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Recent change to lead

I reverted a recent change to the lead, as it seemed to paint a misleading picture of the literature.

The first problem was "There is weak to no evidence of benefit for women". This doesn't seem to be a neutral reflection of the literature. Hallett et al wrote:

Next we conducted a meta-analysis of data from the two independent observational cohorts19 36 on the long-term effect of male circumcision on male-to-female HIV transmission. The overall fixed-effect point-estimate hazard rate was 0.54 (95% CI 0.31 to 0.96) (p1⁄40.04), indicating 46% reduction in transmission rate from 2 years after the operation. Our meta-analysis of the best available cohort data suggests that male circumcision reduces the chance of male-to-female HIV transmission with a latent interval of at least 2 years,18 19 and that this substantially amplifies the potential impact of circumcision interventions in populations.

Larke et al, wrote:

Although at a population-level, widespread male circumcision will benefit women by reducing their risk of exposure to HIV, there are insufficient data to know whether circumcision directly reduces risk of women becoming infected with HIV.

A second problem was the statement that there is "no evidence of benefit in developed countries and among men who have sex with men". The most recent Cochrane review stated:

Current evidence suggests that male circumcision may be protective among MSM who practice primarily insertive anal sex, but the role of male circumcision overall in the prevention of HIV and other sexually transmitted infections among MSM remains to be determined.

For these reasons, I reverted the change. Jakew (talk) 09:54, 21 December 2011 (UTC)

Yes I would agree with that.Doc James (talk · contribs · email) 11:11, 21 December 2011 (UTC)

I've changed the lead again. I've rephrased the bit about benefit for women because the sources don't qualify the situation as controversial so we shouldn't. I've also changed the WHO's recommendations bit to accurately reflect the source and not a subtitle sub-heading in that source, as described elsewhere on this talk page. Finally, I've changed the reference to the review of economic evaluations based on arguments provided in the section above, which seem to have been ignored when that part was recently reverted. Beejaypii (talk) 13:03, 21 December 2011 (UTC)

Strictly speaking the sources don't describe the situation as disputed, either, but I think this edit is okay.

We've discussed the WHO recommendations sentence at length, and you've failed to convince myself or others that it needs to change. The present text is verifiable.

"a review of five economically evaluative studies found they concluded it is cost effective in this population" is needlessly verbose. To make a conclusion about cost-effectiveness, a study would have to evaluate economic aspects, so "economically evaluative" is redundant. "A review of five studies found they concluded it is cost effective in this population" is awkward and seems to unnecessarily distance itself from the statement. The review's conclusions are not disputed in any way, to my knowledge, so why not just assert its findings? "Studies concluded it is cost effective" is more concise; alternatively "several studies have concluded it is cost effective" would also work. Jakew (talk) 14:41, 21 December 2011 (UTC)

Beejaypii, it appears that the additional wording reflected concerns that you may personally hold regarding the results of the studies, but which are not mirrored in the relevant literature. Also, it seems odd that you would consistently try to remove or seriously shorten the WHO material, and then turn around and try to lengthen it with words that add no significant information. Jayjg 16:23, 21 December 2011 (UTC)

How can we say it is cost effective based on this source quote from above? "There are number of limitations associated with these studies. Most of these studies did not considered complications associated with AMC in their cost-effectiveness models. It has been reported that high complication rates challenge the implementation of male circumcision for HIV prevention in Africa . Another important limitation of these studies, except for Kahn et al 2006 , most of the authors did not considered multivariate sensitivity analysis. The uncertainty in the evidence base needs to be reflected in the model." Garycompugeek (talk) 20:31, 21 December 2011 (UTC)

We're not saying that it's cost-effective. We're saying "in this population studies rate it cost effective", "a review of studies found it is cost effective in this population", or "a review found it is cost effective in this population". Or, to include the suggestions above, "... studies concluded it is cost effective" and "... several studies have concluded it is cost effective". Jakew (talk) 21:16, 21 December 2011 (UTC)

I agree Gary, and I was just about to post more on this topic when I got an edit conflict with your contribution. Here's my contribution.

Jakew, I think you may agree then that "disputed" is more objective and neutral than "controversial"?

As for the economic evaluations, the current version of the lead states "...and a review found that it is cost effective..." No it did not. The review found that five economic evaluations concluded it is cost-effective. That's not the same thing:

All published economic evaluations offered the same conclusion that AMC is cost-effective and potentially cost-saving for prevention of heterosexual acquisition of HIV in men. On these grounds, AMC may be seen as a promising new form of strategy for prevention of HIV and should be implemented in conjunction with other evidence-based prevention methods.

