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MEDRS and clinicaltrials.gov

Can someone explain to me why clinicaltrials.gov isn't considered a reliable source? Natureium (talk) 20:06, 30 January 2017 (UTC)

This is a registry of clinical trials, but as I understand it, doesn't review results. As a secondary source, it is probably relaible for basic facts about a trial, such as does it exist, who is running it, etc. But the results of the trials are not reviewed by the site, so this registry cannot be considered a reliable source for those results. --Mark viking (talk) 20:34, 30 January 2017 (UTC)
I've cited it as a source for the fact that a trial is in progress for a specific indication, but several times I've had them removed, almost always by the same editor. I wanted to make sure there wasn't some policy on the subject that I couldn't find. Natureium (talk) 20:46, 30 January 2017 (UTC)
It's a valuable site for human research in progress, but does not stand alone as providing a confirmed result that would be encyclopedic. IMO, it falls under WP:NOTNEWS and this MEDRS section. It is often included in disease articles under External links – which might be valid as a progress report – but some restrictions under WP:ELNO also apply. Better to wait for the acceptable MEDRS review or dig harder to find a review that supports a conclusion. --Zefr (talk) 22:41, 30 January 2017 (UTC)
I think a clinicaltrials.gov URL is "reliable" for the claim that a particular clinical trial is planned or recruiting patients. However, because it is a non-independent source, it's also a poor indicator that anyone ought to care about this particular trial.
A link to a pending or recruiting trial is exactly the kind of thing that should not be used as an ==External link==, per Wikipedia:Manual of Style/Medicine-related articles#External links. Generally speaking, even outside of ==External links==, writing something like "as of 2017, there's one clinical trial in progress" is not encyclopedic information because it's such temporary information. WhatamIdoing (talk) 03:44, 31 January 2017 (UTC)
Natureium: This is an example where secondary review of clinicaltrials.gov leads to encyclopedic information, as stated in the abstract conclusions. --Zefr (talk) 14:22, 31 January 2017 (UTC)
@Zefr: clinicaltrials.gov is a perfectly acceptable source to document that a drug is in clinical trials for a certain indication (this is not a medical claim) and this information may or may not be encylopedic. clinicaltrials.gov is not an acceptable source to support that the drug is efficacious (a medical claim). You may not be interested in the drug development pipeline, but others might be. Boghog (talk) 14:48, 31 January 2017 (UTC)
What about a lot of stage II and III developmental drugs like copanlisib? It's not in clinical use, and review articles aren't available for clinical trials that haven't published any data yet. The information about a drug should include what it can be used for, which is what is being investigated in the clinical trials. The only other source covering most clinical trials are press releases. Is it better to use clinicaltrials.gov as a source, where the information was submitted by the trial sponsor and reviewed by the NIH, or a press release?
It seems it would be better to include information that is "temporary" (trials usually last several years), because even in a few years, it would still be useful information. e.g. "Copanlisib was investigated in a large-scale phase III trial for renal cell carcinoma, but was found to be ineffective for this type of cancer." The reason I think people would care about clinical trials is because it's a major part of the development of the drug, and in the case of a targeted drugs can tell you things that may not be obvious. e.g. "Xyzmab targets ABC, which is expressed on melanoma cells and myeloma cells, but clinical trials done by the drug developer found efficacy only in patients with melanoma." There also might not be any other source for the anticipated indication for the drug or reason it's being developed. Natureium (talk) 15:03, 31 January 2017 (UTC)
  • Lots of drugs go to clinical trials. Of those, about 1 in 10,000 clinical trials leads to a drug being recommended as a treatment for some medical condition. Because of the noise, and because of the highly likelihood that readers or even medical professionals will not understand the significance of saying "drug is being researched for treating X", and because clincialtrials.gov is a primary source as a database of self-published drug information, I think it is out of scope for citing in articles about drugs or medical conditions. There is almost nothing there that is relevant from any perspective except the most specialized slice of research. I have experimented with citing some information from clinicaltrials.gov for use in articles about clinical trials themselves. See PARAMOUNT trial for example. Although this trial is about a drug and a medical condition, I do not think that this trial merits much description in the Wikipedia articles about either the drug or the condition. If anyone is considering talking about a less prominent study than this quite large one, I think even less mention is merited. Blue Rasberry (talk) 15:02, 31 January 2017 (UTC)
I'm not talking about articles about individual clinical trials, I'm talking about developmental drugs that have an article but not much other information. Possible indications seem like critical information in an article about a pre-market drug.
I don't think I've seen any articles so far about drugs in phase I trials, which is when a lot of them fail. And clinicaltrials,gov is information submitted to the NIH by the drug developer. It's not just information anyone can post without review. Natureium (talk) 15:08, 31 January 2017 (UTC)
My trust in the information at CT .gov is limited. "It's not just information anyone can post without review" but it also is low quality information. I know you are talking about articles about drugs. If you have an example to share then let's see but the usual answer is no, because it is self-published low quality information. Beyond that, most people who try to add information about primary research do it in a way that misrepresents the source, so even if it is possible to share information, "no" is just a short way of saying "yes but it is complicated and please talk it through". Blue Rasberry (talk) 15:12, 31 January 2017 (UTC)
about 1 in 10,000 clinical trials leads to a drug being recommended Where did you get this number? That sounds way, way, off. This source suggests it is closer to 1 to 10. With 1 in 10,000 success rate, there would no longer be a pharmaceutical industry. Boghog (talk) 15:29, 31 January 2017 (UTC)
That My number is completely wrong. The rubric is 10,000 preclinical, 1,000 phase 3 (safety), 100 phase 2 (efficacy), 10 to market, 1 useful drug. Error margin - could be great but order of magnitude is close. Sorry for miscommunication. I would rather use the number 1000 than 10,000. The number 10 seems low to me - I doubt that 1 in 10 trials listed at CT. gov result in a treatment recommendation, but would be curious if that were so. I am unable to read the Nature article. I might be ignorant about numbers but still, most studies are dead ends. Blue Rasberry (talk) 15:45, 31 January 2017 (UTC)
Do you mean 1,000 phase 1? Phase 3 is the last phase before marketing. And we are only writing articles about phase II and III drugs, so it seems like it would be closer to 10 anyway. I'm inclined to trust Nature. Natureium (talk) 15:55, 31 January 2017 (UTC)
I think you should correct your above statement that "about 1 in 10,000 clinical trials leads to a drug being recommended as a treatment", then. "10,000 preclinical" means 10,000 tests that are not clinical trials. (The name "pre-clinical" comes from the fact that these tests happen "before" the clinical [i.e., in living humans] trials.) Even according to your rubric, that's 10,000 non-clinical tests but only 1,110 clinical trials to produce one marketable drug.
Also, the claim above is misleading in another sense: very few single trials lead to a new drug being approved. The regulatory agencies look at the overall mass of evidence, not just one isolated trial. WhatamIdoing (talk) 06:50, 1 February 2017 (UTC)
I should rethink all my comments. For now, I want to just say that I provided incorrect information and step away until and unless I can do better fact checking for myself. Blue Rasberry (talk) 19:11, 1 February 2017 (UTC)

While there's likely almost-universal respect for a registry from NIH, the drug analysis pipeline represented by clinicaltrials.gov is not encyclopedic because it is basically "news-in-the-making" and has strong applicability to WP:CRYSTAL and a high failure rate. Should a drug advance into Phase III success, it would typically be published under peer-review in a clinical journal, at which time it would warrant mention in a Research section of a WP article. There is also possibility of reporting bias or data censoring in the registry, as reported here and here. Such examples are major caveats to WP editors, indicating too much potential for misleading conclusions from the registry to warrant its use alone as a source for discussing a disease mechanism. --Zefr (talk) 15:47, 31 January 2017 (UTC)

I think we're all in agreement that results shouldn't be used from clinicaltrials.gov. The information being sourced from clinicaltrials.gov is the mere fact that the compound is being investigated, for which it seems to be an adequate source. Natureium (talk) 15:52, 31 January 2017 (UTC)
On success rate for drug candidates across the whole development process, we have this: 9.6% of 'new drug application' candidates make it to market, according to this industry review (Fig. 1). --Zefr (talk) 16:01, 31 January 2017 (UTC)
  • The OP and I have bumped heads on this before. The specific edits under discussion are:
    • "A phase II trial of patients with pancreatic cancer who failed FOLFIRINOX is in progress." cited to the bareURL https://clinicaltrials.gov/ct2/show/NCT01834235. I removed that here with edit note: "WP:NOTNEWS, primary source.
    • Then the OP restored it in this form: "A phase II trial of patients with pancreatic cancer who failed FOLFIRINOX is in progress and is expected to be complete in October 2017." again cited to the bareURL ref>https://clinicaltrials.gov/ct2/show/NCT01834235. I removed that here with edit note "WP:CRYSTALBALL on a primary source" then left this note at the article Talk page: "User:Natureium about this - please read WP:RELTIME (please), please don't refer to "patients" per WP:MEDMOS, and please don't add crystalball content based on primary sources as you did there. We are an encyclopedia not a newspaper so things should not be in the present tense, and our role is not to give blow by blow on drug development steps. If you use secondary sources you can avoid that problem. Please do that. Thanks. "
    • I didn't cite MEDRS anywhere, fwiw.
    • Discussing clinical trials is kind of complicated in my view.
      • The fact that a trial is happening or has happened just needs a RS, and as with everything in WP, that should be a secondary source so that we know it deserves any WEIGHT at all per NPOV, and avoid WP:NOTNEWS issues etc as mentioned above. If no independent, reliable sources discuss it, why should the WP article?
      • To the extent people want to discuss outcomes of early stage trials, appropriate content should express the uncertainty that besets clinical development of drugs, something like "promising enough to continue development" or "not promising enough to continue development" which may be based on signals of toxicity, signals of efficacy, as well as how the results compare to competing drugs (the latter is discussed with regard to the development of a different drug, Fulvestrant, in endometrial cancer in PMID 26882357 - in that ref the authors ask for people to re-evaluate the potential of this drug in that indication, which the company stopped working on for business reasons - namely they didn't think doctors would use it and they would therefore get insufficient sales to justify further investment, because the drug didn't show much differentiation from already-marketed drugs in the Phase II). If content isn't elaborate about outcomes then I use plain old RS sources; if outcomes are interesting enough to be elaborated on, that needs a MEDRS in source as it is getting into biomedical science.
      • We ~sometimes~ get into fusses with the regard to Phase III trials, like what happened on the Fulvestrant article where a new editor demanded discussion of a phase III trial published in the Lancet, and got so angry that they opened an ANI on it here. These are borderline cases and are exactly discussed in WP:MEDREV; I can see times where we would temporarily add content based on the primary source about the Phase III trial, if it was clear from other MEDRS refs that the outcomes were super important for some reason (answering some long standing question with wide consequences or something), but then replaced by a MEDRS asap. The editor in this case was too angry to even get there. But almost especially for Phase III results, secondary MEDRS sources are best. I think folks are well aware that publications of Phase III results driven by companies are shaped (as was the design of the trial itself) to try to show differentiation from other drugs or treatments. Some publications are better than others at not warping the description of the results and their interpretation in order to achieve that. Jytdog (talk) 16:37, 31 January 2017 (UTC)
btw WAID, the competing "treatment" in the original development of PCSK9 inhibitors like Alirocumab is apheresis - a device based treatment, not a drug. That is discussed in the last paragraph at Alirocumab#Society_and_culture and drove pricing decisions. Jytdog (talk) 16:37, 31 January 2017 (UTC)
This edit is what made me ask the question today, but it's come up in the past as well, and I don't care right now to go through every article I've edited to see what's been removed. Most of the time, I've given up, because I'm a non-confrontational person. However, your NOTNEWS argument assumes that clinical trials are fleeting, rather than essential parts of the development of a drug that are going to be relevant even after the clinical trial is over. You may only care about the current status of a drug once it's marketed, but its history is important as well. Natureium (talk) 16:44, 31 January 2017 (UTC)
Content about a clinical trial being ongoing is very fleeting. Extremely fleeting. The essence of fleeting. Once a trial is completed that is an enduring fact. The fact that a trial was started, is an enduring fact - it is also one that may never have any significance if the trial is not completed (insufficient enrollment, runs out of money, etc) or the results are never made public. WP:NOTNEWS is policy and you should read it and edit according to it. Jytdog (talk) 19:27, 31 January 2017 (UTC)
I agree that just being listed on clinicaltrials.gov is not enough to show notability. We have MEDRS to help keep content we contain notable. We are not a directory of trials. Best to stick with high quality review articles. Doc James (talk · contribs · email) 02:23, 1 February 2017 (UTC)

