro-circ bias. Erikvcl (talk) 04:37, 12 May 2012 (UTC)

Article Talk: pages are for the purpose of discussing article content, not editors. Therefore, any statements about an editor's "decision-making process", or unsubstantiated claims about an editor's "behavior", or farfetched claims about this article having "pro-circ bias", are off topic. Please review WP:TPYES. Jayjg ^(talk) 00:30, 15 May 2012 (UTC)

OK, my turn:

Wikipedia is concerned with the proportion to which views are represented in reliable sources. For practical purposes, scientific consensus means a viewpoint held by the vast majority of sources. Consequently, it's difficult to imagine how assessing the proportion of sources holding a viewpoint could be anything but valid. In principle, I believe that this is a reasonable approach. It is clear that we are having trouble making a decision as to what represents the "majority of sources". Wikipedia policy does state, however, that alternate sources may be presented. Even if you are right about that the majority of sources claim (which you are not, I'm afraid), you still would be wrong for preventing alternate viewpoints from being addressed. See WP:Balance if you are unclear on this policy.
Relativity sources draw from Einstein's work. All sources on the Christian faith draw from the Christian Bible. All sources on the LISP programming language draw from the work of John McCarthy. Sometimes secondary sources all cite the same sources because they've collectively agreed that those are the most important sources. It's difficult to see what your point is here. Your analogies do not hold water here. We are not talking about Einstein or Christianity. We are talking about RCTs that were not conducted properly. A more correct analogy is if we had all of modern physics drawing from "E=MC^3" or "F=MA + 2". When a meta-study draws from a flawed RCT, the meta-study itself can be called into question. Please see WP:MEDASSESS if you are unclear on this policy.
Yes, there is. When the World Health Organisation, the Cochrane Collaboration, the governments of multiple countries, every published meta-analysis, and virtually every published review agree on something, it's a consensus for all practical purposes. You have still failed to confirm that your methods for determining scientific consensus are valid. Please see http://www.cochrane.org/news/blog/how-well-do-meta-analyses-disclose-conflicts-interests-underlying-research-studies . This goes to show my point about WP:MEDASSESS as well. You are indicating that the WHO and the Cochrane_collaboration are reliable sources and prove consensus. Both the WHO and the Cochrane Collaboration's peer review methods have been called into question by multiple sources and are not reliable. And even if we pretend that these two sources are reliable, how does two sources (and the studies reported/reviewed by these two sources) prove world-wide medical consensus? What does "for all practical purposes mean"? You have not shown medical consensus in any way. As I've said before, with the exception of the United States and the countries that it influences (e.g. African country leaders taking bribes from American charities and MGM-device manufacturers), not one country or medical organization in the world backs you up.
medical organisations generally don't make pronouncements about the validity of studies. This is an interesting statement. Obviously medical organizations do make pronouncements about studies through their conclusions. Medical organizations (both private and public) have staff scientists and researchers that analyze evidence and research and draw conclusions based on that research. So far, the research isn't compelling even for the CDC (which, ironically, is a source that you frequently refer to that does make a pronouncement by drawing conclusions).
presumably you're referring to headlines such as "Brazil: Circumcision not an HIV prevention tool for gay men", which (at the risk of stating the painfully obvious) aren't about female-to-male transmission and hence aren't even about the same subject. You are incorrect as Brazil's conclusions does not apply just to gay men. Brazil's conclusion lists a number of reasons. See http://www.circumcisionandhiv.com/2007/04/brazil_rejects_.html http://vivirlatino.com/2007/04/03/brazil-says-no-to-circumcision.php http://www.20minutos.es/noticia/219548/brasil/contra/circuncision-preventiva/ http://www.20minutos.es/noticia/139933 . And even if the conclusions did just apply to gay men, wouldn't this call into question the whole MGM as a preventative measure hypothesis? If you (and the WHO, et al.) are saying that MGM has a protective benefit, why wouldn't it apply to gay men? Isn't the theory that turning a mucous membrane into a hard dry callous (glans) prevents transmission? Why wouldn't this apply to gay men? Never mind that the urethra is also a thin mucous membrane... but why would we want to bring science into the discussion?
repeating this claim won't make it any less false Yes, I suppose it's interesting that you quote a lot of numbers and calculations and studies funded by American charities and American government-sponsored organizations. That's all fairly pointless since the very origin of those numbers is suspect. Unfortunately, article summaries don't show how p is calculated and that's critical. In the case of the African studies, RCT guidelines were not followed (I've outlined many many times the reasons why these were not true RCTs) so that means that the value of p used in the meta-study summaries is incorrect. The accuracy is suspect and therefore, the resultant conclusions are also suspect.
which gave undue weight to a fringe viewpoint This is the very crux of the issue. Most of the world is intact and most of the world's medical organizations reject both the HIV-MGM connection and the very notion that MGM has a prophylactic value at all. If anything, your viewpoint, the viewpoint of the WHO, and the viewpoint of the pro-circ organizations are fringe.
Wikipedia defines WP:FRINGE as: "We use the term fringe theory in a very broad sense to describe ideas that depart significantly from the prevailing or mainstream view in its particular field". Again, please re-read WP:MEDSCI and WP:MEDASSESS as you seem to be unclear on Wikipedia policy. In particular, my counterpoint to the HIV-MGM claims in the lead draws directly from the following Wikipedia policy: "However, when reputable sources contradict one another and are relatively equal in prominence, describe both approaches and work for balance.". The assessment of the study type and methods, as described in WP:MEDASSESS specifically allows us to call into question improperly-performed research. We have the option on Wikipedia of choosing not to use bad research. If there was 1000 studies saying that the earth was flat, this certainly wouldn't constitute good research and it certainly wouldn't be medical consensus. Furthermore, would you trust a study commissioned by an oil company stating that there is no global warming? There are hundreds of studies showing this even though this is a considered a "fringe" viewpoint in the scientific community. The global warming issue parallels this one in that the "fringe" is the most vocal even though the fringe doesn't represent scientific consensus. In this case, the fringe viewpoint is that cutting genitals is the cure to a variety of unproven ills.
there are a handful of sources out there, but that doesn't necessarily mean that they should be cited. By analogy, here is a list of studies compiled by an anti-vaccination activist to show that vaccines are hazardous. Here is a list compiled by an HIV-AIDS denialist to show that HIV doesn't cause AIDS. The fact that a number of sources can be found does not mean that they deserve comparable weight to the mainstream view. This is fundamental to WP:UNDUE. Again, you are mistaken; your examples are laughable. This is nothing like HIV-AIDS denial. To compare the two is to fail to understand both the evidence and the issues involved. Please see my previous comment as I think they address this point as well.
my opinion regarding whether the studies are accurate and correct is no more relevant than yours. Hypothetically speaking, if you were to convince every single editor, including myself, that the studies were completely and utterly wrong, it wouldn't make the slightest bit of difference. As WP:UNDUE clearly states: "Keep in mind that, in determining proper weight, we consider a viewpoint's prevalence in reliable sources, not its prevalence among Wikipedia editors or the general public." If your opinion is no more correct or relevant than mine, then why do you use your opinion to deny inclusion of sources that show prevalence? There are many many sources by medical organizations, research studies, and analysis that cast doubt on your claim of "medical consensus". Your opinion causes you to reject these sources that otherwise would prove you wrong. Then you use techniques (and actions of stonewalling, attrition, etc.) to ensure the article doesn't lose its pro-circ bias.
Finally, please remember to comment on content, not the contributor. Don't speculate about personal biases. Focus on arguments that have actually been made. I focus on arguments that have been made. As I mentioned before, it's much easier to stick to the content when the contributor is following Wikipedia policy. I don't have to speculate about your bias: your words and actions make it clear that you support MGM despite ethical, legal, moral, and scientific concerns. Erikvcl (talk) 05:24, 12 May 2012 (UTC)

"It is clear that we are having trouble making a decision as to what represents the "majority of sources"." — See User:Jakew/reviewsumm. Note that 2 of the 60 reviews are negative towards circumcision protecting against female-to-male HIV transmission.
"Wikipedia policy does state, however, that alternate sources may be presented." — Correct, but they must not be given disproportionate weight. So, for example, it might be appropriate to give them a sentence or two in the body of the article, where several paragraphs describe the mainstream viewpoint, but inappropriate to mention them in the lead, where there are only a few sentences.
"We are not talking about Einstein or Christianity. We are talking about RCTs that were not conducted properly." — Since your argument appears to be based on your personal belief that the RCTs were flawed, there seems no need to respond.
"When a meta-study draws from a flawed RCT, the meta-study itself can be called into question. Please see WP:MEDASSESS if you are unclear on this policy." — WP:MEDASSESS actually states the opposite: "Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." (emph. added)
"You are indicating that the WHO and the Cochrane_collaboration are reliable sources and prove consensus" — Partly correct. They are reliable sources as Wikipedia defines the term (see WP:MEDRS and WP:RS) and, together with other sources, they establish scientific consensus.
"And even if we pretend that these two sources are reliable, how does two sources (and the studies reported/reviewed by these two sources) prove world-wide medical consensus?" — You're attacking a strawman. I did not state that these two sources established consensus by themselves. I stated that these and "the governments of multiple countries, every published meta-analysis, and virtually every published review" do so.
"Obviously medical organizations do make pronouncements about studies through their conclusions." — Their conclusions are generally focused on questions such as, "should we recommend universal circumcision?", which isn't the same question as "does circumcision reduce the risk of heterosexual HIV transmission".
"You are incorrect as Brazil's conclusions does not apply just to gay men. Brazil's conclusion lists a number of reasons" — None of which seem to be that the studies themselves are incorrect.
"If you (and the WHO, et al.) are saying that MGM has a protective benefit, why wouldn't it apply to gay men?" — Circumcision can protect the "insertive" partner, but by far the highest risk during gay sex is for the "receptive" partner in anal sex; obviously this doesn't involve his penis at all. Consequently the degree of protection, on average, is much smaller.
"That's all fairly pointless since the very origin of those numbers is suspect." — you're free to hold whatever view you like about the studies, but their existence is beyond question.
"Most of the world is intact and most of the world's medical organizations reject both the HIV-MGM connection and the very notion that MGM has a prophylactic value at all." — nonsense.
"The assessment of the study type and methods, as described in WP:MEDASSESS specifically allows us to call into question improperly-performed research" — quite the opposite, in fact. See quotation above.
"Furthermore, would you trust a study commissioned by an oil company stating that there is no global warming?" — Personally, no, but that wouldn't be a valid basis for excluding it from a Wikipedia article. Our own opinions of sources are irrelevant, as I keep explaining.
"Again, you are mistaken; your examples are laughable." — I'm sorry you think so.
"If your opinion is no more correct or relevant than mine, then why do you use your opinion to deny inclusion of sources that show prevalence?" — I don't. I apply Wikipedia policy instead.