They aren't unconditionally concluding that circumcision is cost-effective; they're only concluding that the five studies found it was, and therefore "On these grounds...it may be seen as..." And consider the study authors' own discussions of the limitations of their review and the studies they reviewed:

There are number of limitations associated with these studies. Most of these studies did not considered complications associated with AMC in their cost-effectiveness models. It has been reported that high complication rates challenge the implementation of male circumcision for HIV prevention in Africa . Another important limitation of these studies, except for Kahn et al 2006 , most of the authors did not considered multivariate sensitivity analysis. The uncertainty in the evidence base needs to be reflected in the model. To simultaneously assess the implications of uncertainty in all elements of evidence, probabilistic analysis should be used to establish the decision uncertainty associated with each public health intervention being compared , . This informs decision-makers about the probability of each strategy being the most cost-effective conditional on the value that the decision maker places on a unit of health gain. Such methods can also be used to provide an opportunity to apply value of information (VOI) methods to inform priority setting in research , , . Generalizability of the findings is also an important limitation. Most of the studies were based on OF trial . The OF trial was conducted in a single country and used prevailing or local prices to calculate costs. Economic evaluation carried out alongside a randomised controlled trial may differ significantly from usual practice or care . We recommend that future economic evaluations address these limitations and be guided in part by the checklists available for assessing economic evaluations. Economic evaluation provides a useful framework to assist policy makers in allocating resources across competing needs. HIV/AIDS is a considerable burden on society resources, and prevention provides a cost-beneficial solution to address these consequences. To better inform the decision-making process, researchers must continue to produce high-quality, methodological, comparable and scientifically credible economic evaluations.

It's hardly surprising they hedge their bets by preceding their conclusions with "on these grounds" instead of just asserting "we conclude that circumcision is cost-effective"; I don't think they do that anywhere, so we shouldn't attribute that to them in the article.

Your suggestion, Jakew, namely "several studies have concluded it is cost effective" lacks precision where precision is possible, but has the merit of not attributing an unqualified conclusion where there is not one. Beejaypii (talk) 20:37, 21 December 2011 (UTC)

My lack of objection, Beejaypii, is not because of a preference for the term "disputed" but, rather, because I don't think it particularly matters. The edit doesn't seem to do any real harm, and consequently it seems a waste of time to bother debating it.

Regarding the review, the words "on these grounds" are not followed by any reference to cost-effectiveness, and thus are clearly irrelevant.

The most important point here, I feel, is that the review clearly states that all studies find that circumcision is cost-effective. Now, given that the lead is supposed to be a short summary, what is the most concise way to express that information? Choosing such a short summary may lack detail, but detail must be balanced against brevity. Jakew (talk) 21:16, 21 December 2011 (UTC)

What are you talking about? "On these grounds" is an anaphoric reference (a reference to something mentioned previously in the text):

"All published economic evaluations offered the same conclusion that AMC is cost-effective and potentially cost-saving for prevention of heterosexual acquisition of HIV in men. On these grounds..."

What do you think "these grounds" refers to there?

The point still stands. The review did not find that circumcision is cost effective, it found that the five studies concluded that it was - unless you care to ignore the review authors own expression of their conclusions, and their own admission of the weaknesses of their review and the studies they reviewed. Additionally, it does not matter what you feel to be the most important point; what matters is what the source claims and what this article claims it claims. Finally, it's not just about detail and brevity, it's about accuracy and not creating a misleading impression. Beejaypii (talk) 23:12, 21 December 2011 (UTC)

The quote you've used says "All published economic evaluations". Are there economic evaluations that disagree? Jayjg 23:17, 21 December 2011 (UTC)

You need to read the source carefully. Although they haven't expressed it very well, I think you'll find they are referring to the five studies they evaluated. Beejaypii (talk) 23:47, 21 December 2011 (UTC)

... which they describe as "All published economic evaluations". Jayjg 00:03, 22 December 2011 (UTC)

Like I said, you need to read the source carefully. In particular, read the section where they describe how they whittled it down to just five sources. I do think the source is badly written in some respects however, and there is room for doubt - which is probably yet another debate.