I'm seeing several points above, and thought I'd make a quick summary-with-my-notes for anyone whose eyes might be glazing over:

  • Clinicaltrials.gov is neither the best nor (unfortunately) the worst source we've ever seen for statements about temporal/historical fact about a clinical trial.
    • If that source says that the manufacturer is running a clinical trial in X city or of Y phase, then it's unlikely to be wrong (unless the page contains the unfortunately common warning about not having been updated recently).
    • But please don't use it for "conclusions" about a trial, such as whether the thing works.
  • Putting clinical trials information into an article about a medical condition is, and should be, different from putting the same information into an article about the investigational drug itself.
    • If you write an article for an investigational drug, and you do not specify the current status of the drug (e.g., "in Phase II trials {{as of|January 2017}}"), then you have made a mistake. Citing clinicaltrials.gov is not the best way to support that, but it's better than nothing.
    • In terms of disease articles, relevance (as demonstrated by the existence of high-quality sources) becomes the most important factor. For example, there are lots of trials about reducing cholesterol, so who cares about this one? The ==Research directions== section for that article should speak about general trends. But a clinical trial to cure a currently untreatable rare disease should probably be included (possibly with an even better source).
    • We don't want articles to function as a patient-recruiting mechanism for clinical trials.
  • There are multiple potential audiences for an article about an investigational drug:
    • Patients (and their loved ones) – We don't want them to misunderstand the status or meaning of a trial, and, since we assume that none of them are as informed as us and some of them are desperately seeking a hopeful prognosis, we are afraid that they will misunderstand everything.
    • Pharmaceutical industry (from researchers to investors) – We want them to get reasonably current, factual information (e.g., about their competitors' work) from Wikipedia, just like the computer industry or the entertainment industry can get some factual information about their competitors' areas of interest and strategic decisions from Wikipedia.
      • Informing this audience requires us to include information about past clinical trials and treatments that failed or for which development was discontinued. (I like Jytdog's suggested language of "not promising enough to continue development".)
      • Wikipedia is NOTNEWS, but Wikipedia does and should reflect the business/financial news for all industries. Statements such as "Mega Corporation discontinued development of this product in 2015, after spending six jillion dollars on it" or "BigPharma, Inc. sponsored clinical trials of Their Product for X indication from 2014 to 2017" (in an article about the business or the product).
      • We tend to be bad at this. On the one hand, we're afraid that patients will read them and make the wrong choices, so we don't want to say anything beyond "statistically, whatever the drug is, it's not going to work". We also don't have very many people who are interested in these articles, so the articles become out of date. To prevent out-of-date articles, we try to limit articles to 'eternal' information. It's not a good approach, but it might be the best we can do in some instances.
    • Healthcare professionals (e.g., physicians) – They mostly don't care about investigational drugs, because they haven't been approved (yet) in their home country and are therefore irrelevant to daily practice (for >98% of healthcare professionals who provide direct care). A lot of WPMED folks fall into this category; one of the results of this fact is that we tend to overemphasize this audience's concerns at the expense of other people's concerns.
  • The exact wording and the exact location and the exact circumstances really, really matter.

Okay, that might be too long to be as potentially helpful as I'd originally envisioned. Did I miss anything important? WhatamIdoing (talk) 07:41, 1 February 2017 (UTC)

"Wikipedia is NOTNEWS, but Wikipedia does and should reflect the business/financial news for all industries. Statements such as "Mega Corporation discontinued development of this product in 2015, after spending six jillion dollars on it" or "BigPharma, Inc. sponsored clinical trials of Their Product for X indication from 2014 to 2017" (in an article about the business or the product)."
This is a big point for me. It seems that a lot of editors don't care about including business/economic information in articles about pharmaceuticals, but that's a major part of the information about a drug.
"Putting clinical trials information into an article about a medical condition is, and should be, different from putting the same information into an article about the investigational drug itself." and "In terms of disease articles, relevance (as demonstrated by the existence of high-quality sources) becomes the most important factor. For example, there are lots of trials about reducing cholesterol, so who cares about this one? The ==Research directions== section for that article should speak about general trends. But a clinical trial to cure a currently untreatable rare disease should probably be included (possibly with an even better source)."
I agree. I don't think an individual clinical trial would be notable in an article about a medical condition, but a mention of something like "tyrosine kinase inhibitors are being investigated as a treatment for this condition, although none have been approved" would be.
"If you write an article for an investigational drug, and you do not specify the current status of the drug (e.g., "in Phase II trials {{as of|January 2017}}"), then you have made a mistake. Citing clinicaltrials.gov is not the best way to support that, but it's better than nothing. "
This is something that I think it important. Jytdog is saying that clinical trial status is "The essence of fleeting." but so is the fact that a famous person is attending a certain university, and that's certainly put in articles, because it's important information. Clinical trials generally last several years and are still important after they're concluded.
I'm not trying to create long lists of clinical trials, but rather say things like "Examplemab is being investigated in phase II trials for the treatment of pancreatic cancer[1] and colorectal cancer[2]. A phase III trial to determine efficacy in small cell lung cancer was terminated.[3]" How would this not be notable in an article about the experimental drug examplemab, which isn't approved for anything yet? Without mentioning what it's being developed for, you're missing a major part of the information. Even failed clinical trials are relevant for the business/financial information of a drug.
We aren't just a drug information database. A myriad of those already exist. If we want to have comprehensive articles about drugs, they should include comprehensive information, not just information for people who are taking/wanting to take the drug. Natureium (talk) 15:16, 1 February 2017 (UTC)
I care a great deal about the business end of things. My additions to Ensituximab were almost entirely about what has gone on with that compound moving it from antigens in a freezer to where it stands today. Doing that in an encyclopedia is entirely different from what Seeking Alpha does. (WAID, a class of readers you left out is "Stockholders and people who day trade'.) Crazy hype follows publicly traded biotech companies in forums like Seeking Alpha and stock prices bounce and crash based on Phase I and II outcomes, and people anticipate their end-dates and do things like buy stock or short it as clinical trial end-dates approach. I stumbled across Peregrine Pharmaceuticals and related on articles on drugs in their pipeline that were just a mess and cleaned them up. I later found out that members of a stock trading board had hijacked these pages and were using them to hype the company and the drugs. (see here for the reaction at that board.) This is not what WP is for.
But we should indeed provide encyclopedic information about the business stuff - all the work that it actually takes to bring to a new drug to market. There is stuff there for lots of different kinds of people to learn from.
There is no encyclopedic value to saying X trial is ongoing and projecting its end-date. Jytdog (talk) 16:50, 1 February 2017 (UTC)
The rhino in the room is that a very large proportion of trials listed on clinicaltrials.gov never report results: there's rarely a profit in reporting "failed" trials. The result is an unacceptable bias toward positive results. It is especially common for camwoo trials to remain listed as ongoing long past the time they should have reported. LeadSongDog come howl! 18:31, 1 February 2017 (UTC)
No one is suggesting that we use clinicaltrials.gov to document that a drug is efficacious (a medical claim). We are only suggesting that it may be used to document that a drug has been in clinical trials (not a medical claim). Reporting bias is irrelevant in this context. Boghog (talk) 19:14, 1 February 2017 (UTC)
If there are no independent RS discussing it (plain old RS) there is really no justification per UNDUE to include it. clinicaltrials.gov postings are basically SPS with respect to the sponsor of the trial. There is a high bar for submitting info and requirements that must be met, but it is still entirely done by the sponsor. kind of similar to a patent, which is explicitly discussed in WP:SPS. You can contrast that with a drug label which is scrutinized like crazy by regulators before it is published. Jytdog (talk) 20:02, 1 February 2017 (UTC)
Again, completely missing the point. clinicaltrials.gov and patents may be used to document that a company has tested a drug in clinical trials or claimed an invention, not that it works. No medical claims are being made here. The fact that drug companies are exploring a target in itself may be notable. Boghog (talk) 20:16, 1 February 2017 (UTC)
And again, it appears that you are completely missing the point. If the only source available to us that discusses a trial is Clinicaltrials.gov, then we are not in a position to decide for ourselves that the fact that a compound or intervention is in trials is notable. Establishing notability requires independent sourcing, not merely the existence of a Clinicaltrials.gov entry. Note, as well, that because Clinicaltrials.gov relies on study sponsors to submit updates for their records, the site is often very badly out of date. Studies may be delayed, suspended, or terminated without notice; reports of success, failure, or just plain abandonment of trials can appear months or years late—or never appear at all. In other words, the existence of a record on Clinicaltrials.gov reporting that a trial is underway is not actually a reliable indicator that a trial is actually underway. TenOfAllTrades(talk) 20:34, 1 February 2017 (UTC)
It is a reliable indicator that an IND has been filed and the FDA has approved the trial and that fact alone may be notable. Boghog (talk) 20:46, 1 February 2017 (UTC)
I really, really don't like arguments like that bypass normal policies and guidelines; like that a secondary school exists makes it notable, or that a radio station has a license to broadcast makes it notable, or that a journal haveing an impact factor makes it notable. Per NPOV we need independent secondary sources to assign WEIGHT; if there are none it is UNDUE. Really boghog please don't go there. Jytdog (talk) 20:50, 1 February 2017 (UTC)
And I really, really don't like arguments that overextend normal policies and guidelines. From a medical standpoint, clinical trials that have not been covered by secondary sources clearly have no significance. From a business stand point, clinical trials are expensive and the fact that a company has started one may be notable. Boghog (talk) 21:08, 1 February 2017 (UTC)
It's is true that those facts indeed "may" be notable for a particular drug or other intervention. Then again, they may not be. Either way, we shouldn't – and don't need to – be in the business of making that notability call ourselves, solely on the basis of a Clinicaltrials.gov entry. Again, if those particular facts are notable and relevant in any specific instance, then we would expect (and should require) the existence of independent reliable sources to support that assertion of notability. TenOfAllTrades(talk) 20:56, 1 February 2017 (UTC)
We have a number of articles on investigational drugs that have not yet been approved for human use. Most of these have been covered by secondary sources so the subject itself is notable. In these cases, clinicaltrials.gov may be useful in documenting the current status of the drug candidate. And of course, once secondary sources that cover these trials appear, the clinicaltrials.gov citation should be replaced. Boghog (talk) 21:25, 1 February 2017 (UTC)

break for clinicaltrials.gov

Let's back up a minute. Imagine the typical clinical trial for a new drug: sick people (including advocacy groups) + hospital (including researchers) + pharma company, right?

That's a minimum of two, and probably three or more organizations, right? And that means a minimum or two, and probably three or more publicity departments. What do you think the odds are that a clinical trial like that will never get a little news article somewhere?

I don't know about you, but I'm putting the odds right down at zero. My guess seemed testable, so I went to clinicaltrials.gov and set the search to find the most recent additions (=the trials least likely to have publicity, because they're new), in Phase II (=the earliest stage that we typically have an article about).

First drug (well, really a biologic) in the list: a vaccine against norovirus, with a news article here about the fact that trials are happening, easily found in Google News. The next couple are already approved (so lots of sources will be available), so I skipped them. Varlilumab has several business articles; Motley Fool has mentioned the drug and its clinical trials five times during the last month alone. Third one: Durvalumab's trials are all over the news.[1][2]

I stopped there. IMO the question shouldn't really be whether anyone pays attention to clinical trials for investigational drugs (specifically; I explicitly exclude the clinical trials that answer questions like "does exercise make you healthier" or "is aspirin better than ibuprofen"). The business news definitely pays attention to the existence and status. The question is really just: is this an adequate citation to verify these facts? It depends on the exact circumstances, but overall, I think we can assume that for an as-yet-unapproved investigational drugs, it will almost always be WP:DUE to note the existence of clinical trials (i.e., what phase of development the product is in).

