Talk:Acupuncture/Archive 3

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paring lede

As an unlooked for side effect of trying to prettify and and properly integrate User:Mccready's recent edits, I reorganized and significantly rewrote the introduction. On inspection, this is far too drastic a change to introduce without discussion, so I am bringing it here; also, I do not have time tonight properly to place the content that it seems to me has no place in the new order. The major motivation for rewriting the lead section is that it swiftly devolves into verbose argumentation without first adequately explaining what the practice entails. Criticism and acceptance from the scientific community are crucial (lay opinions might also be nice), but I think that citing individual studies and conditions clutters the section and invites WP:SYN without allowing proper depth of treatment. This aggressive flensing leaves the second paragraph far too dependent on Ernst, and will definitely need to be fleshed out with a few recent high-quality unimpeachable systematic reviews. I have tried to err on the side of credulity, please comment and revise. - Eldereft ~(s)talk~ 10:47, 8 April 2008 (UTC)

Acupuncture (from Lat. acus, "needle", and pungere, "prick") or in Standard Mandarin, zhe-n bia-n (a related word zhe-n jiu( refers to acupuncture together with moxibustion) is a technique of inserting and manipulating fine filiform needles into specific points on the body with the aim of relieving pain and for therapeutic purposes. These acupuncture points lie along meridians along which qi, a kind of spiritual energy, is said to flow. There is no generally-accepted anatomical or histological basis for these concepts, and modern acupuncturists tend to view them in functional rather than structural terms, (viz. as a useful metaphor in guiding evaluation and care of patients). Acupuncture is thought to have originated in China and is most commonly associated with Traditional Chinese Medicine (TCM). Different types of acupuncture (Classical Chinese, Japanese, Tibetan, and Korean acupuncture) are practiced and taught throughout the world.

The practice of acupuncture predates the scientific method, and the Western scientific community initially reacted to the idea with skepticism and assignment of a low prior probability. Despite numerous clinical trials designed according to the precepts of evidence based medicine, the objective effectiveness of acupuncture beyond non-specific placebo effects has not been convincingly demonstrated, and remains controversial among researchers and clinicians. Further, several reviews have reported cultural, geographical, or other bias in published outcomes of scientific studies of acupuncture. The body of evidence remains inconclusive but is active and growing, and a 2007 review by Edzard Ernst and colleagues finds that the "emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions".

The WHO, the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), the American Medical Association (AMA) and various government reports have all studied and commented on the efficacy of acupuncture. There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles, and that further research is warranted.

Hi Eldereft, how goes it? Just the other day, as I was marveling at what a remarkable 6,000-year-old, non-climate-changing earth we're living on, I had a psychic premonition that you were editing this page. And I was right!!  ;-)

Great you and Orangemarlin and Davidruben are editing here. Wish I had more faith in WP or I'd be editing this one more actively. Anyway, I appreciate your efforts, including the above attempts at distillation, although there are a couple things I'd argue for changing. In general, I think Mccready's edits here tend to be highly biased and point-y, and that there is little of merit -- substantively or aesthetically -- in his recent attempts at re-writing the lead.

The "convincingly demonstrated beyond placebo" business is something of a red herring, IMO, because acupuncture is a procedure and not a pill, so one can't run double-blinded trials. So Mccready's list is true in a sense, but it is far from the whole truth. I'd be interested in Orangemarlin's view on whether every article on WP on any procedure should contain such a list, because it is equally true that there is no gold-standard EBM evidence for coronary bypass surgery, hip replacement, and on and on. Of course, that's a rhetorical question; it would be ridiculous to include such lists, both for aesthetic and undue weight reasons.

And of course the statement that Mccready keeps wanting to add, that a minority of scientists accept acu, is something that he's unable to support in any way except the most tenuous of original syntheses.

What I think might be better is to say something to the effect that for the last few decades the efficacy and mechanisms of acu has been studied, and remains controversial, and that the most promising areas are in pain control, and treating stress and nausea, and then keep fleshing that out further in the article. That seems consistent with what reviews say, as well as the studies themselves. A good way to weed out the chaff at Pubmed is to use the limits: (a) Type of Article: Clinical Trial, Meta-Analysis, Randomized Controlled Trial, Review; (b) Subsets: Core clinical journals, Dental journals. Can't link to the search directly.

Gotta go; will suggest some prose later. cheers, [[[User:Backin72|Backin72]] (n.b.) 02:30, 9 April 2008 (UTC)

I would say that I am doing great, but the secret government agents that I am watching are preparing for imminent alien activity and I need to hide before Elvis gets involved.

I would disagree that conducting properly blinded RCTs and demonstrating action beyond placebo is impossible. There have been designed some apparently quite clever retractable needles, and a really interesting study was published last week (Components of placebo effect) on splitting out different aspects of care to study individually their influence on the placebo effect. On the other hand, that is just a details issue that can be ironed out once we can all agree on a structural framework. Placebo response figures pretty prominently in the literature, but I am open on how precisely that is presented in the lead.

I would expect that "only a minority of scientists accept acupuncture" is true, but only in the trivial sense - I also have no particular opinion on whether post-surgical outpatient visits should routinely include a scan with a handheld ultrasound for thromboembolism. This statement requires a source, and unless major scientific bodies have start naming it anathema while I was not paying attention, I am not sure that one will be forthcoming.

I would like to avoid cluttering the limited introductory real estate, but characterizing the areas of suggested or demonstrated (lack of)/efficacy should be possible and worthwhile. This might need to be qualified be mentioning the range of use in TCM, which sacrifices a little in the way of paragraph focus.

Thanks for your reply, I look forward to more. - Eldereft ~(s)talk~ 06:33, 9 April 2008 (UTC)

It's easier to approximate the "gold standards" of double-blinding and placebo controls for acupuncture than it is for, say, coronary bypass surgery. It's still far more complicated than doing so with pills, though. So whatever we say about placebo here, as for any therapeutic procedure, should somehow factor in the caveats involved in proper study design. One sentence will do and I'm sure that in an inspired moment I'll come up with one. cheers, Backin72 (n.b.) 07:47, 12 April 2008 (UTC)

Just to add, Eldereft, I haven't forgotten about this. Have been busy IRL, but still taking an occasional moment to swat away some disruption from this page's perennial disruptor. Thanks for your patience. At the moment, I think your version is a move sideways, better and worse in some respects. Sorry for slo-mo editing, but we'll get there. cheers, Backin72 (n.b.) 09:29, 20 April 2008 (UTC)

(de-indent) - OK, how about this? cheers, Backin72 (n.b.) 21:19, 27 April 2008 (UTC)

Explanation: I think my second para is more appropriate since the "prior probability" stuff needs a cite and is jargon-y. As I mentioned above, discussions of efficacy w/r/t placebo are are knotty ones for procedures (e.g. surgery) as opposed to pills, and invoke arguments about study design that I thought were better discussed in the article. Thus, it seemed that a more general statement was better. On the sentence about cultural biases in studies, that's an artifact of a Mccready drive-by where he inappropriately inserts any and all new material into lead sections; I've placed it in the appropriate section, but its weight in the article does not demand lead inclusion. cheers, Backin72 (n.b.) 00:37, 28 April 2008 (UTC)

This page should be beneficial in getting down firm operation definitions of acupuncture, scope, etc.. as well as guidelines on the topic. It would be wise to consider these sources in the reformation of the article. CorticoSpinal (talk) 21:55, 27 April 2008 (UTC)

Mccready and lead, part 19 in a continuing series

For McCready, re this string of attempts [1][2][3][4] to add undue weight, make a point and generally violate the letter and spirit of WP:LEAD... echoing Dematt above, are you trolling? We don't need to use the lead to list all the areas where acu's efficacy is unproven, or even some of them. We cover the topic (i.e., efficacy) more than sufficiently in the lead, and quite a bit more under Acupuncture#Scientific_research_into_efficacy, where we also offlink to Cochrane's list of acu reviews as well. --Backin72 (n.b.) 07:50, 12 April 2008 (UTC)

Effectiveness

For the following conditions, the Cochrane Collaboration concluded there is insufficient evidence that acupuncture is beneficial, often because of the paucity and poor quality of the research and that further research would be needed to support claims for efficacy: Giving up smoking,[5] chronic asthma,[6] bell's palsy,[7] shoulder pain,[8] lateral elbow pain,[9] acute stroke,[10] rheumatoid arthritis,[11] depression,[12] and induction of labour.[13]

please delete all duplication below and merge with above summary (thanks)

Acupuncture for depression - There is insufficient evidence that acupuncture may be helpful with the management of depression[14]

Acupuncture and related interventions for smoking cessation - Acupuncture and related therapies do not appear to help smokers who are trying to quit.[15]

Acupuncture for Bell's palsy - inadequate to allow any conclusion about the efficacy of acupuncture.[16]

Acupuncture for schizophrenia - We found insufficient evidence to recommend the use of acupuncture for people with schizophrenia.[17]

Acupuncture for epilepsy - No strong evidence for acupuncture as a treatment for epilepsy[18]

Auricular acupuncture for cocaine dependence - The authors conclude that there is no evidence that any form of auricular acupuncture is effective for treating cocaine dependence.[19]

Acupuncture for insomnia - there is a lack of high quality clinical evidence supporting the treatment of people with insomnia using acupuncture[20]

Acupuncture for glaucoma - At this point, the effectiveness of acupuncture as a therapeutic modality for glaucoma could not be established[21]

Acupuncture for chronic asthma - Current evidence has not shown an effect in favour of acupuncture compared with control treatment for asthma[22]

Acupuncture for acute stroke - No clear evidence of benefit from acupuncture in acute stroke [23]

Acupuncture for vascular dementia - There is no evidence from randomized controlled trials to determine whether acupuncture provides any effect when treating people with vascular dementia[24]

Acupuncture for treatment of irritable bowel syndrome - There is no evidence to support the use of acupuncture for the treatment of irritable bowel syndrome.[25]

Acupuncture for stroke rehabilitation - No clear evidence of the effects of acupuncture on stroke rehabilitation[26]

Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis - From the little evidence that there is, acupuncture does not appear to improve the symptoms of rheumatoid arthritis.[27]

Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhoea - there is not enough evidence to assess the effect of acupuncture[28]

Acupuncture for induction of labour - There is insufficient evidence describing the efficacy of acupuncture to induce labour[29]

Sourcing

Parts of this article lack references, which is particularly troublesome when making quotes and summarising specific named studies, as the material becomes very hard to verify. Shoemaker's Holiday (talk) 06:39, 22 April 2008 (UTC)

Hi SH -- which parts that cite quotes/studies are unsourced? I'm not aware of any, but maybe I'm overlooking something. I know there is some unsourced stuff in there but it's mostly about the history of acupuncture, not research or quoted opinion. regards, Backin72 (n.b.) 23:00, 23 April 2008 (UTC)

Please, by all means fact tag them. I semi-regularly run through various pages searching for the text "citation needed", but am less likely to notice otherwise. - Eldereft ~(s)talk~ 23:47, 23 April 2008 (UTC)

Bakcin72 bulk revert

The silly bulk revert of my hour's work by Backin72 a few minutes ago cannot be allowed to go unchallenged. This is the last straw. He deleted uncontroversial and good edits and claimed they were addressed on talk. I'm not going to wade through thousands of words of talk to see what he means on this occasion. This new thread will allow him to say why he removed well sourced well edited material which other editors had suggested.Mccready (talk) 01:54, 28 April 2008 (UTC)

First, I reverted because your edit was redundant and sloppy, and ignored discussion on this page.

If it took you an hour to do two cut and pastes -- the second paragraph from Eldereft's draft above, and the material you've been edit warring about, then my heart goes out to you: you must have a very slow internet connection indeed.

Sorry you were puzzled as to where my discussion of my edit might be. Hint: a logical place for it would be at the bottom of Talk:Acupuncture#paring_lede, from which you cut and pasted your hour-long edit. Another good way to find out when editors may have recently edited a page is to use the history, which shows this: 00:37, 28 April 2008 Backin72 (Talk | contribs) (82,370 bytes) (→paring lede: explanation). Lo and behold, there are my comments.

Another thing the edit history shows is that the last time you edited this page, apart from your comment above, was 13:42, 17 March 2008. All this time you've been revert warring on the article, and you haven't discussed till now. You have it backwards: you need to be discussing a lot more and reverting a whole lot less.

As for our respective edits: you may not have noticed that I made a number of edits to the article today, including working in the material over which you've been revert warring. Your edit completely ignored that, and redundantly re-added list of conditions, and with poor formatting as well. As for my changes to the lead, those were based on Eldereft's draft above and our ensuing discussion (more below).

Since your edit adds redundant material and doesn't take into account the discussion following Eldereft's draft, I'm mostly reverting. Please feel free to continue the discussion. Why is "spiritual energy" preferable to "vital energy" given that most TCM-er's wouldn't call qi spiritual? Where is a reliable source on "prior probability", and why does a jargon-ish term like that belong in the lead? And most importantly, what is the threshold for objective efficacy beyond placebo, and how is that reached with acupuncture and other procedures (as opposed to compounds)? Has any surgical technique ever objectively been proven via double-blinded studies to be effective beyond placebo, and if not, isn't that the wrong question to be answering, cf. undue weight? I'd argue yes, and that a more general presentation, with further unpacking in the article, is preferable. --Backin72 (n.b.) 02:24, 28 April 2008 (UTC)

I think the problem we have here is that some kinds of treatment with acupuncture DO seem to survive reasonably serious scientific scrutiny - whilst others are no better than quackery. This is unfortunate because many of us (I have to confess to being one) are very much against the promotion of quackery to the status of science. However, when science shows that something works, it's vital to put away the skepticism and to start seeking an understanding of how the darned thing works. But here we have both...some things that you see all over the place (such as helping people quit smoking using acupuncture) are undoubtedly quackery of the worst kind - whilst others do indeed seem to work against all reasonable predictions. It is therefore ESSENTIAL that those of us on either side of the pseudo-science wars get together on this one subject where we ought to be able to put together something useful. We need to clearly separate out the things that we have good evidence that they work from the things that we have equally strong evidence do not. We can then proceed to write usefully about the areas of medicine where it's useful - including the occasional side-effect...and also to clearly state the areas where it does not work and fraudsters and charlatans need to be exposed for what they are - with appropriate language about the efficacy of placebo-effect "cures". May I suggest first separating out the material we have into two sections and proceeding from there with the detailed wording. SteveBaker (talk) 03:09, 29 April 2008 (UTC)

Hi Steve, and welcome -- your thoughtful comments are most welcome, especially given that the temperature has run a bit high lately. I agreed with almost everything you said except the very last part about splitting things into two sections. It's absolutely important to present the state of the art of scientific knowledge, but we have mostly shades of grey here, and I'd hate to see needless disputation over the somewhat arbitrary demarcation of what is proved vs unproved, as opposed to proved vs disproved. The section Acupuncture#Scientific_research_into_efficacy attempts to simply give evidence regarding different conditions, roughly descending in order of demonstrated efficacy. I'm sure that can be improved upon, but I have serious reservations about putting everything into two baskets... regards, Backin72 (n.b.) 03:24, 29 April 2008 (UTC)

Full protection

I have fully protected this article for a three day period due to apparent edit warring and disagreement. Please sort the issue out using this forum before these three days are up. -- Anonymous Dissident^Talk 04:17, 28 April 2008 (UTC)

Thanks; the principal disruptor generally eschews talk and has been blocked for 7 days, so I think this can be safely removed. cheers, Backin72 (n.b.) 03:26, 29 April 2008 (UTC)

Relationship of acupuncture points and meridians to connective tissue planes

This paper by Langevin and Yandow presents a fascinating (or fascia-nating) hypothesis regarding an anatomical basis for acupoints. Probably the most plausible I've seen. --[[[User:Backin72|Backin72]] (n.b.) 00:45, 11 May 2008 (UTC)

Changing the introductory paragraphs (2)

Regarding the specific quote by Ernst, how about replacing it by one from his (and Simon Singh's) new book:

"acupuncture is very likely to be acting as nothing more than a placebo"

(Trick or Treatment, p 87)? That sounds to me a fairer summary of Ernst's, at least, position? RandomP (talk) 20:07, 10 May 2008 (UTC)

They are both relevant experts, and I have heard good things about that book. It does not come out until August, but if you have an advance copy identical to the retail version it can probably be quoted (cited to both of them unless the organization of the book indicates otherwise). It is verifiable in principle, though you will need to be especially careful not to misrepresent the source in any way. You might want to take it up at Wikipedia:Reliable sources/Noticeboard, though. - Eldereft ~(s)talk~ 20:52, 10 May 2008 (UTC)

It's out in the UK, and I believe you can order it for shipment to the US.

RandomP (talk) 17:27, 11 May 2008 (UTC)

Whoops, time to get a {{globalize}} sticker for my forehead. Thanks. - Eldereft ~(s)talk~ 16:56, 13 May 2008 (UTC)

@RandomP: Except that what we're doing in the lead is attempting to summarize the evidence as presented in the article, not summarize the opinions of Ernst per se. I think we went with the quote that in the present version because we agreed that it squared well with the Cochrane reviews below. We don't have to rely on his quote if another summary (citing different or multiple sources) works better.

Ernst is unquestionably notable, but there are many notable commentators on acu, with a spectrum of opinion. And in any case, the whole point of EBM is that peer-reviewed meta-analyses are more reliable than the opinions of experts. --Backin72 (n.b.) 21:45, 10 May 2008 (UTC)

Currently, the lead represents someone from the "acupuncture is placebo"-camp, which appears to me to include everyone who's seriously studied it in the West, as being from the "acupuncture works sometimes, but not in concordance with the "theory" behind it" camp. That's unacceptable.

I think the scientific consensus on acupuncture is recently quite clear, though before about 2000 there was actual controversy, not least because of the WHO statement. If you want to portray that as a spectrum, I think it's important to point out that there's also a clear temporal trend: the more we know about acupuncture, the less it appears to work.

RandomP (talk) 17:27, 11 May 2008 (UTC)

Hi RandomP -- Ernst may well have changed his view on acu with the publication of his book with Singh. Prior to that, his commentary on acupuncture has been far more nuanced, e.g. "Compelling evidence now suggests that real acupuncture is better than sham acupuncture for a range of pain-related syndromes, e.g. back pain" (2005), as well as the two reviews currently cited in the lead (2006, 2007). The one from 2007 is the source of the quote: "The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions". So there has been no negligent misrepresentation of Ernst (although, as your quote suggests, he may well have changed his mind very recently). Indeed, Ernst's 2007 review reaches a conclusion that contradicts your last sentence regarding a temporal trend: "For 7 indications it has become more positive (i.e. favoring acupuncture) and for 6 it had changed in the opposite direction." [30]

In any case, I hope you agree that per WP:LEAD, our first priority in the lead section is to summarize the most salient points in the article.

As for your perspective on scientific consensus, I'm wondering what sources you base that on? I'm sure you can find some sources saying that acu is likely placebo, but if we're going to assert consensus exists, we'd better be sure our sources can meet the claim. Please see WP:RS#Claims_of_consensus. Who is saying that consensus exists? regards, Backin72 (n.b.) 19:02, 11 May 2008 (UTC)

Concurred - now that the lead is finally pared down to a manageable size, it would be nice to keep it that way. I got distracted by hoping that the new book was out, and was commenting solely on that point. Somewhere under Scientific research into efficacy might be good for the article, though. You might also work it in to (desperately needed) improvements to Scientific theories regarding acupuncture or Medical acupuncture. If you find a reliable source indicating that this placebo opinion is held by a significant portion of relevant researchers, that could be citeable in the lead as such, though.

As a side note, would we be interested in getting one of those nifty series templates for navigation between all the acupuncture articles? There are several. - Eldereft ~(s)talk~ 23:50, 10 May 2008 (UTC)

I too look forward to reading Ernst's book. I don't always agree with his interpretations of evidence, but I agree with his basic approach and believe he's honest. For sure the book will be a good source here and in other acu and CAM articles. Also, contrary to Mccready's fuming, I have no problem citing placebo anywhere here, including lead, but for the lead I agree it would have to be appropriately sourced and presented (since it's kind of complicated).

Thumbs-up on the series box idea (only caveat being formatting, i.e., space at the top). On the other two acu articles you cited, they are kind of a mess... both are very fork-ish and heavy on original research and weight problems. Probably each could be AfD's, salvaging maybe a paragraph's worth of good stuff that could be plopped in here. (And since this article is already long, other stuff, like a more general sci/efficacy article, could be spun off). But a few editors seem to have been really into keeping them, so I haven't pressed that issue.... cheers, Backin72 (n.b.) 00:43, 11 May 2008 (UTC)

Also, although Ernst's forthcoming book will certainly be a reliable source, it won't be quite at the level of a peer-reviewed systematic review, per WP:RS#Scholarship. Books are a good opportunity for scientists to state their opinions; there, they don't have to be quite as conservative as in peer-reviewed journals. Just a small caveat, not a big deal. --Backin72 (n.b.) 04:36, 12 May 2008 (UTC)

(undent) @RandomP - find a funnel plot supporting an inverse relationship between quality of study and likelihood of finding a significant effect. We already have a little bit about the geographic bias and the generally poor (though stellar compared to some alternative medicines) state of the evidence base. While I maintain that this must inform the weight given various studies and positions, I fail to see how it would not be original research to draw such a conclusion based solely on the sources currently cited. Ioannidis 2005 has some interesting ideas on how to interpret a weak evidence base, though applying their criteria directly to the situation at hand would of course run afoul of WP:NOR. - Eldereft ~(s)talk~ 16:56, 13 May 2008 (UTC)

Indications and WHO

The Indications according to acupuncturists in the West section discusses WHO having endorsed the effectiveness of acupuncture for the asterisked conditions. Is this ultimately cited to the 1979 Viewpoint? A great deal has occurred acupuncture research since then, both in terms of elucidating the publication bias in the field and in terms of rigorous investigation. I am not finding a more recent comparable document, but regardless it seems reasonable to at the very least note the historical nature of the opinion if not striking it outright. The closest I have found to the WHO's current stance is the Traditional Medicine factsheet:

Acupuncture has been proven effective in relieving postoperative pain, nausea during pregnancy, nausea and vomiting resulting from chemotherapy, and dental pain with extremely low side effects. It can also alleviate anxiety, panic disorders and insomnia.

