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Revision as of 16:18, 21 September 2014 editJayaguru-Shishya (talk | contribs)Extended confirmed users10,964 edits Perhaps we should wait for the answers of the rest first? =P← Previous edit Revision as of 07:27, 22 September 2014 edit undoMrBill3 (talk | contribs)Autopatrolled, Extended confirmed users, Pending changes reviewers39,593 edits →MEDDATE: WP presents the current scientific consensus. It doesn't supersede academic consensus on need for more recent studyNext edit →
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: I was trying to reach for a compromise, but the consensus is crystal clear on both tags. - ] <small>(])</small> 16:06, 21 September 2014 (UTC) : I was trying to reach for a compromise, but the consensus is crystal clear on both tags. - ] <small>(])</small> 16:06, 21 September 2014 (UTC)
:: I see the discussion going on about the <nowiki>{{cn}}</nowiki> tags, but not about the <nowiki>{{update inline}}</nowiki> tags. That's why I am asking for clarification from MrBill3 and LesVegas actually. I'd suggest that let's wait for their answers (and why not anybody else aswell) first. =P ] (]) 16:18, 21 September 2014 (UTC) :: I see the discussion going on about the <nowiki>{{cn}}</nowiki> tags, but not about the <nowiki>{{update inline}}</nowiki> tags. That's why I am asking for clarification from MrBill3 and LesVegas actually. I'd suggest that let's wait for their answers (and why not anybody else aswell) first. =P ] (]) 16:18, 21 September 2014 (UTC)
::: I don't think the "update inline" tag is appropriate unless there is good reason to believe the material has been superseded by more recent quality references. Perhaps when there are several recent lower quality sources and a more current review/meta-analysis is expected. The tag might be appropriate when there is a updated Cochrane review to call attention to an editor who has full access or another high quality source is available but not free, thus calling attention to the content so an editor with access can update it. For content that there is no more current, high quality source the tag is not appropriate. It is to call attention for editors to update the content from more current sources, not to insert an editor's opinion that the subject of the content should be studied again. If the academic/medical community considers the subject important enough or the earlier results/conclusions currently inadequate new studies will be done and they will be analyzed and discussed, otherwise the tag is based on WP editors' opinions. TLDR: MEDDATE and WP policy defer to the scientific consideration of the medical/academic consensus. - - ] (]) 07:27, 22 September 2014 (UTC)


== Mao's "new acupuncture" == == Mao's "new acupuncture" ==

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Menopausal Syndrome

Commenting on the Chiu paper today, Steven Novella called the results "entirely negative" and concluded ..."A reasonable person can only conclude that acupuncture does not work, and that all the clinical research consistently shows that acupuncture conveys only illusory and nonspecific placebo effects for subjective symptoms."
ScienceBasedMedicine.org is not a reliable source. Anyone is welcome to submit content regardless of credentials. This blog does not even meet WP:RS, much less WP:MEDRS. -A1candidate (talk) 21:49, 15 August 2014 (UTC)
There was a previous discussion about this blog. Editors decided to keep it in the article. User:JzG insisted it was reliable. Mallexikon originally added the source to the article. QuackGuru (talk) 02:34, 16 August 2014 (UTC)
I know, and there was no consensus for it. The blog has no formal peer-review. -A1candidate (talk) 03:06, 16 August 2014 (UTC)
Actually there a previous discussion and editors decided to use the blog in the article. QuackGuru (talk) 03:09, 16 August 2014 (UTC)
There was considerable opposition to using the blog -A1candidate (talk) 03:14, 16 August 2014 (UTC)
You have not provided evidence there was considerable opposition to using it. QuackGuru (talk) 03:16, 16 August 2014 (UTC)
See talk page archives -A1candidate (talk) 03:17, 16 August 2014 (UTC)
I already read the discussion because I was part of the original discussion on this. QuackGuru (talk) 03:19, 16 August 2014 (UTC)
Then you should know that an editor said "A personal website is not RS material", which I fully agree with. -A1candidate (talk) 03:22, 16 August 2014 (UTC)
See Talk:Acupuncture/Archive_13#MEDRS_and_ASF_violations_are_continuing_to_happen_at_ACU_and_TCM for the original discussion. QuackGuru (talk) 03:28, 16 August 2014 (UTC)
Editors observed that "There is strong opposition to including the first here" and "And there was no CON at TCM either." -A1candidate (talk) 09:28, 16 August 2014 (UTC)

Protected edit request on 20 July 2014 2

This edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.

Due to the apparent debate about neutrality evident in this talk page I would like to add the template "pov-section" under the subsection "Scientific view on TCM theory" - Technophant (talk) 09:56, 20 July 2014 (UTC)

  • Given the fact that reviews from high-quality medical journals about the mechanism of acupuncture have been repeatedly removed from this article, I think the POV template is long overdue.
1. A 2008 review article titled Neural mechanism underlying acupuncture analgesia in Progress in Neurobiology, with impact actor of 9.035, was removed.
2. A 2010 review article titled Mechanisms of action for acupuncture in the oncology setting in Current Treatment Options in Oncology, with impact factor of 2.422, failed to be included.
3. A 2011 review article titled Ancient Chinese medicine and mechanistic evidence of acupuncture physiology in European Journal of Physiology, with impact factor of 4.866, was removed.
4. A 2012 meta-analysis titled Characterizing Acupuncture Stimuli Using Brain Imaging with fMRI in PLOS ONE, with impact factor of 3.730, failed to be included
5. A 2013 review article titled Acupuncture in Mayo Clinic Proceedings with impact factor of 5.698 failed to be included.
6. A 2014 review article titled Acupuncture, Connective Tissue, and Peripheral Sensory Modulation in Critical Reviews in Eukaryotic Gene Expression, with impact factor of 2.949, failed to be included
7. A 2014 review article titled Mechanisms of acupuncture-electroacupuncture on persistent pain in Anesthesiology, with impact factor of 5.163, was removed.

There are a lot more sources removed but I don't have time to retrieve all of them. POV tag should stay until they're added back. -A1candidate (talk) 10:55, 20 July 2014 (UTC)

@user:A1candidate - Thank you. Perhaps we are getting somewhere. - Technophant (talk) 11:22, 20 July 2014 (UTC)
I wouldn't thank A1candidate too quickly since (s)he is a professional acupuncturist with a huge COI who really shouldn't be editing these articles so boldly and pushing fringe POV. -- Brangifer (talk) 16:47, 20 July 2014 (UTC)
Even though this comment is struck, I'd like to reiterate that simply being a member of a profession does not cause COI to arise, cf. the "COI?" link in my sig. -Middle 8 (leave me alone • talk to me • COI?) 03:05, 14 August 2014 (UTC)
What do you want to add using what source? I do not see a need for a POV tag at this point in time. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:38, 20 July 2014 (UTC)
Before we even start discussing which reviews, I suggest the following overview statement from a highly authoritative medical textbook:
"The emerging acceptance of acupuncture results in part from its widespread availability and use in the United States today, even within the walls of major medical centers where it is used as an ancillary approach to pain management. Yet its acceptance appears to stem from more than just its communal appeal.
Since the mid-1970s, biochemical and imaging studies have begun to yield evidence that needling can alter central pain-processing pathways, possibly by triggering release of neural mediators that bind to specific receptors in the brain regions that modulate pain perception."
- Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Google Books)
If we could start by agreeing that some of the most authoritative medical textbooks consider acupuncture to be empirically validated to certain degrees, perhaps we can then proceed to discuss the details. -A1candidate (talk) 13:21, 20 July 2014 (UTC)
It could be so, but the whole research that shows that sham acupuncture works as good as real acupuncture ruins your whole thesis. We could just randomly insert needles and pretend to treat people by doing that. Tgeorgescu (talk) 14:08, 20 July 2014 (UTC)
As for real vs sham acupuncture, see PMID 24595780 -A1candidate (talk) 14:22, 20 July 2014 (UTC)
Sham acupuncture can't be considered a true control because it involves activating the nervous system in some way. There's many, many articles criticizing the way sham controls are used. Take a look at this papers conclusion. - Technophant (talk) 16:20, 20 July 2014 (UTC)

Not done: please establish a consensus for this alteration before using the {{edit protected}} template. A healthy combination of editing and talk page discussion after the protection has expired will probably go farther than a protected edit request. ~Adjwilley (talk) 17:29, 20 July 2014 (UTC)

Can you at least remove that personal attack by User:BullRangifer against me? Such personal accusations are completely false and untrue. -A1candidate (talk) 19:33, 20 July 2014 (UTC)
I have stricken the comment. -- Brangifer (talk) 19:40, 20 July 2014 (UTC)
What do you want to say using Harrison's? Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:57, 21 July 2014 (UTC)
I'll try to make it concise and keep it as short as possible:
1a. Proposed inclusion - There is a growing belief among researchers that acupuncture may be effective.
1b. What Harrison's says - "Although methodological problems continue to plague acupuncture trials, belief has been growing even in academic centers that acupuncture may be effective", as quoted directly from Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Google Books)
1c. Rationale for addition - A fringe theory, by definition, departs significantly from mainstream view. In the case of acupuncture, however, there is a growing belief in academic centers that acupuncture is effective, not fringe.
2a. Proposed inclusion - It is used in some major medical centers as an ancillary approach to pain management.
2b. What Harrison's says - "The emerging acceptance of acupuncture results in part from its widespread availability and use in the United States today, even within the walls of major medical centers where it is used as an ancillary approach to pain management", as quoted directly from Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Google Books)
2c. Rationale for addition - Alternative medicine, by definition, is not part of standard medical care. Acupuncture, however, is "ancillary" when it comes to managing chronic pain and it should not be labelled otherwise
3a. Proposed inclusion - In recent decades, biochemical and imaging studies have begun to yield evidence that needling can alter pain perception in the central nervous system, possibly by triggering the release of neurotransmitters that subsequently bind onto specific receptors in brain regions responsible for pain perception.
3b. What Harrison's says - "Since the mid-1970s, biochemical and imaging studies have begun to yield evidence that needling can alter central pain-processing pathways, possibly by triggering release of neural mediators that bind to specific receptors in the brain regions that modulate pain perception." Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Books)
3c. Rationale for addition - This is a scientific fact that has been repeatedly demonstrated numerous times by now. We really need a section for mechanism of action if we are serious about sticking to mainstream science.
Also, would Goldman's Cecil Medicine be an acceptable textbook for an additional source? Once we're done with the textbook basics, we could go on to discuss more specific details as reviewed by high impact factor journals. -A1candidate (talk) 10:44, 21 July 2014 (UTC)
So exactly what text are you wanting to add to what part of the article? Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:46, 21 July 2014 (UTC)
1b "problems continue" "has been growing...may" 1c "...is..." MAY and IS are quite different. If problems continue to plague it seems a clear statement that there is NOT empirical support of the type needed to validate a medical treatment. - - MrBill3 (talk) 11:05, 21 July 2014 (UTC)
Calm down, we're only talking about the beliefs of the academic community which has been growing rather than may be growing. Can we agree on this first? -A1candidate (talk)
It seems there is an effort to inflate the idea that there MAY be some elements of interest to the mainstream academic community while the evidence is still PLAGUED by methodological problems and the theoretical basis is still not validated into a false assertion of a change in the mainstream academic consensus on the validity of the theoretical basis and the evidence for empirical support. As there is no deadline if these concepts are valid surely empirical research not plagued by methodological failures and theoretical bases that are accepted are forthcoming and can be included WHEN this actually occurs. Until then the article should clearly reflect the widespread academic position on these questionable concepts. - - MrBill3 (talk) 13:40, 21 July 2014 (UTC)
Instead of speculating about my motivations to improve the article, you may want to check out what mainstream academic literature says about the topic. Or better yet, read what Harrison's Principles of Internal Medicine says and come back once you're done. Methodological problems has already been mentioned in the article. -A1candidate (talk) 15:28, 21 July 2014 (UTC)

Just want to make a note here that A1's use of medical textbooks here is very promising as is Doc James straightforward question about "what content, and where, do you want to create based on this?" Folks, it doesn't get more mainstream than the most-relied upon medical textbooks like Harrison's and Goldman's Cecil. So everybody breathe a bit here and just go step by step. These are serious sources. A1 step wisely and conservatively in proposing content and quack-fighters put away your knives. Jytdog (talk) 23:24, 21 July 2014 (UTC)

Let me "second that emotion", though I would add a caution; One must keep in mind that authors, even of notable medical textbooks, do include their personal opinions in those books. Sometimes the personal opinions are "pearls" (of crap) included by the authors (with poor crap detectors), sometimes positing hypothetical ideas as if they were fact, and many readers then fall for their words, as if they were firmly established scientific fact, and become fans of the guru author.
What I'm trying to say is that many medical textbooks, while considered eligible for RS status, are far from reliable sources for all medical knowledge. While much of the content might be fine information and helpful in practice, such gems of speculation should not be swallowed whole, but should be subject to trumping by better sources. In such cases, it's much better to use properly performed scientific reviews of the mainstream literature. -- Brangifer (talk) 00:48, 22 July 2014 (UTC)
i hear you. the quotes from the textbook are pretty gentle, I don't think this is going to drive huge changes. but some simple straightforward statements in wikipedia'a voice can be confidently generated using these sources, I think...Jytdog (talk) 02:23, 22 July 2014 (UTC)
I agree. 99% of the time we're likely on safe ground. I'm sure that any controversial uses will get noticed and a discussion can deal with it. -- Brangifer (talk) 02:57, 22 July 2014 (UTC)
I'll agree with BR and Jyt. This article receives enough scrutiny to prevent misuse. @A1 to moderate my comment I can agree with content as described by Jyt. - - MrBill3 (talk) 03:28, 22 July 2014 (UTC)
  • Thanks for the kind words of encouragement, Jytdog. I really appreciate them! After taking a closer look at the article, I think there is one section that could be updated with the suggested additions and that is the historical development of acupuncture.
If you take a look at the "Modern era" subsection, we have a great deal of information about acupuncture during Mao Zedong's leadership, followed by two paragraphs of anecdotes about how acupuncture gained atention in the West. After the early 1970s, however, we suddenly arrive in 2006 with absolutely no mention of what happened to the historical development of acupuncture during a time period of almost half a century (!)
I think the best place to fill this gap would be the last paragraph, just before the 2006 documentary.
The current text says:
Acupuncture has been the subject of active scientific research both in regard to its basis and therapeutic effectiveness since the late 20th century, but it remains a controversial topic. In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anesthesia....
How the new text (in italics) may look like:
Acupuncture has been the subject of active scientific research both in regard to its basis and therapeutic effectiveness since the late 20th century, but it remains a controversial topic. In recent decades, biochemical and imaging studies have begun to yield evidence that needling can alter pain perception in the central nervous system, possibly by triggering the release of neurotransmitters that subsequently bind onto specific receptors in brain regions responsible for pain perception. (Reference to Harrison's) There is a growing belief among researchers that acupuncture may be effective and it has been used in some major medical centers as an ancillary approach to pain management. (Ref Harrison's)
In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anesthesia....
This is obviously not meant to be a final proposal, but I do feel that adding it there would be more appropriate and necessary to fill a huge gap in our documentation of the historical development of acupuncture after the early 1970s.
I'm done with this discussion for now, so if anyone manages to find consensus for my proposed additions, please be bold and edit the article accordingly. -A1candidate (talk) 04:20, 22 July 2014 (UTC)
The latest changes proposed by A1candidate seem reasonable to me. If there is some consensus I don't object to them. Unless someone points to a problem with them I support them. They seem carefully and neutrally phrased. I think they are factual and add some value to the article. The sourcing seems adequate/appropriate. - - MrBill3 (talk) 08:49, 23 July 2014 (UTC)
Read this source: "In conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain." We have a 2011 systematic review of systematic reviews that contradicts the proposal.
This part of the proposal makes little sense: "There is a growing belief among researchers that acupuncture may be effective" QuackGuru (talk) 03:25, 24 July 2014 (UTC)
QG see 1a and 1b above. Jytdog (talk) 03:31, 24 July 2014 (UTC)
"An overview of high-quality Cochrane reviews suggested that acupuncture may alleviate some but not all kinds of pain,"
We should not include text that contradicts high-quality evidence. QuackGuru (talk) 04:01, 24 July 2014 (UTC)
Can you please be more exact? In science, especially medical science, lots of contradictory results do exist. You call one as "high-quality evidence", is the other low-quality then? Jayaguru-Shishya (talk) 20:39, 24 July 2014 (UTC)
I did provide the high-quality evidence. I think it is unproductive for me to repeat my previous comments on this talk page when the evidence was clearly presented.
Your continuing to ask questions as you did before. You claimed two were removed per MEDRS without explaining what the violation is. But I did give a reason for removing those two. All you had to do was check the edit history rather than ask questions. See Talk:Acupuncture#Sourced text was deleted. QuackGuru (talk) 21:17, 24 July 2014 (UTC)
Your reference to your very own post here at the Talk Page doesn't answer my question. Please anwer my questio above, thanks. Jayaguru-Shishya (talk) 22:56, 25 July 2014 (UTC)
Cochrane Reviews provide an explanation of the criteria they use for including or excluding particular studies, often with specific details on individual studies. This provides clear reliable third party sourcing for the evaluation of studies. If you identify a Cochrane Review that discusses a source in question I have full text access and will provide relevant information. Additional guidance on evaluating evidence is available at WP:MEDRS.
I agree with QG that growing belief..may is not appropriate as an encyclopedia with no deadline WP should reflect the conclusions of the highest quality evidence available, Cochrane Reviews and a review of reviews published in a major journal are such evidence. As the research in this field continues if new high quality evidence emerges and receives acceptance in the scientific community it can be added at that time. - - MrBill3 (talk) 00:47, 26 July 2014 (UTC)
This is about the history of acupuncture, not its clinical efficacy. -A1candidate (talk) 00:22, 28 July 2014 (UTC)
"may be effective" is about clinical efficacy. Couching it as a "growing belief" does not exempt the topic of efficacy (be effective) from MEDRS. Please don't strain good faith. If other editors consider this an acceptable description of the beliefs and appropriate content, I won't stand in the way of progress with reasonable consensus. Apologies for tone, constructive collaboration is appreciated. - - MrBill3 (talk) 02:04, 28 July 2014 (UTC)

Am I missing something? Is there some source in the mix here which describes the "beliefs" of researchers, and how those "beliefs" are changing? Alexbrn 09:15, 28 July 2014 (UTC)

yes. see discussion of content from Harrison's above, 1a and 1b (just below the red dot with the "i" in it) Jytdog (talk) 10:23, 28 July 2014 (UTC)
Thanks, gotcha. But the source doesn't say belief has been growing among researchers, but that it has "even" been growing in "academic centers". Wouldn't that be because CAM is now more widespread in such centers (what some call the quackademic medicine phenomenon). If there are more irrational people in these centers it naturally follows the "beliefs" there will swell. Not sure how this can be couched neutrally, but the proposed wording ain't it. Alexbrn 14:46, 28 July 2014 (UTC)
No, the source says that because that is the mainstream scientific consensus. -A1candidate (talk) 02:16, 30 July 2014 (UTC)
A1 I don't think you can bring a source that supports such a broad claim. Again you are just hurting your own cause by being so broad and sloppy. Alexbrn, while I hear where you are coming from, reasonable people can disagree on the why. One could also easily say that academic medical centers are doing it a) to meet a demand (people want it and will come to a place that offers it); b) in an acknowledgement even the most cutting edge medicine cannot adequately manage pain and anxiety, and this is exactly - and only (with a few narrow exceptions for side-effects of treatments and other hard-to-treat and somewhat psychosomatic conditions) - how CAM is deployed in such centers. Not broadly -- not to treat infectious disease or as a primary treatment for cancer - but to assist in managing things like pain and anxiety. I think it reasonable to say that such use - complementary and limited- is pretty darn mainstream. (and here i will trot out the mayo clinic why Mayo uses it, MD Anderson, Memorial Sloan Kettering.... the list of high quality places that offer it goes on and on, and the things they offer it for is consistent. Even if the effect is placebo, it is relatively cheap, very safe, and gives comfort, and those are good things for very sick people. There is a reason that Harrison's discusses it, in the way that it does. I think that this article and related ones would be improved a lot by focusing on what is relatively mainstream and stop fighting quack battles. I think (for what that is worth) we could get a pretty useful article out of that, IF both flanks stopped pressing to dominate and self-limited..... we could work pretty peacefully together on an article with that scope. Jytdog (talk) 02:31, 30 July 2014 (UTC) (added a bit to make this accurate Jytdog (talk) 12:41, 30 July 2014 (UTC))
Hear, hear. "Mainstream = middle ground" is a very promising way to look at articles about CAM's that are used in mainstream (academic) settings. With regard to the "why" of such usage, Ernst has commented along the same lines as Jytdog . The source is 2006, and should not be relied upon for efficacy, but this particular quote remains relevant (and particularly so, I think, given acu's continued use in light of its placebo-ness): "Some clinicians argue that the main point about any medical intervention is that it alleviates the suffering of patients regardless of mechanism and that ‘it is not meaningful to split complex interventions into characteristic and incidental elements’ . If acupuncture alleviates suffering through a powerful placebo effect which theoretically could exceed the total therapeutic effect of conventional therapeutic options, it should be accepted as a useful treatment. Some scientists, however, might find this notion difficult to accept." To say the least!
Ernst continues, pointing to further resolution: "Of course, the scientific study of placebo effects and mechanism is both feasible and important , and the results of such research may significantly contribute to our understanding of how acupuncture works. But, if nonspecific factors are that relevant, we should not study them with a view to harnessing them for clinical practice in general and not just for acupuncture?" --Middle 8 (leave me alone • talk to me • COI?) 09:46, 30 July 2014 (UTC)
Comment: Just noticed I was unintentionally parroting Jytdog re: both "sides" working together. Well, it's never a bad idea. Actually the best thing is to get beyond the idea of "sides" altogether.... it is possible, just by being steadily source-centric. --Middle 8 (leave me alone • talk to me • COI?) 18:28, 4 August 2014 (UTC)
Ernst may be a very well-respected researcher, but we still have to treat such statements per WP:RSOPINION. I don't quite understand what exactly is the point you're trying to make, so perhaps you may wish to be a little more direct? -A1candidate (talk) 01:40, 1 August 2014 (UTC)
@A1candidate: The main thing I'm getting at (and sorry I was unclear) is that the "let's use acu as a CAM" (pro) side and the "acu is little-or-nothing more than a placebo so why use it at all" (anti) side are looking at the same evidence differently. The anti say that we don't use a drug that's no better than a placebo and the same rules should apply here; there are other ways to invoke the placebo effect besides an invasive (albeit quite safe) intervention, like empathic care. The pro say that the relevant issue is the difference between acu and no-acu, not acu and sham. Even though it turns out that the nonspecific effects are most of the treatment, a lot of patients really like it; even if it's all placebo, it's a humdinger of a placebo, not readily duplicated via other means. This is the view espoused by Vickers and (IIRC) the editorial introducing Vickers, and (implicitly anyway) by the body that acted on GERAC; and it's the view that Ernst is talking about ("Some clinicians argue..."). We could source this up and make a nice "rationale for use" section, I think -- as long as we just lay out each side in an NPOV way and avoid trying to have one trump the other (since both are demonstrably significant). Because both sides are sharing the evidence base. (As for the second part of Ernst's quote, I had in mind Kaptchuk's research, more as an aside.) --Middle 8 (leave me alone • talk to me • COI?) 09:18, 1 August 2014 (UTC)
@A1candidate: more.... but I apologize for digressing; for now, suffice it to say I agree with your proposed additions. Not all mainstream researchers, but some; a "growing belief" doesn't imply universality, so the wording is fine. --Middle 8 (leave me alone • talk to me • COI?) 06:38, 2 August 2014 (UTC)

Yes, it's difficult to find a middle ground when it comes to such a controversial issue. The good news is that there are lots of authorities whose job is to determine what is factually correct and what isn't. Our job as editors of Misplaced Pages would be much easier if we could simply stick to their consensus instead of relying on the opinions of Ernst, Vickers, or any other notable individuals. They may be excellent researchers, but they only speak for themselves, not the scientific community as a whole. However, I agree with you that both sides are esentially looking at the same evidence differently. -A1candidate (talk) 02:53, 11 August 2014 (UTC)

Well-said. The closer we can get to MEDRS that meet WP:RS/AC, the better. For sources less strong than that (and particularly editorials), we should be wary speaking in WP's voice. --Middle 8 (leave me alone • talk to me • COI?) 02:59, 14 August 2014 (UTC)

Restoring edit of confirmed sockpuppet

I previously explained the source was invalided: "The most recent meta-analysis appearing in Fertility and Sterility on acupuncture was reevaluated in view of the marked heterogeneity of interventions, controls, data analysis, and timing of interventions in the trials that were included. After removing some of the trials and data based on more rigorous standards for a high quality meta-analysis, a significant benefit of the intervention could no longer be shown."

  • Meldrum, David R.; Fisher, Andrew R.; Butts, Samantha F.; Su, H. Irene; Sammel, Mary D. (2013). "Acupuncture—help, harm, or placebo?". Fertility and Sterility. 99 (7): 1821–1824. doi:10.1016/j.fertnstert.2012.12.046. ISSN 0015-0282. PMID 23357452. If editors want to use the journal Fertility and Sterility we would use the 2013 source not the invalided 2012 source, anyhow.

This edit restored the edit by a confirmed sock account without discussion or consensus. See Talk:Acupuncture/Archive_13#A_massive_revert_-_What_just_happened.3F. I explained it in my edit summary. User:Kww previously explained the policy covering the block evasion. QuackGuru (talk) 18:50, 28 July 2014 (UTC)

Unfortunately, our policies do not prohibit restoration of such material. It also does not allow you to continue to remove it simply because it was added by a sockpuppet originally. You have to discuss the edit on its own merits.—Kww(talk) 19:27, 28 July 2014 (UTC)
As stated by QuackGuru:

Per policy: WP:BAN#Bans apply to all editing, good or bad. User:Kww previously explained the policy covering the block evasion....

If, for example, user QuackGuru got banned, it doesn't mean that any sources used by QuackGuru could no longer be used in the article. I think there is faulty logic here. Jayaguru-Shishya (talk) 21:05, 28 July 2014 (UTC)
I previously explained, there was a problem with the source. QuackGuru (talk) 22:38, 28 July 2014 (UTC)

I added the 2013 source that shows the 2012 source was invalided. QuackGuru (talk) 19:38, 28 July 2014 (UTC)

Agree that WP:BAN no longer enters into it, and that the 2013 source (Meldrum) must be cited if we're going to mention the 2012 source (Zheng). I don't think this edit is the way to go about it; it's too granular and doesn't cite the 2012 source at all. Why not just say something like "a 2012 review found that acupuncture may be a useful adjunct to IVF, but those conclusions were rebutted by a 2013 review", and leave it at that? Here's a try. If "rebut" is too strong a word, someone else can fix. Trying to keep it simple; the article isn't aimed at specialists. --Middle 8 (leave me alone • talk to me • COI?) 06:06, 29 July 2014 (UTC)
If these are indeed quality edits, I don't mind adding them back in. I've been a participant at "project" systemic bias and several of us over there think these types of pages need a lot of work to balance them out. Could somebody show me where these edits are?LesVegas (talk) 16:16, 30 August 2014 (UTC)
"A 2012 systematic review found that acupuncture may be a useful adjunct to IVF," The same 2012 source was restored. QuackGuru (talk) 17:36, 31 August 2014 (UTC)

Anesthesia & Analgesia editorials

This editorial -- Acupuncture#cite_note-Colquhoun2013-9 -- by Colquhoun and Novella is a good critical summary of the literature, but since it's an editorial I'm not sure where it ranks in the MEDRS scheme of things, and it's cited a lot. And its "counterpoint" editorial, the "pro" editorial by Wang et. al. , isn't cited at all. (Both were invited by the publication Anesthesia & Analgesia.) To fix this sourcing and weight problem, I think we should mainly try to cite to sources cited by the editorial(s) (and they're very good places to find MEDRS's and RS's), and should specify that they're a pair of invited editorials. To what degree we cite to them directly, I'm not sure: I would say yes, cite them, but sparingly. (I suppose we can use either or both of them for WP's voice, too, as long as we're not contradicting the other. Right now we cite to Colquhoun for saying in WP's voice that findings on efficacy are "variable and inconsistent" for any condition.) --Middle 8 (leave me alone • talk to me • COI?) 10:19, 31 July 2014 (UTC)

I agree that it's a violation of NPOV to cite Colquhoun many times and completely omit Wang. I think your suggestion of using them sparingly is good. TimidGuy (talk) 10:38, 31 July 2014 (UTC)
That's a good point, I agree. Jayaguru-Shishya (talk) 10:49, 31 July 2014 (UTC)
Both Steven P. Novella and David Colquhoun are notable experts on the topic. The source by Wang et. al is not notable and does not seem it would add anything to the article. QuackGuru (talk) 17:57, 31 July 2014 (UTC)
Both sources are from the same journal. Either the journal is reliable and we include both, or it's unreliabale and we remove both. -A1candidate (talk) 19:32, 31 July 2014 (UTC)
I agree. QuackGuru, you said that Wang et. al is not notable, can you give us any explanations for that? They are both from the same Journal and shall be both included to the article. Jayaguru-Shishya (talk) 20:40, 31 July 2014 (UTC)
I previously explained both authors are notable experts on the topic while the other article seems not notable. Can you give an explanation if you think it is notable? Many sources are from the same journal but we don't include all or nothing. When we cite notable authors, we are citing the mainstream POV. QuackGuru (talk) 01:14, 1 August 2014 (UTC)
Some sources may be considered reliable for statements as to their author's opinion, but not for statements asserted as fact without an inline qualifier. See WP:RSOPINION. -A1candidate (talk) 01:32, 1 August 2014 (UTC)
QuackGuru, no you didn't explain anything. You just said that "Wang et. al is not notable" without giving any explanation. Can you please support your claim? Anyway, I'll be out for this weekend so happy weekend everyone! ^^ Jayaguru-Shishya (talk) 04:07, 1 August 2014 (UTC)
I previously asked: Can you give an explanation if you think it is notable? QuackGuru (talk) 04:50, 1 August 2014 (UTC)
QuackGuru Please quote the policy or guideline that says that a source or author must be WP:NOTABLE in order to be used as a source. I do not believe you will find anything, but am interested to see if you can. You may have other reasons to object, but let's deal with the one you have stated. Thanks. Jytdog (talk) 12:37, 1 August 2014 (UTC)
I believe QG did provide an explanation Novella and Colquhoun are notable experts on the topic, published multiple times in a variety of sources, cited as experts on the topic in multiple sources etc. Sources are evaluated individually, every article in a particular journal does not recieve the same due weight, nor is an article considered reliable based solely on the journal it is published in. The NPOV policy at WP:DUE also provides explanation of the weight due to mainstream scientific / academic view. This actually has all been explained in this thread. IDHT is tendentious. - - MrBill3 (talk) 07:21, 1 August 2014 (UTC)
(e/c) MEDRS says nothing about the notability (WP:N) of authors. It says "experts in the relevant field". Most MEDRS's are written by people who are experts but not notable. (See WP:ACADEMIC.) There is nothing in MEDRS that gives preference to Colquhoun & Novella's editorial over Wang et. al.'s. However, it doesn't give much preference to editorials in general. They are only mentioned once, and are not mentioned at all in WP:MEDASSESS. Which is why we should use them sparingly, at most.
apropos of MrBill3's comments: Yes, of course we take DUE into account. But these are a solicited pair that are given equal prominence by the journal. They agree on the evidence base and disagree on what it means (i.e. the observed effects are small; is that small margin real or just artifact). Brangifer argued awhile ago that there is no unified mainstream scientific view on acu, which I think is pretty obvious given that some academics are busy using acu as a CAM while others denounce such use as "quackademic medicine". So these editorials represent views within a spectrum (which might be closer to an RS than a MEDRS use). I think their main strength is as gateways to high-quality MEDRS's; maybe we can glean a few more meta-analyses. --Middle 8 (leave me alone • talk to me • COI?) 08:28, 1 August 2014 (UTC)
See WP:FRIND: "The best sources to use when describing fringe theories, and in determining their notability and prominence, are independent reliable sources. In particular, the relative space that an article devotes to different aspects of a fringe theory should follow from consideration primarily of the independent sources. Points that are not discussed in independent sources should not be given any space in articles. Independent sources are also necessary to determine the relationship of a fringe theory to mainstream scholarly discourse.
This is also a WP:WEIGHT issue. On Misplaced Pages, we continue to represent the mainstream spectrum. We should keep this ship on course. QuackGuru (talk) 17:40, 1 August 2014 (UTC)
Template:U:QuackGuru, thanks for providing the basis in policy and guideline for the "notability" objection to a source. I have no idea what that means so I cannot have a rational conversation with you about it, other than to say what I wrote below. With respect to "notability" used with respect to a source, I just opened a subthread at Wikipedia_talk:Fringe_theories#First_sentence_needs_improvement to discuss changing this, or making sense of it. So I will not be responding further to this for now. Jytdog (talk) 17:54, 4 August 2014 (UTC)Template:U:QuackGuru, I was moving to fast this morning. WP:FRIND says nothing about a source or author being "notable" so your argument about that has no basis. We are left with the question about whether everything about acupuncture is fringe. Everything about acu is not Fringe, as other sources on this page have demonstrated. some uses of acu are mainstream. So you cannot shoot down every source with WP:FRIND - if it discusses mainstream uses of acu, that no more fails WP:INDY than an oncologist writing an article about cancer. With respect to the invited article, it is as good as the other. Jytdog (talk) 20:33, 4 August 2014 (UTC)
See Misplaced Pages:DUE#Undue_weight and see Misplaced Pages:Neutral_point_of_view/FAQ#Pseudoscience. QuackGuru (talk) 02:43, 5 August 2014 (UTC)
OK, so let's be clear, QuackGuru, you are contending that the entire field of acupuncture is WP:FRINGE and that no part of it is mainstream, is that correct? Jytdog (talk) 03:05, 5 August 2014 (UTC)
QuackGuru, please have the respect to point out what you are exactly trying to say rather than make obscure references to Misplaced Pages Policies. Thanks. Jayaguru-Shishya (talk) 10:47, 5 August 2014 (UTC)