Separately – given that we've already determined that this information is almost always DUE, in the same category as "should we normally include a birth year in biographies, even if we don't have independent sources making a big deal out of the person's birthday?" – a current entry at clinicaltrials.gov is not ideal for this information, although IMO it is probably adequate for it. We could do worse. WhatamIdoing (talk) 21:52, 1 February 2017 (UTC)

Thanks WAID for getting the discussion back on track. I think everyone especially myself needs to chill out. Keep Calm and Carry On. Cheers. Boghog (talk) 17:50, 2 February 2017 (UTC)
I do not agree that anything in Wikipedia is "almost always DUE". That is an essentializing notion that people inevitably abuse. Everything actually does depend on sources, other than truly blue sky things.
I agree that for most Phase II trials one should be able to find at least one independent, reliable source for it and that instead of arguing about clinicaltrials.gov folks just should get off their asses and find such sources.
And btw MotleyFool is a stock-traders board and full of SPS, reprinted press releases, etc. Not great. Jytdog (talk) 19:28, 2 February 2017 (UTC)
Of course we should use the best available sources. However there are times when clinicaltrials.gov is the best available source. You are raising all kinds of off topic issues. Patents, MotleyFool. Calm down. Boghog (talk) 19:35, 2 February 2017 (UTC)
No, the issues are not OFFTOPIC at all. If clinicaltrials.gov is the only source, the trial is not noteworthy and content about is UNDUE. Nothing is "inherently noteworthy" or "inherently notable" or "inherently DUE". But as WAID pointed out, cases where there are no independent secondary sources for a Phase II trial should be rare and not worth wasting time arguing about in a general discussion. Jytdog (talk) 20:02, 2 February 2017 (UTC)
Agree that clinicaltrials.gov is not, alone, evidence of notability; it is a reliable source for info about a trial. — soupvector (talk) 23:45, 2 February 2017 (UTC)
It doesn't matter if the trial is notable. We're not writing separate, whole articles about each trial! We're just trying to decide if it's DUE to say things like "this is being tested in a clinical trial" (aka "No, you can't buy this at the pharmacist's yet"). IMO this basic information about whether a product can be legally sold is always due, and the fact that someone has (currently) cited a minimally acceptable source doesn't change that.
Oh, and once a single apparently acceptable source has been presented, the BURDEN's on the editor who wants a better one, not on the guy who's being told "bring me a source – no, not that kind, bring me another source". WhatamIdoing (talk) 00:35, 3 February 2017 (UTC)
I did not confuse notable (for articles) and noteworthiness/DUE-ness for article content. They are distinct. Editors often get confused about "inherent" qualities of things (topic X is always notable, or topic X is always DUE) and it is the same essentialist fallacy underlying both arguments. And no primary sources should not be used willy nilly. They should be used with care not as the go-to ref; if an editor goes looking and all they find is clinicaltrials.gov, they should not add it. They should not be lazy and reach for clinicaltrials.gov and force other editors to waste their time trying to determine if the specific clinical trial has indeed received attention in secondary sources. The approach you are advocating here is opening the door to wide to UNDUE content and wasting other people's time. Jytdog (talk) 02:33, 3 February 2017 (UTC)
I hope that nobody misinterprets my words that clinicaltrials.gov is "a minimally acceptable source" as recommending it as "the go-to ref".
As for "wasting other people's time", I think that goes both ways: if someone adds a minimally acceptable source about reasonable content, then reverting them and telling them that it's not the best possible source is a waste of their time. My time and yours are not the only limited resources here. WhatamIdoing (talk) 17:30, 3 February 2017 (UTC)
that is where the rubber hits the road. it will generally be newbies or people trying to promote the company or the trial, and both need to learn how to edit aiming for high quality. Good faith editors will learn to use better refs. Jytdog (talk) 21:05, 3 February 2017 (UTC)
Experienced editors will look for better refs and if not available will use minimally acceptable sources. Boghog (talk) 22:39, 3 February 2017 (UTC)
Sure if they are driven by what they think is important, and not what reliable, independent sources say - sure they will. That is an endemic problem, for sure. Jytdog (talk) 18:55, 8 February 2017 (UTC)::::::::::Well, experienced editors should have a whole range of responses available to them. A very quick and easy response to this type of situation would be accepting the minimally acceptable source but tagging it with {{better source}} or {{third-party inline}}.
One of the problems with assuming that good-faith editors will learn to use better sources is that learning requires understanding why the contrbution disappeared in the first place. Typically, when people's first substantive contributions get blanked, they don't know what happened, they don't know how to check the history page to see any edit summaries that might explain it, and they just give up. Remarks along the lines of "I tried to expand a page, but I looked at the page a couple of days later, and my contribution was gone. I guess Wikipedia doesn't think that my work is good enough, so I quit trying" has turned up time and again in user research about why people quit contributing.
Also, I think it would be more appropriate to say that learning our complex sourcing policies requires dedication, rather than the mere presence of good will. People who aren't being paid to cram some fact into Wikipedia might not be dedicated enough to get past the barriers that we're erecting for them. WhatamIdoing (talk) 20:56, 4 February 2017 (UTC)
I hear that and I wish that WMF marketing and training materials managed expectations better and put more emphasis on the fact that while there is lots of things missing from WP and lots of underdeveloped articles, great swaths of Wikipedia are mature. Especially in those mature areas (but in many others), initial efforts to try to edit are going to be rejected because they aren't good enough in any number of ways. When I look at WMF materials I worry they are setting people up for disappointment. Hard balance to strike, but there is a learning curve here. For newcomers who weren't exposed to WMF marketing/training and give up after a failure or two, there is not a lot we can do about that.
About half the time (?) I revert an obvious newbie error i follow up with a note on the editor's talk page about whatever the problem was. Not always. Should probably do that more. But there is never enough time.Jytdog (talk) 18:55, 8 February 2017 (UTC)
<rearranged into mostly chronological order here, ending here>
To the extent clinicaltrials.gov documents that a clinical trial has occurred is both reliable and independent. Boghog (talk) 19:27, 8 February 2017 (UTC)
Boghog how is an entry at clinicaltrials.gov different than a patent with respect to WP:RS? (please do read WP:SPS before you answer) It is a real question. Jytdog (talk) 23:21, 8 February 2017 (UTC)
The critical point is what the source is being used for. A patent is reliable source to document someone has claimed an invention, but not to document that the invention works. An entry in clinicaltrials.gov is a reliable source to document that a clinical trial has started or has completed, but not to document that the drug is efficacious. So in that respect, patents and entries in clinicaltrials.gov are similar. It is also important to keep in mind that the hurdles for starting a clinical trial are much higher than filing a patent application. Boghog (talk) 06:15, 9 February 2017 (UTC)
"Has completed"? No, because many trials never report there completion, particularly when the results are unfavourable to the funders. Perhaps "has reported" but that's not even close to the same thing. LeadSongDog come howl! 07:10, 9 February 2017 (UTC)
"Has completed"? Yes, because one needs to stick to what the source says. If clinicaltrials.gov says completed, it has completed. If clinicaltrials.gov has not said the trial has completed, of course one cannot state that in Wikipedia. The problem of course is that many trials have never reported any results so it is impossible to say what has happened, but at a minimum, we do known that the trial has been registered with the FDA. The good news is that reporting standards have recently been strengthened. Boghog (talk) 07:40, 9 February 2017 (UTC)
Since when do we echo the words of primary, (nearly self published) sources in the voice of the encyclopedia? We're fine with "On clinical trials.gov, the investigators reported that "the study is complete". We will not simply say "the study is complete" without in-text attribution unless there is a reliable, secondary source. LeadSongDog come howl! 08:53, 9 February 2017 (UTC)
If it says on clinicaltrials.gov that the study has completed, the study has completed. The possible issue is the opposite. Results are not always updated, so it may say a study is in progress when it has been completed but it hasn't been updated in the NIH database. Natureium (talk) 18:57, 9 February 2017 (UTC)
good point--Ozzie10aaaa (talk) 11:50, 20 February 2017 (UTC)

LeadSongDog, think about that: When do we echo the words of primary, unambiguously self-published sources in the voices of the encyclopedia?

Well, pretty much every minute of the day. Every time we report the track listing for a music album without adding a qualifier that amounts to "remember, this is just what the band says is on the album – they might not know what the songs they recorded!" Every time we use a DVD to make a list of actors. Every time we cite a corporate or organizational website about their staff and products. Nobody ever writes "Microsoft Office is word processing software – well, according to Microsoft, so take that claim with a grain of salt". And so forth. We do this all the time. WP:INTEXT attribution isn't used for every self-published source, because the self-published sources can be reliable or even authoritative.

The question we have to answer is this: If the researchers actually report to clinicaltrials.gov that the trial is closed or completed, then what's the chance that they're factually wrong about that claim? If you wanted to get someone into a clinical trial, and it was listed there as closed, would you realistically phone up the researchers and say, "Hey, I saw that the trial is listed as closed, but I figured that might be wrong, so I'm calling about this person that I think you should enroll"? Or would you, realistically, rely upon that information being correct, and look for a different trial? WhatamIdoing (talk) 22:34, 9 February 2017 (UTC)

Please tell me you don't seriously wish to see WPMED adopt the level of sourcing used in discography articles;-) It is not our place to "answer" questions. We summarize answers already published in RS and by citation permit readers to make their own determination whether to accept those answers. The circumstance of a CT having completed without findings published should be a transient one. If it is not transient, that would be very troubling, albeit that we may have grown accustomed to this happening. Since WP is NOTNEWS, waiting for the transient state to pass should be the norm. If investigators get a few phone calls because they haven't published findings, perhaps that could be considered a good thing? LeadSongDog come howl! 23:11, 9 February 2017 (UTC)
Well, you didn't specify medical content, so I answered the question that you asked.  ;-)
I'd rather see "This trial on investigational drug completed" sourced to clinicaltrials.gov than "This trial is currently underway", sourced to an out-of-date source, no matter how stellar it used to be.
And the researchers aren't going to get those calls. The profession relies upon the information about recruiting status being correct. The best-case scenario is that the healthcare world will read our article, check clinicaltrials.gov (which they need for inclusion and contact information), discover that our articles are out of date, and think that Wikipedia is an unreliable source of information.
P.S. And when the results are reported, the report will be a primary source, and someone will refuse to allow us to include that because it's not a review. So we'll be stuck with "BigPharma launched a clinical trial for indication X in 2011", sourced to a financial news story, in the article for years, because the ending of the trial is "transient" and should wait for the results to be reported, and when the results are reported, then the existence of only primary-source peer-reviewed papers is "temporary" and should wait for a proper review. In the meantime, we are providing out-of-date and incomplete information to readers for largely artificial reasons, instead of providing historical facts (e.g., the trial finished) from the best reliable source that's available to the world. WhatamIdoing (talk) 17:13, 10 February 2017 (UTC)

Scar free healing

Thoughts on this? Doc James (talk · contribs · email) 07:13, 20 February 2017 (UTC)

Much better than I had initially thought, but still needs some work to adhere to MEDRS & MEDMOS. Will look later. Carl Fredrik 💌 📧 07:43, 20 February 2017 (UTC)
Yes it is not bad. Doc James (talk · contribs · email) 16:34, 21 February 2017 (UTC)

List of beneficial weeds

There are a bunch of medical and quasi-medical claims at List of beneficial weeds, especially in the Medicinal use section. If someone who knows what they are talking about could give this some attention, Wikipedia (and the world) would be better for it. Thank you.  SchreiberBike | ⌨  05:04, 11 February 2017 (UTC)