Jakew (talk) 09:20, 12 May 2012 (UTC)

See User:Jakew/reviewsumm. Note that 2 of the 60 reviews are negative towards circumcision protecting against female-to-male HIV transmission. You're a funny guy, Jakew. Are you really claiming that pubmed represents worldwide opinion on this subject?
Correct, but they must not be given disproportionate weight. So, for example, it might be appropriate to give them a sentence or two in the body of the article, where several paragraphs describe the mainstream viewpoint, but inappropriate to mention them in the lead, where there are only a few sentences. The Circ-Africa statements shouldn't be in the lead because MGM hasn't been shown to be an effective, cost-effective treatment for HIV free of ethical considerations. The majority of sources show that even if there is a benefit to MGM, it's not the most cost-effective solution. Even if we grant that the studies on HIV reduction are scientifically accurate, this subject still shouldn't be in the lead. The lead is supposed to represent the majority opinion on the subject and not represent fringe viewpoints. You should know that.
Since your argument appears to be based on your personal belief that the RCTs were flawed, there seems no need to respond. This isn't my personal belief. It's fact and I've proved it. You're ignoring this fact because Wikipedia policy doesn't require you to examine the methods used by sources it has previously deemed "reliable".
WP:MEDASSESS actually states the opposite: "Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." (emph. added) Not only is Wikipedia policy laughable on this subject (e.g. failing to examine methods used by sources is a recipe for incorrect information getting into Wikipedia), but I you are wrong as well. The type of study isn't RCT since it doesn't meet the criteria. So either way, you are wrong.
Partly correct. They are reliable sources as Wikipedia defines the term (see WP:MEDRS and WP:RS) and, together with other sources, they establish scientific consensus. It is not up to you to determine scientific consensus. How about a reliable secondary source indicates consensus has been reached?
You're attacking a strawman. I did not state that these two sources established consensus by themselves. I stated that these and "the governments of multiple countries, every published meta-analysis, and virtually every published review" do so. Please see my previous comment. Articles in journals that have been heavily criticized and corrupt African countries does not a consensus make. Try again.
Their conclusions are generally focused on questions such as, "should we recommend universal circumcision?", which isn't the same question as "does circumcision reduce the risk of heterosexual HIV transmission". Either way, my point remains. If the worldwide consensus is that cutting genitals isn't the best way to control HIV, the claims shouldn't be in the lead at a minimum.
None of which seem to be that the studies themselves are incorrect. Well if the studies WERE correct, don't you think they'd implement the conclusion? Oh wait, well it appears they considered the ethics and effectiveness! It's just one more bit of evidence to my point that the Africa-Circ statements shouldn't be in the lead.
Circumcision can protect the "insertive" partner, but by far the highest risk during gay sex is for the "receptive" partner in anal sex; obviously this doesn't involve his penis at all. Consequently the degree of protection, on average, is much smaller. It would be good if you could follow the conversation. We have always been talking about female-male transmision so we are talking about the insertive partner. Why are you talking about the receptive partner? Nobody's talking about that. The insertive partner is the one we're talking about whether it's heterosexual sex or homosexual sex. The protection should be equivalent if there's truly a benefit to circ.
you're free to hold whatever view you like about the studies, but their existence is beyond question. Did I question their existence? No, I did not. I presented sources that questioned the methods used by the "RCTs". I don't blindly accept so-called "reliable" sources and jam their dis-proven statements in the lead of an article that people use to make a decision about their children.
nonsense Name one medical organization besides the WHO that recommends MGM for prophylactic reasons? You can't because their isn't one. You are the one who's speaking nonsense.
Personally, no, but that wouldn't be a valid basis for excluding it from a Wikipedia article. Our own opinions of sources are irrelevant, as I keep explaining. Then why do you keep rejecting balance to the Africa-HIV statements? You are obviously trying to protect a viewpoint in the article.
I don't. I apply Wikipedia policy instead. Prove it. Explain to me why this article is pro-circ when the circ articles in other languages are neutral? Are they incorrect in applying Wikipedia policy? Is this one the only one that is correct? If so, then why don't you "correct" the others? Erikvcl (talk) 06:03, 18 May 2012 (UTC)

Erikvcl, when you challenge Jakew to Explain to me why this article is pro-circ when the circ articles in other languages are neutral?, you are begging the question. One cannot simply assume something to be true, and then challenge others to prove it is not true. Jayjg ^(talk) 06:17, 18 May 2012 (UTC)

Quite so. To address Erik's other points:

"Are you really claiming that pubmed represents worldwide opinion on this subject?" — PubMed is skewed towards English-language sources. This is certainly a limitation, but I know of no better databases.
"The Circ-Africa statements shouldn't be in the lead because MGM hasn't been shown to be an effective, cost-effective treatment for HIV free of ethical considerations" — Which Wikipedia policies are the basis for this argument?
"The type of study isn't RCT since it doesn't meet the criteria." — Your personal opinion of the nature of the primary sources is irrelevant, since we have secondary sources to make that assessment. From the cited source: "Main results: Three large RCTs of men from the general population were conducted ...".
"It is not up to you to determine scientific consensus." — Actually, applying Wikipedia policies (which of course includes judging due weight) is up to us.
"How about a reliable secondary source indicates consensus has been reached?" — As you wish. 'Given recent trial results and international consensus that male circumcision is efficacious ...'[13] or: 'In 2004, our colleagues in obstetrics and gynecology stated that “a consensus is forming that circumcision offers protection against UTI, penile cancer, cervical cancer, genital ulcer disease, and HIV.”'[14] or: 'In 2002, a consensus statement concluded circumcision slowed heterosexual HIV transmission.'[15]
"Articles in journals that have been heavily criticized and corrupt African countries does not a consensus make" — So as long as there's a vocal minority to criticise articles, the majority viewpoint doesn't count?
"If the worldwide consensus is that cutting genitals isn't the best way to control HIV, the claims shouldn't be in the lead at a minimum." — That's not a logical argument, even if such a consensus existed.
"Well if the studies WERE correct, don't you think they'd implement the conclusion?" — If you mean "would they recommend universal circumcision?", it wouldn't be the only possible conclusion. To decide whether to make such a recommendation, they'd have to consider not only whether it works, but the expected magnitude of the benefit given the prevalence of HIV in that population, the risks, the costs, ethical considerations, etc.
"We have always been talking about female-male transmision so we are talking about the insertive partner." — I think you've misunderstood. The degree of protection for straight men is greater because the main transmission pathway is through his penis, hence circumcision has the potential to make more difference. In gay men, the main transmission pathway is not through the penis, hence circumcision can reduce only a fraction of the total risk (the exception to this is men who exclusively take an insertive role, but such men are fairly rare).
"Did I question their existence? No, I did not." — Your exact words were: "I asked you to provide non-African studies that confirm the results. You could not."
"Name one medical organization besides the WHO that recommends MGM for prophylactic reasons?" — You're trying to improperly reverse the onus of proof. Your claim was "most of the world's medical organizations reject both the HIV-MGM connection and the very notion that MGM has a prophylactic value at all". You bear the burden of proof for that claim, not me. Furthermore, even if I were to answer your question, it would neither prove nor disprove your claim.
"Then why do you keep rejecting balance to the Africa-HIV statements?" — I'm not rejecting balance; I'm rejecting undue weight. Jakew (talk) 10:23, 18 May 2012 (UTC)

Your response is predictable and indicates you're grasping at straws to keep this article biased. You're rid of me for now, but I'll be back sometime in the future. Jayg, how about you give Jake another medal for handling trolls like me in such a brilliant way. Erikvcl (talk) 13:26, 18 May 2012 (UTC)

Jayg: Please see the FGM article. It is written from the perspective of a human rights issue. This one isn't. This page reads like Morris's website but without the grotesque comics! Just about everyone except for and Jakew claims it to be biased. Erikvcl (talk) 13:24, 18 May 2012 (UTC)

