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TCM based on science

I have found a source that says that "There is a strong scientific basis for traditional chinese medicine" in contrast to the article's current assertion (sourced to Quackwatch) that TCM isn't based on science. The source is this book, page 2, section 1.2. Does it seem reliable, and if so, more reliable than Quackwatch? It was, after all, published by the Royal Society of Chemistry.Everymorning talk 00:57, 27 April 2015 (UTC)

Wow, that is absolutely a very reliable source since it is a textbook published by the Royal Society of Chemistry. FYI, I'm not going to be available to discuss this at length due to real world circumstances right now, but for now I'll just pop in and say that, yes, anything published by the RSC that is specific to the topic of TCM is much more reliable than QuackWatch which is a POV pushing advocacy site. QuackWatch might be reliable for certain claims, but in this article any claim should always be attributed at the very least so that the reader knows where the information is coming from. Is it reliable for this claim, especially in light of this textbook from RSC? Well, I guess that will be for us to decide. Keep in mind, we also say in the lede that acupuncture founded on "pseudoscience" (and we use a pro-acupuncture source out of context to say that, big stretch with out sources!) As I see it, we have several options: option 1 is we use the source next to Quackwatch and others in the lede for parity. Option 2, we delete claims coming from Quackwatch and other one-sided sources because they might not be able to hold their weight next to a source like this. Option 3 we use the source and don't delete claims by Quackwatch and others, but we attribute those to let the reader know where the statements are coming from, in all cases. Option 4 we don't use a high quality source like this and edit war anyone who tries adding it in, yet keep bending sources to make the article appear that all things Chinese medicine are pseudoscience and keep doing this until someone files an RfC. ANywho, those are the options as I see them and I'm not sure which one I'm for yet, three of them seem reasonable, one terrible. LesVegas (talk) 01:43, 27 April 2015 (UTC)

Nobody mentioned Option 5 - we could, you know, examine the source, to um, see if it is any good. I have a small but exciting wager on the outcome. -Roxy the Viking dog™ (resonate) 03:00, 27 April 2015 (UTC)

But wait, Option 5 looks a whole lot like Option 4 especially since you did't even bother to say why a textbook published by RSC would be unreliable. I have a little time this morning to discuss this so if anyone would care to add something, let's hear it before we add the source in. LesVegas (talk) 15:45, 27 April 2015 (UTC)

It's certainly not a preferred source for medical topics. I also note that it includes an internal disclaimer that its contents are not endorsed by the RSC.—Kww(talk) 04:23, 28 April 2015 (UTC)

Sorry, KWW, but it looks like the RSC uses that as a standard disclaimer on all their newer publications. like this one and this one or this one. So perhaps since this source is rock solid after all, the conversation should begin to move towards how and where we add it in and what lower quality sources should be deleted with this taking its place? LesVegas (talk) 19:16, 28 April 2015 (UTC)

If they disclaim it, they disclaim it, so they are not relevant to determining the reliability. Any discussion of reliability can only pertain to the actual author and whether this particular material has survived peer review.—Kww(talk) 05:41, 29 April 2015 (UTC)

They disclaim every book. What is nothing published by RSC reliable now?. MEDRS states that the publisher matters (in cases of a low quality publication) but says nothing about standard legal disclaimers. But if you find something in MEDRS or any policy or guideline that states otherwise, feel free to add that to the discussion before we add this source into the article. LesVegas (talk) 14:06, 29 April 2015 (UTC)

No, but the source has to be evaluated on the merits of the author, not the publisher. If they disclaim it, they disclaim it. Given that it is so clearly a fringe view and not supported by the publisher, it doesn't merit inclusion.—Kww(talk) 18:40, 3 May 2015 (UTC)

KWW, I gave you several examples of RSC using that disclaimer in all their current texts. I could give more, but I have to assume you will ignore those as well. That issue isn't going away. Iff you want to have a discussion as to whether or not anything currently published by RSC is unreliable, we can have that discussion. As I see it, it is your burden to show that standard legal disclaimers are unreliable in Wikilaw. LesVegas (talk) 19:00, 3 May 2015 (UTC)

Just popping in to this discussion. Actually, both of them matter, but even meritorious authors might have published a lot of nonsense that have never passed the scrutinizing eyes of a notable publication. Therefore, we are highly interested in the publisher, but of course, the both have to match. Jayaguru-Shishya (talk) 17:15, 4 May 2015 (UTC)

I'm sorry that you don't understand the meaning of a disclaimer, but it's pretty straightforward: the RSC's reliability is irrelevant to the discussion. Doesn't mean the source is unreliable, but it doesn't mean it's reliable, because they have disclaimed responsibility for the material. If you believe such a ludicrously fringe view to be from a reliable source, you will have to defend its inclusion based on the authors expertise, not the publisher.—Kww(talk) 19:10, 3 May 2015 (UTC)

I have changed it to "Some scientists believe that the theories basis of TCM are poorly understood in the West". Is this a good enough compromise, User:Kww? We are not stating that TCM has a scientific basis whatsoever. User:Mann jess your input here would be helpful too. -A1candidate 19:42, 3 May 2015 (UTC)

I think the basis of TCM is well understood in the West: it's based on folklore and superstition. It isn't science, isn't based on science, and shouldn't be described as being on par with science. Describing it as "poorly understood" implies that it has some unappreciated merit. It doesn't. Your edits leave the reader with the false impression that there is some legitimate scientific controversy about TCM.—Kww(talk) 19:53, 3 May 2015 (UTC)

Well, I live in the West. And I certainly don't understand the theories of TCM. -A1candidate 19:54, 3 May 2015 (UTC)

All you need to understand about them is that they are entertaining folk superstitions at best. The specific details aren't important.—Kww(talk) 19:58, 3 May 2015 (UTC)

I'm afraid we have to disagree, because true skepticism entails understanding the contrary arguments, even if they are demonstrably wrong. -A1candidate 20:07, 3 May 2015 (UTC)

A1, it is my belief that a compromise isn't necessary, but I want to thank you for trying to be a peacemaker. The source is accurate and attributed and reliable according to every guideline I know of, other than the ones being made up on the fly here. At some point this page needs to stop having two sets of rules. I would never suggest a reliable source that criticizes acupuncture is unreliable based on a standard legal disclaimer, even though I have found some in our article. LesVegas (talk) 20:04, 3 May 2015 (UTC)

And, if you read carefully, I haven't suggested that a source is unreliable because it contains a disclaimer either. I've said that you need to make the case for reliability based only upon the parties that haven't issued disclaimers about the contents. You haven't made any effort to do so. As for the page having two sets of rules, it doesn't: sources representing mainstream scientific thought have precedence over mysticism and fringe science. That should be a fairly simple rule to comprehend and abide by. That you persistently wind up on the wrong side of it is a different issue.—Kww(talk) 21:15, 3 May 2015 (UTC)

The content you wish to include is diametrically opposed to the vast majority of the quality sources we have on the topic. Many of those are already cited, including, for example, Ernst. Systematic reviews show, at most, efficacy for reducing certain types of pain, and no results beyond placebo for other conditions. Impartial reviews of TCM indicate it is not science-based or evidence-based, and is almost wholly rejected by the scientific community as a result. Here is a source which sets out explicitly to show that TCM should be seen to have a scientific basis, despite that trend. So, is it reliable? Well, it is a source with a clear agenda: advocating for a minority (or, more likely, fringe) position that I don't see advanced elsewhere. I think the burden on demonstrating its reliability is therefore quite high for it to overturn our MEDRS compliant sources, and even if that were done, it would need to be given due weight, not exclusive weight, when describing the subject.   — Jess· Δ♥ 21:37, 3 May 2015 (UTC)

Coatrack?

An editor recently indicated in an edit summary that there was a WP:coatrack issue here. Rather than just leaving it rather lazily and not very convincingly in an edit summary, raise it here and let's discuss it properly.DrChrissy 22:35, 28 April 2015 (UTC)

DrChrissy are you talking about this edit? When you're starting a Talk page discussion it'd really be nice if you'd help out your fellow editors by specifying the particular edit you're concerned about (and by dropping unnecessary adverbs like 'lazily'). I'd actually disagree with the characterization of that section as a "coatrack" problem but I'd rather not do a whole lot of typing here if that's not what you're talking about. Zad68 02:05, 29 April 2015 (UTC)

@Zad68 Yes, that is the edit - I will be more specific in the future. Sorry about the use of "lazily". It just seems rather unhelpful for an editor to drive-by, leave the template with a negative edit summary and not even bother to take this to the Talk page. I'll curb my frustration in the future.DrChrissy 09:13, 29 April 2015 (UTC)

What do you think doc? -Roxy the Viking dog™ (resonate) 09:39, 29 April 2015 (UTC)

Are you talking to me? If so, please use my user name or I might be wasting my time replying.DrChrissy 09:54, 29 April 2015 (UTC)

Are there any other docs on this page at the moment? So, what do you think? Genuine question. -Roxy the Viking dog™ (resonate) 10:14, 29 April 2015 (UTC)

Please use my user name so that other readers can follow who you are asking a question of.DrChrissy 10:52, 29 April 2015 (UTC)

Sure Chrissy, thanks... No, the inclusion of a short summary section on Veterinary acupuncture isn't a coatrack problem. A general review of the reliable sourcing on acupuncture in shows that vet. acu. is well-represented. This acupuncture article is really getting to be quite sizeable and comprehensive, so it isn't undue here either. Per WP:SUMMARY there should be a section here summarizing what's at the vet. acu. article, or what should be in that article (it's tiny now and given the sourcing available it really could be expanded quite a bit).

The one thing that needs be done though is to move that section to the end per WP:MEDMOS. Actually generally this article needs to be restructured per MEDMOS. Zad68 13:34, 29 April 2015 (UTC)

It is my intention to work on the Vet Acu article soon and we can then provide a summary of that here. Happy to see the Vet Acu section moved toward (to) the end - I appreciate that is the style of medical pages.DrChrissy 14:16, 29 April 2015 (UTC)

@User:Zad68 I moved the Vet section to the end of the article as both you and I agreed, but another editor has moved it back. I believe I am being goaded into edit warring by this, so I will not revert but thought I should let you know.DrChrissy 17:35, 2 May 2015 (UTC)

@DrChrissy - I've restored it back to where it belongs. Hopefully, the disruption will stop. -A1candidate 18:20, 2 May 2015 (UTC)

You have not explained how your edits were an improvement, especially with restoring the MEDRS violations. This edit added misplaced text that is already in the article,. QuackGuru (talk) 18:23, 2 May 2015 (UTC)

It was a reasonable shortening of the article according to User:Sonicyouth86. We do have a section for related practices. See Acupuncture#Related practices. QuackGuru (talk) 01:20, 4 May 2015 (UTC)

Quick comment: I didn't mean to endorse your edits with my self-revert. I just meant that, on second thought, your deletion of sourced content didn't appear like clear-cut vandalism to me because you did provide edit summaries and participated in discussions, that's why I decided to undo my rollback. I'll let editors with deeper knowledge of the subject decide if your edits were constructive. --SonicY (talk) 01:35, 4 May 2015 (UTC)

Deletion of Quackwatch sourced statement

The lead paragraph contains the following statement "TCM theory and practice are not based upon scientific knowledge,<ref name=Barrett2007/>" I propose to delete this statement for the following reasons:

1)The source is outdated - how can this source represent present consensus when it is 7-8 years old.

2)The source is not/may not be peer-reviewed.

3)The source is from a web site with a blog-like approach

4)The source is a partisan site - not NPOV

5)The source is an opinion piece of just a single person and therefore the statement is WP:UNDUE

DrChrissy 10:56, 2 May 2015 (UTC)

Still reliable for our use, as explained to you multiple times by multiple users. Any more of this will be disruptive. -Roxy the Viking dog™ (resonate) 11:09, 2 May 2015 (UTC)

• Support - In addition to what DrChrissy said, we have much better sources including prominent medical textbooks such as Miller's Anesthesia, which says "A scientific basis may exist for acupuncture" (pg. 1235) and "When compared with placebo, acupuncture treatment has proven efficacy for relieving pain" (pg. 1235) or Oxford Textbook of Palliative Medicine , which says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266). This is the mainstream medical consensus, as stated in the NHS's description of acupuncture: "It is based on scientific evidence that shows the treatment can stimulate nerves" and in Chapter 14e of the latest edition of Harrison's Principles of Internal Medicine: "In addition, new research is shedding light on the effects of meditation and acupuncture on central mechanisms of pain processing and perception and regulation of emotion and attention. Although many unanswered questions remain about these effects, findings are pointing to scientifically plausible mechanisms by which these modalities might yield benefit." (pg. 14e-3) -A1candidate 11:11, 2 May 2015 (UTC)

Still reliable for our use, as explained to you multiple times by multiple users. Any more of this will be disruptive. -Roxy the Viking dog™ (resonate) 11:36, 2 May 2015 (UTC)

How can opening a discussion on a Talk page be disruptive! If you don't want to join in, simply walk away - the article content has not been changed!DrChrissy 11:40, 2 May 2015 (UTC)

Nothing wrong with a new discussion Doc, and I encourage you to open discussions on any topic you wish. But please stop opening new discussions on the same subject over and over and over again, especially when you already know the answer. That's disruptive -Roxy the Viking dog™ (resonate) 11:50, 2 May 2015 (UTC)

Firstly, as I have requested on several occassions before, please use my correct user name. Second, it has been suggested several times that the reliability of QW as a source needs to judged on a case-by-case basis. This is what I am doing. Neither you nor I know the "answer" as to whether the source is reliable in this particular case, therefore it can not be disruptive. Perhaps you would like to comment on any one of the 5 points I raised above, rather than trying to disrupt this thread.DrChrissy 11:58, 2 May 2015 (UTC)

QuackWatch is not reliable per se, and there's a firm consensus that it should be used only on a case-by-case basis. I think we could proceed by endorsing the steps of 1) paraphrasing the text in such a manner that there are no longer block quotes, and 2) considering whether acupuncture is a subject that hasn't attracted enough scientific research. If there's a rich variety of scientific research on the subject, then we don't want to include any claims so poor that haven't been even able to make their way through some notable peer-reviewed journal. Jayaguru-Shishya (talk) 12:39, 2 May 2015 (UTC)

• Oppose removal. Came here from posting on WT:MEDRS by DrChrissy. Quackwatch is reliable for its own opinion, and is generally considered reliable on alt med topics of which Acupuncture is one.Use of Quackwatch is appropriate here, but should not be overemphasized if better sources are available. I should caution against the cherry-picking of specific sources that may be "positive" or "negative" towards acupuncture, but to give the full spectrum of opinion by reliable sources per WP:WEIGHT, of which Quackwatch is one. Yobol (talk) 13:38, 2 May 2015 (UTC)

If and I quote: Quackwatch is reliable for its own opinion then using the same logic, DrChrissy opinion, that it is not, -nullifies QW's opinion. Oh come on folks- if my grand children came out with this muddled thinking I'd be on the phone to my lawyer to reclaim back their education fees!--Aspro (talk) 16:07, 2 May 2015 (UTC)

Yobol, just to clarify, are you supporting the use of QW for the particular sentence I indicated in my original posting?DrChrissy 14:19, 2 May 2015 (UTC)

Yes. As far as I know, the underlying principles of TCM (Qi, meridians, etc) is not based on scientific knowledge (based instead on traditional pre-scientific hypotheses/superstition) and therefore appropriate for QW to be used in this context. Yobol (talk) 14:23, 2 May 2015 (UTC)

Is there a more reliable source to confirm this, or is this a marginal position outside the scientific mainstream? Jayaguru-Shishya (talk) 13:02, 3 May 2015 (UTC)

It's an easily falsifiable statement. History confirms that the statement is correct, and since there is no evidence to the contrary, it's a good one and properly sourced. -- BullRangifer (talk) 18:59, 3 May 2015 (UTC)

QW is sufficiently reliable for this statement.—Kww(talk) 14:36, 2 May 2015 (UTC)

Good, that is a real problem solver. Maybe we can include the sources to the article? After all, we don't include claims of marginal position outside the scientific mainstream. Jayaguru-Shishya (talk) 17:19, 4 May 2015 (UTC)

Do we not have a more recent, secondary or tertiary source for this? Surely the medical scientists have published something more reliable in the past decade or so.DrChrissy 14:52, 2 May 2015 (UTC)

Scientists generally don't publish about pre-scientific hypotheses/superstitions which have no basis in human physiology and is generally considered nonsensical in modern terms. This is why we have WP:PARITY. Yobol (talk) 15:25, 2 May 2015 (UTC)

So why is it that when I go to Cochrane Collaboration and type in "Acupuncture" I get 134 hits for systematic reviews?DrChrissy 15:48, 2 May 2015 (UTC)

The content in question is the proposed mechanism of how acupuncture has been traditionally considered to work by acupuncturists/TCM practitioners (Chi, meridians, etc). There is, to my knowledge, no high quality medical source that says any such entities actually exists in the human body. The studies you are seeing are studies as to whether or not acupuncture has an effect, which is a separate question as to whether or not the traditionally proposed mechanisms are correct. Yobol (talk) 15:55, 2 May 2015 (UTC)

You may be correct that there is no high quality medical source to say this, so instead, let's fall back on the opinions of just a single person and forget about how we say that only the highest quality evidence should be used in medical articles. I trust my incredulity comes through.DrChrissy 16:16, 2 May 2015 (UTC)

Um, what? We should be using the highest quality sourcing for this; in this case, Quackwatch fits the bill. Insisting that we have peer-reviewed studies for things that medicine views as nonsense is of course not reasonable and is precisely why we have WP:PARITY, because high quality peer-reviewed sources usually do not talk about what is generally considered nonsense. If you have high quality sourcing saying that Meridians or Chi or whatever actually exists, present them. Otherwise, Quackwatch is perfectly reliable for saying such nonsense does not exist. Yobol (talk) 16:21, 2 May 2015 (UTC)

Well if you don't mind me for saying so that is Pseudoskepticism. Can't argue against a pseudo-skeptic because they can't be proved wrong (and when they are, they just move the goal posts). So its turtles all the way down and no one can disprove it – so they are always right – even when wrong. Lets move on and not waste our time arguing about if QW might sometimes, have something of merit. Over all, we (the bulk of editors) acknowledge that QW is not to be viewed as a reliable source.--Aspro (talk) 16:51, 2 May 2015 (UTC)

Please stop the nonsense of claiming "the bulk of editors" agree with you when you have no evidence of this. Thanks. Yobol (talk) 18:32, 2 May 2015 (UTC)

The talk pages on WP gives evidence to this. Jimmy Wales said and I quote: Zero information is preferred to misleading or false information'. So stop inundating us with pseudo arguments. Scientist are naturally skeptic but they don't grasp at stuff just because it gives their prejudices a warm feeling inside. Thanks.--Aspro (talk) 14:47, 3 May 2015 (UTC)

Well, this article is about acupuncture, not about traditional Chinese medicine, but both of the subjects have attracted significant amount of scientific research. So I have to disagree with Yobol here: yes, scientists do publish a great deal of research concerning acupuncture and traditional Chinese medicine. And what those studies don't say, well it obviously cannot be called part of "scientific mainstream". QuackWatch may be considered as a reliable source in such cases where the subject is so marginal that it hasn't been able to attract scientific attention (e.g. reiki healing). Just imagine, how many researchers are ready to waste their time on such nonsense? On such cases, QuackWatch fits the bill. But that's not the case at acupuncture, I am afraid. We should bear in mind the ArbCom conclusion, labeling QuackWatch as a partisan site. Anyway, the first step is to paraphrase the source so we don't have to use block quotes anymore. The second step is to think about if there are better sources available, or if we are dealing with claims not presented by the scientific consensus. Jayaguru-Shishya (talk) 13:06, 3 May 2015 (UTC)

Please note that I have proposed a specific sentence for deletion. It would help if users !voted and left a clear indication of this in bold at the beginning of one of their posts. This will avoid arguments about "bulk of editors" etc.DrChrissy 18:46, 2 May 2015 (UTC)

• Support as the OP.DrChrissy 18:47, 2 May 2015 (UTC)
• Oppose as the source is reliable for the claim. QuackGuru (talk) 18:49, 2 May 2015 (UTC)
• Oppose per WP:PARITY QW is valid source for discussion of FRINGE notions like modern claims that qi exists and flows along meridians Jytdog (talk) 19:20, 2 May 2015 (UTC)

• User:Jytdog, we have a prominent medical textbook (Oxford Textbook of Palliative Medicine ) which says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266), thereby refuting the notion of vital energy. Why promote QW when there are better sources? -A1candidate 19:26, 2 May 2015 (UTC)

oxford press does not have WP:PSCI and WP:FRINGE governing its content; wikipedia does, and here we call pseudoscience, pseudoscience. we don't just skip over the first part of that sentence you quoted. we pause and say the equivalent of "which is complete bullshit" albeit in a nicer way. we don't "promote" QW, we use it. Jytdog (talk) 19:34, 2 May 2015 (UTC)

I don't see anything useful that isn't already covered by the Oxford textbook. -A1candidate 19:40, 2 May 2015 (UTC)

I don't see anything relevant to this statement covered by the Oxford textbook. — Arthur Rubin (talk) 19:43, 2 May 2015 (UTC)

IT REFUTES THE VALIDITY OF VITAL ENERGY. Did you not read? -A1candidate 19:47, 2 May 2015 (UTC)

That's not what the quote says, and, even if that is elsewhere in the book, it wouldn't support the statement in the article, as it doesn't even imply that there aren't other (potential) bases for acupuncture, accepted by acupuncturists, which are not incompatible with scientific research. 04:38, 3 May 2015 (UTC)

Yes, that is a quadruple negative. Those without an advanced knowledge of English might misinterpret it. — Arthur Rubin (talk) 04:43, 3 May 2015 (UTC)

You obviously speak a different type of English, because the source does imply that it is compatible with neuroscientific research. Whether it is accepted by acupuncturists or not is of peripheral importance. Acceptance by the medical community is what matters. -A1candidate 09:08, 3 May 2015 (UTC)

• Oppose per WP:PARITY and WP:DEADHORSE. — Arthur Rubin (talk) 19:43, 2 May 2015 (UTC)
• Oppose Quackwatch has repeatedly been shown to be reliable at RSN, and WP:PARITY indicates we can use non-MEDRS sources on articles such as these. Further, even if that weren't true, the statement is sourceable elsewhere. This has been discussed to death already.   — Jess· Δ♥ 05:26, 3 May 2015 (UTC)
• Comment Not quite, Jess. There is a firm consensus that QuackWatch is not relaible per se, and it may be only used on a case-by-case basis. So better not say: Quackwatch has repeatedly been shown to be reliable. Actually, we have an ArbCom ruling labeling QuackWatch as a partisan source that should be used with caution. Well, that's not a surprise since not even QuackWatch itself claims to be a peer-reviewed source. QuackWatch sure has its place on some few articles, but acupuncture has been studied relatively lot, and therefore we don't have a compulsive need to include QuackWatch. Jayaguru-Shishya (talk) 13:19, 3 May 2015 (UTC)
  • Not quite, Jayaguru-Shishya. You are overreaching yourself. Three quotes from the amendment: "It is not the job of this committee to determine whether sources are reliable.", "There is an observation that Quackwatch tends to be partisan, and should not be a preferred or exclusive source, but not that it is not a reliable source as is generally understood." "Deeming a source to be reliable or unreliable is almost always going to be a content decision and as such beyond our remit." Most sources can be deemed reliable for certain things and unreliable in others. When I say the NY Times is a RS in reference to a biography it is foolish to say, "better not say: NY Times has repeatedly been shown to be reliable" because it's not a WP:MEDRS. --NeilN 15:18, 3 May 2015 (UTC)
  • NeilN, my comment wasn't addressed to you nor did I say anything about the NYT. I agree with the quotations you gave, however. I've also been emphasizing strongly that the reliability is a matter of context. I guess there was a misunderstanding there. It's also been voiced out by many editors that QuackWatch is reliable in such topics that haven't attracted sufficient scientific interest. And this is exactly the problem we are tackling with many fringe articles. Jayaguru-Shishya (talk) 15:43, 3 May 2015 (UTC)

