Wikipedia talk:Identifying reliable sources (medicine)/Archive 26

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"Do not reject a high-quality study-type" ?

MEDRS says

Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, or conclusions.

I know this has been discussed recently, and I may be being dim, but what does rejecting a study-type look like? Is it saying something like "I deny this is a even a systematic review because it is funded by cigarette manufacturers?" How can a "study-type" have "inclusion criteria, references, funding sources, or conclusions"? Those properties can only belong to instances of a type (i.e. an actual study), and not to a "type" itself. Alexbrn (talk) 06:02, 4 December 2015 (UTC)

Yes, "type" could be dropped. Johnbod (talk) 12:45, 4 December 2015 (UTC)

But then, is it actually right? In my experience the mentioned properties are often taken into account when evaluating sources. Alexbrn (talk) 12:53, 4 December 2015 (UTC)

I'm not sure the meaning is changed much. "Do not reject a study of a high-quality type because of ..." expresses what is presumably the intended meaning more grammatically. Johnbod (talk) 15:21, 7 December 2015 (UTC)

The "study-type" wording is new. It used to say "high-quality type of study". The word high-quality refers to the type of evidence (see: the entire rest of the section that this sentence is in), not to the overall reliability of an individual source. The main point to be made here is "No, you don't get to reject the meta analysis in favor of your cherry-picked randomized controlled trial, merely because you have a personal objection to some characteristic of the meta analysis". WhatamIdoing (talk) 01:54, 8 December 2015 (UTC)

Well we should go back, though "Do not reject a study of a high-quality type because of ..." is clearer, as it is an individual rejection that is being talked about. Johnbod (talk) 13:31, 8 December 2015 (UTC)

I see it as specifying that in this context, quality refers to its position on the hierarchy of evidence. "High-quality study" on its own could potentially refer to primary sources, and is also considerably more subjective. I don't think the objection being addressed is "I deny this is even a systematic review" as much as "This systematic review should be excluded/attributed because of my personal opinions about its inclusion criteria/references/etc," as opposed to objecting based on e.g. the weight of competing sources. This was discussed a few months ago in Archive 15 - it's the entire archive, but the second half is probably more relevant. Sunrise (talk) 02:30, 6 December 2015 (UTC)

WhatamIdoing recently proposed changing that wording to emphasize source quality over source type, since the way the language reads, we can't actually reject a meta-analysis that uses industry funded research that's been red-flagged as having possible conflict of interest. I thought that proposal might be a good idea, but still think there's issues with it, and yeah, we don't want to remove "type" because then we'll get primary studies. Now, the question is, if we have cigarette manufacturers funding studies that show cigarettes have no association with lung cancer and those get picked up in a meta-analysis, what do we do then? LesVegas (talk) 14:58, 7 December 2015 (UTC)

FTR: You have apparently not understood my proposal. WhatamIdoing (talk) 02:11, 8 December 2015 (UTC)

We describe the results of the meta-analysis, and we frame that within the suggestions of RS on the likelihood of bias. A good idea in general and it doesn't require us to rewrite any guidelines. Richard Keatinge (talk) 15:16, 7 December 2015 (UTC)

And we consider if such a deranged proposal is WP:DUE. There is more than sufficient evidence of the contrary that it is impossible that such a meta-analysis could be of acceptable quality. CFCF 💌 📧 15:20, 7 December 2015 (UTC)

Due weight would indeed be important. I think that LesVegas is trying to make the point that a really high-quality study type should almost always be mentioned, however grave the suspicions surrounding it. Richard Keatinge (talk) 15:53, 7 December 2015 (UTC)

Despite the oft-repeated assertions that MEDRS requires us to use industry-funded sources, we most certainly can and do reject meta-analyses for all kinds of reasons – just not (a) in favor of weaker evidence and (b) due to personal objections to funding sources. We cheerfully reject bad meta-analyses in favor of good ones every day of the week, and we also reject sources that have been discredited by academics ("impersonal" objections), or carefully limit them to their proper WP:DUE weight. WhatamIdoing (talk) 02:11, 8 December 2015 (UTC)

These decisions are indeed a matter of weight and consensus. I would still start with a feeling that a large meta-analysis is generally worth mentioning in some context, and that serious doubts about its validity should form part of that context. Richard Keatinge (talk) 10:47, 8 December 2015 (UTC)

Yeah, I am inclined to agree with Richard Keatinge here that mentioning meta-analyses, systematic reviews and the like is usually a worthwhile endeavor and if there are noted issues with those based on funding, methods, or whatever, and we have criticisms which explicitly identify the junk sources, those criticisms should definitely be mentioned. If we have a meta-analysis which was funded by big tobacco, it's still notable even if it's garbage science. It's not for us as editors to question a published meta-analysis. It's for us as editors to just state what sources say, including critical sources. And there's plenty of criticism out there which are easily obtainable and can be easily included. Even the recently famous Coca-Cola study is worthy of inclusion here on WP, although probably 3-4 sentences of scientific rebuttals should follow. I wonder if we should include something in MEDRS saying just that, i.e., "however, if you include high quality study-types with questionable research due to funding sources, methods, etc, please ensure that criticisms also be included, should explicit criticisms of the source in question be available." Shouldn't we add something like that to make it more understandable? LesVegas (talk) 21:10, 8 December 2015 (UTC)

My point was that such an article will never be published in any respectable journal, and we can't act upon hypotheticals that are so unlikely that they will never come to pass. If such a study were ever published it is absolutely correct that editors question it, just not with personal objections. I don't find the current wording to be ideal, but those suggestions are simply superfluous, and don't address the issue at all – there will be a period in which there are no rebuttals for which that wording will actually cause a worse situation than what we have now. As has been mentioned before a WP:MEDDUE guideline is very much needed so that we can avoid this endless and mostly unproductive debate. CFCF 💌 📧 21:51, 8 December 2015 (UTC)

CFCF that's simply not correct, there is an ample amount of research that has been published in very respectable journals and criticized thereafter. I have provided a lot of this very research in varying diffs during the RfC process. I may need to make a note of this in the current RfC, since it appears your opinion is based on not reading these diffs. So much research is industry-funded that researchers would have a hard time conducting meta-analyses if it was all government or independently funded. LesVegas (talk) 23:28, 8 December 2015 (UTC)

This is an entirely unrelated discussion about your example about cigarettes. You have multiple times raised extremely unlikely hypotheticals, but they are made no more likely just because you once provided some unrelated diffs. CFCF 💌 📧 20:40, 9 December 2015 (UTC)

A large meta-analysis might be worth mentioning in some context, but it might not be worth mentioning at all. To give a very relevant example, 167 meta-analyses about acupuncture have been published in the last five years, and even if merely a tenth of them are "large", then we cannot and should not mention all of them in Acupuncture. In that case, it's probably best to pick those that are most reputable and most representative of the overall literature. WhatamIdoing (talk) 04:36, 9 December 2015 (UTC)

Spot on WhatamIdoing. It's good to discern the possibility of a useful consensus. Richard Keatinge (talk) 20:17, 9 December 2015 (UTC)

Yes, agreed Richard, and I agree with WhatamIdoing there as well. Of course there's no way one could mention 167 meta-analyses in an article. I have, in the past, proposed something similar on the Acupuncture article, and am curious if we should add this into our guideline somewhere. Namely, what I proposed was that we mention claims for conditions that Cochrane says something about. So if Cochrane says, "Acupuncture is good for migraines" we can use meta-analyses for migraines. But when Cochrane says, "There's not enough evidence to suggest Acupuncture is efficacious for allergic rhinitis" we don't mention it, meta-analysis or not, or just mention a whole list of conditions which Cochrane says Acupuncture may or may not have benefit for. What seems to happen on that article is that editors will post every single meta-analysis that gets published, good and bad, and edit wars ensue on both sides. So not only is WhatamIdoing's suggestion practical, it also avoids edit wars on articles like that. And I really think something to this affect should be written into the MEDRS guideline. LesVegas (talk) 23:12, 9 December 2015 (UTC)

That is really more "MEDDUE" than "MEDRS", but it might be interesting to figure out how to address that. WhatamIdoing (talk) 06:01, 11 December 2015 (UTC)

You're really trying to interpret this in a way that furthers your point of view at every level LesVegas. Cochrane reviews are considered some of the most authoritative, and would be WP:DUE for exactly the example you say they aren't. CFCF 💌 📧 06:06, 11 December 2015 (UTC)

WP:CGTW#8 keeps coming to mind. Alexbrn (talk) 06:21, 11 December 2015 (UTC)

CFCF, the Cochrane database has a lot of "no good evidence found" results in it. That doesn't mean that we need to go over to Cough syrup and say that there's no good evidence about whether cough syrup causes Alzheimer's. (Even though there isn't! I just ran a systematic review on the subject myself. ;-) Unless a lot of sources are talking about whether cough syrup causes Alzheimer's, there's no need to mention the subject at all. By contrast, there are a lot of sources talking about acupuncture for allergic rhinitis (including approximately one review a year specifically on the subject of allergies and acupuncture, e.g., PMID 25269403), so in that instance, I would include it in the list of "sometimes used this way, but there's no good evidence either way" (or whatever the result of the studies is). WhatamIdoing (talk) 07:24, 11 December 2015 (UTC)

SO if this text boils down to "don't remove strong sources for capricious reasons" can't we say in more plainly? Or even remove it altogether as it's kind of obvious. Alexbrn (talk) 06:21, 11 December 2015 (UTC)

The text exists because we've had problems with this area. Also, nobody believes that their reasons for removing a strong source is capricious. WhatamIdoing (talk) 07:24, 11 December 2015 (UTC)

Then this should be dealt with by normal consensus-building. Sorry, but I really don't think that we need any change to MEDRS. If anything useful were likely to emerge from this mass of verbiage, I suspect we'd have seen it by now. Richard Keatinge (talk) 13:12, 11 December 2015 (UTC)

(Sorry I am arriving late at the discussion.) I have previously disputed the inclusion of this phrase with WAID here. Axl ¤ [Talk] 15:57, 20 January 2016 (UTC)

I've changed the sentence to "Do not reject a source that is compliant with this guideline because of personal objections to inclusion criteria, references, funding sources or conclusions." SarahSV ^(talk) 02:54, 27 January 2016 (UTC)

Change to wording while the RfC is still running

I noticed this change. Thoughts? QuackGuru (talk) 16:39, 29 January 2016 (UTC)

Question on side

Browsing over the discussion, I kinda wondering why the formulation isn't simply:

Do not reject a high-quality type of study due to personal objections

The problem with listing specific reasons without any qualifier is, that there probably always will be some folks claiming the list to be exhaustive and hence conclude objections against high quality studies based on grounds not listed are fair game.--Kmhkmh (talk) 18:58, 29 January 2016 (UTC)

Here is a constructive suggestion, thanks. Reducing bloat, rather than increasing it, must be a good thing. Personally I would consider removing even this sentence. Richard Keatinge (talk) 15:36, 30 January 2016 (UTC)

It's been brought up, more than once. On the whole, the dispute hasn't been about literal details like that, it's mostly about underlying intent. --Tsavage (talk) 15:51, 30 January 2016 (UTC)

Indeed. This accounts for its futile nature. Richard Keatinge (talk) 16:31, 30 January 2016 (UTC)

Guideline change: "Be careful of .. a journal that ... that reports material in a different field."

Wondering about this recent change] to the guideline, from:

Be careful of material published in a journal that lacks peer review or that reports material in a different field.

...to...

Be careful of material published in journals lacking peer review or which reports material mainly in other fields.

Doesn't changing "in a different field" to "mainly in other fields" open up the interpretation to in some cases include multidisciplinary journals like Science, Nature, or Scientific Reporst? It would seem that the intent of the guideline is to address cases where something is entirely out of place in a journal about something else, like a medical review in a political science journal, which is more clearly addressed in the previous wording. --Tsavage (talk) 13:12, 31 January 2016 (UTC)

No, the change does the exact opposite of what you're suggesting it does. It solidifies exactly what you mean it calls into question. This is silly. CFCF 💌 📧 13:25, 31 January 2016 (UTC)

I think it's all superfluous anyway and we should scrap the sentence entirely. We already suggest that sources should come from journals that specialize in that topic when MEDRS mentions this under Biomedical Journals: or its content being outside the journal's normal scope (for instance, an article on the efficacy of a new cancer treatment in a psychiatric journal or the surgical techniques for hip replacement in a urology journal).LesVegas (talk) 04:13, 1 February 2016 (UTC)

Exactly. The more language, the more qualification of guidelines, the more they can be misused and need further qualification—it's a bueraucratic death spiral that makes it harder and harder to avoid long disputes focused more on specific PAG wording than on the content itself.

CFCF: "This is silly." Not silly: in this instance, in a recent glyphosate RfC, one of the recurring arguments against a source was that it was published in Scientific Reports (a high-ranked, MEDLINE-indexed, open-access, multidisciplinary journal from the Nature publishing group), which was challenged as somehow sketchy because of a kerfuffle over the principle of the journal's new paid fast-track peer review as a revenue source.

With that level of argument being commonly entertained by some regular subject editors, it is not hard to see a medical report in, say, Scientific Reports, objected to by arguing that the journal is not sufficiently qualified, citing that it "reports material mainly in other fields, per MEDRS," which SOUNDS different than "in a different field" - the former can make an argumentative case based on the predominant disciplines in the journal, the latter is more simply countered by, "Not applicable, it's a reputable multidisciplinary journal."

Or do we need more language to allow multidisciplinary journals, like Science and Nature? Or do we want to give them less weight in MEDRS?

If THAT seems argumentative and overly detailed in discussing guideline changes, look at the well-joined arguments over changes to MEDRS, or look at content arguments involving the guideline... The place to try to prevent various forms of rule-based gridlock and wikilawyering seems to be in the rules themselves. --Tsavage (talk) 14:43, 1 February 2016 (UTC)

Photographic example of PAGs gone wrong, [1].

Atsme^📞📧 17:11, 3 February 2016 (UTC)

I think an example might help, so here's one with which I am familiar.

Why Extreme Dilutions Reach Non-zero Asymptotes: A Nanoparticulate Hypothesis Based on Froth Flotation. Prashant S. Chikramane, Dhrubajyoti Kalita, Akkihebbal K. Suresh, Shantaram G. Kane, and Jayesh R. Bellare, Department of Chemical Engineering and ‡Department of Biosciences and Bioengineering, Indian Institute of Technology (IIT) Bombay, Adi Shankaracharya Marg, Powai, Mumbai −400076, Maharashtra, India, Langmuir, 2012, 28 (45), pp 15864–15875 DOI: 10.1021/la303477s

This is, in fact, a paper spruiking homeopathy. It made its way into a real journal because the peer reviewers failed to spot that it was a Trojan horse. It has subsequently been misused by homeopathy shills (e.g. Dana Ullman to propose that there is in fact a plausible mechanism by which homeopathy might work, and this was pretty clearly the intent. Iris Bell also has a long history of publishing pro-homeopathy "research" in a series of different journals, she gets away with it only once per journal, once the editors realise they have been taken for a ride, no further papers get in.

So the key question to ask is: are the editors and reviewers likely to be able to spot a ringer.

For what it's worth, I support the first version at the head of this section. A journal out of its field is vulnerable to being hoodwinked, a multidisciplinary journal should have the review processes in place to ensure it is not. The second wording would arguably put Nature in the same category as a subject-specific journal publishing out of its field, which I do not think is reasonable. In any case, we should only include primary sources where the results are uncontentious. A paper in a biomedical journal claiming to have found evidence for qi or meridians should not be included as a primary source because it's an extraordinary claim, we should rely on what secondary sources say about it, but a well-constructed study showing that reiki does not work and exposing an interesting facet of why people believe it anyway, would probably be fine since that finding is uncontroversial (other than to True Believers, who will never be satisfied with a reality-based treatment anyway). Guy (Help!) 09:09, 5 February 2016 (UTC)

On attempts to legislate Clue

Much of the debate above seems to be an argument between opposite entrenched camps determined to amend this guideline to either include or exclude research that favours their own personal views. However, when you read the actual proposals, all of it boils down to attempts to legislate Clue. What we should actually say is: use your good editorial judgment, and if in doubt seek consensus on the talk page.

