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Complementary and alternative medicine was nominated as a good article, but it did not meet the good article criteria at the time (December 12, 2007). There are suggestions below for improving the article. If you can improve it, please do; it may then be renominated.

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Definitions and descriptions

This section is written from an entirely "in universe" perspective. Misplaced Pages articles are expected to include all notable views, but without giving undue weight to fringe views. Since this is a medical article, due weight should be given to mainstream medical opinions. Reading this section, there's no evidence that any such thing exists. Guettarda (talk) 23:07, 16 December 2007 (UTC)

Total nonsense. Editors, I suggest that these comments be totally ignore. Simply is not true. Mainstream medical opinions are ubiquitous and over powering. Nor, is the present balanced view of the article fringe. Furthermore, any and all viewpoints belong in the alternative medicine and complementary medicine articles because of the rules of hypertext document design. Trying to re-create that horribly written alternative medicine article, will not improve this article. -- John Gohde (talk) 11:59, 17 December 2007 (UTC)

"Total nonsense." "totally ignore"....? More ownership issues and lack of collaborative spirit. John, it's time to leave Misplaced Pages or adapt to the environment. You are headed for another block. Your opinion is no more important or valid than any other editor's. -- Fyslee / talk 06:42, 18 December 2007 (UTC)

I was just following the example provided by Ronz.

"Incivility and personal attacks by Fyslee: Fyslee has engaged in incivility and personal attacks ." -- John Gohde (talk) 03:22, 20 December 2007 (UTC)

And what does this have to do with your rudeness and outright rejection of fundamental Misplaced Pages policies? When you decide to move beyond shouting and insults, people might care what you have to say about other people's behaviour. Guettarda (talk) 05:57, 20 December 2007 (UTC)

Simply not true? Have you ever read the WP:NPOV policy? Have you ever read WP:UNDUE? That's what policy says we need to do. As you say: ainstream medical opinions are ubiquitous and over powering; that's why we are rquired to write this article (and all other alternative medicine articles, of course) from a mainstream medicine perspective. We need to give the mainstream views due weight and avoid giving non-mainstream views undue weight. We don't write articles from a sympathetic POV, we write from NPOV. That's a non-negotiable rule of Misplaced Pages. Guettarda (talk) 15:27, 17 December 2007 (UTC)

Simply not true! The mainstream medicine perspective was represented in the article. Nobody represents medicine like academia does. The majority of medicial schools teach CAM. Mainstream Medicine is in favor of CAM. -- John Gohde (talk) 02:46, 20 December 2007 (UTC)

Lets look at one of those surveys that reported the finding that many medical schools teach CAM "With the public's increasing use of complementary and alternative medicine, medical schools must consider the challenge of educating physicians about these therapies." . It seems even the researchers think there are reasons other than scientific evidence that may make the schools may offer CAM courses such as say, public usage and pressure. JamesStewart7 (talk) 15:05, 29 December 2007 (UTC)

Ooh - bold text and exclamation marks. Yelling is such an effective argument. I don't think I can beat arguments like that. Of course, it still doesn't change a thing - the article violates our core policies, and no amount of shouting (or waving crystals around) changes the fact that CAM is fringe, not mainstream. Guettarda (talk) 05:57, 20 December 2007 (UTC)

Yelling is posting with all uppercase letters. Academia is the cutting edge of medicine, and the research cited in the article clearly documents that CAM has gone mainstream and has been accepted by academia for a quite a long time. As I recall, I was the first editor to edit boldly and document this fact in the alternative medicine article, a long time ago. -- John Gohde (talk) 20:39, 20 December 2007 (UTC)

If CAM is mainstream medicine, then you should have nothing to fear if the article is written from a mainstream perspective. And yes, you are yelling. Guettarda (talk) 05:46, 21 December 2007 (UTC)

The article is presently written from a mainstream perspective. -- John Gohde (talk) 18:14, 21 December 2007 (UTC)

"Complementary and alternative medicine (CAM) is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed."

Starting a section with a paragraph-length quote is inappropriate, especially when it's the first "meat" in the article. The mainstream view is also missing - it should be apparent from the beginning that this is a fringe field.

The National Center for Complementary and Alternative Medicine (NCCAM) defines complementary and alternative medicine as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine". It also defines integrative medicine as " mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness".

Following one in-universe definition with another? Not cool.

The expressions "complementary medicine" (CAM) and "alternative medicine" are not used to describe different methods, only to describe the different settings in which the same methods are often used.

This repeats what the lead says, but this time it's said in a coherent fashion, which is good.

CAM has been described as comprising "a diverse group of treatments, ranging from symptomatic interventions to be used in conjunction with traditional therapies—therapeutic touch or meditation—to unique treatments meant to replace conventional chemotherapy or surgery. CAM includes complex and longstanding fields of study, such as acupuncture, ayurvedic medicine, and homoeopathy, but can also be as straightforward as taking a specific dietary supplement to lower blood pressure or blood lipid concentrations."

While this is true (in universe), it's also true that CAM has been described as follows:

There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking.

and

What most sets alternative medicine apart, in our view, is that it has not been scientifically tested and its advocates largely deny the need for such testing.

Mainstream definitions need to prevail, per Misplaced Pages policy.

Ralph Snyderman and Andrew Weil state "integrative medicine is not synonymous with complementary and alternative medicine (CAM). It has a far larger meaning and mission in that it calls for restoration of the focus of medicine on health and healing and emphasizes the centrality of the patient-physician relationship".

Why does this factoid need to be repeated for a third time?

In a frequently-cited review, David M. Eisenberg used the term "unconventional medicine" to signify "medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals."

While this is a slightly less "in universe" definition, it's lacking in specificity, it completely leaves out the "unproven" and "don't think it needs to be proven" angles. Guettarda (talk) 23:07, 16 December 2007 (UTC)

Eisenberg's definition

Eisenberg's definition is a working definition for the purpose of his survey. It's pretty clear that he isn't trying to define the field, but rather, to demarcate it for the purpose of his study. Thus, it really isn't an appropriate definition for the article to use. Guettarda (talk) 21:53, 17 December 2007 (UTC)

It is just one definition, the definition of a pro-alternative medicine person. Other definitions exist that are objectively defined and stable and are not based on his definition that is based on unstable and constantly changing factors. The following is from a previous section in the alternative medicine article:

Alternative definitions

The terms "alternative medicine", "complementary medicine" and "CAM" are generally understood in terms of their relationship to mainstream medicine, as described above.

Other definitions exist that are based on or include other criteria.

David M. Eisenberg relies on a "usage-based" definition, based on its inclusion in medical school curricula, and defines it as

"medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals."

Marcia Angell, former editor-in-chief of the New England Journal of Medicine, takes exception to his definition and relies on an "evidence-based (EBM)" definition, based on its relation to scientifically proven evidence of effectivity (or lack thereof):

"That is not a very satisfactory definition, especially since many alternative remedies have recently found their way into the medical mainstream....There cannot be two kinds of medicine - conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted."