Jayg, we definitely want to make the article better. The results to many of the RCTs weren't released (unfavorable results, maybe?). The RCTs have deep ethical, procedural, and scientific flaws. But the studies using these so-called RCTs are the basis of the HIV-Circ claims in this article. I will be satisfied if we're allowed to challenge these RCTs and their results with additional statements backed by reliable secondary sources. Wikipedia allows for this but some editors, apparently, don't. Personally, I am a big fan of evidence and facts. Erikvcl (talk) 03:17, 4 May 2012 (UTC)

The studies citing the RCTs are general or systematic reviews. They can only be "challenged" if other general or systematic reviews "challenge" them - see WP:MEDRS and WP:NOR. Jayjg ^(talk) 01:42, 11 May 2012 (UTC)

I reproduce here a couple of important points made above, that I don't think gave the right impression. (a) "How do we know if it's a "high quality study" without looking into the details?" - by looking for later peer-reviewed papers and studies that specifically challenge, criticise or counter-argue its main conclusions or methodology. (b) "...counting up articles in journals..."; "WP:UNDUE states: "Wikipedia aims to present competing views in proportion to their representation in reliable sources on the subject". Are you seriously claiming that, when attempting to comply with this, it is invalid to assess the proportion of sources asserting different viewpoints?" - When it says "in proportion to their representation in reliable sources" it doesn't mean that we do the counting of published articles! A better example would be, in a reliable tertiary source like a modern medical textbook, what proportion of the space is given to each of the competing views. --Nigelj (talk) 21:11, 21 May 2012 (UTC)

Fringe View

Please explain one more time, how no medical association of any country advocates routine circumcision for medical or health reasons, and yet, when a molecular biologist exhorts that "circumcision is a biomedical imperative for the 21st century", this is somehow not a fringe view? Specifically, I am discussing references 116, "Why circumcision is a biomedical imperative for the 21(st) century", reference 126, "Infant male circumcision: An evidence-based policy statement", and its repeat, reference 203. Is it proper to use the same reference in multiple places in a wikipedia article, creating the impression that it has more credence and weight than it actually has? How can this advice run counter to the medical advice of every medical association who has a policy regarding circumcision, and be considered mainstream? Tftobin (talk) 00:21, 13 May 2012 (UTC)

Fringe doesn't mean "position not held by medical associations", Tom. Medical associations tend to be fairly conservative, adopting a position that is at least palatable to most of their members. It is an error to conclude from those position statements that anyone holding a non-neutral position holds a fringe view. In fact, there are a wide range of views. As the BMA acknowledge in their (fairly neutral) statement, for example: "There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself."

In any case, since we don't actually include or refer to the "biomedical imperative" quotation, it doesn't matter very much whether that particular claim is a fringe viewpoint (though it would become relevant, of course, if anyone proposed to refer to it in the article). What matters is the claims that we actually use. Our text citing ref 126, for example, says: "In 2012, Morris et al. reported that there is some evidence, albeit mixed, that circumcision may protect against prostate cancer; they called for more extensive research into the matter." This is hardly a fringe viewpoint. Compare it to, say, Cancer Council Australia, who say that "While a recent study suggests that circumcision may reduce the risk of prostate cancer, more research is needed before there is sufficient evidence to recommend population-level circumcision to help reduce prostate cancer incidence."

Regarding ref 126 and (at the time of your post) 203, if a ref is cited multiple times we should use the 'name' attribute in the 'ref' tag to reuse the citation (eg., <ref name="fred1999"/>). But I've removed ref 203 anyway, since it is not the position of a medical association, and hence it doesn't belong in the section to which it was added. Jakew (talk) 07:47, 13 May 2012 (UTC)

Thank you, Jakew. Tftobin (talk) 14:07, 13 May 2012 (UTC)

What exactly does fringe mean? I understand non-neutral. I understand that sometimes medical associations have lag time. What I don't understand, is how someone can call elective surgery a "biomedical imperative", and not be a fringe view. That paper calls it imperative, the Swedish Paediatric society calls it "child abuse" and "assault". Someone who selects studies who agree with a radical view, and uses them to support that radical view, cannot be mainstream. When it goes against the advice of every medical society of every country, that is not forward thinking, it is being manipulative. At best, it is research with an agenda, and a clear bias. Removing healthy parts unnecessarily from children too young to consent can be none other than a fringe view, no matter how it is painted, or rationalized. If this paper is not fringe, there is nothing which can be properly called fringe, and the term has no meaning. It is the very definition of fringe. So, in your interpretation, it is OK to use the most fringe papers as sources, as long as we use selective quotes which would not be considered fringe by other medical resources? If so, what is the point in citing it at all? Why not just use a viable, more mainstream source for the selected quote? Tftobin (talk) 14:07, 13 May 2012 (UTC)

It's not just a case of "lag time", Tom. The fundamental mistake you're making is to assume that any idea not endorsed by multiple medical associations is a fringe view. That isn't the case. "Fringe" is about the degree of support in reliable sources, not the degree of support in medical associations. Lots of ideas are discussed in the medical literature, and many of them have considerable support in reliable sources, even though they aren't endorsed by medical associations. For example, by the time the WHO lent their support to circumcision as HIV prevention, more than 400 studies had been published on that subject, mostly positive.

I agree that Morris' view differs from the view of the Swedish Pediatric Society, but since the SPS's view also differs greatly from that of many other medical associations who regard it as an acceptable choice for parents to make, I'm not sure why it's productive to compare the two. It doesn't seem very fair to deliberately compare his views with those of a medical association at the opposite end of the spectrum, and if you need to do so to make your point it reflects poorly on your argument.

I don't think it's constructive to say "Removing healthy parts unnecessarily from children too young to consent can be none other than a fringe view"; whether we agree or disagree with a viewpoint has nothing to do with whether it is a fringe viewpoint.

Now, the view that it's a "biomedical imperative" might be a fringe view (I haven't looked at the literature to check), but nobody has suggested that we insert that into the article, so it's a non-issue. This isn't about "selective quoting"; it's about due weight (which is what "fringe" is all about), and due weight depends on context. To illustrate, suppose we have a historian writing about World War II. He might be the only author in existence for a certain claim (say, that somebody or other was a high-ranking Nazi), which would make repeating that claim questionable on undue weight grounds (in other words, because it's such an extreme minority view, it's essentially "fringe"). But for many other claims, he's an excellent, authoritative source. Do we throw out the baby with the bath water and declare all of his work to be "fringe"? That would be absurd, I'm sure you'll agree. Alternatively, do we decide that, because he's generally a mainstream historian, every single thing he says deserves maximal weight, including a personal anecdote about his grandparents' cat? Again, that would be absurd. Appropriate weight depends on context.

Finally, you ask "Why not just use a viable, more mainstream source for the selected quote?" The simple answer is that this is a viable, mainstream source for the selected quote. Claiming otherwise is an example of fallacious reasoning, specifically it is a form of poisoning the well (I apologise for the Conservapedia link, but it's the best explanation I could find): person X makes argument A, which is fringe, therefore person X's unrelated argument B is fringe. Jakew (talk) 15:02, 13 May 2012 (UTC)

So, the statements that do not have wide backing from other 'wikipedia-reliable' organizations such as the WHO, in specific, "In women circumcision of the male partner provides substantial protection from cervical cancer and chlamydia. Circumcision has socio-sexual benefits and reduces sexual problems with age. It has no adverse effect on penile sensitivity, function, or sensation during sexual arousal. Most women prefer the circumcised penis for appearance, hygiene and sex." don't push this piece over the edge into fringe, because there are 'reliable' organizations who support the sections which deal with HIV prevention? That makes little or no sense. Who decides whether any particular statement of a borderline fringe piece of research is appropriate, or fringe? At best, this is a questionable article, and a very questionable process. Is comparing the conclusions of this paper, to the opposing views of every medical society of every country that expresses the opinion that the benefits aren't worth the risks, "reflecting poorly on my argument", because they are not 'wikipedia-reliable' sources? No one has addressed the issue that the sources chosen seem cherry picked to support a foregone conclusion. Is it impossible for wikipedia to do better, and quote a secondary resource for the prostate cancer argument, which carries less questionable statements? "Most women prefer the circumcised penis for appearance, hygiene and sex." really goes beyond the pale, is medically and logically unjustifiable, and does not hold up to the slightest logical scrutiny, considering the glaring fact that there are 3 billion plus men with foreskins, and most women have not voiced any objection to that. Wouldn't the HPV vaccine be a far more effective alternative, to prevent cervical and penile cancer? Even before the HPV vaccine was invented, the American Cancer Society stated, "The American Cancer Society does not consider routine circumcision to be a valid or effective measure to prevent such cancers. Research suggesting a pattern in the circumcision status of partners of women with cervical cancer is methodologically flawed, outdated and has not been taken seriously in the medical community for decades." Tftobin (talk) 19:14, 13 May 2012 (UTC)

The determination of "fringe" is supported by which secondary source? Robert B19 (talk) 19:50, 13 May 2012 (UTC)

I am not trying to be obtuse, or give anyone a hard time. It just bothers me, that when a source comes up that some editors don't like, they tag it with "fringe", like using that word is final the kiss of death. Then, articles which most medical personnel would believe really are on the fringe, don't get the fringe tag, because they coincide with someone's bias. I am looking for a level playing field, where those ideas which would be rejected by most medical professionals as absurd, would be the ones labeled fringe. Tftobin (talk) 21:12, 13 May 2012 (UTC)

Tom, let me address your points in turn:

"the statements that do not have wide backing from other 'wikipedia-reliable' organizations [...] don't push this piece over the edge into fringe" — Firstly, I don't understand why you're discussing reliable organisations. To assess due weight we look at reliable sources. That includes statements by organisations, of course, but also many other published works. Secondly, please stop worrying about whether pieces are fringe, which isn't the issue, and pay attention instead to whether views (the ones which we discuss in the article) are fringe.
"because there are 'reliable' organizations who support the sections which deal with HIV prevention?" — I'm afraid you've misunderstood. I used HIV to illustrate the fact that a view can be widely held by reliable sources some time before it is endorsed by medical associations. Whether sources agree with Morris regarding HIV is immaterial, since nobody is proposing to cite Morris re HIV.
"Is comparing the conclusions of this paper, to the opposing views of every medical society of every country that expresses the opinion that the benefits aren't worth the risks, "reflecting poorly on my argument" — Please don't misrepresent my arguments. My specific objection was to your comparison with the views of the Swedish Pediatric Society, as I made perfectly clear.
"No one has addressed the issue that the sources chosen seem cherry picked to support a foregone conclusion" — As far as I can tell, that's merely your opinion. In any case, WP:MEDASSESS specifically states that sources shouldn't be rejected due to personal objections to references.
"Is it impossible for wikipedia to do better, and quote a secondary resource for the prostate cancer argument, which carries less questionable statements?" — as I've already explained, it's a perfectly good source for the statement, and your objections to other statements made by the source are irrelevant.
""Most women prefer the circumcised penis for appearance, hygiene and sex." really goes beyond the pale, is medically and logically unjustifiable" — I get the message: you strongly disagree with the source on this issue. But a) our personal opinions are irrelevant, and b) we don't even mention the claim, so it's completely irrelevant. This is quite exasperating: how many times must I explain this point? Jakew (talk) 21:46, 13 May 2012 (UTC)

I didn't misrepresent anyone's arguments. I merely asked a question. I understood the objection to the views of the Swedish Paediatric Society. I also asked where the line is drawn, between something being fringe, and not fringe. So, from what I can understand, there is some vague process by which some editor or group of editors, assesses due weight by looking at reliable sources, which includes organisations, and many other unnamed published works. Some of us would like more insight, like who gets to make these decisions, and which methods exactly are used to arrive at the conclusion. Thank you for your concern about what I worry about, but I will take care of that myself, Jakew. If editors would stop dismissing dissenting views as fringe, or give a clear enough definition of what is considered fringe so that everyone can tell, we will have made progress. What I don't accept, is that that judgment is reserved to a few. If wikipedia is open, let's all understand how it works. When an editor tells me that something reflects poorly on my argument, I deserve to be able to ask why. Let me lay this perfectly clearly, so there can be no misinterpretation. "Most women prefer the circumcised penis for appearance, hygiene and sex." is an unprovable statement. It cannot be backed up by scientific fact. I am being told, "In any case, WP:MEDASSESS specifically states that sources shouldn't be rejected due to personal objections to references.". OK. An unprovable statement comes on board with an acceptable wikipedia reference to something else...in this case, a vague statement about cancer of the prostate. This has nothing to do with my personal opinion or objection. It points out a hole in the wikipedia process. Because of a reasonable statement, something unscientific becomes cited. Unless, of course, an editor disagrees, and believes that that statement is provable...that it is possible to inquire of every woman in the world whether she prefers a circumcised penis or an uncircumcised penis, and what her reasons are, and then the information can be compiled. No editor has to explain any point. There is no exasperation required, unless someone is personalizing something not meant personally, for some reason. I ask a question. No individual is required to answer. If someone is feeling exasperated, perhaps it is best they sit this one out, and let another editor field the question. Please be assured, I will ask the question, until I understand. For every question such as this that gets asked, there are x number of editors or readers out there who are wondering the same thing. Otherwise, someone else gets to make all the decisions, and all the judgments, and that would be ownership... which would present a serious problem. Tftobin (talk) 00:43, 14 May 2012 (UTC)

Nothing has "come on board", Tom. We don't cite Morris regarding women's preferences, and nobody has proposed that we should.

Regarding "reflects poorly on your argument", the problem was that you chose to compare Morris's views with that of the SPS ('That paper calls it imperative, the Swedish Paediatric society calls it "child abuse" and "assault"'). That isn't a very fair comparison, because the SPS position is at the opposite extreme. For example, if one said 'Fred says, "In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child", while the SPS call it "child abuse" and "assault"', it would give the impression that Fred holds a radical, extreme view. But, of course, "Fred" in this case is the AAP, stating a viewpoint echoed by many medical associations. If comparing the SPS with other medical associations would have that effect, then using it as a comparison to show that Morris's views differ from those of medical associations would tend to exaggerate such differences, to say the least. Jakew (talk) 07:46, 14 May 2012 (UTC)

There are 6 mentions of Morris on the page, beginning with "in contrast, Morris regards circumcision as "mandated", citing reduced risk of balanitis among other benefits". reference 116. WP:Fringe theories states "it is of vital importance that they simply restate what is said by independent secondary sources of reasonable reliability and quality." Do a majority of medical publications and organizations hold that view? No, they do not. Almost no one holds that view. How did it get in here? It coincided with a bias. Is reference 116 of reasonable reliability and quality? I've already demonstrated that it is not, unless you would care to argue that women prefer a circumcised guy can be proven. So, I ask, what is the reference, and its citation, doing here? Why is someone whose views are fringe cited as Further Reading, and External Links, when the views he holds run contrary to those of every known national medical association who has stated a view? Dr. Morris is acknowledged as "an expert" on the subject of circumcision, by the Gilgal Society 999. Why do people who come here constantly see bias? I dunno. Tftobin (talk) 11:12, 14 May 2012 (UTC)

Morris's view regarding balanitis is included for balance, because of the preceding material that reads, "Escala and Rickwood recommend against a policy of routine infant circumcision to avoid balanitis saying that the condition affects no more than 4% of boys, does not cause pathological phimosis, and in most cases is not serious". Very few sources specifically discuss whether routine/universal circumcision should be performed to prevent balanitis, so Morris's view is not particularly fringe in comparison to the view which it balances. However, there is a strong case for removing both of these sources, as they're both obscure and tangential. By analogy, it is reasonable to include nutritional information about broccoli, but unnecessary to discuss whether children should be force-fed the vegetable. If we do include such a viewpoint then we ought to include a reasonable selection for balance, but it is better to include neither.

You haven't demonstrated that ref 116 is of reasonable reliability and quality; rather, you've raised personal objections to its content. This violates both WP:NOR and WP:MEDASSESS, both of which make it clear that our personal assessment of a source is irrelevant.

The rest of your comments seem to be forms of argumentum ad hominem rather than objections to the claim stated in the article, so I won't waste time responding. Jakew (talk) 11:46, 14 May 2012 (UTC)

Editors won't waste time in responding, because there is no response other than it is impossible to survey half the people on the planet. Is it truly a personal objection to point out that something is based on scientific impossibility? This is fact, it is not my personal feeling. Is it ad hominem to mention that someone is given an awfully large amount of exposure, compared to their standing with the medical communuity in the capacity of a doctor within the given field? To me, personally, this is like free advertising space. That issue still needs a response. I personally agree with you, Jakew. I believe it is better to leave out both sets of references, than to include both. I stated it before, as I am certain you recall. I would welcome both references being removed. Are there any objections? Tftobin (talk) 15:29, 14 May 2012 (UTC)

Yes, Tom, it is a personal objection to argue that something is based on scientific impossibility. In any case, the "scientific impossibility" seems to be that you disagree with Morris's generalisation from the samples studied in the refs he cites. Such extrapolation may or may not be appropriate — this isn't the place to discuss it — but it's not uncommon for sources to extrapolate from samples. But the key point is that it doesn't matter whether you or I agree or disagree. Jakew (talk) 16:28, 14 May 2012 (UTC)

No. Scientific impossibility is that Morris or his sources state something as fact, that cannot have physically happened. When an editor can show me how it is possible to poll every woman in the world, and compile the evidence, OK. Extrapolating from samples is one thing. Saying something which everyone knows is impossible is another. No amount of obfuscation is going to hide it. It has nothing to do with me. Some editors seem to want to personalize this. That way, they won't have to reexamine any evidence, or make any changes. If that is what is happening, it is as shameful as it is sad, and more proof that there are issues with editorial control over this page. If a neutral party from outside the circumcision page tells me that the source is appropriate, and that the six references are reasonable and appropriate, I will gladly shut up. Tftobin (talk) 17:06, 14 May 2012 (UTC)

Since it is irrelevant anyway, I don't intend to waste any further time debating it. Jakew (talk) 17:16, 14 May 2012 (UTC)

Irrelevant to whom? There are two quotes, two references, and two links. Each has a variety of medical and scientific problems. No one asked anyone to debate, or to waste time. How you, or anyone else spends their time, is their business. My hope is that someone connected with the RFC will take a look, and determine if there is balance there, or imbalance, neutrality or bias. Tftobin (talk) 18:47, 14 May 2012 (UTC)

It's irrelevant to Wikipedia, per WP:MEDASSESS and WP:NOTAFORUM. Jayjg ^(talk) 00:34, 15 May 2012 (UTC)

What a magical way to make it all go away! That way, problems with the legitimacy, per WP:Fringe theories, disappear. Jakew and I worked out a compromise, where the two counterbalancing statements, and their references, were removed. I find that a lot more cooperative and civil, than having WP:MEDASSESS and WP:NOTAFORUM waved in my face, which is the typical reaction in here. Instead, differences were ironed out, and a compromise made. Tftobin (talk) 13:56, 15 May 2012 (UTC)

