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Clarifying controls

It would be helpful if the article said which bogus points were used: i.e. where were they on the body with respect to the affected area, other acupuncture points, or other acupuncture meridians. For example, if the knee pain study used non-acupoints at or very near the knee, that would mean that the control could have been active according to TCM theory. (TCM suggests needling points close to a painful area even if those points are not traditional acupounts, especially if those same points are painful or ashi points.)

Needling shallowly at a verum point is also active.

Overall, it would be good to note that both controls, though less active than the treatment, are still potentially or actually active according to TCM theory. Ideally, we could use a source saying this in context of GERAC, to avoid coming even close to WP:SYN. But it could still be mentioned in a brief background section without violating SYN as long as we avoided putting a big "however" qualifier in the conclusion.

Some editors may say that the above sounds like special pleading, but the reasoning comes straight from the IOM . They say that the study of traditional medicines must take into account the traditional context of its practice: i.e., how treatments are formulated (which goes to theory) and delivered. The fact that the IOM makes this point establishes it as a well-weighted, mainstream scientific approach to acupuncture. This is obvious on the merits: It's very hard to see how anyone would argue that the possible use of active control group should be ignored unless that person were scientifically illiterate or disingenuous. --Middle 8 (talk) 22:53, 28 May 2012 (UTC)

Unfortunately the source doesn't elaborate on the bogus points, and as far as I understand they could have been ashi points (not very likely, though, given the fact that no de-qi was reached). However, if you want to include this allegation in the article, we would have to find a source for it - otherwise it would be Original Research. Cheers, --Mallexikon (talk) 04:30, 29 May 2012 (UTC)

Primary sources tag

I found a good secondary source and just added it to the references... Don't have time to go through it right now and it's all in German, but this source should be able to cover most citations in this article. Will come back to it. --Mallexikon (talk) 03:02, 5 November 2013 (UTC)

I don't see good secondary sources. This article relies heavily on primary sources. All content that relies on primary sources must be deleted now. QuackGuru (talk) 02:11, 20 November 2013 (UTC)

This is a secondary source? QuackGuru (talk) 02:44, 20 November 2013 (UTC)

The secondary source is from the Gemeinsamer Bundesausschuss. Please read WP:MEDREV: "When using a primary source, Misplaced Pages should not overstate the importance of the result or the conclusions." It does NOT say that primary sources can not be used at all, or have generally considered to be not reliable. Your unreliable source tagging, and questioning the primary source regarding how many health insurances actually initiated GERAC, appears pretty pointy here. --Mallexikon (talk) 03:03, 20 November 2013 (UTC)

The secondary source is from the Gemeinsamer Bundesausschuss? Don't you mean it is a primary source. You did not show how this is a secondary source. QuackGuru (talk) 03:48, 20 November 2013 (UTC)

The Federal Joint Committee (Germany), and other the primary sources are unreliable. The source Gemeinsamer Bundesausschuss is not reliable. QuackGuru (talk) 03:52, 20 November 2013 (UTC)

Agree, this article needs to be filleted - in fact probably deleted, with any usable remnant merged into the main acupuncture article. Alexbrn 03:57, 20 November 2013 (UTC)

I don't think there is a single sentence that is usable for the main acupuncture article. QuackGuru (talk) 04:11, 20 November 2013 (UTC)

There is Ernst's comment .... Alexbrn 04:14, 20 November 2013 (UTC)

This text is sourced using unreliable sources. "In 2000, the paramount decision-making body within the self-government of medical service providers and statutory health insurance companies in Germany, known as the Joint Federal Committee (Gemeinsamer Bundesausschuss), ruled that acupuncture treatment may not be covered by statutory health insurance companies except within the framework of field studies."