Others like George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA), and Phil B. Fontanarosa, Senior Editor of JAMA, share Angell's use of an EBM definition:

"There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is 'Eastern' or 'Western,' is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues-namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy."

Richard Dawkins, Professor of the Public Understanding of Science at Oxford, also uses an EBM definition:

"Alternative medicine is defined as that set of practices which cannot be tested, refuse to be tested, or consistently fail tests. If a healing technique is demonstrated to have curative properties in properly controlled double-blind trials, it ceases to be alternative. It simply...becomes medicine." He also states that "There is no alternative medicine. There is only medicine that works and medicine that doesn't work."

The last three professionals use a definition that is based on the objectively verifiable criteria of the scientific method, not one based on the changing curriculums of various medical schools. According to them it is possible for a method to change categories (main stream vs. alternative) in either direction, based on increased knowledge of its effectiveness or lack thereof.

Well-known proponents of evidence-based medicine who study CAM, such as the Cochrane Collaboration and Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, have retained CAM's generally-accepted definition and do not define CAM as Dawkins does. In their view, there can be "good CAM" or "bad CAM" based on evidentiary support.

-- Fyslee 06:32, 18 December 2007 (UTC)

Cassileth reference

I removed the Cassilith ref which was being used to support the following statement:

Contemporary usage of alternative medicine appears to be growing, with more people using complementary and alternative medicine here and in developed countries.

Cassilith's book review does not support the statement that use of CAM is growing. And, since it's five years old, it really isn't "contemporary". Guettarda (talk) 05:43, 21 December 2007 (UTC)

In Misplaced Pages, five years old is contemporary. -- John Gohde (talk) 18:20, 21 December 2007 (UTC)

There are plenty of references from the 1990's in this article. I don't think your "five years old," reasoning is justified. The quote from the article is

"However one regards complementary and alternative medicine, there is little question that it represents a major sociocultural phenomenon. Large numbers of the general public, including many patients, use the products and services of complementary and alternative medicine. In 2000, Americans spent $10 billion on herbs, vitamins, and other dietary supplements. The estimated growth in the number of chiropractors, acupuncturists, naturopaths, optometrists, podiatrists, and other nonphysician clinicians between 1995 and 2005 is double that of physicians. This situation is replicated in most developed countries."

Is it too tangential? Anthon01 (talk) 08:35, 21 December 2007 (UTC)

It's a book review - and it doesn't seem to be a "fact" from the book - it's part of the introductory "set up" by the reviewer. Not exactly a very good source. Guettarda (talk) 06:43, 24 December 2007 (UTC)

Really?

In 2002, the growth estimate during the years 1995 to 2005 in the USA and other developed countries for the number of chiropractors, acupuncturists, naturopaths, and other nonphysician clinicians was double that of physicians.

To begin with, this really isn't English. But what's far more problematic is that assertion that this estimate was made in 2002. Cassilith doesn't cite a source for this estimate, so there's no way of telling when this estimate was made. In addition, of course, if we want to report 1995-2005 growth rates, we should be reporting growth rates, not estimates. Guettarda (talk) 06:51, 24 December 2007 (UTC)

Relationship or Migration

Let decide what it's going to be? "Relationship between alternative and conventional medicine" or "Migration from alternative to medicine." Either that or we can keep bouncing back and forth. Maybe give equal time to both. ;) Anthon01 (talk) 04:09, 22 December 2007 (UTC)

Migration from alternative to medicine -- John Gohde (talk) 04:20, 22 December 2007 (UTC)

We're writing in English. "Migration from alternative to medicine" is gibberish. Guettarda (talk) 06:52, 24 December 2007 (UTC)

a more detailed review of a footnoted reference

Here's a link that may be useful:

http://findarticles.com/p/articles/mi_qa3859/is_200401/ai_n9362735

It's a longer book review of the book that is summarized in one paragraph in this reference used in the article:

Cassileth, Barrie R. (2002). "The Role of Complementary & Alternative Medicine: Accommodating Pluralism.". NEJM 347: 860-861.

I'm posting it here in case anyone wants to check it out. --Jack-A-Roe (talk) 08:38, 22 December 2007 (UTC)

Clarification please

N.B.: (These questions are just for John. Give him a good chance to answer the questions before entering this discussion. Please respect this.)

Hi John. I'd like to "pick your brain," so to speak, and get a better understanding of what you mean in this edit summary:

• "This is the CAM article. Not the alternative medicine article. The topics are completely different. See NCCAM and actually study the website." (My emphasis.)

To start this off, let me state where I'm "coming from" on this particular matter. Since all CAM methods are alternative medicine methods and techniques (and nothing else), how can CAM and alternative medicine be "completely different" topics? Of course it's a given to those who really know this subject (as we both do extremely well), that CAM includes only a few alternative medicine methods, not all of them, but still nothing other than them.

Complementary and Alternative Medicine (CAM) is an umbrella term for the two manners in which alternative medicine methods are most commonly used:

1. Alternative medicine methods used "Complementary" to mainstream methods:

(a) in combination with them;

(b) in cooperation with them;

(c) by agreement with an (normally) MD, or the MD themselves using them;

(d) often legally because an MD is allowed to practice experimental medicine, although the MD can still be prosecuted for fraud, malpractice, and practicing substandard medicine.

(e) This is the "Collaboration model."

2. Alternative medicine methods used as "Alternatives" to mainstream methods:

(a) instead of them;

(b) often in opposition to them;

(c) often opposed by MDs;

(d) often illegally because of violations of "unlicensed practice of medicine" laws, consumer protection laws, and marketing laws.

(e) This is the "Competition model."

Now what do you think of all this? I have noticed that you have repeatedly claimed that there was a difference and I have been quite puzzled about why you do this.

Please answer these two questions:

A. How can they be "completely different" topics?

(We are talking about precisely the same methods, and the only difference is the setting (a through e).)

B. What is your strategy?

(There must be a reason for your repeated insistence on trying to separate the inseparable, which you claim are "completely different" topics.)

-- Fyslee / talk 06:48, 12 December 2007 (UTC)

I, of course, have already specified above in great detail everything that you are asking for. Yet, I see yet again an absolute total failue to point out one thing that is specifically wrong with this article. -- John Gohde (talk) 12:46, 12 December 2007 (UTC)

I wouldn't ask two questions if I saw such answers, or was satisfied with them. I have seen alot of repetition of the claim that they are different, but seen no evidence for the claim, and repetition doesn't make the claim true. Please answer both of the questions. You are welcome to copy and paste from above the things you believe apply as previous answers or information. Maybe I missed something. -- Fyslee / talk 15:11, 12 December 2007 (UTC)

I am still awaiting answers. -- Fyslee / talk 05:38, 14 December 2007 (UTC)

I entered this discussion long before this entire section of personal attacks was written. My arguments are given above. It is a simple matter of reading the written word above. It is currently section #13.1 which is located between the solid, thick, horizontal bars. -- John Gohde (talk) 14:27, 13 December 2007 (UTC)

I am not addressing anything else in this article. I am addressing a statement you have made and I want answers to two questions. It's as simple as that. BTW, there is nothing that can even remotely be construed as a personal attack in this section. Please answer the questions. -- Fyslee / talk 23:59, 15 December 2007 (UTC)

Still waiting

I am still waiting for clarification. It's only two simple questions. -- Fyslee / talk 15:43, 22 December 2007 (UTC)

"Fyslee is cautioned: Fyslee is cautioned to use reliable sources and to edit from a NPOV. He is reminded that editors with a known partisan point of view should be careful to seek consensus on the talk page of articles to avoid the appearance of a COI if other editors question their edits." See more ...

