Wikipedia talk:WikiProject Medicine/Archive 26

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Wikipedia:WikiProject Unique Identifiers

So, there's a new project which may be of interest to some here. It arises out of Wikipedia:Village_pump_(proposals)#UID_interface_to_Wikipedia, a proposal to make wikipedia articles available by their unique identifier - for instance by their MeSH number. Umm. For reasons which should be all to obvious to anyone interested in computational access to information. And those two pages are all I have to show you, but I live in hope of input from you to take it all further. --Tagishsimon (talk) 21:42, 14 February 2012 (UTC)

List of diets

I'm not sure if this is technically the correct place, but I considered seeking out medical editors to be a good idea nonetheless. I've started to expand this list with brief descriptions, from a predominantly layperson's perspective. Once I've finished the first round of brief descriptions I will restructure it into more appropriate sections. I'll use the subheadings here as a starting point for weight-regulating diets, and add separate ones for religious, vegetarian and other ethically-oriented diets.

The reason I'm posting here is for a bit of advice on how to incorporate the varying scientific opinions and health concerns about many of these diets, particularly for diets where there is not a clear consensus. I've put {{underconstruction}} on the list for the time being, as it would clearly be irresponsible for the list to present itself as usable without touching on the in some cases considerable health concerns. But I'm not sure how to do this in a consistent manner which as far as possible allows the facts to speak for themselves. —WFC— 01:49, 16 February 2012 (UTC)

Merge discussion for Low vision

An article that this Wikiproject has been involved in editing, Low vision, has been proposed for a merge with another article. If you are interested in the merge discussion, please participate by going here, and adding your comments on the discussion page. Thank you. Jonathan Deamer (talk) 20:39, 17 February 2012 (UTC)

Hsp90 a tumor suppressor?

Our article on Hsp90 claims that Hsp90 assists in tumor suppression, but I think this is false. My reasoning is at Talk:Hsp90#Tumor repression?. Could someone please have a look? Thanks, AxelBoldt (talk) 04:55, 20 February 2012 (UTC)

Dispute on merging

From the archive:

What is the prevailing opinion on many short articles vs. fewer longer ones? Does every structure really need a separate article? I'm sure the issue is broader than this, but because I am interested in the hand, this is what caught my eye. I would like to merge, for example, all of the extrinsic muscles of the hand into a single article. At present, each of the muscles have their own separate page. Nearly all of them are a very short stub-class article and a lot of information is duplicated. They have been around for several years in this state and it seems likely they will stay that way.--Taylornate

Yes merging is a good idea. Most diseases deserve there own article but not every muscle and nerve.--Doc James (talk ·contribs · email) 18:38, 28 December 2011 (UTC)

I completed the merge and now suddenly seven weeks later, a couple of users are offended by it. We are discussing it here and I would appreciate any additional input from project medicine.--Taylornate (talk) 18:50, 20 February 2012 (UTC)

You WERE given feedback at the time. --Arcadian (talk) 23:36, 20 February 2012 (UTC)

You said don't merge hundreds of articles without discussion. I sought discussion before merging about ten articles. I got one vague answer from you and one explicit go-ahead from Doc James above. Your recent reversion is unwarranted and contentious. Also, why did you mark your reversions as minor?

I think to maintain clarity we should discuss centrally on the article talk page.--Taylornate (talk) 23:53, 20 February 2012 (UTC)

IMO all the mm of the hand should be in a single article. Only if that article becomes too long should they than be split off into there own individual subpages with a main article keep as summary.Doc James (talk · contribs · email) 13:18, 24 February 2012 (UTC)

Black garlic (food)

I've just reverted User:Jin-ichi sasaki at this article[1] after he broke the formatting and added a reference to something he wrote. That could be fixed, but I am a bit concern about the medical angle. Probably I'm way off base but I don't know much about how we handle such things and would like other eyes. And, if there's no problem, perhaps someone wants to help him fix it? Dougweller (talk) 06:58, 21 February 2012 (UTC)

Vaginal contraceptive film

I've created a new article at vaginal contraceptive film: I would appreciate any scrutiny from more knowledgeable editors, both about the facts of the article, and its presentation. -- The Anome (talk) 14:44, 21 February 2012 (UTC)

Tripterygium wilfordii

The article Tripterygium wilfordii contains quite a bit of dubious medical claims and the whole article may run afoul of WP:MEDRS. It would be helpful if someone with actual medical knowledge took a look at this article. Thank you. — Preceding unsigned comment added by 148.177.1.210 (talk) 18:54, 22 February 2012 (UTC)

Clouding of Consciousness

This article appears odd. The talk page links to Wikipedia:Articles for deletion/Brain fog and there was consensus then, in 2008, to merge or disambiguate. The first sentence is "Clouding of consciousness, also known as mental fog, is a conventional medicine term describing an abnormality in consciousness". It seems like there are some reliable sources given, but I'm skeptical of most of the article. Could someone take a look? Thanks. Jesanj (talk) 21:17, 22 February 2012 (UTC)

Some of us with long memories probably recall Heelop (talk · contribs), who seems to be the driving force behind Clouding of Consciousness. He was a single-purpose account devoted to strenuously promoting the dubious concept of mucoid plaque, and gave up only after intensive effort from numerous editors and admins. Based on that account's history, I'm inclined to be concerned about the current activity at Clouding of Consciousness.

The current article title seems like the result of simple gamesmanship. The AfD concluded that the term "brain fog" was too vague and did not appear in the medical literature. Based on this edit summary, it would appear that Heelop therefore picked a synonym that had a few hits in the (older) medical literature and tacked on an awkward lead sentence explaining that it's a "conventional medicine term". I've redirected it to delirium, which is probably what should have happened a long time ago. MastCell ^Talk 21:42, 22 February 2012 (UTC)

I support the redirect. Clearly having long articles on weird "medical" concepts not based on science is not the way forward. At the same time, I appreciate that not everyone with "clouding of consciousness" has delirium. They might just have difficulty concentrating for one reason or another. JFW | T@lk 22:17, 22 February 2012 (UTC)

I also support some sort of redirect, but wonder if Altered level of consciousness may be a better redirect target. Yobol (talk) 22:43, 22 February 2012 (UTC)

Sure. In any case, User:Heelop has opened a discussion at Talk:Clouding of Consciousness, so perhaps further discussion should be centralized there. MastCell ^Talk 22:49, 22 February 2012 (UTC)

PANDAS

New editor, primary sources, I've notified him of MEDRS, MEDMOS, POV, 3RR on his talk but he's not responding. SandyGeorgia (Talk) 03:38, 24 February 2012 (UTC)

A whole lot more, primary sources, not a recognized condition, content fork to another article (?) just loaded up by same editor previously attempting same at PANDAS: Pediatric acute-onset neuropsychiatric syndrome. SandyGeorgia (Talk) 17:54, 24 February 2012 (UTC)

• Wikipedia:Articles for deletion/Pediatric acute-onset neuropsychiatric syndrome SandyGeorgia (Talk) 18:25, 24 February 2012 (UTC)

Input needed at Talk:Sex_reassignment_surgery_(male-to-female)#Requested_move

The proposal is to change it to "surgery for trans women". (My own view is to use what the surgical RS's use and to change it when the predominant term across the RS's changes.) Any input would be welcome.— James Cantor (talk) 00:12, 26 February 2012 (UTC)

New article bot

I've only recently learned about User:AlexNewArtBot/MedicineSearchResult; I don't see it mentioned on the project page here, did I miss it? SandyGeorgia (Talk) 15:34, 26 February 2012 (UTC)

It's towards the end of ===Other ideas===, under "Tag the talk pages of medicine-related articles". I don't think that anyone is systematically sorting through the page these days, although I take an occasional look. You might also want to add importScript("User:Fred Gandt/getUnpatrolledOfAlexNewArtBotResultsPages.js"); to your /common.js file; that will let you identify which of the new pages still need to be patrolled. WhatamIdoing (talk) 03:33, 27 February 2012 (UTC)

More eyes on Gc-MAF and A-N-acetylgalactosaminidase please

New user Gcmafexpert has been making additions to the above articles which are copyvios and do not meet MEDRS requirements, as well as what looks like continually adding spam links to laboratories that do testing in this area. More eyes would be appreciated. Yobol (talk) 16:47, 26 February 2012 (UTC)

Someone needs to look out for Physical therapy education

Over the last few months, sections of that article have been blanked or replaced with poorly-written, less-informative ones, without anyone noticing. So far, I've gone and reinstated two good sections that had been mangled. Could some of you please watchlist this article so the same thing doesn't happen in the future? Thanks! — Preceding signed comment added by Cymru.lass (talk • contribs) 18:42, 26 February 2012 (UTC)

Reactive attachment disorder

On my computer, this featured article only displays the first 40 references. I don't know why. Biosthmors (talk) 17:57, 27 February 2012 (UTC)

A bot had been used to insert extra parameters in two references, but the bot had mangled the refs by opening an HTML comment and not closing it. I've removed the "blockage" by deleting the HTML comments, and I think I've got the references right now, but the subject is not my area of expertise, so I'd be grateful if someone who knows about RAD could check that the text:

• "In addition to these changes, the DSM-V proposed revision changes also stipulate that the child cannot meet the criteria for an Autistic Spectrum Disorder, which is not specified in the DSM-IV-TR"

is adequately supported by the reference:

• "Diagnostic and Statistical Manual of Mental Disorders: Text Revision. American Psychiatric Association. 2000. pp. 943".

Cheers, --RexxS (talk) 20:52, 27 February 2012 (UTC)

Ugh, just looked, and see that a direct quote of DSM criteria (along with some other tangential stuff) was added there. Folks should be aware that the APA (publisher of DSM) guards their copyright most jealously, does not allow direct quoting or close paraphrasing, stays on top of that on the internet, and has in the past written to WMF (OTRS) to get all issues of quoted diagnostic criteria removed. We had to go through every blooming instance of DSM criteria in articles. I'm concerned about other things happening at that article, but I only removed that part. SandyGeorgia (Talk) 21:04, 27 February 2012 (UTC)

Do you remember where the on-wiki discussion was? I'd be interested to read how fair use exemption was dealt with. Nathan ^T 21:23, 27 February 2012 (UTC)

Give me about an hour and I should be able to find it. SandyGeorgia (Talk) 21:25, 27 February 2012 (UTC)

OK, my first clue was at Talk:Tic_disorder (you can see the wording there), which left me astounded since I was previously aware of the issue of how jealously the APA guarded copyright and had very carefully crafted the text in my own words. The APA complained about a number of articles, so there was a whole big investigation. It took them a long time to clear me ... I was persistent :) The rest is here. I was told long before I came to Wikipedia that the APA would also take on Fair Use claims. SandyGeorgia (Talk) 21:42, 27 February 2012 (UTC)

Awesome, thanks. It looks like fair use wasn't even raised, I wonder why. It's been treated like a DMCA takedown, maybe I'll ask MRG if that was because of the way it was written (i.e. without properly attributed direct quotes in those few instances where the text wasn't fully paraphrased), or if the WMF responds that way to all complaints of copyright ownership of text. Thanks again, Nathan ^T 22:31, 27 February 2012 (UTC)

Erection article

There is a discussion at Talk:Erection#Reverts of recent edits about whether or not a section about nocturnal penile tumescence should be titled by its medical name or one of its various slang names ("morning wood"). Two editors (I'm one of them) are for the medical name, while one editor is for the slang name. This same editor also tried to get the Nocturnal penile tumescence article titled by this particular slang name. And the slang name also currently exists in the Puberty article. Some help from the Med project on this matter would of course be appreciated. 49.212.13.55 (talk) 00:22, 28 February 2012 (UTC)

An RfC has been posted by me at Talk:Erection#Reverts of recent edits; I had not previously been aware of this earlier post here. Your participation will be welcomed. Milkunderwood (talk) 01:06, 28 February 2012 (UTC)

I was a participant in the discussion concerning the unsuccessful move request from Nocturnal penile tumescence to Morning wood, which involved the same editor and arguments. I have not previously been aware of the problem at Puberty. Milkunderwood (talk) 01:16, 28 February 2012 (UTC)

Proposal to add an edit notice to every medical article

I propose adding this edit notice to every medical article. --Anthonyhcole (talk) 12:44, 24 February 2012 (UTC)

For everyone or just non logged in or new users? Doc James (talk · contribs · email) 13:10, 24 February 2012 (UTC)

Sorry Anthony but I don't support that. For a start it is way too long and I don't want to have to scroll down a screenful every time I click edit. It includes non-medical-article editing advice that if you think people need reminding of every time they click edit, then this forum isn't the place to ask. Some of it repeats the text below your edit window anyway. I don't think the opening sentence will be acceptable on the encyclopaedia anyone can edit because it asks the reader to treat every medical article like it was semi protected. I don't agree with the recommendation to use those cite templates. Colin°^Talk 13:14, 24 February 2012 (UTC)

I would support something that is medicine specific regarding referencing and a couple of sentences long at most. Agree we do not need to give general advice.--Doc James (talk · contribs · email) 13:25, 24 February 2012 (UTC)

James, I guess all users.

Thank you for your detailed and thoughtful criticism, Colin. I understand your concern about scrolling down for every edit. We could add a button that permanently dismisses the edit note when a logged-in user clicks it, like we have for fundraising ads.

Regarding the non-medical-article editing advice you criticise, if you'll copy the text you're referring to here, I'll be very happy to tell you why I think it's essential for a serious scholar who would like to contribute correctly first time to a medical article.

Yes, some of it repeats the text below the edit window. But that patchwork of bad layout below the edit window is unreadable. However, if there's some way of removing the duplication from below the box for medical articles that have this edit note, then I guess we should do that.

As for whether this is the correct forum to float this proposal, we disagree.

On the edit note's opening clause, "The easiest way to edit this article is to go to its discussion page and persuade the regulars to add the content for you," I see nothing wrong with that. It's not asking permission, it's asking a favour. It happens all the time, and I'd like to see a lot more of it. If they're too busy or lazy or non techie to quickly master wikicode, at least they've mooted the idea on the talk page. Often such comments or requests get acted upon.

I accept your criticism regarding citation templates, in fact, this is an older version of the template this proposal is based on. The current advice is

Citing sources

• Content not accompanied by an inline "citation" (a footnote marker like this^[14] linked to specified pages in a journal, textbook, etc.) that supports it might be deleted.
• Copy the style of other references in the article and type your reference between <ref> and </ref>. When you save your work, the footnote marker^[14] will appear in the text where you typed the above, and the full reference will appear at the bottom of the article in the list of references.

James, I agree the mini-tutorial is complicated; it is so because the editing process is complicated. As Wikipedia improves its user interface, so, presumably, the tutorial will become shorter. --Anthonyhcole (talk) 14:25, 24 February 2012 (UTC)

I think the idea of an editnotice for medical articles is a good one, but I agree with Colin's concerns. The editnotice will need to be simple and user-friendly, because in the end we don't want to intimidate or scare off novice editors. I'd suggest something friendly and welcoming, followed by a brief pointer to WP:MEDRS since that's really the only "special" guideline that's unique to medical content. MastCell ^Talk 21:35, 24 February 2012 (UTC)

I support the general idea too, as long as the notice isn't too long. I think it would be very useful for those new to editing medical articles to be made aware of MEDRS, as I think this can sometimes be a bit unexpected. One question: how difficult would this be to implement, technically? Jakew (talk) 21:41, 24 February 2012 (UTC)

Is there a precedent for WikiProject-specific edit notices?

I disagree with the statement "The easiest way to edit this article is to go to its discussion page and persuade the regulars to add the content for you". Given the sheer size of WikiProject Medicine and its limited number of editors/page-watchers, is is likely that many edit requests will go unactioned for a while. I believe that the best way to edit the article is to do it yourself. A talk page request should not be presented as the "easiest" way.

A more cynical view is "The laziest way to edit this article is to go to its discussion page and persuade the regulars to add the content for you".

Also, I too am concerned by the length of the notice. Axl ¤ [Talk] 22:36, 24 February 2012 (UTC)

I agree that a pointer to MEDRS would be helpful, but echo the above concerns that we do not want to make (or give the appearance of making) editing medical articles harder. Yobol (talk) 22:53, 24 February 2012 (UTC)

Thanks for the feedback, everybody. I'm not aware of a precedent for a category-specific edit notice, Axl. I presume it's doable, and the Foundation will, I'm pretty sure, fund the technical work required to support it. There seems to be no support here for a detailed mini-tutorial, but some support for a pointer to MEDRS and, possibly, something about citation. Have I got that right? If that's the case, once the text is agreed I'll take it to the Foundation and get it implemented. Text suggestions would be appreciated. --Anthonyhcole (talk) 01:21, 25 February 2012 (UTC)

I'd suggest something very simple, along the lines of

Editing Wikipedia's articles on medical topics comes with some special guidance at MOS:MED and WP:MEDRS.

LeadSongDog come howl! 02:17, 25 February 2012 (UTC)

Aside from the TLDR length, the "citing sources" section has me most concerned. Following those directions at an article like Breast cancer awareness means that the editor will be screwing up. Most of our articles happen to use ref tags, but not all of them. Furthermore, in an unref'd article (and we have about a thousand of them), following those directions will produce a scary red error message. WhatamIdoing (talk) 03:23, 25 February 2012 (UTC)

Those are all good points. Do you have any thoughts on LeadSongDog's suggestion? --Anthonyhcole (talk) 03:48, 25 February 2012 (UTC)

I like Lead's suggestion with maybe a short welcome yes you can edit and a brief outline of WP:MEDRS (like we typically use review articles and major textbooks as references rather than primary research studies) however there are exceptions. The main page has a notice above the edit box. And I am sure a bot could add this sort of notice to all medicine related pages.Doc James (talk · contribs · email) 11:42, 25 February 2012 (UTC)

LeadSongDog's suggestion, while brief, isn't grammatically correct and is a general notice rather than one concerning the article they've just pressed [edit] for. AFAIK the most common abbreviation is WP:MEDMOS. But as MastCell says, the only important specific guideline to mention is WP:MEDRS. There's absolutely no need for newbies to have conform to MEDMOS in their first edits. Although a link to MEDMOS could be added ("for advice on style and layout issues concerning medical articles...") I think adding styleguides to an edit-notice would be much harder to get approval for as then every project would want their own style guides promoted that way. Getting citations right is hard and is a general problem for all articles. So I really think that issue should be dealt with by the general WP community.

Looking at the BLP notice, how about:

This article should adhere to the sourcing guidelines for medical subjects.

I suspect whatever we write may not be noticed just like the "Please note" text below the edit window gets ignored. There's only so much we can do. Perhaps it should be red and flashing :-). Colin°^Talk 12:06, 25 February 2012 (UTC)

First, Dutch pages have all a nl:Template:Disclaimer medisch lemma ('{{Disclaimer medical lemma}}') on top, which I like. I'm not sure whether we have any examples of category or wikiproject-specific edit notices, but for groups of certain interest I would not be against it. BLP's have one because of their status, one could consider that medical pages could have something as well. It would have to be to the point, and not go into the general edit concerns, but concerns specific to medical articles, which, IMHO, is mainly the proper referencing of data, maybe:

Just to notify them that they can't use stuff found on some blog. It would be nice that editors are also following WP:MOS/WP:MEDMOS, but I think the WP:MEDRS-thing is vital. I would be happy if editors add some mis-formatted stuff which is nonetheless 'medically sound' (no pun intended) and properly referenced, then that it is nicely and properly referenced, but totally unreliable and badly referenced. --Dirk Beetstra ^{T C} 12:03, 25 February 2012 (UTC)

Agree (see my post above). To be honest, I think most people don't have a clue what "third-party" means wrt sourcing. WhatAmIDoing is our expert on such wordings and the difficulties people face understanding primary/secondary/tertiary, first/second/third-party, etc. I don't think the notice should go into any details or attempt to nutshell MEDRS or other policies. Just point them to the appropriate guideline(s). I like the (i) icon and think that would help. Colin°^Talk 12:11, 25 February 2012 (UTC)

That is true, but people will hardly read the notice (but they may), people will for sure not follow a link to a guideline. I see that effect A LOT when I am reverting someone with 'rv per Special:Random' - people re-revert with 'why did you revert my edit?'. I think that if it contains some nutshell wording that that would have more effect. Maybe

? --Dirk Beetstra ^{T C} 12:19, 25 February 2012 (UTC)

I think the key point we need to get across is "Please use reliable sources as described in Wikipedia:Identifying reliable sources (medicine). These typically include review articles and major textbooks published in the last 3-5 years. Welcome to Wikipedia and thank you for contributing." I do not think we need a medical disclaimer.Doc James (talk · contribs · email) 12:27, 25 February 2012 (UTC)

I support the solution proposed by LeadSongDog. It's simple and very much medicine-related, no general advice. NCurse _work 17:02, 25 February 2012 (UTC)

This isn't really appropriate for all of our articles. I'd guess that we more than 2000 biographies within our scope. It also isn't relevant to our many articles about medical schools, biomedical device manufacturers, etc. I'm consequently not sure that we should apply any notice to 100% of the articles we've tagged. WhatamIdoing (talk) 20:40, 25 February 2012 (UTC)

I agree that the edit notice should only appear on articles for which its advice is relevant. --Anthonyhcole (talk) 13:24, 26 February 2012 (UTC)

I agree. BLP articles are much easier to tag, though of course biographical information can appear in non-bio articles too. Our scope is much harder to define, and even within a medical article, not all sections may be in need of MEDRS guidance. Sourcing really isn't as simple as saying "please use recent reviews". That's an easy thing to say for someone with ready access to the best sources. We don't require FA-level sourcing from newbies. Colin°^Talk 22:11, 25 February 2012 (UTC)

OK. What about

Health-related information in Wikipedia articles should reflect the current consensus in the medical and scientific literature. Ideal sources for medical information are detailed in our sourcing guideline for medical subjects.