No matter what they are referring to, the source still does not claim, without qualification, that circumcision is cost effective, as Jakew was trying to argue above, and as the current version of the lead ("...a review found it is cost effective in this population...") misleadingly states. The review found that five studies (depending on the interpretation of the phrase "All published economic evaluations" of course, though that still doesn't affect the point I'm making) concluded that circumcision is cost effective and "On these grounds...it may be seen as..." To present that as "...a review found it is cost effective..." is to turn a qualified conclusion about other conclusions into a direct assertion about a characteristic of the phenomena in question, which is to misrepresent the source and misleadingly strengthen the conclusions attributed to it. The same is true where the WHO's detailed body text assertion "Male circumcision should always be considered as part of a comprehensive HIV prevention package.." - which leaves the final decision to those directly responsible for such decisions - is ignored in favour of a section sub-title, "Male circumcision should be part of a comprehensive HIV prevention package", which is obviously devoid of detail and direct context, being primarily a structural element of the text - since when do sub-headings take precedence over detailed body text? And the sub-heading doesn't even contradict the body text, it only represents the bit of the body text describing the context in which HIV should "be considered". Beejaypii (talk) 16:01, 22 December 2011 (UTC)

Are there published economic evaluations that come to a different conclusion? The lede currently states "According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision". Should we similarly examine its sources/methodology and modify its words in an effort to downplay or qualify this conclusion too? Jayjg 17:54, 22 December 2011 (UTC)

(unindenting) So, "studies concluded it is cost effective" seems a reasonable summary of "All published economic evaluations offered the same conclusion that AMC is cost-effective". It's also one word shorter than the current text ("a review found it is cost effective"). Shall we change it? Jakew (talk) 16:39, 22 December 2011 (UTC)

It's the most accurate summary of the source and the most brief proposal yet, so it's hard to imagine a valid reason not to. Jayjg 17:50, 22 December 2011 (UTC)

That seems reasonable Jakew. However, I'd change "concluded" to "have concluded": the former (simple past tense) seems too final and chronologically remote - almost as if the chapter is closed on that issue - whereas the latter (present perfect) maintains the link with the present better.

It has occurred to me, however, that the question remains of why this bit about cost-effectiveness is even in the lead. It seems to answer a question which hasn't even been posed. The article is about the surgical procedure circumcision, not economic considerations in the fight against HIV. I should say, though, that I'm not too concerned with this at the moment.

As for the WHO recommendations, perhaps someone would like to address the issue of prioritising a sub-heading over body text, as is the case with the WHO source?

Finally, why isn't there anything about foreskin restoration in the lead, and only one mention in the article body? It's a sub-topic which seems to have significant prevalence in reliable sources, and that's the justification used for inclusion of the HIV information in the lead (even though it's really more a measure of newsworthiness than importance, and degree of direct relevance, to the main topic)? Beejaypii (talk) 18:45, 22 December 2011 (UTC)

Okay, I think we've rough consensus for "studies have concluded it is cost effective".

Regarding the WHO recommendations, both versions (those with and without "consider") are verifiable, but since the former is shorter, it makes sense to use it. It is in any case the clear intent of the body text anyway, so there's no real conflict that I can see.

Regarding foreskin restoration, very few reliable sources mention it. I found only three at PubMed, and only 207 at Google Scholar (that's about 0.2% of the 112,000 for circumcision). Jakew (talk) 19:36, 22 December 2011 (UTC)

Yes, I think we have rough consense for "studies have concluded it is cost effective".

I'm going to accept the current version of the lead summary of the WHO recommendations, at least for now, because I think your "foreskin restoration" search raises some important issues and I'd prefer to discuss those.

The principle of performing PubMed and other searches to establish relative importance of a sub-topic to the main topic is particularly problematic. Firstly, only sub-topics which are currently newsworthy and being discussed will return significant results: non-controversial sub-topics, whose principles are widely accepted, simply won't be the focus of much discussion and won't return significant results. These kinds of searches do not, therefore, provide an indication of the relative degree of importance of a sub-topic by comparison with another sub-topic where one of those sub-topics is currently newsworthy and the other isn't.

Secondly, in terms of execution, the search principle lends itself well to searches for sub-topics which can be comprehensively referenced via a single term (as is the case with "HIV", which is an unambiguous and highly prevalent abbreviation) but is much more difficult to perform where a concept may be referred to using a variety of words/phrases, as is the case with foreskin restoration, which, to cite a few examples, could be referred to as "restoration of the foreskin", "uncircumcision", "restoring the foreskin", "preputial restoration", "foreskin restoring", "restore the prepuce" and even highly contextual variations such as "restore what they've lost", etc.