It would be nice if the factsheet cited a full report, but sadly it is not that sort of document. Can anyone else find a better resource? - Eldereft (cont.) 04:14, 21 June 2008 (UTC)

Hi Eldereft - to answer your first question, yes, the WHO reference is to the 1979 statement. Agree it's way out of date, but it's cited all over the internet. That doesn't mean we need to, however. Unless we can find a fuller WHO review (and preferably a much more recent statement), I'd be happy to just drop all reference to it, and keep AAMA, and then perhaps another section with additional conditions named by equally notable groups. best, Backin72 (n.b.) 04:59, 28 June 2008 (UTC)

NIH advises against using the consensus statement

The NIH consensus statement now starts off

This statement is more than five years old and is provided solely for historical purposes. Due to the cumulative nature of medical research, new knowledge has inevitably accumulated in this subject area in the time since the statement was initially prepared. Thus some of the material is likely to be out of date, and at worst simply wrong. For reliable, current information on this and other health topics, we recommend consulting the National Institutes of Health's MedlinePlus

http://consensus.nih.gov/1997/1997Acupuncture107html.htm

I think that this probably needs to be noted. 68.57.206.49 (talk) 21:08, 26 June 2008 (UTC)

It is introduced as being from 1997, which should be sufficient caveat. Any specifically superseded statements could be cited and noted, though. - Eldereft (cont.) 23:20, 27 June 2008 (UTC)

UNDUE Weight

Backin72 wants to cherry pick the slight amount of dodgy evidence that may exist for efficacy of acu and put it at the top. This is unacceptable. We all know that acupuncture has no demonstrated effect for the huge range of conditions for which it is used. Shouldn't we put that at the top if this is the route you want to travel? Mccready (talk) 08:23, 28 January 2008 (UTC)

Cochrane Collaboration is dodgy, eh? Sounds like an opinion straight out of the fringes of anti-science. It looks like more editors agree the lead is well-weighted in the version you dislike. The sources are impeccable, like Ernst, and the wording is clear about where there is and isn't efficacy per EBM. --Backin72 (n.b.) 09:03, 28 January 2008 (UTC)

Are you being deliberately obtuse? It's not about Cochrane, which has its share of altmed nuts infiltrated anyway. You, Backin72, gather every bit of evidence in support and want it in the top but have none which says for heaps of conditions it's crap. POV or not? For chrissakes why do you insist on filiform???Mccready (talk) 09:28, 28 January 2008 (UTC)

Ah, I think I see what happened; a sentence I'd thought was there dropped out along the way. Restored. Better approach than just deleting good V RS's, I think. Filiform? Of course, to distinguish them from other needles the reader might know of in a medical context, like hypodermic needles. I think that's called accuracy, not undue weight. --Backin72 (n.b.) 10:45, 28 January 2008 (UTC)

Fair enough. Accepted. Now we have to address undue weight. The top needs to ack that science shows the bulk of conditions acu purports to treat are not amenable to acu. Mccready (talk) 01:38, 30 January 2008 (UTC)

Hehe, hey I just had this same statement made on the Talk:Chiropractic page. Mccready, are you trolling? I agree the article is long, especially the lead, but any shortening needs to be NPOV. More likely, the article could be split up, but don't delete hard work from other editors, make a new page and move it. Also, you can't just cut out one POV and expect it to stick. See if you can shorten it and still be saying the same thing... and it needs to be reliably sourced. ---- Dēmatt (chat) 02:35, 30 January 2008 (UTC)

Well, I removed the unsourced POV statement that remained. ---- Dēmatt (chat) 14:51, 30 January 2008 (UTC)

Thanks Dematt; agree entirely that what you removed was OR. I went even further and reverted, since the earlier wording remains the most accurate depiction of the sources cited (Ernst 2007, and the rest of the EBM reviews). As Ernst explains, the body of evidence is growing, and that evidence is showing efficacy for some conditions and a lack of efficacy for others. For many more conditions, there is not enough evidence to determine efficacy. That's what the sources say. A good example is their review of acupuncture for depression. cheers, Backin72 (n.b.) 20:14, 30 January 2008 (UTC)

Are you guys deliberately ignoring the topic. The topic is UNDUE weight. It's a wiki policy. Pls address the issue.Mccready (talk) 01:55, 31 January 2008 (UTC)

"Undue weight", "article length" -- anything to justify your pruning particular views from the lead. It's called "wikilawyering". Your edits speak louder than your talk-page rationalizations. Happy editing and hope you have a great day, but don't think others haven't seen through your approach. I agree there is some accumulated cruft in the article, but I don't think you possess the objectivity to identify it. --Backin72 (n.b.) 03:24, 31 January 2008 (UTC)

There seemed to be two major infractions in the first few paragraphs. First being Undue weight to a single study, and second being to a NPOV issue wherein the editor asserted that 'further research was warranted" which is not the purview of the article, nor the conclusion of the majority of sources. It would probably be a good idea to dig around a source pile, since I am pretty sure that acupuncture is no longer controversial. It has passed into the realm of 'just doesn't work'. Until that time though, removing the unjustifiable weighting and PoV bits will have to do. —Preceding unsigned comment added by 98.173.216.159 (talk) 23:15, 22 September 2008 (UTC)

After a bit more reading of the various sources (50 through 54 for instance) It seems a good overhaul of this page may be needed. We have at least one instance of One source being included in the meta study that is a different source. Also, we get paragraphs about each time lower back pain gets 5% better via acupuncture, but the data showing all of the various things acupuncture claims to do but fails gets an entry in a table. I'm not sure why this entire section is so upside down, but it looks like it needs a good bit of fixing. —Preceding unsigned comment added by 98.173.216.159 (talk) 23:41, 22 September 2008 (UTC)

Temper, tempers please :-) I've not delved into the recent edit history, but this is generally a well written and informative article. I would though tend to feel that description of what acupuncture claims to be should come before critisms etc. Hence should last paragraph of leadin ("Traditional Chinese medicine's acupuncture theory predates... ") come as the second paragraph of the leader? David Ruben ^Talk 03:36, 31 January 2008 (UTC)

Hi David - we could, although that paragraph (fourth one in the lead, this version) actually contains criticism, unlike the neutral evidence in the second. Maybe can rearrange somehow. I think it does have good article potential. (Mea culpa on temper, but do check the edit history for certain editors' deletionism.  :-) cheers, Backin72 (n.b.) 05:19, 31 January 2008 (UTC)

Backin72, Your abuse doesn't hide the fact the you refuse to engage in sensible discussion. We both know that for a huge range of conditions that acus treat there is no evidence of effectiveness. Does this or not need to be referenced in the top. Mccready (talk) 09:03, 1 February 2008 (UTC)

The reason for my revert is that we already talk about evidence in the lead, and specifically say "For most other conditions[12] reviewers have found either a lack of efficacy (e.g., help in quitting smoking[13]) or have concluded that there is insufficient evidence to determine if acupuncture is effective (e.g., treating shoulder pain[14])." It's redundant then to list a bunch of conditions where evidence for efficacy is lacking or uncertain.

Of cource acu is used clinically for conditions where EBM support is lacking, but that is also true for some biomedical modalities, including most surgical techniques. The Institute of Medicine, one of the four Academies of Sciences in the US, also makes this point (see last paragraph here). If you edited the lead sections of arthroplasty, etc., to add a list like you want to here, how far would you get? Be realistic. If your edits aren't judicious and supported by other editors (it's not just me objecting), they aren't going to stick. regards, Backin72 (n.b.) 21:16, 1 February 2008 (UTC)

If we aren't going to mention specific conditions in the lead where acu is ineffective, then pls explain, Backin72, why we should mention specific conditions were it is claimed to be effective. If you want to edit an article on surgical techniques go right ahead. Your point is irrelevant here. Mccready (talk) 11:27, 2 February 2008 (UTC)

The list of conditions that a particular compound or technique cannot treat is endless. I don't believe we apply your logic to other articles on WP, and surgical techniques are a good comparison because similar blinding issues apply to RCT's. Use common sense, please. --Backin72 (n.b.) 07:35, 3 February 2008 (UTC)

We're getting closer now. Of course the list is endless, but as you have it now you present one person's view that acu relevance is expanding. What are we to do about this UNDUE weight? I reiterate, your comments on other articles are irrelevant. We are talking here about the acu article. Mccready (talk) 03:07, 5 February 2008 (UTC)

Read more carefully, please. Ernst doesn't say acu relevance is expanding; he says the evidence base is, which is a simple statement of fact: more RCT's are being done every year. Your attempt to add a list to the lead is tendentious, redundant and stylistically inappropriate. It's good in the article but ridiculous in the lead. The lead is a summary; we already say that evidence is equivocal or lacking for "most other conditions" in the lead, and I hold firm to my view that enumerating them in the lead is plain silly. And comparisons to other articles are entirely relevant: your edits would never stick in any other article either. How many things does aspirin not treat? Please, common sense applies. You've been blocked before for disruptive editing and I wouldn't be at all surprised to see it happen again. --Backin72 (n.b.) 05:34, 5 February 2008 (UTC)

The articles on Acupuncture should be about acupuncture not anyones belief or idea or arguments about acupuncture. I put in a revision clarifying the yin yang theory as a cyclical system and not a lineal thinking frame. Someone took it out. Why? Did you decide it was too complicated for other people or was it too complicated for you.(editor) The western thinking method is reducing language to 2 levels of thinking and not three as it should be. wakey wakey u guys. From a western point of view thoughts on the function of acupuncture move into the realm of chaos theory. In Chinese Medical thought there is no choas theory because discussion can be using both the inttelectual and the poetic mind. huh?Higher realms of mathematics or philosophy of Chinese Medicine. If someone wants to discuss Acupuncture under the filter of the western medical paradigm do not discuss with them. the conclusions can only be false. Science, western science is based on a concept of contradiction. Acupuncture science is based on concepts of harmony. Harmony can accept contradiction but contradiction cannot accept harmony. just some thoughts and rambling from the mountains. thanks usertalk: michael connelly,1654 august 21,2008 (UTC) —Preceding unsigned comment added by 88.212.106.179 (talk)

• Chinese Acupuncture is not only talking about the Yin-yang theory, but also applying the true human physiological function. From my practice, the Yin-yang theory is another form of language which explains how acupuncture works in human in terms of non-English that makes the Westerners confused. Actually, you can map the Yin-yang theory into Western physiological function that you might feel happy why acupuncture works. Hectorso (talk) 07:16, 20 April 2009 (UTC)Hector So

Dynasty of Origin

Does anyone know the dynasty of origin of acupunture??? I DO!! It originated i the Han dyansaty under the rule of Emperor Wudi. htey also created paper, the seismograph, sundial, and made many new achivements in art. this was a very sucsesful dynasty. 76.102.128.126 (talk) 03:00, 10 April 2008 (UTC)--

If, indeed, you have a source to support this claim, then it would be a useful inclusion to the article. Otherwise, if you can't back up your claim, then we have no way of knowing whether your claim is correct or not. I could step in and just as vociferously claim it originated with any other dynasty. 206.194.127.112 (talk) 00:37, 16 December 2008 (UTC)

The Acupuncture information can be found in Wikipedia [31] Actually, the information also can be found in formal chinese history. Hectorso (talk) 06:49, 21 April 2009 (UTC)Hector So

Commentary on Effectiveness

There may be a place somewhere in this article for this info. Yes or no? QuackGuru (talk) 15:13, 12 April 2008 (UTC)

Yes equivocally. That place, however, is under Section 5: Scientific research into efficacy, ideally as a properly formatted wikitable. The article is already 81 kb long, so it might be preferable to summarize the information and provide a link to a separate Efficacy of acupuncture article. - Eldereft ~(s)talk~ 16:06, 12 April 2008 (UTC)

Under the section Scientific research into efficacy is the place to add this info. A brief summary is preferable. QuackGuru (talk) 16:11, 12 April 2008 (UTC)

Wow, I actually agree with QuackGuru -- now that's a promising omen. I will consult the I Ching and we can take it from there, assuming the goat entrails don't suggest otherwise. ;-)

Actually, what Quackguru says is a pretty good description of how the efficacy section reads now, give or take a condition. That's why the ugly list in the lead is superfluous.

I've expressed concerns in the past that an Efficacy of acupuncture-type article could become a POV fork, but perhaps we could overcome that by keeping this article and an efficacy article adequately harmonized with each other. Certainly there is a lot of material here on efficacy, so it's a logical candidate for splitting, as I did with Regulation of acupuncture, which turned out OK. There is another article, Scientific theories regarding acupuncture, that is basically a lot of WP:OR and WP:WEIGHT "bathwater" with just enough "baby" to retain, perhaps, some value. That's the kind of article I would not want an efficacy article to become. --Backin72 (n.b.) 00:57, 13 April 2008 (UTC)

This article is a lot more peaceful to discuss things unlike the chiropractic article. There is an Effectiveness section that has been repeatedly deleted from the chiropractic article. I have learned from that content dispute. It is better to discuss on the talk page and then edit the article. I hope this article will improve from this discussion and information. QuackGuru (talk) 01:21, 13 April 2008 (UTC)

As a point, the we cannot call the section effectiveness of chiropractic because we cannot study the effectiveness of a profession. Rather, it should state acupuncture vs. SMT which is more factual and appropriate. CorticoSpinal (talk) 07:32, 13 April 2008 (UTC)

Where is acu vs chiro discussed? Not in this article, right? --Backin72 (n.b.) 09:30, 20 April 2008 (UTC)

OK, I added the additional conditions to the efficacy section. I trust that suffices. --Backin72 (n.b.) 20:38, 27 April 2008 (UTC)

Oh this is so silly. The question of efficacy is not if acupuncture can treat certain ailments conclusively but rather if it can have an effect on conditions like "Spleen qi deficiency", or "Xiao Ke". For now I will laugh at the silliness of people, and continue to think that the western "scientific model" has a few thousand years to go to catch up to the Chinese philosophies. --(unsigned comment from sometime in 2008)

I'm going to have to strongly disagree with you. There is a lot of uncertainty as to whether acupuncture is effective in treating ailments. Just because a procedure is old doesn't mean it's superior. After all, trepanation is old, too...

It's for this reason that research continues to be done on acupuncture. If it's effective and safe, then we should definitely use it. And if it isn't effective, then we should not. But your blase dismissal of legitimate scientific inquiry does nothing to address the important issues. 206.194.127.112 (talk) 00:48, 16 December 2008 (UTC)

The unsigned editor above does make a good point, though, about testing modalities as they are traditionally delivered (e.g., allocating patients according to TCM diagnosis, or use of proper needling technique). The Institute of Medicine makes that point too; see the source cited in the first few paragraphs of alternative medicine. Taking this stuff into account makes for better science, and to the extent there is debate over these issues in the literature, the article will be greatly improved if we report it. --Middle 8 (talk) 11:49, 9 February 2009 (UTC)

Why on Earth is it so difficult to write Acupunture is a bluff! A pseudoscientific theory made popular by Maos promise to give "medicin" to the people. There are enough scientific studies to put it in the same leage as homeopathy. —Preceding unsigned comment added by 83.250.152.56 (talk) 23:21, 7 February 2009 (UTC)

Got some, then? --Middle 8 (talk) 11:41, 9 February 2009 (UTC)

They were removed with the argument they were included already. Seems the charlatans win the war. Well, here we have the drawback with Wiki. GF! —Preceding unsigned comment added by 83.250.152.56 (talk) 20:16, 10 February 2009 (UTC)

If they really were included already, what's the prob? Show a diff. --Middle 8 (talk) 19:51, 18 May 2009 (UTC)

Navbox

I have placed a proposed Navigational template at Talk:Acupuncture/Navbox. I would like to move it to template-space and add it to the bottom of the articles in a week or so if there is consensus on its utility. Particularly welcome are any articles I missed, comments on the organizational scheme, and (dis)advantages compared to Category:Acupuncture. - Eldereft ~(s)talk~ 00:31, 28 May 2008 (UTC)

Done. - Eldereft (cont.) 10:00, 23 July 2008 (UTC)

Circular argument

I don't want to be too rigorous, but this phrase here: "There is scientific agreement that an evidence-based medicine (EBM) framework should be used to assess health outcomes and that systematic reviews with strict protocols are essential" is a circular argument. An "evidence-based" medicine is a scientific medicine. It is just a way of saying there is scientific agreement that medicine should be practiced scientifically. If anybody that was not convinced that science was the best way for medicine becomes convinced because of the phrase, it would be because he was tricked. I will remove it because of that. —Preceding unsigned comment added by 189.10.1.162 (talk) 13:39, 16 June 2008 (UTC)

I think there are other ways that scientists could seek to understand this. Evidence-based implies that we're going to do a lot of clinical trials and measure the results. Instead, they could have said "Theory-based" - suggesting that we should seek to understand HOW it works from basic biological principles regardless of whether it seems to work or not. This was never a "circular argument" - but (if we take your view) a "tautology". However, I believe it to be neither of those things - so on reflection, I'm reverting your change. SteveBaker (talk) 14:02, 16 June 2008 (UTC)

That statement definitely may look somewhat weird to us laymen. Fortunately, we have an article about it at Evidence-based medicine. --Taraborn (talk) 20:14, 12 September 2008 (UTC)

This article is meant to be helpful

Wikipedia is meant to be a quick resource of information. It simply does NOT matter whether anyone's personal opinion is that acupuncturists are quacks or legit doctors. I looked up this article for some brief history on the subject and I am appalled that all I found was a completely biased article. Though the author tries to sound neutral it is painfully obvious what their point of view consists of. This entire entry should be taken to the trash and redone with educational content. —Preceding unsigned comment added by 67.189.46.175 (talk) 03:39, 10 July 2008 (UTC)

I would agree to a large extent. There are enormous cultural assumptions throughout this article which, alas, remain prevalent across the West ie that the Westen paradigm is correct and everything outside it is suspect. We talk about 'prescientific ages' in regard to Acupuncture. Well, if one says that the 'scientific age' started at roughly the time of Newton, then maybe. But acupuncture is based on empirical evidence too - ie trail and error, experimentation etc. Not only that but even by this article it relies on 5000 + years of experimentation. Would the Chinese be so stupid as to rely on a medical system which was bogus?

I speak as someone who has been an acupuncture patient on and off for about two years. I can only vouch for its efficacy where a lot of Western Medicine has not worked, something I have seen all around me. Empirically speaking acupuncture is proven for me. I don't give a hoot if the idea of Meridians is not verifiable 'physically' - that is the whole point of the Meridian Theory - that they are energy flows. All that we are encountering is a different paradigm for how the body works to the Western mechanistic ones. The Chinese believe in Subtle Energies, we don't. That's all there is to it. And yet the West knows about Electromagnetic fields and the fact that everything gives off radiation, we just don't apply to physiology.

Underlying these assumptions are cultural ideas. We are talking different paradigms, that's all. This article should be honest about that. I find it interesting that we judge by 'evidence' and not 'results' in scientific tests - in other words, the theory of meridians doesn't register on how we in the West evaluate anatomy so they can't possibly be true.

Also, its interesting that 'alternative therapies' like Acupuncture, Homeopathy, Reiki etc NEVER say to patients 'Don't use Western Medicine'. There are no Acupunture tests disproving Western Medicine. Alternative therapies are not hostile to Western Techniques at all. But to this day Western Medicine remains like a bunch of colonists hiding in their stockade watching the rest of the world with suspicion and hostility. ThePeg (talk) 19:51, 18 July 2008 (UTC)

-- It does not really matter that it worked on you, its placebo effect is well documented in contrary to its clinical effects. And for your other arguments, well, it is proven clinically ordinary medicin works (which by the way is the case by definition) and that acupunkture, homeopathy do not. —Preceding unsigned comment added by 83.250.152.56 (talk) 21:22, 29 January 2009 (UTC)

--It does not matter if there is a clinical proof as well. The only issue is that there are suffering patient deciding that this is helpful for him. Disease being defined as an unpleasant state of suffering of a patient the patient is the ultimate criterion, not the clinical statement. —Preceding unsigned comment added by 84.139.241.74 (talk) 23:35, 24 February 2009 (UTC)

• Acupuncture is an art. The effectiveness is heavily relied on the person who performs because this person really understands how the symptoms relate to the meridian channel. For instance, if a symptom occurs in the lower stream of the channel, then there might be a cause in the upper stream. This kind of art is really difficult to master in a four-year training program.