? By referring to "health-related information" it includes content in articles that may not be specifically about a medical topic (e.g., lead poisoning in Lead) and also excludes content in medical articles that is not covered by WP:MEDRS. --Anthonyhcole (talk) 06:53, 26 February 2012 (UTC)

Why refer to "health-related information" at all? This is an edit notice above a specific article, and isn't going to appear in Lead. So just say "This article...". But overall, I'm not convinced this is worth the effort. Those who come here to push a POV won't be put off by a little notice. And tagging some articles (such as CAM ones) may just cause a whole load of grief. Colin°^Talk 07:49, 26 February 2012 (UTC)

Forget it. This wasn't about the battle between "us" and POV pushers. It was about making it easier for scholars, who can read and understand five paragraphs of clear explanation, to contribute their expertise to an article. As far as effort goes, I offered to shepherd this through. All I needed to know was what do we want to tell new medical editors. --Anthonyhcole (talk) 11:09, 26 February 2012 (UTC)

Anthonyhcole, if you're looking to help scholars, then a notice once they've already hit the edit button isn't really the best way. I think our main problem is getting scholars to hit the edit button at all. An edit notice is like the terms and conditions page you automatically click on when you install software. Nobody reads them. Colin°^Talk 12:12, 26 February 2012 (UTC)

I disagree. I think a reasonable person would expect to be told how to edit, the first time they click "edit". I realise it's longer than we'd all like it to be but, as I said earlier, that is because the editing process is complicated. I don't believe we should fail to offer new editors an essential tutorial when they first click "edit" just because it's longer than a single sentence. --Anthonyhcole (talk) 13:07, 26 February 2012 (UTC)

As a newbie, the biggest hurdle was hitting that "edit" button for the first time (and that's only partly because I couldn't find the damn thing). Some sort of message like ones suggested above or even an intermediate "fyi" page would not have turned me off by that point. In my mind, anything that makes the editing process sufficiently distinct for medicine articles would serve to emphasize the tighter standards we try to uphold. Wafflephile (talk) 17:19, 27 February 2012 (UTC)

• Don't agree with adding any notice. Perhaps a little pointer to WP:MEDRS and WP:MEDMOS at the talkpage might make sense. II | (t - c) 08:00, 26 February 2012 (UTC)

  That's already done. The first sentence of the {{WPMED}} banner points to MEDMOS and MEDRS. WhatamIdoing (talk) 03:26, 27 February 2012 (UTC)

There are lots of topics with special circumstances that would invite similar warnings. This as a default template wouldn't work. As said above, certain pages have concise versions of the same warning. In extreme cases they can be added, but not as a blanket addition. Shadowjams (talk) 08:46, 6 March 2012 (UTC)

Giving MEDRS teeth, similar to BLP

• I appreciate that Anthonyhcole is trying to find a way to address a big problem that affects the accuracy of our medical content and makes editing more difficult for all of us than it need be, but I despair that we haven't found a way to get most folks (experts, advocates alike) to read MEDRS regardless of how often or where we link to it. POV pushers and advocates will continue to ignore it in droves, as they always have. I'm engaged in one article now where MEDRS was explained in detail to a new user two years ago, yet he came back after an absence and took up right where he left off, and non-medical editors are contributing to the problem of incorrect use of sources by supporting his reverts that include medical inaccuracies-- using primary sources to promote a POV. The way forward on this dilemma is for all of us to begin working to give MEDRS some teeth, similar to BLP. No amount of trying to get folks to read MEDRS is going to solve the problem; we have no support from admins and other editors when it comes to reinforcing MEDRS. See discussion here. SandyGeorgia (Talk) 15:40, 26 February 2012 (UTC)

• Sandy, are you suggesting we should have the right to summarily remove potentially misleading or harmful medical info from articles, as we do with potentially libelous or gratuitously harmful information from BLPs, and elevating MEDRS to policy status? --Anthonyhcole (talk) 00:45, 27 February 2012 (UTC) I just followed your link, Sandy, and have a better picture of where you're coming from. I'll read the TimidGuy case, and ASCII's and Short Brigade's links when I get back from work. --Anthonyhcole (talk) 01:39, 27 February 2012 (UTC)

• You already have the right to summarily remove potentially misleading or harmful medical info from articles. This is a wiki and bold editing is encouraged. You may find yourself confronted by POV-pushers who have their own reasons for wanting that info in the article; but NPOV is worth the effort in defending. It's always worth remembering that both policy and guidelines are meant to be descriptive of what we do on the wiki, not prescriptive of the only way that we are allowed to edit. Nevertheless, the practices described by WP:MEDRS enjoy considerable consensus, and the onus is always on the dissenter to produce good reasons why they should not conform to that consensus. In that sense, "policy" or "guideline" makes little difference: breaches of MEDRS for no other reason than personal preference are disruptive, and there are sufficient editors who understand MEDRS to ensure that you don't have defend it on your own. I must admit to a degree of dismay at the seeming inability of ArbCom to grasp the value and necessity of MEDRS; but the answer to that is not to complain, but to take steps to ensure that ArbCom is educated in the value of guidelines that ensure the highest quality sourcing. Anyone for a petition for starters? --RexxS (talk) 01:16, 27 February 2012 (UTC)

Strong support that we give MEDRS teeth. Not sure how to do this though. Doc James (talk · contribs · email) 10:20, 4 March 2012 (UTC)

Carcinosis

I converted a ported dictionary definition to an outline article. Because the term is used in a variety of contexts, I'm thinking that it might be better of to redirect to Metastasis, with or without merging my changes. What I did was superficial (e.g. I never discussed lymphomatosis). There is a paucity of clinical definitions, and I suspect that WP:NOTDICT should doom my efforts.Novangelis (talk) 20:41, 29 February 2012 (UTC)

Melatonin

At, of all place, Talk:Maple syrup I saw someone saying how untrustworthy this article is and how it's been taken over by vendors of OTC drugs. Could someone who has a clue please take a look? Thanks. Dougweller (talk) 15:02, 1 March 2012 (UTC)

It truly is in a sad state. Lots of outdated sources to back claims that it's harmless, will cure cancer, you name it. Thanks for highlighting it.LeadSongDog come howl! 20:19, 2 March 2012 (UTC)

I've just taken out the dosage section (as you did earlier). I started to look though the text and found myself adding two {{cn}} and two {{Unreliable medical source}} in the first section I looked at. I've checked PubMed and Google Scholar and there seems no shortage of reviews in several different areas concerning melatonin, so there's no reason that I can see to pack the article with primary sources. Looking at the talk page, I'm expecting some resistance to any insistence that MEDRS is followed, so any extra eyes would be welcome. --RexxS (talk) 00:24, 3 March 2012 (UTC)

Procedures to detect demonstrable untruths

Please see User talk:Jimbo Wales#Procedures to detect demonstrable untruths (permanent link here), which discusses matters pertaining to the use of the word glucojasinogen in the article "Diabetic neuropathy".
—Wavelength (talk) 20:11, 2 March 2012 (UTC)

RFC on reversion of merge of hand muscles

You are invited to join the discussion at Talk:Extrinsic_extensor_muscles_of_the_hand#RFC_on_reversion_of_merge. Should the merge of articles on individual muscles to Extrinsic_extensor_muscles_of_the_hand be reverted? Taylornate (talk) 04:03, 4 March 2012 (UTC)

Phytosterols

I have added the most recent non-evidence and wondering what to do with the rest of the article which does pretend some kind of beneficial effect by summarizing tons of valid but totally irrelevant health claims? Richiez (talk) 11:53, 4 March 2012 (UTC)

I had a go at collecting the health claims in one section and then summarizing some of the overly detailed stuff, but I'm not sure that it helped very much. There's a fair bit of work that needs to be done. WhatamIdoing (talk) 02:58, 5 March 2012 (UTC)

Cerebroretinal microangiopathy with calcifications and cysts

Article put up in one edit by a brand new editor; could someone have a look, and also anyone who knows this area might be the best person to welcome the folk. SandyGeorgia (Talk) 02:22, 5 March 2012 (UTC)

The article looks good. The editor (Tekivela) is clearly not a newbie. Axl ¤ [Talk] 13:30, 5 March 2012 (UTC)

I have left a welcome message. Axl ¤ [Talk] 13:35, 5 March 2012 (UTC)

Comment required for medical merge

Please comment on a proposed merge at Talk:Warfarin necrosis. Thank you, D O N D E groovily Talk to me 05:15, 5 March 2012 (UTC)

Merge completed. Biosthmors (talk) 16:16, 7 March 2012 (UTC)

Deep vein thrombosis

I have been working on this article for a while, and I have listed it for a peer review. I started the Classification section, and I have rewritten the Causes, Prevention, and Pathophysiology sections. Those sections are the main ones I'm asking for feedback on. I've edited some in other sections, but I have not yet done anything with Signs and symptoms or Diagnosis. Thanks. Biosthmors (talk) 16:44, 7 March 2012 (UTC)

Deletion review for Gabriel Cousens. Input requested.

There's an interesting discussion going on at Deletion Review over whether an article about a prominent raw foods advocate and spiritual teacher should be created or continue being deleted. Of note, there is a controversial section in the article which has raised questions about reliable sources. The article relays medical claims made by the practitioner. The subject also requested deletion of the prior article in an Afd. I would appreciate any thoughtful comments or criticism, especially in the area of your speciality, which is the quality and sufficiency of the reliable sources used (or not used) in this article, and the handling of medical claims. Cheers, Ocaasi ^{t | c} 17:52, 7 March 2012 (UTC)

Revision and Expansion of "Prenatal Care"

I am revising and expanding the Prenatal Care Wikipedia article. The current Wikipedia page is limited to discussing only the issue of prenatal care in relation to race and ethnicity while glancing over the role that socioeconomic plays in the quality and accessibility of prenatal care services. The page is listed as an article in need of cleanup in order to meet Wikipedia's quality standards. My revisions will include reformatting this article to meet Wikipedia's quality standards. My expansion of the article will include a new subtopic entitled "Prenatal Care and Accessibility." This subtopic will expand on the issue of the degree of accessibility of prenatal care services (issues over both lack of knowledge, and availability of prenatal care services), in low-socioeconomic areas. This article is already a part of WikiProject Medicine.

I hope to spread knowledge about prenatal health services that are vital to women's health.

I have gathered academic resources which I would use to expand the article. I was wondering if any WikiProject Medicine members have further resources that could possibly assist in my revisions and expansion along with recommendations on how to improve the overall content of this article. Does anyone have an opinion on whether or not the article presents enough content on prenatal care itself? Any feedback over this particular page is greatly appreciated. Allyssa.abacan (talk) 20:57, 8 March 2012 (UTC)

Revision and Expansion of "Elderly Care"

I'm part of a class at Rice University, in the Poverty, Justice & Human Capabilities minor program, that focuses on issues of global inequality. One of note that has not received much traffic on Wikipedia (likely because it is largely ignored in the US and simply because the article is not done in-depth) is Elderly Care. I plan to spend the next several weeks expanding this article in relation to a few WikiProjects: WP:Economics, WP:SOCIOLOGY and WP:MED, of course. Elderly care certainly falls under the category of Medicine. Clearly, caring for the elderly when they no longer can by themselves any more is an issue of health and age more than anything else. Placing your own life in the hands of others is a bold and often frightening move, so assurance of the utmost daily or urgent medical care, whenever it could possibly be needed, is pivotal.

My goal is to increase the web's awareness of global elderly care. I'm certainly fascinated to see how countries other than the United States handle medicine within the scope of their elderly care, but I also want to make sure I look at the US and other western countries, as we could certainly work on our standards.

Especially since this is my first contribution to Wikipedia, I would love any and all feedback from fellow WikiProject Medicine members and any other members of the Wikipedia community. If you know anything about Geriatrics professionally or recreationally, I would love to hear from you. Also, if you can give me tips on how to stay consistent with writing format of Wikipedia entries, I would greatly accept!

Ellyhutch (talk) 18:51, 8 March 2012 (UTC)

Welcome to Wikipedia. You might find WP:MEDMOS useful for style information, as well as some suggestions on things to include. WP:MEDRS has information about finding the best possible sources, which are usually review articles or university-level textbooks (but, naturally, what kind of source is best depends on what kind of information you're trying to support at the moment). This is a good page for asking questions if you need help with anything in particular. Good luck, WhatamIdoing (talk) 05:37, 9 March 2012 (UTC)

Revision and Expansion of Immigrant health care in the United States

I plan to expand upon the stub article, Immigrant health care in the United States. This article, already designated within the scope of WikiProject Medicine, is currently rated as low-importance. However, I feel it is necessary to revise and contribute more to this article because of its social implications, especially as they concern the distribution of health resources. This article will focus largely on the unequal health care access between immigrants and native-born citizens, as related articles such as Health care in the United States do not shed so much light on such. Because the existence of this disparity has major consequences for the lifestyles of the U.S.’s foreign-born population, this article should garner more attention as a more thorough, fully-developed entry.

While this subject does not refer specifically to a particular medical disease or condition, WikiProject Medicine’s stated goals focus on providing information on a variety of health-related topics. As such, I feel that health care—specifically of immigrants in the U.S.—is relevant and complies with that aim. Therefore I wish to further develop this entry by contributing more thorough background information, all supported by texts from medical journals, policy reports, and government data. Should any objections against this expansion/revision rise, I would appreciate all input and feedback. JoyceChou (talk) 02:54, 9 March 2012 (UTC)

Welcome to Wikipedia. When WPMED rates a page like that as "low importance", we really mean that the page is low on the overall priority list for improvements, not that it's unimportant in the real world. Most pages that are about health issues in a single country are low priority. I'm sure that everyone would appreciate having it improved. This is a good page for asking questions if you run into any trouble. Good luck, WhatamIdoing (talk) 05:41, 9 March 2012 (UTC)

Article Contribution "Human Subject Research"

It is my intention to do a revision to the "Human Subject Research" article. The article will more focus on the abusive aspect of these clinical trials however. Some of these abuses include the exploitation of poor patients in developing countries, conducting trials without patient consent and the lack of subject education about potential participation risk. I feel that in the medical community, we do not have enough dialogue about the protection of patient rights. I also feel that it is our duty to inform the general public not only about the positive aspects of medicine but the downsides as well. Many people who go into the healthcare field do so with some form of altruism. We need to return to that culture of care. I would appreciate feedback on the opinions you have about the outsourcing of many American pharmaceutical company trials to the developing world. B4change1 (talk) 07:34, 9 March 2012 (UTC)B4change1

No doubt many of us at WP:MED have opinions regarding the matter. However our task at Wikipedia is to write encyclopedic articles supported by reliable sources. Wikipedia is not the right forum to discuss such issues. Axl ¤ [Talk] 15:33, 9 March 2012 (UTC)

B4change1, in your statement, you've adopted a non-NPOV, which is fine, because it's your opinion. But for human subject research to say X is an exploitation of Y, it would require the overwhelming majority of reliable sources to reflect that POV. It's fine you have a particlar research interest, and it's fine you want to document it here (assuming you have reliable sources), but please consider trying to give articles their due weight. Otherwise, editors could perceive the article to be inappropriately written or undue. Biosthmors (talk) 19:46, 9 March 2012 (UTC)

Extensive Revisions of Malnutrition

I am an undergraduate pre-medical student at Rice University, and through my studies and experiences I have become passionate about health issues pertaining to unequal access to resources. I am excited to revise the malnutrition page in Wikipedia, which is part of WP:MED. While researching malnutrition, I came across a few conflicting definitions which made it difficult to understand exactly what malnutrition is. UNICEF defines malnutrition as a result of a diet that does not provide the adequate calories and protein necessary for survival (http://www.unicef.org/progressforchildren/2006n4/malnutritiondefinition.html). Based on this understanding, the current article has an incorrect definition and focus. It discusses deficiencies of nutrients (vitamins and minerals), while only briefly addressing calories and protein. I propose to correct this faulty information and refocus the article on the actual definition. This will involve deleting certain parts of the article. As I am not an expert in the field, I would appreciate feedback and critique throughout the process.

As my contribution is for a “Poverty, Gender, and Development” course, I will be adding a section on gender issues relating to malnutrition. Also, people (especially women) with low socioeconomic standing are disproportionately affected by malnutrition. I seek to bring up more social issues surrounding the causes and effects of malnutrition, and plan on adding the article to WP:Economics and WP:Human Rights to encourage more collaboration between these groups on this issue.

Through my research I have sought well-founded arguments and credible research, but I am seeking feedback and input on the most crucial issues pertaining to malnutrition. Through this process, I seek to raise awareness of the causes and effects of malnutrition, and advocate thinking on possible solutions and policy changes that could diminish the extent of malnutrition. Khatchell (talk) 09:07, 9 March 2012 (UTC)

Welcome to Wikipedia. I think the first thing you need to do is to reflect on the inherent contradiction in your first paragraph. You first say that there are many conflicting definitions, and then you say that you want to correct the article to reflect "the actual definition".

It is not logically possible for both of these claims to be true. Either there are multiple valid definitions (in which case, the article should address all of them, not just UNICEF's) or there is a single "actual definition" (in which case, the article needs to be corrected to ignore all the other definitions). WhatamIdoing (talk) 15:57, 9 March 2012 (UTC)

Actually, the problem is simpler than that. The cited UNICEF source says something different than what is attributed to it above:

Malnutrition is a broad term commonly used as an alternative to undernutrition but technically it also refers to overnutrition. People are malnourished if their diet does not provide adequate calories and protein for growth and maintenance or they are unable to fully utilize the food they eat due to illness (undernutrition). They are also malnourished if they consume too many calories (overnutrition).

That may not be the best or only definition, but it is considerably better than what Khatchell describes. Still, the topic has seen significant changes since the 2009 publication of WHO child growth standards and the identification of severe acute malnutrition in infants and children by the WHO and UNICEF. It could use some attention, particularly to the application of non-wp:MEDRS sources. LeadSongDog come howl! 18:01, 9 March 2012 (UTC)

Yes, I agree that the definition I presented for malnutrition is incorrect. I meant to include both undernutrition and overnutrition. In my proposal I meant that there seemed to be conflicting definitions of what malnutrition is: an imbalance in calories, or an imbalance in vitamins/minerals. If means an imbalance in calories, then I feel the article focuses far too much on vitamin deficiencies and micronutrients. The UNICEF definition focuses on calories and protein, while other definitions focus on imbalances in "nutrients". The malnutrition article itself defines it as resulting from "taking an unbalanced diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions". These are the conflicting definitions that I was referring to. From what I see, nutrient refers to a broad range of substances, from "carbohydrates", "proteins", and "fats" to "dietary minerals" and "vitamins". So is the UNICEF definition incorrect when it cites only an imbalance in calories and protein? Are vitamins and dietary minerals implied in the statement when talking about the inability to utilize food? What other sources should I seek out before pinning down a definition? Thanks for your corrections and input. Khatchell (talk) 22:14, 9 March 2012 (UTC)

I think I may have found the source of confusion. From doing more research, I see that there are two types of malnutrition: protein-energy malnutrition and micronutrient deficiency. http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm. So while "malnutrition" refers to undernutrition and overnutrition, it is also split into two distinct types. The current article does not mention "micronutrient deficiency" explicitly and mentions "protein-energy malnutrition" sporadically. Addressing the two types of malnutrition in separate sections of the article would clear up any misunderstanding. From now on, I suggest any further discussion of this article is moved to the article's talk page. Thanks for your help! Khatchell (talk) 07:33, 10 March 2012 (UTC)

So is the UNICEF definition incorrect when it cites only an imbalance in calories and protein?

The answer to this question is that we don't know, and we don't care. Wikipedia editors do not decide whether our WP:Reliable sources are "correct" or "incorrect". That's a job for a real-world expert. Your job as an editor is to accurately and adequately summarize what the (multiple) reliable sources say about this subject. Your job is not to tell UNICEF that they're wrong (or right). We're not trying to find or anoint the Truth™. We're just trying to report what the reliable sources say about the subject. WhatamIdoing (talk) 20:51, 12 March 2012 (UTC)

James Parkinson

The biography of James Parkinson is in terrible shape. Any help adding sources would be greatly appreciated. Viriditas (talk) 02:44, 12 March 2012 (UTC)

Comment

A IP has requested further comments other than from myself here Talk:Sinusitis --Doc James (talk · contribs · email) 12:35, 12 March 2012 (UTC)

RM

There's a requested move (should really be listed as a merge, though) at Talk:Health care system#Proposed move to health system and merge that could use some input. Cheers, Jenks24 (talk) 19:51, 12 March 2012 (UTC)

Oral contraception articles - priority and organization

I'm curious if there's a priority system, and or talk-page box, relevant for this project. I ask because I'm dismayed at the state of the Oral contraceptive formulations article, which is essentially the redirect target for most forms of birth control, even to the exclusion of some actual pharmaceutical names that probably should redirect to those particular formulations, especially given how widespread they are used.

I'm concerned there maybe a lot of fragmented contraception articles that should be looked at as a whole. At the least they should be all unified under a single template, and the individual drugs should be covered respectively. Then of course the broader concept can be covered under the respective articles. I'm sorry if I've missed the articles that do that, but I haven't found them and I'm alarmed at the redirects to the oral contraceptive formations article, since those individual drugs should probably have their own articles. I have no issue with the redirects if the information's covered elsewhere, but the target article seems to be barely more than a stub now.

If someone could direct me to where there is a better organization of these articles I'd appreciate it, but more critically, these key articles should point to an article that offers some real content. And if that article doesn't exist, then it ought to be a priority. Shadowjams (talk) 08:41, 6 March 2012 (UTC)

Which widely used drugs do not yet have articles? Biosthmors (talk) 16:21, 7 March 2012 (UTC)

As I explained, every brand name appears to be a redirect. Usually they're consistent, however Plan B (drug) redirects to Levonorgestrel specifically, and Norgeston redirects to Norgestrel; compare that to Ortho Tri-Cyclen which redirects to Oral contraceptive formulations. So if the current scheme is to redirect all brand names to oral contraceptive formulations, and then to the compound's article, at the least there are some inconsistencies here. To further complicate things, Extended cycle combined hormonal contraceptive is a fork of oral contraceptive formulations. So Seasonique redirects there.

There are also additional hodgepodges of articles, like Progestogen-only pill (which is well developed actually), Combined oral contraceptive pill, and then Oral contraceptive pill, which is a disambiguation-like page that doesn't link to oral contraceptive formulations strangely.

You're probably right that there aren't any glaring omissions in actual drugs covered. I suppose redirecting brand names is correct unless the brand name has some other significance e.g. Tylenol. But putting that part aside, there are a lot of articles, some with a lot of detail, others with not much, that aren't linked together very consistently. And the examples I gave are just the ones I found after a quick look. Someone with some expertise in the field would probably have a better idea of the scope. That's why I ask here. So, is this the current scheme? Brand name to > formulation > specific component drug? And should we consider using Oral contraceptive as a primary page (and not the disambig-like page it is now) and then do {{main|}} headed summary sections that then link to Oral contraceptive formulations, Combined oral contraceptives, and progestogen-only pill (and any I'm missing)? As it is now, the combined oral contraceptive article is the most developed so moving it significantly is probably not an option. Shadowjams (talk) 17:36, 7 March 2012 (UTC)

I miss Lyrl (talk · contribs). She'd have good ideas about how to handle this. WhatamIdoing (talk) 23:22, 7 March 2012 (UTC)

Lyrl was one of the good ones. I'm still hoping to see her come back and be more active. Andrew c (talk · contribs) also worked on a lot of these articles, although I think he's also much less active recently. I agree that oral contraceptive is a reasonable place for most of the general information, maybe with List of oral contraceptive formulations as a link. Individual formulations that are widely used or have a significant history might then be split out from the list. That would be my suggestion. MastCell ^Talk 18:54, 8 March 2012 (UTC)

It seems obvoius to me that any brand name of a drug should redirect to the compound's article. Does anyone disagree? Biosthmors (talk) 16:52, 9 March 2012 (UTC)

We normally (but not always) redirect brand names to the INN per wp:MOSMED#Drugs and medications. There are of course some special cases.LeadSongDog come howl! 17:04, 9 March 2012 (UTC)

If you hadn't found it you might want to know about the Reproductive medicine task force. (As noted above several of the members are less active recently. I only recently resurfaced; miss Lyrl also.) The articles section there might assist you in finding articles on contraceptives. As far as a talk page tag - {{WPMED}} with the reproductive=yes identifies articles as related to the task force.