Gemeinsamer Bundesausschuss 2007, p. 2

"... beschloss der Gemeinsame Bundesausschuss (B-BA) am 16. Oktober 2000, dass Akupunktur nur noch im Rahmen von Modellvorhaben ... von der Gesetzlichen Krankenkasse bezahlt werden kann." ("... on October 16th 2000, the Joint Federal Committee ruled that acupuncture may only be covered by statutory health insurance companies within the framework of field studies ..." As seen at: Endres et al. 2007, p. C101

These are unreliable sources. QuackGuru (talk) 03:58, 20 November 2013 (UTC)

This is getting silly. We are talking about huge RCTs published in respectable medical journals, and the Federal Joint Committee (Germany). Why would these be unreliable sources? And no, the RCTs being primary sources is not a reason to generally throw them out. Please read WP:MEDRS more carefully. --Mallexikon (talk) 04:19, 20 November 2013 (UTC)

These are not secondary sources or reliable sources. AFD or redirect are the only options. Don't make this harder than it has to be. QuackGuru (talk) 04:46, 20 November 2013 (UTC)

You do know there are primary sources in the article. The primary sources are being challenged because they are not WP:SECONDARY sources. These trials are not notable because there are very few reliable sources that discuss the trials. QuackGuru (talk) 04:52, 20 November 2013 (UTC)

"As a result of the GERAC trials, the Joint Federal Committee (Gemeinsamer Bundesausschuss) decided to include acupuncture into the catalogue of services covered by the German statutory health insurances, for the treatment of low back pain and knee pain."

Joint Federal Committee (Gemeinsamer Bundesausschuss) is too close to the event. Please provide a secondary source for the text. QuackGuru (talk) 05:24, 20 November 2013 (UTC)

Federal Joint Committee (Germany)

Is the Federal Joint Committee (Germany) article notable. Does it meet Misplaced Pages notability guidelines? Hmm. QuackGuru (talk) 05:08, 20 November 2013 (UTC)

Sure, man. In your wrath against acupuncture and everybody who is not 100% against it, why not delete the whole Healthcare in Germany article? --Mallexikon (talk) 05:18, 20 November 2013 (UTC)

I propose redirect Federal Joint Committee (Germany) to Healthcare in Germany#Regulation. QuackGuru (talk) 05:33, 20 November 2013 (UTC)

Propose AFD or redirect

In 2006, Edzard Ernst noted that the German Acupuncture Trials (GERAC) had attracted criticism for not controlling the risk of patient de-blinding, and said that they " to conclusively answer the question whether acupuncture helps patients through a specific or a nonspecific effect".<ref>{{cite journal|doi=10.1111/j.1365-2796.2005.01584.x|title=Acupuncture - a critical analysis|year=2006|last1=Ernst|first1=E.|journal=Journal of Internal Medicine|volume=259|issue=2|pages=125–37|pmid=16420542}}</ref>

I propose we add this text to Acupuncture#Modern era after the article has been deleted or redirected.

This is the one of the few references I could find in the article that discusses the trials. The Federal Joint Committee (Germany) is not reliable. It is an organization comprising of the Central Federal Association of Health Insurance Funds, among others. The dated RCTs are the trials. We don't have enough secondary sources or reliable sources on the trials for a separate article. QuackGuru (talk) 04:46, 20 November 2013 (UTC)

a) The Federal Joint Committee is a medical organization as defined by WP:MEDRS. b) Primary sources can be used in medical articles - and this article here is a good example for it because it's mainly descriptive. For trial conclusions and claims of medical efficacy, primary sources won't do but we don't use for that here. And the GERAC are notable because they had a direct impact on the FJC's decisions concerning reimbursement of acupuncture treatment. --Mallexikon (talk) 05:14, 20 November 2013 (UTC)

The primary sources must be deleted now. The Federal Joint Committee is too close to the event. I request secondary sources. QuackGuru (talk) 05:27, 20 November 2013 (UTC)

I deleted the sources. I previously gave my reasons for these types of sources. QuackGuru (talk) 05:53, 20 November 2013 (UTC)