Hectorso (talk) 07:04, 21 April 2009 (UTC)Hector So

"But acupuncture is based on empirical evidence too - ie trail and error, experimentation etc. Not only that but even by this article it relies on 5000 + years of experimentation. Would the Chinese be so stupid as to rely on a medical system which was bogus?" Would we be so stupid as to pretend/assume a pseudoscience is true only because it's been around for a long time? Clinical proof is imperative and actual factual evidence is required for any of it to be taken seriously (and for proper studies to be made.) But this particular brand of superstition requires from the get-go to believe in unprovable metaphysical "truths" for it to work, it at the very least seems quite suspect. I agree with the first poster there, this article needs a complete revision with all the tests showing the evidence from the trials made (such as: http://www.ncbi.nlm.nih.gov/pubmed/15870415?dopt=AbstractPlus .) Hell, a revision wouldn't do, might as well scrap it and rewrite. 84.58.146.249 (talk) 21:29, 8 May 2009 (UTC)

If you take the time to read the article, you'll find that already cites many review articles and other sources meeting WP:MEDRS, including ones that counted that trial you linked to. (Reviews are better on WP than individual studies.) Guess what, some good sources don't dismiss it out of hand. On WP, policy is to cite those, along with all the rest. --Middle 8 (talk) 19:50, 18 May 2009 (UTC)

Acupuncture history is wrong history that originated in China

It is wrong part in objective history that acupuncture was begun in the China.
There is 砭石(zhēn biān = Stone needle's of acupuncture ; Korean - Dolchim) that the Korea used from neolithic age that acupuncture is begun from neolith by inheritance.
However, Dolchim's inheritance of the China does not exist.
And acupuncture was used that entered from eastern country to China in Huangdi Neijing(Somoon part12).
Ancient country of the Korea was called empire of east.
Therefore, mistook that one’s opinion that acupuncture is to happen in the China. (Wrong history that Acupuncture spread from China to Korea)

—Preceding unsigned comment added by 222.233.99.16 (talk) 16:35, 21 July 2008 (UTC)

Can you provide one or more English-translation sources supporting this? thanks, Backin72 (n.b.) 05:14, 31 July 2008 (UTC)

Evidence from neuroimaging studies

The cited review was not conducted systematically. Given the well-known problems with the literature in this area, I think that the authors were not nearly canny enough for the results to be trusted. They did make some attempt to be comprehensive, but included only editorial analysis - it is closer to a book report or blind summary than a proper systematic review. On the other hand, it looked a little snide to call it a non-systematic review, and we already discuss (last I checked) aforementioned problems with the literature. I do not believe that these issues are serious enough to bump the source below the WP:RS threshold, but if anyone would like to characterize this review (without casting aspersions outside of NPOV, of course) to alter its apparent weight, I would not complain. - Eldereft (cont.) 19:03, 20 August 2008 (UTC) Since Acupuncture is also found among native american tribes, see "song of the little knives" and in africa, australia, lapland, s. america, it is wastefull to discuss origins, as no verifiable beginning to the history of natural medicine is verifiable. usertalk m.connelly,21 august 2008 —Preceding unsigned comment added by 88.212.106.179 (talk) 14:37, 21 August 2008 (UTC)

Neutrality

I noticed this article is still under the neutral tag. I'd like to help provide a fresh pair of eyes to any NPOV issues and I'll try my best to be as objective as possible. To note, I am not a health care physician of any sort (to avoid possible accusations of bias) but am pursuing a graduate degree so I know how to appraise research. If there are no additional concerns, I'll tag down the tag. Soyuz113 (talk) 03:39, 29 August 2008 (UTC) ^{(Edits of indef blocked user stricken.)}

Soyuz113 has "been blocked indefinitely from editing in accordance with Wikipedia's blocking policy for sockpuppetry, edit warring, disruption and block evasion." I have stricken his remarks, as striking or removal is customary in such situations. See: Suspected Wikipedia sockpuppets of CorticoSpinal. -- Fyslee / talk 17:50, 11 October 2008 (UTC)

Hey maybe your graduate degree is in philosophy, reasoning, and the scientific process? The Chinese utilized inductive reasoning. They came up with their theories based on observations around them and then applied it to the human body. At any rate, when I read this article it made me wonder if the people who said Chinese medicine is unscientific have any notion of the scientific process. Most articles I read about Chinese medicine on Wikipedia have large sections devoted to the "effectiveness of TCM" (traditional Chinese medicine) and they go on at length about how certain people claim that TCM is unscientific. I think this is false and misleading. TCM is scientific. The Chinese utilized inductive reasoning to conclude things and then debated about it extensively amongst themselves and even performed clinical trials over thousands of years. They kept what worked clinically and elaborated or corrected it when needed. I think it is really absurd that people claim TCM is unscientific. It is like they're saying science is unscientific by completely dismissing the validity of inductive reasoning and the scientific process. And because every article (or almost every article) on Wikipedia devotes so much space to these false ideas, it reads as propaganda. (For references to my claims one can look at the comments in the Materia Medica by Dan Bensky, Steven Clavey, and Erich Stroger.) comment added by ~Harkannin 24.69.176.48 (talk) 07:56, 11 October 2008 (UTC)

FYI, CorticoSpinal is a chiropractor, so he was lying when he wrote "I am not a health care physician of any sort." Of course many would dispute that chiropractors should be allowed to call themselves "physicians", but that's another matter. -- Fyslee / talk 17:50, 11 October 2008 (UTC)

Chiropractors and acupuncturists are all deluded quacks or liars, no wonder they converge on the same pages. Alternative medicine and "TCM" are nonsense. You know what you call an alternative medicine that actually works? You call it "medicine". This article is misleading from the very first paragraph. The opinion of an alternative medicine physician is in plain sight, but the scientific criticisms of CSI(a group who investigates all baloney claims of magical powers) are tucked down in the middle of an article. This makes wikipedia look like a place where gypsies and psychics can peddle their wares.97.100.15.16 (talk) 22:40, 30 December 2008 (UTC)

Read WP:MEDRS. Believe it or not, there are sources more reliable than CSICOP. --Backin72 (n.b.) 11:28, 2 January 2009 (UTC)

acupuncture,

DR dear sir, could you tell me if you can stimulate the pancrea to increase insulin on a diabetic person by using acupncture therapy.....thank you Efrain —Preceding unsigned comment added by 74.233.155.2 (talk) 13:22, 22 October 2008 (UTC)

• To handle a diabetic person, it is not only to stimulate the pancrea, but also to understand why the pancrea cannot be stimulated in daily activity such as exercise, jogging etc. For a normal person, the daily exercise routine helps him or her to maintain the level of insulin in the blood stream where the sugar level can be regulated. Since a person practices acupuncture, he or she knows where the pancrea's location. With this info, you find the meridian channels which are related to the location. After you select all the points which are related to the pancrea, then you do the acupuncture treatment. You may find these info useful. Hectorso (talk) 07:17, 21 April 2009 (UTC)Hector So

Backin72 Bulk Revert

I have asked Backin72 now three times to explain this bulk revert. He has not done so. So I ask here now a fourth time. I think the community would be grateful for your detailed response. (I will take up the issue of my topic ban at AN/I so please do not discuss that issue here.) Mccready (talk) 12:34, 11 December 2008 (UTC)

I'm not going to discuss any of your edits to this page with you, Mccready, because you are indefinitely banned from editing acupuncture or chirporactic (scroll down a little to see the relevant quotes in the diffs):

• "the topic ban is now indefinite"
• "Topic ban is extended to an indefinite ban."

As you can see from reading the page versions associated with those diffs, you were banned because you had exhausted the community's patience with your persistent disregard for basic wikiquette. Your posting here continues that trend. I will not feed it, but I will do what I need to to put a stop to it by notifying admins of your breach of the ban. I will be happy to discuss edits with other editors in good standing, but that doesn't include you, dude -- you can't even post on talk pages. Let me put it plainly to you, paraphrasing the community: please go away. --Backin72 (n.b.) 16:12, 11 December 2008 (UTC)

Note: I've posted regarding this at AN/I (section); (diff). --Backin72 (n.b.) 16:58, 11 December 2008 (UTC)

My reasoning, FWIW

OK, just so no one thinks I'm trying to avoid discussion, here's why I "bulk reverted" three edits by a banned editor. Suffice it to say (as I did in the ES) that I object to removal of material that I believe to be properly sourced and weighted. We, as editors, are discouraged from using weasel words and equivocating; however, if RS's do that, we should leave it in: one critic's equivocation might be another's nuance, and besides, some aspects of medicine are equivocal.

Thus, User:Scientizzle commented at AN/I that "the recent edits attributed to this user in violation of this ban seem, to me, to be generally okay (this and this look like reasonable removal of fluff and unnecessary equivocation....)".

My response:

• this edit is a mixed bag. I looked at the TCM source at the top, and agree it's weak as cited, and have removed it again. However, the edit in the second paragraph deleted phrases like "but is active and growing" to describe the body of evidence: Edzard Ernst himself says this, and a reasonable thing to cite (Mccready, however, has a history of seeking to depict acu as closer to the fringe than most people (and cite-able sources) depict it).
• Which brings us to the next edit. Starting at the bottom: we have Mccready removing Ernst's own (!) verbatim (!!) conclusions from his review: "It is concluded, that acupuncture research is active. The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions."[32] This is absurd, removing the central conclusion of one of our best and most current sources on controlled clinical research. Above that, he removes a source on evidence-based medicine (EBM) that (horrors) informs the reader that EBM includes individualized choices about care as well as meta-analysis of RCT's. I believe that is properly weighted with respect to our abbreviated discussion of EBM.

Bottom line, the WHO/Jia source was weak and worth removing, but getting rid of the Ernst stuff did not improve the article at all. Ernst is no alt-med believer, so one can't accuse the positive/equivocal stuff of bias. The pattern of these edits is a little subtler than usual, but consistent with Mccready's longstanding mission to remove or minimize material that is remotely positive, or equivocal, about scientific research on acupuncture.

Also, let's not remove his ban because he showed up one day and violated it in a semi-reasonable way... sheesh. Before he was banned he was the subject of several posts at AN/I, the first of which described a pattern of endless, disruptive, repetitive edit warring. Go look at that page version and all the reverts documented there. That's a pretty intense pattern. See why I'm not eager to have it repeated here? -- Backin72 (n.b.) 08:37, 12 December 2008 (UTC)

battlefield acupuncture

This might still be a bit too much WP is not a crystal ball but I think it is worth noting here now on the talk page because the military seem to have finished the initial trail phase.http://www.baltimoresun.com/news/nation/bal-te.pain11dec11,0,3574554.story?track=rss--Aspro (talk) 18:04, 11 December 2008 (UTC)

Recent History

This section seems to have been sourced from a single website of Scott Suvow, who is a practitioner of acupuncture. The section makes claims for the effectiveness of acupuncture, for example during the Long March. Surely there must be peer-reviewed historical accounts rather than a commercial website for references. I am deleting that section. If someone can add scholarly references for the specific claims made, then feel free to put it back.Desoto10 (talk) 01:14, 17 December 2008 (UTC)

Hi Desoto10 -- you're right that the source is bad, of course; however, most of the claims are in fact correct, and just need better sources (e.g., Unschuld). (Think of the Suvow link as a sort of temporary convenience link for information that we'll be able to verify elsewhere.) Additionally, some that you removed was from other, good sources (Crozier; Lewith), and you left intact the final paragraph that was from an equally dubious source (some other dude's clinic). In light of the fact that the claims are (mostly) noncontroversial, and that I expect I can find refs for a great deal of it, I've restored the material and tagged it. As for the long march, that's more a matter of history than medicine, and as such it can't really be considered a "claim of efficacy"; our sources will reflect that. Nice catch on the IVF review, btw. -- regards, Backin72 (n.b.) 03:36, 17 December 2008 (UTC)

Sorry about those in-line refs, they didn't register when I was reading. I am not sure about the veracity of the information and so I hope somebody can provide some properly sourced information. Now I am looking at this claim:

"In the 1970s, acupuncture became popular in America after American visitors to China brought back firsthand reports of patients undergoing major surgery using acupuncture as their sole form of anesthesia"

I suspect that this is referring, at least in part, to the saga of James Reston, who wrote an article for the New York Times, Monday July 26, 1971 where he describes his emergency appendectomy in China. It seems as though acupuncture was used only during is recovery to relieve post-operative discomfort. During his actual surgery, standard anesthesia was used, not acupuncture. If the editor has sources for other "firsthand reports" where major surgery was reported using only acupuncture, then these should be added. As it stands, there is no reference at all, so I am going to edit out the general claim and substitute the specific case.Desoto10 (talk) 20:01, 18 December 2008 (UTC)

Thank you; that needed fixing. regards, Backin72 (n.b.) 03:45, 19 December 2008 (UTC)

Indications acccording to...

Ref 28, which is claimed to substantiate use of acupuncture for dysmenorrhorea actually concludes:

"Authors' conclusions High frequency TENS was found to be effective for the treatment of dysmenorrhoea by a number of small trials. The minor adverse effects reported in one trial requires further investigation. There is insufficient evidence to determine the effectiveness of low frequency TENS in reducing dysmenorrhoea. There is also insufficient evidence to determine the effectiveness of acupuncture in reducing dysmenorrhoea, however a single small but methodologically sound trial of acupuncture suggests benefit for this modality. "

Thus, all one could say from this review is that there is insufficient evidence for the effectiveness of acupuncture for this indication. TENS is not acupuncture.Desoto10 (talk) 20:33, 18 December 2008 (UTC)

Right. I haven't been that comfortable with stuff being added to that list; AAMA and WHO have their own conclusions, and it strikes me as poor parallelism (and undue weight) to add other stuff, willy-nilly, based on this study or that review. More on said list below. regards, Backin72 (n.b.) 04:03, 19 December 2008 (UTC)

Indications according to acupuncturists in the West

This large table is highly inappropriate as it implies that there has been a demonstration of efficacy of acupuncture for all of these indications, when, according to the source, the criterion for inclusion was "at least one research article" for each. I would like to condense this information down to a sentence or two that says something to the effect that it is claimed by this specific group that a variety of diseases are amenable to acupuncture treatment and that WHO also lists a variety of potential indications. As it is now, one gets the impression that there is substantial research to back up this list, when, in fact, there is very little.Desoto10 (talk) 20:51, 18 December 2008 (UTC)

Gotta disagree, at least to some extent. Western acupuncturists, like the AAMA, are what WP would call a "significant minority view". Per WP:WEIGHT, "Minority views can receive attention on pages specifically devoted to them". It's OK to say, in this article, that the AAMA says acu may be useful as a complementary therapy for conditions X, Y, and Z as long as we properly attribute the statement. However, it would be entirely appropriate to include a note about their inclusion criteria. I also agree that excerpting the sentence about how its main indications are for pain would be appropriate; that need to be emphasized.

Also, I just came across this source from the WHO ... they obviously go considerably further than Cochrane in terms of efficacy, based on their review of controlled trials. I'm not sure what their methodology was, but they're clearly quite a notable source, so we should put this in someplace. regards, Backin72 (n.b.) 04:35, 19 December 2008 (UTC)

Both done. --Backin72 (n.b.) 08:55, 19 December 2008 (UTC)

I looked into the WHO stuff. Virtually 100% of the referenced articles would not be considered to describe "controlled clinical trials" by any definition. They are what are usually described as "case reports". And they are mostly (naturally) in Chinese journals written in Chinese and so it is difficult to do any QC. This is a difficult position as it seems that the pro-acupuncture groups seem to be willing to promote the concept that acupuncture works for virutally every medical condition known to mankind and so we end up with a lengthly laundry list of indications with precious little to back it up. I would be more comfortable just saying that these lists exist but that there is concern about the studies that underly them (assuming that there is a scholarly reference for that). However, I am new to this article so I won't push it at this point. Thanks for listening.Desoto10 (talk) 00:27, 20 December 2008 (UTC)

Yes, that's pretty much my reading of WHO's methods as well; obviously their criteria are not at all the same as Cochrane's. I understand your concern, but I don't believe there's a problem with enumerating the WHO's list as long as methodology (when stated) and caveats (when made by RS's) are also cited. The viewpoint of a group of clinicians using acupuncture, many of them MD's and PhD's, is a significant one, although according to NPOV, not the dominant one (which, as I understand it, would be a straight biomedical reading along EBM lines). So it's a question of framing and weighting properly.

The final point is that the WHO remain a highly notable and reliable source, even if there is disagreement between them and other groups, so according to the principle of "verifiability not truth" we are obliged to give adequate weight to WHO even if they're "wrong" on certain things. I'd assume there's been some exchange about this stuff in the literature. BTW, Desoto, hope you stick around; your edits are good and you seem like a fair-minded and well-informed editor. regards, Backin72 (n.b.) 02:29, 20 December 2008 (UTC)

Thanks. I have had a peripheral interest in acupuncture from back in the day when I was studying pharmacology. One of my teachers was developing a little electronic gizmo to detect acupuncture points. I think all it did was measure local changes in skin resistance. Anyway, I am squarely in the "scientific evidence-based" camp and so I will argue strongly for things that can be demonstrated to be true (and referenced) based on the scientific method. I am far less interested in sources such as case studies and poorly designed clinical testing. We will likely disagree on many things, but I promise that I approach all topics with an open (although biased) mind.Desoto10 (talk) 22:45, 24 December 2008 (UTC)

Yeah, there isn't too much evidence for the electrical conductance hypothesis, although there's something suggestive there[33]. (From one of the same authors, though, this is an interesting hypothesis about the physical basis of acupoints and meridians.)

We're probably not going to disagree a whole lot over whether EBM-type stuff should be included. We may disagree if you come out strongly for deletion of anything that's not up to EBM gold standards, particularly because WP's mission is broader than Cochrane's: what acupuncture is is more than what EBM reviews say; it's a subset of an entire traditional medicine that is still used by a substantial number of people today. So while we don't mention acupuncture (much) on pages devoted to biomedical theory and practice, we do get into acupuncture theory and practice in fair detail here, per the WP:WEIGHT quote I cited just below your thread-starter above. But we can talk about that more later. Happy holidays, Backin72 (n.b.) 23:41, 25 December 2008 (UTC)

Criticism of TCM theory

"TCM theory predates use of the scientific method and has received various criticisms based on scientific reductionist thinking, since there is no physically verifiable anatomical or histological basis for the existence of acupuncture points or meridians."

I would say that the lack of evidence for the existance of acupuncture points is not the primary reason that the claims of efficacy for acupuncture are often rejected by modern western medical experts. What is lacking is evidence of effectiveness as is required for other treatments. It appears as though, when such evidence is provided, as has been done for some kinds of pain, and some kinds of postoperative nausea and vomiting, western physicians have accepted acupuncuture regardless of the lack of evidence for specific acupuncture points.Desoto10 (talk) 21:00, 18 December 2008 (UTC)

I think the best thing to do is just summarize the sources quoted in the section. The statement as written is consistent with Felix Mann's quote and maybe a couple others. Sure, efficacy is the bottom line, but remember, this section is criticism of TCM theory, so most of the quotes aren't really getting into efficacy; that comes later in the article. (What is interesting is that some of the best evidence for efficacy is the use of PC-6 below the wrist for nausea; say what you will about TCM's prescientific model, but at least it "predicts" that, where biomedicine can't... actually, the way I like to look at TCM's theory is as a big mnemonic device, stated using classical Chinese language. Same idea as a primitive tribe having a calendar that predicts when the dragon in the sky swallows the sun or moon... they didn't know what an eclipse was, but they had observed the phenomenon.) regards, Backin72 (n.b.) 04:13, 19 December 2008 (UTC)

OK, Fyslee went ahead and stuck it in -- and looks like he got it at the right point. Ah, that's better... --Backin72 (n.b.) 02:31, 20 December 2008 (UTC)

"There is general agreement that acupuncture is safe..."

I'm rv-ing these two edits because they do not appear to reflect a very careful reading of sources. Let's look at each:

• NIH Consensus Statement:

"the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. For example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow... are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments."

• NCCAM FAQ:

"Relatively few complications from the use of acupuncture have been reported to the FDA, in light of the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. Practitioners should use a new set of disposable needles taken from a sealed package for each patient and should swab treatment sites with alcohol or another disinfectant before inserting needles. When not delivered properly, acupuncture can cause serious adverse effects, including infections and punctured organs."

• Ernst safety review:

"Acupuncture has adverse effects, like any therapeutic approach. If it is used according to established safety rules and carefully at appropriate anatomic regions, it is a safe treatment method."

Those quotes are more consistent with saying (A) than (B):

(A)"There is general agreement that acupuncture is safe when administered by well-trained practitioners using sterile needles, and that further research is appropriate."

(B)"There is general agreement that further research is appropriate.There is general agreement that serious adverse reactions are uncommon when acupuncture is administered by well-trained practitioners using sterile needles, but minor adverse reactions, poor training and non-sterile needles are concerns."

Why? Because A caveats the issues adequately, while B gives undue weight to risks (cf. Acupuncture#Safety_and_risks), especially compared to other treatment modalities. Under the conditions given in (A), the statement that acupuncture is safe is not only correct, but quote verbatim from the most recent review of one of the most respected scientists studying Alternative medicine according to the principles of Evidence-based medicine (and btw, Edzard Ernst is a total-ass skeptic about everything, so anything he says about acu isn't coming from a place of positive bias). The serious issues mentioned in (B) are relevant (and are mentioned in the safety section), but fall outside the boundaries of the qualification "well-trained practitioners using sterile needles". regards, Backin72 (n.b.) 07:54, 24 December 2008 (UTC)

Added another, too. --Backin72 (n.b.) 23:29, 25 December 2008 (UTC)

Conflict of interest

Please comment. I will tag the article so that people know this discussion is happening. ScienceApologist (talk) 10:45, 28 December 2008 (UTC)

Well, that didn't work out too well, did it. Probably a good idea to drop the attempts to game the system; it reflects poorly on those who do it (especially when you're under ArbCom scrutiny). --Backin72 (n.b.) 04:42, 29 December 2008 (UTC)

2009 systematic reviews

Considering the limitation of the four positive noninferiority studies and the results of the meta-analysis of the three sham-controlled studies, the notion that acupuncture may lower high BP is inconclusive.

Conclusion Sham-controlled RCTs fail to show specific effects of acupuncture for control of menopausal hot flushes.

Here are newer studies to review for inclusion. QuackGuru (talk) 18:02, 2 January 2009 (UTC)

Add this brand new Cochrane Review: Madsen MV, Gøtzsche PC, Hróbjartsson A (2009). "Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups". BMJ. 338: a3115. doi:10.1136/bmj.a3115. PMID 19174438.{{cite journal}}: CS1 maint: multiple names: authors list (link)

We found a small analgesic effect of acupuncture that seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.

— Scientizzle 22:01, 29 January 2009 (UTC)

Yes, good finds. I will get around to adding them soon if no one else does. --Middle 8 (talk) 11:38, 7 February 2009 (UTC)

Edit to lead re migraines

I moved a sentence from the lead section to the article subsection on EBM. It's well worth keeping in the article, but doesn't seem appropriate in the lead: too much weight to one study and one condition. However, I agree that this sentence does point to some larger issues that are lead-worthy, e.g. attempts at blinding and findings re point specificity or lack thereof. I will hunt down an appropriate reference (i.e. something on the order of a review article) and suggest something soon. --Middle 8 (talk) 03:37, 29 January 2009 (UTC)

NPOV edits

This and this are worth examining, but are too WP:BOLD. So, in the spirit of WP:BRD I'm reverting; now the discussion. (And nobody gets to revert me back and say "per BRD" in the edit summary without discussing.)  :-) BTW, I know my revert removed a source; I will put it back later.

First, this source plainly does not go far enough to support this edit. Quoting from the source:

"A small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear."

OM's edit summary said: "Acupuncture does not work. So, let's stay NPOV)". That is a good example of jumping from "absence of evidence" to "evidence of absence". Acupuncture is an active research area and the jury is still out. So, it may be partly true to say this....

"There is no scientific or medical evidence that acupuncture has any efficacy beyond a placebo effect."

...but it's plainly not the whole truth, because it's equally true of virtually all surgical techniques, as well as PT, dentistry etc. We need to be more nuanced in light of other reviews (and commentaries) that find evidence for efficacy, as well as the fact that there is no general agreement over which placebo designs are appropriate (although they're certainly further along with acu, in terms of figuring out how to control for placebo, than they are with many surgical techniques).