• Comment: Some editors here may be unwittingly be putting words in the the mouth of The Journal of the American Medical Association (JAMA) by suggesting they uphold QW to be a reliable medical source. Should we not ask them for an official statement? As it could effect their reputation- what with WP being so widely read. WP editors should not speak on the behalf of another organization as it is not professional behaviour. If I worked for The Journal of the American Medical Association I would be on to the lawyers quickly, to make it very clear that mention of QW does not mean that we accept that QW as a reliable source and any mention is solely down to the writer of such an article -and we 'expect' s/he to have performed due diligence in this respect. We cannot be held responsible for any contributors lapses. We have nothing to comment upon the reliability or otherwise of this site known as QW. Period . Just asking.--Aspro (talk) 15:20, 3 May 2015 (UTC)

• Your hypothetical life is of no interest here. --NeilN 15:26, 3 May 2015 (UTC)

• And you comment is just trying to deflect! Lets be civil OK. It is to improve the quality of WP that is important here, please remember that.--Aspro (talk) 15:35, 3 May 2015 (UTC)

• Articles aren't improved by putting your words in the mouth of a source. I mean, you even say, "WP editors should not speak on the behalf of another organization" and then you blatantly go ahead and do it. Is there anything here that can't be directly surmised by JAMA statements? --NeilN 15:53, 3 May 2015 (UTC)

• You know very well that I was not blatantly putting words into The Journal of the American Medical Association's mouth. Then you go on to ask "Is there anything here that can't be directly surmised by JAMA statements?" Yes there is: all of the above. Is there anything on the the Journal of the American Medical Association site to say that they uphold QW? Think you keep getting your premises mixed up. Take deep breath and stand back, so as to take a fresh look. --Aspro (talk) 17:04, 3 May 2015 (UTC)

@Aspro Is there anything on the the Journal of the American Medical Association site to say that they uphold QW? You mean besides their publication, in their journal, that specifically says Quackwatch is a resource that provides "reliable health information"? Yobol (talk) 23:46, 3 May 2015 (UTC)

@ Yobol The Journal of the American Medical Association does not accept anything ether way. The Journal of the American Medical Association publishes topical articles. Were do you think in their choice of published articles, suggests that they adopt everything their contributors write about? As intimated to -NeilN above, you should keep premises separate. To suggest that the Journal of the American Medical Association support and accept everything they publish is a misunderstanding of the work of journals. So it is absolutely wrong for some editors here to claim that the Journal of the American Medical Association considers QW as a reliable source of medical information based on the articles that they publish. Can I say that any clearer. We (some of us) provide guidance which some editors prefer to ignore (Think to yourself: what is the root of the word ignorant. Step back and look at the bigger picture.) But maybe, I am just trying to catch the wind.--Aspro (talk) 13:28, 4 May 2015 (UTC)

@Yobol (or anybody else) If you have evidence that JAMA supports Quackwatch, please would you provide this evidence - I have looked and I can't find it.DrChrissy 13:10, 4 May 2015 (UTC)

@Aspro, @DrChrissy, have you all not read the Quackwatch article, which references JAMA's specifically citing Quackwatch as a reliable source for medical information? Sigh. Yobol (talk) 13:48, 4 May 2015 (UTC)

That is interesting. Wonder if the executives are aware that their lower down minions in their organization upholds QW. As I said before, we need a qualified statement from the Journal of the American Medical Association to save them from embarrassment. And believe you me, when your read through that QW site it, it is hardly a reliable medial source. The Journal of the American Medical Association's PR may refuse to reply and take the risk that it will not put the journal's reputation into question, based on that link provided, in the short term. Yet what of the future, when WP, being the first port of call for many a medical researcher, who find the Journal of the American Medical Association supports QW as reliable. Is s/he going to add included JAMA in his thesis. Think not. The argument is swaying to the Journal of the American Medical Association to officially state their position on QW as to remove all doubt. Get it from the horses mouth, rather than just guesstimate. For those that are familiar with this sort of things - it don't mean nothing unless it is a policy statement from the executive. Yobol should understand this. — Preceding unsigned comment added by Aspro (talk • contribs)

So you read the statement made by JAMA, published in JAMA, explicitly calling Quackwatch a reliable source for medical information and you call that a "guesstimate"? Now I remember why replying to you is an incredible waste of time. Yobol (talk) 15:52, 4 May 2015 (UTC)

Repeating the sentiment from above, we're not interested in what you think organizations should do to "save them from embarrassment." Focus on what they're actually stating, not on what you would like them to state. --NeilN 15:54, 4 May 2015 (UTC)

Again I ask and point out: Do the executive know about this? Is this what the executive supports. If you have left high skool and worked for a large organisation you should be aware that much of what ends up on a company web-site is not kosher. i.e. just because it is written in black and white it is not gospel – it is just stuff put up on their web-site – which you take to be gospel - can I explain that any more simply? Come on folks, use your brain cells here, If you can edit WP you must have more than two. What is the third one doing? --Aspro (talk) 17:10, 4 May 2015 (UTC)

They have apparently not checked JAMA, so this is just IDHT behavior. On a "JAMA Patient Page", under the heading "How to find reliable online health information and resources," they list Quackwatch, among other sources. JAMA clearly recommends QW as "reliable". This is good enough for us to continue using it on a case by case basis. -- BullRangifer (talk) 14:53, 4 May 2015 (UTC)

Both BullRangifer and Yobol directed us to as evidence that JAMA supports Quackwatch. I am unable to open this article fully, but I can open the previous and subsequent articles. Seems rather odd. Perhaps the article has been removed/redacted? I am able to see the date of publication was 1998. Perhaps in the subsequent 17 years(!) JAMA have seen fit to update their reputable sources?DrChrissy 16:04, 4 May 2015 (UTC)

We can use QuackWatch on a case-by-case basis when the topic is so marginal that it hasn't attracted enough scientific attention. If plenty of sources exist, however, we will use those instead of QuackWatch. Jayaguru-Shishya (talk) 17:23, 4 May 2015 (UTC)

I can open the article just fine, it is still available on the website. Do you have any reason, other than your own apparent dislike for Quackwatch itself, to think JAMA no longer thinks Quackwatch is reliable? If and when you find a similar publication by JAMA saying Quackwatch is no longer reliable, please bring it forward. All I see here are editors who do not like Quackwatch trying their hardest to not acknowledge what high quality sources have said about it. Yobol (talk) 16:09, 4 May 2015 (UTC)

What I am trying to do at the moment is verify statements made by other users. At the moment, I am unable to do this, but I am happy to watch for comments that it can be verified. FYI, I do not dislike Quackwatch, I just intensely dislike its use by some editors when they are too lazy to go and find other peer-reviewed, NPOV secondary sources.DrChrissy 16:24, 4 May 2015 (UTC)

Boys, boys... For claims on medical efficiency we need peer-reviewed MEDRS compliant sources, no matter whom JAMA cites. If the topic is well covered by scientific research, then we don't need QuackWatch. There are subject though, that have been left in the shadows of mainstream science, and therefore QuackWatch is a decent source until better ones pop up. Jayaguru-Shishya (talk) 17:25, 4 May 2015 (UTC)

First, I already verified it and downloaded it. It has not been retracted. Second, sources are not required to conform to the Misplaced Pages policy WP:NPOV, so the term "NPOV source" is meaningless; the proper application of WP:NPOV is whether or not we (as editors) are using the sources in a manner consistent with NPOV. We use partisan/biased sources all the time and they are often necessary to have a fully NPOV compliant article that establishes all significant points of view. Now that it is clear that you and Aspro are showing clear WP:IDHT behavior, I won't waste any more of my time here. Cheers. Yobol (talk) 16:45, 4 May 2015 (UTC)

That page on that site : the Journal of the American Medical Association (that only quacks like I and Yobol can accesses apparently) , (ie not publicly assessable and thus not open to public scrutiny) has small print. That gets the the Journal of the American Medical Association off the hook regarding QW don't you think. Unless the Journal of the American Medical Association makes a official statement upon QW, then there is no substance as to why we should use it. That page referred to (not an article) but just a page – it is just that! How do we put this to you (and et al) that hidden information is not Verifiability. Otherwise people could hid information a splatter WP with nonsense. Cheers--Aspro (talk) 20:31, 4 May 2015 (UTC)

Oppose removal. Perfectly accurate statement, backed up by history. -- BullRangifer (talk) 19:06, 3 May 2015 (UTC)

• Attribute to Stephen Barrett per WP:ATTRIBUTEPOV if it's going to be kept in the lead. Zad68 16:03, 4 May 2015 (UTC)
• Support the removal and the removal of most Quackwatch sources. There are better sources out there to make the claims it makes, and if there aren't, then what does that tell us? Quackwatch is also diametrically opposed to a textbook source I added and doesn't hold weight to it even for parity, so there's that. I do think we should still have Quackwatch on the article to back up what skeptics think about acupuncture, but maybe only one or two cites at most, per weight, and the it should be attributed as Zad says. But I would attribute to Quackwatch or Quackwatch and Stephen Barrett and not Stephen Barrett alone. LesVegas (talk) 17:10, 4 May 2015 (UTC)

And yet another reason not to use QuackwatchI have been editing the Acupuncture article to remove a statement attributed to Quackwatch. I simply could not find the statement in the source provided. I challenged this. The content was re-introduced and suddenly the Quackwatch source provided the content! It appears the source I was originally following was an archive. After my challenge, this was suddenly cleaned up here. How misleading this can be and what a complete waste of my time. It is so dangerous to be using Quackwatch as a source when it is so dynamic! It is a Blog and should be treated as such!DrChrissy 18:57, 4 May 2015 (UTC)

• Do you have any reason to believe that this was anything different than the normal case of an archive and the current text falling out of sync? That's a pretty common phenomenon across all internet sources.—Kww(talk) 19:01, 4 May 2015 (UTC)

(edit conflict)You're upset that the website changed in the last 5 years? Websites tend to do that. Your opinion of quackwatch is, however, not one shared by the editors at RSN, nor by the other reputable sources which reference it.   — Jess· Δ♥ 19:02, 4 May 2015 (UTC)

Chrissy before you started working with that quote from Quackwatch it was quoting the website accurately and the website's most recent version of the content matched what we had in our article. I don't understand what you're saying here, but it probably doesn't matter: the article and the source are now in sync. Zad68 19:03, 4 May 2015 (UTC)

I am wondering whether we are talking about the same quote. I am referring to the quote in the "Scientific reception" section in the version here which states

"Quackwatch states 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.

If you click on the , then click on the hyperlink of the title of the article, it takes you here. This does not contain the quote, it does not even contain the section "The bottom line is". Try searching for the word "nebulous".

DrChrissy

See "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. " QuackGuru (talk) 21:25, 4 May 2015 (UTC)

Wow! The POV editing regarding Quackwatch is just incredible. I have just edited Quackwatch to indicate that the website does not always contain peer-reviewed articles (which it admits on its own FAQs) only to have this reverted twice. Surely this is a fundamental characteristic of Quackwatch which readers need to know. What is wrong with stating what a web-site says about itself?DrChrissy 23:53, 4 May 2015 (UTC)

• Oppose removal By definition, traditional Chinese medicine ("based on a tradition of more than 2,000 years") is not based on scientific knowledge, unless the word "science" is redefined to include what anyone thinks. After the event, it may turn out that some traditional remedies involve components with useful medicinal properties, but TCM is based on chi and meridians and the source is fine (WP:PARITY) for pointing out that TCM is something quite different from medicine based on science. Johnuniq (talk) 01:29, 5 May 2015 (UTC)
• Remove source...keep statement As all can see quackwatch is not seen by all here as the best source (lets assume the same can be said for our readers)....so lets find sources that have a better overall rep....thus readers and edtors will have more confidence in the article overall. I suggest we keep the sentence and just source it with something newer that mentions both TCM and Acupuncture.... like - James M. Humber; Robert F. Almeder (2013). Alternative Medicine and Ethics. Springer Science & Business Media. p. 10. ISBN 978-1-4757-2774-6. -- Moxy (talk) 01:58, 5 May 2015 (UTC)

Cochrane reviews on acupuncture

The words "pseudoscience", "quackery" and the like seem to be thrown at acupuncture without a second thought. My second thought was to check whether these terms really do apply. So, I turned to WP:MEDRS to find out which would be the best way to research this. WP:MEDRS states "Cochrane Library reviews are generally of high-quality...", so I went to the Cochrane Collaboration site and typed "acupuncture" into their reviews search engine. I got 248 hits. I went through the first 20 of these and found the following -

"There is low to moderate-level evidence that compared with no treatment and standard therapy, acupuncture improves pain and stiffness in people with fibromyalgia."

"Limited evidence suggests that acupuncture may have some antipsychotic effects as measured on global and mental state with few adverse effects."

"In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches."

"In the previous version of this review, evidence in support of acupuncture for migraine prophylaxis was considered promising but insufficient. Now, with 12 additional trials, there is consistent evidence that acupuncture provides additional benefit to treatment of acute migraine attacks only or to routine care."

"Acupuncture may reduce period pain, however there is a need for further well-designed randomised controlled trials."

"There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment."

I only looked at the first 20 hits of the search, but if this is a representative sample, it means that approximately 25% of Cochrane reviews find a positive effect of acupuncture. Pseudoscience? Quackery? hmmmm....DrChrissy 20:31, 2 May 2015 (UTC)

Talk pages are not a forum to bring up topics to discuss in general, but are here to improve the article. What specific suggestions do you have to change the text of this article, citing which source? Yobol (talk) 20:36, 2 May 2015 (UTC)

@Yobol Perhaps you missed it but in the opening paragraph it states "TCM theory and practice are not based upon scientific knowledge, and acupuncture is described as a type of pseudoscience. Many within the scientific community consider it to be quackery"....that to me seems to be undue weight.DrChrissy 20:53, 2 May 2015 (UTC)

The rules for lead indicate that that content should be mentioned. That's about as short a mention as is possible, and it's properly sourced, so those words are obviously not "thrown at acupuncture without a second thought." -- BullRangifer (talk) 21:53, 2 May 2015 (UTC)

@DrChrissy - What do you think of the following sources:

1. Harrison's Principles of Internal Medicine: "In addition, new research is shedding light on the effects of meditation and acupuncture on central mechanisms of pain processing and perception and regulation of emotion and attention. Although many unanswered questions remain about these effects, findings are pointing to scientifically plausible mechanisms by which these modalities might yield benefit." (pg. 14e-3)
2. Essentials of Small Animal Anesthesia and Analgesia: "Basic research on acupuncture's mechanisms in Western societies started in 1976 after the endorphin hypothesis of acupuncture's mechanism of action was introduced. Further advancement of acupuncture research was prompted by the introduction of functional magnetic resonance imaging (fMRI) and positron emission tomographic scanning, which revealed the relation between acupuncture stimulation and activation of certain brain structures" (pg. 132)
3. Miller's Anesthesia: "A scientific basis may exist for acupuncture. Acupuncture stimulates high-threshold, small-diameter nerves that activate the spinal cord, brainstem (i.e., periaqueductal gray area), and hypothalamic (i.e., arcuate) neurons, which trigger endogenous opioid mechanisms. The effect of acupuncture analgesia can be reversed by administration of naloxone." (pg. 1235)

I'm particularly interested in your opinion about source #2, since it relates to veterinary medicine. -A1candidate 20:49, 2 May 2015 (UTC

I think all three are excellent sources. I came across the second a few days ago and it is something that we really need to incorporate. It's probably not worth discussing in detail here because a member of the WP:MEDRS police will step in and say because it is veterinary it should not be discussed here. Funny how different factions of the medical profession can have such open or closed minds.DrChrissy 20:59, 2 May 2015 (UTC)

@DrChrissy, I don't think WP:MEDRS forbids the use of veterinary medical textbooks in topics on veterinary medicine. If there are no objections, I'll incorporate the text into the article. -A1candidate 21:07, 2 May 2015 (UTC)

No it does not forbid it because WP:MEDRS does not apply to veterinary science or to animals. I have already incorporated the reference into Veterinary acupuncture - I'll expand a little bit tomorrow. Thank you very much for the reference. Much appreciated.DrChrissy 21:26, 2 May 2015 (UTC)

I beg to differ. MEDRS applies to direct medical claims, even veterinary. If it doesn't say so in the policy, it should. -- BullRangifer (talk) 21:46, 2 May 2015 (UTC)

There is an ongoing discussion on Misplaced Pages talk:Identifying reliable sources (medicine) regarding the possible inclusion of vet medicine into MEDRS - surprised you have missed it. There are not really any strong arguments for it. I seem to remember somewhere that even Jtydog suggested it should not apply to animal articles.DrChrissy 22:11, 2 May 2015 (UTC)

-This section is a jumble, and my attempt to make it legible was reverted. I will not be participating further. Yobol (talk) 21:17, 2 May 2015 (UTC)

At the significance 0.05, 1 in 20 papers will produce a false positive. See WP:EXTRAORDINARY. Tgeorgescu (talk) 21:34, 2 May 2015 (UTC)

Nah - that is pseudoreplication. Each study is independent of all the others. Besides which, they look at the effects of acupuncture on different dysfunctions - totally wrong to lump them together like that. In any case, you are talking about 1 in 20 papers as being a Type I error - how do you explain the findings of the other 5 studies?DrChrissy 21:46, 2 May 2015 (UTC)

Just in response to this comment, you can't make a conclusion on that because you need to know the numbers of both positive and negative results, not just the number of positives. There are also plenty of ways for bias to occur - independence is a pretty big assumption! Sunrise (talk) 02:18, 3 May 2015 (UTC)

User:Sunrise, these issues were obviously taken into account by the Cochrane reviewers, haven't they? -A1candidate 09:03, 3 May 2015 (UTC):::

Your ping didn't work, by the way. In any case, I was responding in the abstract to an abstract statement, without referring to specifics, so that would be a different subject. Sunrise (talk) 08:40, 4 May 2015 (UTC)

Let's not get diverted by this. The 25% which I stated above is probably OR on my part. It was meant as a throw-away comment and not to taken as ststistical evidence trying to convince a reader about any "fact" or trend. My point of the OP was to indentify that there are multiple Cochrane reports out there which have a positive finding with regard to acupuncture. In my mind, the medical dogmatists are wanting it both ways. They are quoting extremely loaded words such as "quackery" and "Pseudoscience" (without quotes by the way!), and then playing down the findings of sources which they normally defend as being amongst the most reliable possible.DrChrissy 10:25, 3 May 2015 (UTC)

Scientific publications have a bias for publishing significant results only; so for every published significant result for it, there could be 19 results which never get published, due to such bias. Tgeorgescu (talk) 10:42, 3 May 2015 (UTC)

Yes, I agree. The Cochrane reviews seem to be different than other branches of science in that they do take into account "no significant difference". I would be the first to say that because I found 6 of 20 reviews had a positive conclusion for acupuncture, this means 14 did not.DrChrissy 10:49, 3 May 2015 (UTC)

Not our job to speculate on such matters. There are statistical methods to evaluate the publication bias, so let's leave that for the scientists. Jayaguru-Shishya (talk) 13:19, 3 May 2015 (UTC)

Our job is also to be careful not to represent pseudoscience as having merit. That a minority of studies on a treatment with such a notably strong placebo effect show weak results of positive impact, using such weak language as "low to moderate-level evidence" and "limited evidence shows that acupuncture may", is unsurprising and unpersuasive.—Kww(talk) 18:48, 3 May 2015 (UTC)

Leave that to the scientists. For you, I'd recommend to WP:STICKTOSOURCES. Ps. Don't you worry about disclaimers, doesn't affect our position in anyway. Jayaguru-Shishya (talk) 17:18, 4 May 2015 (UTC)

Disclaimers don't affect things? I'm sorry that you don't understand their meaning or purpose, Jayaguru-Shishya.—Kww(talk) 18:59, 4 May 2015 (UTC)

Acupuncture has "proven efficacy" and scientific backing

I just reverted a series of edits which indicate quite strongly that TCM has scientific backing and is "effective" without qualification. I think this needs significantly more discussion before being inserted into the article, as it turns our coverage of Acupuncture's efficacy on its head. What sources are we referencing when adding this content? Why are we now aiming to exclude our existing sources which say the precise opposite?   — Jess· Δ♥ 19:55, 3 May 2015 (UTC)

We are using Miller's Anesthesia. Which sources are we excluding, User:Mann jess? -A1candidate 19:57, 3 May 2015 (UTC)

It's not that you are attempting to exclude existing sources, it's that you were attempting to provide false parity.—Kww(talk) 20:03, 3 May 2015 (UTC)

Statements of authoritative medical textbooks need to be given due weight. What would both of you suggest as a compromise? -A1candidate 20:11, 3 May 2015 (UTC)

(edit conflict)First of all, you've taken these three sources: , , and replaced them with just one: . You've not just provided equal weight to this new source, but you've actually given it significantly more weight ("scientists vs quackwatch"). Your edits to later parts of the page are of more concern, but for essentially the same reason.   — Jess· Δ♥ 20:15, 3 May 2015 (UTC)

Well, we can put them back in? I would also appreciate some suggestions from you about how we could give both sources equal weight, User:Mann jess. -A1candidate 20:21, 3 May 2015 (UTC)

In such cases we go with the scientists and omit QuackWatch. Jayaguru-Shishya (talk) 17:20, 4 May 2015 (UTC)

Equal weight? Why should "Traditional Chinese Medicine: Scientific Basis for Its Use" be given equal weight to those three sources? Why is it of that high a quality?   — Jess· Δ♥ 20:28, 3 May 2015 (UTC)

Because it is written by experts in a relevant scientific field (pharmacology) and it is from a respected publisher (Royal Society of Chemistry)? Don't you think this is grounds for a legitimate scientific discussion, User:Kww? -A1candidate 20:32, 3 May 2015 (UTC)

To the extent that it makes claims about pharmacology, I haven't got any objection to its use. There are certainly herbs used in TCM that have legitimate medical value. To the extent that it makes the claim that the underlying concepts of TCM, such as qi, yin, and yang, make scientific sense, I don't see that the expertise in pharmacology is applicable, and the claim itself is clearly a fringe claim. As the publisher has disclaimed responsibility for the contents, the publisher's credentials don't factor into the discussion.—Kww(talk) 21:20, 3 May 2015 (UTC)

The purpose of pointing to the publisher's credentials isn't to imply that they are responsible for contents, but to demonstrate that they are independent of, and unrelated to, the acupuncture community. In any case, we have a prominent medical textbook (Oxford Textbook of Palliative Medicine ) that says "Although based on the theory that needling regulates the flow of vital energy, neuroscience research suggests that acupuncture induces clinical response through modulation of the nervous system" (pg. 266). This demonstrates the medical community's preference for a modern explanation of acupuncture in lieu of a purely traditional explanation ("vital energy"), User:Kww. Also, what good reason do we have to replace a good medical textbook with QuackWatch, User:Mann jess? -A1candidate 22:10, 3 May 2015 (UTC)

KWW, it is claiming TCM has a strong scientific basis, not that TCM herbalism alone has a strong scientific basis. It is simply suggesting that herbs have a pharmacological method of action under TCM, which it's claiming has a strong basis in science. LesVegas (talk) 22:20, 3 May 2015 (UTC)

Exactly, and that's what makes it a fringe claim. That TCM has identified some valuable herbs is non-controversial. I can't imagine any reputable scientist arguing that an herb couldn't possibly have value because TCM uses it. That TCM has a scientific foundation is controversial (controversial to the point of being ludicrous, in fact) and a background in pharmacology doesn't provide strong support for claiming that qi, yin, and yang are viable approaches to studying chemistry.—Kww(talk) 01:13, 4 May 2015 (UTC)

A1, the quote you've provided does not address the first section you changed. It also does not indicate acceptance of TCM or acupuncture within the scientific community. Why use quackwatch? Because it explicitly addresses the claim we are sourcing without interpretation or synthesis, and its findings are consistent with the plethora of other sources which describe the scientific community's opinion.   — Jess· Δ♥ 22:29, 3 May 2015 (UTC)

I am not arguing that TCM is accepted within the scientific community. I am arguing, however, that medical acupuncture is accepted by a large faction of the medical profession (at least the modern explanations for acupuncture are). QuackWatch should be given less weight because it fails to address this second issue. -A1candidate 22:36, 3 May 2015 (UTC)