Feel free to ignore Jayjg's wikilawyering. It is often misapplied.Gsonnenf (talk) 12:49, 16 May 2012 (UTC)

"Misapplied" seems an excellent characterisation of such accusations of wikilawyering... Jakew (talk) 14:42, 16 May 2012 (UTC)

For better or for worse, continued violations of Wikipedia policies and guidelines, should they exist, may be met with measures intended to protect the project. Therefore, it behooves all of us to adhere to those policies, notwithstanding personal opinions as to whether or not various statements are "wikilawyering". For what it is worth, improper accusations that another is wikilawyering may be considered harassment so the continued reminder to focus on content and dispense with ad hominem statements is always relevant. Thank you. -- Avi (talk) 15:26, 16 May 2012 (UTC)

I am not stepping into this fray. I am simply asking a question. JonRichfield mentioned "war in a teacup with WLawyers circling overhead". Certainly, there is a great deal of wikilawyering going on in here, and it isn't limited to any one group of editors. If one does perceive wikilawyering going on, what does one do about it? Certainly, battle hardened editors could take this as seriously as they do WP:Etiquette, or WP:NPOV for that matter, which is to say that change might not be likely. How would one, if one was so inclined, lower the level of wikilawyering? By simply not engaging in it, is ineffective, and gives advantage to the wikilawyer. It is a problem I have given much thought to, and seen no solution. How does one call both sides on it, and not just one, since it really takes two to wikilawyer? How can one say what is proper and improper wikilawyering, since it is all improper? When a neutral editor brought in for an RFC observes it, one can bet it is going on. How can it be de-escalated? This seems like another place where there is a hole in wikipedia policy. Tftobin (talk) 17:10, 16 May 2012 (UTC)

Article Talk: pages are for discussing article content, not for making accusations of "wikilawyering". Please review WP:NPA and WP:TPYES. Jayjg ^(talk) 00:06, 18 May 2012 (UTC)

And, for that matter, WP:WL#Misuse of the term... Jakew (talk) 07:47, 18 May 2012 (UTC)

I made it plain that I was not talking about the current dispute. I was asking a general question. I made no accusation, of wikilawyering, or anything else. I referenced JonRichfield's observation. If an editor wants to give a knee-jerk reaction to someone over the mention of wikilawyering, why does it appear when I ask a general question, and not when the original observation was made, specific to this page? If someone wants to call a misuse of the term, why not direct it at the original editor? It was not me who was misusing it, if indeed it was being misused at all. I was merely referencing its use. If it was an inappropriate set of questions to ask on this talk page, it is still a very relevant set of questions. Where should they be asked? Please ratchet it down a few levels, the polarization is actually choking. Please review WP:CHILL Tftobin (talk) 19:59, 18 May 2012 (UTC)

If someone says that most women prefer something, they aren't necessarily claiming to have polled all women; I guess they probably figure the reader will understand that they're expressing a statement which has some support from one or more statistically significant polls, not necessarily absolute proof. It's common to see that type of statement. ☺Coppertwig (talk) 17:28, 21 May 2012 (UTC)

Is it common, then, to cite it as scientific, or evidence-based? Wouldn't that be a misrepresentation, in either case? Just because it is common, does that make it correct? Correct enough to use in an encyclopedia? Tftobin (talk) 21:24, 21 May 2012 (UTC)

A bit of relief

Might (or might not) interest anyone on this talk page, whatever their views on circ, that google sez: No results found for "sir cum szechuan". I am amazed that no one, so far as can be seen, has used that term on the web before... Egg Centri c 20:50, 24 May 2012 (UTC)

In that same spirit of brotherhood, here's a clip from Belgium Publilc Television thatshows the future of this issue in Eurpoe. http://www.liveleak.com/view?i=2b6_1337792618 It probably belongs in the article links for the ppubic reders. Robert B19 (talk) 16:38, 25 May 2012 (UTC)

recent revert of modification of "strong evidence" sentence

Robert please review the long history of discussions regarding modifying this sentence. Consensus was never established for changing it, and the way you changed it made it misrepresent the source cited. Please seek consensus here before changing this contentious sentence. Thanks. Zad68 20:28, 25 May 2012 (UTC)

Since I started this ssection I'll repost your comment and answeer it in the Editorial Judgment discussion above. Robert B19 (talk) 23:10, 25 May 2012 (UTC)

I've changed "Strong evidence" to "One study" - Wikipedia should not be taking the study's conclusions as its own. --NeilN ^{talk to me} 01:55, 26 May 2012 (UTC)

That is inaccurate, it's not "one study from Africa", but a meta-analysis (a very high quality one - a Cochrane review). Yobol (talk) 02:11, 26 May 2012 (UTC)

It's still one analysis. Again, Wikipedia should not be taking the analysis' conclusions as its own. --NeilN ^{talk to me} 02:20, 26 May 2012 (UTC)

All published meta-analyses of RCT data essentially agree on the point, as do the overwhelming majority of reviews, so it should be asserted as fact in accordance with WP:NPOV. For the other published meta-analyses, see Mills et al, Byakika-Tusiime, and Weiss et al; for an overview of reviews see User:Jakew/reviewsumm. It is particularly misleading to characterise the evidence as "One analysis of studies". Jakew (talk) 08:41, 26 May 2012 (UTC)

Question: Do all these analyses analyze the same set of studies? --NeilN ^{talk to me} 13:04, 26 May 2012 (UTC)

All of them include the three RCTs, yes. Every meta-analysis published since they became available has included them, for obvious reasons. Some (Byakika-Tusiime and Weiss et al) also include observational studies in some of the analyses they present; Weiss et al also compare analysis of RCT data with analysis of non-RCT data. Jakew (talk) 14:51, 26 May 2012 (UTC)

What I'm trying to ask is if the other published analyses included other scientific studies and if so, came up with the "38-66%" number. --NeilN ^{talk to me} 14:58, 26 May 2012 (UTC)

Weiss et al, for example, report on a meta-analysis of observational studies: "Circumcised men were consistently found to be at lower risk of HIV infection, and a meta-analysis of the 15 studies that adjusted for potential confounders showed this reduction to be large and highly statistically significant [adjusted risk ratio (RR) 0.42, 95% confidence interval (CI) 0.34–0.54] [14]." They later compare this to the RCTs: "to summarize the protective effects seen in the trials, we conducted a random-effects meta-analysis of results of these three trials, following the recommendations of the QUORUM statement for reporting trials as appropriate [19]. There was no evidence of heterogeneity between the trials (P 1⁄4 0.86), and the summary rate ratio was 0.42 (95% CI 0.31–0.57; Fig. 2), corresponding to a protective effect of 58% (95% CI 43–69%), identical to that found in the observational studies (58%, 95% CI 46–66%) [14]." Jakew (talk) 15:10, 26 May 2012 (UTC)

I'm going to take that as a "yes, analyses looked at other studies besides the ones looked at by the analysis currently referenced in the article." If that's the case, then the wording should be modified and more cites added to support the wording. --NeilN ^{talk to me} 15:48, 26 May 2012 (UTC)

I'm not sure that it would be appropriate, especially in the lead where space is limited, to discuss analyses of lower-quality studies. WP:MEDASSESS seems to support that: "In general, editors should rely upon high-quality evidence, such as systematic reviews, rather than lower-quality evidence, such as case reports, or non-evidence, such as anecdotes or conventional wisdom. ... The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs)." Jakew (talk) 16:20, 26 May 2012 (UTC)

Jake, but the point remains that if a study has been criticised, the lede should either directly mention the criticism, or the lede should even it out per WP:NPOV. I do not dispute this is a meta-analysis, however it would be unencyclopedic to ignore reviews which have given opposing viewpoints. Pass a Method talk 17:53, 26 May 2012 (UTC)

I've already addressed that point, PassaMethod. The existence of criticism does not by itself mean that we should mention the criticism or omit the criticised material. We must consider due weight. If the criticism represents a major viewpoint held by a comparable number of scientists to those endorsing the criticised material, then yes, we must certainly take it into account. But when the criticism represents the view of a tiny, fringe minority, as is the case here (only 2 of the 60 reviews I found were negative towards circumcision as partial prevention against female-to-male HIV transmission), then to do either of the things you mention would give undue weight to the critics. Jakew (talk) 18:05, 26 May 2012 (UTC)

Jake your definition of "due" is pretty skewed up if you ask me. There are several reviews which dispute your version of the article. As long as you repeat such a selective approach to sources then i think that we will not reach concurrence. Pass a Method talk 18:23, 26 May 2012 (UTC)

Well, I'm sorry that you disagree, PassaMethod, but what I've said above is basically just a restatement of WP:UNDUE, WP:GEVAL, and WP:FRINGE. Jakew (talk) 18:34, 26 May 2012 (UTC)

comment Some high-quality sources have disputed the methodological strength of this African study. Therefore the word "strong" should definitely be out of the lede. Pass a Method talk 07:32, 26 May 2012 (UTC)
- Similarly, some "high-quality" (in the same limited sense) sources have disputed the strength of the evidence linking HIV and AIDS. By your argument, we should therefore say that "Some analyses say that HIV causes AIDS". To do so would give undue weight to a fringe source, just as it would do here. Jakew (talk) 08:23, 26 May 2012 (UTC)

The only issue I have with Zad68's current wording is why is something that specific in the lede? The intro paragraph should give a brief overview of the topic, touching on major concepts, and not delve into details. --NeilN ^{talk to me} 14:34, 27 May 2012 (UTC)