This was not a reliable secondary source. QuackGuru (talk) 05:55, 20 November 2013 (UTC)

No, so far I haven't heard any real rationale from you why you reject the FJC as a reliable source. It's an independent medical body, and they reviewed not just the GERAC, but quite a few other acupuncture trials before their decision (which makes them a secondary source). Please read their English abstract on p. 2. And please stop this disruptive tagging. --Mallexikon (talk) 06:05, 20 November 2013 (UTC)

"As a result of the GERAC trials, the Joint Federal Committee (Gemeinsamer Bundesausschuss) decided to include acupuncture into the catalogue of services covered by the German statutory health insurances, for the treatment of low back pain and knee pain."

The Joint Federal Committee initiated the project to compare the effectiveness of acupuncture to conventional therapy for pain. Four randomized studies were done as part of the German Acupuncture Trials (GERAC). The Joint Federal Committee is part of this event. Since they are too close to the event I requested secondary sources. QuackGuru (talk) 06:11, 20 November 2013 (UTC)

I have executed a WP:NUKEANDPAVE, which has resolved the problems noted. Alexbrn 06:25, 20 November 2013 (UTC)

That fixes the advertizement problems. QuackGuru (talk) 06:27, 20 November 2013 (UTC)

I'm still not convinced that this topic merits a standalone article, though it does seem to be mentioned a bit in the literature (as an exemplar of misleading suggestions from RCTs, it seems). Maybe a sentence or two in the main acupuncture article would be due? Alexbrn 06:30, 20 November 2013 (UTC)

A couple of sentences in the Acupuncture#Modern era might work. A redirect would work but I think an AFD may be the only way to resolve this situation with the previous edit history of this article. QuackGuru (talk) 06:41, 20 November 2013 (UTC)

These are reliable sources. Your requests to throw out the secondary source "being part of this event" doesn't make sense. We're talking about the highest control body in the German healthcare system other than the ministry of health - and it's independent. As I pointed out before, the use of primary sources is also permissible as long as it doesn't cover the conclusions of a trial or claims of medical efficiency. I've asked for comment from the reliable sources noticeboard. Let's wait what they say before you nukeandpave again. --Mallexikon (talk) 07:06, 20 November 2013 (UTC)

I don't think you understand Misplaced Pages policy on secondary sources. Advertizements do not belong in articlespace. QuackGuru (talk) 07:09, 20 November 2013 (UTC)

Poorly-sourced health information; neutrality

I notice A1candidate has re-added a large quantity of poorly-sourced health information to the article that fails WP:MEDRS (specifically for being either a primary source, a non-medical source for health information, or for failing WP:MEDDATE). Conversely Howick, one of only two genuine secondary sourced has been removed (N.B. Howick gives a "negative" assessment of the worth of these trials). This edit appears to be non-neutral. Alexbrn 08:07, 20 November 2013 (UTC)

No, your edits seem to be non-neutral. This is clearly not poorly sourced, and instead of nukeandpave, you could just as well wait what the discussion at the reliable sources noticeboard results in. The Federal Joint Committee is an independent medical organization, and their source is a review of different primary sources regarding acupuncture. --Mallexikon (talk) 08:18, 20 November 2013 (UTC)

Deleting reliably-sourced content (Howick) and adding poorly-sourced content does not advance us towards neutrality. Sourcing health-related content to the output of a middle tier government committee six years ago fall afoul of WP:MEDRS, and including it all gives undue weight. Alexbrn 08:26, 20 November 2013 (UTC)

Sources seem reliable to me (academic journals). The references are messy (cite journal template should be used), but overall I cannot support removal of that information. --_{Piotr Konieczny aka Prokonsul Piotrus| reply here} 08:35, 20 November 2013 (UTC)

Errr, are you familiar with WP:MEDRS? For biomedical content, academic journal ≠ good source, necessarily. Alexbrn 08:38, 20 November 2013 (UTC)