Thanks, Mann jess. If the findings of QuackWatch "are consistent with the plethora of other sources which describe the scientific community's opinion", then we will remove QuackWatch on the peculiar instance and replace it with some of those sources describing the scientific consensus. Jayaguru-Shishya (talk) 17:22, 4 May 2015 (UTC)

You're not? Well, you removed content that said TCM was not based on scientific knowledge, and wrote in its place that scientists believe TCM is just misunderstood. Again, your source does not address that topic, but the ones we are using do, and they back up the existing wording. Also, I don't see any part of your edit which discusses the acceptance of modern explanations of acupuncture by medical professionals. All I see are suggestions that acupuncture is efficacious and backed by science, and our MEDRS compliant sources contradict that claim.   — Jess· Δ♥ 01:37, 4 May 2015 (UTC)

Like I said, I have nothing against restoring that content. What I wrote was "poorly understood", not "misunderstood" - Both terms have different meanings. The part on acceptance by the medical profession was removed here. I stand by this addition, firmly, and request an explanation of why this content should be removed. -A1candidate 02:33, 4 May 2015 (UTC)

"Poorly understood" and "misunderstood" have different meanings, but the difference is not significant to what I wrote. As for the diff, I did not remove that content, so I'm not the one to ask why it was taken out. I'd venture a guess that there is an effort to trim the article, since it's become unwieldy to the point of being nearly incomprehensible.   — Jess· Δ♥ 03:02, 4 May 2015 (UTC)

Trimming the article = Reverting the edits of other editors? Since you're not willing to defend the removal, I request that someone else do so. Otherwise I'm going to restore it back to this version. It is not perfect but at least it's something all of us could (hopefully) live with. -A1candidate 06:54, 4 May 2015 (UTC)

This edit is completely inappropriate. It wholly removes the description of Acupuncture's scientific reception from the lead, and on top of that, goes on to summarize it as an opinion from 2007. The edit was made when discussion thus far has shown such changes to be contentious. Please discuss edits like that before instituting them (and reverting to get them in the article!)   — Jess· Δ♥ 13:57, 4 May 2015 (UTC)

POV on Lede

I added a POV tag to the lede since its neutrality is under dispute by several editors. Here are the two versions being disputed. I'm contending additional reliable sources are needed for parity. Furthermore, one source is being misrepresented since it's used out of context for a strong claim. Let's hear any ideas on how we can resolve this dispute. LesVegas (talk) 22:04, 3 May 2015 (UTC)

Is anyone disputing it that doesn't have a COI in relationship to TCM? Or is it just people that rely financially on people misunderstanding its status as folklore and superstition that object?—Kww(talk) 03:13, 4 May 2015 (UTC)

I don't make a living in relationship to TCM, and I don't appreciate the accusation nor the implication of COI. Kww, I've always tried being cordial with you and yet I feel like you are cotinually being very uncivil towards me. Why? LesVegas (talk) 16:01, 4 May 2015 (UTC)

Because you insistently and persistently portray TCM as having validity. Either you know better, which means your edits fall under one category of problem, or you do not, which means your editing falls under another category of problem.—Kww(talk) 17:42, 4 May 2015 (UTC)

For the record, I don't think TCM is very valid. But it's not what I believe, we are going to rely on what sources say. We're not going to delete reliable sources just because they don't correspond to our point-of-view. Regardless, your justification doesn't excuse your constant incivility, and I'm going to ask that you stop right now and start treating myself and others with more respect. I would not accuse you of working for an industry that is threatened by acupuncture in order to justify edit warring, disruption and other bad behavior. You are an administrator and seem to be intelligent so I shouldn't have to be telling you any of this, but please stop. LesVegas (talk) 18:37, 4 May 2015 (UTC)

I too have absolutely no COI or relationship to TCM. I dislike that you may be lumping me into that. I had not realised until the posting above that you were an administrator. TuT TuT - I would have expected a much more measured posting.DrChrissy 19:24, 4 May 2015 (UTC)

My response was quite measured and not uncivil. I admit that there is a third form of problem that plagues the article: the occasional well-meaning editor that believes that we gullibly parrot sources without evaluating them for fringe science and pseudoscience. Regardless of the motivation, editors that consistently and intentionally make this article misrepresent acupuncture are a problem.—Kww(talk) 19:36, 4 May 2015 (UTC)

We had this discussion about the tag before. We don't need a tag at the top of the page again. Do you remember the previous discussion on this? The result was no consensus to restore the tag. QuackGuru (talk) 20:37, 4 May 2015 (UTC)

How nice of you to finally post here over a day later to justify your removal of the template. Of course, the dispute then was never resolved so you're disrupting again and regardless, this is a new dispute with many new sources being contended. Can you please explain why you ignored the sentence on the template that says, "Please do not remove this message until the dispute is resolved"? Why do you constantly remove POV templates? Also, why did you ignore the rules about removal which say,

Remove this template whenever:

There is consensus on the talkpage or the NPOV Noticeboard that the issue has been resolved

It is not clear what the neutrality issue is, and no satisfactory explanation has been given

Since there was no consensus that it was resolved, and since I made it very clear what the neutrality issue was, what again made you think you could quickly remove the tag? LesVegas (talk) 20:54, 4 May 2015 (UTC)

Editors disagree with making the lede longer. QuackGuru (talk) 21:35, 4 May 2015 (UTC)

Cancer-related pain

User:Arthur Rubin, you deleted a statement from the American College of Chest Physicians which says "in patients with cancer related pain". How is this not part of "cancer-related conditions"? -A1candidate 11:02, 4 May 2015 (UTC)

The same statement in the same article is being paraphrased differently in two different sections. It should only be there once, or it should be explicitly noted that it is the same statement in the same article. The first use refers to "nausea and vomiting from either chemotherapy or radiation therapy", and the second use refers to "cancer-related pain" (and something not relevant and not in the article). Although it's not a fringe article, both references are outside of the medical specialty that the organization and journal normally represent. In other words, both clearly fail WP:MEDRS, unless the authors are expert in the field of the article, not just the field of the journal. I'm beginning to think that both statements should go. — Arthur Rubin (talk) 19:54, 4 May 2015 (UTC)

@A1candidate: — Arthur Rubin (talk) 19:55, 4 May 2015 (UTC)

If that item is listed, it should be under "pain", rather than under "cancer-related conditions". It might be still better to paraphrase the statements together under "Cancer-related conditions", rather than separately under "pain" and "nausea". I still have doubts about it being appropriate at all, though. — Arthur Rubin (talk) 20:12, 4 May 2015 (UTC)

Both are weak sources. These are political opinions rather than scientific evidence. We are using many reviews. We don't need to reach down to lower-quality sources to argue with better sources. QuackGuru (talk) 23:58, 5 May 2015 (UTC)

The clinical practice guidelines is poor evidence and only suggestions. The solid evidence is Cochrane reviews. QuackGuru (talk) 08:23, 8 May 2015 (UTC)

Yes, but they're not perfect. That is why WP:MEDORG must not be ignored. -A1candidate 08:51, 8 May 2015 (UTC)

We have WP:WEIGHT too. This page has over 300 references and is very long. For a mature topic with many reviews we should use better sources. QuackGuru (talk) 09:24, 8 May 2015 (UTC)

I would suggest deleting the blog of David Gorski and remove his polemical statements -A1candidate 09:58, 8 May 2015 (UTC)

I did remove the source David Gorski from a long section. See Talk:Acupuncture/Archive 23#Long section. If you want to remove more specific information I suggest starting a new section. QuackGuru (talk) 18:36, 8 May 2015 (UTC)

The sources are opinions not solid evidence. The sources do not summarise the body. QuackGuru (talk) 20:38, 9 May 2015 (UTC)

Last time I checked, Gorski's name is still there. Then add it to the body instead of removing. -A1candidate 20:51, 9 May 2015 (UTC)

It is where exactly. We have more precise wording using a high-quality review in the body. QuackGuru (talk) 20:54, 9 May 2015 (UTC)

Under section on "ethics" -A1candidate 21:01, 9 May 2015 (UTC)

You have not given a reason to remove it from Acupuncture#Ethics. QuackGuru (talk) 21:04, 9 May 2015 (UTC)

How about failing WP:MEDRS? -A1candidate 21:06, 9 May 2015 (UTC)

The source was discussed before. See WP:FRINGE. QuackGuru (talk) 21:08, 9 May 2015 (UTC)

Listen, I agree with Arthur that the American College of Chest Physicians talking about acupuncture and cancer isn't the same as the American Cancer Society, but it's wrong to outright delete things like this without discussion. There can be a perfectly reasonable argument for its inclusion that is worth examining. For instance, chest physicians like pulmonolgists often see patients undergoing cancer treatment and might give referrals for acupuncture. Based on their expertise, it may be relevant. If we want to have a strict enforcement of the specialization clause in MEDRS, we could absolutely start deleting claims from all non-acupuncture specific journals since it's not within their field of expertise. LesVegas (talk) 21:33, 9 May 2015 (UTC)

Revert of pseudoscience

Regarding this revert: Huh? This is the first time (to my knowledge) the pseudoscience descriptor was removed from that section, so the accusation of edit warring is bizarre.   — Jess· Δ♥ 13:54, 4 May 2015 (UTC)

I was talking about your pattern of editing, not a single revert.DrChrissy 14:27, 4 May 2015 (UTC)

My "pattern of editing"? I reverted you only once prior to that, on an entirely different edit, and I commented on the talk page regarding both reverts. This edit, however, is edit warring; it is a revert of a revert without discussion with the intent of forcing a proposed change into the article despite opposition. You should read WP:EW before citing it. That all said, you undid my change above without providing any rationale. Why did you do that?   — Jess· Δ♥ 15:24, 4 May 2015 (UTC)

And this version was not an improvement. DrChrissy please discuss and get consensus for significant changes before you make them. --NeilN 14:02, 4 May 2015 (UTC)

Please see WP:BRD.DrChrissy 14:24, 4 May 2015 (UTC)

Scientific basis section

I have been trying to bring a little stability and order to this article. I have tried to take details (not the subject) about adverse effects from the lede to the main body of the article. Result - disruptive edit warring! I have tried to take the scientifc basis of acupuncture to its own section so that the lead can remain stable for at least 24 hrs. Result - more disruptive edit warring! I even chose to place this scientific basis above the section on clinical practice. I think everybody would agree that the scientific basis of acupuncture is contentious, so why do those doing the edit warring not want such a section. We can all have our say and leave the lede alone!DrChrissy 14:10, 4 May 2015 (UTC)

You wanted the lead to be stable for 24 hours, so you made significant changes to it? That's a strange rationale. The lead must summarize the body, so there are two problems with your edit: 1) Moving the scientific reception of acupuncture out of the lead means it no longer summarizes the body, and indicates that acupuncture's scientific reception is not a significant part of the topic. 2) Since this detail is already covered in the body, moving the lead into the body means it is now covered twice in two different places (but still not in the lead).   — Jess· Δ♥ 14:14, 4 May 2015 (UTC)

As I stated in the edit summary I was trying to make the first para neutral so we could all leave it alone. Yes, the lead must summarize the body of the article, at the moment, there is little, if any, discussion of the scientific basis in the body of the article. This should be discussed in the body, not the lead, and the lead should only summarize it. I believe it's importance justifies its own heading.DrChrissy 14:21, 4 May 2015 (UTC)

1) We don't have sections in leads. 2) If your intent was to move that entire section out of the lead, it would remove all indication that the mainstream medical community regards acupuncture as a fringe treatment. --NeilN 14:40, 4 May 2015 (UTC)

My intent was/is to move it out of the lead, discuss the section, then when consensus is clear, make a summary in the lead. At the moment, we appear to be having the discussion in the lead which is probably why several editors have already commented it is too long and complicated. My sole intention is to improve the article.DrChrissy 14:53, 4 May 2015 (UTC)

There really are two issues here, and let's not conflate them. The benefits of acupuncture are contentious to the extent that there is legitimate research that shows that it may have some small actual effect through mechanisms that have not been properly isolated. Because of that, we cannot flatly state that acupuncture itself is pseudoscience or quackery. The underlying theories of TCM, however, with yin, yang, qi, meridians, and the like are obvious pseudoscience to the point that they should be unequivocally and decisively described as such in Misplaced Pages's voice and the smattering of contradictory studies dismissed as either erroneous or intentional fringe science. As for moving it "out of the lead": absolutely not. The lead serves as the summary and takeway for readers that skim, and the important takeaway on acupuncture is that it is a practice with dubious benefits that are not certain to exist, and that the theoretical underpinnings on which it was founded are superstition and folklore. Someone that reads the lead should not come away with the impression that it is a widely accepted medical treatment or that there is some kind of controversy over its origin.—Kww(talk) 15:04, 4 May 2015 (UTC)

Misplaced Pages is WP:NOTFORUM. Less personal opinions, more sources. Thank you Kww. Jayaguru-Shishya (talk) 17:24, 4 May 2015 (UTC)

Less interruptions of discussion flow, please. I have provided a reasonable summary of scientific opinion and your implication that I have not is completely unwelcome.—Kww(talk) 17:45, 4 May 2015 (UTC)

• Kww really highlights the issue here, it's the conflation of the TCM ideas (qi, meridians) and the evidence for effectiveness (RCT results). We have to be careful to cover these as separate topics. If there is some evidence for effectiveness beyond placebo, we cannot allow the article to imply that TCM has an accepted basis as the cause of it. Zad68 17:54, 4 May 2015 (UTC)

Expansion of lead

Where are the extensive talk page discussions for this? --NeilN 17:26, 4 May 2015 (UTC)

See Talk:Acupuncture#Acupuncture_has_.22proven_efficacy.22_and_scientific_backing -A1candidate 17:28, 4 May 2015 (UTC)

@NeilN - Are you going to provide an explanation for your removal? -A1candidate 17:31, 4 May 2015 (UTC)

Yes, please use a less misleading edit summary next time. A discussion that's less than one day old, begins with "I think this needs significantly more discussion before being inserted into the article", and was not even about moving content into the lead is not "extensive talk page discussions". You should know that. --NeilN 17:37, 4 May 2015 (UTC)

You still have not provided a policy-based explanation for removing MEDRS sources. -A1candidate 17:43, 4 May 2015 (UTC)

Because your laundry list was misleading and undue. Look at your very first source - (weak recommendation, moderate-quality evidence). The only recommendation classified as "weak". --NeilN 18:00, 4 May 2015 (UTC)

So what do you suggest to make it less misleading, without deleting the views of medical organizations? -A1candidate 18:03, 4 May 2015 (UTC)

What about a section called "National reception" or "Reception by national medical organisations" (or something like that), with a summary in the lead? We alraedy have one section on Scientific reception and another section that could easily be called "Popular reception".DrChrissy 18:13, 4 May 2015 (UTC)

Why would we worry about "popular reception" of an activity that purports to be medicine?—Kww(talk) 18:37, 4 May 2015 (UTC)

• The actual discussion history (started yesterday) cannot be reasonably used to "restore" something that never had consensus for inclusion in the lead in the first place, so per WP:BRD we restore the status quo ante and discuss the proposed change.

  The existing wording in the lead is "Clinical practice varies depending on the country." sourced to Ernst. I can support a small expansion of that one sentence, sourced to a high quality secondary source (note that statements from the individual medical organizations would be primary sources for this purpose). Zad68 18:16, 4 May 2015 (UTC)

Zad, if the medical organizations state their view is based on scientific evidence, doesn't this make them secondary sources?DrChrissy 19:58, 4 May 2015 (UTC)

This is a subtlety in that the same source can be primary or secondary depending on what it's used for. For example, this practice guideline from the American College of Physicians contains some discussion of acupuncture that might be used as a secondary source for "Acupuncture may be helpful for those with chronic back pain that does not respond to other treatment." (However I rush to point out that the guideline is from 2007 and there are plenty of more up-to-date sources.) But that practice guideline itself would be a primary source for "The American College of Physicians has suggested the use of acupuncture for some groups of patients" (to use the wording from the edit that started this discussion). Make sense? Zad68 20:17, 4 May 2015 (UTC)

Yes, I know what you mean. (You may be interested to look here at an essay I wrote on the subject.) I was actually thinking about the UK site which states "NICE makes these recommendations on the basis of scientific evidence."DrChrissy 20:30, 4 May 2015 (UTC)

If we have reliable sources that offer parity, we have to expand the lede for neutrality purposes. If we are worried about the lede being too long, then we have to delete parts of it. But what we cannot do is have it full of one-sided sourcing only. Hence the tag I added. LesVegas (talk) 21:35, 4 May 2015 (UTC)

This information was about effectiveness but we already have information about effectiveness to summarise the body. See "Evidence on the effectiveness of acupuncture is "variable and inconsistent, even for single conditions". An overview of high-quality Cochrane reviews found evidence suggesting that acupuncture may alleviate certain kinds of pain." QuackGuru (talk) 21:40, 4 May 2015 (UTC)

That information serves as parity against Quackwatch calling its basis pseudoscience. Oh, and Quackwatch doesn't hold much weight against a plethora of sources like that so it needs to be replaced by something with equal weight to those national scientific bodies, or be deleted altogether. LesVegas (talk) 21:47, 4 May 2015 (UTC)

Why do you insist on providing "parity"? What parts of our policies and guidelines about pseudoscience do you misinterpret as requiring us to provide equal time to the notion that TCM isn't pseudoscience?—Kww(talk) 21:49, 4 May 2015 (UTC)

Just popping in. If we have more reliable sources than QuackWatch, we can replace it by the more reliable ones. Jayaguru-Shishya (talk) 21:54, 4 May 2015 (UTC)

Effectiveness and pseudoscience are two separate issues. QuackGuru (talk) 21:59, 4 May 2015 (UTC)

@ Kww, I don't mean Misplaced Pages:PARITY when I say parity, I mean Misplaced Pages:BALANCE. All the edits A1 Candidate and DrChrissy and I made in the lede's expansion were towards providing a counter argument to Quackwatch's claims. I didn't delete Quackwatch, even though it really fails the test on Misplaced Pages:GEVAL if you stand Quackwatch up next to notable textbooks, multiple government health organizations, and notable scientific books that disagree with Quackwatch. Really, if we are going to use the claim, we need to find a source that has equal weight to the many acupuncture-positive ones that were deleted. LesVegas (talk) 23:11, 4 May 2015 (UTC)

But the scientific consensus is that TCM is claptrap. I agree that the lead can't describe acupuncture itself as pseudoscience directly and without attribution, but that doesn't apply to TCM. Sources that describe TCM as having a foundation are WP:FRINGE, and cannot be included as being on par and are not necessary (or even desirable) for balance. We don't balance science with pseudoscience, nor present fringe claims as being on par with accepted science.—Kww(talk) 23:19, 4 May 2015 (UTC)

Scientific consensus? Where are you getting your information about scientific consensus saying TCM is a claptrap? Don't tell me the Misplaced Pages article! Kww, don't you know that editors there only pretend there is a consensus amongst scientists by deleting all scientific sources that suggest otherwise? They do, I promise you. These editors actually delete scientific sources and statements that come from the NIH, the NHS, the Routeledge Encyclopedia of Science, texts published by the Royal Society of Chemistry, anesthesia textbooks, and then they claim there is scientific consensus all because Quackwatch says so. They can't ever seem to find anyone else who says exactly what Quackwatch says, but they merely repeat words like "scientific consensus says" which confuses editors just passing by, and making them think the folks trying to add statements by the NHS and NIH are fringe kooks who are just trying to push another strange theory into the encyclopedia. And they also don't want Quackwatch attributed when it says something about TCM, even though an RfC on TCM suggested otherwise. Seriously, if you want good information on TCM or Acupuncture, I'll show you some sources by scientific bodies. Don't read Misplaced Pages for your information anymore. LesVegas (talk) 00:13, 5 May 2015 (UTC)

No, I'm afraid it's people pushing superstition and fraud that are pretending.—Kww(talk) 01:55, 5 May 2015 (UTC)

Full protection...

...for three days. Let's try and continue this here, rather than on the article please. --kelapstick 18:48, 4 May 2015 (UTC)

Not being verifiable?

DrChrissy, what are you talking about? Have you actually clicked the link and read the web page? --NeilN 19:03, 4 May 2015 (UTC)

Stop being so patronising. The link has been changed very recently. When I made my comments, I was being directed to an older version of the Quackwatch article that did not include the statement. The current source now does. The lack of stability in this web-site/blog is another reason we should not be using Quackwatch.DrChrissy 19:19, 4 May 2015 (UTC)

I went back to a 2013 version of the article. Same quote, same link, so your explanation does not make sense to me. --NeilN 19:25, 4 May 2015 (UTC)

The version of the article here directs to this source. I was unable to verify the statement from that source.DrChrissy

Chrissy, the bit of the Quackwatch article we quote here has been on the source web page since April 2011. I'm not seeing support for the idea that the content suffers from "lack of stability". Zad68 19:28, 4 May 2015 (UTC)

Actually, I was talking about the stability of the source, Quackwatch. It is clear that articles are updated - I have no idea how frequently or infrequently, but I wonder if editors are careful enough to keep WP updated with Quackwatch.DrChrissy 19:51, 4 May 2015 (UTC)

Yes I understood you correctly. Quackwatch does indeed update their articles, which many would consider to be a pro and not a con, in that they keep their articles up-to-date. You can use archive.org to see how many updates are made over time. But I get your point, and we probably shouldn't be using a big direct quote like we're using currently, I'd prefer if we summarized it (with attribution). Zad68 19:56, 4 May 2015 (UTC)

Thanks for that and the helpful advice on archive.org. I would agree totally with a summary with attribution, rather than a quote which seems to be a little Wp:Undue.DrChrissy 20:13, 4 May 2015 (UTC)

Edit protected request

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

Please add the {{content}} tag to the article. There is absolutely no disagreement that there is and has been a content dispute, and that either some content not in the article belongs there, or that some content in the article does not belong there. I see no chance that the dispute will be resolved in the near future, but some of the disputes are being discussed, so I believe the tag is appropriate, even while the article is protected. — Arthur Rubin (talk) 20:02, 4 May 2015 (UTC)

I don't see how a tag will improve the article. It solves nothing. QuackGuru (talk) 20:09, 4 May 2015 (UTC)

Yeah, I can support the addition of such a tag in this case. — {{U|Technical 13}} 22:58, 4 May 2015 (UTC)

 Administrator note awaiting further comments — Martin (MSGJ · talk) 08:02, 5 May 2015 (UTC)

• Support along with Arthur if this is the

  The relevance of particular information in (or previously in) this article or section is disputed. The information may have been removed or included by an editor as a result. Please see discussion on the talk page considering whether its inclusion is warranted.

  tag he's talking about, and I've added one or two similar ones myself. I really believe they'll help attract new editors. But how do we keep the war zone away? Well, what I really think will do the trick there is to dramatically lower the threshold for topic bans. Make a couple of disruptive edits, you're automatically topic banned. Go over the 3RR twice, you're topic banned. Act uncivil towards editors, topic banned. Administrators should also not feel impervious to the possibility of being banned either. People need to stop feeling like they are entitled to grossly violate rules here. That'll prevent this battleground editing for good. LesVegas (talk) 12:29, 5 May 2015 (UTC)

great idea Les, but what will you do after you get indeffed from fringe topics, broadly construed. -Roxy the Viking dog™ (resonate) 12:34, 5 May 2015 (UTC)

Good question. I guess I'll start editing bumblebee and Disney articles with you! LesVegas (talk) 12:45, 5 May 2015 (UTC)

• Oppose - We don't need a tag again. According to previous discussion there was no consensus to have the tag. What is the purpose for the tag when there are many editors currently discussing this article? How will the tag improve the article? QuackGuru (talk) 16:06, 5 May 2015 (UTC)

• Support - I see no harm with including the tag, especially since the tag is closely linked to many of the questions discussed here at the Talk Page. Hopefully it will attract more editors to the article. Jayaguru-Shishya (talk) 19:36, 5 May 2015 (UTC)

• How will the tag attract more editors to the article? What would be the purpose of attracting more editors? I think we need less editors not more. QuackGuru (talk) 19:41, 5 May 2015 (UTC)

What the article needs is people who can talk things out...not article owners. -- Moxy (talk) 19:52, 5 May 2015 (UTC)

To talk about what things exactly? Should we talk about the format change? Should we talk about things like what happening to the lede? Or is this a waste of time? QuackGuru (talk) 20:10, 5 May 2015 (UTC)

So far those talks are a good step...but no need for all the edit wars (thus why the page is locked). If people are not aware of the editing habit problems here then they need to step-back and look at what's going on again. All should follow our basic expectations on how to deal with content and sourcing arguments. I understand that this article has had a long history of problems....but this does not mean the basics should not be followed. Perhaps the community should impose a 1 revert for this topic....this may help. -- Moxy (talk) 20:39, 5 May 2015 (UTC)

Why would it be a good step to talk about a format change? Why would it be a good step to talk about a what happening to the lede? Maybe it would help if ArbCom would accept the case rather that talk things out. Talk things out about for what? The edits don't improve anything. QuackGuru (talk) 20:48, 5 May 2015 (UTC)

There are many editors here with different POV's ...thus we have a talk page to talk things out ...this falls under common sense. You may believe all is perfect and nothing should change.. but this is not how it works here.....others may voice opinions or edit the page at will. If they or even you are reverted after a bold edit then a talk should take place...not an editwar. All should try to propose solutions ...not kick each-other in the nuts. If this is beyond peoples capability then they should think about editng other topics that are not as controversial. -- Moxy (talk) 22:22, 5 May 2015 (UTC)

Okay. Who supports this change to the lede? Anyone? QuackGuru (talk) 22:37, 5 May 2015 (UTC)

Hell no. That attributes the mainstream view, widely held, to a single individual, which gives an entirely false impression. Guy (Help!) 22:45, 5 May 2015 (UTC)

We had this before A1candidate's edits of 19:36, 3 May 2015:

Some believe that TCM has a strong scientific basis, but according to Quackwatch, it is not based upon scientific knowledge, and others describe acupuncture as a type of pseudoscience.The claim that acupuncture is medically effective has in the past been declared a pseudoscientific claim, but there is now plausible scientific evidence for acupuncture's effectiveness. However, Massimo Pigliucci and Maarten Boudry describe it as a "borderlands science" lying between normal science and pseudoscience.