The amended close proposed by Jamesday comes closest to this, IMO, but actually I think that any reference to exclusion by country is inappropriate. Any editor active in this area should be well aware that some countries almost never produce negative results. We cannot legislate reliability by changing this guideline, we should follow the sources which tell us. It appears on the face of it that people are trying to make rules that require us to ignore things they find ideologically inconvenient. A bit like North Carolina's attempts to wave seal level rises away. Guy (Help!) 09:46, 5 February 2016 (UTC)

"Some countries almost never produce negative results": Let me ask you, do you think using an 18 year old piece of research that includes primary studies that go back to 1966, none of which would make it onto our encyclopedia for obvious reasons, is actually a reasonable reason to exclude everything, including very high quality sources, from one particular country? Do you think it's reasonable to exclude US published research because it has authors that are Chinese? Not that it matters, in the RfC it was determined it wasn't reasonable. But I'm really curious about what you think. LesVegas (talk) 14:19, 5 February 2016 (UTC)

First of all, it's not just an "18 year old piece of research". A subsequent 2014 meta-analysis (conducted by Chinese researchers, and published in an alt-med journal) found that 99.8% of Chinese acupuncture trials reported a positive outcome and identified this as a major red flag. This is very much an ongoing issue in the literature, so minimizing it as ancient history is inaccurate. Separately, I don't understand the point you keep harping on about "primary studies". All meta-analyses look at "primary studies". How else would one detect bias in the literature, if not by looking at "primary studies"? Finally, I don't have any intention of using literature that is known to be biased in our Wikipedia articles, regardless of what the RfC shitshow was closed as this week. What I see is a small group of editors, most of whom have documented track records of poor-quality or tendentious editing on medical topics, trying to rewrite a core guideline to win a content dispute. I'm less charitable than Guy, in that respect. MastCell ^Talk 02:21, 6 February 2016 (UTC)

Recently described rare diseases

The guidelines say to avoid primary sources and to mainly use secondary sources. In general, this is good guidance. But what about recently described rare diseases? They might not have any secondary sources or they might have secondary sources that are not in-depth enough. Yet, they might have plenty of legitimate primary sources.

In particular, I am thinking about this article: Postorgasmic illness syndrome, and this exchange on its talk page: Talk:Postorgasmic illness syndrome#Deletion_of_a_recent_case_report. What do you think? --POIS22 (talk) 21:01, 12 February 2016 (UTC)

Update - close of original RfC on country of origin has been overturned

The close-review at AN has been closed. See close at the AN here, and importantly, the notes on overturning it in the archive here - the explanation is at the bottom. Please note the close not only overturns the original close, but also re-closes it, with the answer "no" with regard to adding "country of origin".

I suggest that LesVegas withdraw the RfC above about implementing the close, since it now has no basis. I also urge anyone unhappy with the close-review to carefully read the explanation I mentioned above. I will also note the overturning in the RfC above, in case LesVegas elects not to withdraw it. Jytdog (talk) 20:17, 14 February 2016 (UTC)

Removing citations to "apparently predatory publishers"

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

Unintentional forum-shopping here, at WT:NOR, etc. Centralize discussion at original location before it forked. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 09:47, 4 March 2016 (UTC)

Please weigh in: Talk:Predatory open access publishing#Removing citations to "apparently predatory publishers". fgnievinski (talk) 16:18, 3 March 2016 (UTC)

This has been discussed at RSN since Feb 26 here. That discussion is mostly finished, I think. there is no reason to multiply discussions. Jytdog (talk) 16:39, 3 March 2016 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

"Contrabiotic" article

Could someone please look at the new article Contrabiotic? Links to it are being added to other articles; it doesn't look WP:MEDRS compliant to me, but I haven't spent long on it. Peter coxhead (talk) 08:13, 4 March 2016 (UTC)

done. Jytdog (talk) 08:56, 16 March 2016 (UTC)

Request for comment on medical diagnosis of TV character

There is a request for comment about whether a popular TV character should be diagnosed with a "psychosomatic" condition based on a source that is not reliable for medical diagnosis. See Talk:Electromagnetic hypersensitivity#Request for comment. Thanks. Sundayclose (talk) 17:04, 13 March 2016 (UTC)

The issue is that some people don't like the fact that electromagnetic hypersensitivity is bullshit. That's not really our problem to fix. Guy (Help!) 11:43, 16 March 2016 (UTC)

Still confusing secondary and primary sources

I've left this alone for about a year, but it's still not been fixed. The "Ideal sources for such content include: ... guidelines or position statements from national or international expert bodies" statement (emphasis added) is muddled thinking, and directly contradicts our sourcing policies. Organizational guidelines, from an actually authoritative institution, are likely reliable sources and can be treated as secondary or at worst tertiary, depending on their content and its source backing. But a position statement (a.k.a. a press release, advisory bulletin, etc.) is an almost invariably highly politicized primary source, reflecting the interests of industry players, regulatory bodies, medical professionals' associations, and other stakeholders with a viewpoint and with power and/or money in the balance. We should always treat these as primary sources, even if often high-quality ones; we must directly attribute or quote from them verbatim, just like we would for any other kind of organization's position statement or press release, and not repeat what they say in WP's own voice as if it were certain fact. The problem is immediately apparent when you compare the position statements of US vs. European organizations on things like legalization and treatment of addictive drugs, and those of bodies in different fields when it comes to topics like electronic cigarettes. There's a major difference between a medical organization's position statement on an issue that may have socio-political dimensions (when do they not?), and a guideline of actual best medical or medical-research practices from a scientific standpoint. This problem undermines the ability of people to take this guideline seriously. I've been a huge fan of its existence and continued improvement, but because of this really very basic but critical error, I cannot rely on MEDRS as guidance, and always return to our actual policies. If the "or position statements" wording is removed, or even just moved and discussed as primary sourcing, the problem goes away. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 22:41, 26 February 2016 (UTC)

No, you continue to misunderstand this. We mean major scientific and medical bodies. And position statements they put out summarize that body's perspective on whatever the subject of the position, which of course takes into account both the literature and mainstream practice. These are absolutely the kind of secondary sources we want. Now, I have seen people claim that some body is a major medical or scientific body, when it isn't one - the editorial board of the Lancet, was a recent example. About differences - major bodies may different with one another, just as reviews of the evidence may come to different conclusions. Jytdog (talk) 22:59, 26 February 2016 (UTC)

I'm not misunderstanding anything, Jytdog. It doesn't matter if your organization has 10 members or 10 mil.; a press release it issues giving its "official" internal position on a matter is a primary source. It's the very definition of a primary source. Just think about this critically for a minute, neutrally, and stop thinking in terms of who you respect and where your professional pride is, and so on. The NRA has millions of members. When it issues a position statement on something about firearms (even something technical, not about regulatory issues), or anything for that matter, it's a primary source. The Fraternal Order of Police (or insert any of dozens of other professional law enforcement associations) has at least hundreds of thousands of members; when it issues a press release, including about a central concern of law enforcement, and based on the professional input of its most senior members, it remains a primary source. The American Bar Association has millions of members; when it issues a position statement about a legal matter, even though the organization is composed of trained legal experts, it is, yes, a primary source. And so on. Would you like 10 more examples? 50? You have to drop this pretense that medical organizations are magically exempt from all skepticism about the press releases they issue, and that we must take on pure faith that what they say is unassailably neutral and represents a real-world consensus.

You're confusing the reputability of the author-publisher with the nature of the publication. You also seem to be mistaking "primary source" for "unreliable or unusable source". I could be the #1 foremost authority in the entire world on something, but what I publish on my blog as my opinion about it, without any editorial sanity-checking above me, it is by definition a primary source. It might be a very high quality one, and WP might use it – just like a press release from the AMA – but WP has to use it within the rules we have for primary sources, including attribution, not blind repetition of its claims in WP's own voice as facts. (That's not to say that some organizational releases contain no secondary material; as with even journal articles presenting new research, they often begin with focused literature reviews, but those lit. revs. do not cover the conclusion reached and stance taken, whether it is an organizational or individual one.

Let me present this as a question: In what way could it possibly harm our readers' interests for WP to attribute press release claims to the organization that issued the release? Can you come up with one single example of where identifying, in the prose, where we got the idea from is detrimental to our encyclopedic mission? That's all this change would require: Treat primary sources as primary. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 05:47, 27 February 2016 (UTC)

Please don't bring up all kinds of offtopic (and very loaded - heh) examples like the NRA. That is just not helpful. Your historigoraphical analysis is also missing the boat. The way you are doing that, any review is also primary for as to what the authors of the review came up with. And to that I can only say argh. Please hear this. When a major medical or scientific body puts out a statement or position paper, it is synthesizing the best evidence and practices that exist, in order to communicate about something that matters to the field in which they operate. It is not like an editorial someone writes about something that happens to be important to that individual. Please don't characterize them as press releases either. What is at stake here, is what we can express in WP's voice as "accepted knowledge." We rely on the best secondary sources for that, and positions/statements by MSMB (to abbreviate) are some of our best sources for that. I'll just add that your interpretation here is way outside the mainstream of the WP:MED community - I know you have been around a lot longer than me but you don't seem to be aware of how long this has been in here. Jytdog (talk) 05:57, 27 February 2016 (UTC)

The fact that you don't see how this situation is analogous to any situation where leading organization X in topic Y takes a primary stance on issue Z in their field, and think it's all "off topic" if it's not about medicine, is troubling, and is strong evidence in favor of my point that you're treating medical organizations as if they're magically exempt from our sourcing policies. But fine, I won't mention non-medical orgs again in the context, if you won't pretend I believe secondary sources are really primary ones; we all understand already what the difference is: Every literature review [that WP would ever consider using as a source, anyway] is subject to editorial review beyond its author. The nature of a press release or position statement is that its authors simply put it forth; no one outside the organization has editorial, peer-review control over what the AMA or FDA or whatever says before they say it.

I don't see that you're even understanding what the issue is, so I guess I'll just have to RfC this. But I hope that won't be necessary, given that there only seems to be ~~one editor~~ two editors anywhere declining to recognize the difference between publishing a review of research on the one hand, and, on the other, publishing a stand an entity is taking on the basis of that research. The key to understanding the difference is right there in your own wording: "synthesizing the best evidence and practices that exist, in order to communicate about something that matters to the field in which they operate." What is being communicated is what matters here; an official position statement on something is essentially a form of organizational activism; it is primary, necessarily, and is not simply a sifted summary of the research. If an organizational position statement were just a literature review, we'd call it a literature review not a position statement. Maybe it is actually possible to clearly distinguish between organizational publications that are purely secondary (or sometimes tertiary), and those with a stance-positioning component, but so far all I'm hearing from you is sheer denial that anything the AMA (or insert any other TLA of the medical establishment) says can be other than something we must treat as "accepted knowledge" (i.e. WP:TRUTH) and pass it on as such in our own voice. I'll repeat my question, since you didn't answer it:

In what way could it possibly harm our readers' interests for WP to attribute press release claims to the organization that issued the release? Can you come up with one single example of where identifying, in the prose, where we got the idea from is detrimental to our encyclopedic mission?
— SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 06:23, 27 February 2016 (UTC) Updated to account for comment below. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 07:07, 27 February 2016 (UTC)

It is pretty obvious that organization position statements are secondary and not primary. The organization did not directly conduct a clinical trial or perform other types of laboratory research to formulate a position and hence these position statements cannot be considered primary. Rather the organization weighed the available evidence which would include published studies. Hence by definition, these position statements are secondary (or tertiary). Boghog (talk) 06:38, 27 February 2016 (UTC)

Already addressed that. Repeat: "That's not to say that some organizational releases contain no secondary material; as with even journal articles presenting new research, they often begin with focused literature reviews, but those lit. revs. do not cover the conclusion reached and stance taken, whether it is an organizational or individual one." This isn't even a medical vs. other topics matter. If I were a journalist like Jared Diamond, whom everyone seems to like to pick on, and did a pretty thorough review of scholarship in a topic, my book is a secondary source for that scholarship review, but it's a primary source for novel conclusions I pull out of my own head based on that review, which are not connected directly to anything anyone else said before. This is the essence of the difference between primary and secondary sourcing. Even, as already noted twice, primary research papers frequently contain large sections of secondary material, but they are firmly in primary-land when they transition into their own data analysis and conclusions sections. There is no transmogrification wand possessed by the AMA and similar organizations that makes their politicized stance decisions, made upon their review of the research, into secondary material like the review is. Confusing a stance/position taken, predicated on a review of material, for the review of the material itself is like mistaking your personal fandom of the Dallas Cowboys [or whatever sportsball team], based on a review of their win/loss record, for their actual review of their win/loss record. It's a PoV identification of research [about research] with the feelings or decisions that research inspires. They are qualitatively different. General semantics addresses this frequently and concretely; it's Korzybski's classic fallacy of mistaking the map for the territory, the menu for the meal. Anyway, since neither of you will answer the basic question I keep asking, that indicates pretty strongly what an RfC on this should ask. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 07:02, 27 February 2016 (UTC)

Position statements are at least one step removed from an event (i.e., the clinical research on which the position statements are based) and hence per WP:PSTS, are by definition secondary. A RfC to confirm this inescapable interpretation of a long standing policy is a colossal waste of time. Boghog (talk) 07:31, 27 February 2016 (UTC)

Agree. With respect to content considering the evidence such position statements are at least secondary of course. The argumentation of the OP here (essentially, change this to my liking or I won't take it seriously) seems tendentious. Alexbrn (talk) 07:59, 27 February 2016 (UTC)

I think one of the key points is that a position statement (on a factual matter) in this context is not the same as it would be outside of science - instead of being a statement of opinion, it's a statement of analysis. If the AMA writes a statement to support/oppose a funding bill in Congress, I'd assume they didn't base that on empirical evidence drawn from their field of expertise, and therefore treat it as opinion. But when they include factual claims, e.g. "tobacco smoking causes lung cancer," those are based on synthesis of the scientific literature. And as usual, any individual statement could contain a mixture of fact and opinion. Sunrise (talk) 09:09, 27 February 2016 (UTC)

@SMcCandlish: Thank you for your very well argued position on this. I have long wondered why MEDRS has made press releases from the AMA, FDA, WHO and various highly politicized entities that are strongly affected my money and political appointments, international trade and relations (and even interference from the chief executive) to be treated with the same respect and authority as secondary sources and reviews. These press releases by governing boards are completely different than commissioned reviews by those same bodies. Our article Medical consensus says this:

There are many ways of producing medical consensus, but the most usual way is to convene an independent panel of experts, either by a medical association or by a governmental authority.