Also, see my argument in section 13.1. -- John Gohde (talk) 19:21, 22 December 2007 (UTC)

I stand by my above reply. See sections 13.1-1.1 & 13.1-1.2 as well as the recap in sections 13.1.1, 13.1.1-1 & 13.1.1-2 for the answer which I have explicitly explain above. I have absolutely no intentions of repeating myself on this topic which I have already throughly explained above. -- John Gohde (talk) 23:02, 22 December 2007 (UTC)

I don't see anything that reads like a personal attack by Fyslee in this section. Regarding the arbitration ruling, that's a distraction and doesn't apply to this conversation. I'm interested in your replies to the content of his questions. --Jack-A-Roe (talk) 21:26, 22 December 2007 (UTC)

??? I did not complain about a personal attack. The ruling applies here because in my humble opinion, Fyslee has a history of trying to force his/her point of view upon articles. That is exactly what Fyslee is trying to do here. Fyslee has "a known partisan point of view." -- John Gohde (talk) 21:42, 22 December 2007 (UTC)

I am positively questioning all edits made by Fyslee because of his/her "known partisan point of view." -- John Gohde (talk) 21:55, 22 December 2007 (UTC)

The reason I mentioned "personal attack" was in response to your note in this section at timestamp 14:27, 13 December 2007 (UTC) when you wrote: "I entered this discussion long before this entire section of personal attacks was written." I don't see the personal attacks you were referring to.

Regarding Fyslee's "known partisan point of view" I'm aware of the situation. But everyone has a POV one way or another, the question for Misplaced Pages is that person's behavior, not their beliefs; and I don't see any problems with that here. For him or her to ask you about your ideas on the topic seems well within policy. Mentioning the arbitration ruling is not appropriate in this context. A "cautioned" sanction is not an scarlet letter someone must wear for all to see and be reminded of every time there is a small disagreement.

It's clear from your user page that you also have a "known partisan point of view", so I'm sure you understand how it's possible for editors to have a personal POV and still edit articles in a balanced manner. You and Fyslee may be on opposite sides of this debate, but that does not mean it has to feel like a fight. The best thing to do is to focus on the content and not discuss the editors at all, unless there is a breach of policy that needs specific attention. --Jack-A-Roe (talk) 22:12, 22 December 2007 (UTC)

It is even clearer to me that I cannot respond to your comments in any meaningful way without being accused of making a personal attack. Yet you started out your comments with "I don't see anything that reads like a personal attack." I would suggest that if all the editors with your "known partisan point of view" would STOP accusing me of making personal attacks and would STOP trying to force their "known partisan point of view" upon the article; this very article would have had a GA rating by now. -- John Gohde (talk) 22:29, 22 December 2007 (UTC)

I did not accuse you of personal attacks. Not at all, I don't know where you got that idea. I mentioned I did not see any personal attacks by Fyslee in this section of the conversation. Regarding my POV, I have no idea of what you're talking about on that either. I've only edited the article a few times. I'm not involved in this topic and have no agenda - other than fairly representing a balanced cross-section of the sources and relating them accurately. The only reason I entered a comment here at all is that I'm interested in your response to the contents of the questions posed by Fyslee, and it seemed to be the topic was diverted away from the content, for no reasons.

So, please, stop discussing editors, and focus on improving the content of the article. Since there are mutiple POV's there needs to be some discussion so we can fairly balance the presentation. Productive discussion requires mutual respect between all parties. --Jack-A-Roe (talk) 22:42, 22 December 2007 (UTC)

Ok how about we all just accept that everyone (yes even me) has a POV and everyone has an opinion and no one is every really unbiased. There, now we can stop accusing each other of being partisan and focus on how we can unify all the different POVs into one version which we accept as neutral. John Gohde, I have to agree with Fyslee's suggestion that, "We are talking about precisely the same methods, and the only difference is the setting (a through e)" and I would like you to further explain what differences you think there are other than setting. It seems that several members of the wikipedia community do not understand your reasoning behind these proposed difference. JamesStewart7 (talk) 10:08, 29 December 2007 (UTC)

What the heck is going on?

I for one cannot tell what the heck has been updated on this talk page without spending all day on it. Can the editors please put the new comments on the very bottom of this page? -- John Gohde (talk) 18:49, 22 December 2007 (UTC)

Someone requested new comments be added above the references section. I've never seen that done on a talk page before, it does seem a bit confusing. Then again, complicated talk pages are always confusing because they have multiple discussions going on at the same time in several places. You could check the talk page history and look at a comparison since the last time you edited - that will show you all the changes added after that. --Jack-A-Roe (talk) 22:24, 22 December 2007 (UTC)

The post a comment feature of Misplaced Pages puts new comments on the very bottom of the page. I see no reason why this talk page should be any different. -- John Gohde (talk) 01:08, 25 December 2007 (UTC)

No problem, just as long as the refs code isn't deleted, since we do use it on this page. This page is used for discussing edits and their references (the legitimate purpose of an article talk page!), and in the process of developing finished products it's important to be sure the codes are working properly. We can just move the section to the bottom once in awhile. -- Fyslee / talk 02:47, 25 December 2007 (UTC)

The post a comment feature is only practical when starting a new section. Otherwise the edit button to the right of each section heading is the button to use. -- Fyslee / talk 02:51, 25 December 2007 (UTC)

Guilty by association

This page will turn into an extension of Quackwatch if left to the devices of editors who are anti-alt med. Although I agree with much of the criticism of alt med therapies, I do believe that there are some therapies that have some merit. The fact that every non-conventional therapy could fit under alt med could make some of the better aspects of alt med get lump together with the worse. Remember many conventional therapies and some of the biggest money makers have turned out to be not so hot after completion of RCTs. And most conventional modalities have never been subject to RCTs, the standard by which CAM therapies are being held up to. My point is that a reader trying to find out information about CAM will not be served well if all they get is a rehash of Quackwatch and 'pseudoskeptics.com.' It might make sense to distinguish between the 'fringe of the fringe' and more 'conventional alternatives.' Anthon01 (talk) 21:14, 26 December 2007 (UTC)

Proposal: This section should be immediately archived per WP:TALK. --Ronz (talk) 18:01, 27 December 2007 (UTC)

I don't agree. This post is germaine to the direction that this article should take. I appreciate your attempts to keep the talk page on topic, in fact I supported your previous attempt on QW. But this one is different as it is germaine to the metamorphosis this page is likely to undergo. Anthon01 (talk) 18:16, 27 December 2007 (UTC)

The first banner on Misplaced Pages:Talk page guidelines states "it is not set in stone and should be treated with common sense and the occasional exception." Ronz, what you just did was to make a conclusion. I am of the opinion that common sense should prevail in this particular situation. Please articulate, Ronz, why common sense should not make this particular instance an acceptable exception. -- John Gohde (talk) 19:30, 28 December 2007 (UTC)

Edit warring

Can we stop with the edit-warring? Please discuss the issues here, and please follow WP:TALK when you do. --Ronz (talk) 20:39, 27 December 2007 (UTC)

What edit-warring?