No, its' you who doesn't seem to be too familiar with WP:MEDRS. Nowhere it says that generally, primary sources can't be used. They can't be used (for long) for studies' conclusions and for medical efficacy claims... But we're merely talking about the description of an RCT here. Of course they can be used for that. --Mallexikon (talk) 09:14, 20 November 2013 (UTC)

The Joint Federal Committee (Gemeinsamer Bundesausschuss) source is heavily used in this article and they initiated the trials. Does not pass WP:SECONDARY because they are too close to the event. QuackGuru (talk) 08:42, 20 November 2013 (UTC)

I'm afraid you have to read more closely. It was a couple of statutory health insurances who initiated GERAC. The Joint Fed. Committee is a higher-level body who exempted acupuncture from being reimbursable, and only allowed it for reimbursement for two indications (low back pain, knee pain) after the results of GERAC came out. --Mallexikon (talk) 09:09, 20 November 2013 (UTC)

See WP:SECONDARY: Primary sources are original materials that are close to an event, and are often accounts written by people who are directly involved.

Based on your own comments The Joint Fed. Committee is a primary source because they were part of the event. Even if the The Joint Fed. Committee was a secondary source there are newer sources presented. That means The Joint Fed. Committee fails MEDRS and SECONDARY.

The article should be about how the results of the trial influenced policy in Germany. The trial itself in not what this article is about. The details about the trials itself is not notable and not the direction of an encyclopedia article. QuackGuru (talk) 19:01, 22 November 2013 (UTC)

Ok, I get a little tired repeating myself here... Please show some evidence for this suspicion of yours that the Joint Fed. Committee was "part of the event", since they're clearly not. Independent entities. The people of the Committee and the people responsible for GERAC are different people. Thus, the Committee is a secondary source. And why you personally think the details of this trial are not important eludes me... This is an article about the GERAC so it should be able to answer all the questions a reader could have about it (how many patients involved? What concept of sham acupuncture did they use? What concept of standard control? etc. etc.). --Mallexikon (talk) 03:12, 24 November 2013 (UTC)

The Federal Joint Committee (Germany) decided to reimburse acupuncture treatment for low back pain and knee pain. That makes them a primary source because they are part of the event. The details of this trial are not important because this is not a medical article and it is not notable. It is an article about how a clinical trial impacted society. QuackGuru (talk) 03:29, 24 November 2013 (UTC)

Yes, but this article is not about some kind of "event". It's also not about "how a clinical trial impacted society". It's about the trial itself. Of course, GERAC is notable because of its impact on health care in Germany: The Fed. Joint Committee looked at GERAC plus several other acupuncture trials (would you please, please read their English summary on page 2?) and then decided to have acupuncture reimbursed. However, I'm not interested in explaining this again and again. Please take it to the reliable sources noticeboard if you still think that the FJC should be considered a primary source. --Mallexikon (talk) 04:51, 24 November 2013 (UTC)

This article about the trial itself is a WP:COATHOOK. We don't have articles about specific studies. All the medical information about the trial itself should be deleted. The Fed. Joint Committee originally looked at GERAC. You must provide secondary sources and not use The Fed. Joint Committee source itself or the trial itself as a source. QuackGuru (talk) 00:28, 25 November 2013 (UTC)

I started the cleanup process to delete the non-notable information about the trial itself. There is no reason to keep low level details about the trial itself. QuackGuru (talk) 00:39, 25 November 2013 (UTC)

The medical information about the trial itself was restored for no valid reason. QuackGuru (talk) 01:37, 25 November 2013 (UTC)

Mallexikon wrote: "GERAC is notable because of its impact on health care in Germany". Any sources for this (not contemporary news items or primary sources)? Alexbrn 05:18, 24 November 2013 (UTC)

Could you please explain why the Spiegel quote shouldn't be good enough? --Mallexikon (talk) 09:09, 24 November 2013 (UTC)