Finally, it's useful to compare the acupuncture and homeopathy literature. The Royal College of Pathologists recently denounced homeopathy homeopathy as antiscientific. By contrast, BMA issued a qualified endorsement of acupuncture as of 2000, which is where the matter stands.

So, the acu research is in flux, and in the medical community it stands on the cusp of acceptance. In homeopathy, comparatively little research is going on, and it is at the cusp of rejection. The situation with acu may change, but in the meantime, no sticking a fork in anything until it's done. Not on WP, anyway. We should reflect the general scientific literature, not what skeptic blogs or CSICOP articles may be saying. Anyone seriously disagree with that?

OK, that's a good place to start. BTW, I think it's good to give the article some working over. Maybe what comes out of that will be a "good" or "featured" article, for whatever little that's worth in the scheme of things. regards, Middle 8 (talk) 18:54, 3 March 2009 (UTC)

(side note - OM, check your email) --Middle 8 (talk) 18:54, 3 March 2009 (UTC)

also restored a good source and accurate description of text/sources that immediately follow -- Middle 8 (talk) 19:00, 3 March 2009 (UTC)

Sorry dude, but according to WP:MEDRS, and WP:NPOV, there must be reliable evidence. Acupuncture does not work. There is NO evidence that it will, and yes, science does not prove negatives, so to be NPOV, proponents of Fringe theories must show that it's not fringe. You can't. OrangeMarlin ^{Talk• Contributions} 19:17, 3 March 2009 (UTC)

What happened to reliable sources like Ernst? He doesn't say it's BS, he says there seems to be evidence for some conditions. When good sources say something's equivocal, we say that; we don't imply anything like "there is NO evidence that it will" work. You're on the wrong side of NPOV, bro, not me. cheers - Middle 8 (talk) 19:30, 3 March 2009 (UTC)

"Some evidence" by someone (and I admit, Ernst despises CAM cruft about as much as I do) is hardly "this thing works". I'm willing for a compromise, but what you've reverted is so far from a compromise, that I will have to public disclose that you're the Fifth Beatle. OrangeMarlin ^{Talk• Contributions} 20:17, 3 March 2009 (UTC)

Cool, I'm sure we can figure out a compromise (and I felt that way before you thought I might be Mr. Incredible, or ScienceApologist suggested I might be the wicked Syndrome). I find it helpful to think of how we handle other topics on WP; I think it's pretty clear acupuncture is in a sorta grey zone, somewhere between knee arthoplasty (which almost certainly works, yet we can't really prove it does because we don't have a good placebo, and the one notable attempt at placebo control showed it no better than placebo!) and homeopathy (which doesn't work). So, we're smart puppies; I'm sure we can come up with some language -- really, there's not that much distance between your wording and what there is now; maybe just a matter of emphasis, and sticking close to sources (your 2009 source admittedly spins it with a little more cred than you do). More later -- please excuse me while I attempt to go put out a fire I did not wish to see started. -- Middle 8 (talk) 22:02, 3 March 2009 (UTC)

More re lead edits

I've reviewed Middle 8's edits. They are appalling. For instance, here's the first sentence of Middle 8's version.

“ Because acupuncture has been the subject of active scientific research only since the late 20th century, its effects are not well-understood by Western medicine, and its application remains controversial among Western medical researchers and clinicians. ”

And here's the abstract of the source he uses to support it:

“ Even though widely used in today's clinical practice, acupuncture has remained a controversial subject. Many reviews are currently available but most lack a critical stance and some are overtly promotional. The aim of this overview is to provide a balanced, critical analysis of the existing evidence. Some of the original concepts of traditional acupuncture are not supported by good scientific evidence. Several plausible theories attempt to explain how acupuncture works but none are proved beyond doubt. The clinical effectiveness of acupuncture continues to attract controversy. Many controlled clinical trials and numerous systematic reviews of these studies have been published. Considerable problems are encountered when interpreting these data. Heterogeneity is a significant drawback of both clinical trials and systematic reviews. Some of the controversies may be resolved through the use of the new 'placebo needles' which enable researchers to adequately control for placebo effects of acupuncture. The majority of studies using such devices fails to show effects beyond a placebo response. Acupuncture has been associated with serious adverse events but most large-scale studies suggest that these are probably rare. Nonserious adverse effects occur in 7-11% of all patients. In conclusion, acupuncture remains steeped in controversy. Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response. ”

Only the last clause of Middle 8's sentence is supported by the source; the rest is solely Middle 8's opinion. Meanwhile, Middle 8 deletes all evidence against acupuncture from the lead. And this is meant to be NPOV? Shoemaker's Holiday (talk) 09:02, 4 March 2009 (UTC)

Hello Shoemaker's -- with respect, I think your commentary here is inaccurate and creates more heat than light. The version to which I reverted was a fairly long-standing, stable version that had been worked on or at least read by a number of editors, including you (see your comment above on this page, and Eldereft's reply). So, cool the over-dramatic and polarizing rhetoric about how my reverting OM's edit (which I argued was too bold) was "appalling" and "ridiculous POV-pushing".

You say that I "delete(d) all evidence against acupuncture from the lead" -- first, that is not my style, so any such action would've been accidental. Second, if you're referring to references, you're simply wrong; I didn't delete any and in fact had restored the 2009 review that OrangeMarlin added.

As a matter of fact, Shoemaker's, your edit removed an excellent source, Ernst (2006). Do you think I should start shrieking about how your edit was "appalling", and maybe go on over to WP:AE and do so and make you look like an asshole? No, I didn't think so. I'm reasonably certain that your deletion was a simple artifact of reverting to OrangeMarlin's version, and that he either omitted it by accident or believed in good faith that the 2009 review superseded it.

So, I really have no idea what is meant by your assertion that I "delete(d) all evidence against acupuncture from the lead". Maybe you meant that I removed particular language that you preferred? My version does stick close to sources, so I think that's debatable. I see very little wrong with the sentence beginning with "Because acupuncture has been the subject of active scientific research only since the late 20th century...." The "because" part crept in over time and probably is gratuitous, but the rest is pretty straightforward stuff and supported by sources cited in the lead, including this one.

I don't mind debating my edits at all, but characterizing this one as "appalling" is gratuitous drama. --Middle 8 (talk) 10:09, 4 March 2009 (UTC)

I'm sorry, but I don't see how the Ernst source supports the material it was meant to at all. At best, it gives the impression that all positive phrases were extracted from the review, leaving anything that didn't support acupuncture behind. Hence my upset. Shoemaker's Holiday (talk) 13:20, 4 March 2009 (UTC)

I understand that you perceived a red flag, and I think it was probably because the wording in my preferred version of the lead follows different Ernst review, namely 2007 (PMID 17265547), as mentioned by User:II below. Glad we cleared that up. I'm sure we can come up with compromise wording that adequately covers our sources. BTW, funny how Ernst spins things so differently in his 2006 and 2007 reviews, isn't it? That may be partly because his views are evolving, partly because his expressed intention in the 2007 review was to evaluate the scene as critically as possible, and partly because the respective journals in which the reviews were published themselves have subtle biases to which Ernst was playing. Anyway, I need a break. Thanks for your perspective, and I assume we're cool with mutual AGF going forward. --Middle 8 (talk) 21:09, 4 March 2009 (UTC)

Why not just put both the 2009 BMJ review and Ernst's 2007 review (PMID 17265547) for balance? II | (t - c) 19:28, 4 March 2009 (UTC)

Agree completely. In fact, that's what I did prior to OM's and my low-level revert war, and Shoemaker's subsequent revert and expression of dismay. Time for a break on my end for now, but thanks, I think you nailed it. --Middle 8 (talk) 21:09, 4 March 2009 (UTC)

Done, finally. [34] --Middle 8 (talk) 02:58, 25 March 2009 (UTC)

Consistency across WP on evidence-based medicine and procedures

The statement that "there is little evidence for acupuncture's effectiveness" is a true statement as far as it goes, but not the whole truth. The whole truth entails the fact that there is very little evidence for the effectiveness of *any* mainstream surgical technique, by the same standards; and that this is due to the difficulty of designing a good placebo control for a procedure (as opposed to a pill). So, yes, any procedure will inevitably be lacking in gold-standard evidence, i.e. double-blinded, randomized, placebo-controlled trials. Try finding them for coronary bypass surgery, or joint replacement. Ain't there. So I guess we should insert the "no evidence for effectiveness" line in the lead section of every surgery article, right? Maybe have a bot do it to a hundred articles. I bet that wouldn't arouse controversy at all.

I don't know how best to handle this issue consistently across the wiki (obviously, I do have sources saying it is an important issue), but I think that for something this "meta" it would be good to bring in some more fresh, knowledgeable views. If we follow EBM, which has become the dominant paradigm, we will apply the same evidentiary criteria to all procedures, regardless of whether they are "alternative" or not (again, there's no problem finding sources supporting this objective approach). We'll just need a decent number of expert editors to make sure we do it right. What think ye? regards, Middle 8 (talk) 23:33, 12 March 2009 (UTC)

Don't all speak up at once, scholars. --Middle 8 (talk) 19:53, 18 May 2009 (UTC)

OK, I'll bite. What are you talking about? Are you suggesting that there is not peer-reviewed high quality studies demonstrating the safety and effectiveness of various forms of surgery? Have you looked at the surgery journals? In any case, accupuncture is not surgery. Maybe I have missed your point (happens a lot). What particular surgery would you say has no clinical evidence to back up its effectiveness?Desoto10 (talk) 01:02, 23 May 2009 (UTC)

Hi Desoto, thanks for weighing in, and you did miss my point, which is probably because I was unclear (not to mention sarcastic at the end of my first para above). Let me rephrase.

What I'm arguing is that we need to be careful about evidentiary double-standards on WP. The "gold standard" for evidence-based medicine is double-blinded, randomized, placebo-controlled trials, preferably lots of them and amenable to meta-analysis. For obvious reasons, there are virtually no trials meeting those criteria for surgical techniques (how do you blind the surgeon?). My point isn't that there is therefore no evidence for surgical techniques: on the contrary, there is evidence, just(virtually) none meeting EBM's gold standard. A very similar situation holds with acupuncture (which, like surgery, is a procedure requiring skill, and therefore subject to similar problems with blinding, although there has been some progress with "sham acu"). That said, I don't think that this state of affairs need be problematic on WP as long as we stick close to sources, and avoid un-nuanced original syntheses like "there is no evidence" unless a source specifically says so. Make sense? regards, Middle 8 (talk) 00:30, 25 May 2009 (UTC) (added clarification 02:21, 3 June 2009 (UTC))

Acupuncture originated in China?

Regarding the fact-tag in the lead: According to Unschuld, acupuncture's origins in China are uncertain -- which I read as meaning that where/how in China it originated is in question, but there's no real doubt (aside from Otzi the caveman, which is far from definitive) that it did originate in China (initially as a bleeding technique with sharp stones) and spread from there. Does anyone have better information? --Middle 8 (talk) 23:39, 12 March 2009 (UTC)

Hi, I changed the wording of the article which blatantly stated "Acupuncture originated from China" to something along the lines of "the oldest written record is from China and that suggests it came from China". I used a bit more encyclopedic words tho :) I also thought about including this article as an additional citation but it seems a little biased. Please let me know if you disagree with my edits or if you feel the citation is insufficient. --– sampi ^{(talk•contrib•email)} 01:16, 24 March 2009 (UTC)

Hi Sampi, excellent edit [35], although we can probably do a little better on the source. I agree the other one you mention probably isn't suitable. Hope you stick around, fresh editorial input is exactly what this article needs. regards, Middle 8 (talk) 02:26, 25 March 2009 (UTC)

It's nice to see that my edit was well received. I can't promise to stick around very long but I'll do my best. The reference I added is from "Dynamic Chiropractic", which is obviously not completely reliable but I did a quick background check on the author, John Amaro [36], and even though he did most of his Acupuncture studies he China, he also is certified in Japan and by the FACC. He is also from Arizona, so I don't see clear evidence of a Chinese bias. Someone should look into it though.

I also found this book by a Japanese surgeon and acupuncturist, Yoshiaki Omura, which relates the origins to China (chapter 1, specifically page 15). I think we could use it as a source but I'm not sure. Let me know what you think or add it if you think it's a good idea. --– sampi ^{(talk•contrib•email)} 15:35, 4 April 2009 (UTC)

Citing individual studies

Some recent edits (see the cumulative results of several recent ones) have added particular studies from the literature. Those are certainly considered good sources on WP, but neither can we cite (or properly weight) every single one, and there are a lot of them, with equivocal and sometimes contradictory results. Per WP:MEDRS I think we should focus mainly on good review articles, practice guidelines, position statements from respected sci bodies, and other such sources. Accordingly, I might end up outright deleting some, especially in cases where those studies have been cited in a review-type source that's already in the article. --Middle 8 (talk) 02:34, 25 March 2009 (UTC)

Done. [37] Also removed extraordinary claim [38] and followed up on suggestions above to bring more balance to the lead re efficacy. [39] regards, Middle 8 (talk) 03:06, 25 March 2009 (UTC)

Acupuncture detoxification

Acupuncture detoxification should probably be merged into this page - it's a stub, and right now there are three references, including a Cochrane Collaboration review, that there is no evidence to support it. There's the usual gushing endorsements from industry publications, but the reliable sources indicate it's bunk. Thoughts? WLU (t) (c) Wikipedia's rules:^simple/_complex 10:04, 27 May 2009 (UTC)

Bad idea, given that there are ample sources in the article, and this article is already long enough that we're gonna have to spin more stuff off, if anything. Of course, if you keep deleting stuff [40][41], eventually there will be little to merge, and the point will be moot -- but that strikes me as dubious logic, at best.

BTW, you make the classic error of assuming that a lack of evidence means it's bunk; it might be, but it also might be that it's not, and the evidence base is simply weak (in terms of conclusive evidence for or against efficacy). Cochrane says as much [42][43]. We might follow their judicious approach, eh? Nobody (well, not me anyway) is advocating that we ignore or contradict Cochrane; the stuff you'd like to delete doesn't do so. More on that article's talk page.

A final note: whether or not something is proven to work isn't the criterion for whether it should be in WP. Astrology and homeopathy don't work, but no good encyclopedia would disregard them. --Middle 8 (talk) 10:33, 27 May 2009 (UTC)

The article is very short, and the topic unsubstantiated. And in fact, it's pretty conclusively demonstrated it doesn't work pmid = 19004596 (which you have linekd to) "Auricular acupuncture had no effect upon withdrawal severity or craving when provided as an adjunct to a standard methadone detoxification treatment. The results are consistent with the findings of other studies that failed to find any effect of acupuncture in the treatment of drug dependence. The failure to find any clinical gains from the adjunctive use of auricular acupuncture during detoxification from opiates raises concerns about the widespread acceptance of this intervention." A topic's substantiation via scientific testing means we give due weight to the best experts. WLU (t) (c) Wikipedia's rules:^simple/_complex 10:47, 27 May 2009 (UTC)

The nuanced passage from Cochrane that I had in mind was this:

• "The studies had a number of problems with the way their results were reported. The authors conclude that there is no evidence that any form of auricular acupuncture is effective for treating cocaine dependence. They recommend that better research be done, since it was difficult for them to draw conclusions from the few available studies."[44]

See? They're not making the claim (which requires a burden of proof) that acu doesn't work; they're saying evidence doesn't support it and the evidence base is itself poor. Now please explain why giving due weight to those experts (and to Bearn et. al. 2009, to which I mistakenly linked, intending to link to Cochrane's cocaine review) means not having an article on the subject, particularly in light of what those same experts say about homeopathy? Efficacy is not the same as notability. (And even if it were, surgery would be screwed if the criterion for efficacy were whether or not meta-analyses of double-blinded placebo-controlled RCT's clearly showed efficacy. Placebo surgery is harder than placebo acupuncture, but both are far less trivial than a placebo pill. Bit of a double standard, imo.) --Middle 8 (talk) 11:13, 27 May 2009 (UTC)

• Support merger there are better candidates for spin off than this. Verbal chat 12:26, 27 May 2009 (UTC)
• Merge (nominator) - it's a short page and given the lack of evidence of efficacy and evidence of lack of efficacy, it's unlikely to get longer without undue emphasis on the cherry-picked trials that do support it. The page is not destroyed or contributions erased, it would be a section in this page with acupuncture detoxification perhaps as a subheading or as a single sentence. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:55, 27 May 2009 (UTC)

Comment I find it amusing that you say that page is unlikely to get longer "given the lack of evidence of efficacy and evidence of lack of efficacy". All Cochrane talks about is the former -- so you're concocting the latter out of thin air. We're supposed to be more rigorous and conservative that that, WLU. Thanks, Middle 8 (talk) 21:24, 21 September 2009 (UTC)

I think the NIH Consensus Statement as well as TIP 45 are pretty strong statements about the use of acudetox. TIP 45 essentially grants acupuncture detoxification the status of "Best Practice," something that no other field of acupuncture has gained the status of. This page has and should be expanded to include further studies, not pushed tot he bottom of another page.--User:Freesophia

See WP:MEDRS and particularly Wikipedia:MEDRS#Searching_for_sources - the Cochrane review is the best source we have, and it is a better source than the NIH consensus statement. WLU (t) (c) Wikipedia's rules:^simple/_complex 11:29, 18 September 2009 (UTC)

When the US Department of Health and Human Services calls something "best practice," as they did with acu detox in TIP 45, that's something to talk about...that's a source worth noting, don't you think? Even though even they admitted, in the TIP 45 that acudetox lacks RCT's golden stamp of approval, they were impressed by the strong empirical base and outcome reports that say that no, acu detox isn't "bunk." Nothing in the current Acupuncture article explains what is acupuncture detoxification, how it is applied, who is trained in it, what is the history of it, etc. These are important things in the history of acupuncture in the world (25,000+ health promotors trained in acudetox is no small number). Why did you delete the information I edited in? I didn't delete your Cochrane review citation, which I don't agree is the "best source." Acu detox needs to be distinguished from acupuncture. They are different things. Teaching counselors and nurses how to put 5 needles in the ear is something totally different than full body acupuncture. What you've done isn't just decided who's a good source and who's not but rather, you've obliterated acupuncture detoxification from wikipedia...it doesn't exist now. Please revert the page to how it was, so it can be expanded and built on. Let's expand upon the piddly squat that existed on the page a week ago, and the smack dab nothing that exists this moment. ---Freesophia

You mean the 1997 statement? I'm of the opinion that the Cochrane Review, the very best source of information for medical articles over-rides that both by weight and by newness particularly since it deals with the evidence basis in a much more comprehensive way. Acupuncture and acupuncture detox are the same thing - unsupported pseudoscience with a dramatic placebo effect. I see no need to revert the page at all, it's a minor aspect of acupuncture that's unproven. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:33, 19 September 2009 (UTC)

Hi WLU; you are of course entitled to your view that "unsupported pseudoscience with a dramatic placebo effect", but that's not the view reached by our best sources, like Cochrane and other recent review articles. More below. --Middle 8 (talk) 21:24, 21 September 2009 (UTC)

No, I'm talking about TIP 45, 2006 http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.85279. How much have you actually read about acu detox? If not much, then why you're editing an article that you know so little about? The US Department of Health and Human Services thinks it's important. Shouldn't wikipedia? At least 1500 treatment programs use it. 1/3 of drug court programs use it. The National Acupuncture Detoxification Association has been training people in it since the 80's, and continues to oversee certification, training, competency, and reasearch on an international level And even if your "best source" (let's remember, it's your opinion that it's a best source) says it's "unproven" doesn't mean acu detox doesn't exist. There are plenty of medical topics on wikipedia that don't have the Cochrane Review's stamp of approval. If that's your benchmark, then your articles "proven" will be few. However, if you're interested in collaborating with other editors to provide information with both qualitative and quantitative information, we could work together. How bout it? Freesophia (talk) 15:48, 19 September 2009 (UTC)Freesophia

The article has been reverted to what it was before it was obliterated (or, should I say, vandalized by WLU) until this discussion matures beyond the burden of proof (AKA Cochrane Review) and a collaborative effort can begin. I'll be glad to work together with other editors who don't simply cut articles down until they convince the powers that be that they aren't worth mentioning. Freesophia (talk) 16:10, 19 September 2009 (UTC)Freesophia

 Administrator note I've fully protected the redirect page Acupuncture detoxification because of promotional abuses cited in this report. If consensus changes in the period in which it is protected, let me know.--Hu12 (talk) 16:36, 19 September 2009 (UTC)

NADA is a legit organization, as much as the NCCAOM or AMA, etc. Would discussion of NADA by the originator of ear-acupuncture-detox in a good MEDRS (a chapter in a medical textbook by Churchill-Livingstone) suffice to de-fuse some of the spam-assumptions? regards, Middle 8 (talk) 21:24, 21 September 2009 (UTC)

OK, thanks I didn't know this. Still, I haven't received an explanation why the mentioning of NADA is considered promotional abuse. I see that the NCCAOM is mentioned in wiki articles. Could you please explain? thanks. Freesophia (talk) 17:25, 19 September 2009 (UTC)Freesophia

Before throwing around the word vandalism, perhaps you should learn what it means. Also, journal articles are preferred as sources over the statements by organizations, even reputable ones. See WP:MEDRS. WLU (t) (c) Wikipedia's rules:^simple/_complex 19:55, 19 September 2009 (UTC)

Still, statements by reputable organizations have weight, and should be cited accordingly. Cochrane finds no evidence to support use of ear acu for addictions; NIH (using a coarser evidentiary sieve that probably includes clinical experience, case reports etc. -- also aspects of EBM, just not gold standard)[45] calls it a good practice.[46] Though Cochrane is superior, both are good MEDRS's. We should cite them both -- and without the WP:SYNTH-type assumption that acupuncture is pseudoscience just because WLU thinks that pseudoscience is synonymous with Cochrane finding no evidence for efficicacy, or because really shitty MEDRS's like self-published skeptical org's call acu pseudoscience. WLU, you are welcome to express your views about acu on this page as robustly as you like, but you have shown no reason why our use of sources like Cochrane and NIH should be colored by your interpretations -- and that includes deleting articles because you think they're pseudoscience and bunk despite our best MEDRS's not saying so. When someone finds a good MEDRS calling acu that, we can reassess that issue. regards, Middle 8 (talk) 21:24, 21 September 2009 (UTC)

RfC: Was there consensus for merge of Acupuncture detoxification?