I am fairly familiar with the birth control articles, and created some of the navigation templates for reproductive medicine articles. I have not dealt with the individual drug names much, so I am not so familiar with the issues there.

The central organizing template to birth control methods is {{Birth control methods}}. However that template does not cover all birth control articles (see discussion on talk page of that template for a few that are not included, I have tossed around ideas for an additional template, but haven't come up with one). Combined oral contraceptive and Progestin only pill are customary ways of referring to these methods in family planning. (See for instance Contraceptive Technology).

Another article covering much of this area is Hormonal contraception, does that perhaps cover some of the ground you were envisioning for oral contraceptive?

I do not think that oral contraceptive should become a major article. While there is some commonality from the oral delivery method (for instance both have precautions for certain digestive conditions), the differences between combined vs. progestin only are significant. Also several emergency contraceptives are also delivered orally, but they use a variety of chemicals, some of which are anti-progestins, etc. Expanding oral contraceptive as a fuller article would just make yet another article for readers to deal with and for editors to keep up. I don't see what content would belong there that is not readily handled by the current set of articles. Perhaps some examples of what needs covering but doesn't have a place would help. I agree that oral contraceptive could use a little expansion as a disambiguation/set page. Zodon (talk) 06:34, 16 March 2012 (UTC)

Proposal for Social Determinants of Health in Poverty

I am a new user of Wikipedia, and am contributing an article about health outcomes and healthcare for a class at Rice University, where I am a pre-med student. Through my studies in the class “Poverty, Gender, and Human Development” and Rice University, and my many previous learning experiences with medicine, healthcare, and the social safety net, I have gained knowledge about differential health outcomes within poor populations. Therefore, I plan to create a new article entitled Social Determinants of Health in Poverty , and make this a part of WP:MED as well as other Wikiprojects.

This article should contribute to the expansion of understanding of differences in health outcomes between the general population and impoverished populations, as well as within impoverished populations, contributing a vital aspect to social medicine and analysis. I have compiled an extensive list of credible resources from academic journals, books, and non-profit organization reports, and plan on using this information to build a credible entry. However, I will face difficulty in compiling all this information into an extensive but concise presentation that distinguishes impoverished populations and the differences between them precisely. Therefore, I would appreciate feedback throughout the development and writing of my article, as I have limited Wikipedia entry experience.

This article should contribute to this Wikiproject because it provides better understanding the determinants of health in medicine, and contributes to a social understanding of medicine. I would appreciate any suggestions on how to use this article to best contribute to this Wikiproject.

lbockhorn (talk) —Preceding undated comment added 17:37, 9 March 2012 (UTC).

Presently, Health determinant is a wp:Redirect to Risk factor, a quite incomplete article. While that article does discuss determinants, and even lists "social status" as one such, that list is not well referenced. It might be helpful to start with some improvement there before digging too deep into one specific determinant.LeadSongDog come howl! 19:15, 9 March 2012 (UTC)

That could be a content fork off of social determinants of health. It seems best to improve the encylopedic nature of that article first. Biosthmors (talk) 19:24, 9 March 2012 (UTC)

As Biosthmors points out, we already have Social determinants of health, which should cover the territory you're discussing. That article is plastered with warning templates at the top, so may need improvement. Have a look at it and perhaps you can help with that, or, if it's terrible, maybe propose a complete rewrite. You'll need to master WP:MEDRS if you hope to conform to Wikipedia's sourcing standards; and WP:MOS and WP:MEDMOS explain our style. If you decide to do a complete rewrite, propose an outline on Talk:Social determinants of health, and discuss it with editors there first. Again, you must read and understand WP:MEDRS. --Anthonyhcole (talk) 03:52, 10 March 2012 (UTC)

I have visited and read the page Social determinants of health many times, including the warnings, and because of those I would not like to simply extend on that page for many reasons.

I opt to create a new page rather than edit the existing page “Social Determinants in Health” for the following reasons:

1. That article has many tags for subpar content, including having multiple issues, being written like a personal reflection or essay rather than an encyclopedic description of the subject, disputed neutrality, a slanted tone, and the perspective provided deals primarily with Canada and does not represent a world view.

2. This article does not provide a specific approach to how poverty, low income, or low socioeconomic status greatly affects the health of people, and how even with those in poverty there is great disparity between health outcomes. Neglect of this fact provides readers with a limited scope of just how divisively health care disparities cut society, even within similar income classes within a country and across the world.

3. Finally, structural causes inherent in society are not clearly represented, and need to be to provide a clear picture to the public of how structural institutions and policy provide these health differentials between different groups of people, even within the lives of the impoverished.

Lbockhorn (talk) 00:31, 15 March 2012 (UTC) lbockhorn

To keep discussion in one place, I suggest replying at User talk:Lbockhorn, as these three points are listed there and already replied to once. Biosthmors (talk) 16:05, 15 March 2012 (UTC)

Lbockhorn, you give three reasons for starting a separate page here. From where I sit, those three reasons are good reasons to not start a separate page, but to fix the mess that's there. Then we would end up with one much improved article, rather than two WP:MERGE candidates. WhatamIdoing (talk) 17:10, 15 March 2012 (UTC)

Article on multi-infarct dementia needs attention

Can some one in this project group who is well informed on dementia please help with some one? There are certain things in the article multi-infarct dementia which are confusing - you can look at the talk page to get a better idea of which. Indeed, one thing which I do think definitely needs revision is the section on prognosis which appears in this article (see my comments on the talk page). If any one does know about dementia, and can edit this article accordingly and accurately, I shall be extremely grateful. Many thanks for any help, ACEOREVIVED (talk) 15:57, 13 March 2012 (UTC)

HIV/AIDS

Will someone here please check out the new "Controversy" section in the article Full-spectrum light? Is it a hoax? Thanks, --Hordaland (talk) 20:23, 13 March 2012 (UTC)

An anonymous IP editor has already reverted the text. I couldn't find reliable sources to support the claims. Axl ¤ [Talk] 23:40, 13 March 2012 (UTC)

Thank you very much! --Hordaland (talk) 06:20, 14 March 2012 (UTC)

Australasian Triage Scale

Does this article have any merit or should it be merged into something else?NealeFamily (talk) 20:36, 13 March 2012 (UTC)

Triage#Regional_variation seems like the place for it. Wafflephile (talk) 17:19, 14 March 2012 (UTC)

Thanks - I'll tag it with a merge, for when I get the time. NealeFamily (talk) 19:14, 14 March 2012 (UTC)

Education article in the signpost

They refer in part to our experience and looks like there are some efforts in the right direction Wikipedia:Wikipedia_Signpost/2012-03-12/Interview --Doc James (talk · contribs · email) 20:18, 15 March 2012 (UTC)

Extra eyes needed at Epigenetics and Behaviour

I randomly stumbled upon this article. I have no idea what this article is really about, but it raises several red flags of WP:OR/WP:SYNTH. I got zero expertise on this, so I can't say if it's a load of baloney that should be sent to deletion, or if it's salvageable with some work, but I know that it needs some attention from people that know something about something. I'm cross-posting this notice at WP:MED and WP:PSYCH to, so as many eyes as possible will look at this. Headbomb {talk / contribs / physics / books} 21:52, 15 March 2012 (UTC)

Hoax ?

I've been patrolling User:AlexNewArtBot/MedicineSearchResult lately, and keep finding things like this: Ali A.Tehrani. I can't find a single thing to support this article. It looks like a hoax. What concerns me is that it may be a trend. Can anyone else find any reason to think this is not a hoax? Looks like it needs a {{db-nonsense}}, but I'd like other opinions. Also, if it is a hoax, does an admin need to block the creator? SandyGeorgia (Talk) 21:24, 16 March 2012 (UTC)

Sheesh, same here: Enoh's point??? SandyGeorgia (Talk) 21:27, 16 March 2012 (UTC)

Well, it wouldn't be db-nonsense in any case. But they do look like good AfD targets. - Jarry1250 ^{[Deliberation needed]} 21:33, 16 March 2012 (UTC)

And why wouldn't a hoax be db-nonsense? We don't need to send them to AFD. SandyGeorgia (Talk) 21:38, 16 March 2012 (UTC)

Because hoaxes are expressly confined to db-hoax (G3) and not db-nonsense (G1)? It's usually a good idea to send non-obvious-hoaxes to AfD in order to get new angles on then, although I guess this dicussion will serve that purpose. - Jarry1250 ^{[Deliberation needed]} 21:43, 16 March 2012 (UTC)

OK, so it's db-hoax, not db-nonsense. What's non-obvious about it? SandyGeorgia (Talk) 21:45, 16 March 2012 (UTC)

Well, the (blatant|obvious) criterion sets the bar for CSDing hoaxes rather high: specifically to the point where the initial reader has no doubt as to the authenticity of the claims being made. It seems that neither you nor I really has no doubt, so we couldn't delete either article under G3. But a PROD (indeed, read "PROD" for "AfD" above) would almost certainly be a reasonable way to go, or more people could scrutinise the article, then collectively go for G3, I suppose. Oh, and to answer your original point, yeah, I'd probably block the creator(s). - Jarry1250 ^{[Deliberation needed]} 21:54, 16 March 2012 (UTC)

Sorry, it's obvious enough ... my doubts are about how much of this is going on and whether some med admins will help me with new article patrol. SandyGeorgia (Talk) 21:58, 16 March 2012 (UTC)

Hmm, should'nt Ali have set alarm bells ringing as soon as it was tagged as an autobiography? The African "journal" is at a domain that was only registered last month by a domain masker in Virginia. LeadSongDog come howl! 21:51, 16 March 2012 (UTC)

My broader concern is how long it's taking to patrol new articles, since most of them are hoaxes, non-notables, or copyvios. Could use some help. Particularly admin help. SandyGeorgia (Talk) 21:54, 16 March 2012 (UTC)

(edit conflict)

Before deleting, should the contributors be checked for duckiness? LeadSongDog come howl! 21:55, 16 March 2012 (UTC)

Good question ... but which duck? SandyGeorgia (Talk) 21:56, 16 March 2012 (UTC)

Not sure, but this page would seem to offer a few clues on finding related activity.LeadSongDog come howl! 22:11, 16 March 2012 (UTC)

And Marila rita chantia. SandyGeorgia (Talk) 22:15, 16 March 2012 (UTC)

Oh dear, see User:Walkurax (edit | talk | history | links | watch | logs), User:Alexplaugh12 (edit | talk | history | links | watch | logs) User:Blurbzone (edit | talk | history | links | watch | logs) Oluwakayode Osuntokun Joseph Murumbi Joseph Maina Mungai.LeadSongDog come howl! 22:28, 16 March 2012 (UTC)

Lead Song, I'm skiing, so I'm not paying close enough attention. Is there a connection here that warrants an SPI? I want to get a db-hoax on Tehrani, but since I'm not an admin, that would mean I wouldn't be able to see the articles if an SPI is needed. I won't be able to catch up on this for several days, slopes beckon. SandyGeorgia (Talk) 15:12, 17 March 2012 (UTC)

I seem to have badly overreacted to poor sourcing, I'll need to look closer. Please have fun meanwhile, and do come back with all limbs intact :-) LeadSongDog come howl! 17:05, 17 March 2012 (UTC)

Whoops, sorry if I jumped the gun while y'all were researching. I just flagged Ali A.Tehrani as a {{db-hoax}}, as it's entirely made up of parts of Gazi Yasargil, Majid Samii, and Wirginia Maixner.

FWIW, 80.227.122.50 (talk · contribs) was going into those articles (and Neurosurgery) and removing the bits that had been "borrowed" to cover up the problem (sheesh). Got any suspected ducks in the UAE? Dori ☾Talk ⁘ Contribs☽ 02:09, 18 March 2012 (UTC)

We need an admin to get on this. Besides travel preventing me from looking into an SPI, since I'm not an admin, I can't build the case from deleted content. (Thanks, Lead Song-- all limbs intact, still touring.) SandyGeorgia (Talk) 22:50, 18 March 2012 (UTC)

It looks like Enoh's point isn't exactly a hoax, though notability is only due to a single recent and rather obscure paper written by the aforementioned Enoh. That is to say by Enoh H. Kingsly, et al. It does seem rather refspam-ish, but not completely bogus. It might be merged to Cerebral shunt#Shunt routing. After looking closer at some of the others, it seems like a few editors have been trying to improve our coverage of African publications, which also tend to be relatively low circulation and poorly represented in pubmed indexing. In the spirit of wp:CSB we might want to cut them a bit of slack.LeadSongDog come howl! 16:22, 20 March 2012 (UTC)

Temporary job

Village pump notice of a job that requires someone to turn up to an office in NYC for three months, for rather modest compensation. I suggested there that they should get real and make it an online job. Tony (talk) 03:16, 18 March 2012 (UTC)

See above, in #Announcement. JFW | T@lk 09:30, 18 March 2012 (UTC)

Cochrane database

Should the Cochrane systematic reviews be considered as primary or secondary sources for our purposes? Axl ¤ [Talk] 20:47, 20 March 2012 (UTC)

Systematic reviews are one type of review article and review articles are secondary sources. Thus Cochrane produces secondary sources and some of the best at that.--Doc James (talk · contribs · email) 20:56, 20 March 2012 (UTC)

Okay, thanks. Axl ¤ [Talk] 21:10, 20 March 2012 (UTC)

Translation to layspeak

I encountered one of these on New Page Patrol, and in looking through several others, have no idea what they are saying. English translation please? [2] SandyGeorgia (Talk) 02:39, 21 March 2012 (UTC)

Collagen Induction Therapy

Ditto above, this editor has created only one other article, I did some cleanup, rest is Greek to me. I'm hoping we can find and bring some good new editos in to the fold, but I can't tell if these are good articles or not (for example, not sure this one is named correctly). SandyGeorgia (Talk) 03:27, 21 March 2012 (UTC)

Announcement

Hi all,

Consumer Reports is seeking a Wikipedian in Residence -- a paid position to facilitate ties between Wikipedia and a health initiative it is planning. This will be for a 3-month period (with possible 3-month extension) starting in April, based in their offices in Yonkers, New York. If anyone here is interested, please submit an application at your earliest convenience! It comes with a $4000/month stipend, with some relocation funding available if needed. (Also, there are free daily shuttles between their offices and NYC.)

https://jobs-consumers.icims.com/jobs/2103/job

(This position is partially supported by a grant from the Wikimedia Foundation; some additional details are available in the grant proposal submitted to WMF.) Please feel free to ping me with any questions or comments. -Pete (talk) 19:32, 16 March 2012 (UTC)

Wondering. Look forwards to seeing this person join us. Doc James (talk · contribs · email) 20:51, 16 March 2012 (UTC)

4k a month isn't that bad --Guerillero | My Talk 21:16, 16 March 2012 (UTC)

It sounds like a great idea with a lot of potential. Hell, if had 35 hours a week free, I'd apply in a heartbeat. MastCell ^Talk 21:53, 16 March 2012 (UTC)

Looks like my timing on leaving the East Coast was off on this one. SandyGeorgia (Talk) 22:51, 18 March 2012 (UTC)

Sandy, if by chance you've come to the Bay Area, and would be interested in a more library-oriented opportunity, I've got another one for you: OCLC posted a Wikipedian in Residence position for this summer, based in San Mateo. And I'd guess there will only be more of these cropping up :) -Pete (talk) 23:18, 22 March 2012 (UTC)

Thanks, Pete, but I guess my timing on leaving Palo Alto (34 years ago) was off by quite a bit! SandyGeorgia (Talk) 23:43, 22 March 2012 (UTC)

:) Pete (talk)

Endometriosis - unsourced changes to page

• Endometriosis (edit | talk | history | protect | delete | links | watch | logs | views)

This page was recently subject to unsourced changes from an incoming IP edit. It'd be appreciated if members of this WikiProject could help to improve the sourcing of this article, keeping in mind WP:MEDRS. Thank you for your time, — Cirt (talk) 19:45, 19 March 2012 (UTC)

Did NOT mean to step into an ongoing edit war. Sorry. Merely observing that the section is a bit of a hash. Cites same comment on surgery 6 times in different places, does not flow logically. Need to follow in some fashion the path of diagnosis, which varies somewhat depending on the primary presenting symptom. For a woman presenting with pelvic pain, first step is pelvic exam, then, IF something is palpatable,....... . Structure of article implies surgery might be a first step if someone presents with either pain or infertility. — Preceding unsigned comment added by 209.6.69.227 (talk) 20:06, 19 March 2012 (UTC)

Watchlisted. Endometriosis was an area ripe with ascertainment bias in the earlier days, and the Endometriosis Association suffered from a bad case of Founder's Effect; it is important that this article be sourced to secondary reviews. SandyGeorgia (Talk) 17:16, 22 March 2012 (UTC)

SCAR-Fc

New page patrol, brand new editor puts up article in one edit. I did a bit of cleanup, but it's Greek to me-- perhaps others can look over the article and welcome the new editor. SandyGeorgia (Talk) 03:11, 21 March 2012 (UTC)

Oh dear, that all made sense to me. I must be getting so used to impenetrable walls of jargon that I'm losing my sense of plain English. Perhaps some remedial writing work is in order for me... WhatamIdoing (talk) 18:18, 22 March 2012 (UTC)

Diabetes and testosterone article

There is an article on Diabetes and testosterone, but I wonder whether it should be merged with an existing article on Diabetes mellitus - would any one like to read it and take note of the talk page on this article? Many thanks, ACEOREVIVED (talk) 12:06, 21 March 2012 (UTC)

It appears there are no shortage of review articles on the subject. Here are some titles: The role of testosterone in type 2 diabetes and metabolic syndrome in men; Relationship between adiponectin and testosterone in patients with type 2 diabetes; Following the common association between testosterone deficiency and diabetes mellitus, can testosterone be regarded as a new therapy for diabetes?; Low Testosterone in Men with Type 2 Diabetes: Significance and Treatment; Testosterone and type 2 diabetes; Testosterone in Obesity, Metabolic Syndrome and Type 2 Diabetes; Effects of testosterone on Type 2 diabetes and components of the metabolic syndrome; The Dark Side of Testosterone Deficiency: II. Type 2 Diabetes and Insulin Resistance; Testosterone, diabetes mellitus, and the metabolic syndrome. So I think an article could exist. The current article isn't written with good sources though. A merge target could be Diabetes_mellitus_type_2#Medical_conditions as there is a sentence there about testosterone deficiency. Biosthmors (talk) 15:43, 21 March 2012 (UTC)

We already give the topic sufficient weight in the single sentence "Testosterone deficiency is also associated with type 2 diabetes." I guess we could create a page called Medical causes of diabetes mellitus type 2. Otherwise we could add info about testosterone as treatment in the research section. It was not ready for inclusion in the main treatment section last time I looked. Doc James (talk · contribs · email) 17:08, 21 March 2012 (UTC)

The sources mentioned in the article were grossly outdated, and primary to boot. I chopped them. There've been several reviews and new consensus guidelines published in the interim. From what I've seen so far the correlation is established, but not causality. I've put a bit in, but it needs more and better attention than I can give it. It might also fit under Testosterone deficiency, which could discuss other complications. Getting into replacement therapies would attract the usual HRT issues, better to keep the focus elsewhere. LeadSongDog come howl! 17:32, 21 March 2012 (UTC)

This subject was the hobbyhorse of a rather obsessive now-banned editor; see Testosterone vs diabetes (talk · contribs) and friends. The standalone article reflected that one editor's... let's say "highly focused" interest in the topic. I think a more rational approach is to redirect the article to Type 2 diabetes mellitus and cover the potential role of testosterone there, briefly and proportionately. MastCell ^Talk 17:35, 21 March 2012 (UTC)

Yes I dealt with said user on the diabetes page. There really is not that much to say. I think it fits better under Testosterone deficiency than in the diabetes article. We basically state that there is a link. Not much more can be said.Doc James (talk · contribs · email) 18:43, 21 March 2012 (UTC)

Isn't type 2 diabetes also associated with high testosterone, e.g., in polycystic ovarian syndrome? Is this perhaps another instance of "the way it is in men" being assumed to be "the way it is in all humans"? WhatamIdoing (talk) 18:21, 22 March 2012 (UTC)

Rapid Sequence induction

I believe that the name of the article Rapid Sequence induction has to change to Rapid Sequence Intubation(RSI) (a term used in seminars such as ALS, ACLS, ATLS, PHTLS). Also paralytics such as succinylcholine (suxamethonium) and anestetics such as etomidate (useful in increased intracranial pressure) are not referred. 688dim (talk) 09:46, 22 March 2012 (UTC)

A PubMed search for "rapid sequence induction" yields 475 results. "Rapid sequence intubation" yields 313 results.

Since 2000, "induction" has 299 results and "intubation" has 255 results.

Either title is acceptable for Wikipedia. Axl ¤ [Talk] 12:47, 22 March 2012 (UTC)

The article "Rapid sequence induction" does mention succinylcholine and etomidate, although not in the section "Common medications". Please be bold and add the missing information. Axl ¤ [Talk] 12:54, 22 March 2012 (UTC)

Induction of what? It seems ambiguous as an article title. I think it should be changed.--Taylornate (talk) 17:31, 23 March 2012 (UTC)

It is rapid sequence induction, as it is the induction of anaethesia to which the descriptor 'rapid sequence' applies due to the speed to drug protocol and administration. There is nothing particularly rapid about the intubation. The intubation is a secondary necessity in order to maintain a patent airway once anaethesia is induced. Indeed you could choose not to intubate, but use an LMA, or a needle cric to maintain a patent airway, but would still have undertaken RSI. OwainDavies ^(about)_(talk) edited at 18:37, 23 March 2012 (UTC)

Interesting. Would it make sense to add of anesthesia or (anesthesia) to the title to make it more clear? Or would that only be warranted if there was another article with the same name?--Taylornate (talk) 21:57, 23 March 2012 (UTC)

The commonly used term in the literature is "Rapid sequence induction", not "Rapid sequence induction of anaesthesia". Therefore we use the former phrase in Wikipedia. Of course anaesthesia is implicit.

The phrase would only be ambiguous if another discipline used the same phrase for an entirely different process. (Perhaps we could imagine the phrase used in, say, motor engineering.) If that was the case, Wikipedia's article title here would be "Rapid sequence induction (medicine)".