Thirdly, a search for co-occurring terms reveals nothing about the basic nature of the relationship between the concepts represented by those terms, aside from an indication, via prevalence of co-occurrence in sources, that there is a relationship.

Finally, why just use PubMed as a dedicated journal search facility, with its biomedical restrictions, why not other academic search facilities such as ScienceDirect? After all, not all sub-topics of circumcision are necessarily medical, e.g. history and religion for starters. Any attempt to establish relative importance of a sub-topic must take as many aspects as possible into account surely? Beejaypii (talk) 13:53, 23 December 2011 (UTC)

Lead text moved to sub-paragraphs

All content besides definition has been moved from the lead/header text to the relevent sub-paragraphs. No content has been changed or removed. — Preceding unsigned comment added by Okotoimako (talk • contribs) 10:45, 23 December 2011 (UTC)

I reverted this change because it created an inadequate lead that merely served as a dictionary definition. Per WP:LEAD, "The lead serves as an introduction to the article and a summary of its most important aspects." Jakew (talk) 11:14, 23 December 2011 (UTC)

Yes contravenes WP:LEAD --Doc James (talk · contribs · email) 11:47, 23 December 2011 (UTC)

Misplaced Pages promotes the World Health Organization's opinions in the second and third paragraphs of the Introduction, without citing any authoritative opinion to counterbalance it. The citation from the Royal Dutch Medical Association in the fourth paragraph hardly offsets the WHO theories advocated as "strong evidence" in the opening paragraph. In context to its advocacy of the WHO theories, Misplaced Pages uses a very weak citation from the KNMG,i.e., "According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision.", which indicates an ignorance of the KNMG's core statement, "There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene." To keep the Introduction in its current version establishes Misplaced Pages's advocacy of the controversial WHO hypotheses. — Preceding unsigned comment added by Mock The Knife (talk • contribs) 17:06, 23 December 2011 (UTC)

See the above section. Jakew (talk) 17:20, 23 December 2011 (UTC)

NPOV dispute -- Second and Third Paragraphs of the INTRODUCTION above Contents

There has been no attempt to address the imbalance of viewpoint in the opening paragraphs. The second paragraph establishes the World Health Organization as the ultimate authority on the demographics of worldwide circumcision, so that by the third paragraph too much weight has been given to WHO's controversial AIDS theory, and no counterbalancing authority is cited to offset it. The phrase "strong evidence" that introduces the AIDs theory very clearly violates the neutral point of view, i.e., "strong evidence" states seriously a contested assertion as fact.

Misplaced Pages's endorsement of the AIDs research as "strong evidence" states its opinion of the research as fact, violating the neutral point of view. The AIDS studies in Africa have been critiqued and disputed on many grounds, most recently in the December 2011 Journal of Law and Medicine. see Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns Gregory J Boyle and George Hill December 2011 Journal of Law and Medicine http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf

The Royal Dutch Medical Society rejected the AID's theory when it issued its finding in 2010 that "There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene." Mock The Knife (talk) 17:06, 24 December 2011 (UTC)

There is scientific consensus that strong evidence exists. As explained previously, the existence of a small number of individuals expressing a minority point of view does not change that. Jakew (talk) 18:28, 24 December 2011 (UTC)

Archiving rate

Garycompugeek apparently wants to slow down the archiving rate of the Talk: page, which, for the past six months, has been set to 1 week. For the six months before that it was actually set to 5 days. The reason it's set so short is because the Talk: page generally quickly fills up with WP:NOTFORUM violations, typically from new account anti-circumcision activists, or from the many sockpuppets of TipPt or Joe Circus. Is there a consensus here to slow it down? Jayjg 17:04, 28 December 2011 (UTC)

I think a week is perfectly reasonable. It's not as though this is an obscure article that people rarely look at, after all. I'd oppose increasing it to a month. While I'd prefer not to increase it at all, I'd be willing to compromise on a fortnight, with the understanding that it may need to be reduced again if the talk page becomes unmanageable. Jakew (talk) 17:17, 28 December 2011 (UTC)

Obviously, a constant archiving rate of one week is sometimes going to lead to current debate material being archived prematurely (e.g. the table of search methods used to establish weight and associated criticism). I support a compromise change to a fortnightly archiving frequency. I'm going to restore the thread with the table because I last updated it on the 24th - four days ago. Any objections? Beejaypii (talk) 20:26, 28 December 2011 (UTC)