Please copy all pertinent edit-warring comments to this section. -- John Gohde (talk) 18:59, 28 December 2007 (UTC)

Please follow WP:TALK. See WP:3RR, WP:EW, the many comments placed on your talk page, and your arbcom. Thanks! --Ronz (talk) 19:25, 28 December 2007 (UTC)

Please post a reply that is responsive to the specific question asked. -- John Gohde (talk) 21:06, 28 December 2007 (UTC)

Definitions

CAM is a "set of practices which cannot be tested, refuse to be tested, or consistently fail tests" or
CAM is a set of practices whose advocates "deny the need for testing."

These are not definitions. Why should they be presented as such? Anthon01 (talk) 16:39, 28 December 2007 (UTC)

Yes, they are definitions. How not? Guettarda (talk) 16:41, 28 December 2007 (UTC)

The definitions of CAM are

• stuff not part of conventional medicine
  • this is true, but not a definition, since it's hopelessly vague. Is refusing to go to the doctor CAM? Is mercy killing CAM?
• stuff not taught in medical schools
  • as above
• stuff that isn't tested scientifically
  • this is more specific, since it gives a clear criterion to separate CAM from conventional medicine
• stuff that its proponents say don't need to be tested scientifically
  • this gets to the heart of the matter; this is the reason why people say CAM is worth using - because, despite the absence of evidence, it's "useful". They say that anecdotes are good enough. They trust person experience. CAM is a set of remedies that its proponents say works...and that's good enough. We don't need testing to show it works. This is the best demarcation. Guettarda (talk) 16:48, 28 December 2007 (UTC)

These are horrible definitions. It doesn't say "stuff not part of conventional medicine" but medical interventions not part of conventional medicine. This is not vague.

While CAM is "medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals" is a stand alone definition.

It doesn't say "stuff not taught in medical schools" but "medical interventions not taught in medical schools"

"set of practices which cannot be tested, refuse to be tested, or consistently fail tests" is vague characterization of CAM but not a definition. Imagine a dictionary entry that defined it as such. It is incomplete as a definition. For instance, bypass surgery was performed for many years before studies showed that a large percentage of those surgeries were unnecessary. Here is a procedure that failed the test. Are these CAM? Many medical treatments cannot be put through RCTs because of ethics. Are these CAM? Additionally, you are also not adhering to the 'lecture' you gave JohnGoodhe earlier on this page about the 'lead.' You have inserted all the anti-cam stuff in the lead, without any mention of it in the text. Seems a bit bias to me. Anthon01 (talk) 17:06, 28 December 2007 (UTC)

Do you believe that all CAM should be lumped together? A number of CAM procedures are being scientifically tested. Do all CAM disciplines reject scientific testing? Many medical procedures have not been rigorously tested either. Are these CAM? Anthon01 (talk) 17:13, 28 December 2007 (UTC)

I'll take a shot at answering this. CAM is CAM until there is enough scientific evidence to support its use. It is still CAM as long as it is in the testing phase. The definition from Marcia Angell, "There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work" supports this. "Adequately tested" is they key phrase really. I wouldn't call say in vitro studies only adequate testing. I guess it is really up to "scientific concensus" (and I'm sure there are evidence guidlines too) to decide what is adequate. Conventional medicine procedures which have not been rigorously tested would also be CAM under this definition and I see no problem with this. As Fontanarosa and Lundberg state "there is only "evidence-based medicine supported by solid data or unproven medicine". However, I am not aware of any specific conventional medicines that have not been tested that are not specifically classified as experimental. Yes many medical procedures cannot go throug RCTs. Such trials are used for drugs though so it is reasonalbe to expect the same standard of evidence from say homeopathy. Although you cannot do a RCT for a surgery, surgeries are supported by observational studies that at least attempt to make adjustments for the biases inherent in that research approach. Therefore I think it is only reasonable to define CAM as any treatment which does not meet the relevant standard of evidence for that area ie to not be considered CAM homeopathy should be supported by double blind trials, chiropracty and acupuncture should have trials using the best sham techniques available etc. This must hold for every use of the treatment eg if acupuncture is shown to be efficacious for pain but not quitting smoking it would still be CAM to use acupuncture as a smoking treatment. Also I am unaware of any real CAM comparison to surgery or psychotherapy. Can anyone think of a CAM trial where it would be unethical to give a satisfactory placebo (like in surgery where you have to cut someone open) or where the treatment is basically meant to be a placebo (both psychotherapy and a placebo are essentially psychological interventions). Personally I think the lead suggests something to this effect but if anyone thinks differently please suggest improvements.JamesStewart7 (talk) 09:53, 29 December 2007 (UTC)

Institute of Medicine definition(s) and NPOV

Suggest that we source all significant views, but attribute them, and weight them according to significance. Thus, "(CAM is that which) fails tests" (Dawkins) and "(that which) denies the need for tests" (Angell) are OK, but then so is Ernst, who says it is testable, and defines is more or less along the lines of NCCAM. Also, the Merriam-Webster dicdef has some weight. NCCAM is fine too, and indeed I would suggest that a scientifically-recognized group trumps that definition of any individual.

The "gold standard" for scientific consensus is statements by scientific societies, particularly National Academies. There is consensus on Misplaced Pages that statements by such bodies are citable for scientific consensus (see List of pseudosciences and pseudoscientific concepts and List of scientific societies rejecting intelligent design). For those who believe NCCAM is still too political, please have a look at the book on CAM published by the Institute of Medicine of the US Nat'l Academy of Science. See pages 16-19 of Chapter 1, which discusses CAM's definition in detail, and is a superb example of NPOV as well.

The Insitute of Medicine's discussion discusses and criticizes several significant proposed definitions of CAM, including Ernst's, Eisenberg's, Angell's, and NCCAM's. They say:

This discussion of definitions shows that no clear and consistent definition of CAM exists, nor is there a recognized taxonomy to organize the field, although the one proposed by NCCAM is commonly used. Given the committee’s charge and focus, for the purposes of this report, the committee has chosen to use as its working definition of CAM a modification of the definition proposed by the Panel on Definition and Description at a 1995 NIH research methodology conference (Defining and describing complementary and alternative medicine, 1997). This modified definition states that:

Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed.