WP:TITLE details this. Axl ¤ [Talk] 00:04, 24 March 2012 (UTC)

More eyes please

I think we need more eyes on Anti-psychiatry and Medicalization. Some recent edits seem of a dubious nature, and I would appreciate some further input in the area. Many thanks. Yobol (talk) 16:39, 22 March 2012 (UTC)

While I agree the content in question would be better at medicalization there is definitely evidence to support these concerns. There have been a number of academic articles / textbooks discussing the reclassification of what may see as the "human condition" as "disease". For example sadness being classified as depression, shyness as social anxiety disorder, menstruation as PMDD. Not really interested in getting involved in the controversy though.Doc James (talk · contribs · email) 16:59, 22 March 2012 (UTC)

I will watchlist-- at least it will provide a break from the dismal depressing work that is new page patrol. Copyvio, spam, promotional, poorly sourced, non-notable. Yukky work. SandyGeorgia (Talk) 17:11, 22 March 2012 (UTC)

I worked on medicalization a bit. It basically reads like a college-level essay rather than an encyclopedia article, although it does hit most of the major points. It's obviously a very uncritical presentation and essentially a platform to expand on the views of Szasz, Illich, et al., but it's not terrible. The last section or two still need some work, and it generally suffers from under-sourcing its key assertions. I don't have the heart to tackle anti-psychiatry; that article (and topic) have generally brought out some of the worst in Wikipedia.

As an aside, it's interesting to consider how these topics relate to Wikipedia. The thrust of the "medicalization" concept in the 1970s was that medicine functioned as a closed, paternalistic guild and essentially restricted people from involvement in their own well-being. I think a lot of that sort of power-dynamic thinking is evident in editors who view Wikipedia as a way to make an end run around medical authority. In itself that's arguably a laudable goal, although in practice it usually takes the form of people insisting Wikipedia should reflect THE TRUTH about vaccine dangers and the HIV/AIDS lie, rather than what the patriarchs at the CDC and NIH have to say on the subject. But I digress. MastCell ^Talk 17:53, 22 March 2012 (UTC)

For context, the lead-up to the May release of DSM-V has precipitated some heated discussion,[3] especially focussed on turning grief into a disorder. This included two Lancet editorials, then a Huffington Post piece seems to have drawn in The Atlantic on 1 March. But the real fuss is about a call by the DSM-IV chairman Allen Frances for government intervention to force the APA to abandon some of the changes in DSM-V. Many of the participants in the revision process are being said to be in COI due to pharma funding. Rice bowls are being upset and it will be very ugly in the near term. I suggest that wp:NOTNEWS and wp:NODEADLINE are our friends here. LeadSongDog come howl! 18:00, 22 March 2012 (UTC)

I also follow the DSM-5 debates in which Dr. Allen Frances said: My biggest concern regarding DSM-5 is that it will dramatically increase the rates of mental disorder by cheapening the currency of psychiatric diagnosis—arbitrarily and carelessly reducing thresholds for existing disorders and introducing new disorders with high prevalence. This would create millions of newly mislabeled “patients,” resulting in unnecessary and potentially harmful treatment, stigma, and wasteful misallocation of scarce resources. Source: Allen Frances (23 January 2012). “DSM-5 and Diagnostic Inflation: Reply to the DSM-5 Task Force,” Psychiatric Times. Do you suppose that English-speaking countries may sometime realize the shadow of political abuse of psychiatry over them? --Psychiatrick (talk) 07:56, 23 March 2012 (UTC)

Groan - yes, I've seen and read about the DSM V shitstorm on the horizon (goes back to sticking head in sand and hoping it all goes away) Casliber (talk · contribs) 21:30, 24 March 2012 (UTC)

New page patrol

Awful stuff. I worked all morning at User:AlexNewArtBot/MedicineSearchResult, and didn't get to anything between Mihail Roller (where I stopped yesterday) and Heat and Moisture Exchanger, where I stopped today (working from the top). Is it hopeless? I wish we had the power of the BLP to stub the uncited, poorly cited junk. More importantly, I'd love to come across some good new medical editors while I'm patrolling so we could recruit them. At this rate, I'll give up soon. Couldn't even start on SensoMotoric Instruments GmbH, all sourced to self. SandyGeorgia (Talk) 17:26, 22 March 2012 (UTC)

New page patrol is hopeless, soul-crushing work, and spending time there is the fastest route to burnout and cynicism that I can think of. Personally, I gave up on it long ago, after a then-Arbitrator accused me of incompetence and racism for deleting an article which read, in its entirety, "Chaudhury was a good man from Gujrat Pakistan having distinguished son Shujat. Shujat having God gifted qualities espacially in speaking. No one can imagin what he is speaking, people only relize about his lips."

You have better things to do. The worst offenders will come up eventually, and the others aren't necessarily worth bothering with. We have a very limited amount of editorial time and effort, so don't feel bad prioritizing. Then again, I'm burnt-out and cynical from too much time at new-page patrol. :) I do agree that the main reason to do it is to help identify and support new editors who might be interested in working on medical articles. MastCell ^Talk 18:26, 22 March 2012 (UTC)

Interesting new medical articles link. I proposed deletion for SensoMotoric Instruments GmbH.[4] Biosthmors (talk) 18:35, 22 March 2012 (UTC)

Not a good time for me to pick up "hopeless, soul-crushing work" ... but I was just hoping to find a few good new editors out there, like when I first met Colin or GrahamColm, or my earliest mentor, Encephalon. Maybe those days are no more ... everyone wants to advertise or push a POV. SandyGeorgia (Talk) 20:05, 22 March 2012 (UTC)

We-ell, see Wikipedia:GAN#Biology_and_medicine - someone was a rigorous review of Tay–Sachs disease, which'd be good to get right. Also, anyone is welcome to chew through and spit out non-review articles at bipolar disorder or borderline personality disorder, both of which I have an interest in getting buffed, just sputtering and lurching with enthusiasm or lack thereof.....Casliber (talk · contribs) 20:41, 22 March 2012 (UTC)

I started watching WT:MED because WhatamIdoing patrolled my first page and left a greeting on my talk. Not yet a good Wikipedian but hope to be one day. Wafflephile (talk) 20:50, 22 March 2012 (UTC)

Hi Wafflephile, it's good to see you again.

Sandy, have you been using Fred's script (User:Fred Gandt/getUnpatrolledOfAlexNewArtBotResultsPages.js) on that page? It broke for me a few weeks ago. Fred's first guess is that some element got moved or renamed. Possibly related and possibly not, this NPP report page also broke recently. WhatamIdoing (talk) 22:42, 22 March 2012 (UTC)

Update: Fred has fixed the script! Only ten pages (out of about 100) are left to be patrolled. WhatamIdoing (talk) 14:02, 23 March 2012 (UTC)

Plant stanol ester

The article looks like it needs to decide what it is about and in need of some cleanup. Richiez (talk) 18:02, 23 March 2012 (UTC)

Prepare to be horrified

Out of morbid curiosity, I wrote a short script to see how many WP:MED articles cite the Daily Mail as a source. There are 146 such articles, listed here. It's theoretically possible that some of these links are appropriate. But given the Mail's track record when it comes to medical claims, if anyone is looking for a way to improve medical sourcing on this site, reviewing this list with a critical eye seems like as good a place to start as any. :) MastCell ^Talk 23:26, 23 March 2012 (UTC)

"The horror! The horror!" Good pickup. Based on my sample size of one, I found a case of a good faith effort to incorporate news. I'm sure not all will prove as benign.Novangelis (talk) 00:00, 24 March 2012 (UTC)

I looked at a couple, and they were all BLP claims (people who have the condition in question). I'm not sure whether that counts as "appropriate", but it's not a medical claim. WhatamIdoing (talk) 01:11, 24 March 2012 (UTC)

And then there is List of youngest birth mothers, I mean, where does one start with that one. Given the notability one can't delete it. My thinking is the best thing is being able to stick some big fat caveat at the top about taking some of them with a grain of salt...from a secondary source of course. Casliber (talk · contribs) 04:21, 24 March 2012 (UTC)

Yeah, having looked at a few of them, they're certainly not great articles, but so far I can't say I've seen any outrageous medical claims sourced to the Mail.... MastCell ^Talk 05:06, 24 March 2012 (UTC)

At least the Mail leaves stuff on their site for a while, so it's possible to figure out what they actually did say. But if nothing else its a strong warning sign that it needs to be checked. LeadSongDog come howl! 13:58, 24 March 2012 (UTC)

Free access to HighBeam

Editors with more than 1,000 edits and 12 months' work at the English Wikipedia should see Wikipedia:HighBeam about free access to HighBeam Research's online sources, including some academic journals. WhatamIdoing (talk) 01:03, 20 March 2012 (UTC)

It sounds amazing, thank you for the note! NCurse _work 08:03, 21 March 2012 (UTC)

Brilliant! :) I am certainly interested; I lost internet access to my last remaining journal BMJ years ago. It is a struggle for me to get full text papers.--Literaturegeek | T@1k? 21:11, 25 March 2012 (UTC)

Oncology: templates & handbooks

1. I'd like to know if we have any any internal guidelines concerning tumour templates. Also, are there any users responsible for their maintenance? In my opinion, WHO/SEER ICD-0-3 registry would be the most rational choice to adapt, especially that all WHO/IARC classification handbooks are freely available on the web.
2. Talking about valuable resources: on pl.wikibooks you will find Atlas of the Skin Tumors Histopathology, edited by our two prominent pathologist from Medical University of Łódź. English descriptions are included. Images collected there will be suitable for many dermatopathologic entries. Lb.at.wiki (talk) 18:40, 26 March 2012 (UTC)

The histological ones stick pretty close to ICD-O, while the anatomic-system based ones stick pretty close to ICD-10. --Arcadian (talk) 23:34, 26 March 2012 (UTC)

Arcadian is one of our experts for navigation templates, but nobody in particular is officially responsible for anything. WhatamIdoing (talk) 12:16, 27 March 2012 (UTC)

Feedback requested on suggested revision of Universal healthcare article

Hello, I have made a proposal for some edits to the universal healthcare article here Talk:Universal_health_care#Proposed_revision_.28March_2012.29 and would be interested in feedback from other editors.

In addition, I'm also considering simplifying or removing some of the country-specific examples in the articles below, and placing them in a new list Health financing by country or Universal coverage by country or similar (see Health systems by country), because for now there are, for example, descriptions of the Canadian system as socialized medicine, single-payer health care, two-tier healthcare, and national health insurance and the result is 4 different descriptions of the financing of the Canadian system (in addition to the description here: Health care in Canada, rather than a single consensus view.

Combining the country-specific stuff on health financing into a single overview list will help (with links out to detailed country descriptions), so that there is one place people can go, and hence try to keep the generic articles focused on the terminology, with short examples from countries, but not long country-specific sections. If you think some of that would be useful within the text of the articles, we could even transclude summaries from elsewhere.

I think the articles below are all useful as stand-alone articles, but I also think the wiki would benefit from a single place where people could go to read up on health financing by country, which would be linked to all of the below. Finally, I would suggest we move all of the US-specific debates in the below articles to here Health_care_reform_debate_in_the_United_States which has been set aside for that purpose.

• National_health_insurance
• Socialized_medicine
• Single-payer_health_care
• Two-tier_health_care

--Karl.brown (talk) 15:05, 27 March 2012 (UTC)

Cholangiocarcinoma

A new editor appears motivated enough to start updating cholangiocarcinoma (currently a featured article) particularly by incorporating a 2011 review as detailed at my talk and User talk:PCL1029. If PCL starts updating the article, they/the article could probably benefit from some welcoming assitance/watching. Biosthmors (talk) 18:21, 27 March 2012 (UTC)

I'm sure MastCell (talk · contribs) (who originally brought the article to FA) will be able to keep an eye. JFW | T@lk 19:44, 27 March 2012 (UTC)

It's great that someone's interested - I've been meaning to update that article for some time now. It could certainly use an update. I'll drop the editor a line and some encouragement. MastCell ^Talk 17:47, 29 March 2012 (UTC)

Fospropofol

The retractions found at Fospropofol revealed a potentially dangerous situation. I've hidden the worrisome text for now, but it needs pharmacology eyes. LeadSongDog come howl! 20:07, 27 March 2012 (UTC)

I think we should explain that the initial published studies of fospropofol pharmacokinetics were withdrawn because they were (apparently, to my quick read) based on a faulty assay. It sounds like the effort to correct the data has been stymied by changes in ownership of the drug. We could cite the retraction request (PMID 20177373), and there does appear to be a bit of secondary-source coverage in specialty-news outlets (e.g. [5]). I'll try to help out in the near future; for now I think you did the right thing by hiding the retracted material. MastCell ^Talk 17:46, 29 March 2012 (UTC)

Sorting task

If anyone's looking for a pretty simple task, commons:Category:Diseases and disorders needs to be weeded. This involves mostly removing the general "Diseases and disorders" category and adding a more specific one (like "Infectious diseases"). Don't forget that you need to login separately to Commons, and I suggest turning on WP:HotCat in that account to make it faster. (Commons' HotCat is much more powerful than the English Wikipedia's.) WhatamIdoing (talk) 14:55, 29 March 2012 (UTC)

Creating a bot to search Wikipedia for retracted papers

Have been talking to Ivan Oransky at http://retractionwatch.wordpress.com/ regarding retracted journal articles. Pubmed lists about 4000. I am wondering if it would be useful to have a bot that would check Wikipedia for these articles and tag them if they are present? Would improve the reliability of our references. Doc James (talk · contribs · email) 22:20, 16 March 2012 (UTC)

Just to tag them as retracted? Should be uncontroversial. Is there an extant tag to use? I'd think we would want a maintenance category for articles citing retracted sources. It might get tricky when cited indirectly, e.g. via {{cite pmid}} and {{cite doi}}. LeadSongDog come howl! 22:36, 16 March 2012 (UTC)

I think this would be a worthwhile undertaking, and would be happy to help out as time permits. We could search by article title or PubMed ID (assuming that the PMID will appear either as a parameter in {{cite journal}} or {{cite pmid}}. At one point, when Dipak Das ran into trouble, I remember looking around to see how often we had cited his work on resveratrol etc... MastCell ^Talk 23:22, 16 March 2012 (UTC)

Since there are legitimate reasons to cite a retracted paper, I think that a talk page message might make more sense than an inline tag of the {{fact}} sort. On the other hand, a note in the citation (like adding (Retracted.) at the end) might be desirable in all cases. WhatamIdoing (talk) 20:27, 17 March 2012 (UTC)

Not fussed where the tag ends up going as I am happy with each. This is a good idea. Casliber (talk · contribs) 02:41, 18 March 2012 (UTC)

Excellent idea. -- Brangifer (talk) 03:20, 18 March 2012 (UTC)

As these things on occasion turn into a cited discussion of the controversy, we'll at least sometimes need to cite both the original and the retraction. It would be helpful if the bot could provide at least a hint to editors as to where to find the retraction, even if this is just as a hidden inline comment. LeadSongDog come howl! 04:35, 18 March 2012 (UTC)

The basic idea of a bot to check and mark these seems reasonable.

1) I think the retraction would need more than just a hidden citation. It should provide a citation to the source that says it is retracted, to enable readers and editors to verify the retraction (just as we provide sources in general). If it is hidden then it will be more likely that errors and vandalism will go uncaught. It also makes it less useful.

2) Another thing that might be nice to have is a bot that would scan for errata, and augment citations to articles with citations to the published corrections. I do not know if there is a source for data to feed such a bot, so it may not be practical. At the moment it does not look like the {{cite journal}} template even has a facility for citing corrections. Is there some standard in the MOS (either wikipedia, or MED) that covers how to cite corrections? Even if a bot for this is not practical, it might be worth adding the ability to cite corrections to the template, or add a link from the template documentation to where it explains in the appropriate MOS how to cite corrections. Zodon (talk) 05:44, 18 March 2012 (UTC)

If you're just labeling the citation as having been retracted (not discussing why it was retracted in the article), then IMO that doesn't really require an extra citation. A link to the official retraction notice could be provided in some instances, e.g., PMID 22408789, but the fact is that if you go to the original paper online (see PMID 17264214.1 or http://www.pnas.org/content/104/6/2001.long or http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1794300/), it's directly labeled as being retracted. So the paper itself forms the proof that the paper was retracted, and no further citation is actually needed. WhatamIdoing (talk) 06:28, 18 March 2012 (UTC)

Anyway with bot making abilities interested in this? Doc James (talk · contribs · email) 06:22, 18 March 2012 (UTC)

You might talk to User:Citation bot's owner. It already does similar things. WhatamIdoing (talk) 06:31, 18 March 2012 (UTC)

Response to WhatamIdoing above. I think you do need to have a citation. Otherwise how do you confirm retraction for articles that do not have links to PMID or other online databases (or that are not indexed in medline at all). I realize that what the bot would do would probably be based on accessible database information like this. But one has to consider what human editors would do with such a feature as well.

As a hypothetical example - a vandal might add a retracted note to a citation. After that sat for a while, another editor might come along, and see the allegedly retracted source and remove the citation (because it is presumably no longer valid) or post additional source needed, then somebody else comes along and removes the item because it lacks citation for verification.

At the very least the facility needs to be there to allow citation for the retraction (to satisfy verifiability, if it is challenged). Since the facility needs to be there anyway, it would be better if the bot used the facility. Zodon (talk) 08:44, 18 March 2012 (UTC)

Another refinement - it might be nice if the facility had a way of noting that a particular article has been withdrawn because it is supplanted by a newer version. For instance, when ACOG releases a new Committee Opinion or practice bulletin, they may withdraw earlier recommendations on the same topic. (Likewise USPSTF, etc.) Certainly there may be reason to cite old recommendations (for history, or for background information that has not changed), on the other hand it could be handy if a bot could point out newer sources. Zodon (talk) 19:56, 18 March 2012 (UTC)

Zodon, I don't actually object to making it possible to cite the retraction announcement (after all, depending on the subject of the article, you might want to discuss the retraction in the article text), but you missed my point: the actual paper at the publisher's website (not PubMed) says that the paper was retracted. Assuming that the journal follows this standard practice, then there is no need whatsoever for a separate citation even for non-MedLine-indexed papers.

(Of course, we already have a system for citing retraction announcements: you cite it just like you'd cite anything else in the article.) WhatamIdoing (talk) 06:02, 19 March 2012 (UTC)

• What sort of specification are we interested in? It's relatively easy, for instance, to write a script where we feed in a list of retracted PubMed IDs and the script searches (say) WP:MED-tagged articles for citations. It doesn't even need to be a bot per se, if it doesn't actually do any tagging - the script could just generate a list which could be hand-checked (depending on its size). Inevitably, such an approach will miss some citations, but it would be a start and would be relatively straightforward to code. MastCell ^Talk 01:00, 19 March 2012 (UTC)

That sounds excellent. Ivan keeps a data base of articles which we could us in addition to pubmed. Doc James (talk · contribs · email) 01:26, 19 March 2012 (UTC)

OK. PubMed currently lists 2,060 retracted articles. The PMIDs can be exported into a flat text file using the "Send to..." link at the bottom of PubMed. A first step would probably be to export these PMIDs and cross-check them against any other databases we'd like to use, so we can form a complete set of articles to search for. When we go to look for citations in Wikipedia articles, I think it's probably best to search by PubMed ID and by article title (since the title is likely to be unique and some citations may not include the PMID).

We can limit our search to WP:MED-tagged articles. Obviously, we'll probably miss some citations, but it would be a start. James, if you're in contact with the good people at Retraction Watch, perhaps we could start by coordinating with them to come up with a canonical list of PMIDs we want to scan for? It's easy enough to pull article titles once we have the PMID list. If you'd like a hand, let me know. MastCell ^Talk 17:05, 19 March 2012 (UTC)

I seem to recall that there's a standard database dump available of all external links. It should be straightforward to subset that to the urls going to a PMID. Then a database join to get the ones that are also on the retracted list. Actually it would be of interest to know just how many different PMIDs are cited on WP, perhaps with some statistical profiling. Might even be a term paper in it for an ambitious CS student. LeadSongDog come howl! 15:39, 20 March 2012 (UTC)

It's not quite that simple; many of the articlespace PubMed links use the "PMID" magic word instead of a bare URL. As best I can tell, the PMID magic word is translated into a link by the parser when you load the page - so if you look at the database directly, you'll miss the links (they're just stored as "PMID xxxxxx" in plain text).

I'm probably not explaining this well, but it's not a huge barrier in any case. I'd probably just start by pulling a list of WP:MED articles; scan the text of each article against the list of retracted PubMed IDs/article titles; dump all of the hits into a wikimarkup-formatted table; and post the table here. It would be fairly simple to code something like that, I think, and I'd be happy to work on it. MastCell ^Talk 15:59, 20 March 2012 (UTC)

So how do you find retracted items in PubMed? I must be looking in the wrong place - don't seem to be finding it in the documentation. Zodon (talk) 04:18, 21 March 2012 (UTC)

It's definitely not the most intuitive or user-friendly setup. Click on "Limits" (it's directly under the search bar, at least on my browser). Then, on the Limits page, under "Type of article", scroll down to "Retracted publication", check the box, and leave the search bar blank. That should net you a list of all articles tagged as "retracted" on PubMed. MastCell ^Talk 04:21, 21 March 2012 (UTC)

Using the [pt] publication type suffix with the retraction types from the list

retraction of publication[pt] gives 2178

retracted publication[pt] gives 2061

The XML return that the Diberri template filler & presumably the DOI_Bot use include the publication types, so those tools could note retractions.

Misuse format or add in the description in a quote=, or just add a comment.

<PublicationTypeList>

<PublicationType>Journal Article</PublicationType>

<PublicationType>Research Support, Non-U.S. Gov't</PublicationType>

<PublicationType>Research Support, U.S. Gov't, P.H.S.</PublicationType>

</PublicationTypeList> RDBrown (talk) 13:13, 22 March 2012 (UTC)

I wonder whether we could get a |publication type= in {{cite journal}} and get Dave to automagically fill it in for key publication types (reviews and meta-analyses on the one hand, and retractions and letters to the editor on the other). WhatamIdoing (talk) 18:12, 22 March 2012 (UTC)

Scanning... scanning... Rich Farmbrough, 17:39, 25 March 2012 (UTC).

138 articles have retracted PMIDs according to my preliminary results.

Wakefield's seems most widespread at first glance. I created {{Retracted paper}} which takes an optional argument, intended to be a link to the retraction, e.g. {{Retracted paper|pmid=12345678}}}} =>

Rich Farmbrough, 18:46, 25 March 2012 (UTC).