I hope you do start an RfC on it. Can you cite specific cases or WP:PAG on Wikipedia that speak to the issue of press releases from well respected organizations requiring that they be subject to the kind of treatment or restrictions you are suggesting here? I think that would make your case all the firmer, rather than just mentioning the NRA or FOP. A better parallel would be how a press release from the Smithsonian regarding a matter of history would be treated (such as the 1995 decision on how to portray the dropping of the A-Bomb [2]). --David Tornheim (talk) 12:30, 27 February 2016 (UTC)

@David Tornheim: You are confusing position statements with press releases. They are not the same. Also by describing the AMA, FDA, WHO, ... as highly politicized entities, it is clear that you have an axe to grind. Boghog (talk) 13:40, 27 February 2016 (UTC)

Yes, and I sincerely hope we are spared an RfC on this—which would a waste of time, similar to that of having to read the verbiage above. If you can't be succinct, you can't demand others to take you seriously—and any position needing such repeating over and over again to be heard is doomed from the start. CFCF 💌 📧 14:19, 27 February 2016 (UTC)

Boghog, anyone who has actually worked for a large organization knows that AMA, FDA, WHO, etc., are highly politicized entities, by their very nature; it requires no "axe to grind" to observe this. The FDA and WHO are politicized by definition, being governmental/intergovernmental. And AMA is very obviously political, since it takes positions on national regulatory and public policy matters [3], [4], [5], [6], etc. The principal reason organizations like AMA and BMA exist is to represent professionals in their field, collectively, in public policy (i.e. politics, albeit mostly issue-based not electoral). — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 21:16, 27 February 2016 (UTC)

Resetting

I'd like to pull out what Sunrise said pretty clearly above, which I think clarifies SMcCandlish's underlying concern. MEDRS talks about "position statements published by major health organizations". The question, I think, is - can distinctions be usefully made among kinds of position statements (for example - statements that are meant to express "accepted knowledge" vs statements that express "judgements on social issues"), and if so, should MEDRS reflect those distinctions? Again what we would need to be able to do is meaningfully define those "kinds" of things, so that we can write guideline language. I think there is an interesting question there, that does have implications for the guideline. Can we first focus on defining kinds? Examples are helpful in this discussion. Jytdog (talk) 18:36, 27 February 2016 (UTC)

Thanks, Jytdog, for realigning the discussion more practically. The gist of at least one of these distinctions: Is it a medical science conclusion reached by experts convened by the organization, released without direct interference by the organization's brass, or it is a position being taken (or directly shaped) by the board/executives of the organization? This seems at first tangential to Sunrise's approach to the question, but they're actually closely related.

It takes only seconds to find examples of where AMA, BMA, and other organizations issue things that arouse controversy [7], [8], [9], etc. But not all controversies are equivalent; some of them are between organizations, between an organization and a regulatory body, between an organization and a vocal subset of its own members, between an organization and a political segment of the public, etc. And the nature of the controversy can vary, being scientific, political (including religious/moral), organizational (i.e. with regard to the organization's proper role/function), practical (theoretical vs. clinically applied), etc. There's probably a way to encapsulate the sort that affect the reliability issues. The line[s] between a statement of analysis and a position on public policy is not always clear, though. We see this in cases where similar organizations in different sectors of medicine, or in different geographical regions with different regulatory histories, come to conflicting conclusions and recommedations; they can't all be right at the same time, and the reason they're conflicting is obviously political in most such cases, not because one of them is collectively stupid and is doing bad science.

Maybe the line to draw, to start with, is simply whether there's a political component to the statement itself. I.e., any time an organization says something along the lines of "there oughtta be a law ..." they're clearly in press-release land not purely statement-of-science territory.

At any rate, I haven't come with some bone to pick over a list of cherry-picked politicized "smoking gun" statements I don't like; it's a general source classification matter from where I'm sitting. Some statements about the science are clearly being issued with the intent to affect public policy; maybe even most of them are. This is why I think it's safest to treat them as high-quality but primary sources and attribute the claims they make: "According to a 2016 American Pediatric Surgical Association statement, ...". It just seems the cleanest, and lowest-conflict approach. Virtually unassailable from a sourcing policy standpoint. Sunrises's "any individual statement could contain a mixture of fact and opinion" is the crux of the matter to me. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 21:16, 27 February 2016 (UTC)

The three links you provide are not helpful. Controversy over science doesn't mean the science itself is controversial. The morning after pill is safe and effective. ~~Human activity is driving climate change.~~ These are not scientifically controversial statements. Please proceed more carefully here. Our goal needs to be determining how to use statements by MSMBs to support statements of accepted knowledge.

Again, if you cannot have a concrete, careful discussion, this discussion is going nowhere. Jytdog (talk) 21:41, 27 February 2016 (UTC) (strike offtopic example Jytdog (talk) 22:02, 27 February 2016 (UTC))

Agree with statement: "...treat them as high-quality but primary sources and attribute the claims they make: 'According to a 2016 American Pediatric Surgical Association statement, ...'. It just seems the cleanest, and lowest-conflict approach. Virtually unassailable from a sourcing policy standpoint." This is how I have seen them treated in other encyclopedias and in the RS. --David Tornheim (talk) 21:51, 27 February 2016 (UTC)

David that is abolutely incorrect. Wikipedia is not post-modern where everything is relative and the establishment is corrupt. Your continued efforts to make it that way will continue to fail. Jytdog (talk) 21:55, 27 February 2016 (UTC)

Jytdog: Please refrain from such ridiculous comments misrepresenting what I said. I never made either of the black/white assertions you are claiming. If you want to learn something about Postmodernism, try inserting "everything is relative" into the Postmodernism article (or some of the other things I mentioned on Jimbo's page regarding Hume, Plato, Kant and Descartes regarding epistemology that you mistakenly believe are Postmodernist) and see what happens. --David Tornheim (talk) 02:34, 28 February 2016 (UTC)

I should clarify that I don't mean that we need to say "According to the American Lung Association, the research indicates that cigarettes really do cause cancer." Where ALA is doing a review of the science and publishing their own essentially-a-literature-review, that's a secondary source. I meant that we should say "According to the American Lung Association, cigarettes are the leading public health risk for adults" or "According to the American Lung Association, cigarettes should be banned", or some other clearly political stance-taking. I think this is clearer in the formulation below. It would, technically, be "safe" to always attribute everything from organizational political statements, but it would probably be pedantic, and is unnecessary, when the material in question is scientific and secondary, and the claim made is factual not recommending changes in public policy. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 22:10, 27 February 2016 (UTC)

That is what I'm aiming for; I was not implying that every controversy that arises about these statements is one we need to be concerned about, but that there are qualitatively different sorts of them to be distinguished. But here's a completely different approach that could obviate any need to do such an analysis. Maybe something as simple as a one-word clarification plus a footnote will do it:
...scientific position statements published by major health organizations<ref>Organizational position statements are always [[WP:PSTS|primary sources]] for socio-political positions. Where they contain secondary material, such as a literature review, they are secondary sources for the claims in that material. In short, distinguish between a regulatory position about tobacco, which should be directly attributed, and a finding that the research demonstrates that cigarettes cause cancer, which may simply be cited.</ref>
— SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 21:48, 27 February 2016 (UTC)

That proposal is not bad to me. I struggle with the implication that the statement needs to explicitly review the literature to be considered secondary on the science/medicine - in my view it doesn't - but that is a workable proposal. Let's see what others have to say. Jytdog (talk) 22:00, 27 February 2016 (UTC)

Sure, there may be a better way to phrase it. Was just a first draft. I'm more concerned with walling out the political positioning than walling in the science. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 22:02, 27 February 2016 (UTC)

so maybe
...scientific or medical position statements published by major health organizations<ref>Organizational position statements are always [[WP:PSTS|primary sources]] for socio-political positions. Where they contain summaries of the evidence or describe consensus medical practice, they are ideal secondary sources for the claims in that material. In short, distinguish between a regulatory position about tobacco, which should be directly attributed, and a finding that the research demonstrates that cigarettes cause cancer, which may stated in Wikipedia's voice and cited.</ref> ? Jytdog (talk) 22:09, 27 February 2016 (UTC)

Works for me. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 22:11, 27 February 2016 (UTC)

SMcCandlish, what is at stake for you in this, btw. Was there one or more (hopefully more) specific content disputes where this issue came into play? That would people understand why this matters, beyond the abstact level. Thanks. Jytdog (talk) 22:59, 27 February 2016 (UTC)

I'm reluctant to drag up specifics, because several of them are contentious WP:AC/DS matters. The respondents so far in most of this discussion, both above and below this post, are mostly personally involved in two or more of these areas of disputation in which WP:ARBCOM lawyering has been invoked, so it's best not to dig into those sores in great detail, or the same personality conflicts are liable to pop back up. The short version is that socio-political statements (on top of medical/scientific analysis) by organizations are frequently used in contentious areas, and conflict tends to erupt when they are advanced in WP's own voice as facts instead of as the positions of the bodies/establishments advancing them. I've seen this at the electronic cigarettes articles, GMO-related articles, traditional Asian health vs. Western medicine disputes (TCM, accu*, yoga, etc., etc.), chiropractic and orthopedics-related articles (the latter in part because what that word means varies widely depending upon where you are in the world, and the former because there are, similarly, two widely divergent medical vs. newage hoo-ha approaches to it, without it being a difference of regional regulatory definitions), the idea of a scientific consensus that Race (human categorization) is a social construct and an alleged new medical consensus against the idea, etc., etc. I run into the problem pretty frequently, and it can take a long time to sort out in some cases because people are too often convinced that anything a big medical (or scientific-including-sometimes-medical) organization says must be true and can be reported as fact, even if it's clearly a public policy position, not a medical research analysis.

PS: From my position, I have no stake other than wanting to see no interpretational, gameable conflict between MEDRS and NOR/V/RS; I suppose from fringe promoters' PoV, I have an anti-fringe stake in it, but that's a pro-policy stake, so I won't apologize for it. >;-) — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 01:09, 28 February 2016 (UTC)

MEDRS amendment proposal

~~what do folks think about amending the definition of "Secondary" as follows, by adding the underlined parts?~~

~~and medical guidelines or position statements published by major health organizations.^[1]~~

~~References~~

^ Organizational position statements are always primary sources for socio-political positions. Where they contain summaries of the evidence or describe consensus medical practice, they are ideal secondary sources for the claims in that material. Distinguish between a regulatory position about tobacco, which should be directly attributed, and a finding that the research demonstrates that cigarettes cause cancer, which may be stated in Wikipedia's voice and cited.

- Thanks. Jytdog (talk) 22:30, 27 February 2016 (UTC) (note, removed proposed addition of "science or medical" before "position statements" per Sunrise below. Jytdog (talk) 04:02, 28 February 2016 (UTC)) struck per note below Jytdog (talk) 16:53, 28 February 2016 (UTC)) Removed "In short", per CFCF below. Some of us are still working on this. Also fixed a typo ("may" → "may be" in the footnote), and un-struck the heading, since discussion has continued (at least two additional editors have posted). — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 12:37, 29 February 2016 (UTC)

Strong Oppose—pointless, I try to hope anyone who reads this guideline will understand that it covers medical content without this clarification. Also, the "in short" section makes up over half the added material. I wrote an essay about this kind of nonsense: WP:VERBAGE. CFCF 💌 📧 22:47, 27 February 2016 (UTC)
- The "in short" means "in lieu of a detailed explanation, this simple example illustrates the point", but that was really pretty obvious, wasn't it? If you don't like "In short", replace it with "For example", or just remove it, and the passage still gets the point across. Since the "In short" is entirely optional, and your objection seems predicated on its presence, what's the point of the objection? PS: Your essay doesn't seem relevant, and is about talk page filibustering in the form of "proof by verbosity", unrelated to whether policy/guideline wording is clarified with specifics. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 01:55, 28 February 2016 (UTC)

I should have been more clear, but the essay was written with a specific person in mind — one who by sheer virtue of incoherence is able to change opinion in the middle of a discussion. I did not expressly mention filibustering, as I am uncertain that the conduct is intentional — but I am not the first to bring light to this "tendency to drown out discussions through sheer sesquipedalian verbosity"[10], even though I may be the first to write an essay in your honor. CFCF 💌 📧 10:02, 28 February 2016 (UTC)

You didn't actually respond to anything relevant to this discussion, so I'm going to collapse box all of this as off-topic, so others can skip it. Anyway, an editor who is incapable of changing their mind in the course of discussion is fundamentally incapable of consensus-based work – the entire reason we have these discussions is to change each other's minds (and our own) incrementally until we come to a solution everyone can live with (crackpots aside). Your essay's own definition of "verbage" doesn't actually apply; my posts are never characterized by a "lack of any real arguments" (indeed, your problem with them is clearly the difficulty of refuting them) and, as noted above, it's unrelated to a proposal to clarify something in, and (see below) remove excess verbiage from, the guideline. Digging up a 2007 comment from someone who didn't like me because you think it somehow makes you right is really rather creepy. I'll save anything else I have to say about the essay for user talk, which is a good place for you to try to demonstrate any of my arguments being "incoherent". — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 12:37, 29 February 2016 (UTC)

The "in short" can be removed from the proposed text, and additional concision edits have been suggested below. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 12:37, 29 February 2016 (UTC)

I agree that the general idea here is correct, but I think the "scientific and medical" addition probably isn't necessary because the sentence already says that this specifically applies to biomedical information. This formulation could also be interpreted as classifying sources rather than content, when actually each statement (using that word in the generic sense) should be evaluated on its own. If the ALA writes a position statement with the goal of advocating for a cigarette regulation, but says "Tobacco smoke causes lung cancer" in the middle of it, then we can still treat that part as a summary of the evidence. I'd also want to define the boundaries in the footnote more clearly, maybe by linking WP:BIOMEDICAL, since socio-political positions are sometimes matters of fact which are scientifically uncontroversial. Sunrise (talk) 00:53, 28 February 2016 (UTC)
- The distinction between being able to use the secondary "smoking causes cancer" data-based conclusion by just citing it, but needing to attribute the position that cig regulations are needed (more, at all, etc.), is precisely what I'm after here. I don't think it's harmful or redundant to clarify with "scientific or medical position statements", somewhere, even if we don't browbeat people with it repeatedly. What we have presently is a nutshell statement that reads "Ideal sources for biomedical material include ... position statements", which is by itself an overstatement, but perhaps not problematic if we address it later. The lead says "Ideal sources for such content include: ... position statements". The "such content" appears to refer to "biomedical information" but that's in a different paragraph. We repeat this a third time under #Definitions, with "A secondary source in medicine ... include[s] ... position statements", and that's where the error really is, an error of categorical overstatement that is "classifying sources rather than content", exactly as you put it. This is the place to fix it. It simply isn't the case that all positions statements by a particular type of organization are secondary sources or ideal sources for biomedical material/information, but we can probably just address the first of these (the "secondary sources" thing), and the second one (the "ideal biomed source" thing) logically follows. I also have to note that all this repetition, in three places almost back-to-back on the same page, is way more of a concision and redundancy problem than inserting a clarification at one of these places (the most explanatory one) that we mean a particular type of position statement. All the above "verbage"-related hand-wringing is misplaced. If "position statements" in this third instance were changed to "scientific or medical position statements", the point is made, and the issue is closed.
  That said, I'm having difficulties with "socio-political positions are sometimes matters of fact which are scientifically uncontroversial". While that may be the case in right-this-moment "ground truth" terms, with regard to a few particular topics, that sort of thing can change very rapidly and unpredictably based on tomorrow's data. We should still treat such positions as primary; there is no "cost" associated with doing this other than attribution. However, it's possible we're thinking of something different when we think of "socio-political positions"; I suspect this may be the case, because "socio-political positions ... which are scientifically uncontroversial" doesn't really parse well for me. It seems a bit like saying "legal positions that are philosophically uncontroversial" or "aesthetic positions which are ethically uncontroversial"; the first half does not strongly relate to the second, and there can be other valid controversies than the type identified in the second half. What I'm thinking of can be boiled down to this: Is the organization making the statement saying or implying a "should" in the public policy sphere, beyond an "address this problem" generality? If it's advocating or suggesting some kind of particular socio-political response, not just identifying a problem and suggesting that it be addressed somehow, nor suggesting particular responses in medical approaches (the actual purview of the organization in question), then it's not a medical research conclusion, it's a societal and political one. There's a latent OR concern that could come up if we try to approach a specific socio-political position as "scientifically uncontroversial"; it's a "says who?" problem. I'm having a hard time even thinking of one that qualifies, beyond mega-obvious generalities, like "smog is bad for people and the environment, so steps should be taken to reduce it."
  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 01:55, 28 February 2016 (UTC)

I think we agree on the main points here. Would it have been clearer if I said "statements that are sociopolitically controversial" instead of "sociopolitical positions"? My point was that some factual statements (that are not reasonably disputable) are still sociopolitically controversial, and that this doesn't disqualify a position statement from being a strong source in those cases. The idea is to make it clear that public controversy does not necessarily imply scientific controversy - the easiest examples for this, evolution and climate change, aren't medical, but might be good illustrations for what I mean. If we have a position statement saying that homeopathy doesn't work, I don't want the source to be open to arguments that it's unsuitable or needs attribution because it's potentially a subject of public controversy (or supported by certain public figures, or used by X% of the population, etc).