It's not just the medical and quasi-medical claims that need attention; there's also the largely pseudo-scientific notion of companion planting, apart from the problem that "weed" is almost impossible to define clearly. Ideally the whole article should simply be deleted. Peter coxhead (talk) 12:10, 11 February 2017 (UTC)
Companion planting isn't pseudoscientific; it's just the agricultural version of Mutualism (biology). Some of the benefits of intercropping are due to this effect. WhatamIdoing (talk) 16:54, 11 February 2017 (UTC)
This isn't the place to discuss this issue, but if there is sound scientific evidence for many of the claims about particular "companion plants", then please add the sources to companion planting. Peter coxhead (talk) 21:58, 11 February 2017 (UTC)
Whether or not companion planting is a scientific or pseudo-scientific notion is not for me to say. That is something that seems rather out of the scope of our concerns here at WP Medicine. What is also not for me to opine on in what defines a "weed" and what does not, because honestly, my definition would probably be unacceptable for most. What is of concern are any claims of medicinal benefits of certain plants. However, such claims should be backed by sound evidence. Otherwise, I can't say that it's necessarily safe to deem such claims as reliable merely based on hearsay or popular belief. As members of the scientific community, we need objective evidence, not biases of certain individuals. I'm aware that some plant-based medicine does have scientific evidence to back it up. Let's start by critically evaluating that evidence and seeing how it fits in with the rest of the puzzle. As for other claims, the possibilities are endless for research opportunities! What we can do is work with our colleagues in WP:Plants and WP:Agriculture to curate a list of "medically-important plants", and then sift through the literature to find evidence backing up those claims.N. Jain talk to me 01:28, 12 February 2017 (UTC)
I frequent both medicine and agriculture projects, but both perspectives give me a headache when looking at this list. I'd pretty much be in favor of gutting the list of anything that isn't referenced, and a lot of poorly referenced things could go to. As others mentioned, companion planting is a thing in agriculture (planting oats to give your alfalfa some cover so it can establish comes to mind as a normal mainstream use), but there is a lot of woo in that overall topic (biodynamic agriculture, organic, etc.). I'm not sure if the list could be considered notable since a weed with a use isn't really a weed anymore, but I'll take a closer look when work settles down at least. Kingofaces43 (talk) 00:56, 13 February 2017 (UTC)
Kingofaces43 I see your point, that a weed with a use isn't really a weed anymore. I'm of the belief that a weed is any plant that is introduced or invasive in a particular region. That definition would conflict with most people's idea of a weed I think. I don't necessarily mean to have a Wikipedia page dedicated to such a list, but rather a list, similar to a things-to-do list just for personal reference for anyone interested in working on the realm of medically-important plants. 18:26, 13 February 2017 (UTC) — Preceding unsigned comment added by Njain1091 (talk • contribs)
"Introduced in a particular region" covers all commercial crops almost everywhere, and almost all garden plants almost everywhere. Not a particularly useful definition. • • • Peter (Southwood) (talk): 05:12, 20 February 2017 (UTC)
Peter (Southwood) I agree, that it is not a useful definition. And neither is there a particularly agreed upon definition of what constitutes a weed. So I think the problem is (which is not of our concern) that there is no consensus of what a weed is. Therefore, I think that we can safely forget about this topic and let another WikiProject deliberate over it. N. Jain talk to me 19:07, 20 February 2017 (UTC)
However, I would be interested to partner up with anyone who would be interested to investigate medicinal plants and the current evidence. I am always eager to learn! N. Jain (talk to me) 19:11, 20 February 2017 (UTC)
The best definition I've seen (just amongst chatting to other professors who teach intro bio every year) is that a weed is a plant out of place. Not useful for sorting this topic out on wiki per se. Wikiproject Agriculture would be the project most in line with the topic outside this project, but it's also not extremely active. Kingofaces43 (talk) 14:15, 22 February 2017 (UTC)

Keratoconus FAR

The FAR on Keratoconus was opened in August 2015 and received little response. Please, leave comments and save this article from being demoted. Hanif Al Husaini (talk) 12:48, 22 February 2017 (UTC)

It was hit by a lot of COI editing. I cleaned up much of it. Doc James (talk · contribs · email) 17:41, 22 February 2017 (UTC)

Misleading information on Wikidata

Quite recently, there were threads here concerning the compiling of information on Wikidata with the property drug or therapy used for treatment (P2176) (Wikipedia talk:WikiProject Medicine/Archive 92 #Wikidata for pneumonia (failed experiment maybe) and Wikipedia talk:WikiProject Medicine/Archive 93 #Bot glitch replaced descriptions at Wikidata). In an effort to explain to the editors over at Wikidata the problems caused by creating such broad property as one that has for its description "drug, procedure, or therapy that can be used to treat this medical condition (this isn't a statement about its effectiveness)" - which I regard as an oxymoron - I posted my concerns on the talk page of the property d:Property talk:P2176. As I might have expected, there's now a reply that seeks to justify the use of the property for just about any drug for just about any condition. I regard the current position as both misleading and irresponsible and I've said so. Jytdog commented there earlier, but unless there are others who comment, we'll be left with no change to the status quo. --RexxS (talk) 18:23, 22 February 2017 (UTC)

more opinions(gave mine)--Ozzie10aaaa (talk) 11:26, 23 February 2017 (UTC)

What this example shows is, as ever, how undesirable and misleading "data" is without context and evaluation. Unfortunately more and more information from Wikidata is being imported automatically, without even a consideration of consensus here. (As an example from a different topic area, consider the addition of {{taxonbar}} to organism articles. The editor who adds the template may or may not have reviewed it as it was added, but when extra Wikidata properties are added globally, they certainly won't.) I suspect that only action at quite a high level in the Wikipedia hierarchy can do anything about this creeping expansion. Peter coxhead (talk) 12:33, 23 February 2017 (UTC)

Anybody want $200?

If you'd like to do something useful for Wikipedia while earning $200 during March, then please see Wikipedia:Village pump (policy)#.24100 in cash to any editor who can break my record in March. WhatamIdoing (talk) 20:36, 22 February 2017 (UTC)

thanks WAID--Ozzie10aaaa (talk) 18:17, 23 February 2017 (UTC)

Biox

Dear medical experts: Here's an unassessed article about a company that made medical devices. There appear to be lots of sources available for information about the company, and I have added a couple of references and removed some promotional language. However, there is also information about the company's products which would better be improved by someone with medical knowledge.—Anne Delong (talk) 12:57, 23 February 2017 (UTC)

maybe merge to Pulse oximetry--Ozzie10aaaa (talk) 18:16, 23 February 2017 (UTC)
It's probably notable, and if we decide against keeping it as a stand-alone article, then it'd make more sense to merge it to the company that bought it. A mention (and link to the article) in Pulse oximetry would be reasonable. WhatamIdoing (talk) 22:34, 23 February 2017 (UTC)

Surgical procedures and instruments: Electrosurgery and Radiofrequency ablation

RFA- CT scan showing radiofrequency ablation of a liver lesion

i have been kind of thinking about this for the past year or so. In my view the two articles above are about the same thing and should be merged. The content tries to draw a distinction that electrosurgery is high frequency and RF ablation is medium frequency but i don't think this is true or meaningful. Both involve using instruments with electrodes that need to touch tissue, that run electrical current through tissue. (different from Microwave ablation which transmits energy via an antenna). (While you are thinking about this, what do you all think of Radiofrequency ablation (thyroid)?) Putting notices of this on the relevant talk pages.

Thoughts? Jytdog (talk) 18:31, 18 February 2017 (UTC)

Radiofrequency_ablation_(thyroid) has no references and does not exactly follow MEDMOS...IMO--Ozzie10aaaa (talk) 07:04, 19 February 2017 (UTC)
Moved that one to Draft:Radiofrequency ablation (thyroid). Carl Fredrik 💌 📧 17:56, 19 February 2017 (UTC)

I don't think they should be merged, although the underlying technique is the same, the applications that each term is referring to are very different. --WS (talk) 12:39, 24 February 2017 (UTC)

Nicotinamide adenine dinucleotide

Could use more eyes, likewise Nicotinamide riboside

See: Talk:Nicotinamide_adenine_dinucleotide#new_content -- Jytdog (talk) 00:58, 9 February 2017 (UTC)

will keep on both(and commented[3])--Ozzie10aaaa (talk) 11:19, 9 February 2017 (UTC)


Two weeks ago I tried to make a meaningful contribution to the NAD article on Wikipedia. It was labeled as «promotional garbage» by user:Jytdog. The last part of his edit summary was also pure and intended nonsense, and had nothing to do with the content of my original edit.

Within a couple of hours or so I was «edit warring», guilty of «sock puppetry» and given a free, one week sabbatical from Wikipedia. My original edit, a short passage, is now on display at the NAD talk page.

Feedback from other users is appreciated. Thank you. Clowns und Kinder (talk) 19:09, 24 February 2017 (UTC)


NNT graphics

Way down at the bottom of this long article at ProPublica (which is totally worth the time to read or listen to), there's a chart that shows the Number needed to treat and Number needed to harm for a type of drug. I'm really happy with the way this conveys, at a glance, the value that a treatment does (or doesn't) provide. What do you all think about us creating a similar-ish template that would let us plug in the numbers for a given treatment and condition, and then use that template in the ==Treatment== sections and/or in articles about drugs? WhatamIdoing (talk) 07:40, 24 February 2017 (UTC)

Link does not work for me. • • • Peter (Southwood) (talk): 10:59, 24 February 2017 (UTC)
That would be cool. Would be a nice graphic for the cases were we have evidence to support its creation. Doc James (talk · contribs · email) 12:55, 24 February 2017 (UTC)
You may have better luck with this link instead: https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no-but-doctors-say-yes/517368/ (it's the same article).
I read the article in the Atlantic, but did not see any chart of NNT or NNH. I did find a link to this. Is it similar? Cheers,• • • Peter (Southwood) (talk): 19:37, 24 February 2017 (UTC)
We should probably have the template support a caption (which could/should include a source as well as 'these numbers are only for older women' or whatever qualifiers are relevant), but ideally, this information would already be in the article, too. WhatamIdoing (talk) 18:20, 24 February 2017 (UTC)

Competent editor needed

To merge Draft:Oroantral fistula into Oroantral fistula please. Two broadly similar drafts were submitted to AFC at about the same time (by different editors). One got accepted and the author of the other was advised to merge their draft into the accepted article. However it seems that neither of the original authors are comfortable with this task. Roger (Dodger67) (talk) 14:09, 15 February 2017 (UTC)

They both need a lot of work. Have done some. Doc James (talk · contribs · email) 07:12, 16 February 2017 (UTC)
Is this still being worked on? The merge still needs to be completed. Roger (Dodger67) (talk) 21:49, 24 February 2017 (UTC)

{{Wikipedia:WikiProject Medicine/App/Sidebar}}

Hey All We have a new sidebar. Have placed it in the external links section of a couple of articles. One example can be seen here Gout#External_links just below the box linking to media on Commons. Peoples thoughts on placing this in a few articles? Doc James (talk · contribs · email) 13:49, 23 February 2017 (UTC)

It isn't visible in mobile view. Carl Fredrik 💌 📧 14:09, 23 February 2017 (UTC)
Fixed the issue, but it still doesn't look entirely satisfactory. Can't really figure out why/how {{Commons category}} shows up, seeing as it is also based off {{side box}} — which seems to be filtered out… Carl Fredrik 💌 📧 14:28, 23 February 2017 (UTC)
Shows on mobile but agree the formating is not perfect yet. Doc James (talk · contribs · email) 15:39, 23 February 2017 (UTC)
Okay improved the formating on mobile. Doc James (talk · contribs · email) 15:49, 23 February 2017 (UTC)
looks good--Ozzie10aaaa (talk) 01:42, 24 February 2017 (UTC)
Isn't this a WP:SELFREF issue? WhatamIdoing (talk) 22:35, 23 February 2017 (UTC)

Consensus should be gained in the appropriate manner before something like this is implemented into articles, especially when similar things have proven contentious. Yet: The sidebar was added to Gout and HIV/AIDS here and here; I reverted the additions here and here; they were subsequently re-added here and here. No link to consensus was provided, and the bold, revert, and discuss cycle was shirked. — Godsy (TALKCONT) 23:48, 23 February 2017 (UTC)