The committee chose this definition for several reasons. First, this broad definition reflects the scope and essence of CAM as used by the American public. Second, it avoids excluding common practices from the research agenda. The effect of such a broad definition means that all statements and recommendations made in this report will not apply equally to all CAM modalities and there may even be some CAM modalities for which particular statements do not apply at all. The third reason for choosing to define CAM as stated above is that it is patient centered and includes practices that people perceive to have health benefits. Fourth, it encompasses the potential for change. That is, this definition allows a therapy to be accepted as standard practice when there is evidence of effectiveness but still allows the therapy to remain a part of CAM. Furthermore, the chosen definition recognizes that the definition of “conventional” medicine will vary from time to time and from country to country, it does not presume that proven practices will be adopted, and it allows CAM to be evaluated over time.

Maybe we could distill this discussion and just use it? One doesn't get any more authoritative on medicine than the IOM. This approach would address NPOV and VER and OR problems, not to mention solve edit warring. thanks, Jim Butler 20:36, 28 December 2007 (UTC)

Thank you. The lead should not contain every definition or 'characterization" of CAM. Priority should be given to the definition(s) (not characterizations) with greater weight. Anthon01 (talk) 22:00, 28 December 2007 (UTC)

Agree. The Institute of Medicine, being one of the four US National Academies, is the 600-lb gorilla... or at least one of them in English-language WP; other National Academies from other countries also represent sci consensus and can be used too. Other sig POV's can be mentioned too. Jim Butler 22:17, 28 December 2007 (UTC)

Seems like the pendulum has swung too far the other way, in that the lead is getting top heavy. In addition, there is a lot of text in the lead that is not in the body of the article. I would think that writing text into the body is generally a better way to go. Anthon01 (talk) 22:32, 28 December 2007 (UTC)

Happy to add the IOM stuff to the body, too, Anthon01 -- just had limited time, and was just trying to fix up the lead in a good NPOV/VER way that we could live with. regards, Jim Butler 04:26, 29 December 2007 (UTC)

In fact, almost the whole lead is definition. Doesn't seem balanced to me. Anthon01 (talk) 22:35, 28 December 2007 (UTC)

Angell et al says "What most sets alternative medicine apart, in our view, is that it has not been scientifically tested and its advocates largely deny the need for such testing." It is not a definition but a characteristic of CAM. Anthon01 (talk) 22:42, 28 December 2007 (UTC)

I don't really get your distinction between "definition" and "characterization". Seems kind of semantic. Anyway, the most authoritative source we have, IOM, says that there are varying definitions, so I guess that is what we ought to say. That, and give whatever significant definitions (or polemical criticisms disguised as definitions, etc.) that have been put forth. Jim Butler 04:26, 29 December 2007 (UTC)

Jim. Definition is "a concise explanation of the meaning of a word or phrase or symbol"

Characteristic "a distinguishing quality"

An encyclopedia should use the proper terms. Anthon01 (talk) 13:51, 29 December 2007 (UTC)

eg. Definition of Car: a motor vehicle with four wheels; usually propelled by an internal combustion engine.

eg. Characteristic - a car has four wheels. Anthon01 (talk) 16:32, 29 December 2007 (UTC)

I agree. I would call it a very NPOV characterization of CAM. There was never any consensus reached for the merging of the Definition section into the lead. I think that a separate definition should be restored. -- John Gohde (talk) 02:39, 29 December 2007 (UTC)

The lead also has an additional (perhaps even a bigger) problem, in that Misplaced Pages also has an Alternative medicine article that duplicates some of the material in this article. Though I hesitate to suggest it (in view of the considerable effort that would be involved in correcting this), I am wondering whether this article should perhaps be retitled "Complementary medicine" and all alt. med. material moved across to the Alternative medicine article? -- Vitaminman 23:54, 28 December 2007 (UTC)

I would favor redirecting alternative medicine and complementary medicine here. Perhaps a poll a/o article RfC? Jim Butler 04:26, 29 December 2007 (UTC)

I suggest that you try reading the archive of this talk page. The article clearly indicates that there happens to be a complementary medicine article. There have been two very recent attempts to merge these articles. That is why you should read the archives of all three articles. -- John Gohde (talk) 02:35, 29 December 2007 (UTC)

Use of IOM report as a source

Currently the lead contains this paragraph that refers to the IOM report three times:

• According to the Institute of Medicine (IOM), "A lack of consistency in the definition of what is included in CAM is found throughout the literature". For the purposes of their report, entitled "Complementary and Alternative Medicine in the United States" (2005), the IOM adopted this definition: "Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed."

I am definitely in favor of using this report as a source, but am also sounding a caution on how it is used. It is clearly a one-sided report exclusively written by advocates of alternative medical approaches (many are practitioners) who have no choice but to spin things so as to keep their jobs and continue to get their funding from Congress. The IOM is on a limb, and no matter what the evidence or lack of evidence, cannot do anything that cuts off the limb upon which it sits.

The report contains much valuable information, and cites many good sources that may be good in their own right, but when cited usually serve to bolster advocacy of alternative medicine. Because its basis is wishy washy post modernism, it depends on fundamental flaws caused by a suspension of disbelief, (yes, they actually advocate it!), IOW a policy that deliberately chooses to ignore or fail to use critical thinking when it is inconvenient to do so. At the same time they also (on that same page) advocate deviation from "the usual scientific norms" when attempting to judge alternative medicine. While giving lip service to Evidence Based Medicine, they are rather glib about when to abandon objective methods of determining evidence for safety and efficacy, choosing to be "innovative" when necessary. No wonder the report weaves around in a confusing array of conflicting conclusions. They are unwilling to tie themselves firmly to the anchor of objective proofs provided by RCTs. They use them when convenient, but are willing to abandon them when such RCTs consistently go against them, such as with homeopathy.

These are just a few of my concerns about the report. Use it, but be aware it is one-sided advocacy and spin doctoring. An examination of the names in the Committee Biosketches, the Aknowledgements section, and the Public Meetings section, reveals myriad staunch supporters and practitioners of alternative medicine who believe and advocate some pretty weird things. For example, James Gordon's beliefs are so woo woo that he hardly touches the ground (figuratively speaking), yet he is (or was) Chair of the White House Commission on Complementary and Alternative Medicine Policy. These are the ones making policy and sucking taxpayer funds out of Congress. Well, those are my concerns. We can use it and source it as the opinions of believers, and we can seek out some of the sources it uses and quote them as appropriate. -- Fyslee / talk 08:35, 30 December 2007 (UTC)

Most of what you are writing here is opinion. The question is, is this a reliable source. If it is then we should use it according to wikipedia's rules governing reliable sources, and not according to your beliefs. The allegations about keeping their jobs is just opinion, unless you have a source to confirm that? My understanding is that wikipedia should reflect the opinions conveyed by RS and not our own opinions. You are reading the text of a RS and deciding to paint it a particular way. Whether or not they suck taxpayers money doesn't matter unless you could provide a reference the specifically repeats the same accusation in relation to the report. Anthon01 (talk) 16:41, 30 December 2007 (UTC)

It should be used and sourced in the same way we source all RS. Anthon01 (talk) 17:01, 30 December 2007 (UTC)