So instead of removing "always," as you suggest below, I'd prefer something like "Organizational position statements are always primary sources for opinions about socio-political positions." That would address my primary concern. The rest is fairly good, though I would note that it can be wikilawyered by claiming that "Tobacco smoke causes lung cancer" is not explicitly implied to be a "finding" or a "summary of the evidence" (e.g. because it was "only" stated as a fact). I think a good way to close this opening is to frame the boundaries in terms of fact vs opinion, and one shorthand way to do that might be to identify WP:Biomedical information as the general category of content that position statements are good sources for. I actually think the "In short" sentence could be useful, and maybe if we're only making changes in the "Definitions" section then the greater length would be acceptable, but I suppose I wouldn't mind if it's left out. Sunrise (talk) 10:37, 28 February 2016 (UTC)

Yes, agreed that public controversy does not always indicate scientific controversy, and that '"statements that are sociopolitically controversial" instead of "sociopolitical positions"' clarifies. Also, "always primary sources for opinions about socio-political positions" works for me, too. Neutral on the other major point ("identify WP:Biomedical information as the general category of content that position statements are good sources for"); I guess I'd want to see suggested revision wording. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 10:37, 29 February 2016 (UTC)

[Forgot to ping: Sunrise. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 12:37, 29 February 2016 (UTC)]

Support adding it there, without the "In short" wording (my bad!) which CFCF objects to, and we could drop the word "always" from the footnote to hopefully address Sunrise's concern. As noted above, we're saying the same general thing in three places at the top of the document, almost word-for-word; some of that could probably be compressed in the nutshell and lead, with the details being in the #Definitions section; that should address any wordiness concerns. Maybe the one in the lead could be reduced to something like "Ideal sources for such content are the specific types of secondary sources [[#Definitions|identified below]]. Primary sources should generally not ...." The nutshell could be trimmed from "... recognised standard textbooks by experts in a field, or medical guidelines and position statements from national or international expert bodies" to "recognised standard textbooks, or medical guidelines and position statements from major medical organisations". It's already covered in more detail under #Definitions, and the nutshell need not explain the obvious, that textbooks are standard and organisations major because they involve experts. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 02:10, 28 February 2016 (UTC)

One thing I am struggling with here is your statement in the subsection above, that you consider "cigarettes are the leading public health risk for adults" to a socio-political statement, that is primary and must be attributed. That's a science statement. Did you mean that? Jytdog (talk) 04:31, 28 February 2016 (UTC)

It's not a science statement, it's a subjective socio-political one, because "leading" has no objective definition. Smoking doesn't even qualify as the leading cause of preventable death, the most obvious thing one might suppose that "leading public health risk" meant. Depending on who said something like that, they might mean that traditional notions of smoking as "cool" or "sexy" means it has a high memetic potential to continue to be major additional problem for many more generations, which is sociological prognostication. Or it may mean that the organization is using "smoking" as a shorthand for "nicotine" and including e-cigarettes, which is playing definitional word-games, a political gambit. And so on. It could mean any of a dozen or more different things that aren't really science. I picked that example on purpose, because its one that I've seen people try to insert into an article as a bare statement cited but not attributed to [probbaly; this was a while ago] the ALA. What it really should have said was "According to the American Lung Association ...", and perhaps been followed up with a note or at least a footnote that hypertension (which has complex causes, mostly related to poor diet, stress, and lack of exercise) is the actual most frequent cause of preventable death among adults (according to ... additional attribution). I feel I keep needing to say that this isn't really about much of anything but attribution vs. "Wikipedia-voice". — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 10:37, 29 February 2016 (UTC)

smoking cigarettes is unambiguously a leading public health risk and that you have any doubt about whether that is a medico-scientific consensus statement shows that you are coming from some really bent place here. Do not try to win content disputes by changing guidelines. Do not try to legislate WP:CLUE in interpreting policy or guidelines. Jytdog (talk) 18:14, 29 February 2016 (UTC)

I might take issue with "risk", it's too kind to tobacco, feeding into the "it'll be the other guy affected" mentality. I would also take issue with "cigarettes" as other delivery devices are also part of the epidemic. After 50 years the US Surgeon General found that "Since the first Surgeon General’s report on smoking and health in 1964, there have been more than 20 million premature deaths attributable to smoking and exposure to secondhand smoke. Smoking remains the leading preventable cause of premature death in the United States." (p.17) LeadSongDog come howl! 17:36, 1 March 2016 (UTC)

I almost feel like I set a trap (though that wasn't the intent) and you both jumped with enthusiasm rather than accidentally fell into it. There's a mile of difference between "a leading public health risk" and (what I said, and what I saw paraphrased as "fact" from a medical organization position statement last year) "the leading public health risk" for adults. Of course cigarettes are a leading health risk, but it's a clear fact that they're not the primary one, under any sane definition. The frequency of this kind of "just restate a position in WP's own words like it's incontrovertible" error is a stark example of precisely why this guideline's treatment of all med. org.'s position statements as secondary, "ideal" sources we can just paraphrase at will without attribution is wrongheaded and (as to WP's mission) dangerous. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 10:01, 4 March 2016 (UTC)

Comment I think a little more work might be in order. The context of when the statement is made seems to me as important. I used the example of the Smithsonian's decision on the Enola Gay [11] to illustrate this. Even if the Smithsonian had used extensive literature reviews and secondary sources as part of any public statements about why they changed their exhibit, it would be difficult to categorize any of those statements by the Smithsonian at that time as NPOV in Wiki voice of science because the context of the decision was political rather than academic and independent. They would be unlikely to include the literature that contested their view with the same weight as literature that supported their view. Nonetheless, the sources they might have cited might be very usable. This is the reason many of us at the GMO articles have been [uncomfortable] with the use of Wiki-voice regarding AAAS [12] and AMA [13] [14] board claims about a "scientific consensus" on GMO safety that were made by these boards just prior to a vote the same year on California Prop 37 on GMO labeling. There was a lot of cherry-picking going on by the AAAS statement, which appeared to come straight from Monsanto's campaign materials, even though some of the materials cited by during the press releases are indeed good RS. So, I think SMcCandlish's language above needs to consider context of a statement and whether other major organizations have taken a different position. --David Tornheim (talk) 03:38, 28 February 2016 (UTC)

I have no idea what you are on about with the Smithsonian; it isn't pertinent to MEDRS and neither I nor anyone else is going to waste time figuring out if it is relevant. I have no idea what your point is here, with regard to the proposed change, except that you are making it clear that you are trying to change a guideline with broad applications to win a specific content dispute. So pretty much every argument you make going forward is going to be read in that light, and ignored. You still do not understand Wikipedia. You would do us all a favor if you kept your comment shorter as well. Jytdog (talk) 04:00, 28 February 2016 (UTC)

@Jytdog: Please stop with assumptions of bad faith. I will note that your allegation is in connection with GMO's for which you are topic banned. --David Tornheim (talk) 07:08, 28 February 2016 (UTC)

I have not breached my topic ban. That is the worst kind of wikilawyering. Like this other thing you are doing now - trying to manipulate a guideline to gain advantage in a content dispute that you (not me) are involved in, which could be anything. You are the one who introduced the specifics of your topic; not me, and I have not addressed them, and I will not. I am addressing the issues that SMcCandlish has raised, and addressing your transparent attempt to game the system. Jytdog (talk) 08:52, 28 February 2016 (UTC)

David Tornheim — to me is seems you are the one who assumed bad faith. Jytdog is not alone in judging your arguments to be bordering on irrelevant. CFCF 💌 📧 10:02, 28 February 2016 (UTC)

@CFCF: I have responded to you on your talk page here. --David Tornheim (talk) 10:25, 28 February 2016 (UTC)

I am surprised neither of you can see why the Smithsonian's position on the Enola Gay shows how politics can have a huge effect on a prestigious institution's treatment of a subject on which they are experts: in this case history. I hope it is safe to assume you all recognize the Smithsonian as the most prestigious museum in the U.S. (National Geographic put it first on its list for the world [15]). As a curator of historical objects, I think it is also safe to assume that statements from the Smithsonian on the history of objects in their possession should be as reliable as the AMA is on medicine in the U.S. Yet, in the example, their NPOV treatment of history was be greatly challenged by politics: At first the exhibit was going to be very large, then veterans vigorously protested, and the museum planned a smaller "non-controversial" exhibit, then historians protested and the exhibit was cancelled and the president of the Smithsonian was forced to resign. It is hard to imagine under such heavy political pressure, that the Smithsonian's treatment of the Enola Gay could be assessed at the same level of WP:RS as non-controversial historical matters. Our article does an impressive job of handling the controversy by the way: Enola Gay#Exhibition controversy. --David Tornheim (talk) 11:27, 28 February 2016 (UTC)

I understand your critique of political influence, but I have a slightly different viewpoint — and am quick to admit that everything is political. Wikipedia can't aim to right great wrongs and we don't omit reliable viewpoints because of potential bias — instead we report on such bias and counter with what other reliable sources there are. CFCF 💌 📧 11:39, 28 February 2016 (UTC)

Okay, now we are getting somewhere. To some extent I agree that almost everything has some politics to it. It is a question of how much--that is what we are talking about here. The example I gave it was the driving force of the decisions made by the Smithsonian, not their commitment to representations of accepted positions on history from academia. Our article does an excellent job explaining that. I don't see any issue here of righting any great wrongs--we are discussing how to treat positions from major organizations that can be influenced by politics and money. I agree with you that "we don't omit reliable viewpoints because of potential bias — instead we report on such bias and counter with what other reliable sources there are." And the proposal to add the source of a position (especially when there is a political or controversial aspect to it) rather than say it in the Wiki-voice, is an acceptable way to handle it. My main point is that context has a lot to do with whether politics (or money) is a substantial influence or not. And I think that the word "context" should be part of the guideline we are discussing. --David Tornheim (talk) 12:24, 28 February 2016 (UTC)

First — this isn't what the original poster was concerned about, and second — I don't see how this isn't sufficiently dealt with by WP:NPOV. CFCF 💌 📧 17:57, 28 February 2016 (UTC)

CFCF, statements by major health organizations are reliable secondary sources for making statements about health in Wikipedia's voice. There are always FRINGE perspectives out there, that oppose these statements (e.g anti-abortion people claiming the morning after pill is not safe, and claim that the establishment saying it is safe is pure politics). And there are people who mistake Wikipedia as platforms for advocacy, and who think the scientific establishment is corrupt, and try to elevate FRINGE views over mainstream views using post-modernist critiques of science or using claims of "systematic bias", here in Wikipedia. Anti-vaccinationists, anti-abortion advocates, the acu-proponents, the TM people, magnet-bracelets-cure-cancer people.... the list goes on. All of that has nothing to do with what Wikipedia is, and everything to do with what it is not. We do not treat scientific/medical statements by MSMBs as "political. They express the mainstream understandings, and are essential sources for us. Jytdog (talk) 16:50, 28 February 2016 (UTC)

Neither am I stating anything contrary to that. At least I don't think I am — I don't know what MSMB is...? CFCF 💌 📧 17:57, 28 February 2016 (UTC)

CFCF that is how David took it, and i read it that way too, when - in this conversation about using statements by major health orgs as sources, you wrote what you wrote. maybe you spoke more broadly than you intended. sorry MSMB = "major scientific or medical bodies" is what the language used to say - it is now "major health organizations". sorry for the outdated neoacronym. Jytdog (talk) 20:04, 28 February 2016 (UTC)

I want to note that this subsection is now derailed as a useful vehicle for getting feedback on the proposal, due to unproductive SOAPBOXing. I have struck it. Jytdog (talk) 16:53, 28 February 2016 (UTC)
I uncollapsed this. It is exactly why this refinement is never going to fly. Jytdog (talk) 17:41, 29 February 2016 (UTC)

SMcCandlish, this is the pandora's box that your concern about MEDRS opens up, btw. Clueful Wikipedia editors only use these statements by major health organizations to support medico-scientific content. The amendment is somewhat trying to "legislate WP:CLUE" as was discussed earlier above. I don't think that we are going to be able to have a productive discussion about a clarifying amendment, due to advocacy issues. But if you find people citing MEDRS to support making statements in WP's voice about politics sourced to statements by major health organizations, you can just try to help them see that statements about politics are judgements, not expressions of the scientific consensus, and need to be attributed. Jytdog (talk) 17:05, 28 February 2016 (UTC)

That seems premature. Just because CFCF and DT have their own back-and-forth on some side issue (in which you're indulging them >;-), limited to nested replies to one post, doesn't appear to do any violence to the proposal. CFCF raised an objection about "in short" and about what he calls "verbage"; Sunrise raised a different concern, and we're working through it, and resolving the verbiage issue a different way. I'd call that substantial progress. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 10:37, 29 February 2016 (UTC)

^Agree. --David Tornheim (talk) 10:44, 29 February 2016 (UTC)

Strong Oppose as completely unnecessary. Socio-political position statements are outside the scope of MEDRS. Medical position statements that are within scope are secondary, not primary. Finally the off topic examples raised in support of this proposal are not helpful. When an argument cannot be made succinctly, it almost always means there is no cogent argument. Boghog (talk) 11:20, 29 February 2016 (UTC)

There's a notable difference between examples and analogies, Boghog. Also, the net proposal, between Jytdog's original wording, improvements suggested by Sunrise and CFCF (or the "socio-political position statements are outside the scope of MEDRS" wording you and Peter like), combined with my suggested pruning of a three-way redundancy pile-up in the current wording in the top three parts of the guideline, is a notable increase in both succintness and clarity in the guideline's wprding. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 12:53, 29 February 2016 (UTC)

Comment There's a consensus that socio-political position statements are outside the scope of MEDRS; that's not the issue. The problem is how to write down clearly what counts as a "socio-political position statement", which needs explicit in-text attributing, and what counts as a "medical position statement", which does not. The discussion above says to me that, although SMcCandlish's intentions were sound (and I support them), the wordings put forward so far are too easily gamed by supporters of fringe theories in medicine. The status quo isn't perfect, but I haven't yet seen a proposed change that would actually be better. Peter coxhead (talk) 11:58, 29 February 2016 (UTC)

Even just adding "socio-political position statements are outside the scope of MEDRS" would probably help; we're not even drawing that distinction at present. Though the redundancy between the nutshell, the lead, and the MEDRS secondary sources definition should be cleaned up, too. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 12:44, 29 February 2016 (UTC)