References

1. Adams, David James (2013). Traditional Chinese Medicine: Scientific Basis for its Use. Royal Society of Chemistry. p. 2. ISBN 1849736618.
2. Cite error: The named reference Barrett2007 was invoked but never defined (see the help page).
3. Cite error: The named reference Baran2014 was invoked but never defined (see the help page).
4. Cite error: The named reference khine was invoked but never defined (see the help page).
5. Curd, Martin (2013). The Routledge Companion to Philosophy of Science. Routledge. p. 470. ISBN 1135011087.
6. Cite error: The named reference Massimo2013 was invoked but never defined (see the help page).

Any thoughts on this? Jayaguru-Shishya (talk) 17:35, 6 May 2015 (UTC)

This was rejected. QuackGuru (talk) 20:30, 6 May 2015 (UTC)

You seem to be in danger of the fallacy of false equivalency. Some people's POV is that disease is caused by imbalance of yin and yang and can be cured by balancing the flow of qi through meridians using acupuncture. That is a POV, just as the age of Earth being 6,000 years is a POV, but both are based on superstition and dogma, and both are wrong.

This is not a matter of balancing POVs of equal validity. It is a matter for making specific, actionable edit requests, and seeing if there is consensus for them. Science is not a POV, it's a method for separating truth from falsehood.

It is also a matter for controlling long-term civil POV-pushing by acupuncture advocates. We do this on articles like Homeopathy (edit | talk | history | protect | delete | links | watch | logs | views) all the time. Guy (Help!) 22:43, 5 May 2015 (UTC)

All great points....so what to do...we show many sources for what many may seem as contentions ...that is we have both MED sources and textbook source....why textbook source??? Because they go into details about topics and this will let others see the reasons behind the conventional thinking. So do you think a one revert option on this article would help? -- Moxy (talk) 23:03, 5 May 2015 (UTC)

Editors can review all the changes or lack of changes with the recent edits. After over 235 edits little has changed. QuackGuru (talk) 22:48, 5 May 2015 (UTC)

•  Added the maintenance tag — Martin (MSGJ · talk) 08:31, 6 May 2015 (UTC)

"Although minimally invasive"

The lede currently contains the text:

Although minimally invasive, the puncturing of the skin with acupuncture needles poses problems when designing trials that adequately control for placebo effects.

The difficulty of designing trials is adequately sourced, but as far as I can tell "although minimally invasive" is editorial and appears to violate WP:SYN. It is invasive enough to result in numeorus case histories of cardiac tamponade, infection and other adverse events, after all. I can't find a robust source for the implicit claim that acupuncture is a member of the class of minimally invasive procedures (see Invasiveness of surgical procedures § Minimally invasive procedure for a description of the normal use of the term). Minimally invasive is a term normally reserved for techniques that reduce the invasiveness of an established procedure; pain management is normally not invasive at all, whereas acupuncture is, so I think this text is misleading and incorrect. Guy (Help!) 22:54, 5 May 2015 (UTC)

The body says "Due to acupuncture's invasive nature, one of the major challenges in efficacy research is in the design of an appropriate placebo control group." I wonder who made the changes to the lede or the body. QuackGuru (talk) 23:02, 5 May 2015 (UTC)

Review article

A meta-analysis has just been published that might warrant inclusion here. "Acupuncture therapy can significantly improve the hearing of patients with nerve deafness, and the efficacy of acupuncture in combination with medication is superior to medication alone." I am leaving it here for regular editors to decide if it is worth including. — Preceding unsigned comment added by 108.181.201.237 (talk) 19:32, 6 May 2015 (UTC)

• This is a low-impact journal, so I personally think it should probably be left out. Everymorning talk 20:13, 6 May 2015 (UTC)
• The authors are Jiang Y, Shi X, and Tang Y. They might have a COI. QuackGuru (talk) 20:16, 6 May 2015 (UTC)
• The journal is not MEDLINE indexed. Zad68 20:26, 6 May 2015 (UTC)
• Looks great to me! WP:MEDRS states "The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs)" Authors sometimes choose for their own reasons to publish in low impact journals - that does not mean the article itself is poor quality. Not being Medline indexed does not necessarily mean it is poor quality. Perhaps we could have some evidence of the COI accusation?DrChrissy 21:10, 6 May 2015 (UTC)
• Leave it out, not MEDLINE indexed, in a low impact journal. Yobol (talk) 21:17, 6 May 2015 (UTC)
• Please provide the impact factor of the journal as evidence it should not be used.DrChrissy 21:25, 6 May 2015 (UTC)
  • Before sticking your neck out on this one, why not read the paper's own discussion section, and note carefully the drawbacks the authors bring up... Also read WP:EXCEPTIONAL. Zad68 21:30, 6 May 2015 (UTC)
• I am not sticking my neck out, I am simply asking another editor to provide evidence to back up their arguments that 1) there is a potential COI, and 2) the impact factor of the journal.DrChrissy 21:36, 6 May 2015 (UTC)
  • The impact factor is on their website: 1.422. As a comparison to some of the top general medical journals NEJM has a impact factor >50, JAMA ~30, Annals of Internal Medicine ~16. Compared to 2013 impact factors, this would place it #72 in the general medicine category, slightly ahead of the Croatian Medical Journal and the Libyan Journal of Medicine. Yobol (talk) 21:37, 6 May 2015 (UTC)

  • "Looks great to me!" seems like sticking your neck out... Zad68 21:38, 6 May 2015 (UTC)

Interesting discussion! I honestly thought it would be ok to include, but thought I should let you guys decide. A question though, as I clearly do not have a good grip on policies regarding sources in medical articles...why would you exclude this peer-reviewed meta-analysis when in the sections above it seems many of you accept inclusion of the non-peer-reviewed sources from blog sites like Quackwatch? Isn't this review a better source than a non-peer-reviewed blog, despite that it might not be medline indexed? — Preceding unsigned comment added by 108.181.201.237 (talk) 21:53, 6 May 2015 (UTC)

It is a better source, but stand back and wait for the replies you are about to get!DrChrissy 22:01, 6 May 2015 (UTC)

Here come the replies.... Because some people (and everybody can join in the chorus here . It goes like this): Nah-nah-nah – can't hear you? Because it offends my- un-examin-ed- beliefs! nah-nah-nah – can't hear you – nah-nah-nah. Its not on Quack Watch, not on Quack Watch, so nah-nah—nah nah an a nah.--Aspro (talk) 22:36, 6 May 2015 (UTC)

@IP 108: It is important to note that how reliable a source is depends on the context of what text it is being used as a source to support. For instance, Quackwatch is not just your run of the mill blog, but is a highly praised website (praised by medical sources and general media alike); it is also being used to source content in this article that is generally difficult to find in peer reviewed sources, such as discussion of the conceptual basis of acutpuncture. It is not being used to describe the efficacy of acutpuncture in individual diagnoses. This is an important mistake that many editors make, in that they forget that different types of sources can be reliable for different types of text they are used to support. Your suggested source is not a high quality source compared to the others used in this article to describe the efficacy of acupuncture for individual diagnoses, and should therefore not be used for this purpose. Yobol (talk) 22:18, 6 May 2015 (UTC)

@IP 108. You have raised a question that has been raised many, many times, simply because it is such an obvious one to ask. I myself raised the same question on the Talk page of this article just a few days ago. I suggest you have look to see the type of answers you might get here. It is some of the most mis-contrived logic I have ever read.DrChrissy 22:43, 6 May 2015 (UTC)

@DrChrissy, @Aspro, please stop poisoning the well. It is disruptive. Yobol (talk) 22:45, 6 May 2015 (UTC)

Then stop owning this article! It is as simple as that.--Aspro (talk) 22:52, 6 May 2015 (UTC)

@User talk:Yobol How can I possibly be poisoning the well. The IP asked a question and I am answering them. Sorry if my answers disagree with yours but that is life! I am requesting that you strike the accusation about me being disruptive.DrChrissy 22:59, 6 May 2015 (UTC)

• A low-impact journal with a surprising result? In general, for all medical topics, if there's an isolated report in a low-impact journal with a result that isn't reported by in more widely accepted journals, we shouldn't include it. If acupuncture actually cures deafness, it will be eventually reported more widely and we can report it then.—Kww(talk) 23:45, 6 May 2015 (UTC)

1.42 is actually fairly good. In my experience looking at impact factors, it would put the journal in the top half in a medical category. TimidGuy (talk) 17:53, 8 May 2015 (UTC)

It is not MEDLINE indexed. That's not good. QuackGuru (talk) 18:01, 8 May 2015 (UTC)

@TimidGuy: 1.422 may be "ok" in certain very specialized topics, but not in this context. Their impact factor puts them in the bottom 30% of their respective category (87th out of 124). It is not MEDLINE indexed, it has a low impact factor and all signs point to it not being a high quality journal, and therefore should not be used. Yobol (talk) 18:28, 8 May 2015 (UTC)

The review itself admits that not a single one of the studies they looked at had any placebo control. --sciencewatcher (talk) 00:41, 12 May 2015 (UTC)

Scientific consensus (and COI too)

If there is really sci consensus that acupuncture is bunk and that acupuncturists have COI's, why do these counterexamples exist?

• 251 currently-open clinical trials
• Used at multiple academic centers, e.g Harvard, Stanford ... plenty more
• Significant proportion of doctors favor it
• Novella acknowledges/predicts lack of agreement (see final 3 para's)
• Cochrane doesn't consider practicing acupuncturists conflicted when they write about efficacy (I recognize some names; no COI declared). Nor have I found much/any evidence that other editors of tert sources perceive COI.

I notice that a lot of editors who make unsupportable claims re consensus and COI (a) fail to offer adequate sources for their assertions, (b) nonetheless staunchly express certainty, (c) are not themselves scientists or healthcare providers, and (d) seem to be repeating stuff they read on particular science blogs. Anyway these claims are unsupportable and we should respect NPOV. Note I'm talking about prevailing sci opinion, not whether or not those who think it may be effective are right: Misplaced Pages lags, not leads, the development of such opinion. --Middle 8 (t • c | privacy • COI) 11:16, 7 May 2015 (UTC)

An interesting question, and one which goes tot he heart of the protracted argument.

I have studied this exact question and as I understand it the answer is thus:

The trials and such exist because acupuncture has a quasi-religious following, and the followers are quite unable to entertain the possibility that they are wrong. For a less contentious example, look at homeopathy. The doctrines of homeopathy were refuted over a century ago, there is no reason to suppose ti should work and no way it can work, and yet believers are still conducting trials, ignoring negative outcomes, advocating its "integration" into reality-based medicine and in sundry other ways proselytising their creed. Science, of course, doesn't care either way: all science cares about is, are these claims true or not? The answer appears to be: no. Read the pro-acupuncture studies. Most of them start by stating that acupuncture is an ancient form of healing art. It's not ancient, as currently practiced it dates back pretty much to Mao, and to call it a healing art, or effective treatment or whatever, is to beg the question. Very few studies start out by asking whether acupuncture actually works, and those that do tend to find that it doesn't. Most will instead ask how it works, assuming in the opening premises that it could not possibly be placebo, or seek to compare effectiveness with an admittedly therapeutically null intervention.

The Cochrane issue is more contentious. I have a lot of time for Cochrane but I am aware of at least one review which is dominated by the reviewers' own work, with two of their data sets double counted amounting to well over half of all the data considered, including values which have never been duplicated and which are based on an estimated set of figures which, if you were to substitute measured values from work published contemporaneously by the same authors - also the reviewers - move from the high 80s percent to below statistical significance. There have been reviews of hoemopathic remedies with positive conclusions in Cochrane, even though this is clearly wrong. The problem is that Cochrane has not adapted to the problems identified by Ioannidis, which mean that a null treatment would be expected to generate a net positive evidence base through various biases.

The cottage industry in seeking proof for prior belief, as evidenced in your question, is what leads critics to characterise this endeavour as pseudoscience. Guy (Help!) 11:30, 7 May 2015 (UTC)

I welcome this question and thank Middle_8 for raising this in such a calm and objective fashion. It appears that Middle_8 used only US sources for their posting, which is perfectly OK, but I think this could mean the extent of such counterexamples may be considerably underestimated. Anyway, let that not be a diversion. By coincidence, I have been looking very closely at Cochrane systematic reviews of acupuncture. This has caused me to think as a scientist (biologist) (and currently neutral on whether human acupuncture works) why do so many of these systematic reviews conclude there is a positive benefit? If acupuncture really has been debunked, are all these Cochrane reviewers wrong/misguided/incompetent?

I disagree with Guy on 2 points. First, yes, there may be examples of COI or duplication of data in Cochrane, but surely you cannot be arguing this means every systematic review with a positive outcome for acupuncture can be dismissed because of these isolated incidents? Second, Guy states "Very few studies start out by asking whether acupuncture actually works". Many of the Cochrane systematic reviews do exactly this...there is no chat about meridians, qi, energy, etc, they simply ask, "does it work". Many of the trials or reviews directly compare acupuncture with various controls including sham acupuncture, placebos, pharmaceuticals, the waiting room and other therapies. Yesterday, I started working through the Cochrane systematic reviews trying to tabulate relevant details for those reviews finding a positive outcome for acupuncture. This is extremely time-consuming so I am reluctant to continue unless I know it will be accepted, however, I believe it is directly relevant to this thread of "why do counterexamples exist?" so I will post my early draft here.

DrChrissy 13:10, 7 May 2015 (UTC)

Now that M8 and the doc have been so comprehensively dismissed by Guy, can we now expect them to stop their disruption. Please. -Roxy the Viking dog™ (resonate) 13:56, 7 May 2015 (UTC)

I'm sorry Chrissy but because you commented on PMID 25932209 with "Looks great to me!", and haven't retracted it, I can't give your evaluation of sources any weight. Zad68 13:59, 7 May 2015 (UTC)

@Zad Fair enough.DrChrissy 14:05, 7 May 2015 (UTC)

@Zad - actually, perhaps you can show me where in the above I am making an evaluation. The words used are those given in the sources, usually the "authors conclusions".

Well what did you mean when you wrote "Looks great to me!" if you didn't intend that to be an evaluation of the source?? Zad68 14:20, 7 May 2015 (UTC)

Zad beat me to it, but I was going to say that "Looks great to me" kinda gives your feelings away. -Roxy the Viking dog™ (resonate) 14:22, 7 May 2015 (UTC)

@Zad I thought your comment was about me evaluating sources in this thread. Yes? Where have I evaluated sources in this thread?. If you have simply commented on an edit of mine in another thread, isn't that rather off-topic. Or perhaps that is what is trying to be done? Deliberate disruptiveness because you have no answer to the question Mid8 and I are asking. Let's try to comment on the edits rather than the editors, shall we?DrChrissy 14:33, 7 May 2015 (UTC)

So you've put up a table listing sources but have no plans to evaluate them for their quality or fitness for use here? Guy's response did comment on those aspects of sources, so that is definitely part of this conversation. Zad68 14:44, 7 May 2015 (UTC)

What a resounding pile of inconclusive results.

• The trials were of moderate methodological quality, but the number of participants in each trial was relatively low. There was a range of individuals studied, acupuncture techniques used and outcomes measured, so we could not combine the results of the trials to get an overall picture of the effectiveness of acupuncture. Therefore, we could only draw limited conclusions.
• The small sample size, scarcity of studies for each comparison, lack of an ideal sham acupuncture weaken the level of evidence and its clinical implications. (I note that this one is using an unexplained treatment against a disease that no one can agree on precisely what it is or what it affects)
• the information available was small scale and rated to be very low or low quality by the review authors, so not completely provable and valid.
• Three of the four trials in which acupuncture was compared to physiotherapy, massage or relaxation had important methodological shortcomings.
• these findings should be interpreted with caution due to the small number of studies and study participants

You've provided strong evidence for JzGuy's position, not for acupuncture.—Kww(talk) 14:41, 7 May 2015 (UTC)

Two points, DrChrissy.

First, you need to study the language of trial results used in promoting supplements, complementary and alternative medicine (SCAM). These almost invariably include only clinical trials of mainly poor methodology conducted by believers. Few, if any, provide evidence of any credible mechanism. Vanishingly few, if any at all, actually refute the null hypothesis.

Second, Middle8 has a material conflict of interest. Evidence he presents is unlikely to include anything that challenges his beliefs.

The issue with acupuncture is that it is at least minimally plausible that needling might have some effect. There is no evidence that qi or meridians exist, the claimed mechanisms advanced by TCM practitioners and other believers are generally religious and not empirically valid. It is very important to remember that a great deal of the published material is guilty of begging the question, in that it assumes a positive outcome from the trial is (a) not a false positive and (b) validates the underlying belief system, rather than the simple act of needling. The former is addressed by Ioannidis in terms of prior probability, which for most of the conditions covered is actually very low, the latter is more of a concern to us in that we have to be very clear on what the evidence actually says.

You should also think long and hard about this: when an intervention claimed by its proponents to be universal, accumulates an evidence base that varies from null to weak positive, pretty much randomly across a spectrum of conditions, then this suggests extremely strongly that the effects are non-specific (i.e. placebo) and that the major difference between the studies is not the effect of the treatment, but the quality of blinding and other mechanisms to eliminate bias.

You can also see this in analyses of acupuncture and comparable trials from China, where there are almost no negative results, ever. In SCAM studies generally, the more committed the investigator is to the intervention, the more likely the outcome is to be positive. This has been extensively investigated with respect to homeopathy, where there is a direct relationship between study quality and outcome, with the most robust studies being least likely to produce a positive outcome (Linde, 1999). I am pretty sure I have seen similar analysis for acupuncture, but don't recall the cite offhand.

What is clear is that there is no robustly demonstrable difference between real and sham acupuncture:

1. It doesn't seem to matter where you put the needles.
2. It doesn't seem to matter whether you insert the needles or not.
3. It doesn't even seem to matter if you put the needles into the patient or into a rubber hand.

The area of pseudomedicine, cognitive bias, placebo effects, blinding and nonspecific effects is very complex. The studies acupuncture proponents conduct are generally not terribly sophisticated, and are intended to support, rather than test, the premise. This undoubtedly exerts an effect on the outcomes. Skepticism is mandatory when reviewing these trials. And don't forget: acupuncture, and TCM generally, are quasi-religious in character, dominated by ritual and mysticism. There is deep emotional investment on the part of practitioners, many of whom have invested substantial time and resource in study of things which the reality-based community rejects outright, such as acupoints.

You can't take the statements of acupuncture proponents at face value, and you certainly can't assume that a minimally plausible mechanism of transient pain relief is likely to be the actual cause of longer term relief in symptoms whihc always turn out to be measured subjectively. Guy (Help!) 15:17, 7 May 2015 (UTC)

The way you have phrased this is more than a bit misleading. There isn't a scientific consensus that acupuncture itself is complete bunk. There's a consensus that if there's any effect at all, it's small in absolute terms and small relative to the placebo effect. I tend to side with Guy that the doubt exists because of persistent source bias, but I can't dismiss the existence of the doubt. As for the underlying TCM basis of qi, meridians, yin, and yang? Yes, those are uniformly dismissed as nonsense by reliable sources.

Again, an analogy, because it tends to make things more obvious. If there were a group of people that believed penicillin worked by scaring angry demons away, evidence that penicillin was effective would not be evidence that angry demons exist. Acupuncture is in a similar position: there is some small amount of evidence that indicates that it may have some limited effectiveness against some limited number of things. None of that is evidence in favor of TCM.—Kww(talk) 14:41, 7 May 2015 (UTC)

Good grief people! What a waste of your energy! As I stated, the table is an "early draft"! I had one thought of it existing as an appendix linked to a statement such as "Some Cochrane systematic reviews have found a positive benefit of acupuncture under some circumstances", so I/We would not be analysing the sources - Cochrane has already done that for us. Alternatively, it could on a stand-alone "list of...." page, but there could be a link to it on here.DrChrissy 15:01, 7 May 2015 (UTC)

Yes, good point, it would be best if a specific content change proposal were made so that we can focus the conversation on that. The OP's comment didn't actually propose a specific change and I think we're struggling with that. Zad68 15:08, 7 May 2015 (UTC)

I would even object to your summary, given your table. The summary of your table so far would be more like "Cochrane systematic reviews have been unable to reach meaningful positive conclusions due to flawed underlying studies, small trial sizes, methodological defects, and low-quality information".—Kww(talk) 15:32, 7 May 2015 (UTC)

@Guy @Kww Please note that the only sources I have been referring to specifically are Cochrane systematic reviews. I'm sure you know that WP:MEDRS states "Cochrane Library reviews are generally of high-quality and are routinely maintained even if their initial publication dates fall outside the above window." Are you arguing that all Cochrane reviews reporting positive effects of acupuncture can be dismissed as innacurate, flawed, sub-standard or whatever?DrChrissy 15:41, 7 May 2015 (UTC)

No, but as I listed above, all the ones you have provided so far have failed to come to strong conclusions for various reasons.—Kww(talk) 15:45, 7 May 2015 (UTC)

Well perhaps we need to contact Cochrane about this - stating that Misplaced Pages editors (with unknown expertise) are finding fundamental flaws in their expert, peer-reviewed, systematic reviews and these are no longer to be trusted.DrChrissy 15:57, 7 May 2015 (UTC)

I quoted the flaws that the study authors themselves noted, and provided links to the source of each quote. Please don't misrepresent my statements that way.—Kww(talk) 16:02, 7 May 2015 (UTC)

If only we had a source specifically analysing the accuracy of Cochrane reviews of acupuncture. What's that you say? We have?

Just because something is labelled as a systematic review does not mean it is any good. We have to be just as vigilant now as ever. Even a review with a Cochrane label does not make its true. Four out of 12 Cochrane reviews on acupuncture were wrong.

— How good are systematic reviews of acupuncture?

Note the discussion of author COIs.

The crucial bit you missed is that WP:MEDRS says that Cochrane reviews are generally of high quality, and you have interpreted that to mean that any finding of a Cochrane review is of high quality and its conclusions robust - even though the reviews themselves say the opposite.

The Cochrane Collaboration are well aware of widespread criticism of their reviews, and a vulnerability to agenda-driven reviewers. Several reviews have been replaced by newer reviews reversing or nullifying the previous findings. The review on tamiflu is deeply controversial.