No. Wikipedia doesn't work like that. See WP:CON for an explanation of how editing can generate consensus. That's policy and WP:BRD is an essay. If you're that convinced by the importance of essays, you might like to read WP:DRNC. --RexxS (talk) 03:09, 24 February 2017 (UTC)
If a controversial addition is made to an article, then the addition is reverted two days later with a reasonable edit summary, re-adding the addition without consensus is edit warring. That is policy. — Godsy (TALKCONT) 04:45, 24 February 2017 (UTC)
I think you'll find that it's a bit more complicated than that. WhatamIdoing (talk) 07:11, 24 February 2017 (UTC)
Indeed, as is the history of attempts by proponents of this app to advertise it despite objections and without gaining consensus. — Godsy (TALKCONT) 07:38, 24 February 2017 (UTC)
Godsy, Why do you oppose it, and who else opposes it? • • • Peter (Southwood) (talk): 10:54, 24 February 2017 (UTC)
Has been discussed here. A request was made to use a sidebar similar to the commons one instead the noticebar, thus the creation of this. Doc James (talk · contribs · email) 12:59, 24 February 2017 (UTC)
@Pbsouthwood: Aspects of the sidebar have garnered some opposition at Wikipedia talk:WikiProject Medicine/App#Sidebar. — Godsy (TALKCONT) 22:21, 24 February 2017 (UTC)
Godsy The only person I've seen claiming that the addition of the sidebar link is controversial is you. And "the addition is reverted two days later with a reasonable edit summary, re-adding the addition without consensus is edit warring" is complete nonsense. Do you think the folks here can't read WP:EW? An edit war only arises if the situation develops into a series of back-and-forth reverts. - that's the policy. You reverted an editor's good-faith contribution with no other reason than that you wanted the editor to get consensus before editing. Well, that's no reason, and I'd have restored myself if Doc James hadn't beaten me to it. If you disagree with an edit, you supply cogent reasons, and if every edit had to have consensus before being made, we'd never have made an encyclopedia. No wonder we are losing editors year-on-year if they are faced with that sort of stonewalling. --RexxS (talk) 15:26, 24 February 2017 (UTC)
Well it does seem unencyclopedic. What direct relation does this link to download an app have to the encyclopedia topic? Matthew Ferguson (talk) 20:37, 24 February 2017 (UTC)
(edit conflict) @Pbsouthwood and RexxS: There has been a large amount of disagreement over how this app should be advertised in articles. An mfd about the banner was closed as "Keep, but not to be inserted into articles without obtaining consensus to do so." Consensus was not gained, yet it is still present at the top of five articles, against consensus at the mfd. Proponents of the app create advertisements for the banner, insert them into articles, and insist on keeping them there without consensus and despite objections (and against consensus in the case of the banner). Now the sidebar has been created, and inserted into articles, despite objection. All I'm asking is that consensus is gained for it[, in the appropriate manner ("Consensus among a limited group of editors, at one place and time, cannot override community consensus on a wider scale. For instance, unless they can convince the broader community that such action is right, participants in a WikiProject cannot decide that some generally accepted policy or guideline does not apply to articles within its scope."; the sidebar template does not comply with the template section, and may also conflict with the what to link section, of the external links guideline; I made similar points in discussions about the banner, e.g. here), especially before a widespread rollout]. — Godsy (TALKCONT) 20:44, 24 February 2017 (UTC)
@Matthew Ferguson: The app contains a copy of the article that can be accessed offline. In many parts of the world internet access is intermittent or unavailable other than in limited places, and the app seeks to make medical articles permanently available for those people who do not enjoy permanent connections. It fits perfectly well with the WMF vision: "Imagine a world in which every single human being can freely share in the sum of all knowledge. That's our commitment." The app helps our commitment to ensure that "every single human being" has access to our medical information. I see nothing unencyclopedic about that.
@Godsy: If you have objections to the app and our attempts to increase access to medical knowledge for those who don't have a reliable online connection, let's hear them. All I've heard from you so far is secondhand repetition of other people's opinions. This discreet sidebar box is not the banner and you need to adduce some genuine arguments to support your position, not strawmen and red herrings. "Now the sidebar has been created, and inserted into articles, despite objection" - what objection? Your "get consensus before making an edit" objection? If that's all you can come up with, then it's time you dropped the stick and left the discussion to those who understand what a valid objection is. Please review WP:NOT if you're having a problem in trying to find a reasoned objection - if you can't find "didn't get consensus first", there's probably a reason for that. --RexxS (talk) 23:40, 24 February 2017 (UTC)
But isn't this functionality something that is readily achievable by just downloading a print page version of the article as a document to a device? There is already a link in the mediawiki software that provides the option to create an offline version. Matthew Ferguson (talk) 00:34, 25 February 2017 (UTC)
WP:NOT starts by telling us "Wikipedia is not a paper encyclopedia". One advantage of our digital encyclopedia is the ability to follow a hyperlink within an article to a related article. In our article HIV/AIDS it's easy to click on the link to Management of HIV/AIDS, and the offline app preserves that functionality. If you took the time to get all 37,492 medical articles printed out (paper or pdf), how feasible do you think it would be to search through those to get to a linked article? --RexxS (talk) 00:55, 25 February 2017 (UTC)
Can just save as PDF, don't need paper. But yes I understand that the app can have working hyperlinks to other offline articles. Remain unconvinced that link to download an app is appropriate for encyclopedia articles, but then this seems to want to go in external links alongside commons links etc. So it's not too intrusive. Shame we can't get rid of the link to a store that wikimedia put in the side bar without consensus. Matthew Ferguson (talk) 06:03, 25 February 2017 (UTC)
We need to do more for those who are only partly online. We in the developed world take our connectivity for granted. In much of the developing world internet only works for a few hours a day (regardless of how much money you are willing to spend). You typically do not know what articles you are going to need before hand as it depends on what a person presents with. Offline is key for billions of people which is partly why we have seen more than 100K downloads of this 1.2 Gb app.
Would like to see a link to the app download in the left-hand column for medical articles. Would fit well besides "Download as PDF" Doc James (talk · contribs · email) 11:22, 25 February 2017 (UTC)

Alkaline diet – sources

Opinions are needed at Talk:Alkaline diet § Ask Doctor K. about the reliability of different sources for general information about the topic of the alkaline diet – specifically this article by Anthony L. Komaroff and this article from Quackwatch. —Sangdeboeuf (talk) 09:13, 26 February 2017 (UTC)


MFD discussion. See Wikipedia:Miscellany for deletion/Wikipedia:WikiProject Medicine/App/Sidebar. QuackGuru (talk) 17:49, 26 February 2017 (UTC)


more opinions(gave mine)--Ozzie10aaaa (talk) 00:24, 28 February 2017 (UTC)

Process of becoming allergic to something?

Is there an article that covers the process of becoming allergic to something (by developing antibodies in response to a toxin such as beestings or Botox)? I'd like to link it from Management_of_cerebral_palsy#Medication, because one of the side effects of prolonged botulin toxin use is possible allergy. I tried looking up the allergy page, but couldn't find a clearly-written section on the mechanisms behind allergy. Thanks for any help! --122.108.141.214 (talk) 00:16, 28 February 2017 (UTC)

You may be looking for Sensitization (immunology). WhatamIdoing (talk) 00:47, 28 February 2017 (UTC)
Thank you! --122.108.141.214 (talk) 00:59, 28 February 2017 (UTC)

Wikidata again

I just started noticing footnotes appearing in template:Infobox_gene like this one at Bruton's tyrosine kinase: "Drugs that physically interact with Bruton tyrosine kinase view/edit references on wikidata" How did this happen? (see discussion above Wikipedia_talk:WikiProject_Medicine#Misleading_information_on_Wikidata and discussions linked there) This is some kind of whackamole. Jytdog (talk) 21:29, 27 February 2017 (UTC)

apparently few (if any)editors answer/respond at Wikidata talk:WikiProject Medicine--Ozzie10aaaa (talk) 23:01, 28 February 2017 (UTC)

Steven M. Paul

just created this. i have a bit of hero-worship so please review for NPOV. this guy is one of the drivers of the current flowering of interest in discovering CNS drugs at biotech/pharma/VC. thx Jytdog (talk) 05:55, 1 March 2017 (UTC)

was inspired by the creation by someone else of Phil Skolnick, who collaborated with Paul at NIMH. Jytdog (talk) 05:59, 1 March 2017 (UTC)

Article cleanup needed on two neurology-related articles

I encountered Chronic Effects of Neurotrauma Consortium and David Xavier Cifu. The article might have been edited by editors closely related to the subjects, like Dcifu. I hope those around here can look at the articles and trim down or copyedit the articles. --George Ho (talk) 08:04, 1 March 2017 (UTC)

will look (Chronic_Effects_of_Neurotrauma_Consortium)--Ozzie10aaaa (talk) 13:50, 1 March 2017 (UTC)

Disease-modifying treatment?

I came across this concept in the Management of MS article, and I was hoping to link to an article about the general concept in Management of cerebral palsy, because I found a good source saying that CP treatment is usually per-symptom, not disease-modifying. Is there a Wikipedia article which covers the concept of a disease-modifying treatment? --122.108.141.214 (talk) 21:51, 1 March 2017 (UTC)

Relates to disease-modifying antirheumatic drugs, I'm not aware of any article with a broader scope. Carl Fredrik 💌 📧 23:10, 1 March 2017 (UTC)
Thanks! That article implies, without citations, that while 'disease-modifying' originated with antirheumatic treatment, drugs have been used as disease-modifying for other conditions (which gels with the Management of MS article). I guess I was hoping for a broader article, like the uncited stub that Citizendium has that I could link to as an explanation. Because there's a null result with CP (treatments modify the symptoms, not the underlying lesions), it's perhaps not as important, but d'you think it's worth creating a red link in the article in hopefulness? --122.108.141.214 (talk) 23:36, 1 March 2017 (UTC)

Template Mesh2

Hello!

I find {{Mesh2}} (from {{Infobox medical condition}}) don't link correctly when {{{MeshName}}} and {{{MeshNumber}}} are set (and, logically, when Mesh value is clicked). For example in appendicitis. Otherwise, it link correctly when {{{MeshID}}} is set.

In the first case is returned this message:

Internal Server Error

The server encountered an internal error or misconfiguration and was unable to complete your request.

Please contact the server administrator, custserv@nlm.nih.gov and inform them of the time the error occurred, and anything you might have done that may have caused the error. ...

Anybody can solve it?. Thanks! Jmarchn (talk) 18:19, 12 March 2017 (UTC)

Submission at Articles for Creation

Hello, folks. We have a submission at Articles for Creation that is a biography of a now-deceased doctor. The subject's primary claim to notability is being a co-author of a 1943 paper on child-birthing techniques. My review of the sources suggests that this paper had no significant impact in the field, but it would be helpful to get some better-informed opinions on the matter. The draft is Draft:Louis A. Perrotta. The discussion is taking place on the draft's Talk page. Thank you for any assistance that you can provide. NewYorkActuary (talk) 10:46, 2 March 2017 (UTC)

I tend to ignore specific notability criteria and just go by the general ones. Are there sources that specifically discuss him and feature him? If the 1973 New York Magazine article carries a bit about him that is enough for me. However if they only give his name and say he worked there and then only discuss the discovery then it isnt' enough — it has to be about him. The rest of the article needs trimming, and it may be that this will be a 3-4 paragraph article, but that should be fine — as long as it doesn't just list his various memberships like it does now (no-one reasonably cares about that). Carl Fredrik 💌 📧 10:54, 2 March 2017 (UTC)
Although full discussion of the draft will be taking place on the draft's Talk page, I'll briefly respond to one of your questions here. The 1973 article in New York is being used in the draft only to source that fact that Pelham Bay General Hospital exists, was founded in 1960, and has a certain number of beds. It doesn't mention the subject at all. NewYorkActuary (talk) 11:38, 2 March 2017 (UTC)

Improperly sourced medical claims, or are they?

At this edit to Worry, User:59.99.39.8 claims that their addition has nothing to do with WP:MEDRS. I've cut out the section twice and been reverted and I would now like to call for some additional attention from editors who may be better than I am at dealing with these sorts of situations. Tell me if I'm wrong or help me explain what needs to be done. Thanks. jmcgnh(talk) (contribs) 15:00, 2 March 2017 (UTC)

per [4] should be MEDRS[5](have edited)--Ozzie10aaaa (talk) 15:31, 2 March 2017 (UTC)

Giving guidance about student assignments

In a previous version of the WikiProject Medicine page you had some information and helpful links on the topic of using student assignments to improve Wikipedia. I couldn't find it anymore now, where is it? Back then I copied your lines of text to the WikiProject Sanitation. Meanwhile, I have improved it a bit (I think). It now looks like this for the WikiProject Sanitation: https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Sanitation#Student_assignments. EvMsmile (talk) 12:10, 24 February 2017 (UTC)

You mean Template:Student? Doc James (talk · contribs · email) 12:53, 24 February 2017 (UTC)
@EvMsmile: Anyone considering using Wikipedia for student assignments would do well to read through the guidance at outreach:Education. There are a lot of resources available as well at the outreach:Education/Resources page, and I strongly recommend anyone setting up a programme to make use of the meta:Programs & Events Dashboard to help organise the assignments. Means exist for putting organisers in touch with experienced Wikimedians, either locally or online. Hope that helps. --RexxS (talk) 15:46, 24 February 2017 (UTC)
Thanks, these are all useful links which I will study. However, my question was a bit different: Where on the WikiProject Medicine page are you pointing this option out to educators, i.e. that they can get students to edit Wikipedia articles and that there are prior examples for this? I think it should be highlighted clearly somewhere (it used to be there but got lost when you re-structured the page). Also I remember seeing in a powerpoint presentation some examples of the results achieved by medical students (like one saying "editing Wikipedia articles has helped me to improve my language and clarity when I speak to my patients!"). This kind of stuff should be easily findable, i.e. links to publications talking about how medical students edit Wikipedia articles, at which universities, which courses and how successful was it. I know it's available somewhere but does not seem easily accessible from the WikiProject Medicine page which is a pity.EvMsmile (talk) 19:46, 24 February 2017 (UTC)

Current state of medical outreach to schools

Wiki school outreach started in 2011. By around 2012 there was Wikipedia:Education noticeboard and outreach:Education/Resources, which many Wikipedians came to know. Now that education board is not used, and there is no education discussion forum on English Wikipedia. At Outreach wiki there is no discussion of English language programs, and so far as I know, that content has never been developed with volunteer community input and only ever has been for use by WMF staff in their own paid staff outreach outside the English-speaking world. Many of these resources are unsorted and have not been managed by anyone in particular, ever.