Comment SMcCandlish is right that position statements, even by respected medical bodies, are highly politicized and far less reliable than good systematic reviews. They often go far beyond their evidence (even if they are "based on" good reviews, which they aren't always, they don't necessarily even agree with what the reviews say). I'm not sure that we've seen really good wording though, personally I'd just remove the phrase "or position statements " from the lede. Would anyone care to make another suggestion? Richard Keatinge (talk) 13:30, 29 February 2016 (UTC)
- @Richard Keatinge: Right, that was angle I started with on this matter (though I've belatedly noticed that the "or position statements" wording is in there in three places, not just the lead). I'd been willing to compromise toward walling off the socio-political matter at least, since by its very nature it cannot be coming purely from the science, and so is most easily distinguishable as not methodologically sound, being opinion. My impression had been that the consensus here was somehow that the science material in these org. statements was essentially unquestionable, whether I agreed or not. I'm glad to see that's not necessarily the case. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 14:42, 29 February 2016 (UTC)
Comment I broadly agree with SMcCandlish that "position papers" can be, in effect, primary sources in some situations. I don't think it's about the type of position statement (socio-political vs. not): it's about the methodology behind the statement. Jytdog earlier said that, "When a major medical or scientific body puts out a statement or position paper, it is synthesizing the best evidence and practices that exist, in order to communicate about something that matters to the field in which they operate. It is not like an editorial someone writes about something that happens to be important to that individual." The problem is that that's true some of the time, but not all of the time. We want the position statements that are reliable tertiary analyses of evidence. We don't want the position statements that aren't (or, at least, we should recognise them as being primary sources). Bondegezou (talk) 14:07, 29 February 2016 (UTC)
- @Bondegezou: My comment just above, to Richard Keatinge, probably also addresses this. I also agree that even when devoid of politicking they're probably best treated as tertiary, but that was an egg I wasn't really trying to fry at this point. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 14:42, 29 February 2016 (UTC)
Comment Indeed. Rather than talking in quasi-theological terms about whether position statements are primary, secondary, tertiary, or quaternary, we should bear in mind that it is precisely their use of anecdotal evidence that generally distinguishes them from systematic reviews. They are reliable for the opinions of their authors, which we can attribute and use. And they often include or make reference to top-quality reviews of evidence which we can use. Let us not muddle the ill-supported opinions of eminent people with good evidence about reality. I'd just take out any mention here of position statements. Richard Keatinge (talk) 17:04, 29 February 2016 (UTC)
Comment: Removing all instances of the term, position statement, seems like the most effective resolution. If and when common sense fails in a discussion, core content policy (V/NPOV/NOR) is well-able to handle rule-based arguments over whether a position statement, or particular claim within, is ultimately a summary of evidence, or (socio-political or other) opinion based on authority. Adding more language here, to clarify what is already supposed to be a clarification of core content policy, can only lead us further from straightforward content discussions, and into ever more convoluted forms of wiki-lawyering. When in doubt and confusion exists, considering that these are supplementary guidelines, don't pile on more, instead, pare back to the enduring core policies. --Tsavage (talk) 17:32, 29 February 2016 (UTC)
I'm sure I have an opinion about this, but as a newcomer to this thread I cannot make head or tail of what we're discussing. Is there an active amendment proposal under discussion? Or could someone briefly summarize what we're supporting and opposing here? MastCell ^Talk 17:57, 29 February 2016 (UTC)

I made a proposal to amend MEDRS at the top of this subsection and then withdrew it. Folks are still discussing it. Jytdog (talk) 18:10, 29 February 2016 (UTC)

Those calling to remove "position statements" - So what about this on Irritable bowel syndrome and this on concussion and this on water fluoridation? Abstract discussion to deal with theoretical issues is not helpful. Trying to legislate WP:CLUE to win content disputes is not helpful. Jytdog (talk) 18:10, 29 February 2016 (UTC)

What about them? Your first one says "The following guidelines, based on a comprehensive review"...[16] and this does rather point up the difference between guidelines and a review of the evidence. So does your second "To provide an evidence-based, best practises summary to assist physicians with the evaluation and management of sports concussion." [17]. And your last one is conceptually very clear, giving recommendations and, very much in our style, references to the evidence on which they are based, but from which they remain quite distinct. Experts don't confuse the two things. Neither should we.

I don't know anyone in this discussion who's trying to use it to win a content dispute. This is about removing the suggestion that "guidelines or position statements from national or international expert bodies" are "ideal sources", thus allowing WP:CLUE to come into play when we do use position statements. Richard Keatinge (talk) 19:33, 29 February 2016 (UTC)

First, all three specifically call themselves "position statements".

Second, Richard this is not about removing that whole statement and there is no way in hell that this language is coming out of MEDRS. It has been there almost since the beginning and is an essential part of the guideline and is deeply aligned with RS and VERIFY. The proposal to tweak it, is being driven and supported by people bent from content disputes - who come here bearing big shiny axes that they want to grind yet further. And if you read what people are writing and look at where they come from on top of that, the content disputes in which they are trying to gain advantage by gaming the guideline is very clear. Jytdog (talk) 20:14, 29 February 2016 (UTC)

It's not clear to me that there's any attempt to gain advantage, not on this latest proposal anyway. To repeat the central point, position statements are not evidence in the same way that good reviews are. They normally answer questions that the good-quality evidence doesn't, and they do it by relying on poor-quality evidence faute de mieux. They are not "ideal sources" and we should not say that they are. Richard Keatinge (talk) 22:26, 29 February 2016 (UTC)

(edit conflict) Jytdog, that's a massive overgeneralization. I'm here to resolve a conflict between actual policy (specifically WP:PSTS) and this guideline's wording, and have no axe to grind in any medical dispute; I'm strictly neutral on the matters when it comes to conflicts between legitimate medical views/establishments, and strongly against both FRINGE nonsense and COI promotionalism. My participation on those articles' talk pages, and in ArbCom cases about them, have been entirely about the very gaming you decry, about attempts to evade MEDRS, and about digging up sources while people throw their opinions and original research around.

A nothing-can-change stance is not a useful response to a change idea you understand the rationale for but fear might play into the wrong hands. It just needs to be word-smithed so that it doesn't do the latter. The key problem here is that medical specialists (or at least people we think are medical specialists - it's not like we can check credentials) are certain how they interpret different sorts of medical publications, and have written a guideline for themselves, to use against their enemies. But guidelines have to be written for everyone, including editors who are new to the topic, because anyone can edit any article here. It is not "legislating CLUE" to adjust the guideline to be clearer. In your zeal to thwart one kind of gaming, you're enabling another kind. I want to see both of them stop (or at least not be furthered by the ability to endlessly wikilawyer about exactly what is meant by MEDRS's wording). The fact that the wording has been poor and overbroad on this point for a long time doesn't somehow make it fantastic and surgically (pun intended) narrow, it just means that it's high time it was improved.

Simply removing the reference to "position statements" would likely resolve the matter, since it would retain "medical guidelines", like the three you link to examples of. I would prefer to see socio-political position statements explicitly addressed as primary sources, but if "position statements" as a blanket category were removed from the three places where they're being incorrectly defined as ideal secondary ones, that wouldn't strictly be necessary. It's essentially a disambiguation problem: "position statement' has too many conflicting meanings in the context. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 22:32, 29 February 2016 (UTC)

SMcCandlish as we discussed above, there is no conflict. Position statements/treatment guidelines, like the three I linked above, are secondary sources in that they summarize the evidence and medical consensus. As we discussed, they sometimes make judgements about societal/political things, and for that they are of course primary. There is no conflict. And all you are doing here is trying to legislate clueful use of the guideline. This is a hopeless task as all it does is attract less than clueful editors who want to push the tweak to gain advantage in content disputes. There is nothing to do here. The right way to manage clueful use of the guideline is to work it through on the relevant article Talk page, and if that fails bring it to WT:MED to get wider input from clueful editors. Jytdog (talk) 23:22, 29 February 2016 (UTC)

Historical note. This language has been in MEDRS since august 2008; introduced by MastCell in this dif, during a time when the draft guideline was being heavily discussed, just before its promotion to guideline in Sept 2008. There is 8 years of reliance on this and the claim that it is in conflict with VERIFY and RS is invalid. Jytdog (talk) 23:32, 29 February 2016 (UTC)

Please stop recycling the "this language has been in MEDRS since" thing. It doesn't matter how long poor wording has remain unresolved. consensus change, and it can identify and resolve a problem at any time. I'm not going to respond to the rest of that, because this is turning circular. We've already made our points. It's disappointing to me that our positions are so close in user talk yet so widely divergent on this page (yet what I'm saying is the same in both places). — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 09:53, 4 March 2016 (UTC)

Suitable reviews summarize the evidence. As we all agree, they are ideal sources for comments made in Wikipedia's voice. Position statements/treatment guidelines, as you point out, summarize expert consensus, often where the evidence is lacking or where its interpretation is disputed. This is not the same thing, and position statements/treatment guidelines should not be described as an "ideal source". Clueful editors can then avoid distraction from over-confident, often transient, assertions. Richard Keatinge (talk) 08:02, 1 March 2016 (UTC)

SMcCandlish, WP:CONSENSUS is a pillar of WP. This document is the product of consensus, and now has 8 years of consensus behind it. That is not a potato you can throw out the window; not in any Wikipedian way. Jytdog (talk) 14:25, 4 March 2016 (UTC)

Guidelines like this mainly affect new and infrequent editors. Experienced editors in intense content arguments end up citing core content policy: "that's not RS"; "that's OR"; "not NPOV." A significant content dispute won't revolve around whether MEDRS does or doesn't call position papers ideal. Anything that defies MEDRS, must also defy core policy, and policy is the universal standard for responsible reasoning.

It's not veteran editors or anyone half-serious about POV pushing who are stopped by vague, complicated or confusing guidelines, it's inexperienced editors, the fresh eyes we continually need in order to evolve, who may, in trying to contribute, get summarily shut down by a watchdog editor, with a blast of objection, followed by reference to a convenient guideline that, on subsequent examination, may appear to support something it does not.

Guidelines, particularly special-purpose ones like MEDRS, should be EXTRA-ACCESSIBLE to the least experienced editors, and they should clearly promote that verifiability, neutrality, and no original research are the essential concepts and tools, not to be superseded by local restrictions, and that V/NPOV/NOR are all the content RULES that are needed to edit wisely.

Guidelines are only here to promote core policy and flexible collaboration, and when they start doing the opposite, they should be removed, not added to. Wikis work by keeping it simple. --Tsavage (talk) 14:09, 1 March 2016 (UTC)

Policy and guidelines grew out of the consensus of the community - questions that got raised over and over got solved the same way and eventually that got codified. Changes should happen the same way. Go out there and when you come across a content dispute where a statement by a health authority on some sociopolitical matter is being summarized in Wikipedia's voice based on MEDRS, point out that MEDRS is about biomedical/health matters not sociopolitical matters, and if that doesn't solve it, bring it to WT:MED and that view will be supported there. In future times you can point to that, and then to the series of expressed consensus as they build. That is the wiki way to do this, instead of trying to legislate clue. Jytdog (talk) 15:11, 1 March 2016 (UTC)

Arbitrary break

Jytdog, we are trying to do the very opposite of legislating clue. And you seem to be suggesting a bizarre procedure for changing MEDRS. We just want excess and potentially misleading verbage removed. To repeat, this is about removing the suggestion that "guidelines or position statements from national or international expert bodies" are "ideal sources" - for all the reasons rehearsed above, they aren't. Apart from Jytdog, does anyone else oppose this proposal? Richard Keatinge (talk) 15:40, 1 March 2016 (UTC)

You are exactly trying to legislate clue. This guideline is for biomedical/health content and anybody using it to source sociopolitical content, doesn't have a clue. You are now actually making a new and radical proposal here - to remove reference to guidelines and position statements completely. That flies in the face of all past consensus (not to mention reason), and is definitely not going to happen. Not sure why you went that far. Jytdog (talk) 16:10, 1 March 2016 (UTC)

I am clearly not communicating well with you. I can only apologize as I am not quite sure how to fix this problem, but, to repeat, it is precisely the way that "guidelines or position statements from national or international expert bodies" use anecdotal evidence that generally distinguishes them from systematic reviews. They are reliable for the opinions of their authors, which we can attribute and use. And they often include or make reference to top-quality reviews of evidence which we can use. But they aren't "ideal sources". They are often politicized, controversial, rapidly changeable, and explicitly based on poor-quality evidence. Again to repeat, does anyone else object to the proposed change, which is to remove "guidelines or position statements from national or international expert bodies" from the list of "ideal sources". Richard Keatinge (talk) 16:33, 1 March 2016 (UTC)

But in general they are ideal source for topics within the scope of MEDRS, and nobody has credibly argued otherwise. So of course this text shall remain. Alexbrn (talk) 17:12, 1 March 2016 (UTC)

My original response was needlessly harsh, and it suffices to say I oppose the proposal as such for being anti-science. Any reasonable opposition to a guideline or position statement by a major health organization should be included, but that does not mean the position statement is any less valuable. CFCF 💌 📧 17:30, 1 March 2016 (UTC)

Richard thanks for writing that, as it helps me understand where you are coming from. You seem to believe that content in WP's voice sourced to "ideal sources" needs to be purely evidence-based. Our mission is to communicate "accepted knowledge" and in medicine that includes evidence of course, but it also includes standard of care, which is not always evidence-based, even in 2016. Not everything has been studied, and some things that have been studied haven't been studied well, or the studies are inconclusive. Yet doctors still need to do stuff when people are unwell. Treatment guidelines and position statements are our best sources for medicine as it is actually practiced - and for defining what best practices are in the face of all that uncertainty. Please don't let a commitment to evidence-based medicine overwhelm Wikipedia's mission, or become the only filter through which you view it. Jytdog (talk) 17:36, 1 March 2016 (UTC)

Our best sources for medicine as experts recommend... actual practice is a rather different matter. Also, yes, I do think that comments in Wikipedia's voice should be evidence-based, a pro-science policy if you like. The comments of authorities should be attributed to their authorities. So, OK, thanks for your replies, and I think I'll just drop the issue here. The passage I proposed to remove may be poor, but it isn't disastrous. Richard Keatinge (talk) 17:47, 1 March 2016 (UTC)

OK, thanks for acknowledging that. We do get evangelists for EBM here and generally their contributions are great, but when you push it as far as you are pushing it, that stance leaves the mainstream consensus of WP and the field of medicine. EBM =/= "accepted knowledge" in medicine - not in WP or anywhere else. Jytdog (talk) 17:55, 1 March 2016 (UTC)

I always take medical advice from EBM very seriously. [joke] — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 10:28, 4 March 2016 (UTC)

That it takes this much discussion among people who presumably know what they're talking about, to actually communicate what guidelines mean and how they should be used, illustrates the problem: how is a newcomer to understand all of this?

In the specific case of position statements, it has been made clear and agreed upon by multiple editors that positions can contain varying degrees of pure opinion, and positions can vary between statements - one can have conflicting statements on the same topic. To say they are ideal sources does not make sense in this context, if they may also be competing.

Of course one can argue usage, but we shouldn't be arguing how to use a guideline, it should be plain and straightforward, and when it is not, it should go. There is no reasonable assumption based on anything I've read here that removing a confusing phrase will result in bad content, meanwhile, it is entirely reasonable to assume that making a guideline that much less confusing will provide a benefit to editors.