Right, the ship has sailed with regard to some uses of acupuncture in some settings, which have become mainstream. Not the whole field and definitely not many uses, but use of acu as CAM as an adjunct for relief of some pain conditions, nausea from chemo, and a few other things. Please stop treating this like it is black and white. QG it is just as wrong and POV for you to deny this, as it is for others to claim mainstream validity for the whole field and for its model of the body. Jytdog (talk) 17:53, 1 August 2014 (UTC) (including a missing word! Jytdog (talk) 04:58, 2 August 2014 (UTC))

Despite having veered off the precise topic of this thread Jytdog has made a good point and done so well. I tend to agree while validation for the field and it's theoretical basis is still clearly lacking, it seems there is some mainstream acceptance of it's use as an adjunct. True NPOV would mean the article should include this without giving undue weight or mischaracterizing it. This should be approached in a collaborative and cooperative manner. - - MrBill3 (talk) 04:07, 2 August 2014 (UTC)
MrBill3, QuackGuru said: "I previously explained both authors are notable experts on the topic while the other article seems not notable."
He said that "I previously explained", but the diff he presented isn't saying anything else than: "The source by Wang et. al is not notable..."
QuackGuru is making a claim, so I am looking forward to him supporting his claim. So far, I thing he has failed to explain why Wang et. al would not be notable. Jayaguru-Shishya (talk) 20:04, 3 August 2014 (UTC)
notable is the wrong question. Jytdog (talk) 21:30, 3 August 2014 (UTC)

We should use review articles instead of editorials

I don't understand why there's such a long discussion. How about using none of these editorials and replacing it with review articles instead? All of them are from journals dealing with anesthesiology and pain research:

Remove the editorials, replace with reviews. -A1candidate (talk) 02:30, 11 August 2014 (UTC)

Well-said. Editorials are not very strong as MEDRS; as I mentioned above, they're not even mentioned in WP:MEDASSESS. --Middle 8 (leave me alone • talk to me • COI?) 02:59, 14 August 2014 (UTC)

Outstanding issues

Acupuncture and placebo

The first review found some evidence that "biological differences" exist between a placebo response and sham acupuncture. The second review concluded that "acupuncture is more than a placebo". Are there any recent reviews that suggest otherwise? -A1candidate (talk) 02:31, 11 August 2014 (UTC)

Nocebo

Article fails to discuss the nocebo effect of acupuncture:

-A1candidate (talk) 02:31, 11 August 2014 (UTC)

Allergy

Article fails to mention acupuncture treatment for allergic diseases:

-A1candidate (talk) 02:31, 11 August 2014 (UTC)

Mechanism of acupuncture

Article fails to mention mechanism of acupuncture:

-A1candidate (talk) 02:32, 11 August 2014 (UTC)

Acupuncture and the brain

Article fails to mention acupuncture's effect on the brain:

-A1candidate (talk) 02:32, 11 August 2014 (UTC)

We might add a bit about contraindications for certain points, i.e. the "fordidden points" during pregnancy like LI4, SP6, and GB21. I don't remember the source that mentioned that but AFAIK it was a MEDRS. --Middle 8 (leave me alone • talk to me • COI?) 03:09, 14 August 2014 (UTC)
These studies are of the brain's reactions to the body being poked with sharp things. They don't lay the foundation for the effectiveness of acupuncture, just that the brain does, indeed, react to the body being poked with a sharp object. I'm not aware of anyone that denies that.—Kww(talk) 13:37, 13 August 2014 (UTC)
No, they do. Read the meta-analyses carefully. -A1candidate (talk) 13:56, 13 August 2014 (UTC)
Please provide exact quotes from the meta analysis which you find relevant, something that tells us more than is already obvious, which is that every spot in the body has areas in the brain which not only control it but also areas which react to anything which affects it. That's too basic and "duh". What do you have from that source which we can use? -- Brangifer (talk) 23:58, 13 August 2014 (UTC)
e.g. (bold text indicates subsection header): Acupuncture at non-acupuncture points in close proximity to acupuncture points" Two third (64%) , – of 25 studies showed that acupuncture treatments were associated with more activation, mainly in the somatosensory areas, motor areas, basal ganglia, cerebellum, limbic system and higher cognitive areas (e.g. prefrontal cortex). That's 16 of the studies. Different or contradictory results were found in the remaining 9 studies. Also see other quotes under section titled Descriptive findings of differences between verum and sham acupuncture. --Middle 8 (leave me alone • talk to me • COI?) 03:20, 14 August 2014 (UTC)

Article does not conform to scientific consensus

This article fails to conform to scientific consensus

Mayo Clinic
"The current scientific theories provide a basis for stating that acupuncture has an effect on the nervous system"
Johns Hopkins School of Medicine
"The modern scientific explanation is that needling the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain."
National Cancer Institute (USA)
"Acupuncture may work by causing physical responses in nerve cells, the pituitary gland, and parts of the brain"
National Health Service (Britain)
"It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue."
A Scientific Statement From the American Heart Association
"In the manual form of acupuncture, the mechanism of effect appears to be through sensory mechanoreceptor and nociceptor stimulation induced by connective tissues being wound around the needle and activated by mechanotransduction. In the case of electroacupuncture, the effects appear to additionally involve the stimulation of peripheral nerve fibers, including vagal afferents, that in turn activate central opioid (and other) receptors or anti-inflammatory reflex pathways. Reflex increases in sympathetic activity may also be reduced by electroacupuncture. The role of mechanoreceptor stimulation in the BP reductions in animal models is supported by the ability to attenuate this effect by gadolinium, which blocks stretch-activated channels. Both forms of acupuncture have similar central nervous system effects, although electroacupuncture tends to have a greater intensity of effect as determined by functional magnetic resonance imaging studies in humans." (PMID 23608661)

-A1candidate (talk) 02:32, 11 August 2014 (UTC)

These are really good MEDRS's that we've neglected but I don't see how they meet WP:RS/AC any more than some of the meta-analyses we quote. --Middle 8 (leave me alone • talk to me • COI?) 03:31, 14 August 2014 (UTC)
Excellent summary by A1! Given there is still doubt about exactly how acupuncture works, a true 'Mechanism of Acupuncture' section is probably still premature, but you have undoubtedly presented an outstanding case for rewriting the article to make it consistent with current scientific thinking and including a 'Possible Mechanism of action' section. Yet, we have been here before! I painstakingly set up a 'Possible Mechanism of Action' section for this article over a year ago - see: https://en.wikipedia.org/search/?title=Acupuncture&oldid=561592493. It lasted about a week before its reversion. The subheadings for that section are still current and in-line with A1's summary, although some of the refs might need updating. I'd consider putting it back in again, but would this put me up for another bout of reversion and a caution? Tzores (talk) 21:47, 12 August 2014 (UTC)
It seems you have made your homework pretty well, A1candidate! I find it quite impressive all the sources you have listed above. With respect to the scientific consensus issue, what would you suggest? =P Jayaguru-Shishya (talk) 10:37, 13 August 2014 (UTC)
We already state, of scientists, that "They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." This (or some tweaked form of it) is enough - much more would be undue and a section on 'Possible Mechanism of Action' especially so, probably veering into OR territory. Alexbrn 05:24, 13 August 2014 (UTC)
Huh? You'd omit MEDRS even if they don't fully accord with what you just wrote (re: no point specificity)? See PLOS One source supplied by A1Candidate above and my diff giving e.g.'s of quotes from same . --Middle 8 (leave me alone • talk to me • COI?) 03:28, 14 August 2014 (UTC)
First of all, Misplaced Pages is an encyclopedia, not a scientific research paper. Its articles are not supposed to "conform to scientific consensus", although they do report it. They are encyclopedic articles, and of a special nature, largely because of our NPOV policy, which requires coverage of all significant aspects of a topic, unlike normal encyclopedias.
Secondly, those nice snippets are basically saying "duh". Those are not surprising or unique results, and are about the same results as would be expected if you pinched someone or scratched them. Acupuncture does actually touch the body. It affects the body. It's not Therapeutic touch, where hands are waved over the body without actually touching it. These are real effects, but they are non-specific responses to external influences on bodily tissues. This proves nothing special about acupuncture, and says nothing about any specific and unique results from a specific poke in a specific acupoint. There is no consistent, specific, and reproducible reaction from acupuncture which applies to everyone.
There do seem to be some generalized reactions, sometimes of a somewhat positive nature (pain relief), but nothing one can count on, or that could not be obtained by any other method which triggered endorphin production, and certainly not better than, or as strongly or consistently or reproducibly as any of several standard analgesic drugs. That electroacupuncture seems to have a stronger effect is also unsurprising, and it's NOT acupuncture. It's electrotherapy.
So, what specific wordings are you proposing to make to the article? This is all speculation about possible mechanisms, but it really adds nothing we don't already know, so do you have something specific and unique to acupuncture which is a new addition to the article? -- Brangifer (talk) 06:28, 13 August 2014 (UTC)
You obviously failed to read the articles above. Scientific consensus isn't "speculation". It's something we summarize and conform to. -A1candidate (talk) 09:31, 13 August 2014 (UTC)
Brangifer, do you have anything aside from your own ponderings? Jayaguru-Shishya (talk) 10:37, 13 August 2014 (UTC)
A1, those aren't statements of "scientific consensus", they are simple statements of evidence, and that evidence is not special. Anyone, even the most ardent skeptic, will admit that they are true statements. So "...acupuncture has an effect on the nervous system". Duh! Of course it does. Has anyone denied that? No. So "... treatment can stimulate nerves under the skin and in muscle tissue." Duh! Of course it does. Has anyone denied that? No. I could go on with each one of the statements.
This amounts to a two year old finding a penny and presenting it to its mother and thinking that it has found something which no one else in the world knows about, and now it thinks it has taught its mother about the existence of money. The mother says "Oh, what a pretty penny!" If that same child does this every day, all the way up into its twenties, the mother replies "Duh. This is getting old."
So, we need to know what you're getting at, because you haven't brought anything new or enlightening to the table. How would you use these statements in the article? Don't we already acknowledge that the body does sense when it is poked? I don't think we deny that fact. The body is sensitive to anything which touches it. Duh! So what. We need more than what we already know and what we already acknowledge in the article. -- Brangifer (talk) 13:24, 13 August 2014 (UTC)

I love the smell of inappropriate use of sources in the morning. Here, we have promotions for acupuncturists at Mayo and Johns Hopkins being touted as representative of scientific consensus on acupuncture. The others are lay descriptions of acupuncture used to describe services that the scientific community still dismisses as being no more effective than a placebo. That certainly is a creative way to describe the sources, but hints at a strong desire to distort reality.—Kww(talk) 13:33, 13 August 2014 (UTC)

The article in Mayo Clinic Proceedings is classified in PubMed as a review article, not a promotion piece. -A1candidate (talk) 13:52, 13 August 2014 (UTC)
I can't find anywhere on that page where it's referred to as a "review article", but that's really beside the point. It is a RS, in the general sense of the word, but for what purpose in this connection? What you've quoted from it isn't really worth using, even if it was a "review article" which passed the criteria in MEDRS, so what are you proposing that we can do with it? -- Brangifer (talk) 00:36, 14 August 2014 (UTC)
The current scientific theories provide a basis for stating that acupuncture has an effect on the nervous system, but its effects cannot be explained with a single mechanism. -A1candidate (talk) 16:29, 14 August 2014 (UTC)

@A1candidate: you are seriously misrepresenting the NHS source. I only checked that one since I used it not so long ago and did not remember it conforming to your description. And so it does not. This gives me very little confidence that the rest of your edits may be taken at face value. Perhaps a specific proposal where we can all vet your use of sources would be better received? - 2/0 (cont.) 17:23, 14 August 2014 (UTC)

I quoted from NHS exactly as it is stated on their website. If it looks different from what you last saw, that's because the page was changed last month. They update their articles evey two years, so you need to check with the newest version.
If you want a specific proposal from me, see Talk:Acupuncture#Protected_edit_request_on_20_July_2014_2. There's still no consensus over there, so your input is very much welcome -A1candidate (talk) 18:00, 14 August 2014 (UTC)
Nobody said you messed up the copy/paste. Please read more carefully to avoid wasting the time of your fellow editors. You are misrepresenting the conclusions of that source; read it again to see how they treat the subject compared to your proposed use here. They do not conform. This is *never* appropriate. We must only and exactly provide a fair representation of the sources without cherry-picking or quoting out of context. - 2/0 (cont.) 18:38, 14 August 2014 (UTC)
And you are misrepresenting what I propose, which is that acupuncture stimulates the nervous system. That is exactly what the source says. -A1candidate (talk) 18:43, 14 August 2014 (UTC)
I think we all agree that inserting needles under the skin has an effect on the nervous system, at least based on discussion above. Please strike or modify your above aggressive comment in accordance with WP:CIVIL and WP:BATTLEGROUND. - 2/0 (cont.) 19:04, 14 August 2014 (UTC)
(e/c) 2/0, I may be missing something, but I don't see A1 giving any worse than he's getting from you on the aggression front; you both sound exasperated, and it may be just a misunderstanding. The NHS page , as of today, indeed includes verbatim the quote "It is based on scientific evidence....". Is there some other dispute about that source that I'm missing? What misrepresentation are you referring to specifically? Forgive some entirely possible denseness on my side (literally; my sinuses are all too dense at the moment, and it's radiating to what's left of my brain), but I'm not understanding what A1C is proposing to do with the NHS source beyond simply citing or paraphrasing that quote. --Middle 8 (leave me alone • talk to me • COI?) 19:25, 14 August 2014 (UTC)
oh -- you mean that A1Candidate is overstating the degree to which the NHS source represents scientific consensus? If so: yes, I think that several of these sources aren't as close to meeting WP:RS/AC as A1C is suggesting. But the NHS source is an excellent MEDRS, one of the best, and I think there's room for disagreement over how close it is to representing sci consensus. A1C, I hope you're reading this as well: The problem, which Brangifer has imo correctly identified , is that there is no unified sci consensus on most aspects of acu (other than its not being an established treatment). That's why there's such a broad range of views, and so much polarization; the extremes at each end (in real life and on WP) piss each other off. That there are good reasons to use it as a complementary therapy for pain and stress is a mainstream view; that that same view is unsupportable is also a mainstream view. (Note I said "good reasons", which is a superset of "good evidence". Patients really liking it is an example of what many consider a good reason.) So I think it would be better for A1C to portray his sources not as representative of sci consensus, but as MEDRS's (many of them excellent ones) that we need to weight adequately, and so far haven't been (perhaps because editorial consensus has thus far been overaggressive about depicting acu as wholly fringe). A1C, would you consider not reaching quite so far? You're losing some editors by doing so, editors who are reasonable enough to (gasp) accept that we can use good MEDRS's that don't wholly dismiss acu. The fact that many of the sources you're presenting haven't been given more (or any) weight shows how excessively editorial consensus had tended to swing past skepticism into outright, undue debunking. We need less hyperbole all around. It's not hyperbole to say that A1C has found no more and no less than a bunch of MEDRS's, not all but some about as good as they get, that deserve proper integration and weighting. --Middle 8 (leave me alone • talk to me • COI?) 20:14, 14 August 2014 (UTC)
Note. Stimulating nerves does not mean it is effective. QuackGuru (talk) 19:16, 14 August 2014 (UTC)
This is about the mechanism of action, not its effectiveness. -A1candidate (talk) 19:20, 14 August 2014 (UTC)
Exactly; it's a different aspect of point specificity (which I'm sure the text of the article will make clear). --Middle 8 (leave me alone • talk to me • COI?) 19:29, 14 August 2014 (UTC)
The text is under the heading "Theory" not mechanism of action. QuackGuru (talk) 19:34, 14 August 2014 (UTC)
It is referring to the theories about the mechanism of action -A1candidate (talk) 20:04, 14 August 2014 (UTC)
Is the fact that "acupuncture has an effect on the nervous system" some sort of great or new discovery? Has it EVER been denied? Is there any other possible "mechanism of action" when one touches or pokes the skin? (Hormones could also get involved, but that too is not specific.) I'm still not getting what this is about. It's still "duh", uninteresting, not unique, and not evidence for or against any claimed specific effects of acupuncture.
Please make a specific, precisely worded and sourced, proposal that isn't as foolish as the child with the penny, who is now twenty years old and is still presenting the same penny to its mother as if it has invented money. Please place your proposed edit here, in this thread. -- Brangifer (talk) 00:33, 15 August 2014 (UTC)
Just doing a search for "mechanism" in the current version turns up not even a "penny"-type comment. We have:
  1. "TCM is pseudoscience with no valid mechanism" (in lede and body);
  2. "The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles";
  3. "... making many scholarly efforts to integrate evidence for efficacy and discussions of the mechanism impossible"; and
  4. "... even if research is still unable to explain its mechanism."
Similarly unhelpful stuff (with respect to mechanism) appears when one searches for the syllables "nerv" and "neur" (including examples of what is massive undue weight to serious adverse events). And the section Scientific view on TCM theory is almost absurdly weighted to sources from the skeptic movement, and at any rate only mentions endorphins. We can do better than that! Even if a penny is all there is to be found (and there does appear to be more, e.g. point-specific neurological responses), readers at least deserve to know that the damned thing is round, shiny (for awhile), coppery, and a little bigger than a dime. Let's.... de-escalate a little in terms of confrontational approach. What's obvious to editors is not always obvious to the reader. A1Candidate has found some terrific ones, and I'd rather encourage them to keep at it. A1C, how would you do this? There's probably some stuff in those sources on fascia, no? There's stuff from Napadow and Kaptchuk.... a whole lot of stuff has been neglected, which is what happens when too few editors are involved. A1C and Brangifer, you're both great assets here; don't alienate each other. --Middle 8 (leave me alone • talk to me • COI?) 05:41, 15 August 2014 (UTC)
Does the source say that "It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue."? If it does, what's the problem? In my opinion, we better stick to the sources instead of our own ponderings. Jayaguru-Shishya (talk) 18:09, 17 August 2014 (UTC)

Yes, fascia (connective tissue) is discussed in the consensus statement of the American Heart Association as follows:

In the manual form of acupuncture, the mechanism of effect appears to be through sensory mechanoreceptor and nociceptor stimulation induced by connective tissues being wound around the needle and activated by mechanotransduction.

PMID 23608661 -A1candidate (talk) 09:32, 15 August 2014 (UTC)

I added "The mechanism of action for acupuncture is still unclear. Evidence suggests that acupuncture generates a sequence of events that modulate pain signals within the central nervous system." QuackGuru (talk) 17:55, 15 August 2014 (UTC)

You're doing it without consensus. The source is from 2008 and is way past WP:MEDDATE. We have many newer reviews to use -A1candidate (talk) 21:46, 15 August 2014 (UTC)
I added the source you proposed adding to the article. I added this source because it meets MEDRS and it was not ambiguous. QuackGuru (talk) 02:53, 16 August 2014 (UTC)
We should use the newest reviews, which are not ambiguous. -A1candidate (talk) 03:02, 16 August 2014 (UTC)
This was the specific source you wanted in the article and now you don't like what the source said? I added the source that was specifically about the mechanism of action for acupuncture, which was not vague or confusing. QuackGuru (talk) 03:20, 16 August 2014 (UTC)
I was proposing to use it to replace the editorials only. I am not entirely against your edit, but I think it needs to be formulated in a different way. "Modulate pain signals" is an ambigous phrase that requires explanation. -A1candidate (talk) 09:43, 16 August 2014 (UTC)
"They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." There is an explanation in the article. QuackGuru (talk) 16:49, 16 August 2014 (UTC)
Endorphins aren't pain signals. -A1candidate (talk) 17:34, 16 August 2014 (UTC)
The release of endorphins modulate pain signals. QuackGuru (talk) 02:22, 17 August 2014 (UTC)
That is what the article should say to reduce ambiguity -A1candidate (talk) 04:54, 17 August 2014 (UTC)
I added the context from the source according to the summary. QuackGuru (talk) 06:01, 17 August 2014 (UTC)

Arrhythmias

7 individual herbal therapies along with acupuncture and yoga have been studied and reported as having an antiarrhythmic effect:

Despite methodological shortcomings, these studies support acupuncture as an effective treatment for AF (atrial fibrillation), paroxysmal supraventricular tachycardia, inappropriate sinus tachycardia, and symptomatic premature ventricular contraction

-A1candidate (talk) 10:26, 15 August 2014 (UTC)

Good stuff -- hope you're being bold and adding at least some of these as you go, because good MEDRS's shouldn't be controversial -- as long as you're not removing others at the same time. If you also want to remove a MEDRS (for whatever reason), others might object to that part, so I'd do such an edit separately. (See situation below where an editor combined both good and bad edits into one big edit and it got reverted -- that was justified but could have been avoided.) --Middle 8 (leave me alone • talk to me • COI?) 07:50, 17 August 2014 (UTC)
Have these been added into the article? If not, I don't mind helping you guys out here. LesVegas (talk) 16:33, 30 August 2014 (UTC)

No specific explanation was given

No specific explanation was given to restore the poor evidence. The edit summary was "I see no consensus for deleting Mayo Clinic and AMA as sources (although the latter is pretty outdated)". QuackGuru (talk) 07:29, 15 August 2014 (UTC)

Why don't you just say why you think the evidence is poor? You could have said so in your ES or in your post above. Anyway, I agree AMA is quite outdated, and I doubt anyone will mind removing it. But Mayo Clinic falls under Misplaced Pages:MEDRS#Other_sources as a good MEDRS. --Middle 8 (leave me alone • talk to me • COI?) 14:42, 15 August 2014 (UTC)
See Misplaced Pages:MEDRS#Other sources: "however, as much as possible Misplaced Pages articles should cite the more established literature directly."
We are citing high-quality Cochrane reviews and systematic reviews. There is no need to state the opinion of Mayo Clinic or other organisations. This is poor evidence. QuackGuru (talk) 16:20, 15 August 2014 (UTC)
Enough bad evidence meets MEDRS? Lots of marginal evidence would likely be construed as validation. Jim1138 (talk) 20:08, 15 August 2014 (UTC)
Just realized it's under Acupuncture#International_reception and being used as an RS there not a MEDRS. --Middle 8 (leave me alone • talk to me • COI?) 22:41, 15 August 2014 (UTC)
The Acupuncture#International reception section should be about the international reception. What is the point with keeping poor evidence in the wrong section. QuackGuru (talk) 03:00, 16 August 2014 (UTC)
It's not presented as evidence. Not any more than the commentaries by Quackwatch are -- and Mayo Clinic is certainly more mainstream than Quackwatch, I think, as RS go. --Middle 8 (leave me alone • talk to me • COI?) 07:26, 16 August 2014 (UTC)
Quackwatch is not being used in the International reception section. It is misplaced text in the International reception. It would not be acceptable to add to the effectiveness section because it is poor evidence. QuackGuru (talk) 15:42, 16 August 2014 (UTC)
Quackwatch (or SRAM, basically the same thing) was part of that section when I wrote that comment. --Middle 8 (leave me alone • talk to me • COI?) 07:45, 17 August 2014 (UTC)
You claimed "Just realized it's under Acupuncture#International_reception and being used as an RS there not a MEDRS."
That is not accurate. It was being used as MEDRS is the wrong section. The text was a medical claim which falls under MEDRS. A lot of text was misplaced in that section. You have not made an argument to restore the poor evidence against MEDRS. QuackGuru (talk) 17:47, 23 August 2014 (UTC)
What's the problem with using it as an RS? Jayaguru-Shishya (talk) 18:09, 17 August 2014 (UTC)
I thought I previously explained it was presented as evidence in the wrong section. It was poor evidence and misplaced text in the International reception section. It would not be acceptable to add it the effectiveness section because we are using far better sources. No editor suggested that we must use the Mayo Clinic source in the effectiveness section. QuackGuru (talk) 16:21, 21 August 2014 (UTC)

Recent edits

User:QuackGuru just made a series of edits without consensus, which I reverted. You need to discuss each and every one of these editrs before adding them.

The Ice Man hypothesis is not supported by any scientific evidence. -A1candidate (talk) 22:04, 15 August 2014 (UTC)

I'm not entirely comfortable with A1C's bulk reversion, but OTOH I wasn't comfortable with QG's making a whole bunch of edits at once. Some of QG's edits are fine, but others obviously need consensus, and they shouldn't be done all at once. This fundamentally goes to to WP:CONSENSUS. QG, please do them one at a time so that anything viewed as controversial can be handled per WP:BRD. Or better, seek consensus first for major changes. --Middle 8 (leave me alone • talk to me • COI?) 22:52, 15 August 2014 (UTC) added last sentence 23:21, 15 August 2014 (UTC)
Hum deleting recent systematic reviews just because... Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:15, 15 August 2014 (UTC)
No, he needs to do the edits separately from one another. --Middle 8 (leave me alone • talk to me • COI?) 23:19, 15 August 2014 (UTC)
There is no compelling reason for the blanket revert to an older version and you have not given a reason to restore the poor evidence. See Talk:Acupuncture#No_specific_explanation_was_given. QuackGuru (talk) 19:09, 16 August 2014 (UTC)
I agree. Similar discussion have already taken place at Chiropractc (talk). A quote from the discussion: "... It is good practice to perform a series of smaller edits when content has been challenged... MrBill3 (talk) 12:48, 27 July 2014 (UTC)'" Jayaguru-Shishya (talk) 18:13, 17 August 2014 (UTC)
Yes, there is a good reason for a blanket revert, and I explained it above. And I will just once more: a combined good and bad edit is still a bad edit. --Middle 8 (leave me alone • talk to me • COI?) 07:40, 17 August 2014 (UTC)
What on earth? You're redoing a major part of this edit while the discussion here was still under way, and when two editors have objected to your blanket edit? No consensus for Otzi, and this sentence -- "The poor quality evidence suggests that in regard to whether acupuncture in infertile men improves sperm motility, sperm concentration, and the pregnancy rate of couples is insufficient. -- is atrocious. You're edit warring. Don't do that. Wait for consensus. Don't make others clean up your messes please. --Middle 8 (leave me alone • talk to me • COI?) 08:30, 17 August 2014 (UTC)

Jerng et al.

Jerng et al. 2014 was recently removed without explanation. This looks like a decent source to integrate with the existing #Fertility and childbirth section. - 2/0 (cont.) 19:00, 16 August 2014 (UTC)

There should be a discussion over whether Asian Journal of Andrology, which is sponsored by the Chinese government, is considered a reliable source. -A1candidate (talk) 19:10, 16 August 2014 (UTC)
That is a good explanation. Thank you for supplying it when prompted. - 2/0 (cont.) 19:18, 16 August 2014 (UTC)
http://www.researchgate.net/journal/1745-7262_Asian_Journal_of_Andrology The impact factor is 2.14 and it is the only systematic review and meta-analysis covering poor semen quality in infertile males. QuackGuru (talk) 19:43, 16 August 2014 (UTC)
This is the current wording for Jerng et al.: A 2014 systematic review and meta-analysis found poor quality evidence for use of acupuncture in infertile men to improve sperm motility, sperm concentration, and the pregnancy rate; the evidence was rated as insufficient to draw any conclusion regarding efficacy.
While the discussion here was under way, no rationale objection was made for reverting to an older version.
There is still no rationale explanation for reverting to an older version. Removing recent systematic reviews was inappropriate. Restoring the poor and misplaced evidence to the International reception section was also inappropriate. Cochrane reviews and systematic reviews are far better. QuackGuru (talk) 03:44, 21 August 2014 (UTC)

Allergies

Several studies regarding allergies were recently removed. Can we come to a consensus on this text instead of edit warring about it? - 2/0 (cont.) 19:01, 16 August 2014 (UTC)

The addition does not take into account the latest source , Acupuncture for allergic disease therapy – the current state of evidence (2014), in Expert Review of Clinical Immunology. -A1candidate (talk) 19:12, 16 August 2014 (UTC)
The Acupuncture for allergic disease therapy – the current state of evidence (2014) is a Perspective. I don't think it is a systematic review. QuackGuru (talk) 19:23, 16 August 2014 (UTC)
Expert Review of Clinical Immunology publishes review articles. The source says "This review summarizes current evidence for acupuncture treatment of allergies". The review article is written by allergy experts and is newer than the older sources. -A1candidate (talk) 19:37, 16 August 2014 (UTC)
At pubmed it does not say it is a review in the listing of the source. The text says "This review summarizes... but it does not say it is a systematic review. At the of top of the source it says it is a Perspective. Not sure if it meets MEDRS. Thoughts? QuackGuru (talk) 20:01, 16 August 2014 (UTC)
The article was published in July 2014. The indexing procedure in PubMed is still in process. Previous perspective reviews in Expert Review of Clinical Immunology have been indexed by in PubMed as a review. See PMID 23971749 for example. If you have a newer systematic review, we could use it. If not, let's stick to the latest review that we have. -A1candidate (talk) 20:21, 16 August 2014 (UTC)
If it is reliable I would need a copy of the conclusion to make sure I add neutrally written text. QuackGuru (talk) 20:45, 16 August 2014 (UTC)

Time out for a moment. First, "Perspective" is not a genre. The source is a review, obviously, per A1C's multiple and patient clarifications. And a review can still be a MEDRS whether general or systematic; we can use them both, although the former does not supersede the latter.

Just because one doesn't like a source, it's not OK to make tendentious, nitpicky objections every step of the way -- like "it's not a review" when it obviously is. That may "work" -- in the sense that it slow-walks addition of sources one doesn't like, and frustrates those with whom one is disagreeing -- but it's a low-level form of disruption that decreases the quality of discussion. It is absolutely not how WP:DR works. (Or is it?) --Middle 8 (leave me alone • talk to me • COI?) 06:04, 17 August 2014 (UTC)

  • QG, this is what the source concludes:
There are several randomized clinical trials supporting the use of acupuncture in allergic rhinitis as well as the symptom of itch. Experimental studies point to an effect of acupuncture in atopic eczema and asthma; however, large RCTs are lacking. Acupuncture for the treatment of other allergic diseases such as contact eczema, drug rashes or anaphylaxis cannot be recommended to date. Further research is needed to more clearly identify clinical effects above and beyond placebo and mechanisms of action.
The source provides a good overview of the mechanisms of action against allergy. -A1candidate (talk) 00:02, 18 August 2014 (UTC)
About "Further research is needed to more clearly identify clinical effects above and beyond placebo and mechanisms of action." What does this apply to? Allergic rhinitis and itch or atopic eczema and asthma or other allergic diseases? Tgeorgescu (talk) 00:39, 18 August 2014 (UTC)

Note. I added the source to the article. QuackGuru (talk) 04:09, 28 August 2014 (UTC)

Ice Man

The Ice Man's tattoo marks on his body which conform to acupuncture points, suggests to some experts that an acupuncture-like treatment was previously used in Europe 5 millennia ago.