The Wiki Education Foundation has been providing tools for education outreach in the US and Canada since 2014. Notably, they developed the meta:Programs & Events Dashboard, which I think is an essential tool for institutional partnerships of any kind from schools to any sort of Wiki editing meetup to museum partnerships. As of January 2017 in the dashboard there has been a training module available to the public for medical topics - see it at Editing Medical Topics. At this point Wiki Edu has managed several thousand classes with a high success rate and centralized research of outcomes, so I would suggest looking to them for a model of how to do things.

Here are some points to consider -

  • I second RexxS when he says "I strongly recommend anyone setting up a programme to make use of the meta:Programs & Events Dashboard". See this program from 2015 for an example of a medical school group of students editing together. Personally, I do not think that I would give support to any program which did not use this tool just because it prevents so many problems.
  • As EvMsmile says, "I know it's available somewhere but does not seem easily accessible" is true for some of our resources
  • It is challenging in the wiki community to mark things as deprecated. Personally I think that the education noticeboard should be redesigned to be relevant for new uses and that English Wikipedia should not refer routinely refer to the outreach wiki's out of date materials, but I would need review from a few people to make sweeping changes.
  • To start, I made an update to the Wiki Project Medicine partner banner at Wikipedia:WikiProject Medicine/Partners. For some months the project has highlighted Cancer Research UK and Cochrane. Because of many partnerships and scarce real estate, I think that "partners" could be taken as a general concept and instead include categories, like "schools", "expert organizations", or whatever else.

Thoughts? Blue Rasberry (talk) 19:40, 28 February 2017 (UTC)

the points you raise seem reasonable--Ozzie10aaaa (talk) 12:02, 1 March 2017 (UTC)
I'd add intentional communication/collaboration with related and overlapping WikiProjects (Anatomy, Nursing, Pharmacology, Psychology, et al.). The boundaries between academic disciplines can be very blurry on Wikipedia. Unless we recognize that, we could overlook many programs editing articles that fall within this project's scope. —Shelley V. Adams ‹blame
credit› 13:35, 1 March 2017 (UTC)
People who are interested in this will probably be interested in the video of yesterday's talk by Amin Azzam on his student-editing program at UCSF. Also, I'd recommend it to anyone who'd like a little extra boost. It's one of the most engaging presentations on why Wikipedia matters, and how much improving even one page matters, that I've seen. I think it's well worth the 46 minutes. WhatamIdoing (talk) 20:27, 1 March 2017 (UTC)
The Azzam video is essential viewing for new and experienced WPMED editors. Inspiring. Excellent history and guide through the eyes of med students and faculty. The text editing software, Acrolinx, looks useful. Can we get a donated beta version to install via Preferences and test drive here? --Zefr (talk) 23:28, 1 March 2017 (UTC)
Pinging User:Ocaasi and User:Sadads: Do you think that TWL's scope could stretch as far as software that tells you whether you've written something understandable? WhatamIdoing (talk) 19:42, 2 March 2017 (UTC)

Phalloplasty merge

There is longstanding proposal to merge from No-touch surgical technique for penile prosthesis implantation to Phalloplasty which has some disagreement and could do with some expert eyes. Contributions welcome at Talk:Phalloplasty/Archive 1#Merger proposal. Klbrain (talk) 23:02, 2 March 2017 (UTC)

I looked around a bit, and I've gathered that implanting a penile prosthesis is most commonly performed as a treatment for erectile dysfunction on cisgendered males (as contrasted with bottom surgery on transsexuals), and that sources talking about phalloplasty are almost always talking about bottom surgery on trans men. Both of the Wikipedia articles seem to conform to this distinction. I'm therefore dubious about this merge: it appears that some trans men may have prostheses inserted, but the insertion itself comes after the phalloplasty, rather than as part of it. But perhaps someone else knows more about this, and could share an opinion. WhatamIdoing (talk) 02:10, 3 March 2017 (UTC)

Access Help

Any chance someone has access to this review [6]? If so, would someone please email me a copy (PDF, if possible). Thank you! TylerDurden8823 (talk) 05:38, 25 February 2017 (UTC)

Sorry, no access. Doc James (talk · contribs · email) 11:16, 25 February 2017 (UTC)
Thanks for trying, James. Anyone else?? TylerDurden8823 (talk) 18:46, 25 February 2017 (UTC)
I couldn't get access either. It looks like it's not in the common set of journals to say the least, and with an impact factor around 0.5, I'd say there's probably similar information somewhere in more accessible sources. You'd probably need someone with a subscription to this exact organization to get the pdf as opposed to general university access. Kingofaces43 (talk) 19:50, 28 February 2017 (UTC)
I just wanted to second that. I also have access to most journals through a research university and don't have access to that journal. It looks like many of their journals are in Italian, so maybe someone at an Italian university would have access? Unfortunately I don't know anyone who fits the bill to ask. Good luck! Ajpolino (talk) 20:43, 28 February 2017 (UTC)
Have you tried sending an e-mail message to the author? The few times I've tried it, they've usually been remarkably helpful. WhatamIdoing (talk) 02:13, 1 March 2017 (UTC)
Actually, I haven't tried that. I didn't think they would give me access but I suppose it's worth a try. TylerDurden8823 (talk) 00:14, 4 March 2017 (UTC)

Sagliker Syndrome

Is this a real condition, and if so, is it notable enough for a wiki article? (It doesn't currently have one).

There are a lot of articles in various medical journals describing it, supposedly it involves "uglification of the face" resulting from renal failure and hyperthyroidism. All of the articles are written in a rather disjointed (almost word salad-like) manner, though this could be because of the authors not being native English speakers; it seems only Turks have written about this topic.

I'm wondering if it's real or if it's some kind of elaborate hoax (like cello scrotum). Is there anyone here who can verify that? FiredanceThroughTheNight (talk) 05:12, 4 March 2017 (UTC)

[7][8][9]--Ozzie10aaaa (talk) 11:37, 4 March 2017 (UTC)

"efficacy" section for drug?

Thoughts here please: Talk:Nivolumab#Efficacy Jytdog (talk) 21:20, 3 March 2017 (UTC)


more opinions(gave mine)--Ozzie10aaaa (talk) 13:21, 4 March 2017 (UTC)

Relevance of secondary sources to chiropractic article

Chiropractic spinal adjustment

Two secondary sources have been removed from the chiropractic article, suggesting in the edit summary that This is not really relevant. Chiros don't do knees. The sources are reviews of manual therapy and exercise for knee arthritis: [10] & [11].

  • It has been noted that 30% of chiropractic visits are for musculoskeletal problems besides the neck and back [12] and that reliable medical organizations, such as the NHS, describe chiropractic treatments as “often used for musculoskeletal conditions (which affect the muscles, bones and joints). These conditions include: [...] pain or problems with hip, knee, ankle and foot joints” [13].
  • It has also been noted that chiropractors employ “a combination of therapies such as spinal manipulation, massage, heat and cold therapies, electrotherapies, the use of mechanical devices, exercise programs, nutritional advice, orthotics, lifestyle modification and patient education.” [14]
  • One of the sources that was removed explicitly mentioned in the introduction how it was relevant to chiropractors: “Management [of knee OA] aims to control pain and reduce disability...Manual therapy is a physical treatment used by physiotherapists, chiropractors, osteopaths and other practitioners to treat musculoskeletal pain and disability, and includes massage therapy, joint mobilisation and manipulation.".[15]

It is still being argued that the sources are not relevant for the chiropractic article, on the basis that "They relate to the puzzling (to the reader) knee, they are weak evidence and not in any way compelling, and the sources themselves don't even mention chiropractic in the abstract or categories. It gives the storng impression of a standard SCAM tactic of using a positive study on a closely related practice, to imply validity." Further, it has been suggested that "we need reliable independent secondary sources that say chiropractic, (not arbitrary manipulation therapy) has a significant effect on knees that is clearly not down to bias." Any additional comments would be helpful. Here is a link to the talk page discussion. 2001:56A:75B7:9B00:441:A41B:9784:50F1 (talk) 01:06, 16 February 2017 (UTC)

Apologies Jytdog, but can you please show me where I said that PMID 21402325 contains the word chiropractic? In my last bullet point, and at the chiropractic talk page, I quote text from the other one of the two sources that was removed, which is on the same topic, and which does mention chiropractic (as I quoted) in the first paragraph of it's introduction. Here is the full text of the source I have been quoting [16]. Please correct me if I am wrong, or if you have just misunderstood my comment.2001:56A:75B7:9B00:441:A41B:9784:50F1 (talk) 01:43, 16 February 2017 (UTC)
You didn't, but you are arguing that it should be used in the chiropractic article. Jytdog (talk) 03:25, 16 February 2017 (UTC)

Another relevant source demonstrating that chiropractors treat knees. The Canadian Chiropractic Association has published treatment guidelines regarding manipulation of the knees. The guidelines, last updated in 2009 (prior to the research we're discussing) say: There is a level of B or fair evidence for manipulative therapy of the knee and/or full kinetic chain, and of the ankle and/or foot, combined with multimodal or exercise therapy for knee osteoarthritis, patellofemoral pain syndrome, and ankle inversion sprain. [17] You can also read a summary of the guidelines directly from the CCA's website hereJmg873 (talk) 08:21, 16 February 2017 (UTC)