For my part, I'll also leave it at that right here. Given the frequent arguments over MEDRS that I've seen, it's likely there will be wider scrutiny at some point, and that will be up to more than the handful of editors involved right here. --Tsavage (talk) 18:03, 1 March 2016 (UTC)

The guideline is clear and simple. It is for biomedical and health content, and ideal sources are reviews and statements/guidelines by major health authorities. Most folks wanting to change this have some content dispute in the background or have an incorrect understanding of what "accepted knowledge" in WP is. There is no rocket science here, no confusion in the guideline. Tempest in a teapot. Jytdog (talk) 18:19, 1 March 2016 (UTC)

Organizations of medical professionals engage in political activities, using their weight of authority to influence political decisions in ways that would benefit the professionals and not necessarily their medical patients. We have as documented fact that the AMA spent $18,250,000 lobbying legislative bodies in 2013, and $19,650,000 in 2014.[18] According to some of the argument above, all the position papers produced in that effort are medically sound secondary sources. And that argument is simply erroneous. Grammar'sLittleHelper (talk) 21:25, 3 March 2016 (UTC)

Sfarney not a single person above said that. No one. Jytdog (talk) 21:35, 3 March 2016 (UTC)

Excellent! And since lobbying is always a two-prong effort -- persuading the electorate as well as the elected -- we shall be equally discriminating about the position papers the AMA (and others) produce to shape public opinion. It is good to know that wisdom is already incorporated in WP policy. Do you have that reference at your fingertips, by chance? Grammar'sLittleHelper (talk) 22:10, 3 March 2016 (UTC)

no one said that all position papers put out by the AMA are about biomedical science or are useful sources per MEDRS. No one is saying that statements expressing judgements on sociopolitical matters are what MEDRS is talking about. And this is a guideline. You are not making any sense and you are clearly just trolling. There are no Great Conspiracies here for you to uncover. Jytdog (talk) 22:17, 3 March 2016 (UTC)

Nope, not trolling. I am sorry you did not understand. The AMA has a long history of falsifying medical facts for political purposes, most famously on tobacco,www.naturalnews.com/021949.html ^{[unreliable fringe source?]}#] but other subjects too, including X-rays. I offer these fact in agreement with SMcCandlish (talk · contribs), another editor you apparently did not understand. One sad fact of life is that every important fact eventually assumes sociopolitical significance -- including facts of human health. Another sad fact is that no large organization is immune to the corruption of political power. Hence, politically significant statements by such bodies should be considered PRIMARY SOURCE material, not secondary, regardless of the number of studies on which they are based. And be WP:civil. Long memories have access to different facts than short ones. Grammar'sLittleHelper (talk) 22:36, 3 March 2016 (UTC)

So, how does that impact this guideline? And more importantly, how on earth did you think quoting www.naturalnews.com would strengthen your argument? CFCF 💌 📧 23:00, 3 March 2016 (UTC)

From above: Hence, politically significant statements by such bodies should be considered PRIMARY SOURCE material, not secondary, regardless of the number of studies on which they are based. Also note, I did not quote naturalnews.com, I cited it for your personal edification of historical facts, of which some of us have personal and historical memory. The factual statements in that article are true, and they impeach the integrity of the AMA organization as a source of medical information. Grammar'sLittleHelper (talk) 23:18, 3 March 2016 (UTC)

I disagree with you but will not waste time arguing because those points are simply irrelevant to this page — which covers biomedical and health statements and claims. If you wish to bring this up go to WP:NPOV… CFCF 💌 📧 23:25, 3 March 2016 (UTC)

These ideas about AMA and its particular alleged politicization are tangential. The real issues here are that medical professionals who edit WP are apt to believe that "ideal secondary sources include ... guidelines and position statements of ... organizations" only refers to clearly secondary segments of genuinely medical information in them, while many others are going to take the statement at face value (as we're supposed to with WP:POLICY wording, per WP:GAMING, WP:LAWYER and WP:BUREAU) and interpret it more broadly. Like all guidelines, this is supposed to be written for and properly understood by editors generally, not just a specialist subset of them. — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 00:37, 4 March 2016 (UTC)

In the specific case of position statements, it has been made clear and agreed upon by multiple editors that positions can contain varying degrees of pure opinion, and positions can vary between statements - one can have conflicting statements on the same topic. To say they are ideal sources does not make sense in this context, if they may also be competing.

Of course one can argue usage, but we shouldn't be arguing how to use a guideline, it should be plain and straightforward, and when it is not, it should go. There is no reasonable assumption based on anything I've read here that removing a confusing phrase will result in bad content, meanwhile, it is entirely reasonable to assume that making a guideline that much less confusing will provide a benefit to editors.

For my part, I'll also leave it at that right here. Given the frequent arguments over MEDRS that I've seen, it's likely there will be wider scrutiny at some point, and that will be up to more than the handful of editors involved right here. --Tsavage (talk) 18:03, 1 March 2016 (UTC)

Due to the indent level, I'm not sure if that was meant as a response to me or to Jytdog. I agree with most of that, other that "it should go"; more like "it should be improved". — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 10:28, 4 March 2016 (UTC)

To continue with my denouement, I want to return to a key point in this sub-thread, then summarize what I'm concluding from the whole thing: Saying "The guideline is clear and simple" and relying on the fact that change in this particular regard has been successfully resisted for a long time, as one's response to "That it takes this much discussion among people who presumably know what they're talking about, to actually communicate what [the] guidelines mean and how they should be used, illustrates the problem: how is a newcomer to understand all of this?" (and similar observations from others about the need for guidelines to address all editors, not just topical experts), is not actually responsive, it's just "proof by assertion" and hand-waving (in the vernacular, not mathematical, sense).

It's abundantly clear from the above discussion that:

Lots of editors understand what the problems are and that they're problematic.
A small number of MEDRS regulars deny that the problems in the wording exist at all.
A larger number who concede at least some of the problems are not satisfied with the proposed wording changes so far.
There's so much circular chatter and venting that we're not likely to arrive at better wording in this particular discussion.

Thus, I have little choice but to return to my original position that this will likely require a widely-advertised RfC. Enough has been said above by all parties to the matter so far (and in the last round) to construct one. But there's enough temper-rise and issue fatigue that this should be given a rest for a while

In the interim, there's a stand-out piece missing from the entire discussion: Some status quo-defensive respondents express nebulous fears that any of the changes proposed so far somehow create an WP:GAMEable loophole that can be used by pushers of WP:FRINGE nonsense, yet have not articulated this in any concrete way. It's thus difficult for those in favor of some version of the proposed change to take these objections seriously. They sound like the fallacious version of slippery slope, and will need to be made much clearer if they're to be addressed. (A subthread for that below would be useful.) — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼ 10:28, 4 March 2016 (UTC)

As SMcCandlish says, this needs something like a widely-advertised RfC. The following example of divergence between guidelines and evidence may provide some useful food for thought in the meantime:

http://www.bmj.com/content/351/bmj.h3170 Calcium and vitamin D supplementation continue to be recommended to prevent and treat osteoporosis despite evidence of lack of benefit, say Andrew Grey and Mark Bolland. They examine why change is difficult and call for advocacy organisations, academics, and specialist societies to abandon industry ties

http://www.bmj.com/content/351/bmj.h4183 Conclusions Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD, which are unlikely to lead to a clinically significant reduction in risk of fracture.

http://www.bmj.com/content/351/bmj.h4580 Conclusions Dietary calcium intake is not associated with risk of fracture, and there is no clinical trial evidence that increasing calcium intake from dietary sources prevents fractures. Evidence that calcium supplements prevent fractures is weak and inconsistent.

http://www.bmj.com/content/342/bmj.d2040 Conclusions Calcium supplements with or without vitamin D modestly increase the risk of cardiovascular events, especially myocardial infarction

I hope this helps.

Richard Keatinge (talk) 13:46, 4 March 2016 (UTC)

Richard Keatinge I understand your advocacy for EBM, but that is advocacy. Doc James can sometimes fall into this too, and he and I had a pretty serious dispute at Tamiflu before we settled on an appropriate compromise that gave equal WEIGHT to treatment guidelines and the stance of the Cochrane review. Guidelines and meta-analyses are not often in conflict, but when they are, we do not elevate one over the other. What you are proposing makes it literally impossible for us to say much about most of medicine. Guidelines are essential sources in WP, and for doctors around the world. I cannot believe you are taking this stance. Jytdog (talk) 14:14, 4 March 2016 (UTC)

Guidelines are indeed essential sources in Wikipedia and in real life. I use them all the time. However, they are not ideal, and when they (occasionally) conflict with the best evidence, the evidence is the more valid guide to reality. (Weight is a different matter.) I reciprocally find your stance strange and can't imagine how you might rationally defend it. However, I will now really leave this matter until the hoped-for RfC. Richard Keatinge (talk) 15:02, 4 March 2016 (UTC)

You are violating a policy and a pillar, WP:SOAPBOX, and trying to force your advocacy into a guideline, and blatantly. This is wrong. Guidelines are consensus documents. Yes they are subject to groupthink or politics or blah blah but they are an essential source - an ideal source - for finding "accepted knowledge", which is what we try to capture here. We are not after "The Truth". And meta-analyses do not provide The Truth. They cannot predict what actual well-designed clinical trials show (per the famous 1997 NEJM article) - they are only another effort to try to grasp whatever we can of The Truth as well. And they are the product of a few authors and are subject to those authors' errors, biases etc. It may seem to you that you are making an entirely "reasonable" argument and you are, but reason is a whore that starts from assumptions and goes where you want it to go. Your assumptions are bad and an article of faith in any case, and where you want to go is incredibly destructive for Wikipedia. We need guidelines and reviews, especially when they are in conflict. Jytdog (talk) 15:37, 4 March 2016 (UTC)

More

I looked at this when it started, it contained some serious misconceptions, I got busy with other things, and came back... and the same problems are still present. So let's start at the top:

Practice guideline: This is a special, legally significant document whose fundamental meaning is, "If you don't do this, then your professional peers believe that you should get sued for medical malpractice". Many practice guidelines can be found at http://www.guideline.gov/ They are often peer-reviewed and based upon as much evidence as exists. However, their mandate goes beyond evidence, e.g., to telling physicians how they should treat severe, non-anemic fatigue in people with cancers other than breast cancer, even though nearly all of the evidence on that subject is from studying women with breast cancer.
Position statement: This is a smaller statement, usually on a subject where evidence is limited and reasonable, well-informed people might come to opposite conclusions. While there are political position statements, MEDRS doesn't care about them; political stuff – even health-related political stuff, such as "The Association for Medical Bigwigs objects to declaring HIV transmission be a criminal act" – isn't WP:Biomedical information. There's no "biology" in sociopolitical issues. Those sources are still WP:RS, but they're not MEDRS, because they're out of scope. Position statements are very frequently published in peer-reviewed medical journals.
Secondary source: A secondary source is one that is based upon other (primary) sources. All practice guidelines and most position statements are secondary sources. It is possible to self-publish a secondary source; WP:Self-published does not mean primary. It is possible to write a secondary source without being independent; WP:Secondary does not mean independent. It is also possible for a secondary source to be a poor source; secondary can be WP:NOTGOODSOURCE.

Given these facts, I don't see any reason why practice guidelines and position statements from major, reputable, science-based organizations should be considered worse than a review article – which, after all, could have been written by a grad student, created for the sole purpose of pushing a POV, published in a minor journal, and disputed by experts. "An ideal type of source" never means that 100% of the sources in this category are perfect, or even barely reliable. But as a type of source, "what doctors actually [have to] do" and "what major medical organizations currently believe, usually based upon months of internal meetings and peer review" is probably at least as good as "a two-page paper that a post-doc wrote for résumé-padding purposes". WhatamIdoing (talk) 01:40, 3 April 2016 (UTC)

As so often — you are spot-on. I think this discussion is pretty much over by now, this seems a good note to end it on. CFCF 💌 📧 14:13, 3 April 2016 (UTC)

Proposal: Strengthen wording of "in a nutshell" at beginning

Right now, the "nutshell" version of this guideline begins with:

"Ideal sources for biomedical material include... <description of some high-quality medical sources>"

As a relatively new editor, this seems somewhat misleading as a summary of the guide (and associated documents, like this talk page's FAQ). "Ideal" and "include" are very weak wording. An "ideal" Wikipedia article is one that meets the Featured criteria, but there's no realistic expectation that more than a few percent of articles will get there anytime soon. The "meat" of the guide seems to be much stronger than this; saying, if I understand correctly, that most biomedical material should be based on these sources most of the time. IE, there may be exceptions, but the intent is that the sources described should be the "default" for most Wikipedia medical content.

Therefore, I'd suggest amending this introduction to something like:

"Biomedical material in Wikipedia should primarily be based on... <description of some high-quality medical sources>"

Maybe not those exact words, but I think something like this would better represent the fundamental principles and intention of this guide. NeatGrey (talk) 00:07, 13 April 2016 (UTC)

Need for disclaimer

So far hundreds of non-medical articles have been deleted because of some editors' overreaching understanding of wikipedia policies. This misunderstanding assumes that any page that hints at soundness or well-being needs to have MEDRS sources. I propose an insertion along the lines of "except on pages that are not directly related to medical issues" or some variation. Can I get some feedback please? 92.6.190.86 (talk) 08:04, 24 August 2016 (UTC)

No.Carl Fredrik 💌 📧 08:25, 24 August 2016 (UTC)

It does carry the disclaimer "it is best treated with common sense, and occasional exceptions may apply." Also, it describes the characteristics of ideal sources rather than minimally acceptable sources. Sometimes it is applied too aggressively, and sometimes medical quackery flourishes despite the guideline. It's up to diligent editors to avoid mistakes in either direction. Rhoark (talk) 12:06, 24 August 2016 (UTC)

I've never seen it applied too aggressively, and I don't think the common sense clause should hold much weight — this really should be a policy page by now. The deletions this editor is referring to are of a horrible set of phobia articles based upon blog and forum posts and a rudimentary understanding of Greek. Essentially made up phobias based upon nothing but a Greek word and the suffix "phobia". Carl Fredrik 💌 📧 12:28, 24 August 2016 (UTC)

_{That's just your metathesiophobia, Carl. Axl ¤ [Talk] 17:57, 24 August 2016 (UTC)}

No, it's more likely mild neophobia. LeadSongDog come howl! 21:24, 24 August 2016 (UTC)

List of phobias

I recently voted an AfD for a phobia, then nominated one myself. After this phobia page was deleted I went thru its backlinks to delink them and run into more phobias of equally shitty quality. Then I took a look into the whole List of phobias and was astounded to see huge number of them referenced to various dubious websites. I am going to spend some time to clean them away, but I am pretty sure I will need somebody else to join the mopping effort here. Example: "Acousticophobia – fear of noise – a branch of phonophobia" -- really?. Staszek Lem (talk) 02:03, 26 August 2016 (UTC)

Proposed MEDDUE section

CFCF BOLDly added the following today which is great, but I have some issues with this and others may too. Moved here for discussion and consensus-building.

Giving due weight to sources

Shortcuts

	Relevance		Quality		Age		Best possible
Appropriate	Same topic	AND	High	AND	<2 years	OR	Yes
	Related topic	↕	Medium-high	↕	2-5 years	↕	One of several
	Same field	↕	Medium-low	↕	6-9 years	↕	Almost
Inappropriate	Unrelated	OR	Low	OR	10+ years	OR	No
Term	Unrelated		Low quality		Old		Better source available

A relevant source is one where the topic is the same as for the statement you use it for. E.g. — if you're writing about methotrexate treatment for rheumatoid arthritis: the best possible source in one covering treatment options in general, or even specifically methotrexate. The second best is a source that is about a different treatment, but states your topic in passing: "DMARDs have benefits over methotrexate, which may cause leukopenia". Less relevant sources may be a paper on psoratic arthritis that mentions methotrexate as a treatment for RA. Entirely unrelated or marginally related sources should never be used.
Quality assessment is performed according to the section on assessing evidence quality, but in essence means that higher quality sources trump lower quality sources — where the lowest quality sources should be entirely avoided.
Medical research can move very quickly, with evidence changing from one year to the next. Major organizations often recommend reviews of the evidence be no older than 2 years in order to be deemed "best evidence" (providing they haven't been trumped by newer authoritative evidence) . Wikipedia employs a cutoff at 5 years, where anything older than that only being used in exceptional cases, such as rare diseases. Sources older than 10 years should not be used (not including certain related fields such as anatomy, where the body of knowledge moves far slower).
Always seek the best source possible. It is unreasonable to expect editors to always use the best sources, but they should always try. Issues finding or using the best sources may be: pay-walls (see the Resource Exchange for help on accessing pay-walled content); difficulties in determining which source is the best; or it may just be unreasonably time-consuming to go through all possible sources.
When you have several contenders for best possible source, and they don't agree on something make sure to give both viewpoints, but remember to avoid giving false balance.