I dislike having to go through the archives because a discussion has dragged on, and commenting on a thread in the archives is for posterity. Let us try two weeks and see if it is better, I simply set it to one month because that seems to be the most common denominator. Garycompugeek (talk) 15:13, 29 December 2011 (UTC)

I also prefer the current one week archiving period, but am willing to test a two week archiving period, with the understanding that it will be switched back to one week without further discussion if the page starts filling again as it so often has in the past. Jayjg 15:56, 29 December 2011 (UTC)

Completely agree. We may even need to reduce it to less than one week if subjected to a lot of nonsense, as we have been in recent months. Jakew (talk) 16:17, 29 December 2011 (UTC)

And, of course, this change is not retroactive, so Gary, please stop trying to restore to this page dead discussions that have already been archived. Jayjg 17:05, 29 December 2011 (UTC)

Jayjg, Beejaypii added to the table 4 days ago as this] shows. Why are you edit warring on a talk page about archived discussions? If myself or any other editor wants to discuss anything pertaining to the article, who are you to set a time limit? Please self revert immediantely. Garycompugeek (talk) 17:30, 29 December 2011 (UTC)

I'm not sure why Beejaypii was adding to someone else's table, when he should have been making his own table. In any event, there was no on-going discussion of the material, and no likelihood that any consensus would form regarding changing the lede. Instead, what would inevitably happen is this:

1. Beejaypii would propose shortening or in some way discrediting any material seen as favorable to circumcision, particularly in the lede.
2. You would wholeheartedly agree with whatever Beejaypii proposes.
3. Some IP editor, new editor directed here from an anti-circumcision discussion board, or sock of TipPt or Joe Circus would show up and agree.
4. No-one else commenting would agree to the change.
5. Interminable conversation on the topic.
6. Rinse, repeat.

If you like, I can set up a template for this conversation, with parameters for the specific material Beejaypii finds too "pro-circumcision" this time, and an auto-signature for your inevitable concurrence with whatever Beejaypii says. I might even be able to work out some sort of randomized name for the inevitable IP/sock that shows up too. Perhaps Jakew could create a bot that every couple of days would add standard comments in the conversation - for example

The lede still gives UNDUE weight to the pro-circumcision material X. Beejaypii

Agree completely with whatever he said. Garycompugeek

This article will never improve as long as it relies on JUNK SCIENCE!!!. Joe Circus sock59

How does that sound? Jayjg 17:55, 29 December 2011 (UTC)

I found it quite amusing to read. My perspective is quite different. New editor comes to page and complains about pages neutrality or pages name disparity from Female genital mutilation. Jake reverts and points to some obsure archived thread that goes on for decades discouraging said editor and if the poor editor has the nerve to question or complain more Jayjg generally bites their head off. If things continue to go south Avi generally shows up to back both of you up. Want to talk about gaming the system? Jakew's edit count of 1305 ] by far exceeds anyone elses, ex Avi 561, Tip 556, Jayjg 233, Garycompugeek 173, Beejaypii 104. Garycompugeek (talk) 17:54, 30 December 2011 (UTC)

Not sure what edit counts have to do with anything (they certainly have nothing to do with my comment), but TipPt's actual edit count on the article is almost 700, once you include his various socks (User:Zinbarg etc.) and IPs. Jayjg 00:23, 1 January 2012 (UTC)

Before this thread degenerates any further, I've created a new section below combining the table in question with an adaptation of other, related comments I contributed recently. I hope other editors are prepared to engage in the debate. Beejaypii (talk) 01:36, 30 December 2011 (UTC)

Problematic methodology used to establish sub-topic weight (generally, and with respect to HIV information in the current lead)

Because there has been some confusion about which discussion threads are active or not, I'm bringing together material from two related discussions in this new section to clarify the situation.

Here's the latest version of the table (recently bot-archived four days after the last edit to it) which was originally introduced by Coppertwig with this edit, where he invited "others to edit it and add to it."

In addition to what the search results and criticism offered in the table above suggest, it does seem that the principle of performing PubMed and other searches to establish the relative importance of a sub-topic to a main topic is fundamentally problematic.