Excellent - thanks very much, Rich. MastCell ^Talk 18:54, 25 March 2012 (UTC)

Very good. I have replaced retracted sources in asthma and meningitis. Interestingly, quite a few positives are articles that were indeed retracted are mentioned for being retracted (e.g. in Schön scandal and more puzzlingly nicotinamide phosphoribosyltransferase), and of course Wakefield et al 1998 (PMID 9500320) is cited copiously in all articles pertinent to this. JFW | T@lk 19:23, 25 March 2012 (UTC)

Yes interestingly one of the cites in Andrew Wakefield was using 9500320 but was actually a different paper (fixed). I have started tagging, you beat me to the Asthma page, so I made a null edit, which will get me rapped knuckles, probably... . I'll try to get the tagging completed anyway. Rich Farmbrough, 20:51, 25 March 2012 (UTC).

OK all tagged, except Retraction the two Jdwolff fixed, and Cyclin B2 where HEADBOMB has removed the cite and tag. Rich Farmbrough, 23:06, 25 March 2012 (UTC).

Rich, you indicate that one reference from the "Lung cancer" article has been retracted: 17056245. However this is not the reference that you tagged when you edited the article. Axl ¤ [Talk] 01:13, 26 March 2012 (UTC)

Retraction: on closer inspection I see that you actually made several different edits with one edit summary. Axl ¤ [Talk] 01:16, 26 March 2012 (UTC)

Update, I've updated the {{retracted}} template. Please see it's documentation. The biggest thing is that if the citation to the retracted paper is intentional, you need to use {{retracted|intentional=yes}}, otherwise a warning will be displayed. Potentially unintentional citations are found in Category:Articles citing retracted publications. Headbomb {talk / contribs / physics / books} 03:17, 26 March 2012 (UTC)

Do you think it would be useful to wikilink "Retracted" to Retraction? WhatamIdoing (talk) 12:08, 27 March 2012 (UTC)

Thank you, that template and category are big steps forward. I'd definitely love to see a |pubtype= added to the citation templates. It would greatly speed cleanup actions (such as Axl's recent monumental reference scrub at Lung cancer) if one could tell at a glance whether a source was a review, a study, or a comment. LeadSongDog come howl! 15:52, 27 March 2012 (UTC)

Same here. Knowing which are reviews would help tremendously.Doc James (talk · contribs · email) 05:28, 29 March 2012 (UTC)

It's typical for publications to have multiple types, and some of those types have very long names. Unless we want the |pubtype= field to be longer than the rest of the citation, I think we need to pick and choose which get included and how we present them (e.g., perhaps lumping all types of reviews into a single group marked "review" rather than "systematic review"). WhatamIdoing (talk) 15:28, 29 March 2012 (UTC)

Well, the key objective in my mind is to support editors trying to follow wp:MEDASSESS. Accordingly, we need to consider, for instance, how a "case history and review of the literature" article would be reflected. If shown by its better-quality "literature review" PT (or worse, just as "review"), then there is a danger that its primary source elements will be held up with equal weight against a true "review" article. I'd suggest the default should be to use the lowest-ranking PT as the default. Editors can always manually override that bot assessment, and of course bots should respect human input. LeadSongDog come howl! 16:33, 29 March 2012 (UTC)

Coincidentally, Help_talk:Citation_Style_1#.22type.22_field_in_template:cite_journal just popped up an edit to delete mention of |type= from the /doc for {{cite journal}}. LeadSongDog come howl! 20:32, 31 March 2012 (UTC)

Binge drinking article

The binge drinking article has been flagged as being 'written as a medical article'. The article already contains information on issues outside of medicine such as getting into fights, crashing cars and sexual behaviour, although it is true that it mostly focuses on medical consequences. It is hard not to write it as a medical article though as most of the consequences of binge drinking are medicine/health orientated. I am wondering should the tag be removed or can editors make some suggestions on how the article can be expanded to include other relevant areas? Whoever added the tag never posted their concerns on the talk page. It would be helpful to get some feedback on this. Thanks.--Literaturegeek | T@1k? 03:11, 17 March 2012 (UTC)

I've removed the tag. It was essentially being used as a {{POV}} tag, and it seems silly to complain that a health-affecting behavior is written about as a health-affecting behavior. WhatamIdoing (talk) 20:34, 17 March 2012 (UTC)

Thank you, WAID.--Literaturegeek | T@1k? 23:50, 17 March 2012 (UTC)

(outdent) Well the article has just been retagged.--Literaturegeek | T@1k? 12:18, 29 March 2012 (UTC)

Yes, I added it again. As I wrote in the edit summary, I think there is a quite clear difference between the way the binge drinking article is written, and the way other articles on similar subject, like smoking or drug injection, are written. I mean, I don't think it is wrong that a large part of articles like that are about medical aspects of the phenomenon, as a large part of the sources available will be about medical aspects. But I think it has gone over board in the binge drinking article, to the point where the article looks much more like the article on diabetes or hypertension than like the article on smoking, for instance. I mean the whole structure of the article is practically the same as that of articles on diseases, and I would content binge drinking in fact not a disease, but rather a form of recreational drug use.TheFreeloader (talk) 14:59, 29 March 2012 (UTC)

I understand your point of view, but I am not sure it is easy to write about binge drinking in the same way as smoking. We already have an article drinking games; I guess I/we/someone could write a paragraph or two about that and then add a 'see also/main article link to that main article. Maybe try and get some historical information on binge drinking? Do you have any suggestions as to what you think is missing from the article?--Literaturegeek | T@1k? 20:24, 29 March 2012 (UTC)

Even if we all agree that TheFreeloader's ideas for expanding the article (which he is doubtless free to WP:VOLUNTEER to do himself, rather than insisting that some other volunteer do it for him) are great, it's still not a cleanup problem and should not be mis-tagged as one.

Personally, I think that the correct comparison article is Chain smoking, which does not emphasize the "fun" or "recreational" aspects of smoking tobacco. I'm sure that our article on Alcoholic beverages has much of the social/recreational information that TheFreeloader wants, and that article, not Binge drinking, is IMO the correct place for that information. WhatamIdoing (talk) 21:14, 29 March 2012 (UTC)

Well, but do you not see a problem with the fact that the article is essentially set up like a disease article? I think it puts a huge slant of prejudice into the article, when the phenomenon is in fact not classified as a disease by any official body. I am not sure exactly how the article can be fixed, but I don't think it hurts pointing out the problem until a solution is found.TheFreeloader (talk) 21:58, 29 March 2012 (UTC)

I don't have a problem with the overall outline of the article. It could be expanded, e.g., to talk about prevention programs, but the overall outline is okay with me.

Binge drinking, BTW, is called "305.0 Nondependent alcohol abuse" in the ICD-9 and "F10.1 Mental and behavioural disorders due to use of alcohol: harmful use" in the ICD-10, so it is actually considered a valid diagnosis. WhatamIdoing (talk) 00:11, 31 March 2012 (UTC)

Good find of the ICD diagnostic criteria! Given now that we know that ICD class binge drinking as a diagnosable disorder/disease I don't see any reason for the banner to remain in place.--Literaturegeek | T@1k? 20:12, 31 March 2012 (UTC)

Yes, I guess you can have at it, in that case. I will remove the tag. Although getting more history and culture into the article probably still would not hurt. There is some of that here.TheFreeloader (talk) 11:42, 2 April 2012 (UTC)

Thanks TheFreeLoader! I agree that the article would benefit from expansion; it is only 40k in size so still a relatively small article.--Literaturegeek | T@1k? 20:18, 2 April 2012 (UTC)

Gluten-sensitive idiopathic neuropathies

The article was tagged

This article relies on references to primary sources or sources affiliated with the subject, rather than references from independent authors and third-party publications. Please add citations from reliable sources.

So I've been through it removing content that doesn't comply with WP:MEDRS [6] and that's left the article fairly slim. I'm wondering if the title is right. I can't find any instances of "gluten-sensitive idiopathic neuropathy" in PubMed or Google Scholar, and I can't find an instance of it in Google dated earlier than this article, so suspect it may be coining a neologism. It doesn't sound right to me.

I haven't touched the lede. Opinions on what, if anything, to do now would be appreciated. --Anthonyhcole (talk) 21:59, 28 March 2012 (UTC)

It is an article that forms part of the WalledGarden that Pdeitiker (talk · contribs) created around conditions related to gluten sensitivity. There are certainly articles available on the neurological aspects of gluten sensitivity, but I suspect that the title for this article is new coinage. JFW | T@lk 12:45, 30 March 2012 (UTC)

Well, the closest I've found is:

With regard to gluten neuropathy, new research by Dr. Hadjivassiliou has shown that it accounts for 26% of all axonal neuropathies and 34% of idiopathic, sporadic axonal neuropathies (J. Neurol. Neurosurg. Psychiatry 2006;77:1262-6). “The prevalence of gluten-sensitive enteropathy is 10 times higher in patients with axonal neuropathy compared to healthy individuals,” he said. He has also recently published evidence showing that patients with gluten-sensitive neuropathy show improvement on a gluten-free diet, while patients who continue to ingest gluten deteriorate further (Muscle Nerve 2006;34:762-6).

[7]

It's probably worth having a look at the mentioned papers. LeadSongDog come howl! 13:35, 30 March 2012 (UTC)

A field depth issue?

Hello - Although I guess I'm by no means the first to raise the issue I decided to post over at the Village Pump about underdeveloped articles on key topics with a broad scope which somehow seem to drift nebulously under the radar. I took Hematology and Liver disease as examples of articles which don't receive as much attention as they deserve, presumably because of the very size of the fields they cover. Clearly, absolutely no implied criticism was intended of the Medicine Project. Best, —MistyMorn (talk) 19:47, 31 March 2012 (UTC)

The small group of us here are more than welcoming of others who wish to take these topics on.--Doc James (talk · contribs · email) 20:00, 31 March 2012 (UTC)

Yes, I'm aware that the wide range of medical topics don't attract as many contributors as Jennifer Lopez, say, and aren't half as easy... As I say, no criticism was implied: my point is that some 'large' topics seem to invite neglect because of their very size. (Personally, I try to contribute a little around and about within my limited abilities.) —MistyMorn (talk) 20:07, 31 March 2012 (UTC)

You might well be correct in your observation that huge topics are harder to cover. I think the main issue is the level of detail, as well as availability of sources to cover the basics. An article like medicine or death is hard to write because of the sheer enormity of the topic, but strangely it is quite hard to find sources for the kind of content that should be there because most of it is common sense, received wisdom and aggregation.

For an article like hematology, a historical overview would be a good start; for that, there are some sources but they are quite hard to pin down. The same applies to liver disease. JFW | T@lk 03:26, 1 April 2012 (UTC)

Educational project

Again. Does anyone know where to begin tracking these down, found at new page patrol?

• Addressing Chronic Disease in Northern Ontario
• Social determinants of health in poverty

and see:

• User:Lbockhorn mentioning a course at Rice University.

I shall give up soon on new page patrol; it is Just Awful Work. SandyGeorgia (Talk) 15:33, 2 April 2012 (UTC)

• • the social determinants of health in poverty page was proposed as a new page by User:Lbockhorn a few weeks ago in the health/fitness project I believe, and some editors gave her feedback. My own feedback was that this page was a bit too long and would be better served as a section or set of revisions within social determinants of health. --Karl.brown (talk) 17:08, 2 April 2012 (UTC)

Major depressive disorder

Comments on this. I am concerned about the refs:

Working age adults who live alone have significantly higher risk for depression.

Doc James (talk · contribs · email) 19:46, 2 April 2012 (UTC)

Probably it is accurate but given MDD is such a heavily researched area and that there is so much material to consider for inclusion as well as the article being a featured article it's inclusion (sourced to BBC and a primary study) is probably not justified.--Literaturegeek | T@1k? 20:14, 2 April 2012 (UTC)

Yes that is my felling aswell. Doc James (talk · contribs · email) 20:18, 2 April 2012 (UTC)

Efficacy section of chemotherapy article needs work

At the moment, the entire section discussing efficacy in our article on Chemotherapy (edit | talk | history | protect | delete | links | watch | logs | views) is based on a single source, which in turn bases its conclusions on a single endpoint measure: five-year survival. I feel that the source is problematic for a number of reasons, which have come forth in an extended discussion (Talk:Chemotherapy#Efficacy (2)), and which I have summarized in a bulleted list at the end of that section.

I would greatly appreciate some outside opinions, particularly from individuals with expertise in this area. Evaluation of the appropriateness of the paper used now as the basis for the article's efficacy section would be helpful, as would advice and sources for a more thorough, extensive, and balanced discussion of the efficacy of chemotherapy. TenOfAllTrades(talk) 15:23, 3 April 2012 (UTC)

I would be happy to take a look. I think it will be difficult, if not impossible, to make broad statements about the efficacy of chemotherapy since that efficacy varies dramatically with the clinical situation. Chemotherapy for, say, Hodgkin lymphoma is extraordinarily effective and can cure the vast majority of people. At the other extreme, chemotherapy for advanced non-small-cell lung cancer or pancreatic cancer is marginally effective and, in some studies and in some patient populations, no better than supportive and palliative care. MastCell ^Talk 15:57, 3 April 2012 (UTC)

A very quick observation: There seems to be a mismatch between the title ("Efficacy") and the content of the opening and closing sentences. Perhaps "Indications and efficacy" would be a consonant title. —MistyMorn (talk) 16:38, 3 April 2012 (UTC)

Oy. Having looked at the source (PMID 15630849), we should definitely not be citing it here. Aside from some very serious methodologic concerns about the article, it's woefully outdated. For example, it argues (and we uncritically repeat) that chemotherapy is "essentially useless" in multiple myeloma. This is clearly untrue, and seriously (and potentially dangeously) misinforms the reader. Likewise, we (falsely) state that chemotherapy is "essentially useless" in renal cell carcinoma, which is clearly untrue (e.g., PMID 19487381).

There are multiple concerns: the study is outdated and fails to reflect the impact of newer agents; it uses questionable methods; and it relies solely on 5-year survival to measure "benefit". The article measures (or at least attempts to measure) the curative potential of chemotherapy (as 5-year survival is typically a surrogate for cure). It's well-known that very few advanced malignancies can be cured with chemotherapy, but in many instances chemotherapy can improve survival and sometimes quality of life. Those endpoints aren't captured if you look solely at 5-year survival, but they are meaningful nonetheless. MastCell ^Talk 18:03, 3 April 2012 (UTC)

Applications for free, full access, 1-year accounts from HighBeam Research officially open

Just a reminder that 1000 free accounts are available from the internet research database HighBeam Research. HighBeam has full versions of tens of millions of newspaper articles and journals and should be a big help in adding reliable sources--especially older and paywalled ones--into the encyclopedia. Sign-ups require a 1-year old account with 1000 edits. Here's the link to the project page: WP:HighBeam (account sign-ups are linked in the box on the right). Sign-up! And, please tell your Wikipedia-friends about the opportunity! Cheers, Ocaasi ^{t | c} 20:40, 3 April 2012 (UTC)

Wikipedia:HighBeam

Wikipedia:HighBeam describes a limited opportunity for Wikipedia editors to have access to HighBeam Research.
—Wavelength (talk) 22:56, 3 April 2012 (UTC)

Stress (physiology): Light clean-up needed, please

Stress (physiology) has a half-dozen or so redlinks that seem to be common medical terms, but for some reason aren't formed correctly. Could somebody please rephrase these to Wikipedia standard and/or make them redirects?

Thanks -- 186.221.136.197 (talk) 23:13, 4 April 2012 (UTC)

Done - you may wish to check that I've pointed the links accurately. Cheers, --RexxS (talk) 14:39, 5 April 2012 (UTC)

Infectious vs. communicable

The article on infectious disease needs a bit of help. In particular, its lead alludes to a distinction between infectious and communicable, but the article nowhere provides any further information about that distinction. And for those readers who, like me, land on the page as a result of redirection from "communicable disease," the disorienting and surprising experience is not only left untreated, but indeed aggravated.—PaulTanenbaum (talk) 20:20, 4 April 2012 (UTC)

I'm not sure that there really is a distinction drawn these days, but I believe that back in the day, they used "communicable" or "infectious" and "contagious" to differentiate between the likelihood of transmission. Measles was contagious: you were very likely to get it if exposed even briefly. Tuberculosis was not: you might get it, and you might not, but probably not on a brief exposure. WhatamIdoing (talk) 16:55, 5 April 2012 (UTC)

Well... in an article published in PLoS Biology on 3 April 2012, Bellan et al. describe a pedagogical approach that they developed in 2010. Among "the various concepts and methods presented," the first example their article mentions is "the difference between an infectious disease and a communicable disease." Sad to say, although the difference is thus mentioned, it is not elaborated.—PaulTanenbaum (talk) 21:37, 5 April 2012 (UTC)

I found the following definitions here

Infectious disease

a disease caused by a microorganism and therefore potentially infinitely transferable to new individuals. May or may not be communicable. Example of non communicable is disease caused by toxins from food poisoning or infection caused by toxins in the environment, such as tetanus.

Communicable disease

an infectious disease that is contagious and which can be transmitted from one source to another by infectious bacteria or viral organisms.

Contagious disease

a very communicable disease capable of spreading rapidly from one person to another by contact or close proximity.

I'm not sure if that aligns with common usage however. There is also this: [8]

And then of course non-communicable disease, which is defined as a disease which is non-infectious. And some are saying that NCDs are communicable after all.. [9] Seems like we have a bit of a terminology problem... --Karl.brown (talk) 16:17, 6 April 2012 (UTC)

Merge discussion: Birth Control & Contraception & Contragestion

There is a discussion about possible merger of 3 articles, at Talk:Birth_control#Merge_proposal:_Birth_control.2C_Contragestion.2C_Contraception_articles. --Noleander (talk) 14:42, 7 April 2012 (UTC)

And there appears to be support since Dec for some of the merges.--Doc James (talk · contribs · email) 15:31, 7 April 2012 (UTC)

Malnutrition feedback and assistance request

Hi everyone! I have been working on some parts of the Malnutrition page for a few weeks, and I would love feedback on the changes that I have made so far. My goal is to bring this article up to the good article standards since this condition is so common in many parts of the world. I would love some critique and feedback, and I would love to get others involved in improving this article. I'm particularly interested in feedback on the main sections that I added, under the "In special populations" section. I am still improving these sections, and any suggestions would be greatly appreciated! I am having difficultly finding information on young adults and teenagers, so I would love some help with that! Or perhaps if this part of the population has not been studied or is not affected differently than other age groups, this section should be removed. Also, I feel that multiple sources should contribute to the information on signs of malnutrition. Is the medical terminology acceptable, or should general names for the conditions be used? I am not sure how to add an image to the page, so I would love help on that! I was thinking of an image showing some of the more visible effects of malnutrition, such as the extended abdomen. I have not touched the management section at all, but it could probably benefit from up-to-date research. Thanks for your help and feedback!! Khatchell (talk) 20:42, 7 April 2012 (UTC)

Proposal for Social Determinants of Health in Poverty: Cont.

Prev.

I am a new user of Wikipedia, and am contributing an article about health outcomes and healthcare for a class at Rice University, where I am a pre-med student. Through my studies in the class Poverty, Gender, and Human Development and Rice University, and my many previous learning experiences with medicine, healthcare, and the social safety net, I have gained knowledge about differential health outcomes within poor populations. Therefore, I plan to create a new article entitled Social Determinants of Health in Poverty , and make this a part of WP:MED as well as other Wikiprojects."

This article should contribute to the expansion of understanding of differences in health outcomes between the general population and impoverished populations, as well as within impoverished populations, contributing a vital aspect to social medicine and analysis. I have compiled an extensive list of credible resources from academic journals, books, and non-profit organization reports, and plan on using this information to build a credible entry. However, I will face difficulty in compiling all this information into an extensive but concise presentation that distinguishes impoverished populations and the differences between them precisely. Therefore, I would appreciate feedback throughout the development and writing of my article, as I have limited Wikipedia entry experience."

"This article should contribute to this Wikiproject because it provides better understanding the determinants of health in medicine, and contributes to a social understanding of medicine. I would appreciate any suggestions on how to use this article to best contribute to this Wikiproject."

lbockhorn (talk) —Preceding undated comment added 17:37, 9 March 2012 (UTC).

Presently, Health determinant is a wp:Redirect to Risk factor, a quite incomplete article. While that article does discuss determinants, and even lists "social status" as one such, that list is not well referenced. It might be helpful to start with some improvement there before digging too deep into one specific determinant.LeadSongDog come howl! 19:15, 9 March 2012 (UTC)

That could be a content fork off of social determinants of health. It seems best to improve the encylopedic nature of that article first. Biosthmors (talk) 19:24, 9 March 2012 (UTC)

As Biosthmors points out, we already have Social determinants of health, which should cover the territory you're discussing. That article is plastered with warning templates at the top, so may need improvement. Have a look at it and perhaps you can help with that, or, if it's terrible, maybe propose a complete rewrite. You'll need to master WP:MEDRS if you hope to conform to Wikipedia's sourcing standards; and WP:MOS and WP:MEDMOS explain our style. If you decide to do a complete rewrite, propose an outline on Talk:Social determinants of health, and discuss it with editors there first. Again, you must read and understand WP:MEDRS. --Anthonyhcole (talk) 03:52, 10 March 2012 (UTC) I have visited and read the page Social determinants of health many times, including the warnings, and because of those I would not like to simply extend on that page for many reasons.

I opt to create a new page rather than edit the existing page “Social Determinants in Health” for the following reasons:

1. That article has many tags for subpar content, including having multiple issues, being written like a personal reflection or essay rather than an encyclopedic description of the subject, disputed neutrality, a slanted tone, and the perspective provided deals primarily with Canada and does not represent a world view.

2. This article does not provide a specific approach to how poverty, low income, or low socioeconomic status greatly affects the health of people, and how even with those in poverty there is great disparity between health outcomes. Neglect of this fact provides readers with a limited scope of just how divisively health care disparities cut society, even within similar income classes within a country and across the world.

3. Finally, structural causes inherent in society are not clearly represented, and need to be to provide a clear picture to the public of how structural institutions and policy provide these health differentials between different groups of people, even within the lives of the impoverished.

Lbockhorn (talk) 00:31, 15 March 2012 (UTC) lbockhorn

To keep discussion in one place, I suggest replying at User talk:Lbockhorn, as these three points are listed there and already replied to once. Biosthmors (talk) 16:05, 15 March 2012 (UTC)

Lbockhorn, you give three reasons for starting a separate page here. From where I sit, those three reasons are good reasons to not start a separate page, but to fix the mess that's there. Then we would end up with one much improved article, rather than two WP:MERGE candidates. WhatamIdoing (talk) 17:10, 15 March 2012 (UTC)''

New:

I took a look at Risk factor and decided that that article had little to do with my intended topic. I have created Social determinants of health in poverty if you are interested in looking at it. The reason I did not improve Social determinants of health is addressed by my three points, and also on my talk page, and discussion in http://en.wikipedia.org/wiki/Wikipedia_talk:WikiProject_Health_and_fitness . I spent some time looking over WP:MEDRS even though I did not propose a re-write of Social determinants of health, and I think I have conformed to the standard of acceptable resources in medicine, though my research and citations tend towards journals and reports outside of the medical field. Comment if you feel that needs more work. I am currently in the process of re-working the article to conform more closely to the WP:MOS. Please post any suggestions if you have them. Finally, I do not believe that this article is a merge candidate with Social determinants of health, because of their fundamentally different approach to the article, with mine a distinct approach to understanding the challenges the impoverished face- specifically health.