The Ice Man thing is decently well sourced, but I think it has been pretty well rejected. I would like to remove it unless we have more than the current small slice of scientific speculation. - 2/0 (cont.) 19:06, 16 August 2014 (UTC)

  1. ^ Ernst, E. (2006). "Acupuncture--a critical analysis". Journal of Internal Medicine. 259 (2): 125–137. doi:10.1111/j.1365-2796.2005.01584.x. ISSN 0954-6820. PMID 16420542.
The source says: "Bizarrely, the ‘Ice Man’, who lived in the Alps about 5000 years ago, displays tattoo marks on his body which correspond to acupuncture points. To some experts, this suggests that an acupuncture-like therapy was already used in Europe 5 millennia ago ."
The source does not say it is merely speculation. To some experts, it suggests that a form of acupuncture was previously used in Europe 5 millennia ago. QuackGuru (talk) 19:09, 16 August 2014 (UTC)

Weak keep -- QG is right that while it's speculation, it is "expert speculation", plus it's even mentioned in a review. OTOH, Ernst mentions it mostly as an aside, and even adequately-sourced speculation is still speculation -- which means it's pretty weak in terms of WEIGHT. Interesting though. (Like much of speculation :-) --Middle 8 (leave me alone • talk to me • COI?) 06:46, 17 August 2014 (UTC)

There are recent sources in the news. QuackGuru (talk) 07:01, 17 August 2014 (UTC)
It's fine with me, especially with the new evidence. (I think we can safely assume the media didn't botch this roll-out.) Speculative yes, but I don't think it's especially controversial, so no major reason not to have it. And it is interesting; fascia-nating actually (haha). But in the lede?? --Middle 8 (leave me alone • talk to me • COI?) 11:04, 17 August 2014 (UTC)
This discussion is regarding this edit. According to your previous comment, you supported to tentatively keep it in the lede. Now that I explained it is no longer controversial given the current evidence, you are now strongly questioning whether it should be in the lede. Can you see the tattoo marks correspond with acupoints? QuackGuru (talk) 20:23, 17 August 2014 (UTC)
2/0's thread-starter didn't say anything about the lede; sorry for any mixup. It's not WEIGHT-y enough for the lede, but the more recent research should be enough to keep it in the article. Yes, some of his tattoos are right on top of acupoints, and others are within a few mm (diagram: ). And not just random acupoints, but major ones used for pain and tonification, like UB60 and Sp6. And being located under where clothing was worn, they're unlikely to be decorative. Quite intriguing; maybe the underlying connection is related to trigger points. Who knows.... Hey, can we use this as cross-cultural evidence for point specificity? ;-) --Middle 8 (POV-pushing • COI) 17:01, 18 August 2014 (UTC)
If there is more detailed research in the future things could change again. Can we use this as cross-cultural evidence for point specificity? Not sure when no specific proposal was made. QuackGuru (talk) 17:05, 18 August 2014 (UTC)
My last sentence in jest. Hence ;-) --Middle 8 (POV-pushing • COI) 07:57, 19 August 2014 (UTC)
I get it now. All this time you were arguing ad nauseam and reverting me to encourage me to continue to improve the article.
Reverse physiology works? QuackGuru (talk) 18:39, 24 August 2014 (UTC)
My joke (about "cross-cultural evidence for point specificity) was about acupuncture and evidence, not about you. OTOH, it's very hard to see your immediately preceding comments as anything other than baiting. Misplaced Pages isn't a battleground, and when I make an edit, I'm not thinking about you. I could care less about reverse psychology or any other game. Please stop acting as if editors' content disagreements are personal. --Middle 8 (POV-pushing • COI) 07:28, 26 August 2014 (UTC)

1997 NIH statement

The 1997 NIH panel statement is really old and a bit unusual. We should not use it to represent anything modern, though perhaps it can be retained for some historical significance. Thoughts on removing the reference? - 2/0 (cont.) 19:13, 16 August 2014 (UTC)

Agree that it should be removed. There is an explicit warning against using it: "They were current when produced, but are no longer maintained and may now be outdated." -A1candidate (talk) 19:18, 16 August 2014 (UTC)
We are using the 2005 Quackwatch as a source now. See Acupuncture#Ethics. I recently fixed the text. QuackGuru (talk) 19:21, 16 August 2014 (UTC)
The statement was only being used to support some pretty basic and unlikely to be challenged information, so I boldly removed the reference. - 2/0 (cont.) 19:26, 16 August 2014 (UTC)
I requested a source for the non-controversial claims. QuackGuru (talk) 20:08, 16 August 2014 (UTC)
Why did you do that? We don't use sources for non-controversial claims. Such a request can be seen as disruptive, so why do it? You're not making sense. -- Brangifer (talk) 00:50, 17 August 2014 (UTC)
I am not making a request that we must use a source. I was stating when someone finds a source it can be added to the article. QuackGuru (talk) 00:58, 17 August 2014 (UTC)
Ooookaaay...? Then we can remove that CN, since it's not necessary. We don't clutter articles, especially the leads, with unnecessary things. If it's really necessary, the body will contain references. -- Brangifer (talk) 01:01, 17 August 2014 (UTC)
I agree no tag was needed so I removed the tag from the body along with other tags from the body. But now an editor without consensus is deleting lots of text in the body. This text is sourced. QuackGuru (talk) 23:23, 11 September 2014 (UTC)
Indeed, this piece of text was sourced after all. My apologies. I think, however, that your rapid editing makes it really difficult to follow up what's going on. Jayaguru-Shishya (talk) 11:08, 12 September 2014 (UTC)

{{edit protected}} Per the above two comments, it looks like this edit should be undone and the cn tag removed. - 2/0 (cont.) 18:00, 12 September 2014 (UTC)

I don't see consensus to revert only one edit. I disagree with this edit protection request. I strongly disagree with the unprotection request to revert only one edit. All the recent edits to add the tags and to delete the material was a mistake. We should go back to this version and unprotect the article. QuackGuru (talk) 18:19, 12 September 2014 (UTC)
Well, never mind then; turning off the template for now. QG, I agree that there are several recent edits that need to be examined in detail, but I think that we can handle them individually. I am not seeking to have the article unprotected (I just yesterday requested that it be locked), just to have this one change made. Do you disagree that the article as it currently stands would be improved by restoring that sentence about use of qi as an explanatory framework? - 2/0 (cont.) 18:40, 12 September 2014 (UTC)
I think we should go back to this version and it is a waste of time handling each edit individually. I don't see any reason to having this article locked. QuackGuru (talk) 18:47, 12 September 2014 (UTC)
I think you may have mixed up your pronouns there, as I do indeed think the article needs to be locked for now. I would not necessarily be averse to reverting to that version, but the case would need to be made. - 2/0 (cont.) 18:57, 12 September 2014 (UTC)
I fixed the typo. This is what happened. I undid my own edits and removed the tags. Next, after the tags were restored sourced text was deleted. This is a strong case to removed the tags so this won't happen again. QuackGuru (talk) 20:11, 12 September 2014 (UTC)

Indonesia

Recent edit from 222.244.210.15:

All traditional medicines, including TCM, are regulated on Indonesian Minister of Health Regulation in 2013 about Traditional Medicine. Traditional Medicine License (Surat Izin Pengobatan Tradisional -SIPT) will be granted to the practitioners whose methods are scientifically recognized as safe and bring the benefit for health. The TCM clinics are registered but there is no explicit regulation for it. The only TCM method which is accepted by medical logic and is empirically proofed is acupuncture. The acupuncturists can get SIPT and participate on health care facilities.

  1. ^ Menteri Kesehatan Republik Indonesia. 2003. KEPUTUSAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR 1076/MENKES/SK/VII/2003 TENTANG PENYELENGGARAAN PENGOBATAN TRADISIONAL. Template:Id
  2. Cheta Nilawaty dan Rini Kustiati. 13 Agustus 2012. TEMPO, Belum Ada Aturan Soal Klinik Pengobatan Cina. Template:Id

I think there should be something usable here, but not in the current form. Removed here for discussion. - 2/0 (cont.) 13:14, 18 August 2014 (UTC)

No serious dispute

Rather than wait for this discussion to crop up again I will start it again and take the initiative.

TCM is largely pseudoscience, with no valid mechanism of action for the majority of its treatments.

This is no serious dispute. See WP:ASSERT. We don't need to have another discussion every six months. When there is a new source that says TCM is science and there is a mechanism of action for the majority of its treatments we can also include that source with in-text attribution for both sentences. QuackGuru (talk) 01:28, 21 August 2014 (UTC)

Sorry, I'm relatively new to editing and formatting in the Wikipedian community, I've made some tentative edits on an account which I can't remember how to access. However I've also been watching the edit histories daily and talk pages of many subjects in order to learn WP policy and how it's applied in various environments. /End of preface.
Several things about this confuse me. For instance, are you saying that via WP:ASSERT we should present the statement you are addressing as factual rather than opinion? This confuses me, first of all, based on the lack of tangible information in the editorial article itself. But I don't know if that's something we deal with here. More prominently it concerns me because isn't the definition of an editorial article that it is an opinion piece by the editor? Doesn't WP:ASSERT caution specifically against presenting opinion as fact, even if it is a notable opinion?
Secondly, why is this an important addition to a section entitled "theory"? Would it not be more appropriate in the lead? The TCM article itself acknowledges that the source is editorial opinion, although at some point the "editorial" attribution was moved from the lead to the body of the text (in my opinion, a strange move, but maybe there is a policy for that).
It reads:
"Successful results have however been scarce: an editorial in Nature said that while this is simply because TCM is largely pseudoscience without a rational mechanism of action for the majority of its treatments, advocates have argued that it is because research had missed some key features of TCM, such as the subtle interrelationships between ingredients." Once again, sorry for any confusion on my part.OnceTheFish (talk) 18:06, 21 August 2014 (UTC) Sock comments stricken. QuackGuru (talk) 03:50, 23 August 2014 (UTC)
As QuackGuru said, the contrary viewpoint is virtually nonexistent in the medical literature that matters, so we cannot seriously pretend that TCM would be considered scientific by any medical researcher worth his salt, therefore "TCM is pseudoscientific" wins by default. Tgeorgescu (talk) 00:33, 22 August 2014 (UTC)

Funny things are happening again. OnceTheFish is way too familiar with this content dispute. The last time someone was pretending to be a newbie we knew it was a sock account. QuackGuru (talk) 06:11, 22 August 2014 (UTC)

These types of responses are the type which kept me out of this editing game for so long, especially in these topics. I have been bemusedly watching these pages for several months now. It has been an engaging lesson in the stark realities of the wiki project. As to the wonderful welcoming accusation, I would be willing to verify my identity to an admin, or have a longtime contributor who encouraged me to register an account vouch for me to an admin or official representative.
My question, are you arguing that via WP:ASSERT we should present an editorial opinion as fact? This seems utterly contrary to the purpose of this policy. If it is not, could you explain to me where I have read it wrong? Whether or not the other literature says X or Y (which if it does, why are we not using that rather than an editorial opinion?), strictly speaking WP:ASSERT which was the policy cited by QuackGuru seems to say contrary. On top of which, there is a precedence in the TCM wiki proper to identify the attribution of the editorial opinion, which I would guess is how WP:CON develops, although I may be wrong about that as well.
I am not speaking to anything else other than the specific instance of policy which QuackGuru has cited. Thanks.OnceTheFish (talk) 15:36, 22 August 2014 (UTC) Sock comments stricken. QuackGuru (talk) 03:50, 23 August 2014 (UTC)
Again, in reliable sources there isn't a debate whether TCM would be pseudoscience. There is no controversy about this, all such sources concur that it advances pseudoscientific mechanisms for explaining its treatments. If would not be that editorial, fine, there are other reliable sources which make the very same point. Whether each of those treatments is effective or not is another matter, e.g. there might be some herbs which have a real therapeutic effect. But a few herbs which are proven to have such effects do not mean that TCM would not be pseudoscientific, they would just be its lucky guesses. Until Tao, Yin and Yang would be observed in laboratory, it will remain pseudoscience even if it got a couple of treatments right. Oops, I forgot that Tao defined is no Tao at all, so its claims are principally unfalsifiable, relying upon mystical energies which are undefinable and some of its advocates say these have no relation to the present-day meaning of "energy", either. So, I would like that you propose bona fide changes to the article instead of insisting upon advocacy for pseudoscience. User:Jytdog acknowledges there are mainstream uses for acupuncture because it is a convenient way of fooling patients into feeling better, even if it is placebo produced by pseudoscientific practice. Tgeorgescu (talk) 23:23, 22 August 2014 (UTC)
TCM predates science. How would you expect it to explain how a treatment works? Because they say "qi", that means there can't be any rational mechanism? I find that argument unimaginative and unpersuasive. Ancient astronomer/astrologers thought that gods and demons battled in the sky; does that mean that their predicting eclipses was just lucky guessing? --Middle 8 (POV-pushing • COI) 08:57, 26 August 2014 (UTC)
Tgeorgescu please strike your comment. You characterize me bizarrely and are trying to use me as a tool in a debate I am not involved in. I object to that. I also think you do not understand what I represent here. So please just strike your remark. Jytdog (talk) 23:39, 22 August 2014 (UTC)
Ok, I have stricken my comments, but perhaps you should better explain your point. Tgeorgescu (talk) 23:46, 22 August 2014 (UTC)
Tgeorgescu, there seems to be a considerable hostility in the tone of your writing. If I have somehow offended you or broken etiquette, please let me know what in particular I can correct so that we can discuss in a productive manner. Let me clarify my perspective. 1. QuackGuru cited a particular reference, and then a particular policy WP:ASSERT. 2. I asked for clarification of how he would like to implementWP:ASSERT with regards to that reference. 3. The reasoning behind my request is as follows, a)WP:ASSERT states "A simple formulation is to assert facts, including facts about opinions, but don't assert opinions themselves." b) an editorial is, by definition, an opinion. If you search Editorial in wikipedia the following appears: "An editorial, leading article (UK) or leader (UK), is an opinion piece written by the senior editorial staff or publisher of a newspaper, magazine, or any other written document. Editorials may be supposed to reflect the opinion of the periodical." c)Given that the policy QuackGuru cited explicitly dictates that opinions should be written in a separate voice from a point of fact, and an editorial reference is by definition an opinion piece, it follows that the citation of the policy next to the reference is at the very least quite confusing for me. Whether we keep the reference with proper attribution, find another of these non-opinion references you allude to, re-write the WP:ASSERT policy, or correct the definition of "Editorial", I don't know, so I ask you guys. My proposal is to continue WP:CON as we see it in the TCM (traditional Chinese medicine) and Chinese Herbology pages by adding the proper attribution. For example "An editorial in Nature stated that TCM is largely pseudoscience, with no valid mechanism of action for the majority of its treatments." as seen in the lead of Chinese herbology. Furthermore I propose that the attribution of this editorial is moved from the body of the TCM page into the lead, however I don't know if this is the correct page for that. (talk) 01:30, 23 August 2014 (UTC) Sock comments stricken. QuackGuru (talk) 03:50, 23 August 2014 (UTC)
The problem with your position is that there is no reliable source contradicting the position that Traditional Chinese Medicine is pseudoscience. —Kww(talk) 02:32, 23 August 2014 (UTC)
The sock account was blocked. QuackGuru (talk) 03:38, 23 August 2014 (UTC)

well i guess that is done. Tgeorgescu thanks for striking your comment. I am happy to explain whatever you like, but this is not the place for it. If you want to clarify your question (which I don't understand) I would be happy to do it on my talk page. thanks again. Jytdog (talk) 05:48, 23 August 2014 (UTC)

I (user:Ontarioboy) have known (user:OnceThe Fish) for all of his young life as our families have shared weekly dinners for the past twenty years. During dinner conversations I occasionally allude to my own wide-ranging edits on Misplaced Pages and have encouraged my young friend to become active there, which he finally did last month. His first contribution, to the talk:acupuncture page, landed him in the midst of an ongoing quackery controversy and his rather detailed comment was deemed prima facie evidence of sockpuppetry. This is not so. Apart from a small anonymous edit or two back in 2008, he is a first-time novice Wikipedian. David G Anderson (talk) 03:26, 1 September 2014 (UTC)

Where was this edits back in 2008? QuackGuru (talk) 03:32, 1 September 2014 (UTC)

My young friend says that it was at his local college in a modern media class when the instructor had every student go on Misplaced Pages and make a minor edit or two so as to acquire familiarity with the edit process. His contribution was "inconsequential and forgettable" and occurred prior his current interest in TCM, acupuncture and such. David G Anderson (talk) 21:35, 2 September 2014 (UTC)


Serious dispute

We simply don't have RS showing sci consensus that acu is pseudoscience, and we do have RS and other indicia that there is significant disagreement. The large majority of RS discussing acupuncture and TCM are silent on pseudoscience, and nearly all MEDRS are, and there's no reason to believe that silence necessarily indicates agreement or disagreement. But, using common sense, it's highly unlikely that those who use acupuncture in mainstream settings, like academic centers, believe it's pseudoscience.

And yes, there's debate over the pseudoscience label; see the invited "pro" editorials in Analg. Anesth (pro; con); the "pro" article rejects labels like "pseudoscience" and "quackery". The "con" article is still cited in the article, although I think we have consensus not to use either as MEDRS. But they are RS and mainstream. Additionally, there are RS that demarcate acu neither as science nor pseudoscience, but in a grey area between the two; see archived talk. An example is Michael Shermer's recent book chapter: .

So, we have RS showing that acupuncture shouldn't be categorized as pseudoscience on WP. Rather, cf. WP:FRINGE/PS, it falls under "questionable science": "Hypotheses which have a substantial following but which critics describe as pseudoscience". But more than that, we see it being used in some mainstream settings, while others denounce such use as "quackademic medicine". Sounds like "a reasonable amount of academic debate" to me (WP:FRINGE/PS). And we have nothing close to a source meeting WP:RS/AC, which again isn't surprising given acu's broad sphere of usage. So why should we use category:pseudoscience, or otherwise say in WP's voice that acu is pseudoscience? --Middle 8 (POV-pushing • COI) 08:50, 26 August 2014 (UTC)

I agree. So I could recall, that this has been already discussed earlier. That's why at traditional Chinese medicine on a dispute about using Misplaced Pages's voice I reverted the removal of the very editorials expressing these views. According to Kww, however, "yes, it has, with the decision being that a bald description as "pseudoscience" in WP's voice is appropriate".
Whereas reliable sources are bringing forth a significant disagreement over the subject, I think we should definitely include 1) the source behind each claim, and 2) the sources with differing views. Jayaguru-Shishya (talk) 10:52, 26 August 2014 (UTC)

Safe?

With acupuncture "there is a risk of accidental puncture of nerves, which could lead to brain damage or strokes. Kidney damage can result from deep needling in the lower back, and unsterilised needles can transfer HIV and hepatitis." QuackGuru (talk) 17:28, 23 August 2014 (UTC)

Since when is The Daily Telegraph an MEDRS-compliant source? -A1candidate (talk) 01:16, 25 August 2014 (UTC)
Yeah, I'd like to hear that as well. Jayaguru-Shishya (talk) 12:10, 25 August 2014 (UTC)
Yes popular press should not be used for medical content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:35, 25 August 2014 (UTC)
If an editor (who should know better) were to suggest using popular press as MEDRS for "pro-acupuncture" statements, an admin would use that to support sanctioning that editor under AE. Strange the converse doesn't seem to be true.... --Middle 8 (POV-pushing • COI) 08:47, 26 August 2014 (UTC)
You were using a primary source is engage in a "pro-acupuncture" statement. Do you think an admin would use that to support sanctioning you under AE? QuackGuru (talk) 20:23, 26 August 2014 (UTC)
Ummm.... that diff shows me using a peer-rev RS for a non-medical claim. That's not quite the same as your proposal above to use a newspaper as a MEDRS. (BTW, why is the link to your talk page in red? Redlinks imply that no such page exists; it's confusing.) --Middle 8 (POV-pushing • COI) 04:07, 27 August 2014 (UTC)
You added a primary source that violated WP:SECONDARY and WEIGHT. I did not make a proposal to use the source above. See WP:AGF. I was using the talk page to document what was missing from the article and added this. QuackGuru (talk) 04:14, 27 August 2014 (UTC)
If that was why you mentioned the news article, then you should have said so; three editors misunderstood you. In light of your clarification, I'm striking my comments about sourcing. With respect to the point you're trying to make, your quote was selective. The bit you quoted is preceded by "While most acupuncture causes little harm," is consistent with how the literature weights AE's. Omitting important context like that is not a great way to get others to AGF. More re which, please see your talk page. --Middle 8 (POV-pushing • COI) 07:18, 27 August 2014 (UTC)
I wasn't trying to make a point. I was making a note. We are not using that source. QuackGuru (talk) 07:28, 27 August 2014 (UTC)
Why did you post it at all then? Was it to show that the article needs to spend more time on infection and other adverse events?
Here's the full quote -- which is a pretty accurate depiction of our MEDRS's -- with the part you omitted in bold red:
"While most acupuncture causes little harm, there is a risk of accidental puncture of nerves, which could lead to brain damage or strokes. Kidney damage can result from deep needling in the lower back, and unsterilised needles can transfer HIV and hepatitis."
The bold red part -- which you omitted -- shows why it's an UNDUE problem to devote excessive coverage to infection and other serious adverse events. Why did you omit it? --Middle 8 (POV-pushing • COI) 10:21, 28 August 2014 (UTC)
On the contrary, I added "Acupuncture is generally safe when administered using clean technique and sterile single use needles." See diff. I previously explained, I left a note on the talk page. QuackGuru (talk) 19:08, 31 August 2014 (UTC)
I'm not talking about article space edits -- and that was a good article edit, although you didn't make it until you got called out here. Taking material out of context anywhere, including article talk, can create a biased impression. Here, you omitted the one part of the quote that gives the rest of the quote proper weight. Why? See WP:OPPONENT. --Middle 8 (POV-pushing • COI) 04:54, 2 September 2014 (UTC)

I did explain this was only a note. I did not omit anything from the note to myself. QuackGuru (talk) 03:13, 8 September 2014 (UTC)

Strange place for a note to "yourself". Others use this page too. And four editors responded before you explained yourself (and then only when called out). --Middle 8 (contribs • COI) 12:34, 9 September 2014 (UTC)
Re recent edits listing specific infections, please see Talk:Acupuncture#Infection below.

Discussion had already begun below, and the above discussion about the newspaper is extraneous, except for the UNDUE issue. --Middle 8 (POV-pushing • COI) 10:21, 28 August 2014 (UTC)

Quackwatch is a reliable source

Quackwatch stated that:

TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care.

Rather than wait for this discussion to crop up again I will start it again and take the initiative. The source is reliable per many previous discussions. QuackGuru (talk) 16:16, 25 August 2014 (UTC)

Then why start the discussion again? It's a pretty settled matter that QW is reliable for these subjects, but always on a case by case basis. If in doubt, then attribute it to the author, whether it's Barrett or someone else. -- Brangifer (talk) 03:51, 26 August 2014 (UTC)
I don't like using QW. It's really just a personal self published blog. It would be better to use the medical references that it relies upon rather than QW directly. All sources should follow WP:MEDRS. It's hypocritical to use one personal website and then deny others. --Harizotoh9 (talk) 08:06, 26 August 2014 (UTC)
I think it's a good initiative to start the discussion again, but definitely it needs a broader audience than just the editors of Acupuncture. Well, I have to agree with Harizotoh9 here. QuackWatch is a self-published blog that has undergone no academic peer-review process, i.e. the ones hosting that site can publish whatever they want on that site. And we are not interested in one's opinions. Entertaining? Perhaps. Scientific? Perhaps not.
And when it comes to blogs in general, even if we had a eminent Economist like Paul Krugman publishing his blog at The New York Times, we still can't take what he says there as scientific claims (which is really apparent if you read his blog).
If QuackWatch really is a reliable source, sure it would be largely cited in scientific papers. Is it? Jayaguru-Shishya (talk) 10:53, 26 August 2014 (UTC)
As I understand it, under WP:PARITY, Quackwatch can be useful for highly fringe topics that scientists haven't commented on. Acupuncture is not such a topic, and better sources than Quackwatch are usually available. I agree with using it on a case-by-case basis, as Brangifer says. And I'd add: sparingly. BTW, as far as getting Quackwatch declared a non-RS goes, see WP:SNOWBALL. It's been discussed many times, and sometimes with editors who don't usually edit alt-med type stuff, and the result has generally been about as I've outlined it. --Middle 8 (POV-pushing • COI) 12:14, 26 August 2014 (UTC)
Since there are significant areas of acupuncture which have not been discussed in the scientific literature (e.g. anything having to do with a scientific plausibility of qi) quackwatch can be used to explain those points. The quote that QG points out is pretty much in that category. jps (talk) 19:56, 26 August 2014 (UTC)
No, it has been reviewed in scientific literature. And we should cite that instead, as discussed many times before. -A1candidate (talk) 20:05, 26 August 2014 (UTC)
Which scientific literature is that? Has there been a "Qi review" that I missed? jps (talk) 20:16, 26 August 2014 (UTC)
PMID 21870056 -A1candidate (talk) 20:25, 26 August 2014 (UTC)
The source says "we speculate that the mechanism"... According to you we should not include speculation in this article. QuackGuru (talk) 20:41, 26 August 2014 (UTC)
The speculation is about "a separate channel of cellular communications". This is different from their conclusion that "the ancient model appears to have withstood the test of time ". -A1candidate (talk) 20:48, 26 August 2014 (UTC)
You misrepresented the source. It goes on to say "...surprisingly well confirming the popular axiom that the old wine is better than the new." That is ambiguous. QuackGuru (talk) 02:10, 27 August 2014 (UTC)

Explain how that terribly written and poorly researched article passes WP:MEDRS. jps (talk) 01:06, 27 August 2014 (UTC)

Last I checked, medical review articles in peer-reviewed journals (impact factor 3.07 in this case) were MEDRS's. Acupuncture is a good example of a topic area where we have plenty of MEDRS's and thus don't need to use Quackwatch for such purposes. --Middle 8 (POV-pushing • COI) 01:20, 27 August 2014 (UTC) revised 01:41, 27 August 2014 (UTC)
So why is it not cited outside of credulous acupuncturist circlejerks? jps (talk) 02:04, 27 August 2014 (UTC)
It is cited by internists and gynaecologists in this Cochrane review. Can you show me a review paper that cites QW? -A1candidate (talk) 02:12, 27 August 2014 (UTC)
That Chochrane review was written by acupuncturists, so try again. Yes, there are reviews that cite QW, some of which are cited in our article on Quackwatch. jps (talk) 17:45, 29 August 2014 (UTC)
Cochrane review is a Cochrane review. I am afraid we are not interested in your personal opinions about it.
Written by whom? An economist writing about economics is more than preferable, a physicist writing about physics is more than preferable, a physician writing about medicine is more than preferable... I wonder where you managed to break the pattern? ^^
Can you give me few reliable high-quality acedemic sources where QuackWatch is beng cited? Thanks! Jayaguru-Shishya (talk) 19:01, 29 August 2014 (UTC)

Acupuncturists are generally believers in pseudoscience and so cannot be trusted to comment on the pseudoscientific nature of their practice. Their abilities to publish review articles may or may not be relevant to this point (actually, review articles rarely address the subject of pseudoscience). The fact that acupuncture is closely associated with pseudoscientific tosh is not something to be shied away from, and we have plenty of reliable sources to that effect in spite of the acupuncture true believers such as yourself, Middle 8, and A1candidate trying to get it removed because it offends your delicate sensibilities and true beliefs. jps (talk) 20:34, 29 August 2014 (UTC)

@ QTxVi4bEMRbrNqOorWBV aka jps: If you are asserting that I and other editors are trying to suppress V RS material, that is a personal attack unless you can provide clear and convincing diffs (which I don't think you can, or else you would have filed at ANI etc. by now). I strongly object to the assertion that I am here to do anything other than to improve Misplaced Pages. Please provide diffs or strike or clarify your assertion. --Middle 8 (POV-pushing • COI) 05:09, 2 September 2014 (UTC)
I am sorry to disappoint you, but I am not an "acupuncture true believer", neither a mere "acupuncture believer". I hope you can get over such assumptions when editing at Misplaced Pages. Anyway, do you have any facts and sources aside your own personal opinions? I am afraid we are not interested in your own ponderings. As I said, a Cochrane review is a Cochrane review. Should you have a source discrediting that, please do let us know.
Ps. Those high-quality academic sources where QuackWatch is being cited would be more than welcome. Cheers! Jayaguru-Shishya (talk) 20:57, 29 August 2014 (UTC)
We can all see your contributions and know what your general approach has been. If you are not a true believer, you are an apologist for true belief. That makes it very difficult to collaborate with you because you either don't have a head for reality or you are pretending to not care about such. "A Cochrane review is a Cochrane review" is a content-less comment meant to shut-down discussion and I've already pointed you in the direction of the sources that cite QW. Go back to your WP:ADVOCACY. I won't stop you. Cheers! jps (talk) 21:02, 29 August 2014 (UTC)
Do you have some specific edits you'd like to discuss, or are you attacking me as an editor? "....don't have a head for reality...." and ], ouch? Anyway, I hope you could stick to the topic. If there are any other concerns, please do start a new thread or find an appropriate forum to discuss those. Cheers! Jayaguru-Shishya (talk) 21:13, 29 August 2014 (UTC)
Ps. As I said: "Should you have a source discrediting that , please do let us know.. Aside from that, no high-quality academic sources where QuackWatch would have been cited has been provided. Jayaguru-Shishya (talk) 21:23, 29 August 2014 (UTC)
  • Internists and gynaecologists are not acupuncturists. PMID 21870056 isn't the only review that validates the science of acupuncture and disagrees with QW. See PMID 24079683 -A1candidate (talk) 22:27, 29 August 2014 (UTC)

It seems that there is far more heat than light in this thread. Can we all calm down and just drop the sniping? How about just hatting this thread since it's dead in the water? Start a new one which doesn't mention QW. -- Brangifer (talk) 22:37, 29 August 2014 (UTC)

How about removing non-scientific sources like QW? -A1candidate (talk) 23:06, 29 August 2014 (UTC)
How about removing POV-pushing editors like yourself? jps (talk) 00:01, 30 August 2014 (UTC)
Think this discussion would be better off on say Misplaced Pages:Reference_desk/Science. Quackwatch should -in the spirit of Misplaced Pages- be banned as a source (on WP) because of its clear biased agenda. It misleads nouveau editors. It leads them to confuse fact with fiction. --Aspro (talk) 23:28, 29 August 2014 (UTC)
Nonsense. The only people who argue this way are true believers in alternative medicine. I take that kind of opinion pushing to be prima facie evidence of a lack of WP:COMPETENCE, but it is nice because it serves to illustrate who we should be monitoring. I see that you are an anti-vaccine advocate. I'll be sure to revert your blinkered edits as they come through. jps (talk) 00:03, 30 August 2014 (UTC)
Please revert your edit. I happily had a anti-tetanus jab because I did not want to sufferer the (small) risk of getting lockjaw, after getting a hole in my arm. It was a very small risk, as it didn't happen in a situation where where one was likely to contract that bacteria. (I had a fight with my flat-mate on the balcony -so no soil involved) Yet here, in the UK I could have a jab for free – so I had one! Don't be so pontifical. I makes you look ignorant. Next time 'think' before putting fingers to keyboard. OK? --Aspro (talk) 02:39, 30 August 2014 (UTC)
No Aspro, it is your snarky, talk page-violating comments, here and elsewhere, which should be tamed or removed. Stop the attacks.
Those who dispute and criticize Quackwatch are consistently non-mainstream/fringe sources, and individuals who are known quacks, scammers, felons, frauds, and/or individuals who are ignorant of science and medicine, and/or ignorant of all sides of the underlying issues. No mainstream sources offer any serious criticisms, only minor quibbles. Quackwatch is consistently recognized and recommended as a mainstream, very accurate, source. One may not agree with the approach, but the POV is always consistent with the mainstream. Its huge expert base ensures that.
That's why all of the attempts to muzzle, delete, or otherwise limit the appropriate use of Quackwatch (on a case by case basis) have always failed. In fact, such attempts have only solidified its value and importance here. Your attacks create a Streisand effect / Pyrrhic victory / backlash against those who are attacking the largest database of anti-quackery resources on the internet. It is the miner's canary which defends science and medicine from attacks by quacks and frauds. When you attack it, you are revealing your unfitness to edit these subjects. -- Brangifer (talk) 05:58, 30 August 2014 (UTC)
BullRangifer, do you have anything to support what you say or are you again just telling your own opinions? As I have said numerous times, I am afraid we are not interested in your own opinions here. I hope I don't have to tell you that again.
Let's keep it simple: QuackWatch is a self-published site that has not gone under any sort of peer-review process. The moment it turns into a peer-reviewed one, please let us know. Meanwhile, I'd advise to replace any claim made by QuackWatch with a reliable medical source, providing one exists though.
QTxVi4bEMRbrNqOorWBV and BullRanfiger, constantly calling editors who happen to disagree with your own opinions as "advocates" or "POV-pushers" is not constructive editing. Should editing this article cause too much distress, I'd advise to keep a break. If you don't have anything meaningful to say about the content and sources instead of making continuous remarks about the other editors, better not say it at all. Cheers! Jayaguru-Shishya (talk) 06:47, 30 August 2014 (UTC)
Ps. The discussion about QuackWatch may need a bigger forum than mere Acupuncture talk page. Jayaguru-Shishya (talk) 06:54, 30 August 2014 (UTC)

It has had a much larger forum many times, including ArbCom, and it's passed with flying colors every time. Those aren't just my opinions, but the opinions of RS and numerous experienced editors, admins, and ArbCom members. Read the sources at the QW article, and look at the top of its talk page, which lists just a few of the times it's been up for discussion. The guidelines for using QW are pretty straightforward, and they don't include being "banned as a source (on WP)". As for any "clear biased agenda", that agenda is exactly the same agenda which is behind mainstream science and medicine, and Misplaced Pages is a mainstream encyclopedia. It favors truly RS, not fringe ones. You won't find QW disagreeing with mainstream consensus. QW actually does NOT "misleads nouveau editors", simply because it teaches them how not to "confuse fact with fiction." It teaches them the difference and exposes pseudoscientific fiction. (The one who wrote those disparaging remarks in quotes has really exposed themselves, and has now gotten many eyes watching their every move. I doubt they will last very long here.)