Two against, three for. Is that consensus? --Middle 8 (talk) 20:41, 22 September 2009 (UTC)

Summary

Against merge:

• User:Middle 8 [47]
• User:Freesophia [48]

For merge:

• User:Verbal [49]
• User:WLU (nominator) [50]
• User:BullRangifer (added later, see comment below)

and, apparently, User:Hu12 [51], who then used their admin tools to enforce the merge.[52] (I thought "involved admins", who have already edited articles, weren't supposed to use their admin tools on those same articles, but perhaps I've misunderstood this.)

So, two against, three for, and relatively little discussion from the deletionists (except for WLU, although even they lapse into a little bit of WP:IDHT above regarding NIH, 2006). How is this consensus? It appears that a good MEDRS, a 2006 NIH source[53][54], has been overlooked. A representative quote:

Alternative approaches such as acupuncture are safe, inexpensive, and increasingly popular in both detoxification and substance abuse treatment. Although the effectiveness of alternative treatments in detoxification and treatment has not been validated in well-controlled clinical trials, if an alternative therapy brings patients into detoxification and keeps them there, it may have utility beyond whatever specific therapeutic value it may have (Trachtenberg 2000). Other treatments that reside outside the Western biomedical system, typically grouped together under the heading of Complementary or Alternative Medicine, also may be useful for retaining patients. Indeed, given the great cultural diversity in the United States, other culturally appropriate practices should be considered.[55]

That quote is consistent with the various levels of evidence accepted in evidence-based medicine.[56]

IMO, the article should be restored to its earlier sourced state (here); then we can have the debate over which sources to prune and weight. Less sourcing from NADA, and more from better MEDRS's like Cochrane and NIH, is the way to go. Page protection was a major overreaction to an aditor, Freesophia, who found the above NIH source and was adding that and NADA[57] in good faith.

NADA, btw, is a legitimate professional organization that meets WP:N (see this and others) and should not be dismissed outright as spam. It's not high on the list of MEDRS's, but is useful under certain circumstances -- e.g., in its own article, which keeps getting deleted for some reason. --Middle 8 (talk) 20:41, 22 September 2009 (UTC)

I get the point, I just think you're wrong, and selectively picking poor evidence that supports your point while ignoring the higher quality evidence that contradicts it. Deletionist is sometimes regarded as pejorative, and it's an unnecessary projection on the motives of the other editors. I'm also a "he", not a "they". A professional and advocacy organization is not a MEDRS at all and is only useful as a source for information about itself. The quote from the NIH textbook, as well as the discussion, is rather minimal compared to the overall size of the document. The executive summary doesn't mention acupuncture at all, nor do sections 1, 2, 5 or 6. Section 3 chunks it with "other alternative approaches" and doesn't discuss it specifically and would be better served in the alt med article. Section 4 states that it hasn't been subjected to rigorous research as well as essentially ascribing its usefulness to nonspecific effects. I don't think every single intervention using acupuncture needs a separate page. WLU (t) (c) Wikipedia's rules:^simple/_complex 14:51, 23 September 2009 (UTC)

I am an inclusionist, but I don't think all deletionism is bad: just the kind that misconstrues "undue weight" as "no weight at all", which is exactly what you are proposing by wanting to rely only on Cochrane and not NIH at all, thereby violating WP:WEIGHT by giving exclusive (read: undue) weight to Cochrane. Your assertion that I am "selectively picking poor evidence that supports your point" isn't what I'm proposing, because I want Cochrane to go in there. (And while that quote of yours was sort of "pejorative", let's not get sidetracked by tiny civility disputes; reasonable people can disagree over WP:SPADE in a civil manner.)

NIH (2006) is certainly an adequate MEDRS (irrespective of whether it covers acupuncture in detail), especially for sphere of usage and psychosocial aspects of the treatment. NIH (2006) also reflect EBM's utilizaton of evidence besides top-tier, Cochrane-type sources, as I noted above[58]; I guess I should take WP:SILENCE as assent.

I agree NADA isn't much of a MEDRS, if one at all; but they're useful in the same way that something like Quackwatch is useful: as a source for better RS's. And of course, it can be cited in its own article, along with other sources like this.

And by the way, sorry about the gender confusion. I always try to use singular they on WP when I don't know an editor's gender. But if my lack of clairvoyance was upsetting, I assure you, I feel terrible about it. Really I do. ;-) (note: preceding good-natured snark is taken verbatim from WLU's comment at his talk page.) regards, --Middle 8 (talk) 21:27, 23 September 2009 (UTC)

I just added my name as a supporter of the merge. -- Brangifer (talk) 14:00, 24 September 2009 (UTC)

I don't care about the gender confusion, but "they" can lead to confusion.

I don't see a short page about a topic with minimal scientific support and indications by the best sources as not useful as needing a separate page when there is a main page which can easily deal with it by noting it is not supported. I also don't think it's good practice to have something along the lines of "The NIH suggests acupuncture detoxification is useful as a ritual and a means of bringing patients into clinics, while a Cochrane review suggests it has no actual benefit". The sentence shoots itself in the foot. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:47, 25 September 2009 (UTC)

Moving in from the sidelines, I concur that merging it here is probably the best way to treat the detox material. I vaguely remember thinking there was consensus earlier, but I see nothing wrong with re-establishing it now. If more studies on efficacy, prevalence, &c. turn up, we can always split it off later. - 2/0 (cont.) 21:19, 25 September 2009 (UTC)

(de-indent) OK, not a big deal really. I'll add a brief section on auricular acu detox citing aforementioned Cochrane and NIH. And I'll try and restore the article on NADA since I've got sources showing that it, like many professional/advocacy organizations, meets WP:N. cheers, Middle 8 (talk) 23:45, 28 September 2009 (UTC)

Someone removing edits because they don't agree?

I was adding a source from an article I've read that has several references for their sources, but another member keeps undoing my edit. Granted, the first time, I hit "save page" instead of "show preview" (I'm still learning some of the linking codes here), so the source didn't show then and he undid my edit before I could load the screen enough to edit it (and no source is a valid reason for removing it, although it was premature). When I put it on again with the correct citation, he removed it again within a few minutes because it "wasn't a reliable site". Why remove a page with valid sources for the information just because he doesn't think it's a good enough site? It's properly cited and verified... Wouldn't that be against Wiki's guidelines to just remove content because you don't think the sources are good enough or am I missing something? Burleigh2 (talk) 20:30, 28 May 2009 (UTC)

Maybe I misread, can you please place the reference here. I didn't question it as a "reliable site" but as a WP:MEDRS - a reliable source for a medicine related article. There is also the lower bar of WP:RS - a reliable source. These are wikipedia standards for references. I don't think NaturalNews.com meets these criteria. BTW: Thanks for assuming faith with my first edit, but you should have done with the second too :) WP:AGFVerbal chat 20:38, 28 May 2009 (UTC)

Sure, the website is at www.naturalnews.com/025057.html and they list several references (including the Oxford Journal and ScienceDirect.com, which also has their references and abstracts from reputable sites) at the bottom of the page. I don't know how much of a reputation (or lack thereof) that NaturalNews.com has, but the references that each of it's citations list are legit. I am still new to editing Wiki and didn't want to start an "edit war" because I misunderstood something. Burleigh2 (talk) 20:47, 28 May 2009 (UTC)

What we should do is find the article the news story is based on, and bring that here for discussion. Thanks for understanding and not getting upset! I'll have a quick look now but it's late where I am. Verbal chat 20:48, 28 May 2009 (UTC)

Here is the study: doi:10.1016/j.bbr.2008.04.020. I'm not sure if it's already discussed to be honest. I'll have to check later, or maybe another editor knows? Verbal chat 20:52, 28 May 2009 (UTC)

That study appears not to be used (else is cited in a pretty screwy format). NaturalNews is really not a Reliable source in the sense of that guideline, as they are not exactly noted for their objectivity. The Reliable sources noticeboard might disagree, but I highly doubt it. I need to read the full study first, but it looks like it could be cited under Neurohormonal theory. - 2/0 (cont.) 04:37, 29 May 2009 (UTC)

The news release can't be used as a source per Wikipedia:MEDRS#Popular press, and the article itself should be reviewed to make sure it is not undue weight to cite it. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:07, 29 May 2009 (UTC)

That seems more than odd that a study conducted at Harvard University isn't good (unbiased or legit) enough to list for Wikipedia. Is it the study itself or is the the outlet that is reporting on the study? Burleigh2 (talk) 15:39, 29 May 2009 (UTC)

Just being from Harvard doesn't mean it's a great study. We have reviews which pool data from many studies, at it depends on size, methodology, conclusions, peer review, journal prestige... etc. etc. I'm afraid right now I don't have time to review the paper myself. We can't rely on the news report as they are not from WP:RS news outlets, and news reports fail WP:MEDRS. It's better not to rely on single studies too, especially if they go against the reviews. WP isn't for cutting edge research, generally. Thanks, Verbal chat 16:38, 29 May 2009 (UTC)

Part of the issue is undue weight. We are expected to document the current scientific consensus from the best possible resources. As it says here, the best sources are secondary, summarizing broad areas of research and up-to-date proof. Single studies can be errors, outliers, have faked data, and generally don't represent scientific consensus. It also prevents pushing from people with conflicts of interest and generally strong beliefs, who are willing to cherry-pick data and studies to support their views while ignoring dissenting and objections by other readers. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:40, 29 May 2009 (UTC)

Imbalanced, unfair article

Being imbalanced and factual, you could say writing evidence based, doesn't mean being nice. The fact that there is no scientifically plausible method for accupuncture to work is orders of magnitude more important than some 'crazy' ideas ("Many hypotheses have been proposed to address the physiological mechanisms of action of acupuncture").

Wikipedia is made for the lay person, is it not? And the lay person has to have it explained to them, what this scientific lingo means, otherwise one might easily be under the impression that there is a genuine scientific controversy about the hypothesis, when there isn't: accupuncture simply proved to be false by the scientific method. That should be properly emphasized.

Let's not be so open minded that our brains fall out. —Preceding unsigned comment added by 88.130.67.75 (talk) 07:21, 1 June 2009 (UTC)

If you're right about the state of scientific consensus, I'm sure you can find a suitable source. Otherwise we'll have to do the best we can with the sources we have. The Cochrane Collaboration is an outstanding source for reviews; have a look at the one for nausea published in 2009, using acupoint P6. Summary: "P6 acupoint stimulation prevents postoperative nausea and vomiting with few side effects." A review for chronic headache: "CONCLUSION: Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate." These are from some of the best WP:MEDRS's out there. (I'll update the article with 'em presently). Pubmed and Cochrane have lots more reviews of acu for different conditions, with conclusions ranging from + to -, and virtually all calling for more study (in large part because the issue of sham acu as a control isn't settled). Oh, here's something on mechanism. regards, Middle 8 (talk) 01:51, 3 June 2009 (UTC)

Yeah, it's clear that no one should come to Wikipedia for medical information, but too many do so. There are a few poorly designed studies that may show a placebo effect, but otherwise, there is simply no scientific controversy about this procedure. All clinical research, save for the badly designed ones, show it does nothing. SciMedKnowledge (talk) 18:54, 2 June 2009 (UTC)

Again, if that's true, then you should have no problem coming up with definitive references that refute the others we have and finally settle the issue. I would discourage edits like this, i.e. changing text to meet your preference but departing from the original source cited. If we find the best sources and stick close to them, it should be pretty easy to keep the article up to snuff. The citations I gave above on nausea and headache refute your final assertion. regards, Middle 8 (talk) 01:51, 3 June 2009 (UTC)

What a fanciful reinterpretation of the evidence. You are, I suppose, perfectly at liberty to reject the views of organizations like the WHO, and to believe whatever you like in your private life, but it has been the view of the medical establishment for many years now that acupuncture works for a number of conditions and that is really what the article must say. I know it is hard when one's beliefs clash with accepted scientific knowledge but wikipedia is not the place to take up this argument. 72.14.195.225 (talk) 19:57, 2 June 2009 (UTC)

Funny you should say that. Sorry to interject, but the "medical establishment" also used to believe that using Mercury to fight illnesses and leeches to encourage circulation were the best things to do, too. Just because the medical establishment follows a regimen doesn't always mean it's healthy or good and there have been hundreds of examples over the past couple centuries, plus several that have happened just in the past few years (recalled drugs that were commonly prescribed, changing medical procedures, etc). I'm not saying that Acupuncture will be accepted by the WHO anytime soon or at all, but the "medical establishment" has proven that it's not infallible. Burleigh2 (talk) 18:30, 9 June 2009 (UTC)

Not to mention the British Medical Association and several Cochrane reviews... the WHO used a coarser sieve than other reviewers, but they're obviously an "internationally reputable expert bod(y)" and a valid WP:MEDRS. --Middle 8 (talk) 01:51, 3 June 2009 (UTC)

Actually, most MEDRSes have highly criticised the WHO report. We shouldn't use it, when much better, more recent sources are available. Shoemaker's Holiday (talk) 02:25, 3 June 2009 (UTC)

No, we should do right by both NPOV and VER and (a) keep it (it's not that old) and (b) work in good sources that criticize it (keeping in mind WP:PARITY: right or wrong, WHO is a heavyweight as sources go, so WP:NOTTRUTH and all that). BTW, I checked Pubmed, and couldn't find much about the WHO and acu, so which MEDRS's do you have in mind? regards, Middle 8 (talk) 04:37, 3 June 2009 (UTC)

The LAncet, one of the biggest names in medicine, took it and a draft report on homeopathy apart in an editorial: doi:10.1016/S0140-6736(05)67159-0. This is NOT a non-controversial report, and must not be presented as such. Shoemaker's Holiday (talk) 02:16, 4 June 2009 (UTC)

I'd agree. That's a pretty good source, and can be cited for criticism of the WHO report. I worked it in here (keeping in mind WP:WEIGHT issues; WHO is a much bigger fish than the several critics quoted, as Ernst notes in the source). regards, Middle 8 (talk) 04:04, 4 June 2009 (UTC)

If I might step in: The evidence for acupuncture is weak, and recent studies have made it weaker. It has been shown to be ineffective for some conditions, but may be effective for others, mainly related to pain or nausea, though the evidence has grown weaker over time. We can and should reflect this. However, without good sources, we can't just say what we want. Shoemaker's Holiday (talk) 02:23, 3 June 2009 (UTC)

Have "recent studies have made it weaker" according to a good source (preferably something on the order of a good review article)? And if it is true, why did the 2009 Cochrane review for nausea get stronger for efficacy than the previously-revised version? It's more accurate to say that recent studies have weakened the evidence base for some applications and strengthened it for others, as one of the sources in the lead does, coincidentally. regards, Middle 8 (talk) 04:37, 3 June 2009 (UTC)

I suggest this news article http://news.bbc.co.uk/2/hi/health/7011738.stm and others. Now, i had to basically throw out the interpretation that was made by some journalists. I think I'm being intellectually honest in saying that what this study actually shows is that Acupuncture is no more valid or effective than a drunken child randomly slamming nails into your back. Which luckily is mentioned in the BBC's interpretation of the story. The original study is to be found here: http://archinte.ama-assn.org/cgi/content/full/167/17/1892?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=acupuncture&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Other news outlets reported on it saying that "Acupuncture works! Whether real of fake" (which is terribly deceitful) You do need a subscription to access the study, which is why I haven't read it yet. I am basing all I say on what was reported on the study by the press. Which, granted, isn't the best way to go about it. This news article and others should however be enough to state something like this: A German study on the effect of acupuncture on chronic low back pain didn't observe a distinction in the effects of classical acupuncture and a sham version that does not adhere to traditional rules. The study showed that there was a benefit in both of these procedures compared to no procedure at all, suggesting that the improvements are attributable to placebo- or non-specific effect. The last bit of this sounds like non-sceptics are going to jump all over it, I think it should be worded differently, it is none the less backed up by the reports and, presumably, by the study(?). What do you think? - the original poster —Preceding unsigned comment added by 88.130.73.178 (talk) 23:32, 10 June 2009 (UTC)

That well-known study is included in the corresponding reviews that are cited and discussed in the article. WP prefers citing reviews over single studies. regards, Middle 8 (talk) 04:47, 12 June 2009 (UTC)

Idea for resolution: How about replacing the beginning with: "Acupuncture is a pseudoscientific technique of inserting and manipulating fine filiform needles into specific points[...]" Presumably, consensus (?) on the inclusion of Acupuncture in the List of topics characterized as pseudo-science would make the inclusion of the term in the articles introduction non-controversial? —Preceding unsigned comment added by 88.130.125.232 (talk) 21:42, 19 June 2009 (UTC)

How does saying it's a pseudoscience right off the bat resolve anything? That just irritates more people more and is going to create more conflict. Burleigh2 (talk) 18:05, 25 June 2009 (UTC)

@88.130.125.232: no, that wouldn't work. Please see WP:PSCI which explains when and how to use the term on WP. Then re-read the opening paragraphs at List of topics characterized as pseudoscience. Inclusion on that list does not necessarily indicate consensus among either scientists or Wikipedians that a topic is, in fact, pseudoscientific. regards, Middle 8 (talk) 04:04, 27 June 2009 (UTC)

Very long

This article is really long, and the 102K size kind of confirms it. Perhaps a few sections can be split out? SchuminWeb (Talk) 10:03, 6 August 2009 (UTC)

Yes, it's long, but it's a very heavily debated an in-depth topic... it's bound to be long because of the debates on effectiveness and the points of proof for both sides of the fence so it can be as "unbiased" as possible. Burleigh2 (talk) 16:43, 11 August 2009 (UTC)

I tend to agree with Burleigh2. WP:SIZE is not an absolute rule, and 100K-ish isn't that excessive. I'm all for splitting stuff out where possible, but am not altogether sure how to do that without risking a WP:POVFORK. --Middle 8 (talk) 23:09, 11 August 2009 (UTC)

I think there is a mistake

Hi. In the section antiquity, it is claimed that acupuncture needles have been found in 3,000 BC , but the second link says 3,000 years back in inner Mongolia, that's 1,000 BC.

It should to have better sources for this. These claims can basically not be substantiated by some random acupuncture website. If anyone has better informations, provide them please.

Kosto (talk) 15:16, 1 September 2009 (UTC)

Evidence of effectiveness

I think that some people are cherry-picking the references they use to determine the effectiveness of acupuncture. There is so much incorrect information here that it's beyond ridiculous! I have a subscription to Natural Standard, one of the world's best sources on alternative therapies. It is run by doctors and pharmacists and they summarize studies that are evidence-based and peer-reviewed. According to them, there is actually STRONG evidence that acupuncture works for osteoarthritis, chronic pain, and post-operative pain. This is NOT a statement that is easily handed out from them. I'm going to be doing a lot of editing of this article, and I hope you guys can check out the website. It costs money to subscribe to (like many journal websites), but you may be able to get it for free if you attend university as many do subscribe to the website.99.255.196.199 (talk) 02:59, 26 September 2009 (UTC)

For example, what is the point of including a statement from the American Medical Association in the "scientific research into efficacy" section? Not only was it from 1997, but do you really think that the AMA is a neutral source? Also, newer information that has been complied from Natural Standard shows that there is scientific basis behind the use of acupuncture for the conditions I mentioned above.99.255.196.199 (talk) 03:44, 26 September 2009 (UTC)

Shoemaker's Holiday, please explain why Natural Standard is an "extreme fringe source". It is a tertiary source suscribed to by my pharmacy school and many others, uses only evidence-based and peer-reviewed journal articles as its sources, and is run by prominent pharmacists and medical doctors all over the United States. Also, the reason I took out the sourced info from the NIH consensus statement page is because it states on the page: "This statement is more than five years old and is provided solely for historical purposes. Due to the cumulative nature of medical research, new knowledge has inevitably accumulated in this subject area in the time since the statement was initially prepared. Thus some of the material is likely to be out of date, and at worst simply wrong." Not only that, but nowhere on that page does it say that there is no histological or anatomical basis for acupuncture. Their own warning proves to be correct since the NIH's own branch, the NCCAM (National Center for Complementary and Alternative Medicine) posted results in 2004 of a study they funded, showing that acupuncture was effective for osteoarthritis in the knee. With regards to a constantly researched field like acupuncture, you cannot use such old sources even if it is info from the NIH99.255.196.199 (talk) 04:53, 26 September 2009 (UTC)

Natural Standard does no original research, but aggregates other information. Due to access issues it is a poor reference, since you can't even access abstracts. You should put their original sources as references, as then they can be reviewed for fact and NPOV. Clovis Sangrail (talk) 05:09, 26 September 2009 (UTC)

MeridiansRef supporting: http://www.ncbi.nlm.nih.gov/pubmed/15750378 Ref unable to replicate: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1180459 Clovis Sangrail (talk) 05:15, 26 September 2009 (UTC)

So what if Natural Standard doesn't do original research? That certainly doesn't mean it's unreliable. Natural Standard's info is used in Medline and is published in print. It's subscribed to by many health professional schools, yet it's still not good enough? I find that laughable considering the other sources used in this article, including one from the American Medical Association who definitely are not NPOV about the issue. Cochrane's doesn't do original research yet it is cited a million times here. There are MANY references on this website that have poor access because they are located on e-journals that require subscriptions. Let me say again that Natural Standard actually publishes print editions containing this information that one can purchase. There is no access issue with books I presume.

Clovis: "This was reported in an alternative medical journal, and could not be replicated in subsequent trials in western medicine.

The statement you reverted it to was sourced to an admittedly decade-old outdated NIH page that didn't even contain that statement, and another source which quoted an OPINION from one researcher (made in 1993) without any proof whatsoever. It's ridiculous to remove the statement from a credible source like Natural Standard and replace it with the original statement which had NO backing whatsoever.99.255.196.199 (talk) 05:29, 26 September 2009 (UTC)

Allow me to emphasize the following points:

1. It is ludicrous to allow information that is referenced from biased, outdated and unreliable sources (that may not even support the information written in this wiki), while removing information that is found in a reliable, well-known source just because it is found in a complementary medicine journal.