The thing about science is that criticism is absolutely normal, it is what distinguishes science from quasi-religious practices like acupuncture. See if you can find any forum where acupuncturists use objective criteria to determine whether variants such as moxibustion or EAV are valid or not - it doesn't happen, doctrinal differences are exactly that: doctrinal, they cannot be objectively settled. Science, by contrast, seeks objective truth, and the attempt to look sciencey while studiously avoiding rejecting your base premise is what makes SCAM research pseudoscientific instead of scientific. Guy (Help!) 18:14, 7 May 2015 (UTC)

@Guy You stated above that 4/12 Cochrane reviews were incorrect. This means that ony 8/12 were correct. Does this make Cochrane an unreliable source?DrChrissy 21:16, 7 May 2015 (UTC)

@User:Kww Would you please interpret the findings of this article and its suitability for inclusion in the article. My thanks in advance.DrChrissy 22:00, 7 May 2015 (UTC)

Why are you asking about a 2008 study when there are 7 more recent studies cited in this article on this very topic? (See WP:MEDDATE). Yobol (talk) 22:15, 7 May 2015 (UTC)

Oh right. So can I put those 7 studies in the article?DrChrissy 22:33, 7 May 2015 (UTC)

Um, what? Put what 7 studies in what article? Yobol (talk) 22:55, 7 May 2015 (UTC)

We are on the Acupuncture talk page. I was talking about putting the 7 articles into the Acupuncture page. You seem to be suggesting they are better articles than the single article I suggested. It might help if you identified the 7 articles you are talking about so we can all do our interpretations of their reliability.DrChrissy 23:06, 7 May 2015 (UTC)

Being on the Acupuncture talk page, I was talking about the 7 articles about fertility that are already used in the article (refs 121-127) (hence the "cited in this article on this very topic" phrase in my original reply). Just a suggestion, but maybe you should spend more time getting to know this article, since you have already been spending so much time on the talk page? Yobol (talk) 23:15, 7 May 2015 (UTC)

Please stick to comments on the edits, not on the editors.DrChrissy 23:28, 7 May 2015 (UTC)

It's hard having an informed discussion about an article when that editor does not appear to have read the relevant section of the article for which they are suggesting edits. If you choose not to read the article, that is up to you. Yobol (talk) 23:57, 7 May 2015 (UTC)

DrChrissy I directly quoted the authors' conclusions from the articles you had proposed. Please stop implying that I am interpreting the studies.—Kww(talk) 23:18, 7 May 2015 (UTC)

Your edit here looks very much like an interpretation to me.DrChrissy 23:26, 7 May 2015 (UTC)

Given "The trials were of moderate methodological quality, but the number of participants in each trial was relatively low. There was a range of individuals studied, acupuncture techniques used and outcomes measured, so we could not combine the results of the trials to get an overall picture of the effectiveness of acupuncture. Therefore, we could only draw limited conclusions", "The small sample size, scarcity of studies for each comparison, lack of an ideal sham acupuncture weaken the level of evidence and its clinical implications.", "the information available was small scale and rated to be very low or low quality by the review authors, so not completely provable and valid", "Three of the four trials in which acupuncture was compared to physiotherapy, massage or relaxation had important methodological shortcomings", and "these findings should be interpreted with caution due to the small number of studies and study participants" I will stand by it as an accurate summarization, not interpretation. Certainly a far more accurate summary than your proposed "Some Cochrane systematic reviews have found a positive benefit of acupuncture under some circumstances".—Kww(talk) 23:44, 7 May 2015 (UTC)

@Kww I think we have got into the subtleties of semantics and nuances. I suspect this is a complete waste of effort on both our parts given that I have already indicated this is only an early draft of the table.DrChrissy 23:49, 7 May 2015 (UTC)

No, the distinction is not subtle. You pulled out a pile of weak reviews, proposed a misleading summary, and then attempted to claim that everyone that was pointing out that they were weak reviews was doing so out of bias. It struck me as willful misinterpretation and tendentious arguing. Nothing at all subtle about it.—Kww(talk) 00:02, 8 May 2015 (UTC)

Wow! Could you tell me what summary you are talking about?DrChrissy 00:14, 8 May 2015 (UTC)

Do me a favour: read upwards, where I directly replied to your inaccurate summary and then quoted it later. Actually reading other people's replies and considering them is a key discussion skill. Failing to do so makes one look like an intentionally disruptive editor.—Kww(talk) 00:21, 8 May 2015 (UTC)

I have not left a summary anywhere in this thread because I have not presented any material to summarise. I posted the table and suggested a very general, neutral sentence that it might link to. I have clearly stated the table is an early draft, so any statement linked to it would obviously also be up for discussion when the table is finished. You seem to have focussed on the table and associated comments very early in their evolution. Take a step back, relax, and wait until the table is complete. Your constructive criticism will then be very welcome.DrChrissy 00:43, 8 May 2015 (UTC)

Aahh ... so that misleading summary wasn't a summary? It was just a "very general, neutral sentence that it might link to"? Thank you from making your disengenuous behaviour more obvious.—Kww(talk) 00:54, 8 May 2015 (UTC)

@User:Kww I posted the "early draft" table and suggested the "statement" here on this Talk page. A function of Talk pages is to post suggested material for WP:Civil discussion - not to attack other editors. Your classification of my postings as being disengenuous is incorrect and a personal attack. Please do not do this again.— Preceding unsigned comment added by DrChrissy (talk • contribs)

As always, the best way to not be criticized is to not behave in a way worthy of criticism, not to misbehave and then wave WP:NPA at your critics.—Kww(talk) 13:39, 8 May 2015 (UTC)

@DrChrissy: If it is a waste of time, it is not because we have "got into the subtleties of semantics and nuances", it is because you do not seem to want to understand that facts. Kww and I have both explained, in detail, why your interpretation of the Cochrane studies is incorrect, and shown you that the studies themselves are quite open about their methodological limitations. I have also shown you evidence that four out of the twelve studies are wrong anyway. These are not subtleties or nuances, these are fundamental weaknesses in the evidence, noted in authoritative sources. Guy (Help!) 08:06, 8 May 2015 (UTC)

Agree with DrChrissy and Middle8. Those were very insightful statements. -A1candidate 23:45, 7 May 2015 (UTC)

Of course you agree with them, they support the POV you have consistently advanced for years. It remains the fact that they have not addressed the fundamental issue: Cochrane reviews show weak evidence from poor studies and in several cases the Cochrane reviews misrepresent the sources. The weight of evidence is entirely consistent with the idea that acupuncture is an elaborate placebo with documented risks, and entirely fails to refute the null hypothesis. Believers will not accept his this so engage in largely pseudoscientific attempts to prove their beliefs, piling up ever larger numbers of trials all of which share exactly the same flaws. Guy (Help!) 06:51, 8 May 2015 (UTC)

That is why we have to consider the clinical practice guidelines of medical organizations in addition to the Cochrane reviews, JzG. -A1candidate 08:20, 8 May 2015 (UTC)

The problem is that clinical practice guidelines lag even further behind the science. In fact, the entire field of so-called "integrative" medicine is founded on the belief that you can write clinical practice guidelines for the use of any old bullshit, without worrying at all whether it is even remotely plausible. There are clinical practice guidelines for the use of homeopathy, which is the canonical bogus pseudomedical intervention.

The current lede actually summarises the subject rather well: acupuncture is popular, but increasingly isolated in terms of genuine scientific investigation, due to the absence of a proven plasuible mechanism and the rather well documented fact that it does not seem to matter where you put the needles, what you do with them, even whether you actually insert them at all.

I have no doubt that acupuncture proponents sincerely wish and/or believe otherwise, but this has not translated into hard empirical evidence. Most of acupuncture practice is simply nonsense, based on whimsical notions of unverifiable "life force", and it is regrettable that the inevitable (per Ioannidis) existence of a weak positive evidence base is relentlessly exploited by people determined to somehow prove that the whimsy is fact. Guy (Help!) 10:04, 8 May 2015 (UTC)

I think Miller's Anesthesia and much of the scientific community disagrees with you. -A1candidate 10:17, 8 May 2015 (UTC)

As do the statements of several National Medical Organisations.DrChrissy 10:51, 8 May 2015 (UTC)

@A1candidate: I think you'll find that it is medical, not scientific, opinion that dissents from the findings of science. Whatever the former medical students might think, the science is pretty clear: the purported mechanisms of acupuncture are bogus, the risks are real, the benefits are elusive, and most of the research is carried out by those with a strong vested interest in acupuncture's validity. Feel free to cite a good quality source that refutes (rather than repudiating) the null hypothesis. Note that only robust fundamental science or very large and very well designed clinical trials can do this, by definition. As Cochrane notes, most of the trials are neither large nor well designed.

I refer you once again to Ioannidis and the problem of prior plausibility. Acupuncture is an implausible treatment whose outcomes are weak or equivocal and appear to apply randomly across superficially similar pathologies, Ioannidis tells us that any positive results are most likely to be false, and this is in line with the finding that you can stick the needle in a dummy rubber hand and get the same effect. Guy (Help!) 12:11, 8 May 2015 (UTC)

The mechanism includes purinergic signalling, as I've told you before. -A1candidate 12:32, 8 May 2015 (UTC)

I am well aware that you wrote that WP:COATRCAK to crowbar in speculation that this might be the mechanism. Needless to say, there is no remotely credible evidence linking this to most of the claimed effects, no evidence to account for the fact that studies show acupuncture "works" for some conditions and not for other, similar conditions, no evidence of any persistent effect form such signalling, and good evidence that it does not matter if you stick the needles in or not, including evidence that acupuncture "works" equally well if you stick the needles in a dummy rubber hand instead of the patient's hand. How does purinergic signalling affect "treatment" of stroke, leukopaenia, depression and other things acupuncture is claimed to cure:

The problem is much like that of homeopathy cultists. Dana Ullman waves a paper showing that silicates exist in solutions prepared in glass. Well, duh. That is a fact, but an irrelevant one: like doesn't cure like, and there's zero evidence of bioavailability or persistence. Ditto "purinergic signalling". Sticking a needle in someone, has a transient local effect. Who knew, apart from anybody who's ever studied the pain reflex?

Here's an interesting thing, though. If it did work by purinergic signalling that would refute the all the nonsense about qi and meridians. How much success are you having in persuading acupuncturists to drop all that nonsense, based on the newly discovered "real" mechanism? And where are the treatments making use of the same mechanism but avoiding or minimising skin penetration with all its attendant risks of infection and structural damage? Guy (Help!) 20:52, 8 May 2015 (UTC)

The answer to your last question might be found in PMID 22524543. Although Orac/Gorski insists that it has nothing to do with acupuncture, he acknowledges that the experimental design is sound. You can also try asking Edzard Ernst for his opinion about this. -A1candidate 01:04, 9 May 2015 (UTC)

Misplaced Pages is WP:NOTFORUM. Less own ponderings, more sources. Cheers! Jayaguru-Shishya (talk) 17:05, 11 May 2015 (UTC)

I have already talked to both Edzard and David. The short version is: you're engaging in special pleading. There is no such thing as qi, meridians do not exist, it does not matter where you put the needles or even if you insert them, therefore acupuncture, the practice, is bogus. Whether some effects can be obtained by needle insertion is a separate quesiton, and one for the reality-based medical community. Acupunture, the religious pseudomedical intervention, is a bust. There is some accidental overlap with reality, but it is just that: accidental. Discussion of such effects would belong on an article about the effects of insertion of needles, not one on acupuncture-the-pseudomedicine. Guy (Help!) 10:07, 9 May 2015 (UTC)

Could you show me the longer version of Prof. Ernst's reply, please? I am interested to know what he says. -A1candidate 12:14, 9 May 2015 (UTC)

According to Ernst it's a bust but he is but one source. Yet even he won't say it's efficacy is entirely due to placebo effect in published literature because he knows he has to make it through peer review. Why should Misplaced Pages treat this any differently? And why do we have so many Ernst sources on the page anyway? I was counting and most are out of date, per MEDDATE. Shouldn't these be removed and replaced with fresh findings? And per DrChrissy's original point regarding Cochrane reviews, a recent scan of pubmed literature published in 2015 on acupuncture shows positive findings in all but one publication. Why is this Misplaced Pages article so diametrically opposed to recent scientific findings? LesVegas (talk) 20:36, 9 May 2015 (UTC)

Perhaps because he was Europe's first professor of complementary and alternative medicine and specialised in objective analysis of research into implausible treatments. I can't provide the text of the reply as it was not email. However, the reason he says that the effects are consistent with placebo, rather than asserting as fact that they are placebo, is because he is a scientist. SCAM proponents have no qualms about stating speculation as fact (e.g. A1candidate's assertion that acupuncture "works" by purinergic signalling, something the reliable independent sources acknowledge is speculative). Science is inherently conservative, which is why SCAM treatments persist long after they are debunked. If the world paid any real attention to science, homeopathy would be illegal, as it is entirely fraudulent. Acupuncture is minimally plausible so will take even longer to die out, even with the compelling evidence that both location and actual insertion of needles are irrelevant to therapeutic effect, and the fact that effect size is determined by prior belief, all of which are precisely what would be expected form a dramatic placebo. Guy (Help!) 22:33, 9 May 2015 (UTC)

The link you provided is an outdated source. -A1candidate 22:45, 9 May 2015 (UTC)

JzG, please bear in mind that Misplaced Pages is WP:NOTFORUM, and unless you have some strong sources to present, please take the stories you might have had with Ernst over a cup of coffee to user Talk Pages. You are constantly defining the state of acupuncture, but I don't see any sources. Jayaguru-Shishya (talk) 17:06, 11 May 2015 (UTC)

Find me an acupuncturist who only treats the small number of conditions for which the evidence is at least moderately convincing, who does not have whimsical faux-ancient Chinese anatomical charts on the walls, who always uses good aseptic technique and who has sufficient knowledge of reality-based anatomy to avoid puncturing vital organs, and we can examine the practice in the light of that reality-based practice.

A1candidate, I think you should strike the snide insinuation that Prof. Ernst only publishes honest science because peer-reviewers won't let him get away with anything else. That really is unacceptable (you might want to read WP:BLP some time). And when you say acupuncture works by purinergic signalling, you exemplify the problem with your advocacy editing. The correct statement is that according to the best available evidence, acupuncture does not work for most things, but for the few things for which needling (which is connected to acupuncture only accidentally, since meridians, acupoints and qi are all nonsense) does seem to work, there is tentative evidence that purinergic signalling may play a role. Guy (Help!) 21:13, 15 May 2015 (UTC)

"Western Medical Acupuncture"

Western medical acupuncture <> acupuncture. Per the first source given, "it is an adaptation of Chinese acupuncture..." --NeilN 16:30, 8 May 2015 (UTC)

Recent edits to the article by DrChrissy are looking to expand a bit on the term "Western medical acupuncture". The edits were made to the lead and were (in my judgment) rightly reverted by Roxy the dog and NeilN because as they were made they were a problem per WP:LEAD (first edit) and then incorrectly equated TCM acupuncture with Western acupuncture. I think the concept of Western medical acupuncture (which is mentioned only in passing right now) should be expanded, largely to hit on the issues the Kww has been raising -- that acupuncture is done, but there's a distinction between whether it's TCM-based or Western based. This needs to be developed using good-quality sourcing in the body before it's added to the lead, however. Zad68 16:36, 8 May 2015 (UTC)

Agreed, it appears to be undue for the WP:LEAD now, and as written equates the two, which seems to be a misrepresentation of the source. Yobol (talk) 16:39, 8 May 2015 (UTC)

Zad, where is the best place in the article to expand on this where I can avoid being automatically reverted?DrChrissy 16:41, 8 May 2015 (UTC)

I don't see that you were "automatically" reverted, reasons were provided for every revert.

Why not expand the section where "Western medical acupuncture" is already mentioned? Zad68 16:46, 8 May 2015 (UTC)

You should also avoid describing the claims made as facts. The source you are using is a publication by a charity dedicated to the cause of promoting acupuncture as a legitimate medical technique, but the claims they make fall afoul of WP:FRINGE.—Kww(talk) 16:53, 8 May 2015 (UTC)

Which source are you talking about? I trimmed the original posting so it was simply related to use of the term, to avoid what you are saying. However, even this was reverted rather than being discussed. Does this term not exist?DrChrissy 17:05, 8 May 2015 (UTC)

Again please take care to represent the concerns of others accurately. That wasn't the reason the second edit was reverted, it was reverted because it incorrectly implied that TCM and Western were equivalent, and it was a problem per WP:LEAD. Zad68 17:07, 8 May 2015 (UTC)

And by the way, the "new" content added to the body said that it "acts by stimulating the nervous system" and listed several "known modes of action". If you are going to contribute content to the article, please make some effort to present it neutrally. To my knowledge, there is not any consensus that western acupuncture stimulates the nervous system nor are there identified modes of action supporting its efficacy. I cleaned that up, and we're now left with a description of western acupuncture without any discussion of its reception. I don't know if this is the proper weight, but if we're going to discuss it, the blurb should ultimately be expanded.   — Jess· Δ♥ 17:22, 8 May 2015 (UTC)

I did attempt to be neutral. I placed it in quotes. If I had not done that, I would have been in copyvio. If I changed the words and paraphrased, I imagine there would have been accusations of "misrepresentation". Thankyou for cleaning it up. Maybe you would care to help in the expansion that is clearly needed.DrChrissy 17:29, 8 May 2015 (UTC)

Avoiding a copyvio and using neutral wording are two different things. Yes, you did one of them. Please try to also do the other one in the future.   — Jess· Δ♥ 17:38, 8 May 2015 (UTC)

I removed the fringe journals per WP:MEDRS and WP:OVERCITE. QuackGuru (talk) 18:24, 8 May 2015 (UTC)

Deletion of information from this talk page

I recently posted a thread here that involved a question regarding the removal of material from this Talk page. Another editor has seen fit to remove my thread without discussing this first. Please re-instate my posting.DrChrissy 00:25, 9 May 2015 (UTC)

I already explained in an edit summary and on your talk page. Discussion of editor conduct does not belong on an article talk page, per the talk page guidelines. Go to that user's talk page, or try WP:ANI if you feel it is particularly egregious.   — Jess· Δ♥ 00:28, 9 May 2015 (UTC)

I will take the behaviour of the editor to ANI or another forum, I have no problem with that, but you should re-instate my posting so that others are aware of the undiscussed removal of material from this Talk page.DrChrissy 00:32, 9 May 2015 (UTC)

No. Discussion of editor conduct does not belong here. That's the whole point. And just to be clear, no material was removed from the talk page except a section heading you apparently found objectionable. I'm having a seriously hard time characterizing your behavior as anything but disruptive. Please keep discussion focused on article improvement. Thanks.   — Jess· Δ♥ 00:36, 9 May 2015 (UTC)

The hatting and the original removal were both overly aggressive. These aren't BLP violations or WP:FORUM violations, they were were complaints about behaviour on a talk page on the talk page where the behaviour occurred. Those are normally granted some leniency. As for the complaint itself, "clumsy" probably wasn't the best word. "Misleading", "inappropriate", "unacceptable", "unwarranted", or similar would have been accurate without running the risk of insulting the person that put it there.—Kww(talk) 02:27, 9 May 2015 (UTC)

Eye of the beholder. I think your first three adjectives are worse than "clumsy". I'd further explain why clumsy was appropriate but of course, that would risk further offense. --NeilN 02:45, 9 May 2015 (UTC)

@Kww, I disagree, but fair enough. We have 33 sections on this talk in just over a month, which isn't helped by the increasing amount of behavioral discussion lately. The original complaint was about an edit by NeilN that he had already removed. I stand by that being an inappropriate discussion for this page (it can't possibly concern the article), and I left a reasonably unconfrontational message on the OPs talk to explain further. But, reasonable editors can disagree at times, so I appreciate your input, and it turns out my edit didn't end up serving its purpose of staying on-topic anyway. Oh well.   — Jess· Δ♥ 03:08, 9 May 2015 (UTC)

Is this a reliable source?

Is this a reliable source for inclusion in the article?DrChrissy 13:03, 9 May 2015 (UTC)

It doesn't seem particularly good, why would we add yet another of this type? Guy (Help!) 14:06, 9 May 2015 (UTC)

What does the exact text you wanted to use actually say? -Roxy the Viking dog™ (resonate) 14:45, 9 May 2015 (UTC)

Why does it not seem particularly good? What does "this type" mean. Please clarify.DrChrissy 16:46, 9 May 2015 (UTC)

It is a poster session, it is not peer reviewed, therefore it fails WP:MEDRS. Guy (Help!) 22:35, 9 May 2015 (UTC)

How do you know it was not peer-reviewed?DrChrissy 22:44, 9 May 2015 (UTC)

Perhaps I can learn something... The review seems OK to me - what is the problem? Thanks. Gandydancer (talk) 16:02, 15 May 2015 (UTC)

Is this a reliable source (ii)?

Is this a reliable source for inclusion in the article?DrChrissy 13:09, 9 May 2015 (UTC)

What does the exact text you wanted to use actually say? -Roxy the Viking dog™ (resonate) 14:46, 9 May 2015 (UTC)

Does that mean it might be a reliable source?DrChrissy 16:49, 9 May 2015 (UTC)

It means: what does the exact text you wanted to use, say?

The answer is: no, ti is not reliable, because Chinese-authored publications on acupuncture are never negative, so are considered suspect. Guy (Help!) 22:37, 9 May 2015 (UTC)

Wow! Is this racist?DrChrissy 22:45, 9 May 2015 (UTC)

If I remember right, I've been asking numerous times for studies dealing with the possible publication bias. I am not sure if one has provided any, but before that, we are not interested in single editors' speculation or personal findings. Until that, we can use the source unless proven otherwise. Jayaguru-Shishya (talk) 17:11, 11 May 2015 (UTC)

It's certainly systemic bias to exclude all research from an entire country. We don't exclude research just because the authors happen to be from a particular country. So yes, we should absolutely add this in and if Chinese research is ever removed because it's Chinese, a tag like this Template:Systemic bias needs to be placed on the article. LesVegas (talk) 22:57, 9 May 2015 (UTC)

This has nothing to do with racism and everything to do with the sad history of TCM research coming from China. Not only have they been repeatedly caught violating (actual fraud) rules for peer review, their research is generally extremely shoddy, to the point that, for some oddly convenient reason(!), it is always favorable to TCM and never negative. Then, when their positive views don't hold up to examination, we reject them for that reason. This history means that we see red flags, it doesn't mean we will always reject research coming from China. It just needs to be approached very cautiously. -- BullRangifer (talk) 15:45, 10 May 2015 (UTC)

And, just to reemphasize, "scientific sources" is precisely the bias that we are supposed to take. Treating any other perspective as factual is disruptive to the goals of an encyclopedia.—Kww(talk) 16:15, 10 May 2015 (UTC)

I am an East European, by birth and upbringing, and I will gladly admit that the scientific research and scholarship from my country lags very much behind Western science and scholarship, to the extent that anyone from my country willing to have a say in contemporary science or scholarship has to immigrate to the West, or at least publish in Western scientific and scholarly journals. Besides, this is what WP:MEDRS is about: bias in favor of Western scientific sources and maybe of sources who play by the same rules as Western scientific sources. I know that in China promoting TCM it is a matter of constitutional law, so the bias is expressed right there, in the Chinese Constitution (Art. 21). Besides, TCM, effective or not, is a source of money and cultural influence for China, so those who challenge the legitimacy of TCM could be seen as infringing upon the state interests, China is not a liberal democracy, so the "enemies of state" could be fined or imprisoned if they get too critical of those interests. Tgeorgescu (talk) 16:36, 10 May 2015 (UTC)

Kww, what on earth does that mean? "Scientific sources is precisely the bias", what bias? The earlier discussion has been about possible publication bias, and there are statistic tools to evaluate that already, but what is that you are pertaining to here? Jayaguru-Shishya (talk) 18:20, 11 May 2015 (UTC)

Tgeorgescu, I also believe that has nothing to do with racism, but as I've been voicing out numerous times, we need a study to verify those claims. Less opinions, more sources. Thanks. Jayaguru-Shishya (talk) 18:14, 11 May 2015 (UTC)

Tgeorgescu, you said: "I know that in China promoting TCM it is a matter of constitutional law, so the bias is expressed right there, in the Chinese Constitution (Art. 21)." It's good to know that you know, Tgeorgescu, but could you share that specific study with us too? Jayaguru-Shishya (talk) 18:23, 11 May 2015 (UTC)

Article 21 The State develops medical and health services, promotes modern medicine and traditional Chinese medicine, encourages and supports the setting up of various medical and health facilities by the rural economic collectives, State enterprises and institutions and neighbourhood organizations, and promotes health and sanitation activities of a mass character, all for the protection of the people’s health.