I'm afraid that making it any less specific would open it up to complaint about how the findings are characterized. How would you phrase it, "Circumcision is very effective against FTM transmission"? There needs to be one sentence in the lead that summarizes the most important part of the findings about how circumcision affects FTM HIV transmission, as there's about a dozen sentences in the article about it. I don't see any other way to mention it in the lead and have any possibility for it to be stable. Zad68 15:59, 27 May 2012 (UTC)

inability to reach anything approaching consensus

Exactly what is supposed to be done? There is a two month argument, and a doctor (or near doctor) calls for dispute resolution. As it is about to expire, with no consensus in sight, I call for an RFC. One outside editor responds, with mention of "war in a teacup with WLawyers circling overhead." and "I know better than to read it again". Clearly, the wikipedia structure is not working so far. Exactly, what is the next step, when an RFC fails to resolve anything? The Arbitration Committee? Tftobin (talk) 01:40, 26 May 2012 (UTC)

TransporterMan gave a good overview of the options in the DRN thread; see here. Jakew (talk) 07:30, 26 May 2012 (UTC)

Time to move on to step 4 then? I just can't see a compromise solution ever being reached. Maybe that's too pessimistic... Egg Centri c 15:20, 26 May 2012 (UTC)

I'm not opposed to another RfC, but I think we need to try to learn from the previous RfC. Specifically, how can we attract input from more outside editors? I've seen a couple of unsuccessful RfCs recently; neither were neutrally phrased, and in one case it wasn't even clear what the RfC was asking about. It's easy to understand why volunteers would find these characteristics off-putting — I would. So I think we need to take care with the RfC question, to ensure that it's neutral, straightforward, easy to answer, and very, very clear. A little neutral publicity (of the acceptable kinds, such as neutral messages at WT:MED and other places) might help, too. But that's secondary to getting the question right, so I suggest that if we are going to RfC again, we collaborate on the question in advance. Jakew (talk) 18:17, 26 May 2012 (UTC)

I agree. Personally I would like a very broad RfC on all aspects of the article, paticularly reviews of the relevant science. I also want one that won't turn into a witch-hunt. Consequently I'm not sure to what extent, if any, editors' habits should be considered. Egg Centri c 22:14, 26 May 2012 (UTC)

I wonder if there is a way to correlate editors, with both successfully resolved RFCs, and unsuccessfully resolved RFCs? If the same editors are involved in unsuccessfully resolved disputes over and over, this may be an indication that they are simply not prone to consensus. Tftobin (talk) 01:48, 27 May 2012 (UTC)

(Redacted) Egg Centri c 11:21, 27 May 2012 (UTC)

Egg, come on, you've been here long enough to know that article Talk pages are absolutely not the place for this. Would you please remove this very, very off-topic item from this article's Talk page. If you absolutely must follow up on this, I see that Jakew is accessible by email. Zad68 02:31, 27 May 2012 (UTC)

Guys, this talk page is most certainly not the place to be discussing this. Take it elsewhere. I should note that further speculation or discussion of this topic, especially insinuations and speculations about why a fellow editor has or has not taken legal action off-wiki, is governed by our policy on living persons and is frankly, unseemly. You all should know better, and if I see further disruption along this line, I'll take it to administrators. Yobol (talk) 02:07, 27 May 2012 (UTC)

I'm going to go one step further than Yobol. Tom, you watched User:AlexanderLondon get indef-blocked by an admin for harrassing Jakew, in large part for making reference to an off-Wiki attack page. You followed that up with a personal attack against Jake, and another admin called you on it, describing it as a personal attack, and reverted your edit. You now make another personal attack against Jake, making reference to the same site AlexanderLondon referenced when he harassed Jake, by implying that if the attack site's information were false, Jake would sue, so it must be true. This is easily worth a trip to WP:ANI. Tom, please remove immediately the harassing personal attack you have written here about Jakew, and please do not ever again do this. Zad68 02:26, 27 May 2012 (UTC)

I removed the offending entry which you have so vividly described. Was I actually talking about anyone by name, in the quickly reverted entry on Alexander London's talk page? Are you so certain? As I explained to Bbb23, when I said, "Lies get exposed, and corrected, over time", I was not referring to an individual. Tftobin (talk) 04:14, 27 May 2012 (UTC)

A correction: User:Bbb23 who gave you this warning, is not an admin. Zad68 02:59, 27 May 2012 (UTC)

(edited: found five warnings, not three) Tom, for the record, I note that other have as well warned you against making personal attacks. By my count, you have now been warned on five separate occasions against making personal attacks against your fellow editors:

There is a continued pattern of personal attacks continuing after warnings, including today's attack after the 4th warning. Zad68 03:17, 27 May 2012 (UTC)

Do as you please. It isn't like I haven't been personally attacked by some of these people. I've had my comments outside of wikipedia cut and pasted into this very talk page, against the WP:Harrassment policy. I've had some of them agree not to personally attack, only to personally attack within a day. Tftobin (talk) 04:14, 27 May 2012 (UTC)

I have opened an incident report at WP:ANI regarding this incident. Zad68 04:25, 27 May 2012 (UTC)

comment Out of curiosity, is this disagreement still about the word "African" in the lede? Pass a Method talk 20:44, 26 May 2012 (UTC)

It's more about how to present the Cochrane findings and criticism of those findings, see the 2 Talk topics I opened below. Zad68 15:17, 27 May 2012 (UTC)

Talk:Circumcision/FAQ

hello. the faq listed at the top of this talk page only covers the title (circumcision versus genital mutilation). with 72 archive pages, surely the faq should be longer? -badmachine 02:50, 27 May 2012 (UTC)

Outdated HIV and circumcision studies

On review of some of the studies we are using, I note that we are using out-dated sources (reviews from 1999, etc). Certainly systematic reviews that discuss HIV transmission that came out before the recent randomized controlled trials are out of date (and per WP:MEDRS, any studies more than 5 years old is out of date - some of these are much longer than that). I will be removing these studies at some point in the future. Yobol (talk) 22:41, 27 May 2012 (UTC)

Spring cleaning is always a good idea. Most of the older reviews can easily be replaced with more modern sources. I suggest making exceptions for the reviews of complications by Kaplan (1983) and Williams and Kapila (1993), since although these are old, the information that we list is unlikely to be out of date, and I don't think there are more recent sources with the same level of detail. Jakew (talk) 08:04, 28 May 2012 (UTC)

1RR proposal

I invite editors to comment on a 1RR limit proposal here Pass a Method talk 07:01, 29 May 2012 (UTC)

I've removed the RfC tag as it's being misused. Please limit placing that tag to above the actual discussions, not notifications on other pages about the discussion. elektrik SHOOS (talk) 23:26, 30 May 2012 (UTC)

Editorial Judgment

Despite all the heming and the hawing to justify it, "according to policy," the sentence "Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%" can only be included in the introduction by an editorial judgment that consciously slants the introduction in favor of the surgery. Statements to the contrary about "just following sources" and "writing an encyclopidea" don't pass muster. The hiv/aids arguments are the current health scare arguments in favor of circumcvision; assertion of this argument as "strong evidence" by wikipedia itself displays a profound and troublilng contempt for scientific objectivity, as well as condescending scorn for the public reader. Anyway, the English-speaking public are voting against the hiv scaremongering by ignoring it. Wikipedia may panic a few parents into the surgery with its advocacy of the hiv prevention theory; most parents are smart enough to see the absurdity of wikipedias advocacy inthis article. Robert B19 (talk) 00:39, 21 May 2012 (UTC)

Since you've rejected all of the actual arguments made to date in favour of your bad faith theory of deliberate bias, there seems little point in discussing the issue. Jakew (talk) 08:26, 21 May 2012 (UTC)

Are you so certain that the aforementioned editor is the one acting in bad faith? I've found that whenever a wikipedia editor says something similar to "there seems little point in discussing the issue", it is like the Wizard of Oz saying, "The great and powerful Oz has spoken". This is usually the place which most needs to be discussed, and exposed to sunshine. Tftobin (talk) 21:30, 21 May 2012 (UTC)

Please read what you're responding to, Tom. A "bad faith theory of deliberate bias" is a theory that the editors are acting in bad faith by deliberately introducing bias. The key point is that discussion depends upon assuming that other editors are acting in good faith and actually addressing their arguments. Jakew (talk) 11:58, 22 May 2012 (UTC)

Article Talk: pages are for the purpose of discussing article content, not editors. Please review WP:TPYES. Tftobin (talk) 23:25, 22 May 2012 (UTC)

I presume that's directed at Robert B19? Jakew (talk) 07:53, 23 May 2012 (UTC)

Presumption is an awkward game at best, isn't it? Tftobin (talk) 11:38, 24 May 2012 (UTC)

I was already thinking I'd like to see the word "strong" deleted from this sentence. I've just found this article: " (it says it's "open access" but I've only managed to view the abstract) which seems to contradict or partially contradict the sentence. Note in the abstract where it says "the difficulty in translating results from high risk adults in a research setting to the general public". I argue that that supports the idea of removing "strong" and just having the sentence begin with "evidence". I think that one article is enough to support my argument, but here's another one: maybe I can only view the title, but the title seems to say something: "Male circumcision and HIV prevention insufficient evidence and neglected external validity."[16] And here's one; I'm not sure whether I quite understand their conclusion. " the fact that almost 90% of RCTs of interventions for prevention of sexual transmission of HIV have delivered flat results demands careful analysis. " [17] ☺Coppertwig (talk) 17:20, 21 May 2012 (UTC)