2. A large number of sources found here rejecting acupuncture effectiveness or theory are either outdated and found in conventional medicine journals or even worse, from the American Medical Association- the least NPOV source one can possibly find. . Should all this information be purged as well?

3. Please feel free to note on the page that there are conflicting results over whether the points show up in infrared.99.255.196.199 (talk) 05:48, 26 September 2009 (UTC)

It publishes print editions of its information. Search Amazon with the term "Natural Standard". Therefore, it is accessible to 99.9% of the population- those who can afford books or go to a library. It doesn't do original research, but neither does Cochrane, which is cited many times in the article with no controversy. If there is no scientific consensus of the existence of Meridians, then there is no reason to revert to the original statement that stated in an absolute manner that there is no anatomical nor histological evidence of Meridians. As I mentioned, the sources it referenced either did not say this or were quoting an opinion from nearly 2 decades ago. Why revert it to the original statement if your standards on what is a good source are so high? Also, Natural Standard does certainly list its references along with links to abstracts via Pubmed. I don't know where you got the idea that it doesn't, but it's certainly not true. 99.255.196.199 (talk) 05:48, 26 September 2009 (UTC)

> Excellent, then reference the original sources and not Natural standard. Its more transparent. Clovis Sangrail (talk) 05:54, 26 September 2009 (UTC)

Well, someone else (Verbal) just reverted by edits back to the original statement, which used sources that pretty much fail all criteria of what a good source is on Wikipedia. What is with the knee-jerk reverts on here? There is clearly some bias towards skepticism of acupuncture in this article. I will be referencing the original sources, but need sometime as my internet is slow. I will also be clearing out outdated, biased, inaccessible, non-original research sources on this page (of which there are many).99.255.196.199 (talk) 05:59, 26 September 2009 (UTC)

Wow Verbal reverted my deletion of that statement again! That statement still uses 2 references that are completely bogus! One doesn't support the statement, and the other quotes an opinion from a book published in 1993! For the love of god "Rvt editwarring against consensus, POV, non RS etc." - Verbal??? Where is the consensus that it is okay to use information that is referenced like that? Please tell me. Please tell me how deleting that statement is POV.99.255.196.199 (talk) 06:06, 26 September 2009 (UTC)

There is actually a very good reason not to use a particular 2004 study. The osteoarthritis section is already cited to a meta-analysis and a systematic review, both of which are more recent. These papers better represent the current state of knowledge about the issue. If there are more recent reviews of similar quality, we should use those instead. - 2/0 (cont.) 17:40, 26 September 2009 (UTC)

Normally, I would agree that a newer systematic review (that takes older studies and newer studies into account mind you) is important, that particular systematic review includes a lot of smaller studies, and no other study that is half as long as the major study done in 2004. It is unfair to ignore the findings of the larger, more credible study just because the general conclusion found in the systematic review was affected by the inclusion of smaller, shorter studies. But, if I will play by that rule, ignoring the fact that there are many sources from a decade ago on this page, I will give you this link. http://www.ncbi.nlm.nih.gov/pubmed/17215263 This 2007(even newer!!) systematic review was published in Rheumatology and found that acupuncture IS effective. If there are no problems with this, then I will revise the information in the article.99.255.196.199 (talk) 01:59, 28 September 2009 (UTC)

Also, out of 3 sources referenced for the statement "For osteoarthritis, reviews since 2006 show a trivial difference between sham and true acupuncture." on this page, only one supports it. One of the other 2 sources concludes: "Acupuncture that meets criteria for adequate treatment is significantly superior to sham acupuncture and to no additional intervention in improving pain and function in patients with chronic knee pain.", and the last source is mislinked. With the addition of the source I posted above with an even newer systematic review, I believe that warrants a change to the statement to actually reflect current research. Is this agreeable?99.255.196.199 (talk) 02:25, 28 September 2009 (UTC)

Also, here are some more supporting, newer reviews: http://www.ncbi.nlm.nih.gov/pubmed/17674552 (hebrew but translated english abstract)"Recently, two large phase III randomized clinical studies were published on the efficacy of acupuncture in osteoarthritis of the knee. The studies have shown that acupuncture serves as an effective complementary treatment to standard care, improves function and provides pain relief for people with osteoarthritis of the knee. These studies confirm the results of previous studies on acupuncture as effective complementary treatment to standard care."99.255.196.199 (talk) 03:10, 28 September 2009 (UTC)

More http://www.ncbi.nlm.nih.gov/pubmed/17986496 "There is moderate-quality evidence that acupuncture, transcutaneous electrical nerve stimulation, and low-level laser therapy reduce pain", more http://www.ncbi.nlm.nih.gov/pubmed/18552606 "These studies provide evidence that acupuncture is an effective treatment for pain and physical dysfunction associated with osteoarthritis of the knee."99.255.196.199 (talk) 03:10, 28 September 2009 (UTC)

So I take it no one has any objections to adding these newer systematic reviws that support the effectiveness of acupuncture in OA? I will be changing the statement to reflect this as well.99.255.196.199 (talk) 13:41, 29 September 2009 (UTC)

Someone improperly summarized the reviews I posted, so I used direct quotes instead.99.255.196.199 (talk) 02:21, 8 October 2009 (UTC)

Added "OARSI expert consensus recommendation statements" to the OA area. I hope this isn't seen as whitewashing in some way!99.255.196.199 (talk) 16:34, 9 October 2009 (UTC)

Biased article and editing

Here's a message I got on my talk page: "Removal of sourced information, including the opinions of a notable acupuncturist like Felix Mann, is a big no no". Brangifer (talk) 07:10, 26 September 2009 (UTC)"

And yet, this same person deletes all the new information I added about an NIH-funded study showing that acupuncture works for osteoarthritis, which helps balance out what it says about osteoarthritis now, which is simply: "For osteoarthritis, reviews since 2006 show a trivial difference between sham and true acupuncture"

I was going to add more supporting information about another new systematic review in 2007 "Acupuncture treatment for chronic knee pain: a systematic review." showing that acupuncture is effective over sham controls in treating chronic knee pain, but I realized something. It is absolutely useless to try to do that here because there is a group of editors here that refuse to allow any more information on this page that supports acupuncture.99.255.196.199 (talk) 08:21, 26 September 2009 (UTC)

AMA statement

A section got lost in the recent edit war [59]: Was this intentional? The AMA have neither retracted it nor issued a new statement since. Shoemaker's Holiday ^{Over 208 FCs served} 12:48, 26 September 2009 (UTC)

That should be restored. Thanks for noticing! Things can get messy after an editwar. Verbal chat 15:22, 26 September 2009 (UTC)

Fixed. - 2/0 (cont.) 18:30, 27 September 2009 (UTC)

Why should it be kept here? The AMA should not be seen as an NPOV source. Medical organizations have traditionally fought ANYTHING that will erode its power, whether its prescribing powers for pharmacists, more scope of practise for nurses, or alternative medicines. Not only that, but the statement was made in 1997, and there has been a plethora of new research that has since occurred. A major 2004 study I posted got rejected for being too oldso why should a decade-old statement from a POV source be kept?99.255.196.199 (talk) 01:54, 28 September 2009 (UTC)

You write "The AMA should not be seen as an NPOV source...". Of course not! This reveals a misunderstanding of our use of sources here. We use biased and POV sources here. NPOV applies to editorial work, not to sourcing. WE edit in an NPOV manner. Read Wikipedia:NPOV#Explanation_of_the_neutral_point_of_view. Don't worry. Wikipedia is complicated and its policies can be hard to understand. When you've gotten 10,000 or more solid edits under your belt, you will have begun to just scratch the surface. We're all learning here. Right now you have a few edits. Don't let User:2/0's 7,234 edits fool you, since he's got lots of edits from a previous username. Verbal has 14,152, SH has 19,006, and I have 23,459. While edit count doesn't give us any more rights, it does indicate a degree of experience. You may not believe this, but AGF. We're willing to work with you. If we don't respond right away, it may be because we aren't near a PC, or are busy with other things. It doesn't mean you're being deliberately ignored, as you have implied in some of your comments. We have large watchlists and real life responsibilities. My watchlist right now covers 3,846 pages (excluding talk pages). This is just one item on it. -- Brangifer (talk) 04:54, 28 September 2009 (UTC)

Expanding on Brangifer's point a little, what the AMA has to say about acupuncture is relevant to explaining the topic at hand. They do not appear to have issued an updated statement, though there is a good chance some similar medical organization has one that is not currently covered here. - 2/0 (cont.) 06:53, 28 September 2009 (UTC)

Brangifer: You edit in an NPOV manner, correct? From your own explanation of NPOV link: "All editors and all sources have biases (in other words, all editors and all sources have a point of view)—what matters is ***how we combine them to create a neutral article.***", also from the verifiability section: "Such sources include websites and publications expressing views that are widely acknowledged as extremist, or ***promotional*** in nature, or which rely heavily on rumors and personal opinions." One of the purposes of the AMA is to promote the interests of physicians- which often has lead to attacking other professions and alternative theories. Should we also add some statements from acupuncture organizations to see what they think about acupuncture? Let's use some common sense here. When the AMA says: "There is little evidence to confirm the safety or efficacy of most alternative therapies." in 1997, we know this is now false. There is a MOUNTAIN of evidence (referenced in this article alone!) to confirm the safety and efficacy many alternative therapies. There is also a mountain of evidence that rejects many alternative therapies, but acupuncture IS NOT one of them. That statement is thus irrelevant to the reality that exists today. It is plain MISLEADING to readers include a quote like that from the AMA.99.255.196.199 (talk) 12:26, 28 September 2009 (UTC)

Look, I do not care how many edits you have under your belt. What matters is the actions you take. Verbal and SH, with their thousands of edits, reverted my edits several times without responding at all on the talk page. SH dismissed Natural Standard as an extreme fringe source without even looking it up and checking to see who runs it! When you go on my user talk page to say that "Removal of sourced information, including the opinions of a notable acupuncturist like Felix Mann, is a big no no.", then proceed to remove my valid sourced info about osteoarthritis treatment effectiveness, and then when I call you out on it, you respond "I see what you mean, but as I recall it was included with flowery language that was unbalanced and it was just easier to revert the whole mess. The one study could be reinserted, but using neutral language." This is when I had made many specific, individual edits one by one so you didn't have to "revert the whole mess" and instead just revert little parts you found unacceptable. Rather than removing the "flowery" language, you deleted everything. Most of it was quoted directly from the study conclusion abstract, which is written in VERY neutral language! The rest was no more flowery than statements by the NIH or AMA. Now, if you don't have the time to read the talk pages before reverting changes or reading the changes before reverting them, then maybe you should take this page off your watchlist.99.255.196.199 (talk) 12:26, 28 September 2009 (UTC)

2/0I don't think it's at all relevant to explaining the topic at hand. They, in 1997, said there's no evidence to the safety/effectiveness of most alternative therapies (not necessarily acupuncture even mind you). In this same article, we provide mountains of evidence on its safety and effectiveness. It is an outdated opinion, and it comes from a biased source that traditionally promotes the interests of physicians and conventional medicine. I can't even post information from an alternative medicine journal source because it's seen as biased, so how can someone post an opinion from the AMA?99.255.196.199 (talk) 12:26, 28 September 2009 (UTC)

I think you are still misunderstanding the way NPOV works. It is like a grainy mirror that catches the most prominent points from the reliability-weighted aggregation of sources. We just strive to ensure that there are no distortions or chromatic aberrations in the mirror; the AMA gets to have a say on any medical matter, as that is their acknowledged area of expertise. - 2/0 (cont.) 13:44, 28 September 2009 (UTC)

It's important to show viewpoints from a variety of sources, but there are major problems with the AMA statement that make it POV, or just a plain irrelevant and outdated statement. I'd say that it's a pretty big distortion. Here are the problems with the AMA statement:

1. It's from a source that is promotional in nature. The AMA promotes the interests of physicians and conventional medicine, which has traditionally led to them fighting other professions and alternative medicine. As I mentioned, neutrality guidelines say promotional sources shouldn't be allowed.

2. The statement is from 1997- over a decade ago.

3. The statement is not even so much opinionated as it is based on facts... in 1997. "There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information ***currently*** known about these therapies makes it clear that many have not been shown to be efficacious." Note that I emphasize the word "currently" in their statement. Since 1997, we know now that there ARE many studies on effectiveness/safety. This is not even an opinion- it's FACT. This wikipedia page proves that the AMA is wrong. I'm not sure if there's a common sense guideline for wikipedia, but I don't see how the the statement is seen as useful by anyone (despite coming from a highly respected source) if it's just spouting something obviously incorrect... ESPECIALLY since it's in the "scientific research into efficacy" section. You can put in a statement about what the AMA thinks about the use of ACUPUNCTURE (not alternative medicine in general) along with conventional medicine, but to insert a statement from them on the amount of evidence supporting alternative evidence in 1997 is useless.

4. The statement is a GENERAL one, saying that most alternative medicine does not have evidence to back it up. It's like putting the comment from the IOC saying: "Most olympic sports involve playing with balls" in an article about olympic weightlifting. It would be laughed at and thrown out within days. Are there not guidelines for RELEVANCE on wikipedia?99.255.196.199 (talk) 23:46, 28 September 2009 (UTC)

So does anyone have a rebuttal to why the AMA statement should be removed for being outdated, irrelevant (talks about alternative therapies in general, and current state of research in 1997), likely POV, and incorrect? Otherwise, I see no reason to keep it here and am going to have to assume that you folks agree.99.255.196.199 (talk) 03:24, 7 October 2009 (UTC)

Don't assume anything. Silence doesn't mean we agree with you. Your arguments aren't convincing, as evidenced by many other comments here. You need to understand our sourcing policies much better, and continuing to repeat your arguments is beating a dead horse. -- Brangifer (talk) 02:03, 8 October 2009 (UTC)

No one has yet to address the 4 issues with the AMA statement that I have highlighted. That's not beating a dead horse. Tell me WHY my arguments aren't convincing. People have referenced me to the NPOV guidelines and the MEDRs guidelines and I have responded by specifically quoting/highlighting the sections of those guidelines that inclusion of the AMA statement violates. I'm awaiting your response. If my arguments aren't convincing, it should be easy for you to comment on why I'm wrong. Telling me that I don't understand sourcing policies (that I have highlighted for you) does nothing but raise my suspicion that you indeed cannot prove me wrong.99.255.196.199 (talk) 02:18, 8 October 2009 (UTC)

(de-indent) Actually, I think all four criticisms are valid. And I suggest that editors have a look at WP:SILENCE -- there is some validity in IP 99...'s assumption -- and that we remember WP:BITE and not try to "pull rank" just because we happen to have more experience editing Wikipedia (not the most amazing credential, in any case) than the other guy. Let's address the substance, not debate who's the better editor. Additionally, anyone who reverts and says "discuss on talk" or "WP:BRD" has an implicit obligation to discuss on this page -- failing to do so is completely contrary to the letter and spirit of WP:CONSENSUS. That said, I'm OK with keeping the AMA statement as long as dates are given (a good idea of User:JohnCBE's, aka IP 99..., that should have been retained, and which I just restored). Same with NIH consensus statement: old-ish, but there are ameliorating factors (addressed in the text of the article). --Middle 8 (talk) 23:10, 12 October 2009 (UTC)

I have reworded the statement. It's old, but it hasn't been updated and the AMA is a respected medical body (JAMA is its official journal and is among the most respected on the planet). It now focuses exclusively on the comments regarding acupuncture and the ability to treat disease. Is this acceptable? Citing the conspiracy theory of medical research belies the vast amount of research that is and has been conducted on acupuncture and is disrespectful to the doctors who are involved while ignoring publication biases, national pride and other issues with those who promote acupuncture (the former has several citations to support it). WLU (t) (c) Wikipedia's rules:^simple/_complex 22:55, 13 October 2009 (UTC)

I've no idea what "conspiracy theory" you're referring to. I do know that it's out of date (and relies on very outdated, mediocre reviews) and therefore should be either dropped or annotated in some way, whether it's pro-, anti- or mixed with respect to acupuncture. I'm fine with the solution as proposed by JohnCBE and recently restored by Shoemaker's [60].--Middle 8 (talk) 10:00, 14 October 2009 (UTC)

The conspiracy theory comment is a reference to point 1 - "doctor's hate challenges to traditional medicine and are just selfishly protecting themselves and their jobs from the wonder and undeniable effectiveness that is CAM in general and acupuncture in specific." It's CAM's second-favourite argument after "the FDA is in teh drug companies eviel pokets". Sic. I don't think it's a point worth pursuing for many reasons but I also don't think it's a reasonable argument to substantiate any changes to the page.

It may not incorporate recent reviews, but from a purely wikipedia perspective there's no source indicating the information and stance has been altered, and it's already well-qualified with the 1997 date. Were it 1997 I'd say that incorporating only older reviews might be an issue, but since it's already 12 years old, I still see it as unnecessary. From a non-wikipedia perspective, the higher-quality reviews that have since substantially demonstrated their point had merit. I've adjusted the wording and again removed the dating of the reviews. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:07, 14 October 2009 (UTC)

OK, I agree excluding dates is OK since we don't do it with other systematic reviews (per your statement to that effect in an ES or somewhere here). But on its merits, that AMA source is getting pretty ripe. I don't think that including older MEDRS's because we think they agree with later ones is much more than OR, but it's not worth worrying about for now. Sidebar of personal opinion: the "doesn't affect the course of any disease" wording sounds like political spin (which is basically the M.O. of people like Sampson, who I believe authored one of the barely-MEDRS's that AMA was lazy enough to resort to using). Using that phraseing is a convenient way to play down the just-as-clinically-relevant questions of whether acu otherwise affects the body and provides symptomatic relief. (/sidebar) regards, Middle 8 (talk) —Preceding undated comment added 15:51, 15 October 2009 (UTC).

Since the RFC is ongoing and we're still waiting for more clarification, I won't remove again. The best evidence seems to suggest it has uses in the treatment of symptoms (notably pain and nausea) but the only evidence for diseases is in the WHO report. I'm thinking of turning the section into a table, right now it's a mess, hard to read and just plain ugly. Incidentally, I'm on IE6, so I can't tell if I'm actually pasting in Chinese characters or just little squares. Can someone confirm for this and this edit? Possibly others. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:59, 15 October 2009 (UTC)

Rewrite entire article

I came across this article while writing lectures for the first year class in Chinese Medicine paradigms and principles. I'm a national board certified acupuncturist educated in the USA. The graduate program I attended was four years in length. Since graduating I've accumulated 15 years of experience. The bulk of the article is heavily biased. It is quite apparent that most of the contributors have little to no knowledge of acupuncture. Of 126 listed sources only seven (see below) were written by practitioner-scholars who read Chinese. They are standard English language textbooks in the professional curriculum in the USA.

The other 119 sources were written by people whose knowledge of acupuncture is scanty, ethnocentric, and gleaned from other sources from far outside of the cultures that developed acupuncture. These studies focus on one particular allopathic disease entity and then simply ignore the system constructs that guide clinical practice of acupuncture. Whatever they are testing is not acupuncture in vivo. This mortally flawed research has used a caliper as a hammer and declared it useless. Daily in China alone, millions of people receive acupuncture treatment and thousands of studies are conducted with extremely robust sample sizes. Research from many perspectives has been aggressively conducted in China since the early 1950's. This body of professional literature has been almost entirely ignored in the Occident.

This article needs to be rewritten from scratch.

1. ^ a b Acupuncture: A Comprehensive Text, p. 35. Shanghai College of Traditional Chinese Medicine. Translated and edited by John O'Connor ,Dan Bensky. Eastland Press, Seattle, 1981(Fourteenth Printing, 1997).ISBN-939616-00-9. 2. ^ Xinnong, C (1987). Chinese Acupuncture and Moxibustion. Foreign Language Press. p. 53. ISBN 7-119-00378- 4. ^ "Understanding Acupuncture - Stephen Birch, Bob Felt". Redwingbooks.com. Retrieved 2009-09-02. 5. ^ History Of Acupuncture 6. ^ Unschuld, Paul. Chinese Medicine, p. 94. 1998, Paradigm Publications 7. ^ Kaptchuk, Ted J., The Web That Has No Weaver: Understanding Chinese Medicine, McGraw-Hill Professional,

2000 ISBN 0809228408, 9780809228409 500 pages

AnuthaMule (talk) 18:15, 27 September 2009 (UTC)

The main editors of this article also happen to ignore any supportive studies of acupuncture even in journals here. They set high criteria for any positive results, claiming inaccessibility, unreliability, etc. while sources that are used to reject acupuncture on this page often fail that same criteria. You cannot change anything because it requires consensus, yet the cadre of editors here will refuse to discuss the issue on the talk page. Good luck. I think you'll need it.99.255.196.199 (talk) 01:53, 28 September 2009 (UTC)

Controversial statement is incorrectly sourced

"There is no known anatomical or histological basis for the existence of acupuncture points or meridians."

There are 2 problems. 1: This statement in the page uses references found at footnote 5 and 6. The NIH source says that the existence of acupuncture points is controversial. It does not say that they don't exist. Thus, it should not be used as a source.

2: Now we are left with one source, quoting something Felix Mann wrote in his book that was published in 1993- as an opinion. Since then, much more research has occurred with conflicting results as evidenced by here: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1180459 and here http://www.ncbi.nlm.nih.gov/pubmed/15750378. The NIH source used itself states that their existence is controversial. The NIH source was written up in 1997, which is newer than what the Felix Mann source. As I have been notified by others here, it's better to use newer, more credible sources.

Now, can we agree that at least the NIH source should be removed because it doesn't support the statement referencing it?

Can we also agree that the statement should be modified. Brangifer wrote on my user talk page that I can modify it if I find evidence that the existence of the acupuncture points is controversial because "a difference of opinion should be documented". I have 3 that are newer and more factual than the dismissive, opinionated statement from Felix Mann made in 1993.99.255.196.199 (talk) 02:40, 28 September 2009 (UTC)

Go ahead and propose some wording here and let's work on it together. We should be able to come up with something. Brangifer (talk) 04:59, 28 September 2009 (UTC)

That nobody can point to any actual object and say "that is an acupuncture point/meridian" is really not controversial, though last I checked there was still some question of point specificity (treated in the next sentence in the lead). Per WP:REDFLAG, we are going to need a pretty solid source to change this. Sorry, but neither of those sources indicates a sea change in anatomy; I will restrict my comments to saying that clearly neither was written by physicists. I could probably see something discussing the search for physical as opposed to functional existence in #Scientific theories and mechanisms of action, though.