  • Two studies showing weak evidence for effect of manipulation therapy for knee pain, which do not mention chiropractic in either their abstracts or their keywords, are being used to argue that chiropractic is effective for knee pain, based on the assertion that chiropractors perform manipulation on knees. To the reader, this will be puzzling: the links go to abstracts which don't mention chiropractic at all, so why are they even in there? To the more knowledgeable reader familiar with alt-med and the techniques used to claim legitimacy, it's a rather obvious bait-and-switch. There is an intersect between chiro and manipulation therapy on knees, and there is weak evidence that manipulation therapy on knees is beneficial, but to use that evidence to support any claim for legitimacy of chiropractic in the absence of any source that explicitly makes that claim is both WP:SYN and WP:UNDUE.
Inclusion rests on the assumption that manipulation therapy and chiropractic are identical. They are not.
The Jansen source does not mention the word chiropractic at all, anywhere in the article. The French article says that two of the studies used chiropractic manipulation but (explicitly) does not separate effect by type of manipulation used. Using either of these two studies to support claims for the efficacy of chiropractic seems to me to be a pretty blatant breach of WP:V/WP:NOR. Guy (Help!) 11:24, 16 February 2017 (UTC)
Are you still retaining the argument that chiropractors don't treat knees directly? I have some additional research-based stats on extremity adjusting if you are, if not I won't waste the space.
You're now saying that chiropractic manipulation of the joint is different. Can you cite somewhere that chiropractic manipulation of joints (other than the spine) is different from any other practitioner's joint manipulation?
To be clear: Is part of your point that because the study which mentioned chiropractic, did not separate manipulation done by chiropractors, from other practitioners, that it should be excluded? I'm not insinuating anything with this question, I'm genuinely asking to confirm that I understand your argument.
If your primary argument is that one of the two sources doesn't contain mention of chiropractic, I've read the study and agree that it could be [WP:SYN]. As for the source that did contain mention of chiropractic, you stated that two of the studies were studies on chiropractic manipulation. This demonstrates the relevance of this study on the chiropractic page. It means that the studies specifically on chiropractic manipulation of the knee were taken into account during the writing of the conclusion.Jmg873 (talk) 16:53, 16 February 2017 (UTC)
Have you stopped beating your wife yet?
Chiropractors are known for back-cracking. Reference to anything else is going to be puzzling to the reader, so needs context. The context in this case is two studies, one of which does not mention chiropractic and one which references it only for a subset of the included data and does not separate effect size out by type of therapy.
These sources are being used to make claims of efficacy for chiropractic, but they do not substantiate it. Perhaps that's why most chiros stick to back-cracking. Guy (Help!) 18:18, 16 February 2017 (UTC)
Have you stopped beating your wife yet? Is this a violation of WP:5P4? Or is this a joke I don't get? Either way please stay on topic and avoid personal attacks.
Perhaps that's why most chiros stick to back-cracking. Most chiropractors don't just stick to back-cracking. This is discussed in a 2012 review on the literature pertaining to manipulative therapy for the lower extremity: According to Christensen et al,4 extremity treatment is the second most frequently applied procedure within the chiropractic profession with 76.1% reportedly using spinal and extremity procedures as compared with 18.7% who limit their practice to the spine only[18]Full Text Which further demonstrates the relevance of research pertaining to extremity adjusting.
Do you have any contradictory evidence that most chiropractors adjust only the spine? rather than a minority? You continue to ignore repeated requests for substantiation of your statements. That literature review also states There is a level of B for MT of the knee and/or full kinetic chain and of the ankle and/or foot, combined with multimodal or exercise therapy for short-term treatment of knee OA, patellofemoral pain syndrome [...] and a level of C for MT of the knee and/or full kinetic chain and of the ankle and/or foot, combined with multimodal or exercise therapy for long-term treatment of knee OA, patellofemoral pain syndrome..., which we can add to the article as well.Jmg873 (talk) 18:53, 16 February 2017 (UTC)
@Jmg873: It seems Guy forgot to wikilink Have you stopped beating your wife for you. He was ironically pointing out that you asked an apparently loaded question. Many people have trouble recognizing irony, but it does not constitute any kind of personal attack.LeadSongDog come howl! 15:03, 17 February 2017 (UTC)
What part of the spine are the knees? Guy (Help!) 11:43, 22 February 2017 (UTC)

At this point, this is how I see the arguments. I've separated out each argument, with the evidence presented supporting exclusion and inclusion of the articles into the chiropractic page. Please correct me if I miss, or mis-represent something.

Argument: Chiropractors don't treat knees

Evidence Supporting exclusion: no evidence cited
  • That is a lie. The edit summary is brief, I expanded my position on Talk in significant detail. The issue is the principle of least astonishment. The text said chiropractic is effective for osteoarthritis, the studies refer to manual therapy for knee pain, which is not what chiros are known for, and neither abstract nor categorisations make any reference to chiropractic, so a reader seeking to verify the claim that chiropractic is effecteive for osteoarthritis will find instead a discussion of a different, albeit related, therapy, for an area of the body most readers won't associate with chiropractic. Guy (Help!) 12:59, 23 February 2017 (UTC)
Evidence Supporting inclusion Chiropractors do treat knees [19][20]

Argument: Chiropractors are known for back cracking. It would be confusing to the reader.

Evidence supporting exclusion: No evidence cited
  • None needed. Chiropractors are known as back-crackers, that's the public perception. The entirety of the article makes it clear, and the cult was founded on Palmer's notions of the flow of innate in the spine. Guy (Help!) 12:59, 23 February 2017 (UTC)
Evidence supporting inclusion: 76.1% of chiropractors use extremity adjusting in their practice [21]
30% of problems people see chiropractors for are no related to the neck or back. [22]

Argument: Using the Jansen article would be WP:SYN/WP:OR

Evidence supporting exclusion: The Jansen study does not have the word chiropractic mentioned [23] and could be considered a violation of WP:SYN/WP:OR
Evidence supporting inclusion: It is relevant, and not a violation of WP:SYN/WP:OR. A similar discussion was had years ago pertaining to Chiropractic spinal manipulation vs. spinal manipulation. The determination was that spinal manipulation is something that chiropractors perform frequently; it is relevant even if the word "chiropractor" is not mentioned in the article. Talk:Chiropractic/Archive_28#Closing_the_RFC.

Argument: The source that uses the word chiropractic, doesn't separate effects from the studies done by chiropractors, from the studies that were not.

Evidence supporting exclusion: 2 of the 4 sources used in the review were done by chiropractors. The study does not separate the results in the abstract or conclusion [24]
Evidence supporting inclusion: 2/4 studies in the review were on chiropractic manipulation specifically. The study is WP:MEDRS compliant, and relevant for the reasons listed above.
  • But again you miss the point. You want to make a broad claim that chiropractic works for osteoarthritis based on two sources, one of which does not mention chiropractic at all and the other is about manual therapy with, explicitly, no segregation. These would be acceptable sources for the statement that manual therapy shows some signs of effect in knee osteoarthritis, in an article on manual therapy or knee osteoarthritis, but they absolutely do not substantiate the claim that chiropractic is effective for this condition. There's nothing there to distinguish chiropractic joint mobilisation from the reality-based kind, for a start. Chiropractic is founded on the treatment of the nonexistent subluxation complex, and do feel free to provide canonical sources but I see no evidence that this is even claimed to exist anywhere other than the spine. I understand that mixers also engage in garden variety manual therapies, but that does not make them chiropractic therapies. Guy (Help!) 12:59, 23 February 2017 (UTC)
    • It's this last line of argument that I'm finding unconvincing. 'Chiropractic' is presumably whatever chiropractors are licensed to do/could be sued for malpractice if they do wrong. But you seem to be proposing that even if something is legally within the scope of practice for a chiropractor, and even if most or all chiropractors do it, it still isn't really The One True Chiropractic™ unless they're thinking about innate-subluxation-somethings while they perform the procedure. I'm not buying this story. Also, that narrow definition puts editors in the position of trying to write an article about what actual chiropractors do without including all the things they do (and probably without mentioning anything that some of them do). WhatamIdoing (talk) 22:29, 23 February 2017 (UTC)
I believe WAID has a point,--Ozzie10aaaa (talk) 11:25, 5 March 2017 (UTC)
@WhatamIdoing: The bit I'm not buying is the synthesis: "manual therapy is more effective than exercise for those with hip OA" followed by "70% of patients specified back and neck problems as their health problem for which they sought chiropractic care."; therefore some chiropractors may use manual therapy to treat hip/knee OA; therefore chiropractic is effective for hip/knee OA, QED. If a chiropractor stuck a plaster on a paper cut on a patient's hand, would that make chiropractic effective for treating wounds? --RexxS (talk) 18:45, 5 March 2017 (UTC)
If applying sticking plasters were part of their scope of practice (which is beyond my knowledge), and if that were actually an effective treatment (which is not my personal experience), then yes: chiropractors would be effectively treating paper cuts (not all types of wounds).
In the instant case, I think precision in wording could address your concerns. Rather than "Chiropractic cures everything", it could be phrased as something like "People receiving manual therapy reported reductions in hip and knee pain due to osteoarthritis" (or whatever the exact details are from the sources). That removes the implication that innate-subluxation-whatever is relevant and also removes the idea that chiropractic is the only profession that can do this type of treatment. Do you think you could find a way to phrase that fact in the article? WhatamIdoing (talk) 20:39, 5 March 2017 (UTC)
WAID, your comment is logical, but... That is exactly why Guy's objections are so unwarranted, the text that he removed said "A 2011 systematic review and meta-analysis concluded that the addition of manual mobilizations to an exercise program for the treatment of knee osteoarthritis resulted in better pain relief then a supervised exercise program alone and suggested that manual therapists consider adding manual mobilisation to optimise supervised active exercise programs." and "There is silver level evidence that manual therapy is more effective than exercise for the treatment of hip osteoarthritis, however this evidence could be considered to be inconclusive." It was not saying that "chiropractic can cure things", which would be silly anyways because chiropractic is a profession, not a modality. Guy has also removed text saying that cervical mobilization was effective for lateral epicondylitis because it is his opinion that chiropractors don't do the therapies in that review either (mulligan mobilization and cervical manipulation are specifically mentioned and these are fundamental approaches used by chiropractors every day). 75.152.109.249 (talk) 21:48, 5 March 2017 (UTC)

Again, if I missed anything or you think I was unfair about my representation of anything here, please correct it.Jmg873 (talk) 15:57, 18 February 2017 (UTC)

You missed: the papers do not support the claim. And that is the only bit that matters. One does not mention chirporactic, the other says that *some* but an unknown proportion of inteventions were carried out by chiropractors. Only in the topsy-turvy world of SCAM does this in any way validate the claim that chiropractic is effective for knee pain. Guy (Help!) 11:43, 22 February 2017 (UTC)

Wikidata use in Template:Infobox medical condition

pointless. closing. Jytdog (talk) 23:29, 6 March 2017 (UTC)

The following discussion 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.

So apparently both Template:Infobox medical condition (new) and Template:Infobox medical condition are taking data from Wikidata.

The "speciality" field is drawn from Wikidata in both, and both include a link "[edit on Wikidata]" in the bottom corner of the infobox.

I was not aware we were doing this -- maybe we discussed this, and I missed it.

In my view:

  • a) Wikidata is not reliable enough that we should be drawing the "speciality" field from it
  • b) WP articles are not the place to advertise editing Wikidata, and the link "[edit on Wikidata]" should not be in the infobox.

Thoughts? Jytdog (talk) 09:08, 6 March 2017 (UTC)

I disagree, can come with a longer response later (when I have time). However this has happened since ~July 2015 when we automated the imports at Wikimania in Mexico. I'm pretty sure it was advertised here. I fully agree we need to be careful when using Wikidata, but this ought be one of the least controversial cases. That it isn't perfect (eg Abscess) is a good reason to include an edit on Wikidata link — it also increases transparency for readers and editors about where the data is from.
I'd also like to point out a catch-22 present in your argument: Wikidata is not reliable, but if we don't use it it will never be improved to the point where it is reliable, hence we can never use it. Carl Fredrik 💌 📧 09:28, 6 March 2017 (UTC)
There is not good documentation of these conversations but my memory was that speciality was chosen to be one of the less controversial experimental options for matching Wikidata to Wikipedia. It was supposed to be more likely to be correct, and supposed to be less of a problem if it were incorrect.
Those are just perspectives from unorganized conversations but I think that is how many Wikidata decisions have been made to this point. Blue Rasberry (talk) 14:10, 6 March 2017 (UTC)

Right now the mobile app automatically pulls the "definition" of the disease from Wikidata. Because of this IMO it is good to have the "edit on Wikidata" link. With respect to the speciality, this is not really health care information. It was added to Wikidata by a bot based on the ICD 10 codes. I am happy to see it continue to be used. Doc James (talk · contribs · email) 16:36, 6 March 2017 (UTC)

we have boatloads of mobile users and we are pulling the definition from Wikidata. That is unbelievable. You chose to spew garbage into the world through this app. Damn. And I cannot understand why are you find the speciality coming from Wikidata to be OK. People run bots over that add garbage, and people can individually make changes and there is nobody watching, and hell even the founders and trainers encourage people to just freely make changes, no need to think about or cite sources.
Whatever. There is only so much I can do here. I am going to ignore infoboxes and Wikidata going forward; there is no stopping the flood of stupidity. Jytdog (talk) 23:25, 6 March 2017 (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.
User:Jytdog I did not support the use of definitions from Wikidata in the WMF apps. It was just done and I have simply noticed that as a mechanism of vandalism of WP. Note that the WMF app has NOTHING to do with the medical offline WP app. The medical app does NOT use definitions from Wikidata.
With respect to extrapolating the medical speciality from the ICD codes, that works fairly well. It is a minor use and not of the same concern IMO to the definition issue. Do you have examples of ICD 10 codes that do not fit under the speciality their listed? Doc James (talk · contribs · email) 06:42, 7 March 2017 (UTC)
my apologies i thought the app was done at your behest. that is still awful, regardless of how it got there. Jytdog (talk) 06:44, 7 March 2017 (UTC)
These are different apps as I have clarified above. The medical app was done at my request but it is COMPLETELY separate from the WMF apps. Doc James (talk · contribs · email) 06:46, 7 March 2017 (UTC)

I am concerned about the Template:Paraphilia-related support groups that TealHill created and how he is applying it. For example, he applied it to the Pedophilia article while creating a Self-help groups section. See Talk:Pedophilia#Self-help groups section. Permalink here. Like I stated there, "TealHill added this section as a subsection of the Treatment section, and the material was unsourced. This article is about pedophilia; it is not about child sexual abuse (although child sexual abuse is mentioned because pedophiles are likely to commit it). It is not about sexual addiction. What WP:Reliable sources, specifically WP:MEDRS-compliant sources, state that pedophilia is a sexual addiction? What WP:Reliable sources state that self-help groups are a treatment for it? The Pedophilia article makes it very clear that pedophilia is unlikely to be cured. It is not something you simply treat by going to a self-help group. It is not like an alcoholic going to Alcoholics Anonymous at all."