Per your comments above, we are basically in agreement. (It is a RS and I wrote my opinion on this talk page.) It should be used, as I have stated above, and attribution is important. -- Fyslee / talk 17:07, 30 December 2007 (UTC)

Perhaps I misunderstood. You said "We can use it and source it as the opinions of believers ..." It sounds like you want to qualify it as opinions of believers, such as "Advocates say ...?" Did I misunderstand? Anthon01 (talk) 18:25, 30 December 2007 (UTC)

You didn't misunderstand me, but it all depends on how we use it as a RS. The opinions of believers can often be quoted from RS. The NCCAM part of IOM is pretty much owned and controlled by CAM believers and is far from neutral or objective on the subject. They exist to advocate inclusion of CAM in medical practice, and that's what they do. I'm not sure how to attribute it, but it should at least be noted that we are quoting NCCAM. It may not be an issue, but there might conceivably be a situation where more specific attribution might be necessary, IOW if NCCAM leaders who are advocates are quoted, then attribution could be necessary. -- Fyslee / talk 18:46, 30 December 2007 (UTC)

(de-indent) NCCAM is not part of the Institute of Medicine. NCCAM is part of the NIH, which is part of the US Dep't of HHS. The IOM is an independent scientific body. As an Academy of Science, they are at the highest tier of reliable sources for scientific matters, considerably moreso than individual scientists or self-selected groups. Most if not all of the caveats you raise about their independence and impartiality would logically apply to any Academy that has issued statements. Try raising those caveats at the talk pages for, say, List of scientific societies rejecting intelligent design or Scientific opinion on climate change and see how receptive skeptical Wikipedians will be. What's good for the goose is good for the gander.

There will inevitably be variations in opinion among scientists, especially on contentious topics like CAM, but we shouldn't in any way suggest a false equivalance between the IOM and groups like Quackwatch. (I don't quite see you suggesting such a thing, but I'm just saying.) Also, IOM isn't making assertions about efficacy; they're simply trying to lay out a framework for understanding and investigating CAM. That framework may well be more sympathetic to CAM than some critics (and some editors) would like, but the fact remains that IOM's opinion is more indicative of the scientific mainstream than (for purposes of defining CAM and related issues) IOM is a better V RS for scientific opinion any other source so far cited in this article.

P.S. Quackwatch's swiftboating of James Gordon (here) is pretty sickening. Yes, some of his views are fringe-y, but Quackwatch knew damned well that the Bush Administration would dislike his religious views since he was into Rajneesh and Rajneesh didn't die for their sins. More evidence that Quackwatch should be used very sparingly, and not at all when better sources exist, which for the general field of CAM they certainly do. As you know, Fyslee, I strongly supported you in a recent ArbCom case, and never believed you should have been singled out for using Quackwatch as a source on WP, but I agree with the ArbCom's characterization of Quackwatch as partisan and (frequently, per WP:SOURCES) unreliable. regards, Jim Butler 04:21, 31 December 2007 (UTC)

Thanks for straightening things out. Yes, NCCAM isn't part of the IOM. I guess my main point is that some of the main characters from NCCAM are also making their mark in the IOM report and they are definitely not disinterested parties. As far as Gordon goes, the last question that Curry closes with is a good one. Can someone who believes the things Gordon does ......? These types of people are attempting to make policies that affect all Americans, and thus all of us, since what happens in America ends up affecting the whole world. They are certainly doing a good job of enabling The Aquarian Conspiracy, to the detriment of scientific endeavors and the benefit of scam artists who exploit scientific illiteracy. (I am definitely NOT claiming that all people involved in alt med are scammers! Of course not.)

Regarding using Quackwatch as a source, it is best used as a very notable and controversial source of skeptical opinion, not a scientific textbook. That's always been my position. -- Fyslee / talk 05:24, 31 December 2007 (UTC)

So if I understand correctly, qualifying statements made by an independent scientific body as in "according to adovocates of ..." is unacceptable. Anthon01 (talk) 11:22, 31 December 2007 (UTC)

I'm not sure I understand you. (Maybe you are addressing Jim Butler?) I guess my point is that the NCCAM is definitely not independent (it represents the special interest groups of CAM supporters), and the ones whom the IOM (itself an "independent scientific body") got to make the report are not themselves independent (they are deeply invested in promoting CAM, and many of them are also in the NCCAM). I guess when the IOM wanted somone to make a report on CAM, they asked those who believed in it to make a report, at least that's the way the report reads in many places. -- Fyslee / talk 15:23, 31 December 2007 (UTC)

Total nonsense! The NCCAM is a Federal agency which is composed of highly qualified research scientists. They are by definition totally impartial. -- John Gohde (talk) 15:48, 31 December 2007 (UTC)

My point is you seem to want to qualify, in articles, the IOM's report as the opinions of advocates. I don't think it is correct to do that. I think Jim agrees with "What's good for the goose is good for the gander." I took that to mean that an Science Academy report must be treated as such regardless of whether it conflicts with your POV. The Science Academy report is mainstream. Anthon01 (talk) 17:02, 31 December 2007 (UTC)

Pseudoscience category

I see that Guettarda reverted saying "this was discussed". Looking at the archived discussion, I see some OR ("someone gives these criteria for PS, I think CAM fulfills them, etc.") but no sourcing of the claim.

The ArbCom addressed this issue, and WP:NPOV is now clear about when to use Category:Pseudoscience. Per WP:NPOVFAQ#Pseudoscience, attributable evidence of scientific consensus is necessary to use Category:Pseudoscience, while evidence of a sig POV that the topic is pseudoscientific is necessary to mention PS in the article. We have the latter, but for the former, we need a statement by a group such as an Academy of Science. Please provide such a source if you wish to place the category on the article. Thanks. Jim Butler 21:37, 28 December 2007 (UTC)

So, umm, why is pseudoscience listed under the see also section on the alternative medicine page and the complementary medicine page but not the complementary and alternative medicine page. Am I to take it the first two pages are in violation of the apparently little known ArbCom ruling or is the supporting evidence present on those pages but not on this one? Also I would say CAM follows under the "Questionable science" category mentioned on the ArbCom page which would mean "17) Theories which have a substantial following, such as psychoanalysis, but which some critics allege to be pseudoscience, may contain information to that effect, but generally should not be so characterized." JamesStewart7 (talk) 10:17, 29 December 2007 (UTC)

Having just been working on the 'See also' sections in those articles, that ommission was probably my fault. It was certainly not intentional and I have now corrected it, purely so as to maintain parity. -- Vitaminman 10:59, 29 December 2007 (UTC)

Agree, James, with your assessment re CAM in relation to that ruling. (It is now part of WP:NPOV.) The ArbCom set a higher threshold for using Category:Pseudoscience than for including views of critics that a topic is pseudoscientific. For topics with a significant following (as opposed to tiny minority absurdities like Time Cube), the threshold is whether a topic is "generally considered pseudoscience by the scientific community". As with everything else in WP, assertions of general scientific agreement have to be sourced. Such agreement does exist for some CAM topics (e.g., I gather, homeopathy), but not attributably for all of CAM. regards, Jim Butler 03:34, 30 December 2007 (UTC)