The State develops physical culture and promotes mass sports activities to improve the people’s physical fitness.— Constitution of the People's Republic of China (Full text after amendment on March 14, 2004) Art. 21, http://www.npc.gov.cn/englishnpc/Constitution/2007-11/15/content_1372963.htm

So, it is not a study, it is simply what the Chinese Constitution literally states. Tgeorgescu (talk) 20:13, 11 May 2015 (UTC)

Thanks Tgeorgescu, that sure is interesting. So, what do you want to propose with that exactly? Jayaguru-Shishya (talk) 21:20, 12 May 2015 (UTC)

It is clear that it is state policy. How does one implement state policy? Sticks and carrots. Even if there is no immediate persecution for writing against TCM, in totalitarian regimes intellectuals practice self-censorship: they do not want to get in hot water (losing their position at university and ending mining coal or being sent to reeducation camps). Chinese universities are paid by the Chinese state, which also makes a strong case that Chinese scientists may feel compelled to enact the objectives of state policy. Tgeorgescu (talk) 00:59, 13 May 2015 (UTC)

@DrChrissy: You have accused me of racism. Some editors would call that a personal attack and report it. Me, I think it's just cluelessness on your part. I really don't think you know very much about this subject, given the naive questions you are asking.

In the study of acupuncture trials, 252 of 1085 abstracts met the inclusion criteria. Research conducted in certain countries was uniformly favorable to acupuncture; all trials originating in China, Japan, Hong Kong, and Taiwan were positive, as were 10 out of 11 of those published in Russia/USSR. In studies that examined interventions other than acupuncture, 405 of 1100 abstracts met the inclusion criteria. Of trials published in England, 75% gave the test treatment as superior to control. The results for China, Japan, Russia/USSR, and Taiwan were 99%, 89%, 97%, and 95%, respectively. No trial published in China or Russia/USSR found a test treatment to be ineffective.
CONCLUSIONS:
Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries.

— Do certain countries produce only positive results? A systematic review of controlled trials.

No need to apologise, anyone can make a mistake, but next time perhaps ask rather than flying off the handle? Incidentally, this comprehensively answers LesVegas' frivolous demand for a "systemic bias" tag. Yes, there is systemic bias - Chinese studies are grossly biased towards acupuncture, our use of reality-based studies is not just acceptable but mandatory. Guy (Help!) 21:29, 10 May 2015 (UTC) Tgeorgescu, I don't doubt that at all but we are already moving in an area where we would need reliable secondary sources for such claims. Jayaguru-Shishya (talk) 13:27, 13 May 2015 (UTC)

@User:JzG You are very seriously misrepresenting my edits. You stated above ..."but next time perhaps ask rather than flying off the handle?" Here is the edit I posted. This is clearly a question. Please re-edit your previous posting and strike the offending content.DrChrissy 10:20, 11 May 2015 (UTC)

Okay, so did they test for publication bias? Jayaguru-Shishya (talk) 18:26, 11 May 2015 (UTC)

"Publication bias is a possible explanation.", so they tested against publication bias, did they? What was the result? Jayaguru-Shishya (talk) 18:26, 11 May 2015 (UTC)

I find this dleightfully ironic. You accuse me of racism, in two venues, and I take it perfectly calmly, at which point you take umbrage because I characterise your overreaction as "flying off the handle". You give a pretty good impression of reaching for the Spider-Man suit here. Guy (Help!) 13:14, 11 May 2015 (UTC)

Ironic or not, it is a serious request. Please strike the offending material where you misrepresented my actions to other editors.DrChrissy 14:47, 11 May 2015 (UTC)

• Smith, Caroline A; Hay, Phillipa PJ; MacPherson, Hugh; Smith, Caroline A (2010). "Acupuncture for depression". Cochrane Database Syst Rev (1): CD004046. doi:10.1002/14651858.CD004046.pub3. PMID 20091556.
• Ernst, E.; Lee, M. S.; Choi, T.-Y. (2010). "Acupuncture for Depression?: A Systematic Review of Systematic Reviews". Evaluation & the Health Professions. 34 (4): 403–412. doi:10.1177/0163278710386109. ISSN 0163-2787. PMID 21138913.
• We already have these two strong sources in the article. QuackGuru (talk) 21:26, 12 May 2015 (UTC)

The problem also includes peer review scams in these countries:

• Publishing: The peer-review scam
• BioMed Central retracting 43 papers for fake peer review
• Publish or perish in China

BullRangifer (talk) 15:19, 11 May 2015 (UTC)

• Please the acupuncture page. It says "Chinese authors use more Chinese studies, which have been demonstrated to be uniformly positive." Thank you for your collaboration. QuackGuru (talk) 17:17, 11 May 2015 (UTC)

Is this a reliable source (iii)?

Is this a reliable source for inclusion in the article?DrChrissy 13:24, 9 May 2015 (UTC)

No not MEDLINE listed - confused searchDrChrissy 13:46, 9 May 2015 (UTC)

What does the exact text you wanted to use actually say? -Roxy the Viking dog™ (resonate) 14:46, 9 May 2015 (UTC)

I suspect a confused searcher, rather than a confused search ;) -Roxy the Viking dog™ (resonate) 15:04, 9 May 2015 (UTC)

How does this comment possibly relate to the content? This is a personal attack. Please stop.DrChrissy 16:48, 9 May 2015 (UTC)

Remember DocChrissy, MEDRS says that lack of Medline indexing might make it unreliable and that we would want to look into it a bit further is all. And, just so you know, editors here have used that journal in the acupuncture article to criticize it with statements like Between 2000 and 2011, there were 294 adverse events reported in the English-language literature from 25 countries and regions and the most common adverse effect observed was infection (e.g. mycobacterium), and the majority of infections were bacterial in nature, caused by skin contact at the needling site. Infection has also resulted from skin contact with unsterilized equipment or dirty towels, in an unhygienic clinical setting. Other adverse complications included five reported cases of spinal cord injuries (e.g. migrating broken needles or needling too deeply), four brain injuries, four peripheral nerve injuries, five heart injuries, seven other organ and tissue injuries, bilateral hand edema, epithelioid granuloma, pseudolymphoma, argyria, pustules, pancytopenia, and scarring due to hot needle technique. Adverse reactions from acupuncture, which are unusual and uncommon in typical acupuncture practice, were syncope, galactorrhoea, bilateral nystagmus, pyoderma gangrenosum, hepatotoxicity, eruptive lichen planus, and spontaneous needle migration. So it's totally okay to use this journal to talk about adverse events like this, but whenever we pull a positive finding from this journal it's suddenly unreliable. I prefer to be consistent, so I suggest we use eCAM citations since they're already in the article. Oh, and by the way, the eCAM source that quotes all of that information is used in the article 22 times! It seems like some editors here really don't believe it's that unreliable.LesVegas (talk) 00:54, 10 May 2015 (UTC)

Yes, LesVegas, it's more reliable for negative statements than it is for positive ones. If someone makes an interest that is counter to his own best interests, there's less reason to believe that the statement is being made out of bias.—Kww(talk) 14:03, 10 May 2015 (UTC)

AS Kww says, examples of evidenced criticism of any form of SCAM by its own proponents are rare and highly significant. Guy (Help!) 21:25, 10 May 2015 (UTC)

Is this a reliable source (iv)?

Is this a reliable source for inclusion in the article?DrChrissy 13:36, 9 May 2015 (UTC)

No - Not MEDLINE listed.DrChrissy 13:44, 9 May 2015 (UTC)

See above. I'm pretty libertarian with information and I would rather not delete everything from eCAM that's already in the article, so I suggest we use this. The more information the better. LesVegas (talk) 00:56, 10 May 2015 (UTC)

I agree - as per your comment above about "might be unreliable".DrChrissy 11:34, 10 May 2015 (UTC)

I disagree: EBCAM is an unlisted journal with an oxymoronic title that serves primarily to advocate "complementary" and "alternative" medicine. We should only use it when there are no better sources available, and when we do, we need to attribute it.—Kww(talk) 13:55, 10 May 2015 (UTC)

Thank you. That means in your opinion, it can be used.DrChrissy

Sources that are not MEDLINE indexed sure do raise red flags. According to WP:MEDRS, though, this does not mean that the source would be unreliable. Instead, it means that one should look further into the source. That's a good cautious procedure we should embrace. Jayaguru-Shishya (talk) 18:10, 11 May 2015 (UTC)

For an extremely limited number of statements in highly confined contexts, yes. Remember that sources and statements always have to be examined together: the question of "is this a reliable source for x?" may have a completely different answer than "is this a reliable source for y?"—Kww(talk) 19:41, 10 May 2015 (UTC)

It is a reliable source under certain carefully considered circumstances for what SCAM proponents believe, but never for the factual accuracy of what they believe. Thus it might be a source, if no better were available, for a statement about how acupuncture proponents believe the deqi sensation differs between moxibustion and plain acupuncture, but it would be of no value in describing the objective difference betweent hese two treatments, because there is no objective evidence that either of them is reliably different from the other (or indeed from sham acupuncture). Guy (Help!) 21:23, 10 May 2015 (UTC)

Is this a reliable source (v)?

Is this a reliable source for inclusion in the article?DrChrissy 13:50, 9 May 2015 (UTC)

What does the exact text you wanted to use actually say? -Roxy the Viking dog™ (resonate) 14:47, 9 May 2015 (UTC)

I'm confused by why you are asking: I objected when this was included the first time, and it's still in the article. My objection is not due to "reliability", per se, it's to including novel results from single studies. Too many editors have spent too much time trying to find positive evidence for acupuncture, and the result is a laundry-list of one-off confirming studies that get placed into the article immediately, before there is time for the medical and scientific communities to react. If there's a real effect here, there will be further confirming studies and reviews and we can include it then.—Kww(talk) 15:37, 9 May 2015 (UTC)

So are you suggesting that it is not reliable because it is too recent?DrChrissy 16:51, 9 May 2015 (UTC)

I've usually seen editors asking to omit medical sources that are outdated, but never seen one asking to omit a source since it's "too recent". Anyway, aren't we dealing with a MEDLINE indexed review here? We should use that one to replace the outdated ones whenever applicable. Jayaguru-Shishya (talk) 17:07, 11 May 2015 (UTC)

I'm suggesting that "reliability" is not a binary issue, nor is it the only issue to be considered when deciding whether to include material. It's a relatively low-impact factor journal reporting a novel result. If the result was more in line with what we see in more reputable journals and you were using it to source some particular detail, I'd be more inclined to include it. If you were using it to support some statement about one of the authors, I'd be more inclined to include it. If you could show that there was some discussion of the study in more impactful journals, I'd be more inclined to include it. Instead, it's just one more obscure study in an obscure journal that remains unsupported in the mainstream. That could change in the future, but we can wait until then.—Kww(talk) 17:03, 9 May 2015 (UTC)

What size of impact factor are you looking for and what is the basis of this?DrChrissy 17:31, 9 May 2015 (UTC)

I don't understand why you think that I should have some absolute number in mind. There's no magic threshold like 4.6326133543345234523 that makes an instantaneous leap from "unacceptably low" to "unacceptably high". Do you deny that this journal has a relatively low impact factor?—Kww(talk) 17:47, 9 May 2015 (UTC)

While I agree there is probably not a specific value, at what 'range of values would you start to state a journal as having a medium-impact factor rather than a low -factor. Surely there is some objectivity in your analysis and acceptance/rejection of ptential sources?DrChrissy 18:22, 9 May 2015 (UTC)

Why is this journal less reputable than others. What is the basis for this analysis of the source?DrChrissy 17:34, 9 May 2015 (UTC)

Low-impact factor. Impact factor has a strong correlation with reputation.—Kww(talk) 17:47, 9 May 2015 (UTC)

OK, well I guess that we need to sort out the impact factor question then. I had assumed that because this journal is listed in Medline, it is reputable, and therefore on this category of reliability, is acceptable.DrChrissy 18:29, 9 May 2015 (UTC)

Feng, S; Han, M; Fan, Y; Liao, Z. "Acupuncture for the treatment of allergic rhinitis: A systematic review and meta-analysis". American Journal of Rhinologic Society. 29 (1): 57–62. doi:10.2500/ajra.2015.29.4116. PMID 25590322.

The source is in the article. QuackGuru (talk) 18:33, 9 May 2015 (UTC)

I am not certain why KWW suggests his problem is with "novel results from single studies"? This is not a single study, it is a review of single studies - a secondary source. Also, this source is already used in the article under "Allergies". Moreover, there are multiple secondary source now suggesting acupuncture is effective for seasonal rhinitis, they all seem to be mainstream sources and they all seem to agree that there is value:

1. The one DrChrissy links originally: "Our meta-analysis suggests that that acupuncture could be a safe and valid treatment option for AR patients."
2. "There are high-quality randomized controlled trials that demonstrate efficacy and effectiveness for acupuncture in the treatment of both seasonal and perennial allergic rhinitis."
3. "Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with allergic rhinitis who are interested in nonpharmacologic therapy. Option based on randomized controlled trials with limitations, observational studies with consistent effects, and a preponderance of benefit over harm."

I note that the "allergies" section of the article still includes a few older reviews (earlier than 2010) that are out of date per MEDRS and also are not consistent with more recent systematic reviews. The older reviews should be removed in favour of the newer reviews. — Preceding unsigned comment added by 70.65.253.158 (talk) 18:35, 9 May 2015 (UTC)

DrChrissy This is a reliable source but is already in the article. Kww objected to it because of its findings, but its obviously reliable, and up to date, so it went in. If users decide they want to remove it, I suggest they be reported to the noticeboards for disruptive editing. LesVegas (talk) 20:28, 9 May 2015 (UTC)

Yes, it is especially interesting because there are now objections being raised to a paper that is already in the article. I have long suspected that the analysis and comments/dismisals of references in this article are being done on an ad hoc basis with highly subjective statements and a very binary approach to the reliability of sources. I think this thread has just proved that point. And I am still waiting to hear about the range of impact factors that editors are using to classify WP:MEDRS compliant articles as "low".DrChrissy 21:26, 9 May 2015 (UTC)

You make it sound as if the objections are new, or somehow not raised before. As I pointed out, I objected when this was placed in the article and it is currently in the article, so I was a bit confused as to why you were asking about it. As for "ad hoc" evaluation of sources, extraordinary claims always require stronger sources, and impact factors are one of the ways that people evaluate the reliability of medical journals. That allergies can be effectively treated by jabbing people with needles is certainly an extraordinary claim, and there's no support for it in higher impact journals.

If you are stating that we should not evaluate sources on a case-by-case basis based on the nature of the claim, I'm afraid that would require a substantial change in policy: sources are always evaluated on a case-by-case basis.

Now, if you are saying that editors are looking more skeptically at sources that claim acupuncture is effective than they look at sources that claim it is not, of course we are. The effectiveness of acupuncture is not well established, with general consensus being that if it has an effect, it is a small one. Any study that claims that it has a strong effect is making an extraordinary claim, and thus demands an extraordinarily reliable source.—Kww(talk) 22:08, 9 May 2015 (UTC)

Are you deliberately not answering the question? I have asked a direct question about what range of impact factors of journals would you classify as being "low-impact factor". I will help...presumably the lowest value will be 0.1 (I don't think there is a 0.0) You have analysed sources and made statements that a journal's impact factor is low. What is the basis on which you make these statements? What is the upper limit of your range?DrChrissy 22:25, 9 May 2015 (UTC)

This page has a number of high-quality reviews and the page is very long. We don't need to use every source on the planet. Sources that have a lower impact factor can be rejected, especially if the text is redundant. QuackGuru (talk) 22:29, 9 May 2015 (UTC)

I am talking about introducing new content into the article and having this rejected with a binary analysis that the journal has a low-impact factor. How are deleting editors analysing the sources and coming to the conclusion that the journal has a low impact factor?DrChrissy 22:39, 9 May 2015 (UTC)

The source is not new. It is in the article. QuackGuru (talk) 22:41, 9 May 2015 (UTC)

I did answer your question in that there is no fixed number, that it would slide according to the novelty of the claim (among other factors). I note that there are journals relating to immunology with impact factors above 40, which would make this journal's impact factor (between 1.5 and 2.75, depending on the year) "low". As I said, since it's making an extraordinary claim, the real question is what would it take to make the source be classified as extraordinary reliable. Making it to "medium" isn't going to help a bit.—Kww(talk) 22:50, 9 May 2015 (UTC)

Ok, so you say that a journal has a low-impact factor and I say it has a medium-impact factor, how do we decide which is correct?DrChrissy 23:04, 9 May 2015 (UTC)

Impact factor is always relative to its field. For instance, there was discussion not to long ago about Evidence Based Complementary and Alternative Medicine and editors were lambasting it's impact factor, which was in the 2's. But it you look at CAM journals overall, it ranks in the top one or two every year. A&P journals, for instance, typically are 1.something or less. The very fact that a journal even has an impact factor from Thompson Reuters suggests it's reliable, since they don't assign impact factors to disreputable journals and revoke IF's if the journal is caught doing something sleazy. But above all, MEDRS does not ever suggest not using a source because it's impact factor is low. There is wide agreement on the MEDRS talk pages that impact factor should have no bearing on whether we use a source or not. If a source does have an impact factor, that means it's passed the test for likely reliability, and if it has a high impact factor it should be placed above same-aged sources with lower impact factors, at least according to all the MEDRS talk page discussions I've seen. LesVegas (talk) 23:19, 9 May 2015 (UTC)

I agree with this totally. I publish in the veterinary and animal behaviour field - no surprise there. I once had a paper rejected by 2 different journals so I tweaked it and sent it off to Vet Record. They published it. It remains the highest impact factor journal I have ever published in (apart from Nature). The reason - because they circulate Vet Record to all the RCVS members (vets in the UK) and to libraries around the world....It came down to distribution.

With the comments of LesVegas above, can we now accept that because a journal has a low impact factor, this is no reason whatsoever to reject content from this source?DrChrissy 00:02, 10 May 2015 (UTC)

I couldn't agree more. There's been pretty good discussion over the subject at least here. I think user Sunrise put it pretty well: "Again, the point is not that lower IF journals are unreliable, but rather that we cannot use IF to support their reliability" User Famousdog also made a valid point by stating: "There has historically been some absolutely brilliant science published in journals with a very low impact factor for a variety of reasons: because the field is so specialized that the readership is small, or because the research has few (if any) commercial applications, or because certain scientists are sentimentally attached to certain journals" User Roxy the dog has said the same: "I don't believe there is a hard and fast rule on impact factor/reliable sources.", which in turn was supported by user BullRangifer: "Correct. There isn't any." What user LesVegas has said is also consistent with the statements above: "BTW, journal impact factor has no bearing on whether or not a source can be used."

I hope this serves as a small summary for the earlier discussions in regards to the impact factor. Cheers! Jayaguru-Shishya (talk) 18:07, 11 May 2015 (UTC)

Low impact factor is a factor in evaluating sources. The reason that CAM journals have such low impact factors is that they tend to be poor sources.—Kww(talk) 00:26, 10 May 2015 (UTC)

You are in disagreement with MEDRS and consensus of editors on MEDRS talk and while you're entitled to your opinion that impact factors is a factor to evaluate sources, I hope you don't remove reliable sources because of impact factor, because that would be disruptive. LesVegas (talk) 00:36, 10 May 2015 (UTC)

So far as I can tell, I'm in full alignment with all guidelines. Can you show me a guideline that discourages using impact factors in evaluating sources? Especially when trying to demonstrate that a source making an extraordinary claim is a source of extraordinarily high quality? Or even demonstrate this "wide agreement" you discuss so glibly? I certainly hope you can support that more thoroughly than the pronouncement of "broad consensus" you made that one time: that was so ludicrously false that I still don't think even you believed it.—Kww(talk) 02:54, 10 May 2015 (UTC)

@User:Kww In answer to your question, No, I cannot show you a guideline that discourages using impact factors in evaluating sources. Perhaps you can show me a guideline that encourages using impact factors in evaluating sources. If you can, please post it to the new thread I have started below - "Impact factor and reliability of sources".DrChrissy 12:28, 11 May 2015 (UTC)

Comment I have raised the issue of impact factors being used to assess sources at Misplaced Pages talk:Identifying reliable sources‎. I recommend reading the Impact factor article - it's only brief.DrChrissy 14:34, 11 May 2015 (UTC)

Content removal

It now seems that there is an approximate 30 minute time limit to providing information or edits will be deleted - see here. I disagree with this removal of content, expecially with such aggressive editing.DrChrissy 17:13, 9 May 2015 (UTC)

I requested the page number and none was provided. You still have not provided the page number. The text was too complicated for the general reader, anyhow. QuackGuru (talk) 17:17, 9 May 2015 (UTC)

Ermmmm...where am I supposed to provide the page number now that you have deleted the content?DrChrissy 17:21, 9 May 2015 (UTC)

Adrian White, Mike Cummings and Jacqueline Filshie, ed. (2008). An Introduction to Western Medical Acupuncture. Elsevier. ISBN 978-0-443-07177-5.

Please provide the page number on the talk page and a proposal for a rewrite on the talk page. QuackGuru (talk) 17:24, 9 May 2015 (UTC)

I will do in time - but too busy doing other things at the moment. By the way, the diff of the paraphrase you have labelled as "too complicated" can be found here. I am not responsible for this.DrChrissy 17:28, 9 May 2015 (UTC)

I had the time and fixed the wording myself. QuackGuru (talk) 18:00, 9 May 2015 (UTC)

Possible source

• Acupuncture: What Does the Most Reliable Evidence Tell Us?

Given that this is an overview of systematic reviews, it seems like a very reliable source. It covered 32 Cochrane reviews, and concluded that 25 had negative conclusions, 5 positive, and two inconclusive. The abstract states: "The conditions that are most solidly backed up by evidence are chemotherapy-induced nausea/vomiting, postoperative nausea/vomiting, and idiopathic headache." Everymorning talk 21:40, 9 May 2015 (UTC)

Thank you Everymorning for your tireless contributions of good material! This source might be high quality for some things but it is 7 years old and MEDDATE tells us to refresh sources 5 years old. So what I think we would have to do is go through it condition by condition and compare it to the current Cochrane information to see what has changed and what hasn't and we could use this source to back up the information that's current. LesVegas (talk) 22:35, 9 May 2015 (UTC)

In point of fact, five were positive or tentatively positive. In other words, the conclusion from Cochrane reviews is overhwelmingly negative, much as we say in the lede.