Updating the phrasing and the sourcing for this general point of course remains on the table. I recommend MedLine as a source for sources written for non-doctors, and the Cochrane Collaboration for the latest research. WP:MEDRS also has advice on sourcing. - 2/0 (cont.) 06:46, 28 September 2009 (UTC)

(de-indent) I've always thought Mann was rather weak. Per WP:MEDRS, journal articles are best used on WP when they've been adequately cited in reviews. I'm not sure about the ones listed above suggesting evidence for meridians (or something functionally like them), but this article by Langevin et. al. on connective tissue planes could prove useful (and, imho, is the most plausible hypothesis I've yet heard). regards, Middle 8 (talk) 23:51, 28 September 2009 (UTC)

That link is malformed (Wiley does some session and frames stuff - just search for the paper title usually works for me), and I am not sure which paper you mean. I expect that it is one of the ones cited here, though. Definitely that lends weight to my thought above for a new subsection. - 2/0 (cont.) 02:50, 29 September 2009 (UTC)

Hi 2/0, right, it's the footnote 7. Can you reiterate said thought, regarding a new subsection? I no can find the where is it being. thanky, Middle 8 (talk) 05:31, 30 September 2009 (UTC)

Sure, better wording would be: "The existence of acupuncture points is controversial" - sources would be the NIH page and the 2 sources posted on this page supporting and rejecting the detection of the points.99.255.196.199 (talk) 13:39, 29 September 2009 (UTC)

And we could go further if any of the papers turn out to be decent MEDRS's. I think Ernst (in one of his reviews) described Langevin as tantalizing but not convincing, or something to that effect. We could cite that -- that sounds like it's a pretty mainstream view. Ernst goes back and forth, and while I don't always agree with him, he's highly regarded. Citation in an Ernst review definitely boosts a paper to MEDRS-hood. cheers, Middle 8 (talk) 05:40, 30 September 2009 (UTC)

Ah, I see I did not actually say subsection, but that is what I was thinking could be good for adding some of this material to #Scientific theories and mechanisms of action. Anatomical basis, maybe? It has been a while since I read the whole article (cue renewed WP:SPINOUT discussion), but I think there is some material on point specificity which could go there (mindful of original synthesis, of course). - 2/0 (cont.) 18:01, 30 September 2009 (UTC)

Agreed.... see just below. Yes, we should make this a long-term (and short-term, if possible) priority. There are lots of loose ends that haven't been tied up in terms of research, and it would be good to give some idea of the state of play (within the caveats you mention). cheers, Middle 8 (talk) 02:13, 1 October 2009 (UTC)

I'm not sure where we're at with the argument at this point, but I'd like to point out a study just published in September: http://www.ncbi.nlm.nih.gov/pubmed/19672170 "Contact-free infrared thermographic imaging is a reliable and easy-to-handle tool to distinguish between needling at Hegu and needling of a nonacupoint ("sham" acupuncture)."A significant increase in surface temperature occurred within 2 min after needling the acupuncture point Hegu whereas needling of the cutaneous and muscular point, as well as without any manipulation resulted in a decrease of temperature in the monitored area." Thoughts?99.255.196.199 (talk) 03:39, 3 October 2009 (UTC)

Sounds promising, but per WP:MEDRS we should probably wait for it to be cited in in other papera (ideally reviews, in which case we can just cite those). It seems to makes sense to have some threshold for citing particular studies. regards, Middle 8 (talk) 04:34, 4 October 2009 (UTC)

Also: http://www.ncbi.nlm.nih.gov/pubmed/18240287 "Five out of 9 point studies showed positive association between acupuncture points and lower electrical resistance and impedance, while 7 out of 9 meridian studies showed positive association between acupuncture meridians and lower electrical impedance and higher capacitance. The studies were generally poor in quality and limited by small sample size and multiple confounders. Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable. However, the preliminary findings are suggestive and offer future directions for research based on in-depth interpretation of the data." Very interesting! Hopefully, a large scale, high-quality study will eventually be funded in the future to give a definite answer.99.255.196.199 (talk) 03:39, 3 October 2009 (UTC)

Based on what I just posted, it would be correct to say: There is definitely controversy over the existence of these meridians and acupuncture points. Sure, you won't find them in anatomy textbooks, and you can't see them physically, but there does appear to be some evidence that their locations are NOT imaginary and random. I feel there should be a statement noting this after the statement dismissing their existence in the lead.99.255.196.199 (talk) 03:39, 3 October 2009 (UTC)

Agree, that statement in the lede should be qualified and cite more recent sources. Any suggested wording? I think we might say what NIH says (controversial, but used clinically), and then say that there is no consensus on whatever physical or functional basis meridians & points may have, although X, Y, and Z MEDRS's have suggested various explanations. Then expand on those explanations in a subsection in the body of the article. Sound ok? (BTW, good contributions; it would be nice if you and any other IP's posting here could register usernames. It makes collaboration a lot easier for me, anyway.) regards, Middle 8 (talk) 04:34, 4 October 2009 (UTC)

Undent. Trick or Treatment is explicit, no anatomical basis; 12 meridians were based on an as above, so below geographic microcosm of the 12 rivers of China. I've included a google books preview, but this should be in the body as well. The review article isn't much use in the lead and I wouldn't summarize it as supporting the idea that there is evidence for meridians. Could be used in the body. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:29, 5 October 2009 (UTC)

Wait, wait, wait... an extremely opinionated, biased (I love how they selective report study results without citing anything) source is important enough to be in the lead, yet studies showing that areas along the meridian lines and acupuncture points have different electrical properties and emit different thermal responses compared to sham acupuncture isn't??? Can we at least partially show both sides here? Your statement implies that meridians/points don't exist (and thus should render acupuncture as effective as sham acupuncture, which isn't true by the way). I have evidence that suggests otherwise. We don't have to summarize it as evidence of meridians, but we should at least make note of it so that the reader can decide for himself what to make of it, rather than have a quote from some author of a book for laymen that also claims that alternative therapies like acupuncture are dangerous and completely baseless (which we know isn't true at all from the credible reviews cited on this page). This is beginning to remind me of the issue surrounding the AMA statement (which still remains unresolved) where, despite coming from a horribly flawed source, it is still defended to the death because it's against acupuncture. By the way, there are now 2 statements in the same paragraph stating the same thing- that there is no anatomical explanation for the existence of acupuncture points/meridians or why acupuncture works. Anyway, I like what Middle 8 has suggested as a suitable statement rather than leaving just a one-sided statement in the introduction.99.255.196.199 (talk) 03:22, 7 October 2009 (UTC)

Per WP:MEDRS it should stay. If you have a more recent position statement from the AMA please feel free to bring it here. I think your POV is showing, rather than the AMAs. Your proposal wasn't greeted with silence, WP:IDIDN'THEARTHAT. Verbal chat 07:29, 7 October 2009 (UTC)

Uh, in MEDRS, it says to use updated literature unless it's an area where few reviews are taking place- this does not apply to acupuncture. The statement is not up to date. It also says that primary medical literature is more authoritative than public statements. The primary medical literature cited on this page contradicts the AMA statement. Thus, the AMA statement should be removed. Yes, there is no more recently updated statement, but the AMA statement is supposedly factual in nature and is blatantly incorrect as it is commenting on state of research in 1997, which is not true today. You have yet to respond to my last comment on the issue which summarizes why it shouldn't be here. Second, and most importantly, the statement is on "most" alternative medicine in general, NOT acupuncture specifically, and is thus not really relevant in the context of acupuncture. Find me a statement where they comment on acupuncture specifically. Rather than saying that my "POV is showing", please prove me wrong. So far, you have not.99.255.196.199 (talk) 19:50, 7 October 2009 (UTC)

Check out the pages for the authors - Edzard Ernst at least can be considered an authority, and Simon Singh I would venture is also an adequate author. The publisher is mainstream and quality (either W. W. Norton & Company for the version I read, or Bantam Press, part of Random House for the UK version), and a positive review in the inarguably prestigious New England Journal of Medicine [61]. Also, those studies hardly support the existence of meridians given the conclusion of "The studies were generally poor in quality and limited by small sample size and multiple confounders. Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable." I'd summarize that as "there may be evidence for the existence of these points but the research that suggests they exist isn't really clear and was very poor in quality". Hardly a ringing endorsement and certainly not appropriate for the lead. I would argue that Trick or Treatment is an adequate secondary source per MEDRS. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:46, 7 October 2009 (UTC)

I know who they are, but the material in the book does not cite anything most of the time, and is misleading as heck since they tend to report only the reuslts of certain negative studies to prove their point. Academic dishonesty at its finest. Simon Singh is being sued for libel by the way, and from the preliminary hearings, it doesn't look good for him. Just because they write well and have demonstrated knowledge in the area does not mean the source itself is good. From MEDRS: "Most self-published books or books published by vanity presses undergo no independent fact-checking or peer review and consequently are not reliable sources." The book is for laymen and does not cite sources most of the time. Thus, it is not a good secondary source per MEDRS.

I did not say the review was a ringing endorsement as the studies were not high-quality, but it's certainly noteworthy. I said that I would agree with Middle 8's suggestion to keep the current one-sided statement and note that some studies show etc, which certainly warrants discussion. And a book that cites nothing, as well as a statement from someone almost 2 decades ago certainly should not overrule current studies even if they are low-quality. It just makes no sense. By the way, please don't add "very" to "poor in quality" to your summarizing statement. We're supposed to be NPOV here, and that means we shouldn't be changing the conclusions of the authors.99.255.196.199 (talk) 20:04, 7 October 2009 (UTC)

Please review the WP:TPG - new posts should go to the bottom and interspersing comments means following conversations is more confusing. The AMA is pretty big, it's worth including their statement even if old. It does specifically address acupuncture and concludes with the critical statement "Critical reviews of acupuncture summarized by Hafner and others conclude that no evidence exists that acupuncture affects the course of any disease." I've adjusted accordingly to include their specific statement on acupuncture. It's quite clear it's from 1997, so readers are in a position to decide for themselves if the statement is trustworthy or not.

Regards T or T, the authors are reliable, it's a reputable publisher (certainly not vanity press, that's an absurd statement), there is considerable expertise in the authorship, and I see no reason to discount their work. There are citations and further reading in the back of the book (akin to a bibliography rather than footnotes). Singh is being sued for libel in Britain, which is not only ad hominem, but also misleading since Britain is widely seen as having terrible libel laws that are used punitively to prevent valid criticisms and accurate descriptions - see Ben Goldacre's lawsuit by Mathias Rath [62], Irving v Penguin Books and Lipstadt and, well, the Singh suit itself (along with a variety of other criticisms - [63], [64], [65]). Poisoning the well by saying Singh is being sued for libel ignores the fact that freedom of speech is not universally the American one, and Britain's libel laws are often used to silence valid criticism. As far as the biological reality of the acupuncture points and meridians, there is none. That review certainly didn't conclude there was one, it's basically saying "hey, maybe, but really we can't tell". NPOV doesn't mean we don't criticize, it means we try to represent the criticisms fairly. Unless there is evidence that Singh and Ernst's criticisms are wrong or invalid, I'd say they should stay. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:17, 7 October 2009 (UTC)

"Most self-published books or books published by vanity presses undergo no independent fact-checking or peer review and consequently are not reliable sources" I was not really referring to vanity presses but rather the fact that the book is not peer reviewed and they don't use any footnotes to cite their sources. A bibliography is pretty much useless if we want to check on any of their specific claims. This has been commented on by several reviewers and just shows how little credibility they have. Hey, I was not using ad hominem to attack the source, but I was pointing out that you were placing too much faith in the authors. Cry about bad libel laws all you want, but many scientific authors have succeeded in Britain without breaking them. Any author that consistently attacks a certain subject raises my suspicion anyway. Anyway, all of this is irrelevant because the book is still not a reliable source since they don't use any footnotes that allows reasonable fact-checking.

If you added the more specific statement, why would you keep the general statement about alternative therapies in general? It's still irrelevant. Either way, a statement in 1997 commenting on current therapies is useless. As noted by MEDRs guidelines, literature should be up-to-date if possible and primary literature holds more weight. If the primary literature cited on this page contradicts the AMA statement, then it should be removed. It does. Per MEDRs rules, both statements should not be there. It does not matter whether readers can make their own decision on the value of a statement from 1997. It is not in line with the MEDRs guidelines. Prove me wrong or I'm going to have to revert your recent edit on the AMA section. Please wait until discussion finishes next time before editing.

"That review certainly didn't conclude there was one, it's basically saying "hey, maybe, but really we can't tell". The review concluded that although studies have shown positive results, they were not high-quality. Thus, further research on the area is warranted. This pretty much falls in line with the NIH statement that the existence of meridians and acupuncture points is controversial. I don't see how you can argue for the AMA statement being in there, when the NIH statement cited for the statement denying the existence of AP&M is not even used. Instead, a laymen's book and an opinion from one man in 1993 is used. Undue weight is pretty blatant here.99.255.196.199 (talk) 01:40, 8 October 2009 (UTC)

Fixed misattribution of statement to NIH source. I don't know why it was left in there after so many users edited that statement. The Trick or Treatment book is NOT a reliable source according to MEDRs since it's not peer-reviewed. The NIH statement is much more neutral and reliable albeit old. It will also fall into line with the review that suggests there many be electrical property differences along the points/meridians.99.255.196.199 (talk) 01:49, 8 October 2009 (UTC)

Since you added that statement to the AMA section, I decided to make it more specific by making sure the reader knows that the reviews that it's basing its statement on were done in 1992 and 1993- over 15 years ago. If we're going to keep the statements in (and even add more from the 1997-dated page! We've got to make sure that people realize that the information is outdated.

I ask again though, what is the value (beside possibly misleading readers) of having a statement that is highly outdated and contradicted by more reliable primary literature even if it's from a big organization like the AMA? It's not like they are saying an opinion about whether to use acupuncture or not- they are basically stating there is no scientific evidence for the safety/effectiveness of acupuncture- which we all know from more recent studies, is NOT true. Saying that the AMA is big or that the AMA hasn't released a new statement is not a good enough argument considering all the wiki guidelines its inclusion breaks.99.255.196.199 (talk) 01:59, 8 October 2009 (UTC)

PS, this was the last sentence of the conclusion of the review which you decided not to include: "However, the preliminary findings are suggestive and offer future directions for research based on in-depth interpretation of the data"99.255.196.199 (talk) 20:06, 7 October 2009 (UTC)

Yes, they all say that future directions are needed. If you don't think TorT is a reliable source, go to WP:RSN and ask for an opinion. The AMA statement is attributed to 1997, so it has a built-in qualifier. You seem to think that you know the truth about acupuncture - well, it's quite controversial and more evidence is coming in about it. The field is in flux, and criticisms of both acupuncture and the research on acupuncture are valuable and both sides should be represented. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:46, 8 October 2009 (UTC)

I didn't say I knew the truth about acupuncture, but what I do know is that the editors hovering over this article seem to have the most blatant double standards "reliable sources" and acceptable content depending on whether the evidence is supporting or rejecting acupuncture. THAT is what has me in near disbelief. Why should the NIH census statement not be used with regards to acupuncture points and instead we use a laymen's book that does not appropriately cite anything? I have had sources/info rejected before with that reason, yet I doubt anyone is going to revert your edits.99.255.196.199 (talk) 22:34, 8 October 2009 (UTC)

General comment, especially with regard to WLU's de-indented comment above about "as above, so below": Just because the ideas of Chinese medicine originated in Chinese philosophy doesn't mean that Chinese medicine hasn't accumulated useful clinical observations along the way. Read Unschuld; in the earliest texts the meridians are ill-defined and most needling is done on the body, not the extremities. Over time philosophical theory and clinical observation became intertwined, in the same way that a traditional culture might believe in geocentrism and planetary gods but still correctly predict some astronomical phenomena. Sorting this all out is a work in progress. Ernst and Singh's book is an adequate MEDRS but is not superior to peer-reviewed systematic reviews or position statements by expert bodies. --Middle 8 (talk) 10:11, 14 October 2009 (UTC)

I guess the next place this issue takes my argument is: Why does ToTr hold more weight than the NIH statement which was repeatedly removed? The NIH statement included the viewpoint of ToTr since ToTr says they aren't real, and NIH says they are controversial. While the review I linked apparently was not noteworthy enough to include in the lead even though it's suggestive. So why is ToTr more important than both the NIH and a review?JohnCBE (talk) 23:49, 14 October 2009 (UTC)

What statement was removed? Trick or Treatment only appears as a separate mention in the WHO section. Do you mean with reference to the meridians? The NIH statement and TorT are both used in the lead - the NIH states it's hard to reconcile modern medicine with meridians, TorT says there is no anatomical basis for them. I'll try to expand in the body including the previous study that was suggestive of their existence. As is, there's a lot of unsourced text about them in the body. Neither is more "noteworthy", they are used to justify different ideas. TorT is more important than the review because the review was inconclusive, while TorT is a clear statement that is not contradicted by any other reliable source. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:11, 15 October 2009 (UTC)

"This one: Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial." To give detail we could use TorT to note there's no anatomical basis for them, and the systematic review that is suggestive of eletrical property differences. TorT is contradicted by the NIH statement. The NIH says it's controversial, which includes both viewpoints. TorT (who absolutely deny it), and the review (that noted the results of studies on eletrical properities were suggestive and warranted further research).JohnCBE (talk) 13:38, 15 October 2009 (UTC)

For the lead section, I think we can figure out some wording that adequately covers both NIH and ToT (and yes, the latter is a lesser MEDRS than NIH, fwiw), along with a couple of reviews that basically say that there is active but inconclusive research in the area. One of those reviews JohnCBE already identififed; the other I'll dig up (it cites Langevin, so we can include her stuff about connective tissue in the article body). regards, Middle 8 (talk) 16:02, 15 October 2009 (UTC)

Undent. Trick or treatment doesn't deny the existence of the TCM concepts, it says there is no evidence to support their existence and they can't be reconciled with contemporary science. NIH says basically the same thing. Both support the idea that there is no evidence for them, that there is controversy about them, and that they're hard to reconcile with contemporary science. In fact, they're so close I've moved the NIH statement to justify the same sentence as Singh and Ernst [66]. I've only seen one review of research on the electrical impedance of meridians, and I've integrated it into the body along with the NIH and TorT. It certainly shouldn't go in the lead - it's an inconclusive review that suggests future research. Meridians and the specific points are not defined, each system uses different ones and there's evidence to the idea that it doesn't matter where you poke, acupuncture still works. This isn't controversial, there's no conclusive evidenc to say which meridians and points are real that I've seen, and the pages should follow the evidence (and ideally the review articles, not individual studies). If there's evidence either exists, please cite it for review and integration. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:05, 15 October 2009 (UTC)

NIH is a little subtler than the statement (presumably from ToT? it would be great if you could post the specific quote on this page) that there is no evidence to support the existence of meridians -- they say the scientific basis remains elusive and they echo the point above re being used in clinical practice. Specifically:

Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.

I'd like to get closer to that, but need a little downtime to assimilate recent edits and various things IRL. I think the issue of "existence" ultimately depends on whether distal points have activity, whether or not there is a known physical explanation -- and I think NIH hedges because they recognize that that issue remains unsettled. Just a guess. Anyway, as per usual, I think we should stick close to what sources say.

Anyway, I don't see why we shouldn't say in the lead that the topic is being researched (albeit inconclusively) -- there is a spectrum of fringiness, but this is a whole lot closer to mainstream than homeopathy research, for example. The point is not that we have irrefutable proof that meridians or points definitely exist in some functional or structural way, but rather that the issue is taken seriously enough by some mainstream scientists to research it, presumably because of the considerable body of clinical evidence (nothing predicts P6's activity for nausea -- that's certainly interesting). I'll dig up sources later, and if they're good, we can just stick close to them.

BTW, there is actually pretty good agreement about point location despite the polemic of skeptical types like Barrett. I don't know who made that statement, but they didn't know much about TCM and other types of acupuncture, e.g Vietnamese and Japanese. All these systems agree on the standard meridians and points. Cf. also the WHO's standardization of points, agreement across most TCM texts, and standardization on licensure exams throughout the world. Apart from subsystems like ear, hand or foot acupuncture (ouch re the latter), there is virtually no disagreement on the several dozen most commonly-used points and not much on less-used points on the 12 standard channels plus those on the sagittal midline.