Coppertwig, we all owe you a debt of gratitude for finding the study from Journal of Public Health in Africa 2011; 2:e4 by R.S. Van Howe and M.R. Storms. The abstract links to the full text, which actually demolishes the HIV studies that are in the lead. To quote in part from this peer-reviewed article, "Although the World Health Organization (WHO) and UNAIDS have supported circumcision as an HIV preventive in regions with high rates of heterosexually transmitted HIV, the circumcision solution has several fundamental flaws that have been glossed over by its proponents within these organizations. These proponents, who have been touting the “benefits” of circumcision for decades, have developed plans to circumcise Africa on behalf of WHO and UNAIDS .... In this paper, we will expose the lack of scientific evidence, biological plausibility, and epidemiological evidence that provides the foundation for the circumcision solution .... The results of three randomized clinical trials (RCTs) are often presented as proof beyond a reasonable doubt that male circumcision prevents HIV infection.2 After all, RCTs are the gold standard of medical experimentation. However, such accolades only apply to well-designed, well-executed trials. The three RCTs were neither .... The trials were nearly identical in their methodology and in the number of men in each arm of the trial who became infected. The trials shared the same biases, which led to nearly identical results. All had expectation bias (both researcher and participant), selection bias, lead-time bias, attrition bias, duration bias, and early termination that favored the treatment effect the investigators were hoping for.3 All three studies were overpowered such that the biases alone could have provided a statistically significant difference .... Basing policy on studies that were unable to answer their own research question is unwarranted .... African men have reported having undergone circumcision in order not to have to continually use condoms. Such a message has been adopted by public health researchers. A recent South African study assessing determinants of demand for circumcision listed “It means that men don’t have [to] use a condom” as a circumcision advantage in the materials they presented to the men they surveyed.26 If circumcision results in lower condom use, the number of HIV infections will increase .... The men attracted by a free circumcision to enroll in the RCTs are not representative of the general population. The RCT participants were required to want to be circumcised. A faithful monogamous man with a faithful spouse would have little motivation to seek a free circumcision. This selection bias may have resulted in enrollment of men more likely to engage in high-risk behaviors. The free circumcision and financial inducements may have added to the selection bias .... There is no scientific reason to believe that the RCT results would necessarily apply to the general population." Robert B19 (talk) 17:31, 31 May 2012 (UTC)

Same reply posted in the several places Robert has brought up Van Howe & Storm so that we can consolidate into one discussion thread below So you're saying Van Howe & Storm's criticism of the Cochrane review brings up enough doubt that, according to Wikipedia policy and guidelines, we shouldn't use it? Let's discuss that, I will up a new thread for that discussion. Zad68 18:05, 31 May 2012 (UTC)

Assuming good faith does not mean you have to keep believing in a user's good faith where you have reason to think otherwise. Anyone who's spent enough time watching the endless debates here can easily see there's a very clever pro-circumcision lobby editing here. Egg Centri c 16:38, 23 May 2012 (UTC)

Or, to paraphrase, "it's okay not to assume good faith if you don't want to". Jakew (talk) 17:09, 23 May 2012 (UTC)

Do you really think the pro-circumcision lobby is that clever? Or just that blatant, because they know that there in no wikipedia equivalent of a reprimand? Watch. You did not get called out for being off topic, or criticising an editor. Neither did the next editor. Bet I do. That is how things work here, no matter whose attention is brought, or how blatant the rules are bent. Still think it's just a strong interest? Tftobin (talk) 11:28, 24 May 2012 (UTC)

Whether clever is the right word or not (they're certainly not stupid) they're at least knowledgeable enough to use the letter of wikipedia guidelines against the spirit of wikipedia to keep the article pro-circumcision. Egg Centri c 14:56, 24 May 2012 (UTC)

I'm not sure what you're getting at Jake. Of course one still has to show good faith about why someone is pro-circumcision, but at the same time biases shouldn't be ignored when they blatantly spill out into editing. I am certain that if a RfC or RfArb were held on this topic and it were looked at by enough editors then this article would be consdierably less pro circumcision. As an experiment, why don't we all come up with a list of mutually agreed users to avoid editing on this topic for two months, vandalism removal aside, and let's see what uninvolved editors have made of the article by then? Egg Centri c 14:56, 24 May 2012 (UTC)

I'm afraid you've misunderstood, Egg. If someone has made an edit or expressed a viewpoint about article content, then there are usually (at least) two explanations for that: a) that they genuinely believe that this would improve the article in a manner consistent with Wikipedia's pillars, or b) that they wish to push a POV. Assuming good faith means choosing explanation 'a' wherever it is a plausible explanation. Feeling fed up with disagreements or otherwise frustrated does not mean that the explanation is implausible. Whether someone is pro- or anti-circumcision is beside the point, as is why they might hold such a view. Jakew (talk) 15:46, 24 May 2012 (UTC)

My guess is that enough people have been called in for an RFC on this article, that there is total RFC fatigue. The time I called for an RFC, as near as I can see there was only one uninvolved editor who responded. Another wikipedia hole in the process, to be exploited, if someone were inclined to do so. Then a new editor comes in, reacts strongly to what they perceive as obvious imbalance, beats their head on the process for a while, and understandably disappears. I agree with the editor who posted above. Whether someone is pro- or anti-circumcision is beside the point, as is why they might hold such a view. Either no one is in a position to change anything here, about the nature of perceived imbalances, or if they are, that ability is being ignored. Tftobin (talk) 19:46, 24 May 2012 (UTC)

a) and b) are not necessarily exclusive. It is possible to believe that an author believes they are improving an article in line with Wikipedia's pillars and to believe that an author is pushing a POV. Egg Centri c 15:50, 24 May 2012 (UTC)

As a general rule, I think you may be right, but in this specific context I don't think so. The accusation at the start of this thread was that certain editors were "consciously slant[ing] the introduction in favor of the surgery", which (at least as I read it) means intentionally skewing content away from NPOV, and hence is inconsistent with the assumption of good faith. I've no doubt that many editors believe that other editors' actions are contrary to NPOV, and indeed are consistent with a pattern of POV pushing; certainly I hold such a view regarding several editors (I'm not going to name anyone, so please don't ask). To claim that they do so consciously is an assertion of bad faith editing, and one shouldn't do that. Jakew (talk) 16:19, 24 May 2012 (UTC)

I guess it depends what is meant by POV and consciously. It's possible for an editor to believe their POV is infact NPOV, and therefore believe their edits are entirely in good faith and aimed at fixing POV problems, while in the opinion of another editor those edits are causing POV problems. Egg Centri c 16:29, 24 May 2012 (UTC)

Hi Coppertwig. I took a look at the articles. It appears that this is a tricky subject because a number of editors, including yourself, seem to be conflating two different things the Cochrane support says. Cochrane says 1) "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." and 2) "Inclusion of male circumcision into current HIV prevention measures guidelines is warranted, with further research required to assess the feasibility, desirability, and cost-effectiveness of implementing the procedure within local contexts." 1) is a statement about a medical finding, 2) is a statement about how the finding can be used to fight a disease, HIV. The Van Howe article you provided seems to address 2) rather than 1). Meaning, it questions how the medical finding is useful in a general discussion about a program to fight the spread of HIV. I did not at all come away reading the the Van Howe abstract with the idea that 1), the medical finding, was undermined. Certainly not from that short abstract. Please take care to separate these two ideas. The second abstract from Padian et al provided nothing that would warrant a wording change, and I'm not even 100% sure from the timing information I can gather on when each study was release that the Padian article could have been written in response to the Cochrane study. From these two journals, there's nothing that would provide a policy-based reason to change 'strong evidence.' Zad68 17:52, 21 May 2012 (UTC)

Zad, the link Coopertwig probvided blows the HIv studies out of the water. See my response above to coppertwig. Robert B19 (talk) 17:39, 31 May 2012 (UTC)

Same reply posted in the several places Robert has brought up Van Howe & Storm so that we can consolidate into one discussion thread below So you're saying Van Howe & Storm's criticism of the Cochrane review brings up enough doubt that, according to Wikipedia policy and guidelines, we shouldn't use it? Let's discuss that, I will up a new thread for that discussion. Zad68 18:05, 31 May 2012 (UTC)

The problem may be that people don't understand the difference between an argument and a justification. Editors with limited literary experience (or education) outside of Wikipeida's insular environment may not appreicate the wisdom of Encyclpedia Britannicas impartial approach to the same HIV material, introducting it as follows, "Advocates of circumcision cite studies indicating that..." We wouldn't want the public to conclude that Wikipedia's controversial articles a brawl between streetcorner hustlers with an agenda. Robert B19 (talk) 17:12, 22 May 2012 (UTC)

As I've already pointed out, "Advocates of circumcision cite studies indicating that..." is an excellent way of describing the activities of advocates, but not such a good way of describing the relationship between circumcision and HIV. Jakew (talk) 17:19, 22 May 2012 (UTC)

Since you readily admit that it's a pro-circumcision argument, it might be prudent to re-examine its potential for POV abuse in the lead. An HIV medicine for African tribes seems irrelevant to an English-spoeaking population. We've re-read your previous justifications for inclusion, all of them boil down to a narrow exercise of editorial judgement. Robert B19 (talk) 16:33, 23 May 2012 (UTC)