Try to avoid bias when selecting sources. Bias can arise from your search criteria and search tools, and in which sources you have access to (see for example FUTON bias).

Discussion

I have three issues with this.

It would be good to have some opening content like: "Per WP:WEIGHT, content in all Wikipedia articles, including biomedical content, need to be given space and prominence based on what is found in reliable sources. This section discusses WEIGHT with regard to the rest of this guideline. In general, give the most WEIGHT to views found in the best sources as defined in the this guideline and avoid giving UNDUE weight to views that are found only in lower-quality sources, especially when better sources exist."
I struggle with "Medical research can move very quickly" because that is actually somewhat rare. Medical research - and especially views in expert reviews about how to make use of the most recent research, is pretty slow (agonizingly and absurdly slow for people who don't understand the field). We already have major issues with people rushing to add stuff the minute it comes out and this will only feed that RECENTISM problem; we are very conservative in general, not cutting edge. Not sure what to do about this aspect as it also true that we care very much about capturing the most recent solid reviews that come out. I just find that the aim here is off.
Some discussion would be useful about what to do about WEIGHT in the absence of high quality sources. The issue of WP:PARITY on FRINGE-y stuff is relevant to that discussion as well.

Other may have other thoughts of course... Jytdog (talk) 18:07, 9 September 2016 (UTC)

As Jytdog has already touched on, and which is readily apparent from a quick glance through this page's archives, we have recurring problems with editors who misunderstand what was originally a fairly arbitrary "five year rule of thumb" as a hard-and-fast "five-year rule". (Last year, for instance, I remember a very enthusiastic but fundamentally misguided editor who thought that "evaluate this article for quality" meant "flag and delete or replace every source more than five years old" without regard for context, content, or usage.)

I think adding further graduations and an associated color scheme (less than two years, green, good; 2-5 years, yellow, caution; 5-9 years, pink, warning; 10+ years, red, inappropriate) is going to further encourage the use of publication date as a hard and fast criterion for usage, instead of one factor to be weighed among many. (Publication dates tend to be particularly problematic this way, in that they are one of the very few proxies for publication quality that can be objectively and quantitatively determined, even by inexperienced or lay editors. We also sometimes see editors get stuck on the primary/secondary dichotomy in a similar way.)

And all that said, this seems to be a discussion we've had on this talk page before, with similar arguments. See, for instance, Wikipedia talk:Identifying reliable sources (medicine)/Archive 22#MEDDATE, among others. TenOfAllTrades(talk) 20:38, 23 September 2016 (UTC)

Really "Best Possible" is the fundamental criteria. The others, I think, are just factors to consider to determine what the "Best Possible" source is. Sizeofint (talk) 05:43, 24 September 2016 (UTC)

The proposed text states "Wikipedia employs a cutoff at 5 years, where anything older than that only being used in exceptional cases, such as rare diseases. Sources older than 10 years should not be used."

I don't agree with the "Sources older than 10 years should not be used" part since there are some medical topics that have very little research and/or are stuck at the same level they were stuck at ten years ago. For example, I don't see much progress being made regarding topics such as clitoromegaly or biology and sexual orientation. Flyer22 Reborn (talk) 09:48, 3 October 2016 (UTC)

Second iteration

Okay, I'm back quite a lot later — Jytdog, what do you make of these changes?

	Relevance		Quality		Age		Best possible
Appropriate	Same topic	AND	High	AND	<2 years	⇨	Yes
	Related topic	OR	Medium-high	OR	2-5 years	OR	One of several
	Same field	OR	Medium-low	OR	6-9 years	OR	One of many
Inappropriate	Unrelated	OR	Low	OR	10+ years	OR	No
Term	Unrelated		Low quality		Old		Better source available

A relevant source is one where the topic is the same as for the statement you use it for. E.g. — if you're writing about methotrexate treatment for rheumatoid arthritis: the best possible source in one covering treatment options in general, or even specifically methotrexate. The second best is a source that is about a different treatment, but states your topic in passing: "DMARDs have benefits over methotrexate, which may cause leukopenia". Less relevant sources may be a paper on psoratic arthritis that mentions methotrexate as a treatment for RA. Entirely unrelated or marginally related sources should never be used.
Quality assessment is performed according to the section on assessing evidence quality, but in essence means that higher quality sources trump lower quality sources — where the lowest quality sources should be entirely avoided.
Medical research moves in fits and starts: sometimes the state of published evidence can change dramatically from one day to the next, at other times progress is excruciatingly slow. When comparing review articles and if all else is the same — more recent articles should be chosen. Major organizations often recommend reviews of the evidence be no older than 2 years in order to be deemed "best evidence" (providing they haven't been trumped by newer authoritative evidence). rare diseases or areas where research moves slower are exceptions where Wikipedia takes a more pragmatic approach. However, sources older than 10 years should not be used (not including certain related fields such as anatomy, where the body of knowledge moves somewhat slower).
Always seek the best source possible. It is unreasonable to expect editors to always use the best sources, but they should always try. Issues finding or using the best sources may be: pay-walls (see the Resource Exchange for help on accessing pay-walled content); difficulties in determining which source is the best; or it may just be unreasonably time-consuming to go through all possible sources.
When you have several contenders for best possible source, and they don't agree on something make sure to give both viewpoints, but remember to avoid giving false balance.

Try to avoid bias when selecting sources. Bias can arise from your search criteria and search tools, and in which sources you have access to (see for example FUTON bias).

Carl Fredrik 💌 📧 14:59, 29 September 2016 (UTC)

Both the table and the explanatory text still emphasize an overly and inappropriately strict reliance on publication dates. The explanatory text "Wikipedia employs a cutoff at 5 years..." is just making up a policy. At most, we have a roughly-five-year rule of thumb whose appropriate application will vary widely and wildly by topic. TenOfAllTrades(talk) 17:39, 30 September 2016 (UTC)

Rather than stating specific years, perhaps the scale should just be from "newer" to "older". If the newest comprehensive review of a topic is 10 years old and the second oldest is 15 years old, the 10 years old one should be given precedence (assuming they are roughly equivalent in the remaining factors). Sizeofint (talk) 19:57, 30 September 2016 (UTC)

I will contend that the 5 year mark may be repetition — but it is in fact a pretty strict cut-off point on all new content — and that people misunderstand the guideline and apply it where they shouldn't isn't a reason to weaken it across all fields.

I agree we should never remove 6 year old content because it is old, but neither should we add anything that is that dated as long as newer material exists. To answer Sizeofint — the 2 and 5 year cutoffs can be sourced to various major organizations, including HTA-agencies, so I think its absolutely best to leave them — and any medical statement older than 10 years really shouldn't ever be included on Wikipedia — and I think nearly all here stand by that position. I've changed the text somewhat (removing the mention of the 5 year cutoff) and will introduce the latest iteration as long as no major issues are brought forth.

I wonder if it is necessary to clarify in WP:MEDDATE — that this mainly applies to new content, and that old content that breaks the rule should be replaced when possible — but never indiscriminately tagged. Carl Fredrik 💌 📧 10:15, 1 October 2016 (UTC)Carl Fredrik 💌 📧 10:15, 1 October 2016 (UTC)

I don't think accepted knowledge becomes unaccepted just because it is over ten years old. It becomes unaccepted when it is replaced by newer knowledge. It may be that for certain topics the half-life of knowledge is very long. Sizeofint (talk) 15:54, 1 October 2016 (UTC)

Well, that isn't at all the point! There are basically no fields that go 10 years without review — and if there are any those fall under the very clearly defined exception. Purposely choosing sources that are 10 years old, or even doing so inadvertently without any vile intent — skews the presentation of facts towards what was known 10 year ago. The rules don't concern whether or not the knowledge is accepted — they are there because it's impossible to "guess" which content in an article will be proven wrong, and medical "truths" are proven to be false all the time. Tthis is well established in the guideline and really not up for discussion. The 10 year cutoff is no less than extremely lenient — and no we should really not be using >5 year old reviews either. Carl Fredrik 💌 📧 21:23, 1 October 2016 (UTC)

I agree that we should use newer reviews when they are available. My point is when they are not available the most recent comprehensive review should be used, even if it older than five or ten or however many years we have placed the cutoff at. Yes, in general most fields are reviewed much more frequently. My issue is that editors will see this table and then apply the cutoff indiscriminately to those exceptional fields Sizeofint (talk) 02:33, 2 October 2016 (UTC)

This is more over-specification in a guideline whose stock in trade is WP:CREEP. Rhoark (talk) 16:17, 1 October 2016 (UTC)

No, it isn't — I'm not taking such contrarian vitriol into consideration. Carl Fredrik 💌 📧 21:23, 1 October 2016 (UTC)

It looks like you're hell-bent on not taking any criticism into consideration, if it might prompt you to make any substantive change to your predetermined course of action. Three separate editors have now objected to your proposed change to a widely-used Wikipedia guideline.

Really, the deeper problem here is not resolved by further WP:CREEP with MEDRS. The problem is that editors insufficiently competent at reading, interpreting, and applying the medical and scientific literature believe – and indeed, are actively misled into believing – that the application of a sufficient number of MEDRS rules-of-thumb can be an algorithm that will allow editors unfamiliar with the literature to make useful judgements about its reliability. Supplying a rainbow-colored checklist encourages the misapprehension that a purely algorithmic approach can produce meaningful assessments of reliability—worse, it leads to time-wasting arguments with such editors when they refuse to acknowledge or consider any factors besides those on the magic checklist. (To say nothing of the editors who rules-lawyer for the purposes of POV-pushing, generally from out on the FRINGE.)

Cf. John Searle's Chinese room. The algorithmic approach to MEDRS encourages unqualified editors to try to simulate understanding of the medical literature, rather than actually understanding the literature; and it encourages them to mistake the former for the latter. (And unlike Searle's room, the editors who rely too heavily on the MEDRS-derived algorithms tend to output very low quality Chinese.) TenOfAllTrades(talk) 03:03, 2 October 2016 (UTC)

Not at all — and I've made substantive change to the text and the tables following critique. However, when criticism is based on fundamental misunderstandings of what constitutes scientific and medical fact (an ephemeral and ever-changing base) — it cannot be taken into account. When arguments are so thoroughly void that it takes less than one or two sentences to nullify them — I'm not going to pretend they merit due consideration. Neither can anyone claim that Rhoarks comment is intended as constructive criticism — and nor was it to the point, seeing as it argued against the entire existence of this guideline.

The addition I have made tries to explain the case for using newer sources simply, and tries to address the concerns you bring forth, without an algorithmic approach. Seeing as we have a scale, and no clear cutoff apart from those sources which are entirely inappropriate (in the bottom red, which are much more lenient than any other cutoff expressed in this guideline) we have the potential for a more nuanced discussion with less shouting of "this is older than 5 years". Carl Fredrik 💌 📧 08:48, 2 October 2016 (UTC)

I am also concerned about the rote nature of this formula. A high quality review that was published 10 years may ago still be superior to a more recent lower quality review. According to the present version of chart, any review greater than ten years old is considered inappropriate which is not necessarily the case. As this guideline is presently written, we run the risk of encouraging editors to replace older high quality reviews with more recent lower quality reviews. At a minimum, I think a footnote should be added to the age heading stating something along the lines "age guidelines only apply if newer sources with similar or superior quality are available". Until consensus is reached on this talk page, this chart should not be inserted into the guideline. Boghog (talk) 09:18, 2 October 2016 (UTC)

Boghog — I've tried to rectify your concerns with a footnote, but the problem is that a lack of reviews may also indicate that it is a fringe field and that it isn't accepted knowledge. Carl Fredrik 💌 📧 09:53, 2 October 2016 (UTC)

That is an improvement. However a high quality review regardless of age strongly implies the field is not fringe. To paraphrase WAID, a newer review is not automatically better than an older review. Boghog (talk) 10:30, 2 October 2016 (UTC)

While, ceteris paribus, a newer review is better, some areas of medical science move more slowly than others. In some cases, reviews over 10 years old or more are still very useful citations. I, thus, concur with the concerns expressed above: we do not want a formulaic rejection of older studies on age alone. Bondegezou (talk) 10:56, 2 October 2016 (UTC)

(edit conflict) Boghog — A high quality review from the 70s or 80s can most assuredly be fringe today — and the concept of meta-analysis & systematic review is young enough that just 10–15 years go it was far less employed. I agree that newer is isn't automatically better, but if the quality is similar and we are talking about meta-analysis/systematic review which simply takes into consideration newer data as well as the older data — then the conclusions from the newer review are inherently better. The distinction between different types of journal articles is weak in MEDRS at the moment, and I'm working on how to rectify this. Carl Fredrik 💌 📧 11:04, 2 October 2016 (UTC)

Please don't invoke strawman arguments that miss the point of our objections. No one here has argued that 40-year-old review articles should be employed as a matter of course (though there may well be edge cases where they will be appropriate, often when accompanied by newer material). TenOfAllTrades(talk) 13:37, 2 October 2016 (UTC)

CFCF, quit trying to edit war your change into the guideline before you have achieved a consensus on this talk page. That's not how we make changes to Wikipedia policies and guidelines. So far no one on this talk page has endorsed your proposed change. I have reverted your restoration, and I will take this to AN/I if you keep it up. TenOfAllTrades(talk) 13:37, 2 October 2016 (UTC)

It's not a straw-man argument, because much of the same applies to 90s reviews: just take the example of cholesterol and myocardial infarction. Older materials should not be used in medical articles, and I'm tired of debating over a false balance stricken only because of a profound lack of knowledge. I would counter that I am fully willing to go to AN/I — since I know I am in the right to ignore arguments attacking the core premises of MEDRS. However I hope we can produce something overall positive and not lose to the obstructionist tendencies as voiced above. Carl Fredrik 💌 📧 14:01, 3 October 2016 (UTC)

It often seems a good idea to replace editorial judgement based on descriptive guidelines by a flowchart or other deterministic set of rules, but it very rarely turns out to be a good idea in practice. It leads to wikilawyering about the precise boundaries of the choices in the "rules". It discourages editors, especially new editors, from trying to understand the guidance provided, instead encouraging them to follow their interpretation of the "rules". Above all, it devalues editors and their ability to make judgements, when these are ultimately the only way of ensuring quality. Peter coxhead (talk) 14:37, 2 October 2016 (UTC)

I remain sympathetic to the goal of fleshing out MEDDUE here. However, my first and third bullets remain unaddressed (sorry I have not time to add content reflecting them myself) .... there is still no opening to explain the context and tying this very clearly under the UNDUE policy and that is really important - we need to make sure every thing we do is in harmonized with and cites/echoes the other policies and guidelines. And I would like to see PARITY addressed here is as it reads directly on UNDUE.