That's not to say all those points have specific activity; I doubt that many of the lesser-used ones do, or at least it's negligible -- but the research is kind of muddled. They're still hashing out proper "sham" acupuncture, despite Ernst's suggesting that it's pretty much wrapped up. For local pain, like knee pain, point specificity is probably far less important than with distal points like P6, LI4, etc.; however, "ashi" points (tender points, and variations like areas of palpable tension) are recognized in TCM, so how sham-y is a sham treatment if you're sticking a needle where it hurts? The IOM says that alternative medicines should be studied in the way they are delivered, and it's not clear that all studies heed this point. --Middle 8 (talk) 21:30, 15 October 2009 (UTC)

NIH: "Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial." " (ToTR) says there is no evidence to support their existence and they can't be reconciled with contemporary science" Wow, apparently these 2 statements mean the same thing! If they mean the same thing, then why was the NIH consensus statement removed? Why was the ToTr, a much less reliable source, added in place of it? The NIH statement was a quote and yours is a paraphrase from a less reliable source. Earlier on, you removed the NIH source for the statement because you realized I was right. Now you cherry pick information from the NIH and cited them in a sentence combining different viewpoints from both the NIH and ToTr. Amid, the flurry of edits you made, I almost missed that. Could it be you did this because they in fact do not mean the same thing and you didn't like that? Sigh. /Gives up99.255.196.199 (talk) 23:41, 15 October 2009 (UTC)

The Trick or Treatment citation includes a google books link that allows a preview of the relevant pages. If your preview is cut off, I suggest using a gmail or other google account so you don't run into limits - Google Books registers all the attempts by people using the same IP address to read a page as a single person. When registered and logged in to my gmail account I never have preview problems with this source and pages. As far as meridians and points - to suggest they are anything but historical speculation would require a source - so far as I know there's no anatomical basis to them. The electrical impedance study was not indicative of any truth to the meridians - the conclusion clearly states that there is no conclusive evidence. The NIH statement reads as clearly equivocal and not supportive - they are important to the system, they have not yet found objective evidence for qi, meridians, acupuncture points or Blood. If I'm wrong and there are sources, please supply them. The body discusses meridians in more detail, the lead shouldn't. I've removed the NIH reference from the lead since apparently anon believes it is problematic, and rather than trying to fix it, just complained. Which really, really is starting to aggravate me. I'm doing my best to take the criticisms, adjust when sources support it and still edit and modify the page within the policies and guidelines while being polite. For this I get sarcasm, accusations and a lot of blame. Please consider that I'm doing my best with the page - if you have sources that support your points, insert them and adjust accordingly. If you have opinions but do not yet have sources, please wait until you have the sources, then adjust the page. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:26, 18 October 2009 (UTC)

Change to lede

Had my fingers done what I wanted them to do, my edit summary for this edit would have said: "rv - pls discuss signif changes to lede first. Article body covers this, but these changes to lede give too much weight to indiv trial(s) and a weak MEDRS (Sci Daily)". That pretty much sums up my concerns. The article body does cite Kaptchuck and notes that "sham acupuncture" (however that term is understood) is a stronger placebo than a sugar pill; see Acupuncture#Issues_in_study_design. Later today, I will incorporate any good new sources added by the good-faith edit that that my edit reverted, so don't worry and let's not edit war. Generally, I think most editors would agree that the lede is not a good place to start: it's better to edit the body and then make sure the lede reflects that than to jump in and change the stable lede of an article that has been the subject of considerable debate. Hope that clarifies. regards, Middle 8 (talk) 13:14, 30 September 2009 (UTC)

Concur, despite my professed love for that study. - 2/0 (cont.) 17:46, 30 September 2009 (UTC)

That is an excellent study. Maybe we can highlight it a bit more in the subsection contemplated above, and if it seems appropriate, add more to the lede about study design and not all placebos being the same. I'm a bit overloaded right now, but as I mentioned to Clovis on my user talk page, [67], I'll have a go at doing some of this. Next couple days or so; I've got limited computer access owing to my body's lack of cooperation (read: low back pain). Acupuncture's helping like a mofo, btw. :-) cheers, Middle 8 (talk) 02:11, 1 October 2009 (UTC)

P.S. Just for fun, you may want to check out my thoughts on mechanism at my user talk page. They're not original, so I'm hoping that we can incorporate some of these ideas to the extent that we can find them in decent sources. cheers, Middle 8 (talk) 01:35, 3 October 2009 (UTC)

recent edits

Your summary of your revisions"Bit of a whitewash, changes things to give undue weight to singlee studies, removed a negative source to allow a more wishy-washy statement, etc.. "

What on earth?? What whitewash? It was necessary to clarify that the AMA statement was referring to studies done in 1992 and 1993. This is not whitewashing. PLEASE SEE THE DEFINITION OF WHITEWASHING. Also, I was directly quoting the NIH statement rather than 2 unreliable sources! Changes things to give undue weight? I changed the paraphrased summarizing statement from WLU to direct quotes from the studies themselves! I didn't change the weight of anything. I will be taking the necessary actions to get my revisions back in because you have removed them for NO good reason.99.255.196.199 (talk) 03:35, 8 October 2009 (UTC)

SH is right. Your description of your edits isn't quite "straightforward". You don't mention this edit, which alone qualifies as blatant whitewashing, with removal of a very properly sourced and very notable opinion by experts on the subject. As a SPA and anon IP account, you're going to have difficulty getting much traction here, especially with your obvious whitewashing agenda and continued failure to understand our sourcing rules. You still don't seem to have read them very well, as your numerous statements against the use of biased sources reveals. We use biased sources here all the time. Without them we'd have far fewer articles. Read the first two subsections here for why and how we include biased sources in an NPOV manner all the time. Keep in mind that WP:MEDRS isn't the only sourcing policy that applies to this article. By all means begin dispute resolution. I can suggest Wikipedia:Fringe theories/Noticeboard‎ and WP:MEDRS as good places to start, since they are specialists in dealing with this topic. -- Brangifer (talk) 05:21, 8 October 2009 (UTC)

Exactly. You deleted two sources to allow you to use the NCCAM description you prefered for a more extended quote that made things look more ambiguous. You took a single study, arguably being given too much weight already, and added cherry-picked bits of the abstract to give it even more weight. This just doesn't work. Shoemaker's Holiday ^{Over 210 FCs served} 06:16, 8 October 2009 (UTC)

Brangifer, tell me why the other edits are whitewashing. How are adding YEARS OF PUBLICATION to the studies whitewashing? That is the most ridiculous thing I have ever heard of. I've seen this done before in this article.

Also, those 2 sources did not pass MEDRs guidelines as I noted in the discussion, not because of bias (did I say that?), but because of being A) out-dated and B) from a laymen's book that does not properly cite anything in footnotes and is not verifiable. Yes, I preferred the more extended quote not because it made things look more ambiguous, but because it came from a much more reliable source- the NIH consensus statement. And not using out-dated literature is part of wiki guidelines as per discussion. Properly sourced? Really??? Do the sourcing rules state that you're not supposed to attribute a statement to a source that doesn't support that statement? The problem STILL remains as, the statement is still misattributed to the NIH consensus statement.

I did not take a "single study" to give it more weight. The footnote actually listed 2 different reviews, but WLU combined the 2 reviews to one footnote. Did you check? I took quotes from 2 different reviews. Previously, the paraphrase incorrectly summarized only one of the reviews by saying it was superior to sham acupuncture. The abstracts also said it was superior to no intervention and the other review said it was an effective treatment for pain/dysfunction of OA. My changes reflected this fact. The revision I made did not change the weighting at all... well except maybe spreading it between 2 different reviews. I actually had 4 reviews cited that all supported effectiveness of acupuncture in OA, but WLU removed 2 saying that we don't need that many. Clearly, we do need all 4 because there will always be scrutiny of positive review results in wikipedia articles like these.99.255.196.199 (talk) 12:08, 8 October 2009 (UTC)

The AMA statement is already clearly labelled as occurring in 1997. It's unnecessary and a not-too-subtle form of criticism. The AMA has neither updated, nor removed their statement, suggesting it's still their opinion (and really, since 1997 there has been no unequivocal evidence to suggest it's inaccurate). Layman books by reputable experts are certainly still reliable sources, in fact given their expertise we'd arguably be able to cite this information if it were a blog post. Your edit to this article, just like your edit to osteoarthritis on the same subject, obscures the conflicting results between studies and removed the 2007 study published in the Annals of Internal Medicine that was critical of acupuncture treatment of the knee. Not "osteoarthritis", but osteoarthritis of the knee. Also, your mixing of two separate quotes into a single stentence with a single reference is inappropriate. This is basic referencing and attribution. The current statement allows for positive and negative results. WLU (t) (c) Wikipedia's rules:^simple/_complex 14:26, 8 October 2009 (UTC)

HAHA! Really? Noting the year of publication of the reviews its statement is based on is not-too-subtle CRITICISM? Why on earth would you think that? Noting a publication date is OBJECTIVE. Fine, we can keep the statement no matter how out-dated it is, but really, even PUBLICATION DATE of the reviews is not allowed to be noted for being criticsm? That's the most ridiculous thing I've heard all day. Show me the wikipedia guideline that states you cannot mention publication date of a study because it seems to happen a lot on this page.

As I mentioned on your talk page, a previous study I posted was removed for being a year older than a more recent review. That's why I proceeded to remove yours as there were more recent reviews that posted positive results. Not only that, but you paraphrased the results in a biased way and did not note that the MAJORITY of recent reviews support its effectiveness, but instead paraphrased it in a way that implied equal weight for both kinds of results. I apologize for not noting that the studies were regarding OA of the KNEE, but the previous statement which I modified also referred to OA in general even though it also cited older reviews against effectiveness of acupuncture for OA of the knee. I just changed the conclusion to positive and didn't notice it didn't state "knee". No need to call it dishonest. I'm surprised no one changed it all this time when the statement was rejecting acupuncture effectiveness, yet when I posted positive studies, you jumped all over it. Thanks though!

There is no evidence since 1997 that acupuncture is safe and efficacious? Did you read any of this page? Yes, it doesn't work for many conditions, but it also works for some conditions and it has been demonstrated to be safe. To suggest otherwise is just dishonesty. I honestly am not able to believe that you really think that there is NO evidence of acupuncture's safety/efficacy.

Your paraphrasing that only noted the results of one study was even more inappropriate. You only said it was superior to sham acupuncture. You missed the part where it said it was significantly superior to sham acupuncture and no intervention. You missed the other study that said acupuncture was an effective treatment for pain and dysfunction associated with knee OA. This is really basic referencing and attribution. I felt a direct quote would be more accurate. If you want, we can separate quotes from the studies into 3 separate sentences. Also, another referencing error is one that keeps being reverted back into the article- the NIH consensus statement states that the existence of meridians and acupuncture points is controversial. It does not support the following statement: "There are no conventional anatomical or histological features that explain or identify either acupuncture points or energy meridians." This is something I have noted and tried to change many times, only to be reverted many times.99.255.196.199 (talk) 22:25, 8 October 2009 (UTC)

Again, with regards to your laymen book- even though it's written by professional authors, the way it is written is not professional and is not sourced appropriately as its material cannot be verified at all. This was the same reason given to me when my Natural Standard source was disallowed. Even though it's reputable, is cited by Pubmed, is subscribed to by universities and has a board of Harvard medical doctors and researchers that run it, it was rejected and criticized because they did not use footnotes, but a bibliography which was seen by others as an accessibility problem. If a source like Natural Standard can't be used, I don't see why we can use something from a laymen book that does not use footnotes either. I don't see why we can allow double standards so much in this article. See my argument with Clovis Sangrail.99.255.196.199 (talk) 22:25, 8 October 2009 (UTC)

Oh yeah, I wanted to note that it's of course easy for you to paraphrase the OA review results like when you remove 2 sources of mine, stating that it is unnecessary when there is already 1 detailed review. Gee, I wonder what things would look like if we had 4 reviews supporting the effectiveness of acupuncture on OA vs 1 review that is older than most of the other ones. That's the exact reason why I wanted to keep them in, because I knew some other editor would do something sneaky like what you just did.99.255.196.199 (talk) 22:38, 8 October 2009 (UTC)

Please stop SHOUTING and tone down the sarcasm as it makes it harder to be civil. I've removed the NIH citation since it's unnecessary anyway. If you really, really think Trick or Treatment is not sufficiently reliable, try the RSN because everyone else here seems to agree it is fine. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:39, 10 October 2009 (UTC)

Sorry, but when I see blatant attempts at blocking change in this article, like rejecting the addition of publication dates for no good reason, I get a bit feisty. Are you going to comment on how adding publication dates to the reviews is considered as criticism or whitewashing? Better yet, can SH please comment, since he never does and always reverts my changes. Summary: The AMA statement is already left on this page. It's noted that it was released in 1997, but it is reasonable that readers might be mislead into thinking that the reason the AMA hasn't updated their statement since 1997 was because they found no reason to after reviewing new research periodically. This is not the case, as the reviews they base their statement on were done in 1992 and 1993. It is important to include this information as to not mislead the readers. The reason given "it is not necessary" is incorrect for this reason. I also need some proof how this is whitewashing and not-so-subtle criticism.99.229.146.30 (talk) 03:45, 10 October 2009 (UTC)

The Natural Standard source I used meets the same level of Trick or Treatment and more (cited in pubmed, run by board of respected editors, etc), yet it was rejected as a valid source. 1) It doesn't give footnotes so it's unreasonably difficult to verify, and 2) I don't think it's peer-reviewed, per MEDRs. The NIH consensus statement already states the existence of the points is controversial, and the NIH consensus statement is a much more reliable source as it was peer-reviewed. The statement on controversy accounts for what your book says and for what studies on thermal/electrical properties around the points/meridians suggest, so I'd say it summarizes it much better than using your book. We can create a new section on the controversy of their existence by using their book and then by summarizing the results of the reviews on thermal/electrical properties. What is so wrong with this?99.229.146.30 (talk) 03:45, 10 October 2009 (UTC)

So, is it okay to add publicaton dates? So far the counter-arguments has been "whitewashing", and "unnecessary and not-so-subtle criticism". No reasoning behind these 2 arguments has been given except that the AMA statement is already noted as being released in 1997. My main concern is that the reader may be misled because, although it notes right now that the AMA statement is based in 1997, a separate summary statement in the same section states: "The statement on acupuncture specifically concludes that critical reviews have concluded that there is not enough evidence to support acupuncture's effectiveness in treating disease" It is reasonable to assume readers may be misled into thinking that the critical reviews mentioned are recent, and are thus why the AMA has not released a new statement. Is this good enough justification for adding the publication dates in? Every other review-based statement in this article lists publication date, so it's not cherrypicking/POV. I want to change it to "The statement on acupuncture specifically concludes that critical reviews conducted in 1992 and 1993 have concluded that there is not enough evidence to support acupuncture's effectiveness in treating disease".JohnCBE (talk) 15:37, 11 October 2009 (UTC)

Publication dates are appropriate in WP, especially when we're talking about MEDRS's. -- Middle 8 (talk) 22:46, 12 October 2009 (UTC)

The AMA statement is already dated to the 90s and the dates are an implied criticism that's unnecessary. Unless there's other information that states the AMA has altered it's position, there's no reason to have it. I'll adjust the wording so it's clear that the statement is from 1997. Also note that the statement was specifically about treating disease, and there is very little evidence (and pretty much no good evidence) that their conclusion is wrong. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:31, 13 October 2009 (UTC)

The AMA statement is dated, but the critical reviews mentioned in the other statement are not dated. I already explained why the section can be misleading to readers: It is reasonable to assume readers may be misled into thinking that the critical reviews mentioned are recent, and are thus why the AMA has not released a new statement. You keep mentioning that the AMA has not released a new statement- so what? That gives us more reason to date the critical reviews it was based on. Fine, you don't want to remove the AMA statement, but hiding the date of the evidence it used is simply POV. Adding publication dates is completely NPOV: Most review-based statements on this page are dated, and there is absolutely nothing wrong with it. I have yet to see you or SH give any reason why it is implied criticism. If the statement comes from such a prestigious organization like the AMA, then it shouldn't matter right? Your revision deleted the quoted AMA statement and was not necessary since the original recommendation statement made it clear that it was commenting on "most alternative medicine" in general. Now, it does not say that. That's not good paraphrasing. I am reverting it what it was before.JohnCBE (talk) 22:48, 13 October 2009 (UTC)

By the way, I took this to editor assistance, and in the end, the editor seemed to support my view that there is no reason to remove publication dates. If we can't agree, I'd be happy to take this to more formal dispute resolution.JohnCBE (talk) 23:26, 13 October 2009 (UTC)

You'd be better off taking it to a request for comment, which is actually meant to address content issues. Editor assistance is for informal advice. Unless they want to review or weigh in on this talk page about this issue, the opinion on an informal suggestion and advice board that doesn't address specific issues doesn't carry any weight.

The date of the review isn't being hidden, it's the 2nd word in the sentence. The reason why the lack of an update is important is it means the AMA hasn't changed it's mind. That it's been 22 years means it's had plenty of time and evidence, and didn't consider it important enough to update. But really, there's a citation for the AMA's position. If you believe the AMA has changed it's mind, it's up to you to provide it. And again, we're both around 2 reverts, getting into 3RR territory. It's a good idea to stop and see what others have to say. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:45, 14 October 2009 (UTC)

That's not the date the statement was released. You can make your assumptions about why the AMA has not released a new statement, but that is YOUR speculation. The FACT is that their statement released in 1997 was based on reviews conducted in 1992 and 1993. Unless, you can prove otherwise, I would stop trying to fight this point. I did not say the AMA has changed its mind. I have stated this many, many times. I have stated that it is necessary to acknowledge that the AMA's position was based on reviews conducted in 1992 and 1993, and it has not done anything to prove otherwise. It can be seen right there on their report. Your paraphrase is incorrect because the AMA did not adopt any policy about acupuncture specifically. This is the recommendation their policy was adopted on: "There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies." You tried to solve the problem of the statement being vague by summarizing their specific statement on acupuncture that mentioned the reviews, but that allowed me to point out the publication date of the reviews so now you are backtracking by trying to paraphrase (incorrectly) the recommendation statement. I will be using formal dispute resolution tomorrow when I have more time to write if we still haven't resolved this by then.JohnCBE (talk) 02:13, 14 October 2009 (UTC)

Also, you have yet to explain how noting publication dates of reviews is considered criticism (and thus POV). I'd like to hear it. I suspect you know that saying something is "unnecessary" isn't really a strong argument.JohnCBE (talk) 02:14, 14 October 2009 (UTC)

JohnCBE has questioned me on this matter on my talk page, and here is the exchange:

IP guy here, just wondering if you have thought about the my question yet: Do you see noting publication dates of reviews as criticism or whitewashing? JohnCBE (talk) 02:17, 14 October 2009 (UTC)

I have never considered it whitewashing. We do include publication dates in our references, but adding more is a form of adding editorial bias, and that's not allowed here. We present the sources and let readers decide for themselves. Adding editorial bias is a form of criticism that is not based in V & RS, IOW it is criticisms subtly introduced by editors. That's not proper. I'll copy your question and my answer on the talk page. -- Brangifer (talk) 02:41, 14 October 2009 (UTC)

That's my opinion on the matter. -- Brangifer (talk) 02:41, 14 October 2009 (UTC)

Thanks for the response. At least, it's not whitewashing. I'd like to note that publication dates are mentioned not just in references but also in the main text with many reviews mentioned on this page, along with many other pages that have reviews on them. Thus, this cannot be seen as bias. Personally, I don't see anything wrong with letting the reader know how up-to-date the information is without forcing them to rummage through footnotes.JohnCBE (talk) 03:26, 14 October 2009 (UTC)

(undent) If there were a 1997 position statement based on reviews from '92 and '93 that 'recommended acupuncture, there would be some editors champing at the bit to remove it or at least qualify it. Let's be even-handed. That the AMA ststement takes the opposite position is completely irrelevant. Letting readers see the quote and the dates is a reasonable compromise given that the AMA's view is a significant one even though it's plainly based on outdated reviews, at least one of which isn't much of a MEDRS. Good edit by SH on this. regards, Middle 8 (talk) 08:52, 14 October 2009 (UTC)

John, have fun with formal dispute resolution but be sure not to jump to arbitration right away - that's a common rookie mistake. I stand by my earlier statement that the AMA has verifiably made a statement, it's up to other editors to indicate that they have since changed their minds. Regards publication dates mentioned in the text, we don't also include the publication dates of the studies the meta-analyses and reviews reviewed. We don't say "McCarney et all in 2008 looked at studies published between 1970 and 2006", or "Mayhew and Ernst published a 2007 review that examined one study each from 1993, 1998, 2005, another from 2005 and 2006 and concluded..." It's simply the year of publication, as Brangifer states. If another source criticized the review for using old studies, that would be legitemate to include. I'll drop a line on Shoemaker's Holiday's talk page to ask for his reasoning on why the years of the reviews are necessary. I don't see a double-standard since I'm not advocating for unsourced qualifications on any other sources. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:25, 14 October 2009 (UTC)

You're still missing the mark on the issue. No one is stating they have changed their minds. We just think it's fine to list publication dates for the reviews they used to make that statement. They have not noted otherwise, so there is no need to remove information. Your only claim is that it's POV. We indeed do not include publication dates of studies in reviews. However, we do include publication dates of reviews, but that whole line of argument is silly anyway. Context is important. The statement is a comment on "current" state of affairs, and as I said several times before, it is important to know when the research backing this statement up was conducted since readers may think that they just haven't updated their statement because they have conducted new reviews that made it unnecessary. It is up to you to prove otherwise, rather than just deleting information. It's better to drop a line on his page asking why years of reviews are whitewashing.JohnCBE (talk) 20:53, 14 October 2009 (UTC)

Also, I find it interesting that you have now reverted the changes of 3 different people on this issue.JohnCBE (talk) 20:56, 14 October 2009 (UTC)

While we're waiting for the RfC, I have re-added the publication dates since 1 person reverted the re-add of 3 different people.JohnCBE (talk) 13:49, 15 October 2009 (UTC)

@ WLU: Per above, I agree that, for consistency, we ought not give that dates of the "reviews" that AMA relied upon. But it's not incumbent upon critics of the source to prove that AMA has changed their minds. It's up to those who want to retain the source to justify it. If the AMA has left it up on their site, that may be reasonable evidence they still agree with it. OTOH, on the face of it, it's a pretty old MEDRS. It's not talking about unchanging things like basic TCM theory; it's talking about scientific research. As I said, I don't mind keeping it for now, but I do think it's weak because it's old and hasn't been explicitly re-cited by the AMA (unlike NIH 1997, whihc NCCAM linked to several years later, effectively prolonging its shelf life for certain MEDRS purposes). --Middle 8 (talk) 16:08, 15 October 2009 (UTC)

I would argue that WP:PROVEIT doesn't support your contention. There is a source to support the AMA's stance. If someone wants to indicate the AMA has changed its mind, it's up to them to provide a source. This is also not a MEDRS - it's a statement by an organization that summarizes their official position. It makes no claims and only calls for further research. I agree it is weak and old, but until there is evidence that this very prestigious organization has changed it's mind, I think it's appropriate. It is also vital that the date of the statement remain because it demonstrates the glaring weakness to this item - its age. If anyone can find any sources indicating a change in this position, the page would be well-served by the addition. I've looked briefly on google, but unfortunately JAMA clogs up the results. There is one book saying the AMA released a recent whitepaper, but no reference. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:24, 15 October 2009 (UTC)

Since I don't object to it, not much reason to argue a hypothetical. But two things -- first, WP:PROVEIT says "The burden of evidence lies with the editor who adds or restores material." That doesn't mean that those questioning the source have to prove it's not wonderful or that its being outdated doesn't matter; it means that those who want the source have to defend it, and I'm cool with it (barely) because it's the AMA. Second, sure it's a MEDRS: quoting the lead from that page, it falls under "position statements from nationally or internationally reputable expert bodies." And since it's not a systematic review but rather a position statement, I'm flexible on whether or not to include the dates of the reviews on which it's supposed to be based. Otherwise, I think we can move on. regards, Middle 8 (talk) 20:58, 15 October 2009 (UTC)