Your IDHT attitude (which has also drawn attention to you) is causing you to continually repeat your misunderstandings, which have been explained to you many times, but instead of learning, you just repeat them. QW is not a blog, or a scientific journal, but a source of information and expert opinion from scientists, physicians, and scientific skeptics, just like the NYTimes is a source of information for many things. Neither of them use peer review in the normal sense, although QW has a board of expert advisers. No website uses "peer review". Only scientific journals do that. That is not required of every type of RS we use here. You're barking up a straw man tree, so please stop repeating your misunderstandings and misdirections.

Peer review of a website? Really? Have you ever heard of it? No. It is edited by Barrett, a prize winning expert on his topics, with a large team of other experts who advise him, and who also write many of the articles. We use some of them as sources, but only on a case by case basis, and sometimes because WP:PARITY justifies using them. Some are appropriate, and we may use them, and others are not, so we don't use them.

It is often one of the few sources which take on unscientific and pseudoscientific matters, simply because peer reviewed journals don't deal with them. They don't debunk lies. They just ignore them and do their thing, so sometimes there is nothing in the peer reviewed material we can use, so we use QW, SBM, and other skeptical RS. Scientific skeptics, unlike laboratory scientists, deal with the gray border zones between mainstream and fringe, and expose what's going on there. They are like correspondents reporting from the trenches in a war zone. Their opinions are a valuable part of the "sum total of human knowledge" which Misplaced Pages seeks to document. They are RS for doing that. When in doubt, we quote and attribute the opinions to the author, Barrett, or QW. Although his name is on many of the articles, they have often been a team effort, but he gets the credit.

It is not a MEDRS source, but is sometimes quoted when it echoes the same opinions as MEDRS. At other times, when a source doesn't have to be MEDRS, it is used like any other source of opinion. Again, it is always used on a case by case basis. Only if it is found to be clearly wrong, in matters that are not opinion, is it not used (for example a typo or misprint), and it's pretty rare that it's totally wrong, but it's possible an article hasn't been updated. Then we wouldn't use it until it was updated.

Of course believers in alternative medicine think it's always wrong, which just goes to show on which side of the mainstream/fringe, right/wrong, truth/error divide they stand, and they are obviously not standing on the side of what RS say. That puts them at odds with our sourcing policies and with QW. The ones holding the smoking gun aimed at the miner's canary (QW), are holding the evidence of their incompetence in their hands. Don't blame me for pointing it out. They are digging their own grave when they criticize QW. -- Brangifer (talk) 08:38, 30 August 2014 (UTC)

This comment from Brangifer is very good and might become part of a FAQ-like essay relating to sites like Quackwatch. A couple of observations: First, Jayaguru-Shishya, you should heed (or should have heeded) my comment above about WP:SNOWBALL; Quackwatch is frequently used as an RS here (depending on the claim, which is true for any source). But Jaya appears to be kind of new around here so please, let's not bite him too hard. Second, QTxVi4bEMRbrNqOorWBV aka JPS's general "more heat than light" approach and denigration of PMID 21870056 and the Cochrane review that cites it are good examples of POV-pushing from the skeptic side. Just because you don't like some sources doesn't make them not MEDRS. A range of views exists in (and near and at the fringes of) the mainstream, and naturally sources are going to reflect that. Similarly, just calling Harvard and Yale Med Schools, et. al., "quackademic" doesn't make them any less mainstream; it doesn't win or end the debate, it simply highlights the fact that debate exists. To the degree that acupuncture is accepted in mainstream academic settings, we need to treat it as having mainstream as well as fringe aspects. Because we follow the mainstream. --Middle 8 (POV-pushing • COI) 12:24, 30 August 2014 (UTC)
  • Brangifer's comment is false and incorrect because scientific journals do deal with disproven therapies, especially popular ones such as PMID 15061600 and PMID 21322466. With regards to QW's comment that TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care, it is clearly an opinion statement. -A1candidate (talk) 01:11, 31 August 2014 (UTC)
Yes, that quote is very much opinion and stating it in WP's voice violates WP:CRYSTAL, which says: "Predictions, speculation, forecasts and theories stated by reliable, expert sources or recognized entities in a field may be included, though editors should be aware of creating undue bias to any specific point-of-view." Stating it in WP's voice also violates WP:ASSERT, because we don't have RS evidence that this opinion is held by the sci community. It's a view of scientific skeptics, and significant, and could be cited as long as it's not an UNDUE problem, but not to the exclusion of other views. (I think Brangifer might agree with that, but of course he speaks for himself.) --Middle 8 (POV-pushing • COI) 04:46, 2 September 2014 (UTC)
Of course acupuncturists would be in favor of using low-quality sources that proffer poor methodology in exchange for claims that qi exists. Mention in a Cochrane review does not confer reliability on nonsense. That's not how it works. The fact is that there is no mechanism ever proposed for qi -- and claimed correlations which are not done with rigor but rather with anecdotal pareidolia of a match between a central nervous system and the absurd number of meridians proposed in acupuncture texts is no more reasonable a conclusion than someone who goes on about ley lines and tectonic faults.. That needs to be made clear in the article. jps (talk) 13:04, 2 September 2014 (UTC)
@jps - Your response is threaded after mine, but if you're responding to me I have no idea which "low quality sources" you're talking about, nor do I assert qi exists. What I do think is that translation is possible in some cases. Perhaps not for acu, but for herbs, why not? A TCM pattern like "damp heat" can be translated roughly as purulence, especially when herbs used to treat it (e.g huang lien) contain antibiotic compounds like berberine. That's not pareidolia. (Great word btw.) --Middle 8 (POV-pushing • COI) 15:21, 2 September 2014 (UTC)

You are on a roller coaster, here. PMID 21870056 nearly asserts that qi exists in the way I describe. Treating it as the end of the discussion about qi (or even a perspective which is debated) is problematic. jps (talk) 17:02, 2 September 2014 (UTC)

Reliable source? - "From Alien Abductions to Zone Therapy"

What about this one: "From Alien Abductions to Zone Therapy", are we using books on extraterrestrials (!) now too? Jayaguru-Shishya (talk) 12:10, 25 August 2014 (UTC)

It is not a scientific source and we should not use it. -A1candidate (talk) 20:27, 26 August 2014 (UTC)
We are not using a book on extraterrestrials in general. QuackGuru (talk) 20:45, 26 August 2014 (UTC)

Copied from User talk:Jayaguru-Shishya#Encyclopedia of Pseudoscience is a reliable source

I haven't yet found where to access that book. The name, however, implies that it has something to do with extraterrestrials, is that right? If so, are we using an encyclopedia on extraterrestrials to support claims on medical efficiency? Jayaguru-Shishya (talk) 09:35, 26 August 2014 (UTC)
The Encyclopedia of Pseudoscience is not a book about extraterrestrials in general. The encyclopedia covers pseudoscience from Alien abductions to zone therapy. The name does not imply it is a book on extraterrestrials in general. It covers a wide range of pseudoscience topics. Please don't get involved in an edit war or claim the source is not reliable. Did you read the Encyclopedia of Pseudoscience page? QuackGuru (talk) 19:40, 26 August 2014 (UTC)
Have I made even one single revert concerning your addition of this book? Jayaguru-Shishya (talk) 20:10, 26 August 2014 (UTC)
You have made a comment on the talk page which concerns me. Do you agree your comment on the talk page was misleading or you made a mistake? QuackGuru (talk) 20:16, 26 August 2014 (UTC)

This was copied from his talk page. QuackGuru (talk) 20:34, 26 August 2014 (UTC)

The discussion belongs here, not on his talk page. -A1candidate (talk) 20:38, 26 August 2014 (UTC)
He is misrepresenting the book. Do you concur? QuackGuru (talk) 20:45, 26 August 2014 (UTC)
I would agree that the book is certainly much more about than aliens and UFOs, but according to our article on Encyclopedia of Pseudoscience, many of its contributors hail from dubious institutions such as "Center for UFO Studies" and "Department of Religious Studies". The publisher does not sound very reputable either -A1candidate (talk) 20:58, 26 August 2014 (UTC)
You claim the book is much more about aliens and UFOs. No, I previously explained the encyclopedia covers many pseudosciences.
Do you think the encyclopedia is widely used on Misplaced Pages? QuackGuru (talk) 21:06, 26 August 2014 (UTC)
The publisher is in general a decent publisher and good enough to not disqualify one of its books on the basis of the publisher alone. But there do seem to be some perhaps reasonable grounds to question some of the content as per reviews in the article. It would help a lot if it was more clearly indicated what specific material from the book is being used as well as the name and reputation of the author of the specific article in question.John Carter (talk) 21:29, 26 August 2014 (UTC)

Copied from User talk:Jayaguru-Shishya#Encyclopedia of Pseudoscience is a reliable source

You changing your previous comment and questioning weather the book is reliable. You claimed "What about this one: "From Alien Abductions to Zone Therapy", are we using books on extraterrestrials (!) now too?."
I told you the book is not on extraterrestrials in general. See WP:IDHT. QuackGuru (talk) 20:29, 26 August 2014 (UTC)
You are not giving a valid reason for deleting sourced text. For example, you have not shown how the encyclopedia is unreliable. QuackGuru (talk) 21:10, 26 August 2014 (UTC)
I meant to say that the book is much more than aliens and UFOs. Being cited on Misplaced Pages has no relevance to its reliability and I don't think it qualifies as an actual medical textbook. -A1candidate (talk) 21:49, 26 August 2014 (UTC)

No need to include any extraterrestrial / UFO authors for medical claims, that's it! Please do find a better source. So simple, problem solved! Jayaguru-Shishya (talk) 21:44, 26 August 2014 (UTC)

The above comment seems to be taking the editors own assumptions as conclusions and such behavior is not considered acceptable here. In short the only problem in this topic is the problem of the editor who apparently is making completely unwarranted assumptions about the content of a book based apparently simply upon a misreading of the title. The real list of articles contained in the book beyond the names of the first and last alphabetical entries can be found at Misplaced Pages:WikiProject Skepticism/Encyclopedic articles#Encyclopedia of Pseudoscience. I might go further and say that it strikes me as being potentially problematic behavior to attempt to dismiss such a source on the extremely dubious rationale apparently being used here.John Carter (talk) 21:55, 26 August 2014 (UTC)
"Alien abductions", "extraterrestrial intelligence", "communication with extraterrestrial intelligence" ... are you pretty sure this is a medical textbook? So should we be using this as a medical source? Jayaguru-Shishya (talk) 22:10, 26 August 2014 (UTC)
I never said it was a medical textbook and I very strongly suggest that editors here refrain from any further disruptive editing of that type. I had asked a question regarding what content the source is being used to support in the article. It is in fact generally common practice to indicate that at the beginning of a thread to make discussion easier and I am rather surprised that the OP had not indicated that earlier in the thread. I find the questions asked above to be counterproductive because they seem to be making implicit assumptions about matters which have never been so far as I can see specifically introduced into discussion. Unfortunately such conduct can be seen as problematic. I would very much welcome seeing more clearly useful comments perhaps along the lines of directly responding to the questions I had asked earlier.John Carter (talk) 22:23, 26 August 2014 (UTC)

Jayaguru-Shishya, please stop the endlessly repetitive IDHT disruptive comments! When it comes to determining whether a source is a RS, it all depends on how it's used. No single source (even the New York Times) is considered reliable in every situation, and there is practically no single source that isn't considered a RS for some very limited purpose (such as the nonsensical insane Twitter speculations of a weirdo, used in an article about that weirdo, for the purpose of documenting their POV).

If you will check the two places where the Encyclopedia of Pseudoscience is being used in this article, it is used appropriately for the use intended in that context. Context is everything when determining whether a source is being used appropriately. If so, then it is a RS for that purpose. SMH...! (I really get tired of explaining this basic stuff when competence is lacking.) Can we hat this yet?! -- Brangifer (talk) 22:57, 26 August 2014 (UTC)

Its contributors are mostly from the humanities department. The book is not from a notable academic publisher and it is more than a decade old. Please read WP:MEDRS carefully. -A1candidate (talk) 23:40, 26 August 2014 (UTC)
MEDRS does not apply to the way this source is being used. This is documenting the POV of those who consider the subject worthy of being included in an encyclopedia about pseudoscience. MEDRS citations rarely deal with pseudoscience. They generally ignore it. -- Brangifer (talk) 00:03, 27 August 2014 (UTC)
All health content here is subject to WP:MEDRS. If you wish to edit Misplaced Pages, please respect our policies and guidelines. -A1candidate (talk) 00:24, 27 August 2014 (UTC)
Like I already said if you disagree and wish to resolve this matter the appropriate forum would be RSN. Also I believe you may be making a mistake of overgeneralization. Not all content in all articles relating to medicine broadly construed must necessarily always adhere to MEDRS and this particularly includes content relating to public perceptions and history and other material not of an explicitly medical nature.John Carter (talk) 00:33, 27 August 2014 (UTC)
The source is not being used for biomedical information it being used for how acupuncture is described/viewed. Please read the guidelines you cite. While your at it read the core policy NPOV which requires we present the significant published views on the subject. Might I also suggest reading Tendentious editing. As above the appropriate forum is RSN, be sure to specify what content is supported by the source and why you don't think it is a reliable source for that content. - - MrBill3 (talk) 00:39, 27 August 2014 (UTC)
The content backed up by the source is not just of a medical nature, it is also a direct health claim so WP:MEDRS applies. -A1candidate (talk) 00:42, 27 August 2014 (UTC)
A1candidate, there is another solution. Try to suggest altered wording which justifies using the source. You obviously believe the source is misused. How about suggesting tweaks of the wording? Maybe we can find a solution that way. Okay? -- Brangifer (talk) 00:51, 27 August 2014 (UTC)
Read the content some contemporary practitioners...have abandoned the concepts of qi and meridians as pseudoscientific." not a health claim but a description of the views and practices of some contemporary practitioners, and "Some modern practitioners...They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." again neither biomedical information presented as fact nor a health claim but the explanations and realizations of an identified specific group. The source is RS for what some practitioners think or say. Note also all of the information associated with this content that is of a biomedical nature is very well spelled out and supported with MEDRS quality sources when it is presented in terms of health claims and biomedical information. Your IDHT is becoming quite tendentious RSN has been suggested. This article is under discretionary sanctions. Consider this a notification of the PAG in relation to Tendentious editing and Discretionary sanctions A1candidate. Please consider this in your further editing. - - MrBill3 (talk) 01:03, 27 August 2014 (UTC)
I was referring to this content, not the one you quoted. -A1candidate (talk) 01:19, 27 August 2014 (UTC)
We can compromise and tweak the text. QuackGuru (talk) 05:19, 27 August 2014 (UTC)

Thank you for the clarification. It really helps when objecting to a source to specify what content is being challenged. The content I quoted is all that is currently in the article supported by this source.

I agree with A1candidate that the content in the diff provided above is difficult to justify supporting with Williams 2013. I agree a more MEDRS compliant source is appropriate for "There is no evidence that inserting needles can affect the course of any disease." I apologize for my contentiousness, it was due to a misunderstanding. - - MrBill3 (talk) 01:32, 27 August 2014 (UTC)

This comment was very helpful. I can tweak the text to a specific group. QuackGuru (talk) 05:17, 27 August 2014 (UTC)

The phrase in the article: 'lack of evidence that it can affect the course of any disease' is not consistent with a published Cochrane review. Tension-type headache are considered to be diseases by the current version of the WHO's ICD-10 (disease number G44.2). The 2009 Cochrane review of acupuncture for tension headache (www.ncbi.nlm.nih.gov/pubmed/19160338) states "acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches". The WP article actually refers to tension headaches in the Headaches and migraines section but incorrectly cites a Cochrane review on migraine and contradicts itself. With consensus, the latter incorrect citation should reasonably be corrected to cite the correct article and the contradictory statement should be removed. Is the Cochrane review on tension headache sufficient to withdraw the statement on lack of evidence that acupuncture can affect the course of any disease? Tzores (talk) 05:52, 27 August 2014 (UTC)

The Cochrane review does not clearly state benefit. "could be a valuable non-pharmacological tool" With respect to affected long term disease outcomes it states "Long-term effects (beyond 3 months) were not investigated" Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:46, 27 August 2014 (UTC)

The source we are working with

It states "Orthodox researchers posit that the practice generates endorphines, chemicals imilar to narcotics, but they add that, although pain is reduced, there is no evidence that the application of needles can influence the course of any organic disease."

The source is from 2013. The publisher is "Routledge" which is well respect in the humanities. Acupuncture being on the fringe of science is covered by the humanities and thus this source is not unreasonable.

The next question is how should we summarize it. Maybe "Western medicine, while accepting it may affect pain through increasing the bodies release of endorphins, does not consider acupuncture to alter the long term course of diseases" Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:54, 27 August 2014 (UTC)

The text you're proposing is an excellent example of WP:OR. All medical articles must rely on scientific sources. -A1candidate (talk) 07:43, 27 August 2014 (UTC)
Should not be too difficult to support this by other sources aswell I imagine. In fact we have "The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits" which is basically the same thing. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:06, 27 August 2014 (UTC)
Yes, this review is much better than the non-scientific source. I have no objections to using it for now, although I note that it is slightly past WP:MEDDATE so we should continue to look for more recent reviews. -A1candidate (talk) 07:43, 27 August 2014 (UTC)
I agree with A1candidate. The source is being used for claims on medical efficiency, and it is already outdated per WP:MEDDATE. We should not use outdated sources for such claims. Jayaguru-Shishya (talk) 17:22, 10 September 2014 (UTC)
My post below was almost e/c'd with A1C's post, and agree -- prefer the solid MEDRS. --Middle 8 (POV-pushing • COI) 07:57, 27 August 2014 (UTC)
A1candidate, if you agree then what was the reason you tried to delete the text from the lede along with other reviews? QuackGuru (talk) 08:47, 27 August 2014 (UTC)
It's not an unreasonable claim, and we should be able to work it in somehow. But acu isn't so fringe that we lack full-blown MEDRS's on it -- quite the contrary; it's been massively researched -- and I think we should use those whenever possible.
And I'm not so sure that the amelioration of pain and stress doesn't affect the long term course of chronic diseases -- it's just a very very non-specific effect. Isn't that why it's used as a complementary therapy in academic medical centers like Harvard and U-Maryland etc etc? Or is that just to make patients feel better... or is that the same thing? (Seriously, just because critics call such use "quackademic" doesn't change the fact that these settings are about as mainstream as it gets. We need to reflect that. Why is it used so widely? The answer isn't irreconcilable with systematic reviews.) --Middle 8 (POV-pushing • COI) 07:44, 27 August 2014 (UTC)
Yes agree we can just stick with the better source that says more or less the same thing. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:55, 27 August 2014 (UTC)
I also agree the source is reliable for the claim: "The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits". There is broad consensus to use the source for the claim but it was inappropriately tagged. I left a note on the Jayaguru-Shishya's talk page about the tag. QuackGuru (talk) 16:54, 10 September 2014 (UTC)
The source is outdated per WP:MEDDATE, and it's used to support claims on medical efficiency. We should not use outdated sources for that. Jayaguru-Shishya (talk) 17:22, 10 September 2014 (UTC)
There are no objections to using this source. See diff. QuackGuru (talk) 17:42, 10 September 2014 (UTC)

Oops, got mistaken. The discussion here is about replacing Williams by Wang et al. (2008). The Williams source is still being used, but there is no consensus for Wang et al. (2008) on claims about medical efficiency on another sentences. No consensus for that one, it's not even been discussed. Jayaguru-Shishya (talk) 18:16, 11 September 2014 (UTC)

MEDRS and WEIGHT issues in recent edits

This edit uses a non-MEDRS for a MEDRS claim (and goes even further by speaking in WP's voice), and this one worsens the already excessive undue weight given to serious adverse events. (Contra this ES, those two errors don't cancel each other out; and whatever else one can say about Williams' Encyclopedia of Pseudoscience, it's not a MEDRS.) Following WP:BRD, I reverted both . Now's the time for the editor, QuackGuru, to make a case for these edits; now is not the time to edit war . --Middle 8 (POV-pushing • COI) 00:54, 27 August 2014 (UTC) added more 01:08, 27 August 2014 (UTC)

Why on earth is QG going to FTN before even trying WP:DR here? That could be construed as a canvassing attempt. --Middle 8 (POV-pushing • COI) 02:32, 27 August 2014 (UTC)
Acupuncture is also within the domain of the humanities and thus a humanities textbook may be appropriate for certain statement. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:56, 27 August 2014 (UTC)
Certain statements, sure, but a MEDRS statement? I could see that if we didn't have much in the way of MEDRS's, but that's not the case here. If at all possible we should stick with MEDRS. --Middle 8 (POV-pushing • COI) 07:23, 27 August 2014 (UTC)
When making claims on medical efficiency, we follow MEDRS. The source under discussion is not MEDRS compliant. Jayaguru-Shishya (talk) 08:34, 27 August 2014 (UTC)
The source has been in the article for a while now. I don't see consensus to delete the 2013 source. QuackGuru (talk) 08:40, 27 August 2014 (UTC)

If anyone still thinks it is canvassing to use the WP:NOTICEBOARD I encourage you to MFD the noticeboard or expect you to strike your comments. There was a previous thread I started for Talk:Acupuncture#Safe.3F. There was some information missing from the safety section. I read the existing sources in the article and updated it accordingly. Things are very quiet again and the article is stable. If past behaviour is any indicator of future behaviuor a certain editor will soon return and delete sourced again as he did in the past. Does he make counterproductive edits?

I was removing text that was not MEDRS compliant but he restored it.

In 1997, the American Medical Association Council on Scientific Affairs stated that, "There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well- designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies." So what was the motivation to restore this? How is using a source that does not mention acupuncture improve the article? Read the edit summary. He thought one of the sources was dated. So why restore it? QuackGuru (talk) 15:46, 27 August 2014 (UTC)

Infection

This is a break in the "MEDRS and WEIGHT issues in recent edits" section to focus on the edit about infection.

Regarding this edit and then a repeat of the same edit: (moved from above)

Infections included mycobacterium, staphylococcus, septic arthritis, necrotizing fasciitis, pneumoretroperitoneum, facial erysipelas, HIV, Listeria monocytogenes-caused arthritis, and infections via Enterococcus faecalis, and Pseudomonas. This text was deleted but the source says infections was a major complication.
— User:QuackGuru 08:02, 27 August 2014

QuackGuru's comment above doesn't address the UNDUE problem I mentioned above and at FTN. (Let's not fork anymore please.) I will repeat:

We don't need to list every opportunistic pathogen. Serious adverse events, which include infection, are rare, per multiple sources.

The "Safety" section is already unduly weighted toward irrelevant details of very rare events. (This is the case largely because of one editors' insistence that every detail of every adverse event, no matter how rare, be covered. If we did this with ibuprofen, that article would be easily a dozen times as long as it is now.). --Middle 8 (POV-pushing • COI) 10:23, 28 August 2014 (UTC)

Removed extraneous list of pathogens: --Middle 8 (POV-pushing • COI) 10:34, 28 August 2014 (UTC)
Adverse events that are very unlikely at each session become very important when applied across the whole population. The FDA withdraws drugs during post-marketing monitoring for events that were too rare to show up in large clinical trials, after all. We need to list infection as a possible complication, as it is any time the skin barrier is broken. So far as I can tell, those pathogens are not associated with acupuncture per se so much as they just happened to be lingering around to be introduced. I am fine just noting that infections can occur without listing out every pathogen that has been observed. - 2/0 (cont.) 15:32, 28 August 2014 (UTC)
Agree entirely, and in particular I agree with your first two sentences. More on undue weight in that section later... --Middle 8 (POV-pushing • COI) 11:41, 30 August 2014 (UTC)

Academic centers

As mentioned above, acupuncture is used at a number of academic centers. This certainly belongs in the article; for starters, I've added its own subsection under Acupuncture#International_reception . It's used at a great many such places, and at some point we might have so many that it may be a good idea to create a list.

I know acupuncture is a fringe topic, and I would like to apologize in advance for pushing mainstream POV into it. :-) --Middle 8 (POV-pushing • COI) 14:44, 28 August 2014 (UTC)

This is a good edit. I tweaked the text to indicate that the list presented is not exhaustive. We of course need to be careful not to imply that just because these centers use the practice that they know how it works (or even where it is effective), but we do need the information that it is used at hospitals as well as at stand alone clinics. A third or maybe even a fourth example citing non-US use would be good to help reflect a worldwide view. Maybe one from China and one from Germany or somewhere like that? - 2/0 (cont.) 15:25, 28 August 2014 (UTC)
Thanks; yes, good idea re worldwide view. We can also talk about acu's role in medical education worldwide; in China, IIRC, TCM is taught as anywhere from (very roughly) 5% to 50% of the curriculum. --Middle 8 (POV-pushing • COI) 12:00, 30 August 2014 (UTC)
I agree, that's valuable piece of information. The sources are perfectly reliable to illustrate the use of acupuncture at academic centers. I'll try to see if I can find anything about the situation in Finland (HYKS, KYKS, OYKS, TYKS and TAYS). Jayaguru-Shishya (talk) 11:57, 1 September 2014 (UTC)
Acupuncture is among popular CAM treatments in all five Nordic countries but it is used less in Finland.
Since acupuncture is deregulated in Finland many people without education in healthcare are able to give acupuncture treatment.
I have included specific information about Finland. QuackGuru (talk) 20:05, 5 September 2014 (UTC)

Primary sources/poor sources and original research

http://www.brighamandwomens.org/Departments_and_Services/medicine/Services/oshercenter/acupuncture.aspx

This source is a link to a hospital website. It is unreliable.

http://medicine.yale.edu/psychiatry/psychology/predoc/sites/cmhc/substanceabuse.aspx

This source is a link to a School of Medicine website. Where does this link mention acupuncture? Auricular acupuncture and acupuncture are different. The sentence is poorly sourced and partly fails verification. See WP:CIR. QuackGuru (talk) 02:02, 30 August 2014 (UTC)

IMO, the above criticisms from QuackGuru lack merit and the bit about competence (CIR) is gratuitous. Anyone else think QG is making any valid points here? --Middle 8 (POV-pushing • COI) 12:00, 30 August 2014 (UTC)
You are not addressing that you are adding primary sources and text that failed verification. I previously explained, Auricular acupuncture (ear acupuncture) is not acupuncture. You ignored it was original research. See WP:IDHT. Adding even more primary sources or poor sources is not appropriate. You have not shown how the sources are reliable in accordance with WP:SECONDARY. QuackGuru (talk) 17:41, 30 August 2014 (UTC)

QG is correct that even Misplaced Pages has a separate article on Auriculotherapy. jps (talk) 17:58, 30 August 2014 (UTC)

QG is incorrect. Ear acupuncture is a common form of acupuncture. See the meta-analysis below. -A1candidate (talk) 18:37, 30 August 2014 (UTC)
Did you read the entry for Auriculotherapy? Do you understand this is a primary source that says Auricular Acupuncture? User:John Carter warned you about nonproductive editing on the article talk page.
"This systematic review evaluated the effects of ear acupuncture, ear acupressure and auriculotherapy for cigarette smoking cessation (SC) at end-of-treatment (EoT), three, six and 12 months follow-up."
According to the source ear acupuncture, ear acupressure and auriculotherapy are a bit different or is the source ambiguous? Middle 8's comment does not make sense given the evidence. QuackGuru (talk) 03:50, 31 August 2014 (UTC)

I did discuss the problems with this edit on Jayaguru-Shishya's talk page. Jayaguru-Shishya largely ignored my concerns or did not understand. "He wrote If you have a specific edit you'd like to discuss, please let me know. So far, you have said that "there is original research in the article using a primary source", and you are giving me a diff where QTxVi4bEMRbrNqOorWBV says at the Talk Page that "even Misplaced Pages has a separate article on Auriculotherapy". I am sorry, I don't really see the connection here? I did let him know the issues. See WP:CIR. I left a message on his talk page. QuackGuru (talk) 19:16, 5 September 2014 (UTC)

The source does not verify the claim "several". This confirms the source does not say "several". QuackGuru (talk) 19:33, 5 September 2014 (UTC)

So if Misplaced Pages has a separate article on Auriculotherapy, how is it connected to original research? :D I alrady provided you a source (which seriously nobody needs). As Middle 8 well put it: "just as auricular acu is a kind of acu, and chocolate milk is a kind of milk". Just common sense.
QuackGuru, do you know what "paraphrasing" means? I think user NuclearWarfare has already noticed you about "getting caught over specific wording", right? If you have problems with paraphrasing yourself, please leave it to other editors, that's what I'd like to suggest. Cheers and happy weekend! Jayaguru-Shishya (talk) 20:27, 5 September 2014 (UTC)
Indeed, indeed... "Being of a number more than two or three but not many" (http://www.thefreedictionary.com/several) Jayaguru-Shishya (talk) 20:44, 5 September 2014 (UTC)
I fixed the issues by using another source that verified the claim rather than use a source that was ambiguous. As a bonus, I expanded the sentence and included Duke. QuackGuru (talk) 20:41, 5 September 2014 (UTC)

I had a discussion on Jayaguru-Shishya's talk page: You added largely duplication using primary/poor sources. Rather than use poor sources I replaced it with independent sources. In my edit summary I explained one of the sources failed verification. This was discussed on the talk page. The section for the US under International reception already states "Acupuncture is used at many places in the US, including Harvard, Stanford, and Yale." Independent sources were being used but you restored the text using a bunch primary sources. There is no need for duplication or a separate section. The text for each country can go into each specific section for each country in the Acupuncture#International reception section. Please stop adding poor/primary sources when better sources were found. Please don't continue to WP:BATTLE. QuackGuru (talk) 21:22, 1 September 2014 (UTC)

After I explained it too Jayaguru-Shishya that there is still problems with the text and many is closer to the source he ignored my concerns and restored the original research and unneeded primary sources. He also restored the tag without consensus. User:RexxS also explained Jayaguru-Shishya removed well sourced text. See Acupuncture#Reception for the current text. QuackGuru (talk) 15:57, 6 September 2014 (UTC)

Do you mean the discussion which resulted to an administrative warning to you? The one where you were making accusations against me? Well, let's see dear.
    • The first diff where you claim that I "largely duplication using primary/poor sources", it has been already discussed at the Talk Page. Consensus? No problem for using primary sources to illustrate the use of acupuncture at mainstream medical centers.
    • The second diff, you said that: " I explained one of the sources failed verification". That's not true, I'm afraid. When one opens your diff, the edit summary merely says: "failed verification and duplication". So where is the "explanation you mentioned? Answer: there is none.
    • The third diff, you are saying that it was discussed that the source above failed verification. Let's see your diff more closely: it is pertaining to user QTxVi4bEMRbrNqOorWBV's comment "QG is correct that even Misplaced Pages has a separate article on Auriculotherapy." So, what does this have to do with "a source failing verification"? You just picked up a random comment from the Talk Page and use it to "support" something that has nothing to do with it...?
    • You said: "Please don't continue to WP:BATTLE.". Funny, you got warned by an administrator for your post.
    • "... he ignored my concerns and restored the original research and unneeded primary sources". Please see this section and participate the discussion if you have something meaningful to say. Jayaguru-Shishya (talk) 19:43, 6 September 2014 (UTC)

Ear acupuncture is a form of acupuncture

Drug and Alcohol Dependence (journal) with impact factor of 3.278 caries more weight than QuackGuru's incorrect claims:

Ear acupuncture is a common form of acupuncture. EAP showed superiority over non-specific/inactive controls.

-A1candidate (talk) 18:32, 30 August 2014 (UTC)

Yeah, the argument that ear acupuncture isn't acupuncture is tendentious. --Middle 8 (POV-pushing • COI) 02:54, 31 August 2014 (UTC)
It is, of course, a particularly ludicrous form of acupuncture apparently based on the ridiculous idea that the ear is a homunculus, but that's by the by. Guy (Help!) 23:19, 31 August 2014 (UTC)
Yes, I certainly don't know of any biomedical evidence for a homunculus on the ear.....creative idea though, and novelty probably helps (along with ritual, noxious stimulus, TLC, community setting for drug detox....) --Middle 8 (POV-pushing • COI) 15:53, 2 September 2014 (UTC)
Ear acupuncture is a form of acupuncture. Nobody seriously would have needed a source for that though, right? I've heard that some have started to look for clues from the actual name itself ^^ Jayaguru-Shishya (talk) 11:57, 1 September 2014 (UTC)
Please show a source to support your claims. -A1candidate (talk) 00:00, 1 September 2014 (UTC)
Here is a ref for you to read. QuackGuru (talk) 03:19, 1 September 2014 (UTC)

Summarize

The lead is supposed to be a simple summary.