Lbockhorn (talk) 04:59, 8 April 2012 (UTC)lbockhorn

Biotherapy

Hello. Could someone take a look at this article? We've had several editors vandalize or change the terms, so it could use a review and any recommendations for future expansion/merging or deletion. Viriditas (talk) 21:55, 4 April 2012 (UTC)

Looks completely spurious to me: [10] [11] [12] [13] —MistyMorn (talk) 22:07, 4 April 2012 (UTC)

The related MeSH term is biological therapy. —MistyMorn (talk) 22:14, 4 April 2012 (UTC)

For the time being, I've replaced the twaddle with a shameful one-line stub. —MistyMorn (talk) 22:58, 4 April 2012 (UTC)

I pulled most of the list of examples from the old version. I believe that hormone therapy (e.g., insulin) is the most common form of biological therapy, so that should be included, but perhaps someone could dredge up an actual source for that first. WhatamIdoing (talk) 16:59, 5 April 2012 (UTC)

I am surprised by the missionary zeal to reintroduce these mainly fringe therapies wholesale into such a short stub. With the exception of phage therapy, which is a bit of a special case, there seems to be no robust evidence of efficacy for any of these alternative treatments. I was tempted to remove them as WP:UNDUE, and have indeed removed a couple for that reason (more than for WP:FRINGE as I claimed in the edit summary). However, for the sake of consensus I have taken the time to try to reframe the material responsibly. At the same time, I really think it would be far better to expand the part of the stub which refers to the received use of the term, which hitherto has been unaccountably ignored. —MistyMorn (talk) 21:46, 5 April 2012 (UTC)

Acknowledging that they exist, and that the English Wikipedia has articles on them, is not the same as saying that they are effective for treating any particular medical condition.

Having said that, maggot debridement therapy apparently has an FDA-approved indication, so it has been formally declared to be safe and effective. It's also got several dozen review articles up on PubMed about it, and about 200 other journal articles, not to mention dozens of medical textbooks and reference manuals, so it's hardly "alternative" or "fringe" medicine that needs to be "reframed responsibly". (Disgusting, yes. Unfamiliar to most people, yes. But it's mainstream medicine.) WhatamIdoing (talk) 01:00, 6 April 2012 (UTC)

If you look at the links I provided above, you'll see that the term 'biotherapy' is generally used in quite different ways ([14] [15] [16] [17]). Therefore to insist on giving so much relative weight to these non-standard treatments is imo WP:UNDUE and seems willful. Especially when, until yesterday, the page for some reason completely failed to mention the primary usage of the term! —MistyMorn (talk) 01:28, 6 April 2012 (UTC)

Misty, you might like to check the article history before you get any further with your comments about "willfulness" and "missionary zeal" and "insisting on" anything. You will find that I have made only one edit in the entire history of the article. You, on the other hand, seem to have made seven so far, and all of them seem to be aimed at excising verifiable information that helped WP:Build the web.

If you're concerned that merely mentioning the existence of these treatments in a single, see-also type of sentence (which is all I provided; you're the one who turned it into a multi-sentence paragraph) is overwhelming the stub, then the correct solution is normally to expand the rest of the page, not to delete the appropriate material and relevant navigational links.

And, again, not all of these are "non-standard treatments", even if you personally didn't know anything about them before reading that page. WhatamIdoing (talk) 13:53, 6 April 2012 (UTC)

WhatamIdoing, I find this to and fro depressing and am going to leave the article before I risk losing it. To clarify, I in no way connected your name with the previous state of the article (and of course I have nothing against you). Maybe my choice of words was unfortunate. What I do find surprising is your insistence on prominently reintroducing and then defending material which has little to do with the commonly accepted usage of the term 'biotherapy' - especially when, in the previous version (4 years of history summarized here), the article had so perversely ignored the commonly accepted meaning of its title! If you want to stretch points in this way I guess that any form of treatment which uses biological materials can be classified as a biotherapy. For example, blood transfusion? But that's not how the term is generally used. Fyi, I was indeed aware of the existence of some of these unconventional treatments with little evidence base (eg [18]) which, when insisted on in some corners of clinical practice, can pose serious hygiene challenges for negligible clinical benefit (eg [19]). And leeching has a long history (Though to revive my spirits, I'll insert a link here to the leech gather on the lonely moor). But all this is a bit beside the point if the term 'biotherapy' is commonly used in quite different ways. Imo, the unconventional usages you're championing might possibly warrant some mention in a much expanded article, but not in this tiny stub. It just seems to me unhelpful for readers of this general encyclopedia. Maybe others would like to comment. Thank you. —MistyMorn (talk) 15:12, 6 April 2012 (UTC)

Btw, for some facts, try looking up in PubMed strings like
biological therapy[mh] AND leeching[mh]
biological therapy[mh] AND ("maggot therapy" OR "maggot debridement")
You'll find only a tiny fraction of the 200 thousand plus articles regarding humans that are indexed with the MeSH term biological therapy[mh]. —MistyMorn (talk) 16:58, 6 April 2012 (UTC)

Those terms are on distinct branches of the MESH tree. By "AND"ing the search terms you exclude most articles except only the few that refer to both MESH topics. A Pubmed query on ("biotherapy"[All Fields]) AND ("review"[Publication Type]) turns up a respectable 460 reviews. LeadSongDog come howl! 22:22, 6 April 2012 (UTC)

Thank you indeed for providing some third-party input, LeadSongDog.
I have to admit that I don't understand your particular use of bracketing or quotation marks in that search string; however, it seems to have some effect because what for me would be a more orthodox search string, biotherapy[All Fields] AND review[Publication Type], evokes 8187 results. To me, that simply means that PubMed retrieves 8187 articles containing the word biotherapy that have been indexed by NLM librarians as reviews. ANDing with maggot* OR leech* as wild cards -- ie biotherapy[All Fields] AND review[Publication Type] AND (maggot* OR leech*) -- provides only 9 results, indicating to me that 9 reviews that contain the word biotherapy in any field also contain a word such as leech, leeching, maggot etc. Inspection of the abstracts indicates that only two of those nine reviews (one in Chinese and one regarding veterinary medicine) actually regard maggot debridement (n=2) or leeching (n=0). Thus, 2/8187 (0.02%) reviews containing the word biotherapy appear to be about maggot debridement therapy or leeching. Of note, ORing "biological therapy" into the string does not change the numerator: ie (biotherapy[All Fields] OR "biological therapy") AND review[Publication Type] AND (maggot* OR leech*) = 9. I think this illustrates why biological therapy and leeching are on different arms of the MeSH tree, and also why treatments such as maggot debridement and leeching do not deserve mention on the Biotherapy page. —MistyMorn (talk) 23:23, 6 April 2012 (UTC)

My apologies for contributing to any miscommunication here. I hope we can sort this out. I'm curious, has anyone reviewed the redirect for biological therapy? It currently redirects to immunotherapy. Viriditas (talk) 23:30, 6 April 2012 (UTC)

Not your fault at all (and actually I'm ruing my choice of words when replying to WhatamIdoing earlier). I had the redirect on my to-do list. I'd guess a redirect to biotherapy (where immunotherapy is clearly linked) is almost obligatory. Thanks, —MistyMorn (talk) 23:44, 6 April 2012 (UTC)

The use of quotation marks around "biotherapy" tells Pubmed to look for that exact term, not "biological therapy", which otherwise would be consided a match. It's important to see the actual query, as reported on the right side of the Pubmed page. A search on "maggot debridement" AND review finds 11 reviews, but these do not use the MESH heading "biological therapy", e.g. PMID 19452661. LeadSongDog come howl! 06:37, 7 April 2012 (UTC)

Yes, but I'm not really sure why we need to exclude biological therapy from that PubMed query, unless you're really suggesting that the bolded mention of the MeSH term in the opening sentence of the article is misleading and needs changing (indeed, biological therapy is the MeSH redirect for biotherapy, which is not an actual entry term). Anyway, I can't see any bibliometric arguments for arbitrarily, imo, including stuff like maggot debridement, which I guess is just the uncorrected legacy of an historical hoax or misunderstanding. Following the alternative course of abstractly stretching the MeSH-equivalent definition of biotherapy to contemplate use of non-synthesized insulin, blood transfusion, organ transplantation etc (in contrast though with the MeSH tree) would presumably imply that the Chemotherapy page needs changing in a similar way to take in any form of drug therapy... something which seems to me quite inappropriate. Perhaps it would be preferable to edit the mention of the term biological therapy at the start of this stub? Thoughts? —MistyMorn (talk) 07:41, 7 April 2012 (UTC)

Chemotherapy has a whole section explaining its historical definition, which was therapy with any chemical (somewhat narrowly defined; it generally excluded plant extracts and the like, even those are technically chemicals, too.).

My reason for including these items is because some readers will be looking for them when they visit this page. We need to WP:Build the web and assist our readers. Furthermore, the fact that these are forms of biotherapy is trivially supported by the sources, e.g.,

• "One form of biotherapy that has made a major comeback in the 21st century is maggot debridement therapy (MDT), also referred to as larval therapy."[20]
• "Yet another long-used form of biotherapy, maggot debridement, has also been found to be effective in eradicating MRSA colonization of diabetic foot ulcers"(PMID 18395871)

and so forth. It's not a hoax or a misunderstanding. The soures really do define it this way. The website for the International Biotherapy Society at Hebrew University-Hadassah Medical School lists all of these and more. Including the things that our sources define as being biotherapy is not "arbitrary". WhatamIdoing (talk) 17:24, 7 April 2012 (UTC)

To me, the original article (made from a single-purpose account totaling 5 edits in <1 hour), which completely ignored the normal usage of its subject, looks to me like a hoax, POV pushing, or a mistake (a bit like writing an article on Literature which only considers the literature).
Wiktionary lists two distinct usages of the word biotherapy. Imo, an encyclopedic entry titled Biotherapy, however brief (and I'm afraid don't feel qualified to expand this stub into a proper article) should focus on the main usage in keeping with WP:COMMONNAME. At the same time, there could also be a separate article on use of living animals for medical treatment or as an adjunct to medical diagnosis, perhaps titled Zootherapy (with a disambiguation hat link provided on the Biotherapy page), as I think the "vandals" were trying to let us know in gf. If there's some consensus here, perhaps you and others would like to start that article, incorporating the material I excluded from Biotherapy, together of course your own work? —MistyMorn (talk) 19:17, 7 April 2012 (UTC)

I certainly agree that readers looking for the 'zootherapy' usage of 'biotherapy' need directions: imo, that need would be best addressed by a disambiguation hatnote. —MistyMorn (talk) 14:31, 9 April 2012 (UTC)

Btw, when I say hoax/misunderstanding, I mean this: That whoever originally started the article ignored -- whether deliberately or not, the primary meaning/usage of biotherapy -- as commonly employed and understood in the literature. Viriditas asked for an opinion on that page, and since I realize there are relatively few contributors to this project I tried to help out by fixing an obvious misconception which had survived for several years. Maybe my choice of words here was sometimes unfortunate, but I have worked to resolve a concern then raised by WhatamIdoing. —MistyMorn (talk) 13:25, 9 April 2012 (UTC)

Zootherapy proposal

Given the existence of Wiktionary lists two distinct usages of the word 'biotherapy' (ie 1) immunotherapy, gene therapy etc -- aka biological therapy vs. 2) living organism-related therapies -- aka zootherapy), and seeing that the biological therapy therapy usage is the one commonly adopted in the scholarly literature (see [21] [22]), I propose finding a suitable home for the organism-related therapy usage in a new page titled Zootherapy. I think this proposal is in line with WP:COMMONNAME and is appropriate for Wikipedia the encyclopedia, as distinct from Wiktionary. Please feel free to support/oppose or comment on issues. —MistyMorn (talk) 09:20, 8 April 2012 (UTC)

Comment I see the Animal-assisted therapy page has an ongoing discussion about its scope. There might be some issues of definition/overlap between Zootherapy and Animal-assisted therapy? —MistyMorn (talk) 06:59, 8 April 2012 (UTC)

Comment Further, as Zootherapy, with its long and varied history, could arguably be considered a separate topic an alternative solution might be to have a second 'Biotherapy' page titled something like Biotherapy (animal-assisted). This option would also obviate potential objections that 'zootherapy' is a neologism which is not yet universally recognized by dictionaries —MistyMorn (talk) 14:02, 9 April 2012 (UTC)

I agree with your comments above that Biotherapy was WP:NOTDONE when it was started. We apparently disagree on whether that constitutes a serious, blanking-worthy problem or a normal opportunity for collaboration.

I don't think that splitting a stub is ever a desirable approach. Additionally, I'm also not sure that it's possible to draw a non-arbitrary line between the two. For example, does BCG therapy get filed with "immunotherapy" or with "living organisms"? It's both, after all. WhatamIdoing (talk) 16:53, 9 April 2012 (UTC)

So I've been blanking rather than collaborating? You may not have noticed but I've worked quite hard on this, trying to collaborate, even though the specific issue really doesn't interest me that much. The reason I came here is because it's been brought to my attention that this project is short of collaborators. I'm trying to help out. But this may be bad for my blood pressure. Help! —MistyMorn (talk) 18:32, 9 April 2012 (UTC)

WikiProject Immunology

Hi all, I am trying to get the support to set up a WikiProject for immunology. My reasons are stated at the proposal page, a discussion has also be initiated. Currently, I am just trying to get a feel of how many editors are interested, and whether we have enough to build a task group for a one-month drive, or to improve on one major article, to see how feasible it is to have a WikiProject. Any input, whether opposing or supporting, would be very much appreciated. Again, the link to the proposal is here. Many thanks. Kinkreet^{~♥moshi moshi♥~} 13:20, 5 April 2012 (UTC)

I would have thought that a task force within the umbrella of WikiProject Medicine would be a better place than a separate project, particularly as there is an existing proposal dating from August 2010. Have you looked at Wikipedia talk:WikiProject Medicine/Task forces#Autoimmune diseases or just Immunology? Sadly neither of the two editors signed there appear to be currently active, but it may give you an idea of how MED task forces are proposed. --RexxS (talk) 14:37, 5 April 2012 (UTC)

The number of active editors on Wikipedia who deal with health sciences is small. While creating taskforces may be useful it is hard to find enough people to join and keep it active. It is often good just to bring discussion here.--Doc James (talk · contribs · email) 15:16, 5 April 2012 (UTC)

Immunology would benefit from a dedicated WikiProject, rather than being a task force, but it would need a critical mass of editors to achieve anything. The concepts are very abstract, and a lot of work is required on immunology-related content. JFW | T@lk 16:28, 5 April 2012 (UTC)

If there aren't very many people interested, then I'd be happy to "host" them as a task force here, to relieve them of the administrivia involved in setting up and maintaining a project. Then when they get bigger, they could easily spin themselves off as a separate project. WhatamIdoing (talk) 17:01, 5 April 2012 (UTC)

I'm by no means an expert on immunology but I do have some background knowledge through my degree and experience. Would be willing to help on the more basic topics :) Regards, --—Cyclonenim | Chat  12:27, 9 April 2012 (UTC)

I'm a fairly good copyeditor and "tweaker for readability". I have had several undergrad- and grad-level courses in immunology. If you will post me on my Talk page when you think I might be helpful on a specific article, I would be pleased to do what I can as time allows.

Very best regards:

Cliff (a/k/a "Uploadvirus") (talk) 06:14, 10 April 2012 (UTC)

Hereditary leiomyomatosis and renal cell cancer

DrMirco has done great work creating this article. It touches a large number of more, less or vaguely associated syndromes and rare diseases so please have a look if you can add some wikilinks or content. Richiez (talk) 14:41, 9 April 2012 (UTC)

Indeed! I've done a little copyediting but run into a problem which I've outlined on the talk page. Regards, —MistyMorn (talk) 17:37, 9 April 2012 (UTC)

Tay–Sachs disease

Tay–Sachs disease has been listed at Wikipedia:Good article nominations#Biology_and_medicine for about six weeks. Ebe is hoping for a stringent reviewer, with a future FAC in mind. WhatamIdoing (talk) 18:21, 9 April 2012 (UTC)

Pictures Requested

Hello Everyone:

I have busted my hump two rather extensive articles that are getting to the point of being fairly decent and comprehensive. I intend to spend considerable time over the next month or so on them to put the "finishing touches" on them.

The articles are, however, in desperate need of decent micrographs. If anyone can find one suitable for use and insert them whenever they get the chance, I would be very grateful. The articles are large cell lung carcinoma with rhabdoid phenotype and giant cell carcinoma of the lung. Although I don't remember because of my old age and the length of time since the peer review, I think someone told me that the one I used in combined small cell lung carcinoma might be one that is copyrighted, so if someone wants to check that and insert one thats not a "no-no", that would (obviously) be quite desirable.

Lastly, I hope each and every one of you are doing well, and thanks so much for the favors you all done me in the past ... particularly putting up with me when I'm an idiot (truly, there should be a special barnstar for that one) :-O

Best regards: Cliff (a/k/a "Uploadvirus") (talk) 06:35, 10 April 2012 (UTC)

Request for suggestions on Medical associations

Hi -

I've been trying to do a bit of cleanup in the category trees in Health. I came across the following two:

• Category:Health_care-related_professional_associations
• Category:Medical_associations

As I'm looking at the articles, it seems that there seems to be some overlap in the categories. I'm wondering if anyone could propose a rational division of the categories, or would you suggest that they simply be merged instead? If we keep all of the separate categories, what should the criteria be? Is it all about degrees? In addition, the main 'article' for the category Category:Medical_associations is Health association. That article itself could clearly use some help, but if someone has a definition for Medical association that separates it from nursing association, surgery association, dental association, etc. If anyone wants to take a crack at a better definition (and perhaps rename) of Health association and somehow fix these two cats + that article I'm all ears for your suggestions.

Finally, there is this one: Category:Medical_and_health_organizations, this category and its subcats is a big mess - do you have any suggestion on a standard way to organize these? There seems to be a few cats which come up - hospitals/teaching hospitals as one, but I'm not sure what other big organizational buckets should be created. --Karl.brown (talk) 04:24, 8 April 2012 (UTC)

I looked at some of this (did some cleanup on some of the items). As far as medical and health organizations - might consider "Medical and health organizations by organization type" - what I am thinking would go in here are things like: Medical museums‎, Medical and health foundations, Health maintenance organizations, Hospitals, Health centers, Health agencies, Medical research institutes, Health charities - basically items where the defining character for the category is the type of the organization (as compared to the location/condition/specialty). This is only if you feel there are too many subcategories in the main category (there are a fair number, but I am not sure there are too many.) Zodon (talk) 08:51, 10 April 2012 (UTC)

For cat by type, I'd suggest starting with major categories, along these lines: Health care delivery organizations, Medical research organizations, Health advocacy groups, Health professional organizations, Health regulators. As Teaching hospitals cross so many boundaries, they might need their own cat too. wp:WikiProject Categories may be able to help. LeadSongDog come howl! 13:32, 10 April 2012 (UTC)

Long time no see

I'm sure many of you won't know me but some of you may remember me as a regular editor here a year or two ago. I've been spending the past 7 months or so at a diagnostic mycology laboratory so I'm going to try and update a lot of the Wikipedia articles on fungi and their diseases. Anyone willing to help, please feel free to get in touch here or on my talk page :) Regards, --—Cyclonenim | Chat  12:25, 9 April 2012 (UTC)

Welcome back! I remember you, but then, I'm a dinosaur. MastCell ^Talk 21:13, 9 April 2012 (UTC)

I'd suggest a visit to Medicinal mushrooms for starters. Sourcing there is in dire need of an adept.LeadSongDog come howl! 22:17, 9 April 2012 (UTC)

There is an editor who appears to be making sure that the refs stay poor.--Doc James (talk · contribs · email) 23:44, 9 April 2012 (UTC)

Hmm, well I don't have much experience with medicinal use of mushrooms, more the clinical treatment and diagnosis side of mycology, but I'll take a look. Regards, --—Cyclonenim | Chat  18:15, 10 April 2012 (UTC)

It's great to have you back on board! NCurse _work 05:05, 11 April 2012 (UTC)

Thank you! Regards, --—Cyclonenim | Chat  15:53, 11 April 2012 (UTC)

I remember you, nice to see you back again. I hope that you are doing well.--Literaturegeek | T@1k? 22:22, 11 April 2012 (UTC)

Thank you :) Regards, --—Cyclonenim | Chat  18:21, 12 April 2012 (UTC)

Yes great to see long term Wikipedians return. There is still a lot of work to do :-) Doc James (talk · contribs · email) 20:29, 12 April 2012 (UTC)

Yet more trouble at Major depressive disorder

Some of you might already be aware that we've had a problem at this article for a while, regarding a single editor with an axe to grind over the use of a van Gogh painting there (he feels it's an injustice to what van Gogh intended the painting to portray). He's used several socks and now an editor, who I strongly suspect to be him under yet another username, and after unsuccessfully trying to unilaterally introduce the change, has started an RfC. I would appreciate your input there so we can finally put this issue to rest. See here. Many thanks. Basalisk ^{inspect damage}⁄_berate 07:00, 11 April 2012 (UTC)

Given the subject of the painting, I have to say I think the protestor might conceivably have a point (independently of behaviour on the Talk page, which I've deliberately avoided looking at for now). Imo, a key question might be whether any of the accepted case definitions of "major depressive disorders" include episodes of end-of-life depression. Otherwise, a strict justification of the appropriateness of the painting to illustrate a "major depressive disorder" would inevitably involve some degree of speculation on Van Gogh's own condition and his artistic intentions. Personally, I don't feel that the present illustration is a major travesty of Van Gogh or anyone else. However, I suppose it could be argued that it is not strictly pertinent to the topic. I guess it might eventually be possible to find a closer match. Just 2 non-polemical cents, —MistyMorn (talk) 11:29, 11 April 2012 (UTC)

I understand what you're saying, but as I've pointed out several times in the discussion already, I feel that what van Gogh intended when he created the painting is irrelevant - it is simply a good illustration of a despairing man. Even if van Gogh didn't intend it to look that way, it does, and since despair is a critical element of clinical depression I feel the painting is an appropriate illustration. Do you see my point? Basalisk ^{inspect damage}⁄_berate 12:49, 11 April 2012 (UTC)

Yes, I do, definitely. And I also did before! On purely editorial grounds, I also slightly wonder whether a closer match might be available which would share with the Van Gogh painting the virtue of communicating the suffering behind the stigma, as it were. (When I'm next on my travels I could ask a friend who has helped prepare the calalogue for an exhibition on the depiction of disease in art.) Though it also occurs to me that few artists gain a more sympathetic response from the general public than Van Gogh -- especially as regards mental suffering. So there may be, as you say, a strong argument for using this particular image. Perhaps the caption could be refocused to include a brief rationale for its use. Maybe something vasguely along the lines of "van Gogh's picture conveys something of the despair and isolation characteristic of clinical depression."
Best, —MistyMorn (talk) 13:43, 11 April 2012 (UTC)

Yes, although the image is a very fine illustration, it shouldn't convey the wrong idea. Say, someone sees that painting somewhere else they'll think "oh yeah, this is about despair: it says so on Wikipedia". Maybe there just simply isn't a prefect illustration, but it should be as good as possible. So, i support the idea of a caption of some sort, or finding a different image. benzband (talk) 16:22, 14 April 2012 (UTC)

Second-hand smoke and Passive smoking

I don't know what is going on with these articles, but as they stand Second-hand smoke and Passive smoking are two nearly identical articles, apparently resulting from a naming dispute. bd2412 T 04:07, 14 April 2012 (UTC)

Yes it is indeed a co-tract. I have thus returned it to a redirect.Doc James (talk · contribs · email) 23:26, 14 April 2012 (UTC)

Blaming the patients

Hi, to all of you at WP:MED. Thanks so much for all the good work you do. It's encouraging to see this kind of pro bono service from the medical community.