Firstly, only sub-topics which are currently newsworthy and being discussed will return significant results: non-controversial sub-topics, whose principles are widely accepted, simply won't be the focus of much discussion and won't return significant results. These kinds of searches do not, therefore, provide an indication of the relative degree of importance of a sub-topic by comparison with another sub-topic where one or more of those sub-topics is currently newsworthy and one or more of the others isn't. And even when comparing two newsworthy sub-topics, these searches still don't provide an indication of the relative degree of importance they have to the main topic.

Secondly, in terms of execution, the search principle lends itself well to searches for sub-topics which can be comprehensively referenced via a single term (as is the case with "HIV", which is an unambiguous and highly prevalent abbreviation) but is much more difficult to perform where a concept may be referred to using a variety of words/phrases, as is the case with foreskin restoration for example, which, to cite a few possibilites, could be referred to as "restoration of the foreskin", "uncircumcision", "restoring the foreskin", "preputial restoration", "foreskin restoring", "restore the prepuce" and even highly contextual variations such as "restore what they've lost", etc.

Thirdly, a search for co-occurring terms reveals nothing about the nature of the relationship between the concepts represented by those terms, aside from an indication, via prevalence of co-occurrence in sources, that there is some relationship.

Finally, why just use PubMed as a dedicated journal search facility, with its biomedical restrictions, why not other academic search facilities such as ScienceDirect? After all, not all sub-topics of circumcision are necessarily medical, e.g. history and religion for starters. Any attempt to establish relative importance of a sub-topic must take as many aspects as possible into account surely? Beejaypii (talk) 01:16, 30 December 2011 (UTC)

It seems there are significant problems involved in trying to justify dedicating a large portion of the lead (currently over 25%) to the HIV issue. The HIV issue is a sub-topic of a sub-topic (medical aspects) of the main article topic, and even within that sub-topic it does not have as direct and intrinsic a relationship to the surgical procedure as other medical aspects. Therefore, and based on closer examination of what seems to be seriously flawed methodology used to justify the weight apportioned to HIV in the lead thus far, I again suggest reducing the HIV coverage in the lead, to this concise summary:

Additionally, strong evidence that circumcision reduces the risk of HIV infection in heterosexual men has led to the WHO recommending circumcision, with respect to that population, as an additional HIV prevention strategy, with the proviso that it should always be considered as part of a comprehensive HIV prevention package.

In particular, I think we need to keep in mind that the main topic of this article is the medical procedure circumcision, with its procedural, historical, religious, cultural (to name a few) sub-topics, as well as sub-topics of those sub-topics. So, any objections to the change I propose? Beejaypii (talk) 01:56, 31 December 2011 (UTC)

Please see previous discussions. Jakew (talk) 09:28, 31 December 2011 (UTC)

I assume you're referring to discussions I haven't been involved in (otherwise your request makes little sense) which deal with the criticism of the term co-occurrence search methodology I've introduced into the table above. If that is indeed the case, would you mind pointing me to those discussions? Beejaypii (talk) 12:13, 31 December 2011 (UTC)

No, Beejaypii, I'm referring to previous discussions in which you've proposed to shorten the HIV material, and others (including myself) have rejected that proposal.

As for your criticism of the "co-occurrence" methodology, I think you've overstated your case somewhat, but I basically agree with your fundamental point that such methodologies are inexact. I've already agreed said so, in Talk:Circumcision/Archive 68#Weight of HIV in lead, where I wrote: "it's a fairly crude methodology". But I continued "it's among the best available", and that's the important point: while a perfect indicator of due weight would be wonderful, we only need a rough estimate. After all, those of us reasonably familiar with the literature should have a good idea of the relative importance of various topics, and we only need the figures to help quantify that. And since we don't have anything better, these data will have to suffice. Jakew (talk) 13:29, 31 December 2011 (UTC)

I also wonder what has changed from the relatively recent descussions we've had about shortening the amount of space given to HIV in the lede. As I recall, the last two times you proposed changing the lede, Garycompugeek inevitably agreed with everything you said, and no-one else did. What has changed since then? Based on the weight given to HIV in recent medical literature about circumcision, the lede should probably devote more space to HIV than it currently does. Jayjg 00:28, 1 January 2012 (UTC)

Jakew, why refer me to previous discussions that I was actually involved in? Additionally, why refer me to discussions which did not include a detailed analysis of the methodology criticised in the table and accompanying post by me above? The debate has obviously moved forward and those discussions do not provide answers to the points I've made.