It's amusing that people don't realise the message behind this analysis. Acupuncture is claimed by proponents to treat all kinds of things. It turns out that most of the research is junk and on balance negative, and the areas where outcomes are positive are basically random, indicating that, as per Ioannidis, they are simply islands of false positives. Guy (Help!) 22:41, 9 May 2015 (UTC)

Guy, if you compare this data with Cochrane's newest data DocChrissy has pulled up, it has changed significantly. LesVegas (talk) 22:52, 9 May 2015 (UTC)

Guy, your analysis of the report is extremely misleading. 5 of the reports were positive. These are 5 independent, stand-alone reports that have been assessed by the same authors who analysed and accepted there was no effect for 25 others. It is the height of scientific naivety to simply then disregard the 5 with the positive effects. It is not a game of numbers and to suggest 'more were negative therefore there is no effect', is just scientifically baffling.DrChrissy 23:11, 9 May 2015 (UTC)

And that's correct too. And that's why we have to quote statements directly. If the source says the glass is half full, we cannot say it's half-empty, lest we commit OR. LesVegas (talk) 23:23, 9 May 2015 (UTC)

When introducing material from Cochrane reviews, I have used the conclusions, often quoting these direct. My edits have often been removed with edit summaries such as "methodological flaws", "low number of patients" when these comments are about trials not leading to the conclusions. If a conclusion in a Cochrane review states "There was an effect of X.", we should accept this....we are editors, not researchers).DrChrissy 23:50, 9 May 2015 (UTC)

Quote mining is a way of misrepresenting sources. If the Cochrane review says its own evidence is weak or unreliable, stating that Cochrane found definitive proof of efficacy of acupuncture is misleading. Tgeorgescu (talk) 01:25, 10 May 2015 (UTC)

I am amused that you accuse me of being misleading, and then say "five of the studies were positive". What is actually says is: Thirty-two reviews were found, covering a wide range of conditions. Twenty-five of them failed to demonstrate the effectiveness of acupuncture. Five reviews arrived at positive or tentatively positive conclusions and two were inconclusive. I think that is exactly in line with what I said, but five being "positive or tentaively positive" is certainly not the same thing as five being positive. Still, you did nicely illustrate my point that SCAM proponents misrepresenting weak or equivocal evidence as being unambiguously positive. Well done for that. at least. Guy (Help!) 21:20, 10 May 2015 (UTC)

I added the conclusion to the lede. See "Cochrane reviews found acupuncture is not effective for a wide range of conditions." QuackGuru (talk) 06:10, 11 May 2015 (UTC)

I just read a copy of the PDF file. Please read the conclusions not the abstract. QuackGuru (talk) 02:09, 10 May 2015 (UTC)

RfC on COI for alt-med practitioners

See Wikipedia_talk:Conflict_of_interest#RfC_on_COI_for_alt-med_practitioners Jytdog (talk) 16:41, 10 May 2015 (UTC)

This was closed with no consensus. I archived it and it can now be found at the top of archive 20. The close is in this dif. Jytdog (talk) 11:39, 22 May 2015 (UTC)

Is that the reason that one of our acupuncturists has removed hisher name from the list of acupuncturist eds working on this page? Without discussion? -Roxy the Mainstream dog™ (resonate) 13:32, 22 May 2015 (UTC)

Unfortunately, yes. We aren't precluded from deciding that Herbxue's behaviour demonstrates a COI, though. His recent edits would be pretty weak evidence of that, but if you are aware of better, feel free to present it.—Kww(talk) 14:51, 22 May 2015 (UTC)

... and being a practitioner of a discredited therapy, which deceives its patients, isn't a COI for editing here. If you say so, then OK, but it doesn't make sense. -Roxy the Mainstream dog™ (resonate) 14:54, 22 May 2015 (UTC)

Roxy there was no discussion or convincing case for QG to put that on the acu talk page to begin with, it was harassment in my opinion. Anyway, I also made it clear on my page that I am a practitioner and I have never tried to hide the fact, not even a little bit. By the way, I never deceive anyone in my professional life and I think you should refrain from suggesting that again. You have no idea how I communicate the possible risks and benefits of acupuncture to patients, or how aggressively I refer out for patients that need to be seen by a physician. Herbxue (talk) 18:11, 22 May 2015 (UTC)

I'll take this a step further and say that Herbxue should not disclose whether they are an acupuncture practitioner or not. We operate on an anonymous editing model specifically for this reason - to avoid harassing editors based on their professional background, personal connections, etc. and to avoid personal insults like insinuating that an editor is corrupt. If there are concerns that the editor is making non-NPOV edits by using weak or cherry-picked sources to create the appearance of support for a fringe view by mainstream science, then that could be discussed based on the edits and sources without all the drama-mongering and bullying. CorporateM (Talk) 20:34, 22 May 2015 (UTC)

Actually, one of the major weaknesses of our model is that it allows conflicts of interest to persist undetected for years. I wouldn't tout that as an "advantage" at all. More like our Achilles' heel.—Kww(talk) 20:44, 22 May 2015 (UTC)

CorporateM - please have look at Herbxue's user page. everybody here, fwiw -- here is my take. since the community didn't arrive at a consensus, from my perspective it is pretty risky/risque behavior to claim that anybody has a COI because they are an alt med practitioner. I wouldn't do it. Unless, that is, a given practitioner is writing about his or her specific practice (Uncle Ben's Acupuncture on 1st Street in Springfield)... which I haven't seen happen here. Lots of people in the RfC said that WP:ADVOCACY is a major concern in these articles. If anybody wants to go after anybody over POV-pushing, I suggest you do it simply and directly as a POV-pushing case based on actual edits, and not on what anybody does in the RW. Jytdog (talk) 21:23, 22 May 2015 (UTC)

Chinese authors or Chinese studies

According to a discussion in another thread there may be bias studies in this article.

Template:Systemic bias

Maybe this tag will help. QuackGuru (talk) 01:38, 11 May 2015 (UTC)

It's a delicate enough topic that I can't imagine that tag doing anything positive.—Kww(talk) 01:44, 11 May 2015 (UTC)

Maybe we can replace the current tag with this tag. QuackGuru (talk) 01:46, 11 May 2015 (UTC)

You'd need to slap another POV tag on top for that one.--TMCk (talk) 02:00, 11 May 2015 (UTC)

Sure, but please present the studies first. Publication bias is not an opinion, it's tested by statistic methods. Cheers! Jayaguru-Shishya (talk) 18:27, 11 May 2015 (UTC)

Recent changes

• This edit added too much detail to the lede. More concise information in the lede is "It is rarely used alone but rather as an adjunct to other forms of treatment." There is a discussion about the sources. See Talk:Acupuncture#Cancer-related pain and see Talk:Acupuncture#Expansion of lead. The lede should be 4 paragraphs not 5.
• This edit added this to the ethics section again but the same source is summarised in the effectiveness section.
• This edit deleted this from the body again but it not speculation. The edit was previously discussed. See Talk:Acupuncture#Iceman tattoo.
• This edit added information about electroacupuncture again but the article is about acupuncture not a related practice. There is a section for Acupuncture#Related practices that does have information on electroacupuncture.
• This change deleted text that is not in other section.
• This change combined a section that is part of the scientific view of acupuncture. It is not about a reception in general.
• The lede was trimmed too much. The WP:LEDE should be four paragraphs, especially for a complex topic. See WP:LEADLENGTH. QuackGuru (talk) 06:26, 11 May 2015 (UTC)

No QuackGuru, the lede should not be four paragraphs. Jayaguru-Shishya (talk) 18:30, 11 May 2015 (UTC)

The short citations link to the long citations. See Acupuncture#cite_note-21 for example. Also see Acupuncture#cite_note-242. The short citation links to the full citation. See Acupuncture#CITEREFWiseman_.26_Ellis1996. QuackGuru (talk) 22:14, 12 May 2015 (UTC)

The edit being discusses on LesVegas' talk page was discussed in this thread. User:Jayaguru-Shishya, there is no consensus to have 5 paragraphs. QuackGuru (talk) 22:54, 12 May 2015 (UTC)

The recent change was a violation of consensus and did not improve the lede. QuackGuru (talk) 18:51, 13 May 2015 (UTC)

This change deleted a 2012 review.

This change does not appear to be sourced and I don't see a reason to add attribution to the author.

This change added no wiki tags.

Where should I begin? The text about medical organizations for human is original research and are lower-quality sources compared to other sources. This page is getting too long again. We can't include every source. The text about guidelines for the management of pain in cats and dogs is about veterinary acupuncture. The text is already in the veterinary acupuncture article. It does not belong here. The text about electroacupuncture is a related practice. It is not specifically about acupuncture. The text about the modulatory effects of acupuncture is overly technical and is incoherent to the general reader. QuackGuru (talk) 07:30, 21 May 2015 (UTC)

Impact factor and reliability of sources

The subject of journal impact factors and their relation to the reliability of sources for this article has been raised. I have searched various WP pages (below) for statements regarding the impact factor of journals.

Policy articles

Misplaced Pages:Verifiability - No relevant statement

Misplaced Pages:Neutral point of view - No relevant statement

Misplaced Pages:No original research - No relevant statement

Content Guideline

Misplaced Pages:Identifying reliable sources - No relevant statement

Misplaced Pages:Offline sources - No relevant statement

Misplaced Pages:Fringe theories - No relevant statement

Misplaced Pages:Non-free content - No relevant statement

Notability Guideline

Misplaced Pages:Notability - No relevant statement

Essays

Misplaced Pages:Offline sources - No relevant statement

The only article I have found (possibly) mentioning impact factor is WP:MEDRS which states - To access the full text, the editor may need to visit a medical library or ask someone at the WikiProject Resource Exchange or WikiProject Medicine's talk page to either provide an electronic copy or read the source and summarize what it says; if neither is possible, the editor may need to settle for using a lower-impact source. Note this states "lower-impact source", not "lower-impact factor source".

In summary, I suggest there is nothing on Misplaced Pages to support the argument that the reliability of a source can be judged by its impact factor.

DrChrissy 11:32, 11 May 2015 (UTC)

Other than years of precedent, you mean? You are inexperienced in this area. Several of those with whom you disagree, are very experienced in medical and pseudomedical subjects on Misplaced Pages. Journal impact factor is of huge importance. A new study in Nature is likely to merit inclusion, a new study in the Journal of Acupuncture and Meridian Studies is extremely unlikely to merit inclusion. The impact factor is a measure (we can argue about how accurate later) of how trusted a journal is. Journals such as NEJM, The Lancet and the like, have a very high threshold for inclusion: a paper must be not only well written and well argued, but its subject must usually be of genuine and provable significance, to make it into these journals. In particular, it would be very unusual to reference a claim in a low-impact journal that contradicts a finding in a much higher impact journal. Guy (Help!) 12:27, 11 May 2015 (UTC)

Whether I am inexperienced or not, I believe my review of the WP policy articles was sufficiently thorough and my summary posted for WP accurate. After all, we are dealing with WP editing here, not how outside journals conduct their affairs. I strongly suggest you read Impact factor. I was amazed to see that approximately 50% of this article is about criticism of impact factors and the way they are used. For example, "The Higher Education Funding Council for England was urged by the House of Commons Science and Technology Select Committee to remind Research Assessment Exercise panels that they are obliged to assess the quality of the content of individual articles, not the reputation of the journal in which they are published".DrChrissy 12:45, 11 May 2015 (UTC)

Misplaced Pages guidelines are descriptive not prescriptive. They lag practice and sometimes don't reflect it at all when something is obvious, as this is. Incidentally, you also reverted my moving of an overall summary form a book tot he head of a para. I did that because the para is currently confusing in a way that it is not with the framing statement at the head of the para. It started out reading "some studies show it works for this, other say it doesn't, it might work, it might not" and so on - in fact the conclusion is that it doesn't work, and if you start by establishing that, the rest makes a lot more sense. Guy (Help!) 13:06, 11 May 2015 (UTC)

I don't think there is anything "obvious" with the impact factor issue, and it probably explains why it's been discussed so many times earlier. Jayaguru-Shishya (talk) 18:31, 11 May 2015 (UTC)

I think this is such a basic part of the source evaluation process that nobody added it to the guideline. Unlike the RAE panels, we are discouraged from directly analyzing the research quality in the paper and are restricted to analyzing the overall reliability of the source in which it is published relative to the statement we wish to make based on the source. Can I suggest that you take this up in a more general venue? It's certainly not an acupuncture-specific topic: nobody is suggesting that impact factors be either used or ignored only for acupuncture-related articles, and that way you can feel comfortable that you are receiving an answer that isn't specifically designed to attack acupuncture. My access to computers will be spotty today, so my participation will be low.—Kww(talk) 12:56, 11 May 2015 (UTC)

I suspect if you read Impact factor you might not have the opnion of it being such a basic part of source evaluation. Anyway, I have raised the issue on Misplaced Pages talk:Identifying reliable sources.DrChrissy 13:17, 11 May 2015 (UTC)

The policy page that is relevant to looking at the impact factor is WP:V, where it says "must be attributed to a reliable, published source". Looking at the impact factor is one of many attributes that can be of value in determining whether the source is reliable for the use proposed. It is neither possible nor desirable for the general policy pages to attempt to be prescriptive about every factor that might go into determining "reliable," so noting that they don't mention it is really of no value. It might be of value to add a mention of it at WP:MEDRS. Zad68 15:18, 11 May 2015 (UTC)

There are other ways of attributing to a reliable, published source - for example ISBN and ISSN numbers.DrChrissy 16:32, 11 May 2015 (UTC)

The point I was making was regarding the word reliable and not attributed. Zad68 16:34, 11 May 2015 (UTC)

Could someone please provide a recent (< 5yrs old) source indicating that impact factors are a recommended way of assessing the quality of a journal.DrChrissy 17:08, 11 May 2015 (UTC)

Why would it be necessary that the source < 5 years old? Do you have evidence that the utility of impact factors has changed significantly in the past 5 years as opposed to the years before then? Zad68 17:18, 11 May 2015 (UTC)

It is not "necessary" to be <5 years old - I suggested that so the source would be WP:MEDRS compliant. There are many articles > 5 yrs old which identify the problems with impact factors, but I was hoping to get a more recent perspective.DrChrissy 18:27, 11 May 2015 (UTC)

I think user DrChrissy is pertaining to WP:MEDDATE. Anyway, there's been pretty good discussion over the subject at least here. I think user Sunrise put it pretty well: "Again, the point is not that lower IF journals are unreliable, but rather that we cannot use IF to support their reliability" User Famousdog also made a valid point by stating: "There has historically been some absolutely brilliant science published in journals with a very low impact factor for a variety of reasons: because the field is so specialized that the readership is small, or because the research has few (if any) commercial applications, or because certain scientists are sentimentally attached to certain journals" User Roxy the dog has said the same: "I don't believe there is a hard and fast rule on impact factor/reliable sources.", which in turn has been supported by user BullRangifer: "Correct. There isn't any." What user LesVegas has said is also consistent with the statements above: "BTW, journal impact factor has no bearing on whether or not a source can be used."

I hope this serves as a small summary for the earlier discussions in regards to the impact factor. Jayaguru-Shishya (talk) 18:33, 11 May 2015 (UTC)

Outside perspective

I haven't read the entire article yet, but the Lead gave me the impression of repeating over and over again, often with extreme and editorialized language, that acupuncture is not considered an acceptable medical practice by traditional medicine.

Certainly that warrants inclusion in a neutral and balanced way, but I would think as an encyclopedia, our principle objective with the article should not be to provide medical advice, but to document the history of the practice - the scientific investigation of it being only one element of the article that is primarily relevant to recent history.

I don't have any background in acupuncture and have never tried it; but the first thing that comes to mind for me is its role in Asian culture, whereas the Lead depicts it as a scam, which I don't think is representative of the total body of literature. In comparison, certainly Christianity has been debunked by scientists and you can see how different the Lead is in that article. CorporateM (Talk) 14:14, 11 May 2015 (UTC)

Welcome! It is good to see a fresh editor here. I have been looking at other articles on contentious subjects such as Ghost, Loch ness monster, Creationism and they seem to have managed to get a neutral Lead, even including criticism. I hope we can achieve that here.DrChrissy 14:25, 11 May 2015 (UTC)

CorporateM, present day mainstream Christianity doesn't make scientific/medical claims. --NeilN 14:28, 11 May 2015 (UTC)

That's correct. This article is guided by different policies than religious articles - for example WP:MEDRS and WP:FRINGE, and even falls under special arbcom rulings. The topics are really not comparable, and we need to take that into account when assessing content. That said, the lead was recently reworked considerably, which I think may have addressed some of those concerns (before they were even raised).   — Jess· Δ♥ 14:43, 11 May 2015 (UTC)

Creationists do make scientific claims, so to that degree we have Christians engaged in pseudoscience. They are powerful and influential enough to get their politicians to ban some books and force the teaching of young earth creationism in public schools in the USA. -- BullRangifer (talk) 14:47, 11 May 2015 (UTC)

One cannot really disprove that Jesus is God or that God exists. Science and historical scholarship cannot tell if those are true or false, since those are not falsifiable statements. There are philosophical arguments for atheism and against it, but science is neutral in this respect. All historians have done is debunk specific falsifiable claims (like biblical inerrancy or the historicity of the book of Genesis), but there are Christians who accept such results and still are Christians. There is no contradiction between accepting evolution and being a Christian. Tgeorgescu (talk) 14:52, 11 May 2015 (UTC)

(edit conflict)@BullRangifer True. So a more comparable example might be creation science or Intelligent design, which would hit on WP:FRINGE but not WP:MEDRS. The point, though, is that we can't model our lead on Acupuncture after Christianity, because different policies apply.   — Jess· Δ♥ 14:53, 11 May 2015 (UTC)

(edit conflict) That's Creation science, which isn't exactly mainstream Christianity. --NeilN 14:56, 11 May 2015 (UTC)

I don't see the content being medical in nature as good justification for a contentious writing style and I disagree that the article should focus so heavily on medicine. Things like resurrection, conception without intercourse, and wine containing the holy spirit are scientific claims made by christianity that are all just as bogus as traditional Asian beliefs like yin/yang, qi, meridians, etc., which I would say are closer to religion or culture than medicine. I don't think it is big of us to write attack-style content about the practices of Eastern cultures and glowing articles about our own society's equally bogus beliefs. I also don't believe acupuncture is actually a fringe topic, except when it comes to the element of reception among the medical field, which is just one part of the subject. Rather, the current article contains a Reception section that shows that support of acupuncture is wide-spread and a popularly held belief, not a fringe one. Fringe is often just what we label concepts we do not ourselves believe. CorporateM (Talk) 15:03, 11 May 2015 (UTC)

Except that not all Christians consider that wine contains Holy Spirit or that Jesus was born without sex. Christianity is an umbrella concept, it means a lot of different things to different people. And we don't offer it special status, you might want to check how WP:RNPOV is applied in articles pertaining to the history of Christianity: they do not flatter Christian prejudices or pander to piety. Tgeorgescu (talk) 15:07, 11 May 2015 (UTC)

CorporateM, please show me modern day research on "conception without intercourse" or "wine containing the holy spirit". --NeilN 15:08, 11 May 2015 (UTC)

(edit conflict)@CorporateM Acupuncture is a medical intervention, and it is fringe within the medical community. WP:FRINGE certainly applies, whether or not is has a historical or religious following as well.   — Jess· Δ♥ 15:10, 11 May 2015 (UTC)

Yes, it applies to the aspect of it as a medical treatment, but that is only one part of the subject and a very western view only relevant to recent history. Just doing some quick Google searches on the history of acupuncture turns up how it was seen as a method of attaining harmony between the living and the dead, has some tie-in with the Asian superstitious belief about the number 5, and gaining "harmony" with the natural world. This is all cultural and religious history important to Asian culture. We are not a WebMD or digital doctor. Our main goal should be to document the history of the practice. CorporateM (Talk) 15:26, 11 May 2015 (UTC)

Sorry, I'm not buying that acupuncture is not predominantly a medical intervention, and I don't see our sourcing backing that claim up.   — Jess· Δ♥ 15:34, 11 May 2015 (UTC)

User:CorporateM One thought I had a short while ago was to split the article into 2 separate articles - Traditional acupuncture and Western medical acupuncture. This would make science editors such as myself, more comfortable editing the latter, whilst leaving the Traditionalists to edit the former. I'm just throwing this out - I will probably not spend time defending this, but I thought you might like to know.DrChrissy 16:24, 11 May 2015 (UTC)

Each article should document the debate and represent multiple viewpoints fairly; we don't split articles to allow POV camps to each have their own page. However, just as there is an article on Regulation of acupuncture, in a perfect world we would have neutral, high quality sub-pages on History of acupuncture and maybe something on ancient Chinese medical practices. It is large enough of a topic to warrant multiple sub-articles. CorporateM (Talk) 18:03, 11 May 2015 (UTC)

Allergies

We have:

A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis (AR). Several randomized clinical trials (RCTs) support the use of acupuncture for AR and itch. Experimental studies refer to a specific effect of acupuncture in atopic eczema and asthma, but large RCTs are lacking. Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis is not recommended. Additional research is required to clearly determine any effects of allergic disease therapy above placebo. There is insufficient evidence that acupuncture has specific effects on seasonal allergic rhinitis (SAR). There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis (PAR), though all of the efficacy studies were small and conclusions should be made with caution. There is mixed evidence for the symptomatic treatment or prevention of AR. For seasonal AR, the evidence failed to demonstrate specific effects for acupuncture. For perennial AR, there was suggestive evidence for the effectiveness of acupuncture. Acupuncture is an unproven treatment for allergic-immunologic conditions.

References

1. Feng, S; Han, M; Fan, Y; Liao, Z. "Acupuncture for the treatment of allergic rhinitis: A systematic review and meta-analysis". American Journal of Rhinologic Society. 29 (1): 57–62. doi:10.2500/ajra.2015.29.4116. PMID 25590322.
2. ^ Pfab, Florian; Schalock, Peter C; Napadow, Vitaly; Athanasiadis, Georgios I; Huss-Marp, Johannes; Ring, Johannes (2014). "Acupuncture for allergic disease therapy – the current state of evidence". Expert Review of Clinical Immunology. 10 (7): 1–11. doi:10.1586/1744666X.2014.924855. ISSN 1744-666X. PMID 24881629.
3. ^ Witt, C.M.; Brinkhaus, B. (2010). "Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis — An overview about previous and ongoing studies". Autonomic Neuroscience. 157 (1–2): 42–45. doi:10.1016/j.autneu.2010.06.006. ISSN 1566-0702. PMID 20609633.
4. ^ Lee, Myeong Soo; Pittler, Max H.; Shin, Byung-Cheul; Kim, Jong-In; Ernst, Edzard (2009). "Acupuncture for allergic rhinitis: a systematic review". Annals of Allergy, Asthma & Immunology. 102 (4): 269–279. doi:10.1016/S1081-1206(10)60330-4. ISSN 1081-1206. PMID 19441597.
5. Shah, Rachna; Greenberger, Paul A. (2012). "Chapter 29: Unproved and controversial methods and theories in allergy-immunology". Allergy and Asthma Proceedings. 33 (3): 100–102. doi:10.2500/aap.2012.33.3562. ISSN 1088-5412. PMID 22794702.

This is confusing.

1. It might be a good option for AR
2. Several trials support it
3. There's no evidence it works for SAR
4. There's limited evidence for AR
5. The studies are bad
6. For SAR the evidence fails to demonstrate a specific effect
7. For AR there is suggestive evidence
8. Acupuncture is an unproven treatment for allergies.

Actually that last point is the most significant, and makes sense of the rest. IMO the para should be:

Acupuncture is an unproven treatment for allergic-immunologic conditions. A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis (AR), and a number of randomized clinical trials (RCTs) support the use of acupuncture for AR and itch. There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis (PAR), though all of the efficacy studies were small and conclusions should be made with caution. There is mixed evidence for the symptomatic treatment or prevention of AR. For seasonal AR, the evidence failed to demonstrate specific effects for acupuncture. There is insufficient evidence that acupuncture has specific effects on seasonal allergic rhinitis (SAR). Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis is not recommended.

References

1. Shah, Rachna; Greenberger, Paul A. (2012). "Chapter 29: Unproved and controversial methods and theories in allergy-immunology". Allergy and Asthma Proceedings. 33 (3): 100–102. doi:10.2500/aap.2012.33.3562. ISSN 1088-5412. PMID 22794702.
2. Feng, S; Han, M; Fan, Y; Liao, Z. "Acupuncture for the treatment of allergic rhinitis: A systematic review and meta-analysis". American Journal of Rhinologic Society. 29 (1): 57–62. doi:10.2500/ajra.2015.29.4116. PMID 25590322.
3. ^ Pfab, Florian; Schalock, Peter C; Napadow, Vitaly; Athanasiadis, Georgios I; Huss-Marp, Johannes; Ring, Johannes (2014). "Acupuncture for allergic disease therapy – the current state of evidence". Expert Review of Clinical Immunology. 10 (7): 1–11. doi:10.1586/1744666X.2014.924855. ISSN 1744-666X. PMID 24881629.
4. ^ Witt, C.M.; Brinkhaus, B. (2010). "Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis — An overview about previous and ongoing studies". Autonomic Neuroscience. 157 (1–2): 42–45. doi:10.1016/j.autneu.2010.06.006. ISSN 1566-0702. PMID 20609633.
5. ^ Lee, Myeong Soo; Pittler, Max H.; Shin, Byung-Cheul; Kim, Jong-In; Ernst, Edzard (2009). "Acupuncture for allergic rhinitis: a systematic review". Annals of Allergy, Asthma & Immunology. 102 (4): 269–279. doi:10.1016/S1081-1206(10)60330-4. ISSN 1081-1206. PMID 19441597.