" A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which" can be summarized as "A systematic review"

Because a "systematic review of systematic reviews highlighted recent high-quality randomized controlled trials" is a type of systematic review. We can get into the specifics in the body of the article. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:19, 31 August 2014 (UTC)

Agree it was too much detail for the lede. QuackGuru (talk) 04:34, 31 August 2014 (UTC)

Only problem is that it's now inaccurate. Here's the deal -- Doc, hope you're reading:

  1. Efficacy is defined as real acu being better than sham -- that's the thing readers need to know, that we aren't telling them.
  2. Ernst '11 found that a majority of the reviews he looked at were positive for pain, but then caveated that finding -- by pointing to findings from more recent and better trials. Agreed that that level of detail belongs in the body, not the lede.
  3. Some trials for pain show sham = real, and meta-analyses vary in their conclusions. We already say that in the lede when we talk about efficacy.

So what we need to in the lede is simple -- drop the statement in question and replace it with a statement along the lines of #1. --Middle 8 (POV-pushing • COI) 05:31, 31 August 2014 (UTC)

So what are you proposing? Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:39, 31 August 2014 (UTC)
How about this? (good timing of your comment :-) --Middle 8 (POV-pushing • COI) 05:47, 31 August 2014 (UTC)
The proposal is now ambiguous and deleted sourced text that summerised the body. Now the text does not summarise the body. Middle 8 has had a problem with deleting sourced text. User:Jmh649, maybe we should also shorten the body. It says "The review also highlighted recent high-quality randomized controlled trials which found that for reducing pain, real acupuncture was no better than sham acupuncture." It is a bit too wordy. See Acupuncture#Pain. QuackGuru (talk) 06:03, 31 August 2014 (UTC)
You need to use references per WP:V and WP:MEDRS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:03, 31 August 2014 (UTC)
We don't source every statement in the lede... and naive readers aren't going to know what sham acu is. (I do hope for the sake of the article that you understand it's a true statement... it's acu study design 101.) --Middle 8 (POV-pushing • COI) 08:25, 31 August 2014 (UTC)
I previously explained the text you added to the lede did not summarise the body. QuackGuru (talk) 08:29, 31 August 2014 (UTC)
You claim readers won't know what sham is. See https://en.wikipedia.org/Acupuncture#cite_note-Madsen2009-11 QuackGuru (talk) 10:13, 31 August 2014 (UTC)
An accurate claim at the time , seeing you added that note subsequently -- which is a good addition, though I think the reader would be better served if it were in the lede and not a note. --Middle 8 (POV-pushing • COI) 07:41, 1 September 2014 (UTC)
We should also tell the reader that another form of sham acu is the use of real needled at non-acupoint locations. --Middle 8 (POV-pushing • COI) 07:52, 1 September 2014 (UTC)

Anyway just noticed that we said the same thing already in the paragraph using that ref? So deleted it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:07, 31 August 2014 (UTC)

The statement is different from the other text. It is comparing sham versus real acupuncture. QuackGuru (talk) 06:20, 31 August 2014 (UTC)

This "while a systematic review of systematic reviews found little evidence that acupuncture is an effective treatment for reducing pain"

Is more or less the same as "A systematic review found that for reducing pain real acupuncture was no better than sham acupuncture."

When one says that there is little evidence for something one needs a comparator and that comparator is sham acupuncture. IMO we do not need to say both in the lead. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:10, 31 August 2014 (UTC)

I will compromise and merge the other statement so there will only be one sentence. QuackGuru (talk) 07:33, 31 August 2014 (UTC)

The wording is simplified and adjusted. QuackGuru (talk) 08:12, 31 August 2014 (UTC)

It is incorrect. Newer meta-analysis concludes that significant, but modest differences exist between sham and verum. -A1candidate (talk) 15:28, 31 August 2014 (UTC)

"Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said the study "impressively and clearly" showed that the effects of acupuncture were mostly due to placebo. "The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies."

Jha, Alok (10 September 2012). "Acupuncture useful, but overall of little benefit, study shows". The Guardian. {{cite news}}: Italic or bold markup not allowed in: |newspaper= (help)

"What really matters is that Vickers et al showed that the difference is far too small to be of the slightest clinical interest."

Colquhoun, David (17 September 2012). "Re: Risks of acupuncture range from stray needles to pneumothorax, finds study". BMJ.

A systematic review of systematic reviews is a higher quality authoritative source. The author of this source is Edzard Ernst. He invalided the Vickers study.

That Vickers study shows no meaningful difference according to which experts on the subject? See above. QuackGuru (talk) 17:32, 31 August 2014 (UTC)

Ernst's review couldn't have "invalided" Vickers because the latter hadn't even been written yet. --Middle 8 (POV-pushing • COI) 06:19, 1 September 2014 (UTC)
The source says "We found acupuncture to be superior to both no-acupuncture control and sham acupuncture for the treatment of chronic pain," wrote Vickers in the September 10 edition of the Archives of Internal Medicine." Ernst was reviewing Vickers. QuackGuru (talk) 06:27, 1 September 2014 (UTC)
Newspapers and news reports of BMJ aren't MEDRS compliant. An older review (2011) cannot be used to disqualify a newer meta-analysis (2012). -A1candidate (talk) 17:54, 31 August 2014 (UTC)
You disagree that a systematic review of systematic reviews is a higher quality source?
This is a newer 2013 meta-analysis written in part by Vickers: "When comparing acupuncture to sham controls, there was little evidence that the effects of acupuncture on pain were modified by any of the acupuncture characteristics evaluated, including style of acupuncture, the number or placement of needles, the number, frequency or duration of sessions, patient-practitioner interactions and the experience of the acupuncturist..."
MacPherson, Hugh; Maschino, Alexandra C; Lewith, George; Foster, Nadine E; Witt, Claudia; Vickers, Andrew J; Acupuncture Trialists' Collaboration (2013). Eldabe, Sam (ed.). "Characteristics of Acupuncture Treatment Associated with Outcome: An Individual Patient Meta-Analysis of 17,922 Patients with Chronic Pain in Randomised Controlled Trials". PLoS ONE. 8 (10): e77438. doi:10.1371/journal.pone.0077438. PMC 3795671. PMID 24146995.{{cite journal}}: CS1 maint: unflagged free DOI (link)
According to your previous argument a 2012 is the newer meta-analysis. That is incorrect. See (PMID 24146995). QuackGuru (talk) 18:09, 31 August 2014 (UTC)
You conveniently ignored the fact that "Increased number of needles and more sessions appear to be associated with better outcomes when comparing acupuncture to non-acupuncture controls. This suggests that the dose of acupuncture is important", as they concluded in the 2013 meta-analysis. -A1candidate (talk) 18:34, 31 August 2014 (UTC)
This detail is in the body. See Acupuncture#Scientific view on TCM theory. The lede should be kept a summary. That would be too much detail for the lede and we are using a better source (a systematic review of systematic reviews) for the main point. QuackGuru (talk) 18:47, 31 August 2014 (UTC)
A newer meta-analysis of 18,000 patients carries more weight than older systematic review of reviews. -A1candidate (talk) 19:21, 31 August 2014 (UTC)
Or at least it would if there was a remotely plausible mechanism of action, and solid evidence for the existence of qi and meridians, and evidence that the location of needling makes any difference. But there isn't.
You have made it rather plain that you are a True Believer, and the review you promote was also written by True Believers. Oddly, when anyone who is not a True Believer conducts the test, the effect seems to vanish. I wonder why that is? Guy (Help!) 23:17, 31 August 2014 (UTC)
Yes, I'm a True Believer in science, if that's what you're trying to say. -A1candidate (talk) 23:58, 31 August 2014 (UTC)
Guy, even if it is written by true believers (and I'm not sure that's wholly true), it still passed peer review, and is still part of the literature that we seek to represent. The "effect" in this case -- the statistical significance of their findings -- is not belief-dependent. Nobody has suggested that if a non-true believer re-crunched the numbers, their findings would change; only the interpretation of those findings is contested. AFAIK, it's the only meta-analysis of individual patient data in acu research, which is the gold standard of meta-analysis., so it does weigh considerably. And in order for acu to have a small specific effect, prescientific Chinese ideas don't have to be true; how else would you expect them to have explained acu in their time? With reference to fascia and endorphins? ;-) --Middle 8 (POV-pushing • COI) 06:16, 1 September 2014 (UTC)
All this speculation about "true believers" is totally useless. If there is such a bias, it sure have been studied and one could find a source for it. If it's not, then we don't speculate on that either.
I do agree with Middle 8 about the weight of that meta-analysis though. Jayaguru-Shishya (talk) 11:57, 1 September 2014 (UTC)
(e/c) A1Candidate almost always brings really good MEDRS's to the discussion, but shoots themselves in the foot by overstating their weight relative to other sources. But they still weigh. Multiple editors have commented that there is POV-pushing from both sides, but while the pro-acu side inevitably gets called out, the anti-acu side (no matter how extreme) gets a free pass. --Middle 8 (POV-pushing • COI) 06:47, 1 September 2014 (UTC)
The main point of (PMID 24146995) is redundant. The lede says more or less the same thing that there is little difference between sham and acupuncture. QuackGuru (talk) 06:33, 1 September 2014 (UTC)
It depends on which trial or review one is talking about. Efficacy (to whatever degree it may exist) is defined as the (statistically significant) difference between sham and real -- period. Whatever generalization we make about sham should be nothing more or less than what we say about efficacy. And efficacy is handled reasonably well in the lede. Let's not act as if sham is some new thing to be hashed out and weighted. 2/0, A1Candidate, Brangifer, Jaya-S, Doc James and Guy will know what I'm saying, even if you, QG, claim not to. --Middle 8 (POV-pushing • COI) 11:56, 2 September 2014 (UTC)
Utter rubbish. Efficacy is the extent to which a treatment has a positive effect. Period. You're confusing the fact that 'sham acu' (a placebo) is effective, as is 'real acu' for exactly the same reason. What you're not prepared to accept is that any attempt to explain a mechanism for differential action between sham and real will inevitably be laughed at as unscientific mumbo-jumbo. --RexxS (talk) 16:45, 2 September 2014 (UTC)
Hi RexxS. Of course sham acu is effective! When I say "Efficacy is the extent...." I mean "efficacy beyond placebo", which is what researchers are interested in. Ask 2/0 or Brangifer if you don't believe me. And tone down your rhetoric please. --Middle 8 (POV-pushing • COI) 17:08, 2 September 2014 (UTC)

Fixed wording to reflect source -- ES self-explanatory, and I'm that any science-literate editors willing to look at the source will see that it's accurate. But this being Misplaced Pages, who can say if that will happen? --Middle 8 (POV-pushing • COI) 08:01, 1 September 2014 (UTC)

A systematic review of systematic reviews found real acupuncture was no better than sham acupuncture and concluded that their is little evidence that acupuncture is an effective treatment for reducing pain.
A systematic review of systematic reviews of acupuncture for pain concluded that there is little evidence that acupuncture is an effective treatment, i.e. that real acupuncture may be no better than sham acupuncture.
You added original research. You recently tried to add OR to the lede and now you are doing it again.
The source does not say it "may be" be no better. The other part was also misleading and ambiguous. The source says "In conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain." Please stop adding original research to the lede. QuackGuru (talk) 17:01, 1 September 2014 (UTC)
Neither of those diffs is OR; please see your talk page. --Middle 8 (POV-pushing • COI) 08:41, 2 September 2014 (UTC)
Thanks for accurately quoting his conclusion (see PMID 21440191). Why not cite that? I don't see any mention of sham in the conclusion or the abstract. --Middle 8 (POV-pushing • COI) 04:33, 2 September 2014 (UTC)
Sham acu is a worthy topic but this paper doesn't support what you seem to want to say. You've been pushing this sentence for months and arguing that Moffet, then Ernst support it, but they don't. --Middle 8 (POV-pushing • COI) 04:36, 2 September 2014 (UTC)
The part you added "may be" no better I could not verify. The current text is accurately summarised. You claimed RexxS's ad hominem & general drama is a confession of weakness. You had a discussion on User:RexxS's talk page too. See User_talk:RexxS/Archive_25#Ernst_re_pain..._and_talk.... We already had a discussion about this. See Wikipedia_talk:WikiProject_Medicine/Archive_51#Acupuncture_again. QuackGuru (talk) 14:33, 2 September 2014 (UTC)
Again why use wording that's not in the abstract or conclusion, and not supported by the text? Especially when you demand that others meet that standard? (Nothing against RexxS, but he was wrong in that case, and Imperfectly Informed was correct. There aren't two correct answers. We could go to RSN if editors here don't figure it out.) --Middle 8 (POV-pushing • COI) 16:19, 2 September 2014 (UTC)
No, I was not wrong. No matter how many times you try to deny it, you can't invalidate the conclusions of a reliable secondary source that you dislike by making your own amateur analysis to try to discredit it. Ernst is never in any doubt that real acu is no better than sham acu and we all know that any differences are so small as to be insignificant both statistically and clinically. That's the correct answer and that's what should be reflected in the lead if we should need that much detail (which we don't). --RexxS (talk) 16:45, 2 September 2014 (UTC)
Sure you were wrong; you made several mistakes interpreting the paper in the original discussion, and this is another. See User:Middle_8/Ernst-11. And of course sham acu is sometimes better than real acu: the majority of the 57 reviews he studied were positive for acupuncture, if you recall. (Positive meaning "showing efficacy", i.e. "efficacy beyond placebo", i.e. "real acu being superior to sham to a statistically significant degree.) Read the lede; of course there's still some debate over efficacy, mainly for pain and nausea, although that may be due to artifact. --Middle 8 (POV-pushing • COI) 17:14, 2 September 2014 (UTC)
The source does not specifically state "sham acu is sometimes better than real acu". QuackGuru (talk) 17:18, 2 September 2014 (UTC)
Not in those exact words, no. But that's what it found. I cover all that and more at User:Middle_8/Ernst-11, which I hope you and others find helpful. -Middle 8 (POV-pushing • COI) 19:24, 2 September 2014 (UTC)
You want to replace verified text in accordance with V with your own SYN/OR interpretation? QuackGuru (talk) 19:34, 2 September 2014 (UTC)

I would like to restore the comment that was deleted. QuackGuru (talk) 16:48, 2 September 2014 (UTC)

To QuackGuru (and all editors here): Most humble apologies for my overwrite of your edit, QG! https://en.wikipedia.org/search/?title=Talk:Acupuncture&diff=prev&oldid=623878169] I would never, ever do such a thing intentionally. In this instance, the buttons on my trackball are a bit sticky, so I must have accidentally selected your comment, not realized I'd done so, and then deleted it as soon as I started typing. To make matters worse, Doc James asked me what was the deal with that edit, and I simply explained the text I added, being sufficiently out of it that I didn't see from the diff that I'd actually overwritten QG's comment. Have been editing a lot today, obviously need a break. Apologies to all for the distraction and any misunderstandings caused. --Middle 8 (POV-pushing • COI) 12:53, 3 September 2014 (UTC)
According to this comment on 19:10, 2 September 2014 you got upset about my comment. That was your initial reaction after I restored my comment on 16:50, 2 September 2014 you deleted early on 16:19, 2 September 2014. You added OR research to the lede twice recently. Is this a pattern? QuackGuru (talk) 17:16, 3 September 2014 (UTC)
No, QG, as I said I had absolutely no idea what I'd done until Jytdog clued me into what Doc James meant by posting on my page asking, rightly, what was the deal. I'm sorry you choose to take my apology in bad faith. I didn't agree with your post (hence that first diff you cite ) but I sure as heck didn't delete it on purpose!
I'm very disappointed that in response to my apology you'd reply with a post like this, implying ulterior motive, and repeating an inaccurate allegation that I added "OR to the lede". It takes some gall for you to do that, frankly, because I posted on your user talk speifically refuting that exact same assertion. Here is the diff; short version: Please stop calling it OR every time an editor merely uses wording that is not your exact preferred wording, or is not verbatim from a source. There's this thing called "paraphrasing".
I'm also disappointed that after I posted to Doc's user talk explaining my mistake, and he replied saying he was glad it was just a mistake, that you would then post there seeking to depict my mistake as intentional. Why are you doing this? I'll repeat: what can we do to end this apparent bad blood between us? I posted a sincere olive branch to you last week , but you deleted it without comment . --Middle 8 (POV-pushing • COI)

I went ahead and restored it. QuackGuru (talk) 16:51, 2 September 2014 (UTC)

QG, since you're insisting on rehashing past heat rather than light, I'll say this for the record: Now go back and read RexxS's hyperbole. My comments are WP:SPADE and comparatively quite tame. But why focus on old drama? Why not comment on the substance at hand? I've given ample food fr thought at User:Middle_8/Ernst-11. --Middle 8 (POV-pushing • COI) 19:10, 2 September 2014 (UTC)

Jha, Alok (10 September 2012). "Acupuncture useful, but overall of little benefit, study shows". The Guardian. Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said the study "impressively and clearly" showed that the effects of acupuncture were mostly due to placebo. "The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies. Several investigations have shown that the verbal or non-verbal communication between the patient and the therapist is more important than the actual needling. If such factors would be accounted for, the effect of acupuncture on chronic pain might disappear completely." {{cite news}}: Italic or bold markup not allowed in: |newspaper= (help) Here is another source where Ernst makes a similar point. This is the same author who wrote the 2011 source. See (PMID 21440191). QuackGuru (talk) 19:53, 2 September 2014 (UTC)

The Guardian doesn't meet MEDRS for claims on medical efficiency, so we are not using it. Jayaguru-Shishya (talk) 20:19, 2 September 2014 (UTC)
Do you disagree that this is the same author who made a similar point? QuackGuru (talk) 20:35, 2 September 2014 (UTC)
(e/c)::@Jayaguru-Shishya - Well, the interpretation that has prevailed (and with which I've agreed) is that the source is Ernst himself (and the Guardian is considered reliable for reproducing his words), and per WP:SOURCES (I think), someone like Ernst can be an RS when self-publishing because he's an expert who has published under peer-review, as long as they're talking about their field of expertise (in which they've published). That said I am reconsidering whether such a quote is acceptable as a MEDRS (as opposed to RS) and leaning toward not. If Ernst really wants to refute that paper there's a way to do it: publish something. Colquhoun did, and we can cite that, and it says much the same thing, so deleting Ernst shouldn't be a big deal IMO. We should probably draw the line at MEDRS, and not allow Ernst, because otherwise we get an UNDUE problem whereby an expert's opinion is given the same weight as a carefully crafted MEDRS. In fact, the gold standard of MEDRS's: meta-analysis of individual patient data. Yes, I know the criticisms of Vickers are that the differences he find between sham and verum, though statistically significant, aren't clinically significant and may be artifactual (unblinding). Still it weighs, and significantly. After all, criticisms can be made of other MEDR's, such as their non-adherence to STRICTA, and we don't deprecate them nearly as much as Vickers has been deprecated. (Matter of fact, QG, some time back, fought the inclusion of nothing more than the four types of pain Vickers looked at. Vickers, a gold-standard source, the biggest and most exacting meta-analysis ever (AFAIK) for acu. Yet more double-standard. (whew -- need a timeout) --Middle 8 (POV-pushing • COI) 20:37, 2 September 2014 (UTC)
What Ernst said in the past and present has not changed. There is no debate over what Ernst said then. QuackGuru (talk) 20:44, 2 September 2014 (UTC)
Which is irrelevant to whether his comment is a MEDRS. (RS, yes, it is, but he is making a MEDRS claim in that quote.) Now, if he criticize Vickers in a more recent review -- which I may have missed -- then that supersedes the Guardian source. --Middle 8 (POV-pushing • COI) 21:01, 2 September 2014 (UTC)
Exactly, exactly.... Jayaguru-Shishya (talk) 21:05, 2 September 2014 (UTC)

Arbitrary break for more input

I've outlined the issue regarding Ernst '11 (PMID 21440191), and have filed at WT:MEDRS. (I don't remember if we discussed this there or elsewhere before but that does seem the best venue.) --Middle 8 (POV-pushing • COI) 17:49, 2 September 2014 (UTC)

See WT:MEDRS#Acupuncture_source. Have also explained the issue clearly at User:Middle_8/Ernst-11, and remember, you can email me (or any editor with access) for a copy. Let's go for more light and less heat, fellow editors! -Middle 8 (POV-pushing • COI) 18:01, 2 September 2014 (UTC)
Is Middle 8 canvassing editors on there talk page long after the discussion was over? Not sure why you are bringing it up again.
Do you remember you had a discussion on User:RexxS's talk page. See User_talk:RexxS/Archive_25#Ernst_re_pain..._and_talk.... We did have a long discussion on this talk page and at Wikipedia_talk:WikiProject_Medicine/Archive_51#Acupuncture_again. QuackGuru (talk) 17:59, 2 September 2014 (UTC)
If I understand the point being made, it is pretty straightforward. Many trials exist of acupuncture vs. sham or placebo, but proper blinding to the the controls is difficult if not impossible due tot he nature of acupuncture (e.g. the tendency to leave bruising for up to a fortnight afterwards, a dead giveaway). There's also the problem that negative results are virtually never published in the acupuncture / TCM journals, and most are published in China where there is a well documented systemic bias. You want to assert the primacy of the larger trials, despite the lack of any proven mechanism of effect. Ernst makes the point, quite forcefully, in numerous venues including this paper, that the positive results are weak and not getting any stronger, whereas increasingly sophisticated controls show ever more strongly that needling is ineffective (and this is additive to the finding that the location of needling is irrelevant, as expected form the absence of any empirical basis for the locations traditionally used, and lack of unanimity between traditions).
However, I find reading any argument by pro-quackery editors frustrating and I become impatient, so if someone could distil the actual question into a short sentence, I will email it to the source and ask (this is legitimate when it's a matter of clarifying our interpretation, rather than original research). Guy (Help!) 19:39, 2 September 2014 (UTC)
@ JzG: Here's a better, simpler summation than the below: should we cite Ernst's statement "real acupuncture was no better than sham" as being the conclusion of his review per se, or not. The statement appears in the first paragraph on p. 762 of PMID 21440191.
In context, it is apparent that his statement refers to some recent, high-quality trials that showed null results. Contrary to QG's reading, it does not refer to the reviews he looked at, and is not a general conclusion of his review. The majority of those reviews were actually positive for acu, but with numerous contradictions and caveats. That's why he said those result should be seen in light of recent, better trials. The highlighted text at User:Middle_8/Ernst-11 illustrates this context, and the unlikelihood of QG's reading. --Middle 8 (POV-pushing • COI) 05:09, 3 September 2014 (UTC)
And the answer is: yes, undoubtedly. That is his settled view, and you can read his blog yourself for plenty more to that effect. You are playing semantic games, when to an outsider it is very obvious what he means, and it is not in the least bit flattering or supportive of acupuncture. Guy (Help!) 21:55, 3 September 2014 (UTC)
@ JzG (talk · contribs)/Guy - We can get both the letter and spirit of the law right without doing violence to either. That's the hallmark of a good encyclopedia. Did Ernst reply to you? I'd like to see exactly what you asked and what he replied. Thanks, --Middle 8 (POV-pushing • COI) 05:00, 4 September 2014 (UTC) edited for wl 05:07, 4 September 2014 (UTC)
@ JzG (talk · contribs)/Guy - Another way to put it is, what does that phrase "real acupuncture was no better than sham" refer to? Answer: one particular trial authored by Suarez-Almazon et. al., 2010. And I know that the results of that trial are consistent with Ernst's overall (and unsupportive) take on acu . I apologize for not asking the question as clearly as I should have. But I am not playing semantic games: I'm reading the source correctly. Read the source carefully if you doubt that, and AGF. --Middle 8 (contribs • COI) 09:18, 6 September 2014 (UTC)
Acu fans say "Even sham acupuncture works as well as the real thing! Acupuncture is amazing!" - whereas the reality based community has stripped away first placement of needles and then whether needles are even used, and it makes no difference to the outcome, meaning that acupuncture is a placebo intervention and the effects are due to the theatre not the needles. If you are wedded to the outcome, this is a Big Problem and you must find ways to wave it away. If you are wedded to the process - i.e. finding out whether a treatment is real or not and using only those that have definie specific efgfects - then you shrug your shoulders, stop using that treatment and move on. Science is not threatened by acupuncture, nor is it threatened by the finding that it doesn't work. Guy (Help!) 13:00, 6 September 2014 (UTC)
Yes, and? All this is obvious to me, and has jack-squat to do with reading the source. You've fooled yourself into thinking this is about POV-pushing, just as RexxS did. Since I posted at WT:MEDRS, the two people who have looked at the source -- 2/0 and Peter Coxhead -- agree with my reading. That number will inevitably increase; it's not a difficult call. The ONLY reason there's a debate is that QuackGuru is yet again insisting on his way, and another "skeptic" decided it was all about "taking sides" -- plus I posed the question unclearly because I was so annoyed with the situation, causing eyes to glaze over. This summary is pretty clear though, and see WT:MEDRS discussion. --Middle 8 (contribs • COI) 18:59, 6 September 2014 (UTC)
earlier, longer reply to Guy
@ JzG: (I hope you're not counting me as pro-quackery.) tl;dr: The question is simply one of context: what does the statement "real acupuncture was no better than sham" (the bolded sentence in the excerpt at User:Middle_8/Ernst-11) refer to: (a) the high-quality trials Ernst points to (whose negative results Ernst correctly predicted set the pattern for future high-quality trials) -- that's the right answer -- or (b) the findings of the 57-odd reviews that he reviews. (end tl;dr)
QuackGuru wants to cite all or part of that sentence as referring to (b), and by extension, all of the acu literature. But the literature, as we know, still has some reviews finding efficacy (however artifactual) for pain and nausea -- that's why there's so much controversy in the blogosphere, right? If it were slam-dunk like homeopathy is, Steve Novella wouldn't be skewering the extant reviews finding for efficacy. This isn't about how I or anyone might want it to be, it's what is the meaning of Ernst '11 and what is the current state of the literature, which is what we're obliged to depict. I mean, come on, per WP:ENC we don't play fast and loose with the meaning of Ernst's paper, even if that sentence is "the spirit of where Ernst thinks things are headed" (which is the source of much of the confusion). --Middle 8 (POV-pushing • COI) abridged 20:14, 2 September 2014 (UTC)

Hypertension

Systematic review conducted according to the Cochrane standards showed that acupuncture significantly reduced systolic and diastolic blood pressure, although further confirmation of is required.

-A1candidate (talk) 00:08, 1 September 2014 (UTC)

You are once again misrepresenting a source. This is a pattern with you.
The source looks good, though, so I have added a section. - 2/0 (cont.) 01:19, 1 September 2014 (UTC)
That's what the source says, further confirmation of results is required. -A1candidate (talk) 01:41, 1 September 2014 (UTC)
The source says "a definite conclusion on efficacy and adverse events associated with acupuncture cannot be drawn from this review." It belongs in the other conditions section. QuackGuru (talk) 03:06, 1 September 2014 (UTC)

It is not hypertension. It was essential hypertension. QuackGuru (talk) 06:03, 1 September 2014 (UTC)

Which is a kind of hypertension (just as auricular acu is a kind of acu, and chocolate milk is a kind of milk). --Middle 8 (POV-pushing • COI) 06:13, 2 September 2014 (UTC)

Rearrange

Section under "effectiveness" should be rearranged in a logical manner, either alphabetically or by physiologcally. The current arrangement appears random and unsystematic. -A1candidate (talk) 01:52, 1 September 2014 (UTC)

I think User:Jmh649 is best at arranging sections and articles. QuackGuru (talk) 03:25, 1 September 2014 (UTC)
IMO the one with the best evidence should go first. This means that pain should go first. No strong feeling about the ordering of the rest. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:37, 3 September 2014 (UTC)

After pain, low back pain goes next. QuackGuru (talk) 04:59, 9 September 2014 (UTC)

Time out: Academic centers, again, and a request

A section that four editors thought was adequately-sourced has disappeared without explanation in a complex partial revert by QuackGuru . (Previous discussion above.)

Controversial changes are part of the process, but don't bury them; do them individually. An editor watching the page wouldn't even know there was a wholesale deletion. The ES gave no clue -- "update (replace poorly sourced text with text from an independent source)" -- and so many other changes are made that the character count actually increases.

This isn't the first instance of a complex edit that combines good edits with controversial or poor ones. There's this, discussed above. Two editors asked QG not to do that again, but he re-did a large part of it anyway . Such edits are hard to follow, hard to discuss individually (or revert, should BRD apply), and they need to stop.

For the sake of collaboration, is it asking too much for editors to discuss changes, and not make complex edits that mix together decent changes with dicey ones? And to make one major edit at a time and use accurate ES's? --Middle 8 (POV-pushing • COI) 10:01, 1 September 2014 (UTC)

Addressing QG's objections:
(I tire of QG's spurious objections; see also e.g. Talk:Acupuncture#Allergies where he attempts to argue a review article isn't a review article.) --Middle 8 (POV-pushing • COI) 10:16, 1 September 2014 (UTC)
You added largely duplication and I found better sourcing. You don't need to use a bunch of primary sources. "Acupuncture is used at many places in the US, including Harvard, Stanford, and Yale." The article already stated this. The text each country can go into each specific section for each country in the International reception. You need to stop adding primary sources when better sources were found. QuackGuru (talk) 17:12, 1 September 2014 (UTC)
As pointed out at Talk:Acupuncture#Academic centers, the sources are perfectly reliable to illustrate the use of acupuncture at academic centers. I restored the original edits concerning this area. Please try to seek for consensus before making controversial edits. Jayaguru-Shishya (talk) 18:18, 1 September 2014 (UTC)
Thanks, agree, and I improved on your edit per ES --Middle 8 (POV-pushing • COI) 18:44, 1 September 2014 (UTC)
Jaya-S is right: Calling the sites of universities or their affiliates "Primary sources" is in this case a spurious objection; the sites are reliable for services they provide. And I'm not convinced "Academic centers" shouldn't have its own section, and QG hasn't explained why, other than "US-centric bias". Why should reception only be organized by country, as opposed to group (e.g. doctors, different organizations)? --Middle 8 (POV-pushing • COI) 18:46, 1 September 2014 (UTC)
We have more sections than needed. Why a section for just one sentence when that can be dealt with in the section above. Have adjusted. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:43, 1 September 2014 (UTC)

Request re: collaboration

QuackGuru: Will you PLEASE STOP MAKING MULTIPLE MAJOR EDITS AT ONCE? And discuss them on talk, and use clear ES's? Without a clear diff, discussion and/or ES, it's virtually impossible to tell what you're doing! --Middle 8 (POV-pushing • COI) 18:49, 1 September 2014 (UTC) moved 04:06, 2 September 2014 (UTC)

This is normal for QuackGuru, and I think the time has come to request escalation. Large-scale rapid fire editing, WP:OWNership and a dismissive response to dissent are a long-standing problem with this editor. Guy (Help!) 09:08, 2 September 2014 (UTC)
Yes, it is normal behavior for him/her and IMO it has been allowed to go on for far too long. Normal differences in POV are good for an article, but this sort of behavior has resulted in a seriously flawed article. Gandydancer (talk) 12:04, 2 September 2014 (UTC)
On the contrary, a lot of QG's edits are valuable in redressing the POV-pushing by SPAs in articles like this. Many of those would love to see QG removed from these articles because he's not prepared to sit back and see them owned by the SPAs and practitioners who have a vested interest in seeing Misplaced Pages give a positive spin to their subject. If you have a problem with a particular edit, then take it to talk. Remember that this page is for discussing improvements to the article, so if you think QG has violated policy, name that policy, find the diffs, and take it to dispute resolution. Time to put up or shut, not smear other editors with unspecific grumbles. --RexxS (talk) 16:56, 2 September 2014 (UTC)
I'd be happy to see QuackGuru get some mentoring, say from Doc James or Kww, but dunno if they'd want to take it on. And I don't think my request to do edits one at a time is POV-pushing. "Unspecified grumbles?" See diffs above: Talk:Acupuncture#Time_out:_Academic_centers.2C_again.2C_and_a_request. BTW, RexxS, your civility, coolness and lack of NPA continue to underwhelm.--Middle 8 (POV-pushing • COI) 19:00, 2 September 2014 (UTC)
I do not think anything short of a binding restriction to a maximum mumber of edits per article per day will work. Guy (Help!) 19:42, 2 September 2014 (UTC)
I agree. Mass edits without a chance for discussion creates problems. It's not collaborative editing, and QG does this far too often. Your idea might work. Set some limit. -- Brangifer (talk) 04:39, 3 September 2014 (UTC)
Mentoring or something to help improve talk page usage would also help. A lot. Want to paraphrase a source (generally a desirable thing per COPYVIO)? Prepare for round after round of "I could not verify the text" and "OR was added to the article". --Middle 8 (POV-pushing • COI) 20:43, 3 September 2014 (UTC)

What is this really about?