I need some help. In some parts of the Lyme disease (LD) article, patients and caregivers are blamed for the difficulties introduced by the LD controversy. I don't think that's a good policy, for either the patients or the medical field. I've shown previously in the LD discussion page, and elsewhere (diffs upon request, or see my user contributions) that the patients' complaints are justified by demonstrable and consequential errors in the mainstream science, that so far have resisted the usual self-correction process that keeps medical science moving forward. I'm not suggesting that we describe in detail the evidence that the science is bad, just that we remove the biased assumption that the patients MUST be either wrong or badly motivated.

I wonder if there's anyone at WP:MED who would be willing to collaborate in editing the article so as to correct for the (understandable) bias of the medical community against the patients and caregivers.. I don't mean to introduce a bias against the doctors, even those who have originated and propagated the regrettable errors.

I'm not "editing boldly" in this situation, because the debate is so polarized that even good edits might be construed as an attack on the article by "patient advocates". I've decided to be a single-issue editor so far, because as a scientist I don't feel comfortable passing along opinions that I haven't personally verified by checking the science in the primary literature. I'd be glad to help check science in other controversial fields on request, though - it's been intriguing following the chain of evidence back to its origins, and not as laborious as one might think, thanks to Pubmed.

I do understand WP policies, including MEDRS, SYN, and OR.

Thanks for your attention, best wishes, Postpostmod (talk) 12:25, 1 April 2012 (UTC)

Are you referring to "Lyme disease"? The only area where I see "blame" being assigned to patients/caregivers is in the subsection "Harrassment of researchers". The references ( [23], [24] ) look good to me. (I have not been able to check the Nature reference.) Axl ¤ [Talk] 13:56, 1 April 2012 (UTC)

Hi Axl, nice to meet you. I appreciate your extremely quick reply. I'm not questioning that one can find references in both the medical literature and the press, in which patients are blamed for medical controversies. I hope others will also read my request carefully, and respond independently, after some thought, so that we won't merely generate a chain-reaction of team support within WP:MED. Thanks again, Postpostmod (talk) 14:42, 1 April 2012 (UTC)

Maybe start by giving us the exact text you find objectionable with the refs supporting it.--Doc James (talk · contribs · email) 15:16, 1 April 2012 (UTC)

Hi Doc James, thanks for joining in. And hi again, Axl. I'll break this up for easy reading.

The paragraph Axl identified is the main thing I have in mind. The problem isn't about references.

I think It's unseemly to give encyclopedic status to such emotionally loaded material. We don't have tear-jerking stories from patients in the article, though there are plenty in the press.

There are several emotional rants denigrating Lyme patients in the medical journals.

And there are many factual descriptions of patient pain and disability in the medical journals.

We need to write about the controversy, it's part of the subject. People have strong feelings about it. But there's no reason for us to actively provoke emotional reactions in the reader.

Could we just remove the problem paragraph - the ref is from 2001, anyway - and make sure it isn't replaced by something worse?

There's at least one other place I think needs some tweaking, but let's leave that out for now.

In brief, I'm asking that the article refrain from dissing the patients.  ;-).

Thanks for your time, best wishes, Postpostmod (talk) 01:14, 2 April 2012 (UTC)

Okay, so we have a verifiable, even uncontested fact here: A world-class expert got multiple, serious death threats—serious enough that someone went to the trouble and expense of hiring body guards. And these death threats came not from, say, political nutcases, but from patients, right? And we're all agreed that issuing death threats is a felony in the United States, rather than protected free speech, right?

And you don't want us to mention the fact that it happened, because it makes these criminals look bad? I don't know about you, but I believe that anyone who issues death threats deserves to look bad. Furthermore, this criminal behavior on the part of some patients is seriously harming the majority of patients, who have a harder time finding care providers as a result. Why shouldn't these normal patients be told that the criminals among them are screwing up their care?

The only change I'd make to this paragraph is to insert the word "some" in the phrase "threatened by patients and patient advocacy groups". WhatamIdoing (talk) 03:33, 2 April 2012 (UTC)

Yes. It's not a matter of "blaming" patients or "denigrating" them groundlessly. When a group of people threatens a medical researcher with death for failing to validate their perceptions of their illness, that's a bit transgressive. And regardless of the value judgments we assign, it's certainly notable, in the sense that our article on the topic should mention it. MastCell ^Talk 03:43, 2 April 2012 (UTC)

Is there any way of quantifying it? Could one say "a small vocal / violent minority" or "N% of ..." or something like that? If it can be done, it should address both concerns; i.e. to get the factual information there that it did / does happen, but to ensure that not all patients end up tarred with the same brush. Pesky (talk) 07:45, 2 April 2012 (UTC)

From the first reference:-

"[H]ordes of patients had started to stalk him. They showed up at his public engagements, holding signs that read "How many more will you kill?" and "Steer Clear of Steere!" They depicted him in the media as a demon, worse than the spirochetes, the tick-borne bacteria that they claimed inhabited their bodies.... Egged on by advocacy groups, they infected his sterile world, trying to destroy his reputation and career."

The reference does not imply that these "hordes of patients" are a minority. If anything, Wikipedia's article avoids such value-laden terms. Axl ¤ [Talk] 12:21, 2 April 2012 (UTC)

• Looks sourced from here. SandyGeorgia (Talk) 15:35, 2 April 2012 (UTC)

Ah, I didn't mean to imply that I thought it was a minority, I just used the wrong example for a possible way of stating something, obviously! (I'm still post-anaesthesia brain-foggy myself, so please bear with me). Does any other source give us any idea of numbers? Scores? Hundreds? Thousands? Or any idea of what percentage of his patients? "Hordes" can mean vastly different things to different people, and the ideal situation would be to give readers a ball-park figure, if it's available. Pesky (talk) 18:54, 2 April 2012 (UTC)

Given that there are ~25,000 cases of acute infection each year, and that most of them recover without any lingering effects, it seems highly probable that the "chronic Lyme" patients are a minority. And given that most people can't be bothered to write a letter, much less to engage in in-person protests, it seems highly likely that the subset of "badly behaved chronic Lyme patients" (e.g., those making death threats) is a tiny minority. But I doubt that it's been quantified by any reliable source. WhatamIdoing (talk) 19:21, 2 April 2012 (UTC)

Sorry, I didn't mean to pump up anybody's adrenaline. But it does show why it's not a good idea to use such colorful language in an encyclopedia. It's kind of like "death tax" and "death panel": generates lots of heat, not much light. The purple prose is the main thing that makes the Grann article suspect as a source, in my view. Along with the fact that Steere hired a PR agent to get himself into the press (see the article - it's kind of buried in there, after the quote from Polly Murray, who discovered the cluster of patients in Lyme and called in the CDC in 1975).

If we want to have a media article in there about the controversy, how about the article published in the actual NYT (not the magazine), [here]? It's more informative about the cause of the controversy, and doesn't malign either the patients or Dr. Steere. It does treats Steere, like the patients, as a fallible human being. Maybe that's a good thing.

It doesn't seem as if anyone here is interested in why the science remains controversial, particularly the current diagnostic testing scheme. I admit I'm puzzled by the lack of interest in this question. To me, it's the most interesting part of the subject - the rest of it is all hand-waving and hearsay. If anyone would like to exercise due diligence, the papers about the testing I discussed with MastCell on his talk page are PMID 18532885 and PMID 8903216. There's one about diagnosing a patient discussed on the LD talk page, PMID 17429088. And the one I was going to do next is Jiang et al. 2010, PMID 21112481. This last one presents the Chinese CDC's independently derived criteria for Lyme Western blot interpretation. Heck, maybe in a couple of years we New Englanders can solve that part of the problem by outsourcing the testing to China. ;-) Best wishes to all, Postpostmod (talk) 23:10, 2 April 2012 (UTC)

We typically use review article rather than primary research papers per WP:MEDRS. --Doc James (talk · contribs · email) 23:40, 2 April 2012 (UTC)

BTW is this what we are referring to?

In 2001, The New York Times Magazine reported that Allen Steere, chief of immunology and rheumatology at Tufts Medical Center and a codiscoverer and leading expert on Lyme disease, had been harassed, stalked, and threatened by patients and patient advocacy groups angry at his refusal to substantiate their diagnoses of chronic Lyme disease and endorse long-term antibiotic therapy. Because this intimidation included death threats, Steere was assigned security guards. Paul G. Auwaerter, director of infectious disease at Johns Hopkins School of Medicine, cited the political controversy and high emotions as contributing to a "poisonous atmosphere" around Lyme disease, which he believes has led to doctors trying to avoid having Lyme patients in their practice.

Doc James (talk · contribs · email) 23:53, 2 April 2012 (UTC)

Yes, that, and the heading "Harrassment of researchers".

See how it affected WAID, here?

Not a good thing for an encyclopedia to inspire, in the millions of people who might read it.

Basically, it suggests that everyone who questions Steere's science and its consequences for the patients, is a potentially homicidal nutcase.

(I'm not blaming you for feeling this way, WAID; it's the fault of the paragraph and the sensationalized story to which it refers.)

Since no one wants to just remove the paragraph,

I've suggested a more appropriate, encyclopedic ref to replace it, above.

I guess I should write the paragraph for the WP article, which describes this ref.

Best wishes to all, Postpostmod (talk) 01:02, 3 April 2012 (UTC)

I think WhatamIdoing's response was forceful but not, as you're trying to portray it, excessively emotional or irrational . The article doesn't state nor imply that anyone who disagrees with Steere is homicidal. It does convey the rather remarkable fact that Steere has been driven into hiding and threatened with death by people who disagree with his research findings. One might think that a responsible patient-advocacy community would denounce death threats as a tactic; if you've seen sources to the effect that the "Lyme-literate" community has distanced itself from these excesses, then we should certainly include those to avoid painting with an overly broad brush.

I'm not necessarily wedded to the David Grann piece from the New York Times Magazine, but your reasons for replacing it boil down to the fact that you dislike the piece, which isn't enough for me to want to replace it with an older source. MastCell ^Talk 04:15, 3 April 2012 (UTC)

" The purple prose is the main thing that makes the Grann article suspect as a source, in my view. "

— Postpostmod

I disagree with your assertion that Grann's article uses "purple prose". I do not consider it a "suspect source".

" If we want to have a media article in there about the controversy, how about the article published in the actual NYT (not the magazine), here? "

— Postpostmod

You refer to an article written in May 2009. Grann's article was written in June 2001.

" Yes, that, and the heading "Harrassment of researchers".... Not a good thing for an encyclopedia to inspire, in the millions of people who might read it. "

— Postpostmod

Wikipedia is not censored. We report information that is referenced to reliable sources. Your only valid objection here is based on assertion that Grann's article is "unreliable". I disagree with your assessment. Axl ¤ [Talk] 11:15, 3 April 2012 (UTC)

I can't imagine any way of accurately communicating the undisputed facts about death threats being issued to researchers without "inspiring" normal people to be appalled at the criminal behavior. Can you? IMO the only way to prevent the encyclopedia from "inspiring" this normal reaction is to censor it outright so that readers do not learn the facts. WhatamIdoing (talk) 18:34, 3 April 2012 (UTC)

Okay, consensus is, it stays in. I moved it to the Media section. I think that's appropriate for a magazine article. Thank you all for your attention, Postpostmod (talk) 23:19, 7 April 2012 (UTC)

I see that Yobol reverted your edit. I agree with Yobol. Axl ¤ [Talk] 19:59, 8 April 2012 (UTC)

I too agree with Yobol. If any change is to be made, adding the word "some" as a modifier would be appropriate. The impression should be created that it's not the majority of patients who are guilty of this behavior, but we should not leave the impression that it's a lone wolf. It's actually an unusual and very notable situation that should not be buried or ignored. It would also be nice to actually name the offending groups. -- Brangifer (talk) 20:25, 8 April 2012 (UTC)

Hi folks,

(I wrote the following lengthy response in my sandbox a week ago, then decided you all seem to prefer to cut to the chase. So I made my little edit instead. But now I guess I'll post this so it will be in the record. Someday people will wonder how this all played out. It belongs in the thread after MastCell's comment of 3 April.)

Oh dear. I had hoped to avoid critizing Dr. Steere. In my view, the main reason not to repeat the accusations against the patients in Wikipedia, is simply that they were reported in a piece of "creative" non-fiction which is obviously very biased toward propagating one POV. (i.e. that Steere is both a scientific hero and an innocent victim of crazy people). But you won't read Dr. Steere's papers to get the other perspective. You're ignoring the evidence.

To be fair, I don't think he knows what he's doing. I think doctors were begging him for a standardized test and cure, and he obliged them. Trouble is, the test is insensitive, and the cure doesn't work.

Also, I had hoped to avoid lengthy prose. This probably seems way too long and complex to a digital native. (Did any of you read Nicholas Carr's The Shallows?).

I'll answer you each individually.

Dear WhatamIdoing,

You refer to "undisputed facts". The protests are a matter of public record. But the death threats? Not so much. How would one go about disputing Steere's accusation against the patients? The idea that the death threats were "multiple" and "serious", as you say above, is not supported by physical evidence. Only the one email was shown to Grann, and since no one investigated where it came from, it is essentially a nasty email from an anonymous source. The "multiple" idea is mere assertion, from Dr. Steere, seconded by his PR agent, who was paid to get it into the press (that's essentially the job description for a PR agent, in case you didn't know).

I agree, I wouldn't like to get such an email. (Although I did once find a dead rat on my doorstep after displeasing a former employee who came from Siciliy, and I did wonder for a second - only rat I've seen in the 20 years I've lived here. But I didn't call the police or the press - I just told myself not to be melodramatic. :-) )

I certainly deplore the illegal, reprehensible email. It sounds like a teenage fan of Schwartzenegger to me. No one should send such a thing to anybody

There's no evidence presented of "stalking" in the legal sense. In this context, it's another example of trying to produce bias by using emotionally loaded prose.

I didn't do the public protests. But I think it's a good moral act to perform them. The first thing good people do when they're affected by something this bad (i.e., a systematically-decreed misdiagnosis), is to ask, How can I prevent this from happening to others? Granted, when this involves questioning icons of the mainstream medical establishment, the chances of success are slim. But one has the duty to try.

There isn't much private citizens can do, except demonstrate and educate. How else are children, nature-lovers, and gardening grandmothers to be protected from the same fate as the patient in PMID 17429088, for example?

I'm sure the hiring of the rent-a-cops, assuming it happened (Grann didn't see them), was less expensive than the PR agency. I won't call it a pseudo-event, but one does have to consider the possibilities. I think we can all see that Dr. Steere is very media-savvy. This isn't necessarily a bad thing, it's just a skill that most scientists and doctors don't have.

If you would critically read the few papers I've referenced, you could see that I'm neither ill-informed, vengeful, nor unduly "internet-armed", as the latest cliche goes. It's all there on PubMed. I can only assume that mainstream medicine hasn't done anything about it because they're all too busy following the leader, instead of checking the science. Apparently that's the norm, rather than the unfortunate exception, in medicine.

Finally, I agree with you 100%, that a "normal person" would be "appalled at the criminal behavior". That's what I meant to say above, that your reaction is typical.

Therefore, the Grann article, and Wikipedia's description of it as if it were factual, is seriously prejudicial against the patients.

It will distract both normal people and their family doctors from realizing that LD is serious, under-diagnosed, and under-treated, contrary to Steere's disease model.

I can't tell you how many children I see playing in the grass in shorts and flip-flops, in this highly endemic area. The 5-14 yo age group has the highest rate of (reported) infection: http://www.cdc.gov/lyme/stats/chartstables/incidencebyagesex.html

They all wear bike helmets, though. Safety is a matter of education.

Sorry I have to disagree with you on this. I think you're doing a great job overall. I hope you and yours are well, Postpostmod

Axl, I do appreciate your responding. First a couple of factual notes: I didn't mention any article from 2009. And I never used the word "unreliable", although your putting it in quotes makes it look like you think I did. I'll bold what I think are the most relevant words, since my style may be too elaborate for easy reading.)

I did imply that the Grann article is not an appropriate source. It is in a magazine, which must be considered on a contextual basis, according to WP:RS. The prose is too emotional to grant it the status of a "news" article. I think you're confusing the NYTMagazine with the NYT newpaper. At best, it's a bid to entertain via a sensational human interest story. That a PR agent hired by Steere was admittedly involved does not look good.

Regarding purple prose, I realized I should not use any slang expressions here, because it might not mean the same thing in other countries as it does in the US. I'll give you an example of what I mean about the tone of the prose:

You said:

"From the first reference:-

"[H]ordes of patients had started to stalk him. They showed up at his public engagements, holding signs that read "How many more will you kill?" and "Steer Clear of Steere!" They depicted him in the media as a demon, worse than the spirochetes, the tick-borne bacteria that they claimed inhabited their bodies.... Egged on by advocacy groups, they infected his sterile world, trying to destroy his reputation and career."

The reference does not imply that these "hordes of patients" are a minority. If anything, Wikipedia's article avoids such value-laden terms. Axl ¤ [Talk] 8:21 am, 2 April 2012, last Monday (4 days ago) (UTC−4)"

I agree with you that Wikipedia avoids such value-laden terms. I think it's right to do so.

Could you tell me what you think the purpose of that rule is?

In other words, if it's too "value-laden" for Wikipedia, why are we accepting a magazine article that uses such language, as if it's a factual report?

If anything, MastCell's summary dignifies the accusation beyond its origin. It takes a questionably derived "fact", removes it from the context that would allow people to recognize the questionable nature of the source, and presents it as if it were an "undisputed fact". Sure, this tactic often works, in a PR sense - but does Wikipedia really want to stoop to that?

Sorry I have to argue with you. Best wishes, Postpostmod

MastCell, What can I say? I know you can do whatever you want with the article. It's my responsibility to try to improve the article. It's not my responsibility to get upset about the (predictable) lack of results.

Well, that's quite enough. I'm off to Arizona to bird the famous San Pedro Reserve and Ramsey Canyon. Along with a companion, who has been attacked by demonic spirochetes, threatening him with a slow and painful decline into a twilit world of pain and confusion. But he has been snatched from the jaws of destruction by a good doctor who braves the hordes of desperate, IDSA-armed medical boards eager to take away his license.

(See how silly that kind of language sounds, when it comes from the "other side"? ;-)

I know you're all doing the best you can. I even think that about Dr. Steere.

Sometimes we say about a scientist that "he just doesn't have it", "it" being the talent to do research that uncovers actual facts about nature. It must be frustrating to get oneself into a powerful position and then not quite have the talent to back it up.

Best wishes to you all, Postpostmod (talk) 23:27, 14 April 2012 (UTC)

Our sources are not required to be neutral, and they are not required to "show their work". If a reputable, independent periodical asserts the existence of (for example) multiple death threats, and this claim is not contradicted by equally reputable, equally independent sources, then we accept that as a verifiable fact. For example, the media reported multiple death threats being issued against Barack Obama during the previous presidential campaign, and the community didn't entertain any whingeing about whether the journalists reported that they personally saw the threatening communications.

It doesn't matter if someone hires a public relations professional, and you're wrong about the job description for a PR person. Their job is frequently to answer media inquiries so that the client doesn't have to waste his time on it. (Remember all that stuff in the articles about how many times he refused interviews? Those rejections are normally delivered by the person that you claim is trying to increase his media exposure.) If I were to make one suggestion about how you could better educate yourself, it would be to find someone who has actually done that profesionally, and ask them what they think about your rather limited notion of PR work. WhatamIdoing (talk) 00:57, 15 April 2012 (UTC)

" First a couple of factual notes: I didn't mention any article from 2009. "

— Postpostmod

I refer to this statement: "If we want to have a media article in there about the controversy, how about the article published in the actual NYT (not the magazine), here?" Actually I made a mistake; the article was from 1999, not 2009. Sorry for the confusion.

" And I never used the word "unreliable" "

— Postpostmod

I didn't intend to to imply that you explicitly stated the word "unreliable". You stated "makes the Grann article suspect as a source". Isn't this the same as saying that it is unreliable? If you believe that the Grann article is actually reliable, please correct my misapprehension. I used the word "unreliable" in quotes because it is your only valid reason for excluding the reference from "Lyme disease", per WP:MEDRS.

" I agree with you that Wikipedia avoids such value-laden terms. "

— Postpostmod

That isn't what I said. I said "Wikipedia's article avoids such value-laden terms." I.e., the article "Lyme disease" avoids such terms. There is a guideline here.

" In other words, if it's too "value-laden" for Wikipedia, why are we accepting a magazine article that uses such language, as if it's a factual report? "

— Postpostmod

WP:MEDRS applies to choice of sources. WP:WTA applies to the text in Wikipedia's articles. Both are guidelines.

" It takes a questionably derived "fact", removes it from the context that would allow people to recognize the questionable nature of the source, and presents it as if it were an "undisputed fact". "

— Postpostmod

Well, that's your opinion. Axl ¤ [Talk] 09:50, 16 April 2012 (UTC)

Any objections to my copying this thread over to the LD talk page? I initially broached it over here, in case anyone at WP:MED would feel more comfortable breaking ranks and expressing consideration for patients and caregivers, in this relatively private environment, rather than the talk page of a contentious article. But that didn't happen, and the paragraph will remain in the article with its heading. It would be nice for readers who know about the use of the discussion page, to see what reasoning was used in keeping this paragraph in. Best wishes, Postpostmod (talk) 15:40, 17 April 2012 (UTC)

You are very intent on framing this conflict as a Manichean dichotomy where either you're with the patients or against them. I think a lot of physicians feel that they are actually doing the right thing for patients by refusing to prescribe ineffective and potentially dangerous medications which lack an evidence base. I'll assume that you're not as disparaging and patronizing toward physicians who refuse to prescribe antibiotics for the common cold. Presumably you don't ask those physicians leading questions about why they won't "break ranks" with the medical orthodoxy and have "consideration for the patients" who demand antibiotics for their upper respiratory infections.