Energy therapy

There have been a few recent edits around this phrase; "Energy therapies are supposed to involve the use of energy fields" Anthon01 removed supposed to citing weasel words. Personally I don't see how "supposed to" constitutes weasel words, "This page in a nutshell:Avoid phrases such as "some people say" without sources." WP:Weasel words. Supposed to was originally placed in the article because people doubt the existance of energy fields. It looks like I, JzG and Mccready want to avoid implicitly stating that energy fields exist in this sentence. If anyone has a version of the sentence that they consider non-weasel wordy that does not suggest that energy fields exist please state it here. Otherwise I have no problems with the quoted wording (JzG's edit) or the current version (my edit). I dislike Mccready's last version for grammatical reasons only. If the sentence was reworded so that it was easier to understand I would also consider this edit acceptable. If anyone dislikes all of these revision due to weasel words, then please just tag the sentence weasel words and we can look for a source attribution and the sentence can take the form of "So and so states that energy therapies involve energy fields". JamesStewart7 (talk) 14:37, 29 December 2007 (UTC)

I will fix this in about 20 minutes. Anthon01 (talk) 14:57, 29 December 2007 (UTC)

Done. Anthon01 (talk) 15:07, 29 December 2007 (UTC)

I am not trying to bypass the opinion of three editors. I thought I provided a solution. Please read text carefully.

This is the text I propose.

Please clarify the problems with the text. Anthon01 (talk) 15:24, 29 December 2007 (UTC)

The problem is this "involve the use of energy fields" implicitly suggests that energy fields are real. I support Mccready's opposition to this proposed wording. You have to propose a wording that avoids any implicit suggestion that energy fields exist if you want us to suggest it. At the very least you have to provide an impressive argument here about why we should accept the existance of energy fields without reliable evidence or convince us that "involve the use" does not imply existance. JamesStewart7 (talk) 15:29, 29 December 2007 (UTC)

I will try. First of all, in the non woo woo world, energy fields do exist. Physics confirms that. The issue here is CAM energy medicine includes both fields that are purported to exists, but have not been proven and fields that have been proven to exist but are being used in an unconventional manner. So the very first sentence is accurate. It is a general "umbrella" statement about energy field therapies. The first sub-section outlines the totally woo woo stuff and states "not proven." Anthon01 (talk) 15:39, 29 December 2007 (UTC)

Medical education section

A lot of it has recently been fact tagged. I think it may be better to remove it all until the references are found though as it seems to contradict itself "However, alternative medicine is taught in several schools as part of the curriculum", "To obtain competence in practicing clinical alternative medicine, qualifications must be obtained from individual medical societies". It's taught but you cannot get qualified. This "Teaching is based mostly on theory and understanding alternative medicine, with emphasis on being able to communicate with alternative medicine specialists." especially seems to suggest that alternative medicine is taught with the intention that students won't actually practice alternative medicne, but simply be aware of possible interactions or may need case information from alternative medicine practitioners. Since there is no source though, it is impossible to tell. Also it is suggested that BMAS and the college of naturopathic medicine provide their training to doctors only "The student must have graduated and be a qualified doctor.. The British Medical Acupuncture Society, which offers medical acupuncture certificates to doctors, is one such example, as is the College of Naturopathic Medicine UK and Ireland.", at least that is my reading of it. This, however, "We hope all our BMAS members will apply for the Certificate of Basic Competence... Membership is open to any UK registered health professional with an interest in acupuncture. Membership fees remain very reasonable." seems to suggest that the course is open to more than doctors. This also suggests otherwise for the college of naturopathic medicine "Prerequisites: 5 GCSEs or 2 A Levels, or equivalent academic and/or work experience. Medical Doctors, Dentists, Nurses, Physiotherapists, Pharmacists, Midwives, Chiropractors, Osteopaths, etc, may not be required to take Unit 1" . So since the organisations own pages seem to directly refute these uncited claims I think I'll remove a few of the more doubtful ones. JamesStewart7 (talk) 14:51, 29 December 2007 (UTC)

I'm not sure what the goal was of the the fact-tagger, but I think one or two references can cover the whole thing. It's interesting that you have, probably unintentionally, pointed out that medical doctors require a more rigorous training than CAM's. However, I don't think that a "society" can license anyone to do anything (at least in the US, and per my personal understanding of UK medicine, nor can they there). So, I guess in the UK, I could hang out a big certification that I was an Acupuncturist. I wonder what a real doctor (you know, one that has 4 years of college, 4 years of medical school, 1 year of internship, 3 years of residency, possibly 3-5 years of fellowship) would do if they had that certification. Do no harm, being one of the primary ethics of a physician, I guess they could perform acupuncture, since it does no harm or good. OrangeMarlin 17:57, 29 December 2007 (UTC)

I think we can just assume that the fact tagger wanted to point out that the sentences are unreferenced (it wasn't me btw). In some countries, some terms eg doctor are legall protected ie you cannot legally call yourself a doctor if you do not have the training so I guess in a sense society can license you to practice medicine. To the best of my knowledge, however, anyone can call themself, say an acupuncturist as it is not a legally protected term. JamesStewart7 (talk) 23:17, 29 December 2007 (UTC)

This is not the complementary medicine article nor is it the conventional medicine article. There is no requirement whatsoever for a physician to be practicing CAM. Requirements for physicians practicing CAM should be in the complementary medicine article. If the majority of the educational institutions are teaching CAM then they are obviously not hostile towards CAM. -- John Gohde (talk) 20:10, 29 December 2007 (UTC)

The choice of curriculum in educational institutions is rarely determined by scientific credibility alone, but by many other factors, including public demand, big money donations from individuals who wish to sponsor research and departments, the possibility of getting grants from private individuals, corporations, and the government, etc.. Many such programs produce no research worth quoting, fail to diss their own negative research results that shows they are researching figments of people's imaginations, and in many other ways do whatever is necessary to avoid cutting off the hand that feeds them and employs them. The NCCAM itself suffers from this problem. -- Fyslee / talk 23:01, 29 December 2007 (UTC)

Interesting points regarding the subject:

BMJ 2007;334:659 (31 March), doi:10.1136/bmj.39163.672847.DB

News

UK universities offer degrees in 'pseudoscience,' Nature article says

David Spurgeon

Quebec

A subject that many researchers see as a pseudoscience is achieving scientific status within the British education system, says a news report in the science journal Nature (2007:446;352-3, doi: 10.1038/446352a).

In an accompanying commentary (pp 373-4, doi: 10.1038/446373a), David Colquhoun, of University College London's pharmacology department, says, 'The least that one can expect of a bachelor of science (BSc) honours degree is that the subject of the degree is science. Yet in December 2006 the UK Universities and Colleges Admissions Service advertised 61 courses for complementary medicine, of which 45 are BSc honours degrees.

'Most complementary and alternative medicine (CAM) is not science because the vast majority of it is not based on empirical evidence. Homeopathy, for example, has barely changed since the beginning of the nineteenth century. It is much more like religion than science. Worse still, many of the doctrines of CAM, and quite a lot . . .