What is this really about?! We are probably all various types of healers, and probably all want to see people's pain and dysfunction relieved...Let's have a section called "Acupuncturists' Experiences" where those experienced in this form of therapy can share case studies. And another section can be there called "Not Everyone Agrees", where people who are threatened by this modality can voice their negativity.Merriels (talk) 03:15, 3 September 2014 (UTC)

That would be great for a blog or private website, but not here. We are creating an article in an encyclopedia, and all discussion should be directed towards that end. This is not a forum. Read WP:TALK. -- Brangifer (talk) 04:41, 3 September 2014 (UTC)

Not superior to sham for low back pain symptoms

"Acupuncture is considered to be a form of alternative or complementary medicine, and as noted above, it has not been established to be superior to sham acupuncture for the relief of symptoms of low back pain." QuackGuru (talk) 06:26, 4 September 2014 (UTC)

A good source, which weighs, along Being a case study, a review of clinical practice with only a small part devoted to efficacy, and not a systematic review, this is not a very strong MEDRS relative to with our other MEDRS's on low back pain -- which are not unanimously negative. Some are more recent too I believe.
Remember, if MEDRS's were unanimously negative on efficacy this wouldn't be nearly as controversial a topic. But right now we have good MEDRS's finding for efficacy for pain (probably acu's most significant indication), and a lot of the dissent is in sources that aren't MEDRS or even clear-cut RS. That's a picture of a field with significant remaining controversy. I trust that is a common-sense observation.... --Middle 8 (POV-pushing • COI) 07:00, 4 September 2014 (UTC) edited: struck text and added new text 04:55, 7 September 2014 (UTC); edited said new text again11:13, 7 September 2014 (UTC)
This source is also good MEDRS. I don't get the objection. This is specifically for low back pain not pain in general. QuackGuru (talk) 07:14, 4 September 2014 (UTC)
It's not an objection. I wasn't objecting when I thought the source was a meta-analysis. My second para is a general comment; my opinion on the source is in the first para. Yes, it's fine, again keeping in mind whatever other MEDRS's we have for low back pain. But remember that we treat low back pain as a subset of back pain: distinct in a sense but not wholly distinct. --Middle 8 (POV-pushing • COI) 08:45, 4 September 2014 (UTC) edited: struck text and added new text 04:55, 7 September 2014 (UTC)
I noticed you are still a little apprehensive about including this. QuackGuru (talk) 02:42, 6 September 2014 (UTC)
No, I just want to make sure we WEIGHT it properly. --Middle 8 (contribs • COI) 20:10, 6 September 2014 (UTC)

"Real accupuncture is not superior to sham acupuncture for alleviating low back pain symptoms." I summarised the text and the preceding sentence is a proposal. QuackGuru (talk) 02:43, 6 September 2014 (UTC)

I thought it was a meta-analysis, but it's not, is it? It's a case study. Weak MEDRS. Instead we should find whatever source they used for that statement, and use attribution wording just as we do with other reviews on pain (because MEDRS's on pain aren't unanimous, and we don't use a source to speak in WP's voice when equally-strong sources disagree).
BTW, here's a game: "Find a statement that's incorrect/UNDUE/out-of-context but sounds like it should be correct, and propose it. If no one objects, put the POV edit in the article. If someone objects, depict their objection as a POV-push." But you wouldn't do something like that, right? --Middle 8 (contribs • COI) 20:10, 6 September 2014 (UTC) edited 04:55, 7 September 2014 (UTC)
The source is a review. I don't know why you think it is a case study. QuackGuru (talk) 05:02, 7 September 2014 (UTC)
OK, I've got it in front of me. Yes it's a review of multiple aspects of clinical practice, no it's not a systematic review. They cite seven sources, two of which are systematic reviews; these are superior and we should use them as well. They also cite five primary studies. So it's MEDRS but lower weight than systematic reviews. And no we do not speak in WP's voice with a source that is inferior to other MEDRS's including ones that contradict it. --Middle 8 (contribs • COI) 07:51, 7 September 2014 (UTC) edited 11:15, 7 September 2014 (UTC)
And it's not a proper summary of the paper; they're actually endorsing using acu for low back pain because it's "more effective than no treatment". And they review not only "Clinical Evidence" but also "Pathophysiology and Effect of Therapy", "Clinical Use", and other aspects. You appear very eager to get those words "real acupuncture... not superior to sham" in the article no matter what. But we let sources dictate wording, not the other way around. Your proposal is not unreasonable, but it's not the best way to summarize the source, either. What the reader needs to know about sham is that it's a control and that it involved either faux points of faux needling. IMO you need to follow sources more, and spend less time thinking of wording you'd like to see and then trying to find sources to fit it.
So I propose that instead of copying and pasting the phrase you've been pushing for, we get a copy of this source to other editors and figure out how best to summarize it. --Middle 8 (contribs • COI) 08:17, 7 September 2014 (UTC)

Tags

Hello everyone! I've added a NPOV tag to your article because I see on the talk page that its content is and has obviously been under dispute for a very long time. Just to remind everyone, per Misplaced Pages policy, please do not remove the tag until the disputes have been resolved and there is consensus to do so. Also, I came here from the Countering Systemic Bias project page, and am also considering adding in a systemic bias tag but wanted to ask everyone's thoughts first. My hope for that tag is to attract other editors to the page that come from other cultural and linguistic backgrounds who can add something positive to your work here. I lived in Asia for several years and can read Mandarin and see much information I can add here. I would just go ahead and add it, but don't want to shame the article by over-tagging it. This can also be a talk page section where we can work to positively resolve the neutrality issues, and any input is welcomed. Thank you! LesVegas (talk) 20:04, 4 September 2014 (UTC)

For a new, unexperienced editor such bold moves are ill advised. Tgeorgescu (talk) 20:18, 4 September 2014 (UTC)

The root cause of the problem is the false equivalence given to the views of anti-fluoridationists and the scientific community. The scientific consensus, by definition, incorporates all significant valid viewpoints. It develops over time in response to new data. In maters of science, the scientific consensus view is inherently the neutral point of view for Misplaced Pages purposes. To "balance" that with anti- views is to compromise fundamental policy.

— Guy,
Quoted by Tgeorgescu (talk) 20:22, 4 September 2014 (UTC)
Hi Tgeorgescu! What moves are you referring to? Certainly not the neutral POV tag, as from this talk page alone, we see many editors with many disputes over the neutrality of the article. The tag I added seems highly appropriate and I'm frankly baffled why I'm the first person to add it. Of course, your input is very welcome and I'm glad to have you participating in this discussion! Regarding your quote, I'm not trying to balance the scientific view with unscientific viewpoints, nor do I think any editors here are trying to do so. For example, if you look at this talk page above at A1Candidate's proposed additions, he has numerous high quality scientific sources he wants to add in to give a more well-rounded viewpoint here, and perhaps this section on the talk page can be used as a medium to discuss how best to add these in. And I do want to be bold, as that's Misplaced Pages's motto, but not overly bold which is why I haven't added the systemic bias tag yet. What are your thoughts on that? If you'd like to read our discussion, you certainly can at this link here LesVegas (talk) 20:40, 4 September 2014 (UTC)
re "and perhaps this section on the talk page can be used as a medium to discuss how best to add these in" -- agree 100%! --Middle 8 (contribs • COI)
@Tgeorgescu: Adding a tag is not a bold move. A good-faith invitation for more eyes on the article is always to be welcomed. Your comment is somewhat WP:BITE-y imho ... not an outright bite, but a bit of a snap. :-) Completely agree that we need to make sure that the reasons for the tag are clear and fairly precise. --Middle 8 (contribs • COI) 00:20, 5 September 2014 (UTC)

Disputed content doesn't necessarily mean there is a POV dispute. Note that in placing a tag you should follow the instructions at Template:POV, which includes "pointing to specific issues that are actionable within the content policies." In other words: what POV is being under- or over-represented, and why? It seems to me from the talk discussion above that the article's representation of efficacy is fairly neutral, though of course I could be mistaken. I've removed the tag for now pending discussion of this. Sunrise (talk) 21:06, 4 September 2014 (UTC)

Thanks for pointing out that I've only been vague thus far as to what the disputes are. So far, we have he lack of inclusion of:
  • 1)A1candiate's information he pulled up on acupuncture and placebo
  • 2) Nocebo
  • 3) Allergies
  • 4) Mechanism of acupuncture (which directly contradicts the lede, thus the neutrality dispute)
  • 5) acupuncture and the brain data (again giving a mechanism of action)
  • 6) inclusion of arrhythmia information
  • 7) the validity of Quackwatch as a source. I see the large blockquotes content is specifically disputed.
  • 8) Middle 8 has unresolved issues with acupuncture and safety as it's stated in the article
  • 9) a dispute about an encyclopedia on aliens and related subjects ought to be used as a source
  • 10) Weight issues
  • 11) For me, systemic bias issues. I see additional weight issues by putting sources using non-STRICTA, and NIMH-adopted reporting standards ion equal footing with studies/review articles that do.
And going back into this talk page's archives I see:
  • 1) unresolved conflicts regarding "Strong Bias Toward Sceptic Researchers"
  • 2) lack of inclusion of well-sourced information regarding Myofascial Meridians. By the way, the person proposing this contacted me about the merger of that article and this one. He's been banned so while I don't think merging them is likely, I do think the idea behind that unresolved dispute should be honored and some of the contents of that article be added into this main one.
  • 3) lack of inclusion of many sources showing positive results for acupuncture (many times, and these are unresolved conflicts from the best I can tell)
  • 4) a source in Nature which has been disputed many times and appears to be unresolved
  • 5) Weight issues in the lede, such as cost effectiveness which appear unresolved
  • 6) unresolved conflicts, from what I can tell, regarding inclusion and placement of information on adverse events in the article
  • 7) lack of inclusion on a dopamine-modulated mechanism of action for acupuncture
  • 8) lack of encompassing international studies (which is another instance of systemic bias)
  • 9) Unresolved conflicts on the dispute of cherry-picked sources in the pain section, from what I can tell
  • 10) unresolved conflicts on removal of information from Nancy Snyderman
  • 11) and this list goes on and on. I'll add to it as we proceed and invite anyone else to do so as well!
Anyway, now that we have an active list, I see no reason why the POV tag shouldn't be added back. Let's get to work so we can get rid of this tag! LesVegas (talk) 22:12, 4 September 2014 (UTC)
Thanks for the list, but it's still unclear what you think the POV disputes are. Discussions about the inclusion of specific content or the reliability of specific sources, or just commenting that a particular issue is not resolved, do not mean that we have an NPOV issue. Many disputes on Misplaced Pages remain unresolved when discussion stops, and that isn't unusual. A few of the entries seem like they relate to the NPOV policy, but they still don't specify what actionable issues you're identifying, except perhaps #11 in the first list. As I asked in my previous comment, what POV or POVs do you think are currently over- or under-represented in the article? Sunrise (talk) 23:21, 4 September 2014 (UTC)
Keep in mind that, per WP:NPOV, the article is supposed to reflect the weighted sum of WP:MEDRS-compliant sources without inserting a false balance. The banned editor to whom you are referring was not banned for no reason - if you rely on their summary you will get a skewed view. I would like to second Sunrise's request for specificity in your objections. If you make your case reasonably I am certain we can work something out. - 2/0 (cont.) 23:37, 4 September 2014 (UTC)
Agree. His list is a really good start (more than a start), and certainly adequate to justify the tag (I've seen edit wars over tags in the past and am glad we haven't "gone there". There are no deadlines on WP, and as long as we're making reasonable progress (or are stalemated but actively recruiting new editorial eyes), the tag is fine. --Middle 8 (contribs • COI) 00:33, 5 September 2014 (UTC)
Thanks guys for your participation! Sunrise, your original response prompted me to go back into the archives here and I've found many more objections to neutrality on this article. I knew it was odd nobody added a POV tag before, indeed it was odd because this tag has been added before, many times. Not once do any of the issues appear to be resolved before the tag is removed, per policy. So I'm not breaking new ground by arguing for this tag, as much as I'd love to pat myself on the head. Regarding which POV is underrepresented, I think it's safe to say the sceptic POV is over-represented (as another editor said in "Strong Bias Towards Sceptic Researchers) and all other viewpoints are under-represented. This includes, but is not limited to, alternative medicine proponents, governmental bodies (such as the NHS, Federal Joint Committee, the CMBV, and many more)' acupuncture professionals (there is a notable lack of information regarding various acupuncture styles, such as Tung, classical, Japanese styles, Korean, only TCM which is the sole subject of both praise and attack in the article,( although there is a separate tag for this particular example)), whatever POV Middle 8, A1candidate, Herbxue, Jayaguru-Shishu, Bob MeeowCat and many others represent (as they seem to have continuous unresolved problems with some dominant POV's in this article), as well as systemic bias for multiple reasons I won't go into here, but if interested, anyone is welcome to go into here Again, the systemic bias issue is somewhat different, which is why I was proposing the addition of a systemic bias tag as well. I'd love to hear any opinions on that as well! I may be wrong here, and if I am, I totally don't mind putting a POV-check tag on the article instead and invite others to come here and check things out on the NPOV noticeboard. Nothing hurts from having more peeps give us their opinion. Anyway, I hope I answered your questions well! I'm always glad for input! Peace! LesVegas (talk) 01:02, 5 September 2014 (UTC)
About the skeptical bias, science is organized skepticism. So remove skepticism and there is no science left. Tgeorgescu (talk) 01:07, 5 September 2014 (UTC)
Hey there Tgeorgescu! Glad to see you again bro. I apologize for confusion about skepticism. I was largely using another user's objection which I found in the archives of this here talk page, entitled "Strong Bias Toward Sceptic Researchers". I totally agree with you, skepticism is a scientific pillar. What I think that editor really meant is there is a strong bias toward cynical researchers and the cynical point of view. In the archives, I noticed that there was a dispute between the researchers Vickers and Ernst, where conclusions of one of these gents's work (I don't remember which one) was criticized as nothing more than a platform to make ad homiem attacks. If true, that would be cynicism, and the article would have undue weight if that viewpoint were given a larger platform than it deserved. Anyway, sorry for the confusion, I'm not at all suggesting we get rid of sources rooted in valid scientific inquiry. Peace! LesVegas (talk) 01:31, 5 September 2014 (UTC)
Hi LesVegas! I knew what you meant by "skeptical bias", and semantics aside, I don't think the term is all that unclear. Of course one cannot be too scientific or too skeptical when it comes to the rational study of objective phenomena. However, one can take a given conclusion too far in a certain direction, or give too much weight to one segment of the mainstream. When the trend apparent in the acu literature suggesting the null result is overgeneralized (or perhaps prematurely extended) to all the literature, and we start saying without qualification (or with insufficient qualification, relative to extant MEDRS's) that acupuncture is a placebo, that's an example of skeptical bias. When the consensus of scientific skeptics is taken as being identical to the mainstream consensus despite ther being no unified mainstream consensus -- particularly on the question of whether there is a place for acu in medicine -- that too is an example of skeptical bias. Welcome! I like your approach on this page. --Middle 8 (contribs • COI) 07:22, 5 September 2014 (UTC)
I think LesVeges' list gives justification enough to keep the tag. We've still got quite a lot to improve with this article! Cheers! Jayaguru-Shishya (talk) 14:46, 5 September 2014 (UTC)

OK, now that there seems to be some agreement about the use of this tag, I propose we start by resolving issue número uno on the list, A1candidate's proposal to rectify this info on acupuncture and placebo, specifically, this:

"The first review found some evidence that "biological differences" exist between a placebo response and sham acupuncture. The second review concluded that "acupuncture is more than a placebo". Are there any recent reviews that suggest otherwise? " as quoted by master editor A1candidate, Misplaced Pages, 2014 LesVegas (talk) 01:38, 5 September 2014 (UTC)

Note that A1candidate has a reputation for misrepresenting sources. We cannot use anything they propose without thoroughly checking it first. That said, your idea to add more about the several different styles and traditions of acupuncture is an excellent one. I could see adding such material under #Clinical practice, or maybe #Theory or #History, depending on how we present it. Does that sound like something worth working at? - 2/0 (cont.) 12:21, 5 September 2014 (UTC)
Great idea! While we're waiting to see about these sources and how to use them, we could get to work on the varying styles and traditions. Now, I must confess that I'm not a practitioner of this medicine, but I have bounced around in Asia for several years and learned about this medicine firsthand, and here in the US I've worked on some translation projects regarding the medicine so I know a few things and can probably help guide it along. We will likely need the input of any professional acupuncturists to fill in the details I will surely miss. So, I'm thinking we start by adding in information about Master Tung style which is a family lineage system, Japanese Acupuncture (which has many sub-styles and could even be an article unto itself), Korean style acupuncture, European styles, and perhaps classical styles based primarily on the Huang Di Nei Jing Su Wen which are sometimes also family type lineage systems, ala Jeffrey Yuen, and sometimes classical style is steeped solely in the literature. There's also the 5 Element style of acupuncture, which was a lineage system that comes from a guy named Worsley I believe. TCM is just one form, and it has it's own unique history which we could add into the article. Alright, I'm glad you're in support of adding this information! Are there any pro's who would like to oversee 2/0 and I to make sure we have the best possible information to add? LesVegas (talk) 00:21, 6 September 2014 (UTC)
@LesVegas: Did you bother to read the section Pain? It answers your "issue número uno" - Yes there are newer reviews that suggest otherwise and they are cited in that section. It's worth noting as well that Hopton & MacPherson (2010), the second source you want included is already used in that section to cite "A 2010 systematic review suggested that acupuncture is more than a placebo for commonly occurring chronic pain conditions, but the authors acknowledged that it is still unknown if the overall benefit is clinically meaningful or cost-effective." Now have you got any specific wording that you want introduced into the article or shall I just remove the tag until you've done your homework and have got something useful to add? --RexxS (talk) 18:16, 5 September 2014 (UTC)
Hi RexxS! Thanks for your posting here. Yes, I noticed the Pain Practice reference last night when I got to work on researching this and am glad to see you did as well. The reason I included this example as "numero uno" was not really because it's the change I wanted to see, but what A1Candidate wanted. I suppose we can ask him specifically how he wants that reference included, but I imagine he would like to see it in a section on placebo and/or cost-effectiveness as well, which is why he included it on this talk page earlier under 7. Outstanding Issues, 7.1 Acupuncture and Placebo. I'll go to his talk page and ask him! Peace! LesVegas (talk) 23:41, 5 September 2014 (UTC)
The effectiveness section also covers sources that mention placebo too. There is no need for another section when it is already discussed in the appropriate section. The source is already used in the Acupuncture#Cost-effectiveness section. A 2010 systematic review found it is unknown if the overall benefit of acupuncture is cost-effective. QuackGuru (talk) 00:12, 6 September 2014 (UTC)
Thanks QuackGuru! See what I told you about how you cite everything? That's perfect, and it'll help us alot. Now, I should mention that I tend to babble and only said cost-effectiveness because it seemed appropriate in my sanguine mouth. But A1candidate never said it needed to be added to that section, only implied that it should be added as information regarding the acupuncture and placebo. I'm assuming he either means adding a section on acupuncture and placebo, or adding the information to the existing section "Scientific View on TCM Theory". But I'll let him speak for himself on that outstanding issue. LesVegas (talk) 00:33, 6 September 2014 (UTC)

The tag was removed multiple times

  • 1) The information on acupuncture and placebo was resolved. If a source was not added to the article yet that does not mean we need a tag for that.
  • 2) Nocebo Which specific source? A tag is not needed to add one or two sources. What is needed it to let editors know which source may be applicable for inclusion.
  • 3) All the sources for allergies were added to the article.
  • 4) Mechanism of acupuncture was added to the article which does not contradict the lede.
  • 5) Acupuncture and the brain data was resolved. They don't show the effectiveness of acupuncture.
  • 6) Inclusion of arrhythmia information. What source is specifically about acupuncture?
  • 7) The validity of Quackwatch as a source was resolved.
  • 8) The issues with acupuncture and safety as it's stated in the article was resolved. If it is too long we can start a new article titled Safety of acupuncture.
  • 9) A dispute about the Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy was resolved.
  • 10) I don't see any unresolved weight issues.
  • 11) The Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) (and the National Institute of Mental Health (NIMH)-adapted standards ion equal footing with studies/review) is covered by WP:MEDRS, and WP:WEIGHT and WP:FRINGE on Misplaced Pages. There is not a strong Bias Toward Sceptic Researchers. See Talk:Acupuncture/Archive_13#Strong_Bias_towards_Skeptic_Researchers.
  • 12) The information regarding Myofascial Meridians using primary and fringe sources were inappropriate to use.
  • 13) There is no lack of inclusion of many sources showing positive results for acupuncture? What sources?
  • 14) The source in Nature was resolved.
  • 15) The issues in the lede was resolved.
  • 16) The text about adverse events are in the proper place in the article
  • 17) There is no lack of inclusion on a dopamine-modulated mechanism of action for acupuncture The following sentence is in the article. Evidence suggests that acupuncture generates a sequence of events that include the release of endogenous opioid-like substances that modulate pain signals within the central nervous system.
  • 18) There is no lack of encompassing international studies. For example, the Chinese journals were unreliable.
  • 19) The issues with sources in the pain section was resolved. For example, the following source is already in pain. Hopton A, MacPherson H (2010). "Acupuncture for chronic pain: is acupuncture more than an effective placebo? A systematic review of pooled data from meta-analyses". Pain Practice. 10 (2): 94–102. doi:10.1111/j.1533-2500.2009.00337.x. PMID 20070551.
  • 20) The removal of information from Nancy Snyderman was resolved. It was resolved when the unreliable source was removed. See Talk:Acupuncture/Archive_11#Dr._Nancy_Snyderman_information_repeatedly_removed.
  • From what I can discern, the dispute is mainly with editors who did not like what the reliable sources said. There is no consensus for a tag that was added and removed multiple times.
Hi Quackguru! Thank you for contributing here, the more the merrier! I appreciate the amount of work you put into your post, and think you can be a valuable asset towards resolution here because I see you frequently put a tremendous amount of effort into making your points, and it appears you have a good deal of knowledge about the history of the disputes on this topic. I also see that you reference your points quite well on this talk page, and that's a big plus to any discussion. Clearly you have a passion for this subject and you put in a great deal of work towards your efforts. I see, for instance, on #17 that you provided an excellent reference to support your point. I didn't see what appeared to be a complete resolution on the talk pages, but then again I'm human and I may have overlooked something on that one issue. Would you be so kind as to provide sourcing for when/where exactly some of these other issues were resolved? No hurry, I don't want to overburden you, it will take time to resolve the issues where there is still clear disagreement. That way, we can all debate whether we feel like there has been a valid resolution, point by point, or not. If 3-4 feel like issue #10 is resolved and 3-4 feel like it's unresolved, well then the tag would still be justified, right? But if we all feel it's a non-issue, then we could go ahead and scratch it off the list and spend our time on other issues on the list. That's where I think you can be a tremendous asset to everyone here.
Regarding consensus for the tag, I very sorry but I must disagree with you as there are several other editors who support this tag. If all the issues had been resolved, these editors wouldn't support the tag. And in my opinion, we also wouldn't have had a history of this tag. But you did state that the POV tag was removed multiple times already( per consensus and not just some random single editor) and I will look into the edit history deeper to see who removed it, why it was removed, and what everyone's justification was for de-tagging the page and report these findings back here because I think they can be a great help in this current effort. And please feel more than free to disagree with anything I'm saying here. If you feel the inclusion of this tag to still be unjustified, you will have my full support to go onto the neutral point of view noticeboards and ask for an outside/third-party opinion. Again, I appreciate your response and look forward to working with you! LesVegas (talk) 23:22, 5 September 2014 (UTC)
As an editor who has yet to weigh in here, I'm feeling the need to jump in now to count myself among those who do not support the POV tag. I know that there are a few outstanding issues, and in articles with this one there likely always will be, but I don't see that a case has been made here for the POV tag. Cheers, Dawn Bard (talk) 23:44, 5 September 2014 (UTC)
Hi Dawn Bard! I'm sorry I just now saw your post here. Thank you for contributing your POV about the debate on POV!. It is my understanding that the outstanding issues that are unresolved are the purpose of the tag, but I could be wrong. Anyway, I'm filing something on the NPOV noticeboard for clarification just so we know for sure. Again, I appreciate you adding to the debate here. Peace! LesVegas (talk) 03:50, 8 September 2014 (UTC)

The history of the tag

Hey QuackGuru, I hope you're well! I apologize for just now getting back to you and everyone else on this, but I've been going through the acupuncture edit history, edit by edit, to see what the history of the neutral point of view tag removal was. In the process, I've learned a great deal about the history of point of view disputes on this page, and I also saw, as you stated, we have had tags and had them removed multiple times. Not because everyone worked out their differences on the talk page, but because one editor removed the tag, often saying that this page is "always under dispute, so there's no reason for the tag." Here are the diffs of the tag removal prior to the tag I put on the other day:

You make a good point there, LesVegas. I can't find any "always under dispute, so there's no reason for the tag." from Template:POV, so I don't think it can be considered as a valid argument. I think the circumstances when the tag can be removed have been expressed by you clearly at Talk:Acupuncture#When_to_remove. Jayaguru-Shishya (talk) 18:59, 8 September 2014 (UTC)

Failed verification?

Wiki-aricle:

"Acupuncture is used at several academic medical centers,"

QuackGuru :

" Failed verification. How does the source verify the claim Acupuncture is used at "several" academic medical centers? Encyclopedic content must be verifiable."

The given reference :

"As it turns out, Johns Hopkins is coming late to the party. Acupuncture is already a fait accompli at many peer institutions—Mayo Clinic, Duke, Stanford, UCLA and at least a dozen others included. Most of these medical centers"

So, verified. Joshua Jonathan -Let's talk! 19:25, 5 September 2014 (UTC)

The sources does not state it is only used at "several" academic medical centers. The source goes much beyond that. Acupuncture is used at many academic medical centers,... QuackGuru (talk) 19:57, 5 September 2014 (UTC)
Please feel free to change it to "many" per the source. Seems straightforward. --Middle 8 (contribs • COI) 04:20, 6 September 2014 (UTC)

Whitewashing

in this edit Jayaguru-Shishya removed Gorski's well-sourced commentary on the reception of acupuncture in the USA without any hint in the edit summary: "So far, it seems you are the only editor having problem with the text. Please get consensus first for your further edits. See Talk:Acupuncture#Academic_centers". This kind of whitewashing of critical content by stealth is utterly unacceptable. If JS is only here to POV-push for an acupuncture article that has all criticism removed, he needs to be topic-banned from the subject. --RexxS (talk) 23:31, 5 September 2014 (UTC)

Acupuncture is used at many academic medical centers, including Duke Center for Integrative Medicine, the Johns Hopkins School of Medicine, Mayo Clinic, Stanford University School of Medicine, David Geffen School of Medicine at UCLA, Harvard Medical School, and Yale School of Medicine. The current wording is sourced in accordance with V. The previous text failed V. I also fixed the wikilinks to the appropriate articles and added Duke.

There is no basis for the tag. See Talk:Acupuncture#The tag was removed multiple times. QuackGuru (talk) 23:45, 5 September 2014 (UTC)

Whoa, let's AGF -- I don't see Jaya-S attempting to whitewash. Jaya-S's ES references the section above Talk:Acupuncture#Academic_centers, in which I pointed out that acu is used at academic centers, which are mainstream. Indeed, Harvard, Yale and Stanford are as mainstream as it gets. That means acu isn't wholly fringe, which affects WEIGHT. We shouldn't preface mainstream use of something by saying "according to one scientist, the following is an example of pseudoscience": that's pretty far from NPOV! --Middle 8 (contribs • COI) 03:39, 6 September 2014 (UTC) edited 05:54, 6 September 2014 (UTC), 06:00, 6 September 2014 (UTC)
Gorski's comments are well-sourced and should go in but not with the wording in that diff (pre-change) . --Middle 8 (contribs • COI) 09:07, 6 September 2014 (UTC)
Remember what A1Candidate wrote above: 1b. What Harrison's says - "Although methodological problems continue to plague acupuncture trials, belief has been growing even in academic centers that acupuncture may be effective", as quoted directly from Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Google Books). --Middle 8 (contribs • COI) 03:39, 6 September 2014 (UTC)
Meta-comment: And those views in academic centers are not incompatible with systematic reviews, if they're using acu for its non-specific effects. Non-specifically, yes, it does make patients feel better. Both real and sham do that. If the question is "whether to refer", then the difference between sham and real isn't very relevant. Maybe acu will evolve into a non-specific thing like massage. That's how I and a lot of my colleagues see it already. More than one of my profs has said candidly (in front of the whole class) that it doesn't really matter where you put the needles. Go figure. The TCM diagnostic system is mostly for herbs. --Middle 8 (contribs • COI) 04:03, 6 September 2014 (UTC) edited 06:00, 6 September 2014 (UTC)
Middle 8, you took the words out of my mouth. We have these renowned mainstream academic centers like Yale, Harvard and Stanford that use acupuncture. We don't have to filter the light through lenses of any color. Jayaguru-Shishya (talk) 11:08, 6 September 2014 (UTC)

Template POV: When to remove the tag

Hi guys, just so we're all on the same page here and there's no confusion, I wanted to post this information from Template:POV on when to remove a tag:

When to remove

This template is not meant to be a permanent resident on any article. You may remove this template whenever any one of the following is true:

  1. There is consensus on the talkpage or the NPOV Noticeboard that the issue has been resolved.
  2. It is not clear what the neutrality issue is, and no satisfactory explanation has been given.
  3. In the absence of any discussion, or if the discussion has become dormant.

Since #3 is clearly not applicable to this highly discussed page, and since #2 is not applicable since I listed the many outstanding neutrality issues, we have one way to remove the tag, which is to #1 resolve the neutrality issues with consensus. Now I know that may sound like an impossible task, but I believe everyone here is capable of collaboration. Now let's hold hands and sing Kumbaya! LesVegas (talk) 01:21, 6 September 2014 (UTC)

I agree. I don't see consensus to remove the tag, and edit-warring over a tag is VERY lame. There are good-faith and policy-based reasons to keep it, including integrating some of the sources A1Candidate has put forth. As I've said before, although A1C sometimes overstates the weight of those sources, they are MEDRS's, and properly weighted, generally should be integrated into the article. The tag invites more eyes, and more eyes are good: it's been hard to find a middle ground between excessively entrenched "pro" and "anti" acu views, and more than one very good editor has become disillusioned about that state of affairs and left. So let's get more eyes on this article and break the logjam. --Middle 8 (contribs • COI) 04:18, 6 September 2014 (UTC)
Agree. I can't really see why the template should not be there. Jayaguru-Shishya (talk) 11:10, 6 September 2014 (UTC)
If that tag is really that offensive to some, perhaps a compromise choice of a different tag would work. --Middle 8 (contribs • COI) 04:25, 6 September 2014 (UTC)

A general note -- I'm really impressed with LesVegas's enthusiasm and being able and willing to provide specific ideas. They've been around for only two months, and that level of cluefulness and collaborative spirit is unusual in such a recently-joined editor. Once again, welcome LesVegas! Your contributions are very much appreciated! --Middle 8 (contribs • COI) 04:34, 6 September 2014 (UTC)

User:Dawn Bard explained "I don't see that a case has been made here for the POV tag." There is no need for any kind of tag. See Talk:Acupuncture#The tag was removed multiple times. QuackGuru (talk) 16:10, 6 September 2014 (UTC)

I should have gone a bit farther, actually, User:QuackGuru - not only do I not think a case has been made for the tag, but reading everything here, I do think a case has been made against the tag. Thanks to everyone who's participating here; it's clear a lot of effort has been made. Cheers, Dawn Bard (talk) 18:40, 6 September 2014 (UTC)

I think that there should be a {{alt-med}} template which implies a neutrality dispute, because it is implicit in any Misplaced Pages article touching on alternative medicine that it will either display a reality-based bias and thus be hated and reviled by the quacks that support the therapy, or it will not yet have gained attention from the reality based community and will therefore be non-compliant with NPOV. This may be a slightly cynical view... Guy (Help!) 22:24, 6 September 2014 (UTC)

Bias can go in any direction if there are WP:OWN issues and tendentiousness; it all depends upon the balance of editors. True for any article. --Middle 8 (contribs • COI) 03:03, 7 September 2014 (UTC)

So anyway, trying to determine consensus re the issues for which the article was tagged. As Les Vegas pasted in from Template:POV, it's ok to remove once "There is consensus on the talkpage or the NPOV Noticeboard that the issue has been resolved."

  • No NPOV concern; don't need tag - QuackGuru, Dawn Bird, Guy (I think), 2/0 (I think), Tgeorgescu (I think)
  • NPOV concern; do need tag - LesVegas, Jayaguru-Shishya, myself, A1Candidate (I think)

I may have missed a few, but even so I don't see consensus here. The reasons for concern are non-trivial: weighting of sources, specifically integrating A1Candidate's suggested MEDRS's, which do weigh even if A1C sometimes overestimates their weight. I would also add the concern of too much given to sources on adverse events. Kww, e.g., was dubious about putting <<5 known deaths in 10 years>> in the lede.