In any case, in the interest of redundancy and centralized discussion, it's probably better to leave a link to this discussion at Talk:Lyme disease rather than copy over the whole thing. MastCell ^Talk 17:51, 17 April 2012 (UTC)

Hi MastCell, 

I had a great time birding in southeastern Arizona. We saw 92 species, 46 of which were new to us. I'd never really visited the desert before. The scenery is so different there - it's like going to the moon, for someone used to a much moister climate. 

Maybe you didn't notice, I've conceded. The paragraph will stay in, having been fully supported by WP:MED, which has control over the article. I would think that this thread is just about done. 

I have to admit, I'm scratching my head over your latest comment. 

You seem to forget that you are the one who inserted the polarizing paragraph accusing patients of stalking, death threats, etc. into the article, and I am the one who wanted to take it out. Who is setting up the doctor vs. patient, black-and-white conflict in the article? It's not me. 

The same goes for "disparaging and patronizing". I guess that stuff is supposed to go only one way, and that way is not toward you ;-). On that subject, I read a funny book on my trip, called Lamb, by Christopher Moore. The setting is two thousand years ago. One of the characters invents sarcasm, and then is disappointed when his friends start using it back at him. He says he imagined it being used for good, not for evil, and one of the friends says something like, "you mean you didn't imagine it being used against you." But even so, I'm sorry if I sound like that. An eye for an eye makes the whole world blind. 

Also, you seem to be trying to associate me somehow with doctors who prescribe antibiotics for colds. The "whiney patient who wants antibiotics for a cold" trope has been repeated so widely, that it's becoming a mere talking point. I think it has surrendered its status as an aid to serious discussion. Of course, it refers to a real problem. But I don't see that the "common cold", which is self-limiting, and caused by viruses, for which there's no biological rationale for treating with antibiotics, is relevant here. Have you forgotten the difference between viruses and bacteria? or do you think I have? The comparison makes no sense. Especially since I haven't said one word about antibiotics in any of our long discussions about the problems with the IDSA guidelines regarding the standardized test. A  person not committed to WP:AGF might think that you're simply "energizing your base". 

As to what I say to doctors I meet socially, I usually ask them a few sympathetic questions about how they're finding the practice of medicine these days, and the sad stories start pouring out. They blame different combinations of factors, but a surprising number have a lot of simmering frustration and anger quite close to the surface, sort of like House, or Cox in Scrubs. There seems to be something really wrong there.

With regard to not copying the thread over, yes, fine, let's put a link for now, and then maybe copy it after it's been archived, so it doesn't get edited in two places. I think most casual readers don't even quite understand that there is a discussion page, they think everything happens by making edits in the article. Getting them over to WP:MED and an understanding of your gatekeeping role and its mechanisms would further strain their attention, when what they're really trying to do is to understand the disease.

Finally, I'd like to reiterate that I'm sure everyone involved means well, and is doing what they think is best. Happy editing, best wishes, Postpostmod (talk) 20:38, 19 April 2012 (UTC)

CFD: People who carried Hemophilia

There is currently a category Category:People with hemophilia and I'd like comments on possible related category alterations. Looking at the Category, it seems to naturally fall into two pieces: First, descendants of Queen Victoria like Alexei Nikolaevich, Tsarevich of Russia and secondly those whose Hemophilia is relevant because they have HIV/AIDS (and one HIV/AIDS activist where it doesn't say). Should these somehow be split into subcategories? Additionally, those women who are in the family trees between Victoria and the Hemophiliac descendants like Tsarina Alexandra Feodorovna (Alix of Hesse) should probably have a Category of their own, but I'm trying to figure out a name Category:People who carried hemophilia seems reasonable, but I don't like putting it in past tense. The fact the Tsarina was a carrier is a significant part of why she is Notable (yes, I know that she would almost certainly have a Wikipedia page in a Universe where she wasn't a carrier). Open to all ideas here.Naraht (talk) 16:13, 12 April 2012 (UTC)

Perhaps something like Category:Genetic carriers of hemophilia would be less awkward. WhatamIdoing (talk) 19:43, 14 April 2012 (UTC)

Given that the article is Haemophilia, should the category Category:People with hemophilia be changed to match the spelling?Naraht (talk) 10:02, 16 April 2012 (UTC)

Tool to determine which references are secondary sources and which are primary

Has any work been done to develop such a tool? Was discussed here Wikipedia_talk:WikiProject_Medicine/Archive_26#Creating_a_bot_to_search_Wikipedia_for_retracted_papers. Doc James (talk · contribs · email) 22:10, 13 April 2012 (UTC)

Nothing that I've heard of. There has to be an agreed way to use the result first. To my thinking, that way is adding a new parameter "pubtype" to the citation templates, which would be rendered as (research article), (review), etc. There was some confusion over whether the existing parameter "type" was meant for this purpose, but some editors want this for media type, such as (film), (book), etc. The template talk pages have all soft-redirected to centralized discussions at Help_talk:Citation_Style_1.

I expect user:diberri, user:smith609, or user:gadget850 would be best equipped to tackle such a change, if they have the time available and inclination. LeadSongDog come howl! 16:17, 14 April 2012 (UTC)

We can't really make such a determination automagically, because it depends on how you use the source. A systematic review, although something we would unhesitatingly label a secondary source, is actually a primary source for the statement "In 2007, a systematic review was published about the relationship between foo and bar". WhatamIdoing (talk) 19:48, 14 April 2012 (UTC)

Yes, and parts of a Discussion / Introduction sections of, say, an RCT can sometimes provide genuine secondary sources. —MistyMorn (talk) 20:15, 14 April 2012 (UTC)

All articles indexed by pubmed are labelled as to whether or not they are a review article and this is what I propose we go by. We can allow humans to make sure editors to it. I would not consider the introduction of primary sources to typically be secondary sources. The authors usually just highlight the research that pertains to their own conclusion and do not typically do a wide review.--Doc James (talk · contribs · email) 22:38, 14 April 2012 (UTC)

In practice, unfortunately, that often tends to be true. —MistyMorn (talk) 23:05, 14 April 2012 (UTC)

Secondary sources do not have to "do a wide review". Secondary sources an be incredibly narrow. Many systematic reviews by the Cochrane Collaboration fail to provide a wide review, and that "failure" (that tight focus on just "the research that pertains to their own conclusion") is considered one of their strengths. Secondary sources can also be unreliable, biased, and self-serving. They're still secondary sources. "Secondary" is not another way to spell "good". A source can be both secondary and completely inappropriate. WhatamIdoing (talk) 00:34, 15 April 2012 (UTC)

Sure but a primary research article looking at 10 people who took substance X to threat DM is never appropriated. Especially when review articles looking at all 50 studies of said substance exists. A "review article" is a marker of quality but not the only one. Thus the suggestion is to add this as "one" piece of info in the references not as the only piece.Doc James (talk · contribs · email) 01:21, 15 April 2012 (UTC)

I'm concerned that we will have problems with editors who are unfamiliar with our medical sourcing guidelines (or with the medical and scientific literature in general) misunderstanding or misusing this one parameter to guide their entire decision to accept or reject a paper as a source for one of our articles. We had a serious problem just a couple of weeks ago where one editor insisted that because a paper was identified as a "Review" in PubMed it would be inappropriate for Wikipedia editors to consider any other measures of the paper's quality. Putting further emphasis on this one binary-valued parameter is apt to encourage this problem. As WhatamIdoing notes above, "Secondary" is not another way to spell "good"—but we would be encouraging conflation of the two. A bad review is not better than a good primary source. TenOfAllTrades(talk) 14:50, 15 April 2012 (UTC)

You bet it isn't! I shouldn't really be butting in here, because I haven't yet properly thought through WP:MEDRS and its implications, but I do feel that critical sensitivity to context is important (I may be wrong, but I think I heard Doc James making a point somewhat along those lines just recently about an Efficacy subsection on the Chemotherapy page). Especially in less traveled areas where high quality reviews are scarce. Superfluous 2c perhaps, —MistyMorn (talk) 20:19, 15 April 2012 (UTC)

Whether a primary research article is appropriate depends on how you're using it. An old case study is great to support a statement about the first-ever description of a disease. It's an impossibly bad source if used to de-bunk modern reviews.

And I still believe that MEDRS is correct to tell editors not to reject a review because they personally disagree with the paper's inclusion criteria and conclusions, and/or because they believed that accurate information would cause some patients to wonder whether an unpleasant treatment produced enough benefits to be worthwhile, which appears to be exactly what Ten (and others) did in the case he mentions. (There, by the way, it wasn't a case of primary vs secondary sources; it was a question of whether treatment efficacy is mentioned at all, using the only relevant source anyone has yet found.) WhatamIdoing (talk) 21:55, 15 April 2012 (UTC)

WhatamIdoing, that's beneath you. I deliberately avoided linking to the article or discussions in question because I wanted to avoid making this into any sort of interpersonal conflict, and because I didn't want to look like I was picking on you. Continuing to assert that I and other editors rejected the use of the paper (discussed above at #Efficacy section of chemotherapy article needs work, and at Talk:Chemotherapy#Efficacy (2)) because we personally disagreed with its conclusions is an unjustified attack on our integrity. Our use of a dubious source was misleading to the point of recklessness, for reasons amply enumerated in the discussions I've linked. The attitude exemplified by your statement is precisely why I am so concerned about taking steps that would further emphasize this one metric of source quality at the expense of all others. TenOfAllTrades(talk) 22:45, 15 April 2012 (UTC)

(edit conflict) But in practice, the problem is not editors who think one review paper outweighs all others, it's the editors who do not differentiate between primary and secondary sources and insist on stuffing articles with primary studies that support their POV. In 9 cases out of 10, you would be right to equate "secondary" with "better than primary". --RexxS (talk) 21:58, 15 April 2012 (UTC)

We state the year that an article was published and equate more recent years with "better". Does this mean we should be getting rid of the year parameter as some old studies where good? 9 times out of 10 published primary research articles are overly positive about the subject matter at hand. We have the issue with SSRIs research in which positive studies are published and negative ones are not. Thus only a review that looks at the unpublished literature is able to give us a more accurate picture of reality.

We have articles like this Medicinal_mushrooms because we have users actively not wanting to give WP:MEDRS teeth and editors to fill articles with every positive little study every done. There are typically 10 to a 100 primary research articles for every review article. If we want to give them all equal weight regardless of if they are a review or not the primary research will swamp the review articles. It is so much easier for people with a POV to push it if we allow free us of primary research as can be seen here [[25]] before cleanup.Doc James (talk · contribs · email) 00:35, 16 April 2012 (UTC)

I think I agree with much of what you're saying, and I wouldn't want you to get the impression that I'm not. I completely understand and agree with the point that we usually use the primary-vs-secondary-source distinction as a way to (rightly) discourage the introduction of low-quality, speculative, fringe junk into our articles. I've put a fair bit of time into editing articles related to vaccination, so you can believe I've been exposed to more than enough of that crap.

I only point out that we also have problems going the other direction—that is, the equally mistaken view that if a source is nominally a 'secondary' source, it must be worthy of inclusion. It has been suggested that this would be a useful tool for editors looking to prune/evaluate references used in Wikipedia articles. I think that this would be a dangerous shortcut if used for that purpose, as it would tend to encourage editors to give the 'reviews' a free pass.

Incidentally, I got a bit lost there in your point about "a review that looks at the unpublished literature". When a 'review' represents the original outlet for a given clinical study, it is not a secondary source for that information; at that point it becomes a primary source, and we should be evaluating it as such. Part of the problem, I suppose, is that the definition of "Review" varies from journal to journal, and it covers a whole continuum of different article types, with varying degrees and elements of the property we might think of as 'secondaryness'. TenOfAllTrades(talk) 01:12, 16 April 2012 (UTC)

The Cochrane group does systematic reviews that include a look at the grey literature/ unpublished literature and this does not make them primary refs. --Doc James (talk · contribs · email) 05:10, 16 April 2012 (UTC)

I would be very careful to draw a distinction between the grey literature and unpublished literature; those are two quite different things. The grey literature is just another type (well, several other types, really) of primary source, covered by different (and varying) standards and practices compared to the peer-reviewed journal literature. TenOfAllTrades(talk) 18:22, 17 April 2012 (UTC)

What seems to be missing is the recognition that whenever pseudonymous wikipedians assess a specific primary source as being worth using, we engage in a form of OR that carries a considerable risk of granting that source wp:UNDUE weight. By relying on published bibliographic metadata we avoid this pitfall. In no way would that mean that for instance a recent high quality primary source could not be used to update an older secondary one. But masking that knowledge of which sources are primary from all but the few editors with ready access to them cannot possibly be constructive. Wè've seen over and over again how well intentioned editors will use primary sources as authoritative, often under the assertion that "it's in a peer-reviewed journal", while ignoring later sources that negate what they say. Marking citations with a pubtype will not on its own change that, but it will make it readily apparent as to when articles are heavily reliant on primary sources. At minimum, I would hope we can ensure these do not reach FAC without discussion of source quality. LeadSongDog come howl! 01:36, 16 April 2012 (UTC)

Whoah—wait a minute. Who's talking about 'masking' the identity of sources? The full citation should be right there in our footnotes, with a link straight to the freely-accessible full abstract on PubMed (which is a far more useful tool for our editors to use in making determinations about the nature of a source).

I'm not sure that your second sentence follows from the first one—how does metadata prevent pseudonymous Wikipedians from engaging in a form of OR that grants sources – primary, or secondary, review or meta-analysis – undue weight? In the chemotherapy case mentioned above, we had exactly that problem with a source that was nominally a review article (though it was really a badly-done meta-analysis), wherein we granted undue weight to the conclusions of one obscure 'review' article. (Frighteningly, there's even grounds to suspect that we distorted the published literatures by doing so—the paper was published in 2004, but received more than half of its total citations in other works after February 2011 when it was first used as a reference in Wikipedia.) TenOfAllTrades(talk) 02:21, 16 April 2012 (UTC)

I do not see how this justifies not provided this simple piece of information?Doc James (talk · contribs · email) 05:14, 16 April 2012 (UTC)

There are lots of 'simple' pieces of information that go into determining whether or not a source – primary or secondary – is 'reliable' enough for use in a Wikipedia article. The alternative question is, why should we include this one particular piece of information in the absence of all others? (All of the other information that we include in a citation is standard information used to identify and locate the source; this would be our first step into meta-information designed to guide our readers' evaluation of a source's quality or relevance.) It's also trivial to look up for each paper the journal's impact factor, or the number of times a given paper has been cited, or the number of PubMed-indexed publications written by each author. None of these factors by themselves would determine whether or not a paper was appropriate to cite in a Wikipedia article, but all could reasonably form part of our heuristic. Providing only one indicator of quality discourages readers and editors from considering or applying any of the other important criteria in judging a paper's quality or relevance.

Incidentally, we have yet another low-grade secondary source being pushed at Talk:Thiomersal controversy#The evidence favors a link. In this review article (PDF), the authors think that counting the number of papers that agree with their preferred conclusion is a meaningful form of meta-analysis. For bonus points, it's worth noting that the journal publishers or PubMed dropped the ball somewhere, as the PubMed/MEDLINE entry fails to note the article's status as a review. TenOfAllTrades(talk) 18:22, 17 April 2012 (UTC)

Although it's about the best we have available, I don't think anyone seriously regards Pubmed metadata as beyond error, especially records such as that, created at 06:00 on 27 December, probably during the late stages of tryptophan recovery :-) If Pubmed get their metadata wrong in a few cases, it's a trivial correction for WP article editors to make. Incidentally, it appears that paper was balanced by another review in the same journal issue, PMID 20628442. The publication type would hardly be the first piece of metadata we cite which is used in assessment. Authors, Journal, Date, (number of) pages and even Title all bear on the source assessment. The guidance found in Citing Medicine on the matter is at "Box 62 : Other types of material to include in notes" on p.44 of Chapter 1. Journals. LeadSongDog come howl! 20:10, 17 April 2012 (UTC)

I think there's a significant difference between choosing better sources, when we have a choice between multiple sources and some are clearly better than others (e.g., a meta-analysis of actual data vs counting up publications, assuming the point being made is about something other than the popularity of the subject in publications), and choosing to have a noticeably incomplete article because we personally dislike the only source we're all aware of. In that latter case, we should be careful about presenting the conclusions of a less-than-stellar source, but IMO we should not omit the subject entirely, nor should we write it based on our personal beliefs about what the answers ought to be, rather than on our sole (so far) reliable source.

As for the Chemotherapy problem, I'm not sure how else to interpret the comments on the talk page, which include statements like:

• "By including the article without discussion, you run the risk of causing cancer patients to reject medical treatment that might save their lives."—as clear a case of someone trying to manipulate the article's contents to help patients make the "right" choice in the real world as I've seen this year.
• "No, we shouldn't be reporting the results of an eight-year-old paper that uses even older data, analyzing it in a non-standard way, making...questionable...judgements about which data, diseases, and outcomes to omit" [ellipses in the original]—if this isn't a case of "reject[ing] a high-quality type of study due to personal objections to the study's inclusion criteria", then I don't know what would be. WhatamIdoing (talk) 14:18, 18 April 2012 (UTC)

The "right type of source" is only part of the criteria for deciding whether or not it is appropriate to use a particular source in a Wikipedia article. Your focus on that one point to the exclusion of all others isn't helpful. The right type of source that offers an answer to a poorly-asked or irrelevant question isn't something we should use.

Moreover, Wikipedia's editors aren't acting as the sole arbiters of this paper's quality or relevance. As I've already noted on our article's talk page, this paper has received very little recognition from the academic community, being cited just a baker's dozen times in other journal articles in the eight years since it was published. Even then, it was not always cited for its conclusions but sometimes for trivial background facts (including that cancer is treated principally with surgery, chemotherapy, and radiation [26]; or that radiation therapy is an important treatment modality [27]). When the academic community is reluctant to cite a review, we should be too. TenOfAllTrades(talk) 16:53, 18 April 2012 (UTC)

I have just looked at the discussion and the offending source. I have left my opinion there. Axl ¤ [Talk] 17:47, 18 April 2012 (UTC)

A metaquery perhaps...

As a newbie here, I'm just wondering about a key, underlying question (imo)... Assuming that none of us here believes that Wikipedia can or should compete with systematic reviews of the literature, and that we all basically accept that secondary sources (eg reviews, viewpoint/hypothesis articles, editorials etc) vary greatly in quality, scope and intention, then what can and should be the role of WP:MEDRES?

In practice, it seems to me that, here at least, Wikipedia can't aspire to being more than a convenient and widely consulted first stop for general information -- a bit like a free library of narrative reviews (or fragments thereof) of somewhat uncertain provenance and oversight. In that case, the aim of WP:MEDRES might be to provide the best feasible quality of readily consultable information within the intrinsic limitations of the format, while protecting against POV pushing, piloted misinformation, and other specific concerns such as information feedback loops.

To do that, imo, WP:MEDRES needs to address a variety of different editorial challenges, including POV pushing (magical mystery tour?) and inappropriately formulated POV issues (chemotherapy -- sinner or saint?), alongside the usual methodological concerns of trying to avoid the bias pitfalls to which we are all susceptible. That's one reason why I feel sensitivity to context is important for us from a purely editorial perspective.

At the risk of stating the blatantly obvious, while the Wikipedia policy and guideline collection may superficially resemble the Cochrane Handbook, we're not just in a different league here, we're in a different ballpark. —MistyMorn (talk) 10:00, 16 April 2012 (UTC)

Also at the risk of stating the obvious, Wikipedia is an encyclopedia, and as such is intended to be a summary of reliable information published elsewhere. A paper encyclopedia does not 'compete' with a medical textbook, and there is no reason to consider Wikipedia as competing with other sources of information. The model that Wikipedia is based upon has certain weaknesses, and the lack of an inherent mechanism to counter POV is one of the most pernicious. For that reason, creating policies and guidelines that support NPOV is essential, and I would argue that the guidance within MEDRS is a model for how RS should be implemented throughout the encyclopedia. As far as possible, I believe that we have to isolate our choice of sources from subjective opinion, and MEDRS provides a raft of criteria for enabling an objective assessment. From that viewpoint, MEDRS is already one of the best shields we have against deviations from NPOV. I'm not sure I'd want to go too far along the line of "context-sensitivity" (although I'm sympathetic to your intentions), because that may open the door to any POV-pusher to argue that their source has to be viewed in terms of their context. To take an extreme example, a Flat-Earther may be able to quote a Flat-Earth website in the Flat Earth article, but it would be a mistake to refer to the Earth as "allegedly round" just to accommodate a partisan source that asserts that the Earth is flat. --RexxS (talk) 16:44, 16 April 2012 (UTC)

Yes, I agree entirely about the need to defend from POV pushing and pulling. Thank you for taking the time to make this thoughtful reply which helps me get the question a wee bit clearer in my head. Prior to sticking a toe in the water here in the last couple of weeks, my feeling has been that this area of Wikipedia has the unusual advantage of being able to refer to levels of evidence, but also an unusually tricky responsibility towards readers. It's not that I see Wikipedia competing with other sources of medical information, it's just that I sense that many people tend to turn to Wikipedia as a first port of call. I feel that MEDRES needs to be complimented by the editorial sensitivity of regular contributors... Now there's another hot air platitude! Cheers, —MistyMorn (talk) 17:18, 16 April 2012 (UTC)

Yes, we are in a different ballpark. A WP article is intentionally a tertiary work. It summarizes secondary works on its subject, such as the relevant Cochrane reviews. It relies on the expertise of the authors and editors of those secondary works to determine the relative weight, correctness, importance, and reliability to assign to different primary works. In rare cases where the only relevant secondary sources have serious shortcomings, such as being out of date in a fast-changing field, we can with caution justify the use of primary sources, but we must craft assertions in such a way as to minimize any chance of injecting our own POV. We normally do this by in-text attribution (not just citation) which makes it apparent to the reader what we have done. Key phrases for this are of forms such as "An initial [clinical trial] by [Smith and Jones] reported in [2011] that [XYZ treatment] [insert key phrase from results summary in source]". Any substantial challenge to that source in the subsequent literature should be cause for concern. wp:PSTS should make this clear. LeadSongDog come howl! 19:06, 16 April 2012 (UTC)

And this should only be done within topics in which their are not recent review articles or major textbooks which are few and far in between (and would at least be sub articles of main topics).Doc James (talk · contribs · email) 22:39, 16 April 2012 (UTC)

Agree. Tks, —MistyMorn (talk) 10:10, 17 April 2012 (UTC)