TealHill also added a "Treatment of abusers" section to the Child sexual abuse article, pointing readers to the Pedophilia#Treatment section as though pedophiles and child sexual abusers are automatically one and the same and as though treatment of pedophiles is automatically the same treatment used on child sexual abusers. The Pedophilia article makes it explicitly clear that pedophilia and child sexual abuse are not the same thing. It makes it clear that many people who have committed child sexual abuse are not technically pedophiles. Also keep in mind that child sexual abuse is a term that can include sexual activity between underage post-pubescents and adults, not just adults being sexual with prepubescent children.

At the Pornography addiction article, TealHill also replaced sourced material with the template; see here. At the Paraphilia article, he added a "Self-help groups" section with nothing but the template; see here. My issue with TealHill's template and with his edits related to this matter is that paraphilias are not necessarily sex addictions, and self-help groups are not usually listed in medical sources as treatments for paraphilias. And, of course, there is the issue of TealHill replacing or adding sections with nothing but this template. Flyer22 Reborn (talk) 05:51, 7 March 2017 (UTC)

Content needs references to support it first of all. Doc James (talk · contribs · email) 06:38, 7 March 2017 (UTC)
As long as TealHill understands what WP:MEDRS-compliant sources are. A source confusing child sexual abusers with pedophiles will not suffice. Flyer22 Reborn (talk) 06:49, 7 March 2017 (UTC)

Malicious(?) edits on Lactobacillus

Lactobacillus

Please review these 2 edits. I believe they are malicious. Thanks. Gzuufy (talk) 17:59, 25 February 2017 (UTC)

I don't think they are malicious, but merely misguided edits from a new editor. I've restored the text and references, as I believe they are relevant to an understanding of the topic. I've dropped a note on the editors' talk page explaining as best I can. --RexxS (talk) 18:36, 25 February 2017 (UTC)
[25]new editors do that sometimes--Ozzie10aaaa (talk) 20:28, 25 February 2017 (UTC)


Move of Female genital prolapse article

Opinions on the following move issue would be greatly appreciated: Talk:Pelvic Organ Prolapse#Move of article. Permalink here. Flyer22 Reborn (talk) 23:33, 25 February 2017 (UTC)


more opinions(gave mine),--Ozzie10aaaa (talk) 13:55, 7 March 2017 (UTC)

Pro-life or anti-abortion in a specific title

See:

Best, Carl Fredrik 💌 📧 15:45, 7 March 2017 (UTC)

Commented. Flyer22 Reborn (talk) 16:06, 7 March 2017 (UTC)

Gender differences in suicide article

We need opinions on the following discussion: Talk:Gender differences in suicide#"reported suicide attempts are 3 times more common among females than males". The main issues are on display here and here. As seen at Talk:Suicide/Archive 6#Not supported by majority of sources and here, there was a similar debate had at the Suicide article talk page, which involved Doc James, Jytdog, CFCF and myself. Flyer22 Reborn (talk) 06:46, 7 March 2017 (UTC)

Commented. Doc James (talk · contribs · email) 06:57, 7 March 2017 (UTC)
Thanks, Doc James. If you and/or others are willing to keep an eye on the article, it would be greatly appreciated. I don't think that the IP will listen, despite the sources I've provided on the issue. I am willing to re-word matters per sources, but questioning information that is consistently reported in the literature is a problem unless new and valid sources suggest otherwise. Flyer22 Reborn (talk) 07:38, 7 March 2017 (UTC)
watchlisted. Jytdog (talk) 08:01, 7 March 2017 (UTC)
We had another account very very involved with this issue. Wondering if they are related? Doc James (talk · contribs · email) 17:46, 7 March 2017 (UTC)

ICMS

https://en.wikipedia.org/w/index.php?title=Stem_cell_research_policy&action=edit&section=3 the ICMS website has nothing on it later than 2012, the founders were sanctioned by the FDA for unregulated stemcell practice. http://www.quackwatch.org/02ConsumerProtection/FDAActions/regenexx/overview.html. Please can someone look at this? AmyEBHC (talk) 03:45, 9 March 2017 (UTC) Thank you

Removed that text. Doc James (talk · contribs · email) 05:25, 9 March 2017 (UTC)

Books based on WP's medical content without proper attribution or the same license

  • These 10,600 by CTI Reviews[26]
  • These 7 books by CE4RT[27]

I guess the question is what should we do? Doc James (talk · contribs · email) 05:33, 9 March 2017 (UTC)

We can start by banning the publishers from being cited per WP:CIRCULAR. Carl Fredrik 💌 📧 09:28, 9 March 2017 (UTC)
yes that's a good start--Ozzie10aaaa (talk) 10:55, 9 March 2017 (UTC)

Acne listed at Redirects for discussion

An editor has asked for a discussion to address the redirect Acne. Please participate in the redirect discussion if you have not already done so. --My Core Competency is Competency (talk) 19:51, 9 March 2017 (UTC)


Note this is now a request to rename an article
Please comment, it is important to make sure a bad decision isn't made only because those who actually know what they are talking about didn't pay attention. Carl Fredrik 💌 📧 22:34, 9 March 2017 (UTC)

Write up of the Cochrane Wikipedia partnership

[29] Doc James (talk · contribs · email) 00:34, 1 March 2017 (UTC)

great collaboration!--Ozzie10aaaa (talk) 11:54, 1 March 2017 (UTC)
wow this is fantastic :) Mramoeba (talk) 06:02, 10 March 2017 (UTC)

Well, boogers

Wikimedia Commons has media related to Nasal mucus.

We have one representative image of dried nasal mucus that is not that representative.

...not that representative one must agree

Could a few editors please do the unpleasant task of, well, picking your nose and taking a picture of it for the good of the project? The very odd image is hardly fit for the article. I'm sorry to appear gross but this has been on my to-do list for some time. I am also, considering the Internet, shocked at the lack of booger images among commons' 37,520,934 images. Anna Frodesiak (talk) 12:48, 9 March 2017 (UTC)

Is there any reason why have an article of the dried variant only? Carl Fredrik 💌 📧 18:22, 9 March 2017 (UTC)
Good question, CFCF. Dried nasal mucus could be moved to Nasal mucus and talk about snot and runny noses as well. Maybe suggest it at talk....or maybe I will. Anna Frodesiak (talk) 01:36, 10 March 2017 (UTC)
Oh, I see you've redirected it to mucus. Something tells me that is a controversial move. I mean, maybe nose mucus in all its forms deserves its own article. Thoughts? Or should this be a discussion at the Talk:Mucus now? Anna Frodesiak (talk) 01:39, 10 March 2017 (UTC)
Nasal mucus or respiratory mucus may merit an article — the dried variant does not. The article was also really horrible. Feel free to create a new one with proper sources. Carl Fredrik 💌 📧 01:26, 11 March 2017 (UTC)

Myocardial infarction heads-up

A driveby editor (zero edits to the article, zero edits to the talkpage other than the nom) has just nominated Myocardial infarction at GAN (review page here). Because newly-promoted GAs are now eligible for the main page—and because, owing to recent events the entire DMG Media group will be watching the main page like a hawk for any potential "Wikipedia puts lives at risk!!!" angle—if any error slips through it's likely to be quite high-profile. By its nature this is an unstable article as so many drive-by IPs and good-faith newcomers want to add something they've read to it; it could probably do with being given the once-over to ensure no woo or outdated research has slipped in. (As I've previously given multiple warnings to the nominator for disruptive editing, I'm a little reluctant to become directly involved myself as I won't be considered neutral.) Courtesy ping to Jclemens who's doing the GA review, to let him know that other people may turn up and comment. ‑ Iridescent 12:25, 9 March 2017 (UTC)

commented[30](missing many references)--Ozzie10aaaa (talk) 13:19, 9 March 2017 (UTC)
Have addressed some of the sourcing gaps though more refs are needed. TylerDurden8823 (talk) 14:20, 9 March 2017 (UTC)
The more eyes the better! Especially if we can get folks with non-U.S. perspective and those with actual cardiology (vs. EMS/primary care) experience. It's my habit to never quick fail a nominated vital article, even if it's not really GA-worthy, because even in a 'no pass, no way' situation, the scrutiny should improve an important, oft-visited article. c.f. User:Jclemens/VAGA. Cheers, Jclemens (talk) 17:29, 9 March 2017 (UTC)
This is going to require a lot of work to get to GA. Doc James (talk · contribs · email) 17:45, 9 March 2017 (UTC)
I appreciate the idea of never quick-failing Jclemens. I think it is a very decent position to treat all good faith applications with some respect, because a thorough review often results in better articles, even if the result isn't a promotion. However no-one is going to chastise you for failing this drive-by nomination on simply procedural grounds and it hardly seems to be worth the time to actually review it. Carl Fredrik 💌 📧 18:29, 9 March 2017 (UTC)
For an article as core as this, it's not going to hurt to give it a top-to-bottom cleanup periodically, even if the GAN ultimately crashes and burns. Regardless of how many disclaimers we put out, this is an article which a lot of readers will be using as their primary source on the topic, as it's so near the top of the Google results for "heart attack". ‑ Iridescent 23:48, 9 March 2017 (UTC)
I updated the lead not that long ago. It is more the body that needs work. Doc James (talk · contribs · email) 02:41, 10 March 2017 (UTC)
If everyone chipped in and cleaned up what we identify in the GA process, we might just 'succeed' without any appreciable input from the nominator. I can think of worse things happening... Jclemens (talk) 06:43, 10 March 2017 (UTC)
True, will take a look. Doc James (talk · contribs · email) 00:37, 11 March 2017 (UTC)
OK, first bit of my review is up at Talk:Myocardial infarction/GA1. Please feel free to review the reviewer, and let me know if you think I should take a different approach to the article. Jclemens (talk) 07:16, 11 March 2017 (UTC)

Featured article candidates

β-Hydroxy β-methylbutyric acid

HMB FAC

Round 2

Cross-posted at WT:WikiProject Pharmacology and WT:WikiProject Molecular and Cell Biology

The beta-hydroxy beta-methylbutyric acid article has been renominated for FA status. at Wikipedia:Featured article candidates/Beta-Hydroxy beta-methylbutyric acid/archive2. It still needs at least 1 more reviewer. Seppi333 (Insert 2¢)

November 2016 update: The article now has enough medical reviewers; the pharmacology content still needs reviewers though. Seppi333 (Insert 2¢)

Third time through the meat grinder

January 2017 nomination: See Wikipedia:Featured article candidates/Beta-Hydroxy beta-methylbutyric acid/archive3. Seppi333 (Insert 2¢)

Acne vulgaris FAC

Acne vulgaris on a very oily skin

See Wikipedia:Featured article candidates/Acne vulgaris/archive1. Seppi333 (Insert 2¢)

January 2017 nomination: Wikipedia:Featured article candidates/Acne vulgaris/archive2. Seppi333 (Insert 2¢)
  • need more opinions at above FA's,thank you--Ozzie10aaaa (talk) [Timestamped at 15:59 on 12 Jan 2017 (UTC)]
@Ozzie10aaaa: I've edited your timestamp to prevent the bot from archiving this thread. This is the reason I've been signing my posts with 3 tildes instead of 4 in this thread. Seppi333 (Insert 2¢)
cool ;-)--Ozzie10aaaa (talk)



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