If the methodology in question is good enough to be applied, please demonstrate its use to justify 25% of the lead dedicated to the HIV issue. In other words, please provide specific counter arguments to the points I've made.

How can "those of us reasonably familiar with the literature" be confident that the "good idea of the relative importance of various topics" that we "should have" is not influenced by our own prejudices? What are the safeguards? Your assertion sounds like an argument in favour of the POV of yourself and others in the current context.

Jayjg, if you think "the lead should probably devote more space to HIV than it currently does", and if you're confident about that (your use of 'probably' suggests some doubt on your part), please provide arguments supporting your opinion, or at least explain what you mean by "ased on the weight given to HIV in recent medical literature about circumcision". In particular I'd be interested to know how you've ascertained the weight given to HIV and how that pertains to assessing the weight of the HIV issue relative to the main article topic in relation to the relative weight of all other sub-topics to the main article topic. Beejaypii (talk) 03:24, 1 January 2012 (UTC)

Beejaypii, the reason why I referred you to those discussions was because you asked whether there were objections to your proposal to shorten this material. Since several people (including myself) have previously explained their objections to doing so, doing so again seems an inefficient use of time. Jakew (talk) 11:19, 1 January 2012 (UTC)

Indeed, this constantly re-asking essentially the same questions is an extremely "inefficient use of time". That's why I'm going to respond here minimally, while noting my previous reasoning and objections, which Beejaypii can assume will never change unless he produces some actually new and convincing material or arguments, which he so far has not. Jayjg 16:43, 1 January 2012 (UTC)

Jakew and Jayjg, if all my arguments above have already been countered, produce the evidence. If my arguments are unconvincing, counter them. Beejaypii (talk) 02:32, 2 January 2012 (UTC)

This has already been done, which is why this is an "inefficient use of time". There is no way of measuring the exact importance of HIV to circumcision, but a review of the recent literature (particularly medical) indicates that it is of significant importance. It is therefore quite obvious that the lede should at least mention the topic, and any editor who suggests removing it entirely, or that it is a "compromise" to even mention it, can be dismissed out of hand, because the arguments put forward for removing it entirely are neither policy-based nor rational (e.g. "JUNK SCIENCE!!!", "it's only relevant to Africa!!!", "an article criticized the WHO's position!!!"). Now, whether one-tenth, one-quarter, or one-third of the lede should be devoted to the topic can never be decided in a purely mathematical way. Rather, editors must examine the different proposals, and see which prose seems to best summarize the topic. From that perspective, proposals designed solely to minimize the amount of text devoted to the topic – as opposed to proposals designed to best summarize the topic - will never achieve consensus, regardless of their purported rationales. Jayjg 20:11, 4 January 2012 (UTC)

I agree with Beejaypii's proposal. His logic is quite sound and Jake's is quite week. I am making a compromise (a rare bird around here) for I did not want any mention of HIV in the lead and feel its Wp:UNDUE for reasons stated above. The paragraph summarizes the sources well. Garycompugeek (talk) 15:55, 31 December 2011 (UTC)

Maybe someone should propose a RfC to get greater input.Doc James (talk · contribs · email) 05:01, 1 January 2012 (UTC)

The "logic" of using results of intersection of search results is bizarre: Google Books search for "Islam" 30,500,000 results; "Circumcision" yields 2,520,000; together 109,000 results (about 4% of circumcision and 0.3% of Islam), so using the logic posed about, one should remove Islam from the lead before HIV since the relationship appears statistically an order of magnitude weaker. This of course would be preposterous, given that many (most?) circumcisions are following the precepts of Islam rather than for HIV or anything else that ails you. Just another statistical argument that amounts to nada, like virtually the entire thread above. Carlossuarez46 (talk) 22:41, 2 January 2012 (UTC)

I agree with you about the search methodology. However, I'm not sure what your stance is in relation to this discussion topic: are you arguing that dedicating roughly 25% of the current lead to the HIV sub-topic is justified or not? Beejaypii (talk) 07:38, 4 January 2012 (UTC)

The lead should identify what the topic is, why it's important (or at least notable), and do a quick summary of the major points to be delved into. Perhaps the lead on HIV can be shortened to the simple first statement "strong evidence..." and leave the rest for details, but some may claim that the bald statement without some further clarification is biased in which case the additional statements are added to provide balance - and if that takes up space, well - WP is full of space. Carlossuarez46 (talk) 17:09, 4 January 2012 (UTC)

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