The issue of how why we prefer more recent reviews to older ones, is still handled in a clunky way. It isn't that complicated; newer reviews take into account primary literature that has emerged since the last one. We don't need to get all elaborate about that. I do agree that the visual aid will tend to get used robotically and I the text handles this multifactorial thing much better - if there is a figure it needs to reflect more nuance and inter-relationship and not present an abusable simplified schematic... Jytdog (talk) 20:47, 2 October 2016 (UTC)

I commented above that I'm not sure about the "no sources older than ten years" part since there are some topics where very little progress is being made. Flyer22 Reborn (talk) 09:52, 3 October 2016 (UTC)

We currently employ a rather strict "no sources older than 5 years" rule in this guideline, with few exceptions. I have an extremely difficult time coming up with any topic (spare anatomy — already mentioned as an exception) — where a 10 year limit would have any negative effect. If a disease is so rare that not so much as a case-report (already not allowed per our requirements on secondary sources) has been published in the last 10 years, then it likely is rare enough that it isn't accepted into Orphanet, and should probably not be covered. Carl Fredrik 💌 📧 14:01, 3 October 2016 (UTC)

I don't read the current guideline as being overly strict about a five-year cutoff. It has some wiggle room and reads more like a rule of thumb to me. To me the emphasis is on the second part, capturing the latest review cycle.

In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones, and editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written. The range of reviews you examine should be wide enough to catch at least one full review cycle, containing newer reviews written and published in the light of older ones and of more-recent primary studies. Sizeofint (talk) 14:10, 3 October 2016 (UTC)

CFF please see that the way you are reading the current MEDDATE section has drifted away from the consensus reading of it, which is more flexible than you are expressing here. We do strongly prefer sources < 5 years old and pretty much any time you update an older review with a newer one and update content based on the newer review, it will be an improvement and noncontroversial. But that is different than "a rather strict "no sources older than 5 years" rule in this guideline, with few exceptions." And in general the community is allergic to "rules" per se. It is unclear to me what is driving your efforts to make this guideline rule-based but I hope you reconsider. In light of all that and in light of the lack of consensus you are getting to make this rule based, if you do bring this to ANI it will not go well for you and that would not be good for the project. Please adjust your approach. Jytdog (talk) 14:22, 3 October 2016 (UTC)

(ec) Re: "We currently employ a rather strict "no sources older than 5 years" rule in this guideline...". That's not really true either. "Five" appears exactly twice in the guideline; once in an external link showing how to do a date-restricted PubMed query, and once in a passage where it is wrapped in cautions about how the five year suggestion has all kinds of attached provisos and caveats and ceteris paribus considerations. We actually water down the five-year suggestion as much as possible because it's so frequently misunderstood and misused. The opening of the "up-to-date evidence" section reads:

Keeping an article up-to-date while maintaining the more-important goal of reliability is important. These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or where few reviews are published. (my emphasis added)

The bullet point that mentions "five or so years" (that doesn't sound "rather strict" to me) doesn't instruct editors to throw out older reviews, but to examine them in the context of more recent publications where available. It specifically encourages editors to familiarize themselves with at least "one full review cycle" (however long a time period that might represent).

The bullet point right after the "five year" line emphasizes that more recent isn't always better:

Assessing reviews may be difficult. While the most-recent reviews include later research results, this does not automatically give more weight to the most recent review...

Finally, there's an exception carved out for Cochrane reviews (using a numeral "5" rather than the word "five"), followed by a very explicit notation that "A newer source which is of lower quality does not supersede an older source of higher quality."

The reason why there's so much explanatory text around those "five"s is because editors unfamiliar with Wikipedia editing and/or unfamiliar with the medical and scientific literature are so prone to misunderstand and misapply the five-year rule-of-thumb as a strict prohibition. Creating a color-coded table that lets them avoid reading any instructions at all is going to make that misconception worse, rather than better. TenOfAllTrades(talk) 14:52, 3 October 2016 (UTC)

CFCF, you stated, "I have an extremely difficult time coming up with any topic (spare anatomy — already mentioned as an exception) — where a 10 year limit would have any negative effect." I noted that clitoromegaly is one of the areas where very little progress is being made in terms of research. And that's because clitoromegaly is rare. I don't see why a five or ten-year rule should apply to that case. Flyer22 Reborn (talk) 16:58, 3 October 2016 (UTC)

But I take it that you view clitoromegaly as being covered by the anatomy exception? Flyer22 Reborn (talk) 17:10, 3 October 2016 (UTC)

balanced diverse, multicultural sources to counter western/euro-centrism

[removal of eurocentric bias, replace with diverse, multicultural detail]

There is a eurocentric bias against non-western medical sources, as evidenced in the omission of non-western medical sources as reputable. This western bias continues a long tradition of not recognizing other peoples/cultures/traditions as equals and suppressing/oppressing non-western peoples/cultures/traditions. Western medical bias is a relict of a nasty, racist past. Prevailing western authority of scientific and medical matters is a form of cultural imperialism. Therefore, it is necessary to promote diverse, multicultural, and balanced sources to counter the relict of western/eurocentrism and western cultural imperialism.

The inclusion or intentional omission of balanced diverse/international sources, where relevant, may indeed be an issue that needs to be addressed in a separate section of Wikipedia talk:Identifying reliable sources (medicine). — Preceding unsigned comment added by 80.246.138.109 (talk) 06:23, 20 October 2016 (UTC)

continued from:

Regarding removal of eurocentric bias in Wikipedia:Identifying reliable sources (medicine) and corrected at revision

Wikipedia policy demands that we must present neutral, unbiased consensus. The reference to European/American/Western authorities and the omission of non-white authorities directly conflicts with the policy on neutrality and bias. The world has changed, the eurocentric bias of the past is no longer authoritative and dominant. let us move forward and embrace and promote the diversity of world cultures.

That isn't balance either and some of the added sources are questionable.

The eurocentric sources currently prevailing are just as questionable (or valid, depending on your bias).

The African Journal of Biomedical Research, Myanmar Medical Journal, Indian Journal of Medical Sciences , Chinese Medical Journal are just as valid and reputable.

Wikipedia should not become a bastion of eurocentric authority and bias. Please let us progress.

We must strive to embrace diversity and promote a multicultural Wikipedia. Therefore, it is imperative to correct the wrongs and update the sources accordingly.

— Preceding unsigned comment added by 80.246.137.147 (talk) 04:00, 20 October 2016 (UTC)

The place to discuss this is at the guideline's talk page. It is one thing to add to the list of reliable sources, but you replaced the list of Western sources with a new list of non-Western sources. This is not balanced. Also one needs to be very careful about sources. According to a Chinese government investigation, "80% of data in Chinese clinical trials have been fabricated". Science Alert. Boghog (talk) 04:17, 20 October 2016 (UTC)

Another problem is that the list of journal that you have added (African Journal of Biomedical Research, Myanmar Medical Journal, Indian Journal of Medical Sciences, Chinese Medical Journal) as far as I can tell have not issued any practice guidelines, and hence do not belong in this list. Boghog (talk) 04:30, 20 October 2016 (UTC)

Agreed, having both Western and non-Western source list is more balanced. Fabrication of research is not new, neither is it unique to the Chinese, it is a universal problem and is also a common issue in the west: "Fraud and misconduct in clinical research: A concern". Perspect Clin Res.. Should we also discriminate against western sources due to fraud? Favoring one (possibly questionable) source over another, based on ethnic/political/national affiliations or inclinations is indeed biased. We should not be swayed by political or ethnocentric interests when considering sources, but present balanced information. Prevailing western authority of scientific and medical matters is a form of cultural imperialism. Therefore, the inclusion or intentional omission of balanced diverse/international sources, where relevant, may indeed be an issue that needs to be addressed in a separate section of Wikipedia talk:Identifying reliable sources (medicine) (talk) 04:50, 20 October 2016 (UTC)

Frankly, this "cultural imperialism" stuff is silly. We use the best sources regardless of origin since science is science wherever it comes from from Iceland to Peru. Some sources have a reputation for being poor by dint of their origin (e.g. known dodgy journals, or nation states with established questionable records for research publication) and we accordingly disfavour them. It is in fact a kind of racism of low expectations to try and crowbar in sources based just on somebody's quota system for nationalities (or author gender or whatever): the best science will rise to prominence without our help. Alexbrn (talk) 07:00, 20 October 2016 (UTC)

"cultural imperialism" stuff is silly... but not to the majority of the non-western world, who have and still experience this. Non-western medical authorities have their own unique practices, guidelines, and history. Most articles present the western medical tradition as the sole authority on medical matters, even when non-western medical authorities have their differing practices. The presumed superiority of the FDA over the China Food and Drug Administration ("CFDA") is based on this cultural/ethnic/political bias. Non-western medical sources are automatically questioned and deemed disreputable, by this ethnocentric bias, as recently evidenced by your actions.

Instead of continuing with this bias, we should present balanced information that covers the diverse practices of various national medical authorities.

It is 2016, not 1916, why are we even debating this? — Preceding unsigned comment added by 80.246.139.116 (talk) 08:24, 20 October 2016 (UTC)

Yes Wikipedia is biased - in favour of good sources per WP:MEDRS. This will naturally lead to as diverse sourcing as is reflected in the real world. This whole argument is spurious and made with zero evidence. If there is a problem, perhaps some examples of where it applies? Wikipedia certainly does have a problem with advocates of bogus medical treatments trying to use dodgy sources (e.g. Chinese sources lauding the amazing powers of TCM). Alexbrn (talk) 09:17, 20 October 2016 (UTC)

Developing nations are developing. That is not a moral judgement nor is it biased. And that edit you made misses the point of this section; of course for health issues specific to Ghana one would look to the see what the Ghana Health Service has to say about that - why would you not? On the other hand if you wanted to understand the best way to treat say diabetes, a disease that happens anywhere, why would not look to what health authorities from developed nations which have the resources to develop the most sophisticated understanding and approaches - not to mention the resources to communicate that understanding - have to say about it? Science is science. Jytdog (talk) 12:13, 20 October 2016 (UTC)

the FDA (or some other powerful western org) is not the medical authority of the planet. Wikipedia is not an extension of a political/national/governmental entity. Many users of Wikipedia live outside of the US/UK and have reliance on the reputability of their own medical authorities, and not a foreign entity. Currently, FDA ruling supersedes local non-western, independent authority in many articles, which is biased against the local authority.

historical example of the issue: FDA and American medical organizations refused hormonal therapy treatment for estrogenic breast cancer - tamoxifen was not approved since the 60s. The US medical establishment only recognized surgery, radiation and chemo. However countries outside the US provided hormonal therapy for estrogenic breast cancer. It took several decades for the US to catch up with the rest of the world in treatment of hormonal breast cancer and provide hormonal therapy for estrogenic breast cancer, irregardless of stage. This example outlines that diverse national practices and medical perspectives do exist. Not all countries practice the same treatments and share the same persepectives. If the European medical society supports and approves Hyperthermia therapy, that does not translate to universal submission to European medical authority and acceptance of Hyperthermia therapy in the US.

Hyperthermia therapy has been rejected by American medical establishment for well over a century. However European and Asian medical authority have accepted this treatment as safe and effective and have been practicing this for decades.

Photodynamic therapy has also been rejected by American medical establishment, while Russian medical established has approved and treated patients with photodynamic therapy since the 1990s.

Wikipedia articles on hyperthermia or ablation have a bias towards western medical establishment and present the opinions of western medical authority.

Try to edit an ablation article mentioning that ablation has been used to treat tumors in Japan since the 1960s, and a resulting reversion of the article will quickly follow with a reason being that it does not provide reputable (western) sources.

Why should wikipedia present the views/opinions of western/anglo medical authorities?

We should present both western (American/Anglo) medical perspectives as well as non-western to present balanced, unbiased information. Instead, we currently have western, eurocentric bias in many articles.

An example in [19], states "Whole-body hyperthermia is generally considered to be a promising experimental cancer treatment"

besides being uncited, problems with this statement include that it is biased and presents the opinions of US medical authority and not European or Asia.

such statements should be modified to cover the conflicting opinions of both medical authorities — Preceding unsigned comment added by 80.246.141.219 (talk) 15:58, 20 October 2016 (UTC)

This is really an unrelated point from the issue at hand (i.e., what medical organizations publish material that constitutes reliable evidence-based medicine), but brain hyperthermia is a prooxidant neurotoxic condition that enhances blood-brain barrier and blood-cerebrospinal fluid barrier permeability, so that experimental treatment is certainly not without adverse effects. Seppi333 (Insert 2¢) 01:40, 21 October 2016 (UTC)

Just thought I'd point out about the edit here that there's nothing apparently unreliable about the Japanese Society of Medical Oncology added as an example for "major professional medical or scientific societies" - it's affiliated with the European Society for Medical Oncology and says that it "has selected Annals of Oncology as our official journal." Of course, not being unreliable doesn't necessarily make it (or any national oncology society) the best example of "major professional medical or scientific societies" when only a couple of examples are being given. Similarly, while I'm sure India's National Health Mission does great work, it's not apparent that it issues many statements or practice guidelines that would be used as references on Wikipedia. --tronvillain (talk) 13:45, 21 October 2016 (UTC)

I agree with initial editor in this section, there is immense push of western mainstream view throughout wikipedie. here is an example. This policy is fundamentally flawed in that it makes it easier for editors to go to any article they think is related and push their biased western view and ignore other sources. 178.223.26.53 (talk) 09:02, 25 October 2016 (UTC) A solution might be to have indication of the sourcing, and indication of conflicting views in other parts of the world. West laughs at some eastern philosophies, yet some of its ways lead to healthier lives. 178.223.26.53 (talk) 09:07, 25 October 2016 (UTC)

Why is it that when people complain of bias it's always to promote some fringe pseudoscience crap? Keeping that stuff away is the purpose of this guideline! If you want to write about your magic hocus pocus you can go somewhere else, Wikipedia is not for you… Carl Fredrik 💌 📧 12:54, 25 October 2016 (UTC)

your western superiority bias is so innate to your thinking that you are unable to perceive it or be aware of it. so sad. 178.148.30.195 (talk) 14:12, 25 October 2016 (UTC)

There's nothing western about science - as Steven Novella says, "It is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. Which part of that exactly do you disagree with? Do you disagree with being thorough? Using careful observation? Being systematic? Or using consistent logic?” You just don't like that alternative medicine doesn't stand up to rigorous scientific examination. --tronvillain (talk) 15:23, 25 October 2016 (UTC)

Unlike Carl Fredrik who can't discuss rationally, you are asking a very good question. So here is my answer. It is not science that if problematic, but much higher preference of western resources and disparaging of eastern resources as not being reliable enough. Even western source, WebMD is legitimate to use in Wikipedie EXCEPT when supports views and evidence perceived as legitimate by scientific research from the east. 178.148.30.195 (talk) 15:29, 25 October 2016 (UTC)

WebMD should rarely be used as a source, even for western medicine. We state in the policy that it should only be used for uncontroversial information and even then when there is better literature (as there almost always is) that should be cited instead. MEDRS doesn't discriminate between eastern and western medicine. It asks that we use the best (i.e. most comprehensive and recent) available secondary sources for medical content. If these sources say some traditional medicinal practices don't work then that is what our articles should say as well. Sizeofint (talk) 16:10, 25 October 2016 (UTC)

I ask that people Wikipedia:Deny recognition here. It is not our job to convince people of the errors in their world view. This is evidently not going to result in any change of policy, by engaging in discussion you risk falling to the level of the WP:Troll and risk wasting valuable time you could spend doing other things. (I know it's hard, it makes you mad to know that people can be this wrong, but please just leave it.)Carl Fredrik 💌 📧 17:28, 25 October 2016 (UTC)

Mirror 176.221.76.3 (talk) 17:33, 25 October 2016 (UTC)

[1] Organizational position statements are always primary sources for socio-political positions. Where they contain summaries of the evidence or describe consensus medical practice, they are ideal secondary sources for the claims in that material. Distinguish between a regulatory position about tobacco, which should be directly attributed, and a finding that the research demonstrates that cigarettes cause cancer, which may be stated in Wikipedia's voice and cited.

[1]