The explicit purpose for that tag is new editorial eyes. Surely THAT cannot be a bad idea. In order to avoid edit warring I'm not going to put it back right away. In the meantime: is this reasoning flawed? --Middle 8 (contribs • COI) 09:07, 7 September 2014 (UTC)

Well, in general it's a bad idea to rely much on counting editors, because (as it is said) consensus is not a vote (WP:CON, WP:VOTE, WP:DEM). But if the purpose is just to get new editorial eyes, an easy way around having to deal with this tag dispute would be to request input from a page like the NPOV noticeboard. Sunrise (talk) 00:23, 8 September 2014 (UTC)
@Sunrise: - Certainly true that consensus isn't only about numbers, but numbers can factor in; it's hard for me to see how ca. 35-45% of editors with NPOV concerns is compatible with concensus. I'm not going to insist on it, but my understanding has always been that the default is to keep an NPOV tag when a significant number of editors have good faith and comprehensible policy-based concerns. Do you disagree with that understanding, or do you think the concerns I mentioned in my post above (beginning with "So anyway, trying to...") aren't relevant, or what? Happy editing, --Middle 8 (contribs • COI) 20:42, 8 September 2014 (UTC)
Of course numbers can and do factor in, but they're never the end of the story. :-) Determining consensus is often pretty difficult - I have some experience as an RfC closer, and I would make two points: i) in a discussion as complicated as this one it might take hours of analysis for even the most experienced closers to determine a consensus, and ii) it is not that uncommon for consensus to be established even against the majority of editors in a discussion. I agree that the default is generally to keep a tag on the article if valid concerns have been shown, but then the question is whether the concerns are valid, and I don't think that has been established at this point. The POV tag is also somewhat of a special case that it pays to be cautious about, because it is so commonly misused as a "mark of shame." Sunrise (talk) 21:54, 8 September 2014 (UTC)
Yeah Sunrise! That's a great idea. I'll request input from the NPOV noticeboard so we can get some clarification! Thanks for your valuable suggestions! LesVegas (talk) 03:17, 8 September 2014 (UTC)
FWIW, my suggestion was that you could use it to draw attention to the article itself and any specific NPOV issues you see, and thus avoid dealing with a tag dispute. Tag disputes, not being directly related to article content, tend to be unproductive. The question you've posed at NPOVN might lead to a long dispute, but I wouldn't expect much to come out of it - we'll get a wider audience to look at the page, but it will be harder for them to contribute unless you can describe the issues that you see more clearly. Sunrise (talk) 19:14, 8 September 2014 (UTC)
@Sunrise: -- agree, when concerns are pervasive and general it's hard to boil them down for a noticeboard. Hence in part my preference for a tag; editors can browse the page and jump in and ask. What we really need is an infusion of ca. a half-dozen science-literate editors seeking a "reasonable middle", as Jytdog put it, and who aren't here to fight either side of the alt-med wars. --Middle 8 (contribs • COI) 20:42, 8 September 2014 (UTC)
I agree in part, but I would add that if specific concerns can't be established, other editors won't be able to tell whether you have a point or not, and will probably be inclined to assume that you don't. I would also add that since the ultimate goal is to accurately reflect the RS, in some cases the article may reflect somewhere between any two positions but in other cases it will not - e.g. Evolution and Global warming. Whether or not that's the case here I can't say, since I don't really want to get deep into the article content myself, although my superficial analysis is that the article is at least fairly close to neutrality on most issues. Sunrise (talk) 21:54, 8 September 2014 (UTC)
@Sunrise: This is probably stale, but I'll comment just for the record. This is probably more granular than you said you were interested in, but if you don't want to consider this further, someone else may at some point.
I agree with your two points (mentioned above in the post starting with "Of course numbers can...."), and with your observation about WP:GEVAL as applied to articles like evolution. The problem is that we have POV-warriors from the "skeptic" side who are eager to depict acupuncture research as being just as settled as that of homeopathy (i.e. that it doesn't work), and who are objecting to NPOV-tagging even subsections of the article despite good reasons being given (see section above).
With acupuncture there is a real debate in the literature, even if one side is wrong. There exist MEDRS's of equal weight disputing whether or not acupuncture is effective for some types of pain and nausea; this is apparent in the lede and body. But the article is dominated by editors who take the stance that skeptic bloggers do -- that the MEDRS's finding for efficacy are all flawed -- and gives short shrift to sources finding that it works. If NPOV and VER mean anything, they mean that we should follow the debate as reflected in MEDRS's, not as depicted in blogs, many of which are barely V RS.
So that's some of the the context for my concerns expressed above in the post starting with "So anyway, ...". See also section above, where editors Guy and QuackGuru object to simply specifying the kinds of pain a review examined, the former misusing WP:GEVAL's reasoning.
Again, my comment is mostly for the record. I think that in almost any other topic area, the tag would be kept. In the current environment -- where, e.g., one editor is allowed to dominate the whole article with impunity -- it's not even possible to keep the tag alive, let alone engage the debate that it's meant to indicate. --Middle 8 (contribs • COI) 07:01, 15 September 2014 (UTC)

Low level details restored against consensus

"" Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture. The source says it was for chronic pain. So why delete text what the source said? See Acupuncture#Pain.

"We need to be sure not to imply this is for chronic pain in general either by specifying "kinds of pain" or enumerating those kinds. I prefer shorter, but it's no biggie." User:Alexbrn explained on January 4, 2014.

The Vickers study was largely criticised by experts. Instead of deleting the controversial Vickers sources we reached a compromise with the wording. But now Middle 8 decided to add the extra details again. This edit was clearly against consensus when the previous discussion was against including it.

We already had a discussion about the details for the Vickers text. The result of the discussion back in January 2014 was against including the extra details. See Talk:Acupuncture/Archive 12#Low level details.3F. QuackGuru (talk) 01:39, 7 September 2014 (UTC)

"Consensus" at that time was among three editors and is likely to change. Sure Vickers been criticized, but the way to handle that is to weight the criticism adequately. This type of source is the gold-standard of meta-analysis: it uses individual patient data (cf. ). Yet we give it less space than multiple studies of rare SAE's in the pain section. This imbalance is primarily a result of your WP:OWN and POV-pushing and needs to change.
My proposal: A 2012 meta-analysis of individual patient data conducted by the Acupuncture Trialists' Collaboration found "relatively modest" efficiency of acupuncture (in comparison to sham) for the treatment of back and neck pain, osteoarthritis, chronic headache, and shoulder pain, and on that basis concluded that it "is more than a placebo" and a reasonable referral option.
This is too sparse:
Your proposal: A 2012 meta-analysis conducted by the Acupuncture Trialists' Collaboration found "relatively modest" efficiency of acupuncture (in comparison to sham) for the treatment of four different types of chronic pain, and on that basis concluded that it "is more than a placebo" and a reasonable referral option."
So why omit the kinds of pain?? We give that detail for all our other reviews. Am tagging the efficacy section with Template:POV-section for this reason. --Middle 8 (contribs • COI) 02:41, 7 September 2014 (UTC)
@QuackGuru: - I tagged that section at 02:44, 7 September 2014‎, and you removed it less than 24 hours later (18:15, 7 September 2014‎) without any comment here. That's completely inappropriate! --Middle 8 (contribs • COI) 06:32, 9 September 2014 (UTC)
It is inappropriate to add a tag that disputed an entire section when it was only a dispute over one sentence. QuackGuru (talk) 06:37, 9 September 2014 (UTC)
So improve it, put in a better one. Respect other editors' effort at WP:DR and don't be so OWN-y and revert so much. --Middle 8 (contribs • COI) 11:19, 9 September 2014 (UTC)
We should omit the kinds of pain because there is no evidence that acupuncture is specific, and no reason to believe that the effect on subjective outcomes like pain is due to specific effects or indeed anything other than placebo effects and other confounders. Guy (Help!) 08:49, 8 September 2014 (UTC)
@JzG: That reasoning puts the cart before the horse. Yes, acu probably isn't specific, but the existence of MEDRS's like this is why the question is still debated. Even if/though you hate it, this paper passed peer review in a legit journal and found specificity to statistical significance, and weighs not insignificantly, because of the type of meta-analysis it is (this kind). Anyway, other meta-analysis we cite, we say what type of pain it studied, and Vickers was basically four reviews in one. Also, I'm restoring the tag that QG inappropriately removed. --Middle 8 (contribs • COI) 19:57, 8 September 2014 (UTC) edited20:27, 8 September 2014 (UTC)
IOW: Misplaced Pages lags sources. How would you handle that with acu? Would you depict it as being as settled (per MEDRS) as homeopathy? --Middle 8 (contribs • COI) 01:05, 9 September 2014 (UTC)


Funding/Support:The Acupuncture Trialists' Collaboration is funded by an R21 (AT004189I from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) to Dr Vickers) and by a grant from the Samueli Institute. Dr MacPherson's work has been supported in part by the UK National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0707-10186). The views expressed in this publication are those of the author(s) and not necessarily those of the NCCAM NHS, the NIHR, or the Department of Health in England."

Was the study was funded or ran by alternative medicine promoters? Is the funding of NCCAM notoriously indicative of very shoddy research? Were they exposed in the Skeptical Inquirer? QuackGuru (talk) 22:19, 8 September 2014 (UTC)

NCCAM funding indicates nothing other than that it pisses off some people; no V RS impeaches it definitively, it's just one view. Per NPOV we cover all views, we don't suppress major ones, especially when they pass peer review and are published in a good journal. And Skeptical Inquirer lacks PARITY with that journal. Even if you found a MEDRS of comparable weight to Vickers that impeached NCCAM, all that would mean is that we'd give the former equal coverage. Nice try. --Middle 8 (contribs • COI) 11:19, 9 September 2014 (UTC) (copy-edited, added sentence 05:34, 15 September 2014 (UTC))

Explaining sham acu to the reader in lede

ES self-explanatory. We do need to tell the reader about both kinds of sham acu (faux needling and faux points). I made sure in this edit to explain exactly what it means when real is no better than sham, i.e. no efficacy. Also semi-boldly removed Ernst '11 with its inadequate depiction of context for statement re sham (it shouldn't be there anyway while it's being challenged; those who want it haven't met WP:BURDEN). (Now a certain editor may feel the need to evert, claiming this is OR....but please read on.)

Anyway, never let it be said that I oppose discussion of sham in the lede, and what it means when real acu is no better than sham. All I insist on is proper sourcing, especially not distorting sources. Here, we manage to get the job done by simply paraphrasing existing sources on study design (and obvious scientific principles about controls) to present an uncontroversial explanation. If editors feel that more sourcing is needed, try adding a fact tag instead of reverting. After all we should be improving each others' edits whenever possible, and not edit-warring, right? --Middle 8 (contribs • COI) 13:08, 7 September 2014 (UTC)

To clarify, use of Ernst '11 in the lede is being discussed at WT:MEDRS#Acupuncture_source. My objection is to citing it in the lede without saying what he's talking about (i.e., we shouldn't make it look like it's a general statement). Half of the people who have looked at it agree that Ernst's statement about sham is specifically about one paper, not the whole body of literature. Given that, I felt that those who wanted to keep it hand't met WP:BURDEN, so I removed it -- perhaps prematurely; I certainly didn't want it to lead to drama. --Middle 8 (contribs • COI) 12:53, 8 September 2014 (UTC)
Are continuing to edit against consensus? You are continuing to try to rewrite or delete the same sentence. This is going on far too long. Now you replaced sourced text with SYN and OR. You have a failure of understanding you are repeatedly adding OR to this article. I will stop calling your edits original research when you stop adding original research to this article. QuackGuru (talk) 18:00, 7 September 2014 (UTC)
Well, SYN is a kind of OR. How is what I wrote OR? Its a rudimentary explanation of study design. --Middle 8 (contribs • COI) 03:25, 8 September 2014 (UTC)
In my impression, it is typical for you to call every edit that doesn't please you as OR. I can tell that from my own experience when you have failed to explain even I have asked you. You must learn to explain why you consider some specific edit as OR. That kind of editing is not helpful even despite of the good intentions. Jayaguru-Shishya (talk) 19:46, 8 September 2014 (UTC)
You were previously told you need a reference for when you made an edit to the lede on 31 August 2014. You made similar edit on 7 September 2014 and here we are again at the talk page. For starters, I previously explained here that the part "that indicates a lack of effectiveness" was SYN/OR. I assume you read my comment when you made these comments but you still ask what was the original research. Your edit was also not a summary of the body in accordance with lede. Do you agree you will stop adding original research to this article? QuackGuru (talk) 03:47, 8 September 2014 (UTC)
Right, Doc James said that this edit of mine needed a reference, so in this edit I used Madsen as a ref (for sham as faux needling), and fact-tagged the other bit about sham at faux points (which should be easily findable). What's the problem?
Re OR, you're saying that this is OR: "when real acupuncture is found to be no better than sham acupuncture, that indicates a lack of effectiveness (i.e., compared to placebo)." WHAT??? Sham acu is the placebo! So my statement is the same as saying "when a treatment is no better than a placebo, the treatment is ineffective," which is about the same as saying "the sun is a big bright ball in the sky!"
I will address the diffs you cite above in another post. --Middle 8 (contribs • COI) 10:56, 8 September 2014 (UTC)
QuackGuru, you are making untruthful claims here. You said: "For starters, I previously explained here that the part "that indicates a lack of effectiveness" was SYN/OR.", but when taking a look at at the diff, you do not explain anything. Why do you do this? In that diff you merely repeat your opinion that it was SYN/OR. Where are the explanations that it is SYN/OR? Not only you fail to communicate yourself here, your diffs are misleading and disrupting the development of this article. Jayaguru-Shishya (talk) 19:46, 8 September 2014 (UTC)
https://en.wikipedia.org/Acupuncture#cite_note-Madsen2009-13
That text for Madsen2009 is in a note towards the bottom of the page. It does not belong in the lede.
This is the first sentence: Acupuncture (from Latin, 'acus' (needle) + 'punctura' (to puncture)) is the stimulation of specific acupuncture points along the skin of the body involving various methods such as penetration by thin needles...
The text for non-acupoints does not belong in the lede and the reader already knows that acupuncture is stimulation at acupoints. Therefore, at non-acupoints it is not traditional acupuncture.
The part "when real acupuncture is found to be no better than sham acupuncture, that indicates a lack of effectiveness (i.e., compared to placebo)." is OR and had no citation at the end of the sentence. Do you understand now that you are replacing sourced text with OR and with text that did not summarise the body? The previous wording was sourced and is a summary of the body. QuackGuru (talk) 15:31, 8 September 2014 (UTC)
@QuackGuru: - Re Madsen, it sounds like you're objecting to my making a change simply because it changed something you'd written earlier. Madsen is a source explaining what sham is, and my edit used it that way, while you used it as a footnote. Either is acceptable. Yes, sham is different from real acu, and is a control, hence the need to explain the difference to the reader, since research is a hot topic. (There being two kinds of sham: faux needling and faux points.)
QG, no, I don't agree with you about your take on OR. Paraphrasing a source or explaining how a simple concept like a scientific control works with acu is not OR. --Middle 8 (contribs • COI) 20:19, 8 September 2014 (UTC)
Sham is placebo. We don't need a source for that, just like we don't need to cite Galileo Galilei when we say that the world is round. QuackGuru, you have been notified by admin NuclearWarfare already before about not getting stuck with specific wordings. You show complete incompetence to paraphrase sources when it comes to your comments. It's not helping to develop the article. Jayaguru-Shishya (talk) 19:46, 8 September 2014 (UTC)
@Jayaguru-Shishya: - Great analogy! BTW, I agree (entirely!) re the importance of not getting stuck over specific wording, but I don't read the diff from NW as commenting on QG's wording. --Middle 8 (contribs • COI) 20:06, 8 September 2014 (UTC)
Oooh, perhaps I have understood something wrong about it? :O I guess I have to take another look. Jayaguru-Shishya (talk) 20:21, 8 September 2014 (UTC)

I previously explained The part "when real acupuncture is found to be no better than sham acupuncture, that indicates a lack of effectiveness (i.e., compared to placebo)." is OR and had no citation at the end of the sentence. Middle 8 claimed "QG, no, I don't agree with you about your take on OR." Middle 8 was not paraphrasing a source and the edit violated lede. See WP:CIR. QuackGuru (talk) 22:06, 8 September 2014 (UTC)

@ QG - I already explained my view re OR and will only add that we have plenty of sources on study design and don't need to source every statement in the lede, especially obvious ones. CIR? Give me a break; you totally misread OR. --Middle 8 (contribs • COI) 11:21, 9 September 2014 (UTC) ...... comment moved to proper section 11:29, 9 September 2014 (UTC)
A study design in not a summary of the body and the edits were largely OR. The previous version before your edit was sourced. Your view on OR is to WP:IAR? QuackGuru (talk) 15:48, 9 September 2014 (UTC)
Not "a" study design. The general concept of a scientific control, as underlies all sham studies, where sham is the placebo control. --Middle 8 (contribs • COI) 16:20, 9 September 2014 (UTC)

Important: Could you clarify?

Hi QG, this is important, so please read it and respond.

At WT:MEDRS you wrote:

"To clarify, we do cite the systematic review 2011 not the older Suarez-Almazor 2010 source for the text. We usually don't use randomized controlled trials (RCTs) as good MEDRS. We typically use the reviews who cite the RCTs and/or other sources."

First question: This sounds like you're acknowledging that when we cite Ernst '11 in the lede, we are citing it as a summation of what Suarze-Almador is saying, as opposed to his summary of the literature as a whole. Is that true? If not, could you explain your reasoning?

Second question: Would you please answer my question from WT:MEDRS, regarding your quote above -- and if not, again, could you explain your reasoning? Here:

"Are you agreeing that Ernst's statement "real acupuncture was no better than sham" can be cited for Suarez-Almazor 2010 and only for Suarez-Almazor 2010? If you and other editors agree, then we can close this. (In no way to I dispute what Ernst's view of the bigger picture is)."

Thanks! Since you're accusing me of misconduct at Kww's user talk, I'm sure he (let alone I) would very much appreciate seeing a straight, clear answer from you, in order to know you're being clear and aboveboard. We all want to de-escalate and avoid drama, and open communication is the best way to do that. Feel free to either answer here or just cut and paste this and reply at my user talk. Also for question #2, obviously, please go ahead and reply at WT:MEDRS. But please don't ignore either question.... they are very important, imo, to WP:DR right now. --Middle 8 (contribs • COI) 12:11, 8 September 2014 (UTC)

The above comment by Middle 8 was moved from my talk page to here.

We should cite the 2011 systematic review of systematic reviews for the text not the older source or another source. See diff. It is irrelevant to this discussion on Misplaced Pages what Ernst is citing for his conclusion. We should not continue to second guess MEDRS compliant sources and we should not use another source such as Suarze-Almador to cite the text. QuackGuru (talk) 15:31, 8 September 2014 (UTC)
@QuackGuru: QG, sorry, I don't understand what you mean. Both questions are "yes" or "no" questions. Could you start by stating "my answer to Middle 8's question one is and my answer to Middle 8's question 2 is ", and then briefly explain your reasoning if the answer to either is "no"? I'd appreciate that very much. I think the answer to both may be yes, and we disagree on how to frame Ernst '11 in the lede, but I want to be sure. Thanks for your help here. --Middle 8 (contribs • COI) 19:50, 8 September 2014 (UTC)
Suarez-Almazor, Maria E.; Looney, Carol; Liu, Yanfang; Cox, Vanessa; Pietz, Kenneth; Marcus, Donald M.; Street, Richard L. (2010). "A randomized controlled trial of acupuncture for osteoarthritis of the knee: Effects of patient-provider communication". Arthritis Care & Research. 62 (9): 1229–1236. doi:10.1002/acr.20225. ISSN 2151-464X. PMID 20506122.
Ernst, E.; Lee, Myeong Soo; Choi, Tae-Young (2011). "Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews" (PDF). PAIN. 152 (4): 755–764. doi:10.1016/j.pain.2010.11.004. ISSN 0304-3959. PMID 21440191.
What specifically does Ernst's statement "real acupuncture was no better than sham" refer to? It is not applicable to improving the acupuncture page whether Ersnt cited the Suarez-Almazor 2010 source for the text.
First question: It is completely irrelevant what Ernst cited. We don't question reliable sources.
Second question: According to MEDRS we cited recent reviews not RCTs or primary sources. We are using Ernst 2011 as a conclusion.
According to your Misplaced Pages:Disruptive editing you think we should not use Ersnt 2011 for sham verus real acu or it seems you think we should add context that is your own personal interpretation or add unsourced text to the lede. There is a footnote that explains what sham is. It is not a summary for text in the lede. QuackGuru (talk) 22:06, 8 September 2014 (UTC)
@ QG - (see below re your WP:KETTLE-ish "disruption" allegations.) See, I was hoping you'd just give a straight answer, not dodge the question by saying "It is not applicable to improving the acupuncture page whether Ersnt cited the Suarez-Almazor 2010 source for the text." It's this kind of unwillingness to have a simple dialogue that frustrates consensus-building, and is why I sometimes use bold edits: to try to get a productive discussion moving.
It makes a big difference what Ernst is referring to when he says "real acupuncture was no better than sham". Context matters, and to argue that it doesn't is not only tendentious, it's absurd. We can't just pick any statement made by Ernst in that review and then say "Ernst said that"; that's obvious. And of course we do say in the body that Ernst's statement is about more recent trials (actually just Suarez-Almador), so I think you know it is relevant.
I'm not saying Ernst is endorsing acupuncture at all; 2/0 got it exactly right at WT:MEDRS, and I agree Ernst's prediction is clear, is consistent with Suarez-Almador, and has largely proven correct. Nor do I want to keep sham out of the lede (obviously, per my last edit that so offended you). I'm just saying, let's get it right, per WP:ENC, and provide context.
All this argument over such a basic thing! No wonder most editors don't stick around here! --Middle 8 (contribs • COI) 12:24, 9 September 2014 (UTC)
To clarify: If we were to cite any given statement without context, we'd get contradictions: e.g. Ernst also said "The majority of the early reviews arrived at negative conclusions , while the majority of the 57 recent reviews were positive." That statement and the statement "real acupuncture was no better than sham" cannot both be true about the same thing. And of course the former (green) statement refers to the dataset (the 57 reviews) while the latter refers to the more recent trial by Suarez-Almador. So of course we need to say, in the lede, what Ernst's latter statement is referring to, and that's why Vzaak's bolf compromise edit from 9 July was accepted.
So here I am, explaining how context matters to the editor who just said that it didn't. I doubt that you actually believe your statement "It is not applicable to improving the acupuncture page whether Ersnt cited the Suarez-Almazor 2010 source for the text." But the kind of disingenuous tendentiousness exhibited in your comment attracts no warning from admins. I know very well that some admins read these exchanges. Apparently, striking a "skeptic" pose allows an editor to get away with actions that harm the encyclopedia: in this case, allowing a content error to remain in the lede. --Middle 8 (contribs • COI) 06:03, 15 September 2014 (UTC)
@QuackGuru -- I'll discuss those "disruptive" diffs of mine that you posted . First consider how dramatically you've affected the editing environment for anyone else here; see Wikichecker: acupuncture. You have 206 mainspace edits since May 29th. That's more than the next 10 editors combined. You dominate the article and you are not helpful at talk. Sometimes you don't reply, while ignoring other editors' concerns in mainspace: see above section, and here, and here. Or you reply inadequately, e.g. refusing to answer a simple question just above. Or you use the talk page in just plain odd ways, like here.
Under those circumstances, the occasional bold edit makes sense: see BRD: Cases for use. But you revert and then say I'm editing against consensus? Dude, a great deal of the "consensus" here is just you! Maybe the real problem is that I'm challenging your "ownership" and that pisses you off.
So here are the diffs, A, B, C, xx and D. (xx is a duplicate of B).
  • 8 July, A: Bold and justified, and worked out well: Triggered a debate resulting in another bold edit by Vzaak , which was accepted; see talk: Bold edit to resolve the issue. Vzaak's edit: "A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain real acupuncture was no better than sham acupuncture." Addresses my concerns re context in the lede nicely (cf. above) and was fine by others too. You liked Vzaak's compromise also; your words: "It is a good compromise with the in-text attribution." (Why the change of heart since?)
  • 27 August, Doc James reverts, being (almost certainly) unaware of earlier discussion & consensus. 30 August, I notice that and revert back to consensus version by Vzaak: . 31 August, Doc reverts again and opens discussion above at Talk:Acupuncture#Summarize. I join discussion and make mildly bold edit B, which is my first edit attempting to define sham for the reader and explain the simple concept of placebos and efficacy -- the stuff you think is OR. However Doc James once again reverts, wanting a source , which I assume was meant for the two types of sham.
  • On 1 Sept, I make a moderately bold edit, rewording to satisfy Doc James while being faithful to the spirit of Vzaak's compromise: edit C, i.e. A systematic review of systematic reviews of acupuncture for pain concluded that there is little evidence that acupuncture is an effective treatment, i.e. that real acupuncture may be no better than sham acupuncture. This is a different angle, a shorthand way of describing Ernst's feelings that the results of newer trials may well generalize to future research; my ES implies this but could've been clearer. Pretty simple idea, that in the future we may see the general result of real = sham.... but given your highly literal and narrow take on OR, you disliked this, of course. And less than 9 hours later, you reverted , and complained at Talk about how we'd covered this, somehow forgetting about Vzaak's compromise edit that we all liked (except Doc James who wasn't around for the discussion). At this point, I file at WT:MEDRS and continue to discuss above.
  • 7 September: Again to break an impasse I try a bold edit, this time improving on my edit B by using a source per request: edit D. This was like B except: (1) it partly sourced sham, using Madsen, which you'd added as a note to the header about sham as faux needling. (Yes, I know I changed your note around... it's a wiki). (2) I fact-tagged the other aspect of sham (faux points); not a disputed concept. (3) Removed Ernst's wording entirely -- and this I would not have done in hindsight, but the whole business of WT:MEDRS had me wikistressed and not thinking clearly. After "sleeping on it" I actually decided to self-rv, but you'd already done so. It would have been better to somehow retain the spirit of Vzaak's compromise, and I stand corrected, or rather reverted.
So all these edits are good ones, except part of D where I the outright removed of Ernst '11 rather than improving wording. I'm obviously sticking close to the consensus version and I'm improving rather than reverting outright. Yet you don't recognize good edits; you see only someone doing it differently than you, which you can't stand.
Why is it bad when I make changes, but not when other editors do? Others are outright reverting more than I am. Why do I get the special treatment of your clamoring to take me to AE?
Finally a general note: We need to remember that a certain amount of good-faith reverting is inevitable, and doesn't somehow "disrupt" the article when it's non-combative and infrequent, as here. In that situation, "disruption" just becomes a convenient excuse to go after "undesirable" editors (which is a bit reminiscent of when cops in places like Ferguson, Missouri arrest people for "trespassing" in public places, or "disorderly conduct" for peaceful gatherings).
So overall there's no disruption except in the world where you, QG, own this page and any challenge to your ownership is intolerable. You need to de-escalate with me specifically; don't ever do this selective evidence thing with me again . And you need to disengage from your extreme ownership of this page imo. --Middle 8 (contribs • COI) 16:24, 9 September 2014 (UTC) copy-edited 06:09, 15 September 2014 (UTC)
Don't worry, another user who quickly stopped by at the article, he also noticed the same thing. :-) Jayaguru-Shishya (talk) 17:31, 9 September 2014 (UTC) This comment originally came right after the final bullet point in my post above dataed 16:24, 9 September 2014. Moving it so that it's not splitting latter comment --Middle 8 (contribs • COI) 22:23, 15 September 2014 (UTC)

The text for the systematic review of systematic reviews was redundant. It was simplified into one sentence rather than have two separate sentences. The edits by User:Middle 8 did not improve the page. Ignoring WP:V and WP:LEDE is not productive. QuackGuru (talk) 16:33, 9 September 2014 (UTC)

And that comment takes the cake for IDHT, given how you just repeated yourself about those diffs so quickly after I discussed them in detail and refuted your claim. And no, omitting context is not redundant. Later. --Middle 8 (contribs • COI) 16:44, 9 September 2014 (UTC)
And those five diffs, how do they not improve the page? How do they ignore WP:Vand WP:LEDE? The thing that's not productive here is you. If you do not have the capability to communicate yourself, I'd advise you to choose an easier topic. I do assume good faith with you, but "The proverbial bull in a china shop might have good intentions, but he's clearly bad for business." WP:CIR Jayaguru-Shishya (talk) 17:36, 9 September 2014 (UTC)
I was not responding to your specific comment above. I was making a note about the redundant text and to explain to other editors that your edits violated V and LEDE. Middle 8 continued to violated original research and LEDE but does not acknowledge his mistakes. The reason he rearranged the part that real acupuncture is no better than sham is because he thinks the source doesn't support general statement. But the text is obviously sourced. QuackGuru (talk) 16:51, 9 September 2014 (UTC)

Outdated reviews in the article

Greetings! I tagged the source "Ernst, E. (2006)" for being outdated per WP:MEDDATE. The tag was first removed by 2/0 per "thank you, but this is a statement of history, not medicine; minor gmr", even it is used in the text to support claims on medical efficiency. The text says:

"Ernst also described the statement in a 2006 peer reviewed article as "Perhaps the most obviously over-optimistic overview ", noting that of the 35 conditions that the WHO stated acupuncture was effective for, 27 of the systematic reviews that the WHO report was based on found that acupuncture was not effective for treating the specified condition."

This can be found from the original review under the title "Clinical effectiveness". I don't really see why this would be about history, not efficiency. Anyway, the tag was later restored by user LesVeges until it got removed again by QuackGuru per "The source is a review and reliable.". QuackGuru, exactly. According to WP:MEDDATE:

Look for reviews published in the last five years or so, preferably in the last two or three years.