I'm looking for evidence of WP:CONTINUEDCOVERAGE. Alexbrn 04:38, 25 November 2013 (UTC)

Not needed. GERAC has had a WP:LASTING effect (inclusion of acupuncture into the list of services covered by the statutory health insurances). Please also read WP:EVENTCRIT again ("Events are probably notable if they have enduring historical significance and meet the general notability guideline, or if they have a significant lasting effect. Events are also very likely to be notable if they have widespread (national or international) impact and were very widely covered in diverse sources, especially if also re-analyzed afterwards..." --Mallexikon (talk) 05:34, 25 November 2013 (UTC)

Recent problematic edits / faithfully representing sources

There have been some edits to the article recently that appear to misrepresent the sources and have the unfortunate effect of skewing POV. For example just now, Mallexikon has removed the words "The trials found no significant differences between acupuncture and sham acupuncture" with the comment "deleting material not supported by the source given ...". Yet the source states: "the difference between real and sham acupuncture in the GERAC trial was not statistically significant". Mallexikon - have you got an explanation? Alexbrn 07:07, 24 November 2013 (UTC)

Yes. Edit conflict. I wanted to delete "Within the academic community, the trials have received criticism for failing to show that needling has any effect", which was sourced with the quote "These programmes of research do not confirm the hypothesis that needling at specific points is essential to achieve satisfactory clinical effects of acupuncture". But you deleted it simultaneously , which resulted in my edit merely being a paraphrasing and actually no deletion. --Mallexikon (talk) 07:19, 24 November 2013 (UTC)

I see. So, we have still ended up with a misrepresentation and a deletion; please repair the damage cause by the edit conflict by restoring the text that got lost and citing it correctly per WP:INTEGRITY. This brings me to a second problem, the use of a fringe journal Acupuncture in Medicine for commenting on acupuncture; this is not a usable source since (most obviously) it lacks independence of the topic (the article cited is written by Mike Cummings, a director of the British Medical Acupuncture Society); it needs to be removed. Alexbrn 07:45, 24 November 2013 (UTC)

Beg to differ. If a director of the British Medical Acupuncture Society points out findings that are contrary to TCM beliefs, that's the opposite of bias. --Mallexikon (talk) 07:59, 24 November 2013 (UTC)

It doesn't matter what he's saying, but having Misplaced Pages state that he "points out" something clinical is contrary to WP:FRINGE. Meanwhile, the content from the reliable secondary source remains deleted! Alexbrn 08:08, 24 November 2013 (UTC)

Could you please produce some evidence that acupuncture is WP:FRINGE? And what content from a reliable source remaining deleted are you talking about? --Mallexikon (talk) 08:27, 24 November 2013 (UTC)

WP:FRINGE applies to all "Alternative medicine" articles on WP by definition. I specify the text you deleted in the opening message of this section. Alexbrn 08:35, 24 November 2013 (UTC)

Could you please show me that definition? And I'm still not sure what text you mean. --Mallexikon (talk) 09:04, 24 November 2013 (UTC)

"By definition" here means it defines itself: alternative medicine is outside the mainstream and so fringe by definition. If you doubt this, the folk at WP:FT/N could comment but it would be a waste of that noticeboard's time to ask in my view. I actually quote the words you erroneously deleted in my opening comment here; I can't really be more explicit than that. When you were notified of the edit conflict by the Wikimedia software, did you not check to see what was happening to the text as a result? there is text missing an a mis-used source now. Alexbrn 09:35, 24 November 2013 (UTC)

Your statement about acupuncture automatically being WP:FRINGE will be discussed at the AfD... Regarding the quoted words I allegedly erroneously deleted ("The trials found no significant differences between acupuncture and sham acupuncture"): calm down. I only paraphrased them ("It has been pointed out that the GERAC study couldn't find any advantage of needling specific acupuncture points in contrast to random points") . --Mallexikon (talk) 05:42, 25 November 2013 (UTC)