I have added the relevant URLs and any or all of these sources (except the Google search) are RS and can be used here and in other articles. -- Fyslee / talk 22:54, 29 December 2007 (UTC)

In the USA, licensing of doctors and most other healing-modality professionals is handled by licensing boards on the state level. Not all states have the same level of rigor in this regard. Some states for example, even require licenses for ordinary non-medical massage practitioners, with different types of license for plain massage, "holistic healing" massage other technical massage such as shiatsu, etc., and of course chiropractic, and sometimes non-bodywork such as nutritionists. Sometimes it depends on the words people use to describe their work, an example being that some states require licensing for a "psychotherapist", or a "marriage, family and child counsellor", yet not for "life counsellor", or "life coach", who might do pretty much the same work. For some modalities, in some states, no license is required. It's a large complicated topic, with many special interests involved, including for example - insurance companies, hospitals, HMO's, professional associations like the AMA, pharma corps, medical schools, trade schools, supplement companies, and on and on. I learned this information from various sources, but I don't have the specific references or time to look for them right now but I thought the info might be helpful to the discussion for context. --Jack-A-Roe (talk) 23:19, 29 December 2007 (UTC)

I'm a current medical student in the US. CAM is discussed in two contexts. (1) In our humanism course, to teach us how to discover which alternatives our patients are using so that we can advise them regarding pros/cons (no pun intended). (2) In our pharmacology course, so we can recognize which illnesses, predominantly renal, come from CAM treatments. It is not discussed in the sense that we are taught how to treat patients with any of those modalities. Obviously none of this could go in the article, but I thought you might all be interested, for what it's worth. Antelan 23:08, 30 December 2007 (UTC)

The Reference Numbers Are Off by One

The reference numbers for all these references are off by one.

It appears to me that somebody edited the lead something improperly, which resulted in one reference being skipped. Can that editor please fix their edit? -- John Gohde (talk) 20:54, 29 December 2007 (UTC)

Footnote numbers can't be used in Misplaced Pages to refer to specific references. They change constantly when references are added or moved. They can be dependably discussed either by copying the text of the footnote or by using the embedded ref name=" " parameter. Probably whoever made the edit that changed the numbers doesn't even know that it happened or when. --Jack-A-Roe (talk) 23:00, 29 December 2007 (UTC)

Try hopping back and forth in the edit history until you find the last edit where the numbers were right. That's where you'll find what went wrong and can fix it. -- Fyslee / talk 23:04, 29 December 2007 (UTC)

At present, reference #19 is repeated twice. The mark up for #19 and #20 is correct. But, when you attempt to edit the entire article the problem either disappears entirely, or a different reference number (usually #30) is repeated twice. -- John Gohde (talk) 23:42, 29 December 2007 (UTC)

That's strange... there are no duplicates showing up in my browser. Maybe you need to purge your local cache, or the Misplaced Pages server cache for your browser. Take a look at this page: Misplaced Pages:Purge, maybe that will help. If not, you could try posting at the Village Pump - technical section. --Jack-A-Roe (talk) 23:54, 29 December 2007 (UTC)

I don't understand the problem since I can't find anything wrong. -- Fyslee / talk 03:43, 30 December 2007 (UTC)

Quackwatch at top of the page

McCready. Putting Quackwatch at the top of the page makes wiki appear bias. Why the rush to mention QW? There are more important to discuss. Quackwatch isn't that important. Anthon01 (talk) 17:09, 31 December 2007 (UTC)

Quackwatch is a self-published source and a poor V RS for scientific opinion, so it's a gross violation of WP:WEIGHT to put it alongside much better V RS's. See WP:V and particularly WP:SOURCES. Indeed, the ArbCom characterized Quackwatch as a unreliable and partisan source. I don't say it can't be used at all on WP; I agree with WP:INDY that articles on fringe topics, which often have little more than self-published sources, can suffer from vanity and NPOV issues and thus require balancing with a Quackwatch-type, self-published source. But the general field of CAM is extremely well-known, and we have much better sources (Dawkins, Angell) expressing the same significant, critical POV the Quackwatch does. So I see little reason to include Quackwatch in this article at all, and certainly not dignify it in the lead as being on par with good (and, in the case of

References

1. O’Connor BB, Calabrese C, Cardeña E, Eisenberg D, Fincher J, Hufford DJ, Jonas WB, Kaptchuk T, Martin SC, Scott AW, Zhang X (Panel on Definition and Description, CAM Research Methodology Conference, April 1995). (1997). "Defining and describing complementary and alternative medicine". Alternative Therapies. 3 (2): 49–57.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
2. "What is Complementary and Alternative Medicine (CAM)?". Retrieved 2006-07-11. NCCAM
3. Kamerow D. (2007). "Wham, bam, thank you CAM". Brit Med J. 335: 647.
4. ^ Alternative medicine meets science. Fontanarosa P.B., and Lundberg G.D. JAMA. 1998; 280: 1618-1619.
5. ^ Alternative medicine--the risks of untested and unregulated remedies. Angell M, Kassirer JP. N Engl J Med 1998;339:839.
6. Snyderman, R.; Weil, A. T. (2002-02-25). "Integrative Medicine: Bringing Medicine Back To Its Roots". Archives of Internal Medicine. Retrieved 2006-07-11. {{cite journal}}: Cite journal requires |journal= (help)CS1 maint: multiple names: authors list (link) PMID 11863470
7. David M. Eisenberg
8. ^ Unconventional Medicine in the United States -- Prevalence, Costs, and Patterns of Use. Eisenberg D, et al. N Engl J Med 1993; 328:246-252.
9. alternative medicine Function: noun: "any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain." ; retrieved from Merriam-Webster Online on 5 August 2006.
10. Simonyi Professorship web site
11. A callous world. Richard Holloway. Book review Richard Dawkins A Devil's Chaplain. The Guardian, February 15, 2003.
12. Dawkins, Richard (2003). A Devil's Chaplain. Weidenfeld & Nicolson. {{cite book}}: More than one of |author= and |last= specified (help)
13. The Cochrane Collaboration Complementary Medicine Field, www.compmed.umm.edu/Cochrane/index.html. Retrieved 5 August 2006.
14. The HealthWatch Award 2005: Prof. Edzard Ernst Complementary medicine: the good the bad and the ugly. www.healthwatch-uk.org/awardwinners/edzardernst.html, retrieved 5 August 2006
15. "Complementary medicine is diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine." Ernst et al British General Practitioner 1995; 45:506
16. ^ Cassileth, Barrie R. (2002). "The Role of Complementary & Alternative Medicine: Accommodating Pluralism". NEJM. 347: 860–861. Cite error: The named reference "Cassileth" was defined multiple times with different content (see the help page).
17. http://books.nap.edu/openbook.php?record_id=11182&page=17
18. http://www.nap.edu/catalog.php?record_id=11182
19. http://books.nap.edu/openbook.php?record_id=11182&page=19

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