Where, out of interest, did I "readily admit that it's a pro-circumcision argument"? Jakew (talk) 17:07, 23 May 2012 (UTC)

There's a hillbilly booth at the County Fair that reminds me of these discussions. They grease up a pig and people pay a dollar to catch the pig. Guess what... no sooner they catch it the pig squeals and slips away. Robert B19 (talk) 21:20, 23 May 2012 (UTC)

Please do not revert other editors post/concerns on the talk page. Garycompugeek (talk) 14:44, 24 May 2012 (UTC)

Excuse me--"African tribes"? Surely you don't mean to suggest that clinical trials are conducted on shield-beating Zulu warriors? Or that the language a person speaks affects the mechanisms of HIV acquisition? Morrowulf (talk) 04:47, 25 May 2012 (UTC)

A scientific theorry has to be tested in more than a limited geographical poplation to acheive the credibility that would make it a plausible theory. I suggest you offer us some evidence of other experiemnts that confirm the African experiemtns in other parts of the world. Robert B19 (talk) 16:56, 25 May 2012 (UTC)

Robert please review the long history of discussions regarding modifying this sentence. Consensus was never established for changing it, and the way you changed it made it misrepresent the source cited. Please seek consensus here before changing this contentious sentence. Thanks. Zad68 20:28, 25 May 2012 (UTC)

I assure you that I'm very familiar with all the previous discusions, have read them up the gazoo so to speak. Since you agree that the sentence is contentious, I shall assume that you have no objection to a POV tag on the article while we resolve the dispute, which in the opinion of numerous editors weights the article heavily in favor of circumcision. The problem with the previous discussion is that it never directly addressed the responsibility of editorial judgment in the article, and if the truth must be told, too often the previous arguments were like the pea in a shell game, constantly shifting to avoid responding to specific objections. When all else failed a linkj to a previous argument was deemed the proof of last resort, and we were even treated to a digression about the Kuipers Belt beyond the orbit of Pluto I propose that as men of honor, who have no intent to deceive us or the public, you restate your original editorial motivation to include the HIJV studies in the lead, and how and why you came to that conclusion. Robert B19 (talk) 23:22, 25 May 2012 (UTC)

Thank you, Robert B19, for the succinct synopsis. There is so much dissembling and deflection going on in here, sometimes it is hard to keep one's feet on the ground. That was right on the money. Tftobin (talk) 01:22, 26 May 2012 (UTC)

TFtobin, your patience under fire hsas been admirable. So far they failed to restate their original motivation to include th HIV theory in the lead. Other scientists scoff at such a preposterious theory, incapable of being tested or repliacted anywhere else in the world. They jammed it into the article a while back without conscensus, now kill the clock until objections die of inertia. — Preceding unsigned comment added by Robert B19 (talk • contribs) 18:07, 27 May 2012 (UTC)

Robert, honestly I am having a hard time understanding exactly what information you want from me. It sounds like you want me to talk about my motivation for mentioning Cochrane in the lead? This sounds like a personal question--you want me to explain my motivations for doing something. This does not sound like it is on-topic here at this article's Talk page, so I will not respond here, but as you've asked this question several times now, if you can help me understand what it is you are looking for me to explain, I'll do my best on my User_Talk:Zad68 page. I hope this closes this pursuit of what appears to be an off-topic discussion here. Thanks. Zad68 23:15, 28 May 2012 (UTC)

Not your personal motivation, your editorial motivation, as I said above: "I propose that as men of honor, who have no intent to deceive us or the public, you restate your original editorial motivation to include the HIV studies in the lead, and how and why you came to that conclusion." Robert B19 (talk) 20:47, 29 May 2012 (UTC)

The answer is: Per WP:LEAD. WP:LEAD says, in part, that the lead "should explain why the topic is interesting or notable, and summarize the most important points—including any prominent controversies. The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources...." I just went to scholar.google.com and searched for "circumcision"--not "circumcision AND HIV", just "circumcision." Half of the results that I saw on the first page discussed how circumcision relates to HIV, mentioning both circumcision and HIV together in the search result title. About 20 sentences in the article talk about HIV, including a link to a full other Wikipedia article on the topic. In my editorial judgement, two sentences in the lead that talk about circumcision and HIV look to be right on target to meet WP:LEAD. It would be astonishing to me if HIV were not in the lead for this article. Does this answer your question? Honest question back to you: What is your editorial motivation for removing the HIV studies from the lead (if indeed that is your editorial judgment), which appears to go against WP:LEAD? Zad68 21:21, 29 May 2012 (UTC)

There are ten circumcision results on the google scholar first page you found. 4 of them refeer to the RTCs africain oone way or another; that can't be a basis for supporting the HIv theory in the lead. Coppertwig has effectively demoiished it with the article it found. Robert B19 (talk) 17:45, 31 May 2012 (UTC)

Same reply posted in the several places Robert has brought up Van Howe & Storm so that we can consolidate into one discussion thread below So you're saying Van Howe & Storm's criticism of the Cochrane review brings up enough doubt that, according to Wikipedia policy and guidelines, we shouldn't use it? Let's discuss that, I will up a new thread for that discussion. Zad68 18:05, 31 May 2012 (UTC)

I'm utterly mystified by the amount of weight you seem to be assigning to a single fringe opinion piece, Robert. Is there any particular reason why you're viewing Van Howe's claims as the final word on the subject? Jakew (talk) 17:55, 31 May 2012 (UTC)

I should note that the journal in question is an open source journal not indexed in MEDLINE and likely fails WP:MEDRS. A quick look at the editorial board of the journal shows all of one person...never a good sign. Yobol (talk) 18:01, 31 May 2012 (UTC)

Note I have opened a new thread below about Van Howe and Storm's criticism of Cochrane so that we don't have this discussion fragmented out across several threads. Zad68 18:18, 31 May 2012 (UTC)

^ ^a ^b ^c Alanis MC, Lucidi RS (2004). "Neonatal circumcision: a review of the world's oldest and most controversial operation". Obstet Gynecol Surv. 59 (5): 379–95. doi:10.1097/00006254-200405000-00026. PMID 15097799. {{cite journal}}: Unknown parameter |month= ignored (help)
^ Moses S, Bailey RC, Ronald AR (1998). "Male circumcision: assessment of health benefits and risks". Sex Transm Infect. 74 (5): 368–73. doi:10.1136/sti.74.5.368. PMC 1758146. PMID 10195035. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
^ Crawford DA (2002). "Circumcision: a consideration of some of the controversy". J Child Health Care. 6 (4): 259–70. doi:10.1177/136749350200600403. PMID 12503896. {{cite journal}}: Unknown parameter |month= ignored (help)
^ ^a ^b ^c Cite error: The named reference KNMG was invoked but never defined (see the help page).
^ Hutcheson, Joel C. (2004). "Male neonatal circumcision: indications, controversies and complications" (PDF). Urol Clin North Am. 31 (3): 461–467. doi:doi:10.1016/j.ucl.2004.04.011. PMID 15313055. Retrieved July 18, 2011. {{cite journal}}: Check |doi= value (help); Unknown parameter |month= ignored (help)
^ Cite error: The named reference RACPSumm was invoked but never defined (see the help page).
^ ^a ^b Dettmeyer, R; Parzeller, M; Laux, J; Friedl (2011). "Medical and legal aspects of genital mutilation and circumcision. Part II: Male circumcision". Arch Kriminol. 337 (3–4): 85–101. {{cite journal}}: |access-date= requires |url= (help); Text "first4 H" ignored (help); Text "first5 B" ignored (help); Text "first6 H" ignored (help); Text "last5 Zedler" ignored (help); Text "last6 Bratzke" ignored (help)

[alanis2004-1] Alanis MC, Lucidi RS (2004). "Neonatal circumcision: a review of the world's oldest and most controversial operation". Obstet Gynecol Surv. 59 (5): 379–95. doi:10.1097/00006254-200405000-00026. PMID 15097799. {{cite journal}}: Unknown parameter |month= ignored (help)

[2] Moses S, Bailey RC, Ronald AR (1998). "Male circumcision: assessment of health benefits and risks". Sex Transm Infect. 74 (5): 368–73. doi:10.1136/sti.74.5.368. PMC 1758146. PMID 10195035. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

[3] Crawford DA (2002). "Circumcision: a consideration of some of the controversy". J Child Health Care. 6 (4): 259–70. doi:10.1177/136749350200600403. PMID 12503896. {{cite journal}}: Unknown parameter |month= ignored (help)

[KNMG-4] Cite error: The named reference KNMG was invoked but never defined (see the help page).

[5] Hutcheson, Joel C. (2004). "Male neonatal circumcision: indications, controversies and complications" (PDF). Urol Clin North Am. 31 (3): 461–467. doi:doi:10.1016/j.ucl.2004.04.011. PMID 15313055. Retrieved July 18, 2011. {{cite journal}}: Check |doi= value (help); Unknown parameter |month= ignored (help)

[RACPSumm-6] Cite error: The named reference RACPSumm was invoked but never defined (see the help page).

[Dettmeyer2011-7] Dettmeyer, R; Parzeller, M; Laux, J; Friedl (2011). "Medical and legal aspects of genital mutilation and circumcision. Part II: Male circumcision". Arch Kriminol. 337 (3–4): 85–101. {{cite journal}}: |access-date= requires |url= (help); Text "first4 H" ignored (help); Text "first5 B" ignored (help); Text "first6 H" ignored (help); Text "last5 Zedler" ignored (help); Text "last6 Bratzke" ignored (help)

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