"It has been pointed out..." undermines the source. The fringe journal has been restored. The Acupuncture in Medicine is as fringe as it gets. There are better sources. QuackGuru (talk) 19:01, 25 November 2013 (UTC)

That's not a "paraphrase" of the deleted content. Alexbrn 05:47, 25 November 2013 (UTC)

"No difference between A and B"... "no advantage of A over B"... why would this not be a paraphrase? --Mallexikon (talk) 05:54, 25 November 2013 (UTC)

Primary sources

I've left primary source citations next to secondary source citations at quite a few places now... The reason for this is that the primary source citations are more reader-friendly (English translation given), while their data is the same. One could argue, however, that the primary sources should generally eliminated. Comments? --Mallexikon (talk) 08:33, 25 November 2013 (UTC)

Yes, and that includes nearly all of the material coming from the Gemeinsamer Bundesausschuss. Alexbrn 08:37, 25 November 2013 (UTC)

The primary sources were replaced with more primary sources. All the primary sources and dated sources about the trials itself must be deleted. The dated Gemeinsamer Bundesausschuss source is being misused in this article to discuss medical information. QuackGuru (talk) 19:10, 25 November 2013 (UTC)

It is mainly being used to describe the set-up and outcomes of the RCTs. It is a clear secondary source even if you stubbornly repeat it was primary. On top of that, Misplaced Pages:Reliable sources/Noticeboard#GERAC consensus has made very clear that no, all the primary sources and dated sources must not at all be deleted. --Mallexikon (talk) 01:55, 26 November 2013 (UTC)

You did not tell other editors this is not a medical article and that you used the source to discuss unimportant low level details about trial itself.

The entire German Acupuncture Trials#Overview section is a coat rack. I propose the entire section must be nuked unless anyone likes a WP:SOAPBOX article. QuackGuru (talk) 18:08, 26 November 2013 (UTC)

Its not. Its simply letting the reader know about the findings of the trials, according to secondary sources. -A1candidate (talk) 18:13, 26 November 2013 (UTC)

Do you think this is a medical article about the trials itself? QuackGuru (talk) 18:21, 26 November 2013 (UTC)

"Only registered physicians with an additional license for acupuncture and at least two years of clinical experience in acupuncture treatment qualified as performing acupuncturists."

This text does not seem relevant to this page. QuackGuru (talk) 22:04, 26 November 2013 (UTC)

Dated 2003 source does not summarise the body

According to Schweizer Fernsehen, the total cost of the trials amounted to 7.5 million Euros.

The low level details using unreliable sources are used everywhere in this article. QuackGuru (talk) 19:35, 26 November 2013 (UTC)

Low level unimportant details failed verification

The trials received coverage from most of the major media outlets in Germany. This article is very poorly written. The source an editor added failed verification. QuackGuru (talk) 19:38, 26 November 2013 (UTC)

Unreliable sourced under the reference section

I removed the unreliable sources. The unreliable sources are not needed in the reference section. They were not used to verify the text. QuackGuru (talk) 19:42, 26 November 2013 (UTC)

Dated 2005 Deutsche Medizinische Wochenschrift as unreliable

The trials were published in 2006. How could a dated 2005 source be reliable? This seems too old when there are newer sources. QuackGuru (talk) 20:24, 26 November 2013 (UTC)

Reference 78

• Ernst, E. (2006). "Acupuncture - a critical analysis". Journal of Internal Medicine. 259 (2): 125–37. doi:10.1111/j.1365-2796.2005.01584.x. PMID 16420542.
• Wettig, D (2005). "Die GERAC-Gonarthrose-Studie". Der Schmerz. 19 (4): 330–1, author reply 331–2. doi:10.1007/s00482-005-0404-0. PMID 16145742.

There are two sources but I think only one is used to verify the text. QuackGuru (talk) 20:43, 26 November 2013 (UTC)

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