The source is a 2006 review used for claims on medical efficiency, and therefore it's outdated. The review is also used at the Efficiency section. I think the source should be removed and we should look for more up-to-date sources instead. :P Jayaguru-Shishya (talk) 10:45, 10 September 2014 (UTC)

Efficacy section
That particular statement is describing that particular WHO report and the state of research at that point in time. The text does not seem to be misleading. No opinion on other uses of the source. - 2/0 (cont.) 10:54, 10 September 2014 (UTC)
Isn't that what you can say on every mention of an outdated source? "Well, it reported the state of research at that point in time"? Science is accumulative in nature, and like WP:MEDDATE puts it, we should only use sources that are recent enough. I'd understand something like: "In the 1930's it was still believed...", but now we are dealing with a 2006 review in the Journal of Internal Medicine. The review goes about the medical efficiency, and as such it is used in the article. Not just the review is outdated, I wonder why we are including such statements in the Ethics section? Jayaguru-Shishya (talk) 11:32, 10 September 2014 (UTC)
You seem to be misreading my position.
More productively, do you have a suggestion for replacing each instance where the source is used? - 2/0 (cont.) 12:08, 10 September 2014 (UTC)
2/0, sorry if you feel like I was misreading your position, that wasn't my intention. To answer your question: no, I don't have anything to replace the source. As I said earlier, I think the source should be removed as an outdated one when it is used for claims on medical efficiency. If someone finds newer sources to support these claims, they'd be more than welcome. For statements like "Clinical practice varies depending on the country.", I think it suits just well. Jayaguru-Shishya (talk) 13:16, 10 September 2014 (UTC)
You are continuing to tag reliable sources even after consensus was reached the source is reliable for the claim. QuackGuru (talk) 16:59, 10 September 2014 (UTC)
QuackGuru, I'm very sorry but I have to agree with Jayaguru-Shisha on this one. Again, I appreciate how you cite everything you say on this here talk page, but in this instance I checked your links and don't see where any consensus was reached about this source. That's not the source he is talking about, it appears to be an older argument. I'm sorry if I'm mistaken when reading your link, but I see a different source that a few editors agreed upon, not this one. We need to tag sources older than 5 years and remove statements if they cannot be backed up with more recent sources. They may have been reliable in the past, but science moves fast and they are outdated now. You seem reasonable so I'm sure you can agree that we don't need any fossils decaying the page. LesVegas (talk) 03:45, 11 September 2014 (UTC)
We don't tag and delete sources just because they are older than five years. QuackGuru (talk) 03:50, 11 September 2014 (UTC)
Actually, that's not true, I see on acupuncture many times where this has happened. A few days ago, I went though and examined almost every single edit over the past year. Anyway, there are plenty of edits where outdated sources are removed. Please look here here here hereherehere and here. By the way, not to quibble, but most of those edits were yours. LesVegas (talk) 04:38, 11 September 2014 (UTC)
The older sources were removed when we had better sources. I deleted the older sources because I found another source. QuackGuru (talk) 04:45, 11 September 2014 (UTC)
Well that's exactly what we're trying to do with the tags. We are trying to find more current sources. Did you replace all the other sources with new ones too? Not that you're required to do that or anything, but I am just curious. But I think my links speak for themselves, and that you do agree old sources can't be used. LesVegas (talk) 04:56, 11 September 2014 (UTC)
No, first you should find other sources. If you can't find another source you should not tag the source or remove the source. QuackGuru (talk) 05:05, 11 September 2014 (UTC)
Now QuackGuru, be honest, did you do this in every instance? Did you replace the sources with new sources? Did other past editors in my list of links do it, such as Roxy the Dog or Jmh649? Not that you or they or anyone is required to do so, I don't see anywhere on WP:MEDDATE where it says you are required to replace outdated material with fresh material, only that sources should be 2-3 years old and definitely within 5 years old. I also don't see anywhere where you are required to tag it, I just think tagging is better than deleting it right away (which is what everyone in my list of links did.) To me, this seems very reasonable. I came onto this page tagging the article with a POV tag because all tags, used appropriately, are much more reasonable than the alternative. LesVegas (talk) 05:30, 11 September 2014 (UTC)
You should not delete any source because it is older. I previously explained to you that you should first find another source. QuackGuru (talk) 05:53, 11 September 2014 (UTC)
There is no such policy. We don't use outdated sources in the article. Jayaguru-Shishya (talk) 09:54, 11 September 2014 (UTC)
Of course we use older sources in articles. Only when a newer source is found we replace the older source with a newer source. QuackGuru (talk) 17:31, 11 September 2014 (UTC)
What about in these other instances? here here hereherehere and here If you could address all of these instances that would be helpful because I don't see that these were all replaced with new sourcing. Again, not that it's a requirement. I see nowhere in the policies where this is required, only that aged sourcing isn't allowed. But if we decided on a precedent somewhere, I don't see much evidence for it yet and am more than willing to hear your case out! LesVegas (talk) 17:52, 11 September 2014 (UTC)

According to LesVegas, QuackGuru is literally correct. QuackGuru (talk) 18:42, 11 September 2014 (UTC)

QuackGuru, I commended you earlier for citing everything you say, but when I actually click on what you cite, I have noticed that you repeatedly cite diffs which do not truly say what you claim. Please see WP:DISRUPTSIGNS for why this is a problem. When you do this repeatedly, as you have done recently by claiming a fellow editor has 4 reverts when he hasn't, when you falsely cite a claim of consensus, and when you say "do not delete any source because it is older" and I provide you diffs where you did just that, and you ignore them, it becomes problematic. I engaged in discussion with you on this thread for far too long. I repeatedly asked you questions and you repeatedly danced around them NOT GETTING IT and then you edited as you saw fit. I've been nothing but nice to you, but don't mistake that for being a pushover. LesVegas (talk) 04:24, 12 September 2014 (UTC)

Wang, Shu-Ming; Kain, Zeev N.; White, Paul F. (2008)

The source is an outdated one per WP:MEDDATE. Jayaguru-Shishya (talk) 19:27, 10 September 2014 (UTC)
Please don't move my comment again. QuackGuru (talk) 19:52, 10 September 2014 (UTC)
There is broad consensus to use the 2008 source. See Talk:Acupuncture#The_source_we_are_working_with_.5B39.5D. QuackGuru (talk) 17:31, 11 September 2014 (UTC)
Better not to WP:IDHT QuackGuru. You already made clear your stance at my Talk Page, where I replied to you that: "So far, it seems you, A1candidate, Middle 8, Doc James and I who have commented there. You and Doc James seem to be in favor of the source (even it's outdater per WP:MEDDATE), and I'd like to hear clarification from Middle 8 and A1candidate." Five editors commenting does not establish "a broad consensus", as you put it. Especially when User:A1candidateand User:Middle 8 are wished to provide clarification for their comments. And like User:Les Veges already said: "I checked your links and don't see where any consensus was reached about this source.". Jayaguru-Shishya (talk) 18:15, 11 September 2014 (UTC)
Actually, see my latest post here. What you pertain as "consensus" has nothing to do with the the source that is tagged as outdated now. The original source being used is expressed here by Doc James: . The replacement for it is being suggested here: . The original is still being used. You have also been noticed about this by user LesVegas. You are falsely claiming consensus.
. Anyway, the discussion about removal of Wang et al. (2008) is related to whole different uses of that source. At the moment, we are using an outdated source for medical claims. Cheers! Jayaguru-Shishya (talk) 18:30, 11 September 2014 (UTC)
Nope. See diffs. QuackGuru (talk) 18:39, 11 September 2014 (UTC)

Jayaguru-Shishya was informed of the disruptive editing at the acupuncture page in April 2014. User:Jayaguru-Shishya was restoring a tag to another sentence. Revert 1. Deleting tags. Revert 2. Restoring a lot of tags. Revert 3. Restoring QuackGuru's edits and deleting material. Revert 4. After making edit after edit it suggests there may be no consensus for at least some of the changes. QuackGuru (talk) 20:24, 11 September 2014 (UTC)

Indeed, how does a notice from April - when I just had started editing here - does have to do with the issue on your mind? However, you just got warned by administrator last week. If I was you, I'd keep extremely careful; I hope you will learn from your mistakes.
" Revert 1. Deleting tags"? I reverted the edits by user LesVegas, and I informed about this on his/her Talk Page. LesVegas agreed with my revert after the correction that I made. What's your problem with that?
"Revert 2. Restoring a lot of tags", what problem are you having there? As clearly stated in the edit summary after the 24 edits you made in a row: "Woa! 24 edits in a row! Anyway, I had the time to check up only the 4 first of your tag removals. The others should have be inspected as well. I'll recover the other edits you made with the next edit (even it took a lot of time)". Please state it clearly if you are unhappy with something. As these unsourced sentences are tagged, I and the rest of Misplaced Pages community has a change to review if those sources given later really do not verify the claims. I already removed some which I had time to take a look.
"Revert 3. Restoring QuackGuru's edits and deleting material" I reverted back to your edit :-) ! LOL!
Revert 4 ... ??? Jayaguru-Shishya (talk) 20:55, 11 September 2014 (UTC)
Where are the 4 reverts? I already showed 4 reverts. The 4 diffs show 4 reverts. I already discussed it that the sources are reliable for the claim. QuackGuru (talk) 21:04, 11 September 2014 (UTC)
Why do you ask "Where are the 4 reverts" when you quote them straight afterwards? ...and you actually keep pertaining to those over and over again...
Anyway, please answer now honestly QuackGuru ("yes" or "no"). First, are the sources outdated per WP:MEDDATE (older than five years) to support any medical claims? Second, are the sources in question used to support medical claims (MERDS)? ~Thanks. Jayaguru-Shishya (talk) 21:23, 11 September 2014 (UTC)

MEDDATE

The above section seems to have gone off the rails a bit, so I am starting a new one, with an admonishment to please stick to the talk page guidelines instead of sniping at each other (@Jayaguru-Shishya, @QuackGuru, @LesVegas).

My reading of the WP:MEDDATE guideline is right there in the header for the section: use up-to-date evidence. The bit about capturing a full review cycle seems key. The way we know that evidence is not up-to-date is that it has been superseded by a source of similar or higher quality; most of the time, updated sources will indicate that the text should be tweaked - scientific revolutions are rare. Rather than wholesale deleting verifiable material, I respectfully suggest that we use {{update inline}} and update the material as new sources are found. - 2/0 (cont.) 18:15, 12 September 2014 (UTC)

We don't wholesale delete verifiable material because it is older than five years and we don't tag sources older than five years. When newer sources are found then we update the material. You don't see on other articles editors tagging sources just because they are a bit old. Lost of articles have sources older than five years. The tag 'updateinline' wikilinks to Misplaced Pages:Manual of Style/Dates and numbers#Chronological items. That makes no sense. Tags for medical claims are only used to delete the source. QuackGuru (talk) 18:23, 12 September 2014 (UTC)
I agree with you 2/0. I think tagging the old sources is a lot better way than to just delete an outdated source straight away. This is how the other editors can easily pay attention to sources needing update as well. Jayaguru-Shishya (talk) 19:33, 12 September 2014 (UTC)
The tag you used is not about tagging older sources. I previously explained the tags are not relevant to medical claims and the tags for medical claims are typically used for deleting older sources when there are newer sources or for deleting unreliable sources. What is the benefit for a tag that wiklinks to Misplaced Pages:Manual_of_Style/Dates_and_numbers#Chronological_items? QuackGuru (talk) 19:38, 12 September 2014 (UTC)

2/0, I want to thank you for having the article protected and for moderating this discussion. Yes, I completely agree, tagging outdated sources is what needs to be done here. Science changes all the time and we need to find updated sourcing. I don't agree that tags for medical claims are only used to delete the course, that is only one potential outcome amongst several. More likely, we find a new source to back it up, or we modify whatever statement is being made based on whatever the newer sourcing says. But a tag buys us time to do that. And I may be wrong here, but in Misplaced Pages's policies and guidelines I don't see anywhere where it says we are required to tag it, only that old medical sourcing can't be used. I just feel that tags are a much more reasonable solution than just going out and immediately deleting everything outdated. LesVegas (talk) 18:38, 13 September 2014 (UTC)

You have not given a reason to tag numerous sources. You wrote "I don't see anywhere where it says we are required to tag it". There is no need to tag source after source. QuackGuru (talk) 18:53, 13 September 2014 (UTC)
My point was we could just outright delete them. Would you prefer that or the tag? LesVegas (talk) 19:14, 13 September 2014 (UTC)
It is not appropriate to suggest we delete solid MEDRS compliant sources and you know it is not required to tag sources. QuackGuru (talk) 19:19, 13 September 2014 (UTC)
Part of MEDRS compliance is MEDDATE. I'm going to ask kindly that you please don't twist my words. LesVegas (talk) 19:29, 13 September 2014 (UTC)
Do you think it is required to tag solid MEDRS compliant sources? QuackGuru (talk) 19:34, 13 September 2014 (UTC)
No, because a solid MEDRS compliant source meets all requirements for reliability, including MEDDATE. And thank you for deescalating your questions, and giving me an actual question. I do appreciate it QuackGuru. LesVegas (talk) 19:39, 13 September 2014 (UTC)
Even if a source is over 10 (or even 20) years old, it is still a solid MEDRS source unless you can present a newer source. QuackGuru (talk) 19:59, 13 September 2014 (UTC)
Yes, well there are exceptions made for history sections, Cochrane Library reviews that have been updated and seminal works in the field. If it's an area where few reviews are being published in the field, then it's okay. If other, newer reviews are published, we use those instead and delete the older reviews. First we should tag them, though. And all other cases MEDDATE says we want sources to be within the last 5 years, but preferably the last 2-3. Further, review articles should use recent primary studies. I'm afraid I have to disagree with keeping it because it was once a solid MEDRS source. Some of these sources are aged rockstars with potbellies trying to sing well past their prime. LesVegas (talk) 20:47, 13 September 2014 (UTC)
I think you are still missing the point of MEDDATE, LesVegas and Jayaguru-Shishya. The timespans are given to provide context for what the guideline means by "recent"; the term is relative, and interpretation could be a point of contention if that context were lacking. A source is only actually outdated and in need of replacement if the research has moved on; that is why the focus on capturing a complete review cycle - different fields update at different rates. If further clarification is required, WT:MED or WT:MEDRS should be able to provide. - 2/0 (cont.) 21:24, 13 September 2014 (UTC)
Yes, MEDDATE does talk about looking for reviews within one full review cycle. But only relying on the idea of a review cycle creates a great deal of ambiguity. What are the date ranges we should be using? Do date ranges then not apply at all? This seems especially inapplicable since, worldwide, the acupuncture literature is updated on a very regular basis. Further, we have seen a recent increase in the reporting standards in acupuncture literature due to the STRICTA checklist becoming the official extension of CONSORT in 2010. Many reviews published before that time used studies which used poor quality reporting standards. Not all literature follows CONSORT, but now there's defined parameters, we know if they do not follow it, they can be criticized for not doing so. Coincidentally, it is now nearly 2015, and it's been five years after the adoption of these standards. All the more reason for us to follow Misplaced Pages's MEDDATE guidelines of 5 year maximum lifespan, there actually is wisdom in these numbers. Of course, I don't mind replacing the outdated literature with newer stuff myself. But when we're not sure if there's newer stuff, we should use {{update inline}} so we can get other editors on board to check. LesVegas (talk) 00:38, 14 September 2014 (UTC)
I previously explained that tag links to Misplaced Pages:Manual of Style/Dates and numbers#Chronological items. That makes the tag irrelevant to medical claims. You want to use a tag that is not applicable? Until there is a newer source the current source is reliable. QuackGuru (talk) 00:44, 14 September 2014 (UTC)
No it doesn't. Update inline wikilinks to here, explaining it needs an update. LesVegas (talk) 00:51, 14 September 2014 (UTC)
This is the Template:Update inline. Click where it says . When you click on the tag it links to Misplaced Pages:Manual_of_Style/Dates_and_numbers#Chronological_items. Click on the tag. QuackGuru (talk) 01:02, 14 September 2014 (UTC)
OK, you're right, when you click on that it does go to Manual of Style. I do apologize. But it does indicate there the need for updating, which is helpful. Alternatively, I see that we could use the tag, and since the source falls outside the range, it violates one aspect of MEDRS. Any opinions? LesVegas (talk) 01:18, 14 September 2014 (UTC)
The Update inline tag does not indicate there a need to use a newer source. That is not what the tag is used for. I created the MEDRS tag to tag an unreliable source. You haven't shown what source is unreliable. QuackGuru (talk) 01:32, 14 September 2014 (UTC)

The contention that a source is outdated needs to be supported by a more current source. Per MEDRS, "These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or few reviews are being published." Consideration of the level of quality of the source is also appropriate, a brand new low quality source carries less due weight than a solid high quality source that is not as recent. Another consideration is the weight given the source in other publications. If an older source is frequently cited by recent publications it still carries weight. - - MrBill3 (talk) 05:53, 14 September 2014 (UTC)

Like I stated here at WP:Med, "I think that WP:MEDDATE is clear on the matter; we should not remove a medical source simply because it's not published in the last five years or so. Unless, of course, more recent reviews are available. But WP:MEDDATE points out, "Within this range, assessing them may be difficult. While the most-recent reviews include later research results, do not automatically give more weight to the review that happens to have been published most recently, as this is recentism." And it gives space to areas that are less researched, stating that sourcing "may need to be relaxed in areas where little progress is being made or few reviews are being published." My opinion on the particular case you are citing is that "we leave it alone until newer sources of similar caliber are identified." Flyer22 (talk) 17:03, 14 September 2014 (UTC)
The steps to take are fairly obvious to anyone used to dealing with MEDRS:
  • If a source is more than about five years old (less where the literature is extensive, more when it isn't), then identify the quality of the source by using the guidance at MEDRS.
  • Next start examining the best literature for a newer source of the same or better quality. Again MEDRS indicates what sort of journals and what type of secondary sources represent the highest quality.
  • If no newer sources of the same or better quality exist, then the old source remains the best we have and will stay. Never replace a source with one of a lower quality even if that one is newer. Never delete a source purely on the grounds of age. In some fields that I am familiar with, the seminal work was done 70 years ago.
  • If there is a newer source of equal or better quality, then see if the content needs to be amended (often a newer review comes to the same conclusions as the previous one). If no change is needed, you can just replace the older source.
  • If the newer source of equal or better quality indicates an amendment to the content, then make the changes and replace the old source with the new one. At that point, you will probably find you may have to justify both your summary of the newer source and your assumption that the newer source is no worse than the older one it replaces.
The purpose of tagging is to attract more editors to an article; it is not to cast doubt on the content. If there is a lack of editors engaging at a particular subject, then tagging is justified; otherwise it isn't. In this case {{update}} and its section- and inline- variants really isn't the tag to warn of potential problems with MEDDATE.
In the event of disagreement, the article talk page is the first place to discuss issues. The talk page at WT:MED is watched by a editors with a broad range of interests and considerable experience with MEDMOS and MEDRS and is probably the best place to seek further opinions related to those topics. --RexxS (talk) 17:57, 14 September 2014 (UTC)

Okay, so now we have discussed the interpretation of MEDDATE and how strictly we should follow the 5 year limit. How about the {{inline update}} tag, what's the sentiment on that one? QuackGuru and RexxS seemed to agree that it should not be used. 2/0 said at some point that we can use it though. How about MrBill3 and LesVegas, what's your opinion? Jayaguru-Shishya (talk) 14:20, 21 September 2014 (UTC)

I was trying to reach for a compromise, but the consensus is crystal clear on both tags. - 2/0 (cont.) 16:06, 21 September 2014 (UTC)
I see the discussion going on about the {{cn}} tags, but not about the {{update inline}} tags. That's why I am asking for clarification from MrBill3 and LesVegas actually. I'd suggest that let's wait for their answers (and why not anybody else aswell) first. =P Jayaguru-Shishya (talk) 16:18, 21 September 2014 (UTC)
I don't think the "update inline" tag is appropriate unless there is good reason to believe the material has been superseded by more recent quality references. Perhaps when there are several recent lower quality sources and a more current review/meta-analysis is expected. The tag might be appropriate when there is a updated Cochrane review to call attention to an editor who has full access or another high quality source is available but not free, thus calling attention to the content so an editor with access can update it. For content that there is no more current, high quality source the tag is not appropriate. It is to call attention for editors to update the content from more current sources, not to insert an editor's opinion that the subject of the content should be studied again. If the academic/medical community considers the subject important enough or the earlier results/conclusions currently inadequate new studies will be done and they will be analyzed and discussed, otherwise the tag is based on WP editors' opinions. TLDR: MEDDATE and WP policy defer to the scientific consideration of the medical/academic consensus. - - MrBill3 (talk) 07:27, 22 September 2014 (UTC)

Mao's "new acupuncture"

This material is directly supported by the source immediately following it. I might phrase it slightly differently, but that can wait until the article is unlocked. Would there be any objection to restoring the material through protection? - 2/0 (cont.) 18:43, 12 September 2014 (UTC)

Check the article history. A lot of text was deleted. We should go back to before the controversial edits were made. QuackGuru (talk) 18:52, 12 September 2014 (UTC)

Early superstition

The source given for this material appears to be in Chinese, but the text itself is readily supported by Taylor 2005 later in the paragraph. Would there be any objection to restoring the text using that as a source? - 2/0 (cont.) 18:49, 12 September 2014 (UTC)

We can request to go back to this version to fix all the problems rather than continue arguing or we can wait for the article to be unprotected. QuackGuru (talk) 18:56, 12 September 2014 (UTC)
Good. I find it important that the {{cn}} tags are kept. That helps the editors to evaluate the text and whether it's properly sourced or not. Jayaguru-Shishya (talk) 19:33, 12 September 2014 (UTC)
There is even unsourced text in the lede for mundane claims. The tag was used to delete the text. The tag is for editors. It is not for readers. QuackGuru (talk) 19:42, 12 September 2014 (UTC)
@Jayaguru-Shishya: I am having trouble parsing your comment as pertains to this discussion. Do you support restoring the text you removed using the source I verified? Do we have consensus to use {{editprotected}} to edit the material back into the article? - 2/0 (cont.) 17:38, 14 September 2014 (UTC)
I don't think we need a edit protected request. The incompetent editors who deleted sourced text and/or tag MEDRS compliant sources need a vacation from this article. If you insist on an edit protected request I support a larger revert before the incompetent edits were made. See Talk:Acupuncture#Larger revert. QuackGuru (talk) 17:48, 14 September 2014 (UTC)
Sorry for the late answer 2/0. Yes, we can use Taylor 2005 in order to restore the text. Would you suggest the old phrasing or something else? For example, the source goes as follows:

Mao called for the 'co-operation of Chinese and Western medical doctors' in Yan'an in 1944, but was not explicit as to how such a co-operation might be achieved. His slogan was interpreted as a general 'scientification of Chinese medicine and popularization of Western medicine. In order to remove the feudalist and superstitious elements of Chinese medicine, some physicians attempted a rigorous transformation of the medicine according to the foremost precepts of the Communist revolution, i.e. those of the 'new', 'scientific', and 'unified'. Acupuncture came to represent this 'new' medicine largely because of its practical value during wartime. The term 'new' implied free from superstition and the heavy links to a feudal past. Instead of the components of the new culture would have to be forward-moving and enterprising. Mao advocated that such a change would be possible through the use of 'science'. By 'science' Mao was not so much referring to the science linked with the Western investigation of nature, but more to the Marxist ideal of science as the criteria for true knowledge. For Mao stated that 'this type of new democratic culture is scientific. It is opposed to all feudal and superstitious ideas: it stands for seeking the truth from facts, it stands for objective truth and for unity between theory and practice'.

The edit protect, I think the "Edit protected" template is not needed as long as we don't have to make a mass revert back to the version where all the {{cn}} tags were removed. It's much easier to make fixes to the current version rather than the version some 24-29 edits (?) ago. Cheers! Jayaguru-Shishya (talk) 17:52, 15 September 2014 (UTC)
The old phrasing or something else is not relevant to this discussion. It is much easier to revert back to the version before the mass tags were restored all over the place and before you deleted sourced text. You deleted sourced material per what? QuackGuru (talk) 18:39, 15 September 2014 (UTC)
Focusing specifically on this discrete improvement to the article, I find the old text adequate but would not object to something else along the same lines. That whole section could use more detail anyway.
@QuackGuru: if we decide to do a larger revert, the edit proposed here will just be subsumed in it - no harm done, easily fixed. In the meantime, it looks like we are much closer to consensus that this material improves the article. Would you be open to providing this material to our readers now while we finish discussing everything else? - 2/0 (cont.) 19:13, 15 September 2014 (UTC)
There never was consensus in the first place to delete the text or add tags all over the place. You can request WP:UNPROTECT now and we can move on. QuackGuru (talk) 19:21, 15 September 2014 (UTC)
No tags have been added, the existing ones just have been restored. Jayaguru-Shishya (talk) 19:30, 15 September 2014 (UTC)
I previously explained I self-reverted my own edit. Now you have to explain why you want tags everywhere. Are you adding tags to other articles? QuackGuru (talk) 18:44, 16 September 2014 (UTC)
Perhaps you should try to follow up the discussion more carefully, QuackGuru? Please see the latest discussion here. A quote from there: "I still can't understand, however, why {{cn]] tags are being removed from sections where obviously no sources have been given. (See Acupuncture#Theory)." Jayaguru-Shishya (talk) 18:57, 16 September 2014 (UTC)
I previously asked, "Are you adding tags to other articles?" Apparently not. QuackGuru (talk) 19:01, 16 September 2014 (UTC)

Protected edit request on 12 September 2014

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Listed on Add "|displayauthors=9" where 9 authors are listed in a citation. Hamish59 (talk) 19:00, 12 September 2014 (UTC)

This can be done after the text is restored otherwise it may make it difficult to revert back to the previous version. QuackGuru (talk) 19:14, 12 September 2014 (UTC)
 Done. If we revert over the change, it is easy enough to fix. - 2/0 (cont.) 19:16, 12 September 2014 (UTC)
I think "|displayauthors=4" is preferable there is no need to list nine authors. Four is pretty much standard on WP. Just my 2¢. - - MrBill3 (talk) 05:43, 14 September 2014 (UTC)

Larger revert

Above, QuackGuru suggests that we revert to an earlier version of the article and discuss from there; diff of convenience. It looks like that would quell a bit of cite-bombing basic aspects of the article (good), some update-inline (discussed elsewhere), a restore wikilink to Quackwatch (I think that is the first instance in the article, so linking is indicated), and restore the three edits I just mentioned as accurately cited. A wholesale revert to this version would be fine with me, or we can work on it piecemeal. - 2/0 (cont.) 19:05, 12 September 2014 (UTC)

I think it'd be much easier to keep working from the current version of the article. The alternative would be this large wave of 24 subsequent edits. These edits have not been discussed at all. Compared to that, restoring three edits is a lot easier option. Jayaguru-Shishya (talk) 19:55, 12 September 2014 (UTC)
You wrote "These edits have not been discussed at all." So where is the previous discussion or consensus for the tags in the first place? I undid my own edits when I removed the tags. QuackGuru (talk) 19:57, 12 September 2014 (UTC)
"I had the time to check up only the 4 first of your tag removals. The others should have be inspected as well. I'll recover the other edits you made". Clear and simple, if there is a claim that we have unsourced material in the article, sure it needs to be inspected. Indeed, you could easily have explained at the Talk Page if you found unnecessary {{cn}} tags. Jayaguru-Shishya (talk) 20:08, 12 September 2014 (UTC)
You have not given a reason to have the unnecessary tags and they should be removed or do you want to delete more text? I explained it in my edit summary I undid my own edit. Were the tags discussed? See here. I was only undoing my own mistake. QuackGuru (talk) 20:20, 12 September 2014 (UTC)

2/0, I wouldn't mind reverting back to that version and taking out and altering problematic edits as you and QuackGuru suggest. However, this does bring up a larger question: when someone makes 24 rapid-fire, unchecked edits, in my view it becomes impossible not to do anything other than what Jayaguru-Shishya did in his large revert. If, out of those 24 edits, let's say 16 were good quality uncontroversial edits. How could an editor possibly handle what he thinks are 8 problematic edits piecemeal without going over the 3RR? I'm really not trying to bring up old history here, but old history is once again new history, as some other editors mentioned this sort of issue before so it seems that going forward we need something solid in place to prevent incidents like this from happening again. Jayaguru-Shishya, do you think that's a reasonable solution? Do you think we could revert back and discuss all the problematic edits? QuackGuru, what do you think could be done to prevent things like this from happening again? Or am I off base here? LesVegas (talk) 19:06, 13 September 2014 (UTC)

You haven't justified your revert. There was no 24 rapid-fire edits. QuackGuru (talk) 19:12, 13 September 2014 (UTC)
QuackGuru, you're right it wasn't 24 edits, it was actually 29. I'm trying not to go there again with you, I'm trying to have a reasonable discussion this time. LesVegas (talk) 19:24, 13 September 2014 (UTC)
QuackGuru also catches flak for making multiple changes in a single edit. I am sure neither of you, Jayaguru-Shishya and LesVegas, would bring such a complaint since it would be wildly inappropriate to try to institute a backdoor article ban in that way. Laziness is not a valid reason to revert, and the suggestion that it is smacks of trying to own the article content. We have a history function and there is no deadline.
To move the discussion back where it belongs, focusing on the content rather than the contributor: I did actually take the time to sort through the series of edits in question. It was neither difficult nor particularly time-consuming. The edit summaries were accurate and the content changes relatively simple and straightforward. Are there any policy-based objections to the changes? - 2/0 (cont.) 21:08, 13 September 2014 (UTC)

We have now had four independent MEDRS-savvy editors weigh in on tagging older sources where no better source has been identified. Does this give us consensus to go back to here and work from that base? - 2/0 (cont.) 11:55, 16 September 2014 (UTC)

There is consensus to go back this version and continue to improve the article. QuackGuru (talk) 15:17, 16 September 2014 (UTC)
You are right, I should have linked to the version sans tags. - 2/0 (cont.) 15:37, 16 September 2014 (UTC)
Well, it's possible to continue editing even if a larger revert is made. I still can't understand, however, why {{cn]] tags are being removed from sections where obviously no sources have been given. (See Acupuncture#Theory). The content of this edit (Acupuncture#Effectiveness) should equally be restored. Jayaguru-Shishya (talk) 18:35, 16 September 2014 (UTC)

Efficacy and Safety of Needle Acupuncture for Treating Gynecologic and Obstetric Disorders: An Overview

Any thoughts on using this source for stating/supporting that the evidence for use for pelvic and low-back pain during pregnancy, pain during labor, primary dysmenorrhea, and menopausal symptoms is inconclusive? - 2/0 (cont.) 00:43, 16 September 2014 (UTC)

We don't need any more fringe journals. If we allow this then we can expect a huge flood. QuackGuru (talk) 02:46, 16 September 2014 (UTC)
Works for me, thanks. - 2/0 (cont.) 11:45, 16 September 2014 (UTC)
For effectiveness we have plenty of sources. For other sections it is a case by case basis. Sometimes we can use fringe journals to fill in the blanks. The flood is over for now. QuackGuru (talk) 15:20, 16 September 2014 (UTC)

Quick MEDMOS fix

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At the end of the first paragraph of Acupuncture#Clinical practice, the sentence "For the majority of cases, the needles will stay in place for 10 to 20 minutes while you are lying still" should be replaced with "For the majority of cases, the needles will stay in place for 10 to 20 minutes while the patient remains still" per WP:MEDMOS. - 2/0 (cont.) 18:07, 16 September 2014 (UTC)

I think it should be person rather than patient. QuackGuru (talk) 18:25, 16 September 2014 (UTC)
Or just end the sentence after "20 minutes"? - 2/0 (cont.) 18:28, 16 September 2014 (UTC)
The person is also lying down. QuackGuru (talk) 18:30, 16 September 2014 (UTC)
The acupuncturist is presumably also a person, though.
What if we combine with the penultimate sentence: "A typical session entails lying still while approximately five to twenty needles are applied and left in place for ten to twenty minutes."? - 2/0 (cont.) 19:19, 16 September 2014 (UTC)
The two sentences are making separate points.
If you still don't like the word person we can use another word.
"For the majority of cases, the needles will stay in place for 10 to 20 minutes while the individual is lying still." QuackGuru (talk) 20:05, 16 September 2014 (UTC)
The points are different but not disparate. Having the extra clause in there breaks up the flow of the sentence in a somewhat awkward manner. Combining the sentences also helps with the synonym problem - we use "typically", "common", "regular", and "majority" in those four sentences cited to the same source to describe how a session usually progresses. We could try: "A typical session entails lying down while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes." - 2/0 (cont.) 21:46, 16 September 2014 (UTC)
"A typical session entails lying still while approximately five to twenty needles are inserted; for the majority of cases, the needles will be left in place for ten to twenty minutes." QuackGuru (talk) 22:03, 16 September 2014 (UTC)
Very important this. Think of the complications that would ensue if the patient didn't lie still at a crucial moment, and the acupuncturist punctured the patient in the wrong place. Malpractice suits, treating patients for the wrong condition, it'd be awful. -Roxy the dog™ (resonate) 22:28, 16 September 2014 (UTC)
That wording looks good to me, thanks for working on this. - 2/0 (cont.) 23:32, 16 September 2014 (UTC)

A quick grammatical fix: the first clause of Acupuncture#Other conditions, "For the following conditions, the Cochrane Collaboration or other reviews have concluded there is no strong evidence of benefit for" should be replaced with "For the following conditions, the Cochrane Collaboration or other reviews have concluded there is no strong evidence of benefit:". - 2/0 (cont.) 18:27, 16 September 2014 (UTC)

Both Done. — Mr. Stradivarius 06:09, 17 September 2014 (UTC)
Your change differs slightly from the proposal. QuackGuru (talk) 07:16, 17 September 2014 (UTC)
Eh? It looks right to me - what is missing? - 2/0 (cont.) 10:59, 17 September 2014 (UTC)
There was an additional change made to the ref. No worries. I fixed it in my sandbox. QuackGuru (talk) 15:57, 17 September 2014 (UTC)

Regarding new consensus on MEDDATE's application

Hey all! I want to thank 2/0 for posting to the MEDRS board to get feedback regarding dating of sources. I also would like to ask questions amongst some editors here because there has been differing opinions on MEDDATE's application, even amongst individual editors here over time. Here is an example between this old diff which appears to have very different reasoning than this current diff. I would also like to highlight these edits hereherehere and here since they now differ with our current community consensus on how to apply MEDDATE to sourcing. Now I just want to make it clear, I'm not criticizing anyone or calling anyone a hypocrite because I believe we are all free to change our opinions, and hey, I happen to now agree, based on the reasoning of everyone at the MEDRS talk page. I also discovered this very subject was discussed during the drafting of MEDDATE With that in mind, I just want to get everyone's opinion on a matter. If this community now believes that we shouldn't regard the 5 year rule as sacrosanct how would everyone feel if I restored any of the content that was removed from any of the diffs showing removal of old sources, provided they are still reliable and there are no new updated sources on the subject? LesVegas (talk) 18:44, 17 September 2014 (UTC)

The old diff you cite shows you are mistaken. The ref that was older than ten years old and was replaced with a newer source. I already explained, that the older sources were removed because we are using newer sources. I don't see any reason to continue arguing about this. However, if a source was deleted that was not making a medical claim it could still be reliable. QuackGuru (talk) 19:36, 17 September 2014 (UTC)
New consensus same as the old - glad I am that we have that settled.
Your links and are arguing different points. Your protestation that you are not insinuating hypocrisy is appreciated.
: The 1997 consensus statement is now only of historical interest. We discussed this not so long ago.
: A banned tendentious sockmaster might on occasion make an edit that we would like to keep, but the present case is not the exception.
: "dated" is stronger reasoning than merely "old".
: I am not sure we should be according that source any weight anyway, but that is not a medical claim.
If you have a specific proposal for text or sourcing that should be added to the article, we should discuss that. - 2/0 (cont.) 15:34, 18 September 2014 (UTC)
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