I think that is offers a more logical progression. Note that this removes two WP:WEASEL phrases endemic in studies where the evidence is crap. Discuss. Guy (Help!) 15:16, 11 May 2015 (UTC)

This is better and makes the text more readable. The key is the the first sentence. QuackGuru (talk) 16:20, 11 May 2015 (UTC)

Alternatively

As a compromise, we could try this:

A 2015 meta-analysis suggests that acupuncture might be a good option for people with allergic rhinitis (AR). Several randomized clinical trials (RCTs) support the use of acupuncture for AR and itch. Experimental studies refer to a specific effect of acupuncture in atopic eczema and asthma, but large RCTs are lacking. Using acupuncture to treat other allergic conditions such as contact eczema, drug rashes, or anaphylaxis is not recommended. Additional research is required to clearly determine any effects of allergic disease therapy above placebo. There is insufficient evidence that acupuncture has specific effects on seasonal allergic rhinitis (SAR). There is some evidence that acupuncture might have specific effects on perennial allergic rhinitis (PAR), though all of the efficacy studies were small and conclusions should be made with caution. There is mixed evidence for the symptomatic treatment or prevention of AR. For seasonal AR, the evidence failed to demonstrate specific effects for acupuncture. For perennial AR, there was suggestive evidence for the effectiveness of acupuncture. A 2015 clinical practice guideline released by the American Academy of Otolaryngology – Head and Neck Surgery stated that clinicians may offer acupuncture as a treatment for allergic rhinitis to patients interested in non-pharmacologic treatments. According to Middleton's Allergy, "although preliminary clinical reports suggest potential benefits, there is insufficient reliable evidence to rate acupuncture as an effective therapy".

References

1. Feng, S; Han, M; Fan, Y; Liao, Z. "Acupuncture for the treatment of allergic rhinitis: A systematic review and meta-analysis". American Journal of Rhinologic Society. 29 (1): 57–62. doi:10.2500/ajra.2015.29.4116. PMID 25590322.
2. ^ Pfab, Florian; Schalock, Peter C; Napadow, Vitaly; Athanasiadis, Georgios I; Huss-Marp, Johannes; Ring, Johannes (2014). "Acupuncture for allergic disease therapy – the current state of evidence". Expert Review of Clinical Immunology. 10 (7): 1–11. doi:10.1586/1744666X.2014.924855. ISSN 1744-666X. PMID 24881629.
3. ^ Witt, C.M.; Brinkhaus, B. (2010). "Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis — An overview about previous and ongoing studies". Autonomic Neuroscience. 157 (1–2): 42–45. doi:10.1016/j.autneu.2010.06.006. ISSN 1566-0702. PMID 20609633.
4. ^ Lee, Myeong Soo; Pittler, Max H.; Shin, Byung-Cheul; Kim, Jong-In; Ernst, Edzard (2009). "Acupuncture for allergic rhinitis: a systematic review". Annals of Allergy, Asthma & Immunology. 102 (4): 269–279. doi:10.1016/S1081-1206(10)60330-4. ISSN 1081-1206. PMID 19441597.
5. Seidman, M. D.; Gurgel, R. K.; Lin, S. Y.; Schwartz, S. R.; Baroody, F. M.; Bonner, J. R.; Dawson, D. E.; Dykewicz, M. S.; Hackell, J. M.; Han, J. K.; Ishman, S. L.; Krouse, H. J.; Malekzadeh, S.; Mims, J. W.; Omole, F. S.; Reddy, W. D.; Wallace, D. V.; Walsh, S. A.; Warren, B. E.; Wilson, M. N.; Nnacheta, L. C. (2 February 2015). "Clinical Practice Guideline: Allergic Rhinitis Executive Summary". Otolaryngology -- Head and Neck Surgery. 152 (2): 197–206. doi:10.1177/0194599814562166. PMID 25645524.
6. Adkinson, N. Franklin, ed. (2014). Middleton's Allergy: Principles and Practice (Eight edition ed.). Philadelphia: Elsevier Saunders. p. 1647. ISBN 978-0-323-08593-9. {{cite book}}: |edition= has extra text (help)

The solution to your apparent dilemna/confusion is to stick to the words and statements of authoritative medical textbooks such as Middleton's Allergy. -A1candidate 16:11, 11 May 2015 (UTC)

This is not an improvement and makes the text less readable and the section too long. The proposal by Guy is much better. QuackGuru (talk) 16:20, 11 May 2015 (UTC)

I also think it's too long. The solution is to cut away most (or all) of the reviews, leaving the WP:MEDORG and the authoritative textbook alone. -A1candidate 16:24, 11 May 2015 (UTC)

That's a "compromise"? Not hardly. I also draw to your attention the words of Stephan Schultz at the top of my Talk page: "In science, any compromise between a correct statement and a wrong statement is a wrong statement". Guy (Help!) 21:25, 11 May 2015 (UTC)

• I need to review the sourcing and conclusions, I think this is a matter of emphasis. Depending on which source you look at or weight you can shade the representation of the sources in one direction or the other. I have a feeling Guy's content represents the overall state of the best-quality sources better. Zad68 16:25, 11 May 2015 (UTC)

The sources and content have not, you will note, changed, other than to remove two short sentences, one of which appears in more or less identical form in literally thousands of poorly constructed SCAM trials. All I did was rearrange the text to read more logically. Guy (Help!) 21:25, 11 May 2015 (UTC)

I went ahead and tried to improve the wording and organise the text. QuackGuru (talk) 19:18, 12 May 2015 (UTC)

It seems odd that Guy and QG's proposed wording would place the oldest secondary source first in the section? There is a clear difference between the wording of the conclusions of sources older than 2013 and those newer than 2013. I think this is because the newer reviews (after 2013) include 2-3 recently published RCTs that are not included in the older reviews.70.65.253.158 (talk) 19:38, 12 May 2015 (UTC)

See WP:RECENTISM. It is not about which source came first. It is about an overview of the section. QuackGuru (talk) 19:48, 12 May 2015 (UTC)

Hmmm, I read the essay on recentism; it does not say that the best summaries result from using the oldest reviews first? As such, I am not sure what your point is QG. We have 4-5 secondary sources and the newer one include RCT studies that the older ones do not. The newer reviews also seem to have more favourable conclusions. The recentism essay suggests that we should not exclude the older reviews just because there are newer reviews, but it certainly does not suggest that it is better to give older reviews more weight.70.65.253.158 (talk) 20:26, 12 May 2015 (UTC)

, didn't you earlier argue and organize the sources from the most recent to the oldest? Jayaguru-Shishya (talk) 21:13, 12 May 2015 (UTC)

Why don't you log into your account? It is not about older versus newer. It was about placement for a general summary of the section. QuackGuru (talk) 20:34, 12 May 2015 (UTC)

What does logging in to an account have to do with acupuncture for allergies? If your arguments are cogent then that is all that should matter; try not to get distracted. So your opinion is that the oldest review that fits within MEDRS timeframe on this subject makes the best start to a section on the topic? Even though it is not consistent with newer reviews in mainstream journals? My opinion is that when there is a bunch of reviews that are mentioned in a section in the body of the article then they should be in chronological order unless there is some clear reason why older reviews should be given ore weight than the newer reviews. Do you have any good reason why the oldest review is the best to start the section on allergies?70.65.253.158 (talk) 20:49, 12 May 2015 (UTC)

Reliable source (i)

This source seems to be reliable for inclusion in the article.DrChrissy 15:20, 11 May 2015 (UTC)

For what purpose, exactly? Above you've noted that you have gone to the individual policy page WP:V, and under Reliable sources that policy page says "The appropriateness of any source depends on the context." Would you please stop throwing up sources without context, as per policy it is impossible to determine the fitness of a particular source without a proposed use. Zad68 15:27, 11 May 2015 (UTC)

What is wrong with providing reliable sources for editors to look at and consider for inclusion? If you do not wish to include content from the source, that is your decision. There may be other editors who will thank me for providing reliable sources. What exactly is wrong with indicating to others that a source is WP:MEDRS compliant. I am providing these sources for other editors to use, and it is they who will indicate the context.DrChrissy 15:41, 11 May 2015 (UTC)

You stated specifically that, in your evaluation, the source "seems to be reliable for inclusion in the article". Without context, such an evaluation can't be made, per the policy page I pointed you to. Zad68 15:44, 11 May 2015 (UTC)

Ok, cool. This source is reliable for verifying that Hugh MacPherson has published open access articles. Unfortunately, it's a primary source for that claim, and we try to avoid primary sources. Bummer. That's what you were hoping to include, right?   — Jess· Δ♥ 15:44, 11 May 2015 (UTC)

@Zad68 I agree with you totally - we can not evaluate the reliability until it is in context.DrChrissy 15:49, 11 May 2015 (UTC)

OK DrChrissy so you'll either be proposing the context, or renaming these sections to something other than "Reliable source (#)"? Maybe "Here is a source I found" or the like. But better would be to actually go the next step and propose the content change, just like Guy did. Zad68 15:52, 11 May 2015 (UTC)

@Jess How can you possibly know what I want to include. The source would be secondary for the material I might wish to include.DrChrissy 15:51, 11 May 2015 (UTC)

The productive way to solve this problem would be to go ahead and propose the context for the source's use, right? Zad68 15:53, 11 May 2015 (UTC)

Yes, but I do not have time just at the moment - I am too busy answering questions about why I am putting forward sources for possible inclusion.DrChrissy 16:00, 11 May 2015 (UTC)

"How can you possibly know what I want to include." Precisely.   — Jess· Δ♥ 17:50, 11 May 2015 (UTC)

• Dodgy authors (sources of equally lukewarm supportive studies on the canonical quackery that is homeopathy), dodgy journal, equivocal findings, adds nothing new because it basically shows that th emore convincing your placebo, the less well acupuncture "works" - which we already know. No thanks. Guy (Help!) 21:31, 11 May 2015 (UTC)

I don't know about the authors, although you seem to have knowledge about them you might wish to share. As for "dodgy journal", is it WP:MEDRS compliant? Yes/no? DrChrissy 22:34, 11 May 2015 (UTC)

PLoS One may or may not be reliable, depending on the content. PLoS Medicine is reliable. The authors of this paper are long-time SCAM proponents; their presentation of data is honest enough but they have a tendency to spin the conclusions and abstracts. Their recourse to "more research is needed" for treatments where a couple of centuries of research have consistently failed to produce a robust result, for example. Lewith and Witt are hoemopathy believers, a sure sign of inadequate critical faculties. On the plus sidePLoS is trying to fix the problem. Guy (Help!) 08:05, 12 May 2015 (UTC)

Did you mean to send that url?DrChrissy 10:32, 12 May 2015 (UTC)

JzG, that might be the case indeed, I don't doubt about that. The talk page is, however, running a risk to turn into a forum instead of discussion about the article content. Anyway, you seem to have a lot of opinions, but mostly you are not supporting them by any sources and there is a risk that someone might mistake those as given facts. Please remember that Misplaced Pages is WP:NOTFORUM. Thanks. Jayaguru-Shishya (talk) 21:29, 12 May 2015 (UTC)

The solution to that is obvious: DrChrissy can propose actual edits rather than simply a list of (mainly junk) articles found via Google or whatever. Guy (Help!) 22:56, 12 May 2015 (UTC)

Reliable source (ii)

Reliable source (ii)

This source seems to be reliable for inclusion in the article.DrChrissy 15:34, 11 May 2015 (UTC)

Source and content, please.   — Jess· Δ♥ 15:36, 11 May 2015 (UTC)

I am under no obligation to provide content - I am simply indicating to other editors this appears to be a WP:MEDRS compliant article.DrChrissy 15:43, 11 May 2015 (UTC)

For what purpose? Zad68 15:45, 11 May 2015 (UTC)

(edit conflict)Not under an obligation, no, but we can all do a google scholar search. You've opened something like 10 sections for these. If your hope was just to list sources without proposing any changes to the article, can you do that all in one section, please?   — Jess· Δ♥ 15:46, 11 May 2015 (UTC)

My hope is that editors will point out that an entire source is not WP:MEDRS compliant before other editors naively use them and perhaps damage the article. I have placed each one as a separate thread in the anticipation that there will be different reasons for why the sources are not compliant. This seems to be working above - note the discussion on impact factors about one of the suggested sources.DrChrissy 15:58, 11 May 2015 (UTC)

DrChrissy, this is getting very tiring. It's blatant IDHT behavior. You have been requested many times, including here, to provide context. A source is not reliable or unreliable on a standalone basis. It depends on how it is to be used. We even use blacklisted sources as RS on occasion!

Your refusal to provide context when requested is very uncollaborative. If you do this again, anyone here would be correct to collapse your request as a talk page violation until you provide context. -- BullRangifer (talk) 17:50, 11 May 2015 (UTC)

Just why are people so against me providing potential sources...what is the problem with that? Nobody has to answer or do anything about it - the potential sources can just sit there in the Talk page, not affecting content, waiting for editors to come and use them. Is this against any policy or guideline?DrChrissy 17:56, 11 May 2015 (UTC)

Not sure what to tell you. Many editors have asked you not to do this - in fact, it appears in every single section. You can just ignore us all if you want, but that's not a great way of collaborating. Posting some random source without any commentary or content proposal each in a new section isn't an effective way of improving the article, and repeatedly engaging in behavior several editors have told you is unhelpful quickly becomes disruptive.   — Jess· Δ♥ 18:04, 11 May 2015 (UTC)

(e/c) What is wrong with people asking you to provide the context for a source you're describing as "reliable", which is something required by policy to determine whether it is indeed reliable? Zad68 18:05, 11 May 2015 (UTC)

There is nothing wrong with making the request, but that does not mean I have to do what you and others are trying to bully me into. Please indicate which policy or guideline I am contravening.DrChrissy 18:13, 11 May 2015 (UTC)

It is routine for editors to just drop a quick line on the Talk page with a potential source without other editors demanding they provide more information. I have done this many times and in some cases seen editors follow up on a very good source I found, that I knew wouldn't otherwise be found, but didn't have time to incorporate. OTOH, it is pretty obnoxious to create a dozen sections on the Talk page with each one just mentioning some random source. I get the sense there is a strong desire to bully this editor.

In any case, I see that the journal is peer-reviewed and appears to be a secondary source (review article). Does anyone have access to its impact score? This particular study found that 80% of studies found acupuncture reduced pain and 60% found it increased heat tolerance (or something like that). CorporateM (Talk) 18:16, 11 May 2015 (UTC)

I have noticed some of the author's names such as Shin Takayama, Michael Simang, Takashi Seki. See Acupuncture#cite_ref-Ernst2012_77-0 for more information on Chinese authors. Could this be a red flag? QuackGuru (talk) 18:36, 11 May 2015 (UTC)

We should document the debate, stating that Western reviews tend to show negative results, while Eastern ones show positive results and why they each dispute the others' results. We do not operate on the ethnocentric assumption that the US is correct. That being said, we would need different sources that state this directly and this source could play a role as part of that debate, with various points and counter-points being aruged.

Personally, I probably won't have time to look at this kind of stuff for a while though. I'd like to work on the Regulation section later this week - currently exclusively cited to primary sources and not in WP:Summary style given there is a sub-article. People tend to focus excessively on whatever is controversial, but there's plenty of boring stuff that needs working on. CorporateM (Talk) 18:52, 11 May 2015 (UTC)

Sure, I am waiting for them to release a paper on this. QuackGuru, please bear in mind though, that Misplaced Pages is not a blog where we invite people to share their thoughts that have not (yet) been able to pass the scientific process. Jayaguru-Shishya (talk) 19:12, 11 May 2015 (UTC)

Presuming the sources accurately reflect the current article-text, the dynamic appears to be supported by RS', hence the link provided by the OP. CorporateM (Talk) 19:48, 11 May 2015 (UTC)

• Relevance unclear, journal questionable and prone to publishing bollocks. Exclude unless there is reference in reliable independent sources that attests to the reliability and significance of this finding. Guy (Help!) 21:29, 11 May 2015 (UTC)

Please clarify what you mean by "prone to publishing bollocks"...it is not a phrase I have come across in articles regarding assessing the reliability of sources. Perhaps this is OR?DrChrissy 22:29, 11 May 2015 (UTC)

Discussion here. This is very well known among those familiar with the medical literature. Guy (Help!) 08:03, 12 May 2015 (UTC)

I think it would help the discussion flow better if you did not such medical jargon as per WP:Jargon. It could be considered disruptive.DrChrissy 09:48, 12 May 2015 (UTC)

Bollocks is not medical jargon, it is a British English colloquialism. Guy (Help!) 22:55, 12 May 2015 (UTC)

Reliable source? (iii)

This source seems to be reliable for inclusion in the article.DrChrissy 20:38, 11 May 2015 (UTC)

Explore? Are you serious? Being published in Explore is more or less a guarantee that something is false or profoundly dubious. The editor is bloody Dean Radin, for FSM's sake.

You appear to be engaging in a dumpster-dive of epic proportions. While you're at PLoS, read this: . It is far and away the most cited and influential paper on PLoS Medicine. It explains a big chunk of PLoS One and pretty much all of Explore. Read it fully. We'll wait. Guy (Help!) 21:35, 11 May 2015 (UTC)

Is the journal WP:MEDRS compliant - yes/no?DrChrissy 22:23, 11 May 2015 (UTC)

Were the studies were placebo controlled? I can't tell from the abstract. Any citations to the review yet? What's the impact factor of the journal? If you answer those questions you'll be well on your way to figuring out how high on the MEDRS scale it comes. --sciencewatcher (talk) 02:53, 12 May 2015 (UTC)

@JzG: Chrissy's comment seems civil enough and does not provide any justification to ABF. I'm not sure I understand why you would tell them they are engaging in a "dumpster-dive of epic proportions" or make sarcastic, scoffing comments about whether they are serious. I don't know anything about this journal, but I've certainly seen editors do much worse and be treated with respect, patience, guidance and healthy debate.

Chrissy, you've already been asked repeatedly to stop making a dozen separate sections for every source you want to suggest; can you knock it off? You can always just start a string on sources, then suggest them one at a time in the same section. CorporateM (Talk) 05:37, 12 May 2015 (UTC)

ABF has nothing to do with it. I am just astounded that anybody would propose Explore as. Source for anything, let alone a medical claim. This is a WP:COMPETENCE issue. Nobody who is even slightly familiar with the field of pseudoscience or pseudo medicine would make such a proposal. Guy (Help!) 07:10, 12 May 2015 (UTC)

@User:CorporateM Thanks for the advice - will follow this in the future.DrChrissy 09:51, 12 May 2015 (UTC)

@User:JzG Your comment here is inaccurate and contravenes WP:Civil. Please strike this comment.DrChrissy 10:04, 12 May 2015 (UTC)

I suggested the source above for the following reasons -

• It is relevant to the article
• It is an established journal (estb. 2005)
• It is recent (2015) (actually it is In press)
• It is a systematic review
• It is a meta-analysis
• The authors appear to have appropriate qualifications
• It is indexed to MEDLINE

I believe this makes it WP:MEDRS compliant. I checked these all before I suggested the source.DrChrissy 10:25, 12 May 2015 (UTC)

I pointed out the by now obvious fact that you lack an understanding of the medical literature in general, and the literature on SCAM in particular. For example, you proposed Explore as a source - it is utterly worthless, and well known to be so by anybody with even passing familiarity wiht the subject. This supports my view that your lack of knowledge of the field is contributing to an excessive volume of naive errors. The number of rejected requests you've made should, by now, have alerted you to this problem. I did not call you a racist or anything else unacceptable due to policy, I merely pointed out that your lack of understanding of the subject area is causing you to fall flat on your face pretty much every time. Guy (Help!) 11:21, 12 May 2015 (UTC)

What do you mean by "rejected requests"?DrChrissy 11:32, 12 May 2015 (UTC)

I repeat - is this source WP:MEDRS compliant? If it is not, please tell me why not. It is indexed to MEDLINE which according to WP:MEDRS indicates it is a reliable source. I am using WP guidelines when I suggest sources. Please enlighten us why you consider this journal is not reliable. Where on Misplaced Pages are there guidelines to support your statements, or is this just your opinion?DrChrissy 12:04, 12 May 2015 (UTC)

DrChrissy as has already been explained to you, a source cannot be determined to be "reliable" without the context of the actual content proposed that uses the source. What is the content you are proposing using this source?

Also, are you trying to make a point regarding WP:MEDRS using this source, or do you genuinely believe this source to be "WP:MEDRS compliant" (for an unspecified use, but assumed to be for sourcing biomedical content based on your mention of MEDRS)? This is a genuine question to you, I look forward to reading your detailed answer. Zad68 12:16, 12 May 2015 (UTC)

I have already stated that I am in agreement that the reliability of a source is dependent on context. The question I asked above is whether this source is WP:MEDRS compliant? If it is not, please tell me why not. There is no point in me proposing content if this source is not compliant.DrChrissy 13:09, 12 May 2015 (UTC)

It is an unfortunately popular misconception that "reliability" is an intrinsic property of a given source or publication, rather than dependent on context—how and where that publication is intended to be used on Misplaced Pages. WP:MEDRS compliance isn't a binary judgement, and how a source is evaluated under MEDRS depends on the context. (For example, it is popular to mis-apply MEDRS' five-year rule of thumb as a hard-and-fast criterion, with unfortunate results. In a very active field, a four-year-old review could have been repeatedly superseded by more recent, better-quality reviews; in a less-active but well-established area, a six-year-old review may still accurately reflect the gold standard for treatment and knowledge. Articles published in May 2010 aren't magically MEDRS-compliant this month and MEDRS-noncompliant next month. It appears that you're making a similar sort of binary judgement error above, where you presume that anything indexed in MEDLINE is automatically "reliable".)

Don't be coy, and don't waste the time of other editors by not giving them enough information to make an informed judgement about your question. TenOfAllTrades(talk) 14:07, 12 May 2015 (UTC)

What TenOfAllTrades said. This smacks of JAQing off by now. Guy (Help!) 22:45, 12 May 2015 (UTC)

I still don't understand the hostility. The proposed content to be added should be obvious - Chrissy wants to add the results of the study. Regarding competence, editors are not required to have any knowledge of the subject to contribute. On the contrary, contributing to subjects you know nothing about is a good way to learn about them and this is a healthy motive for editing. I know nothing about the subject, except that it involves putting needles in your body and is associated with Asian heritage dating back to the pre-BC era. Am I not allowed to edit since I am unfamiliar with the subject? On the contrary, I would say I am an ideal person to edit, because people who are familiar with the subject usually have an opinion already that skews their editing. CorporateM (Talk) 14:45, 12 May 2015 (UTC)

DrChrissy: I notice you didn't reply to my comment above. Have you actually read the full-text of this review? As others have said, it's not a yes/no decision. You just have to evaluate the quality of the source. I agree with CorporateM that the hostility isn't helpful. --sciencewatcher (talk) 17:27, 12 May 2015 (UTC)

Hi Sciencewatcher. Thank you for your civility. The answer is No, I have not yet read the full article. However, I would point out that I have brought the article to the Talk page for discussion. I have not attempted to enter this as content on the article page, and I would much prefer to read the entire article if I was to edit the article using this source.DrChrissy 18:52, 12 May 2015 (UTC)

Well, taking a quick look at this paper: journal has a low impact factor (0.935), article has zero citations, and I'm guessing the studies are uncontrolled. Any one of these would be a mark against using it as a MEDRS reference. We do sometimes use brand new reviews with zero citations, but generally only if we know they are very high quality (e.g. Cochrane review or similar). --sciencewatcher (talk) 21:13, 12 May 2015 (UTC)

The journal may have a low impact factor but impact factor does not appear in any guidelines/policies as a method of judging the quality of an article within the journal. ...and then you are "guessing" there are no conrols to the studies...is this a robust way to approach indicating to other editors the suitability of a source? I have tried to use Cochrane reviews to edit this article but they have been rejected as sub-standard.DrChrissy 23:11, 12 May 2015 (UTC)

No, of course I don't think it's appropriate to guess about the studies -- that's why I was asking you. You're the one who wanted to add this review, so you really should have read it. MEDRS says "Determining the reliability of any individual journal article may also take into account whether the article has garnered significant positive citations in sources of undisputed reliability". It doesn't mention about impact factor, but I see you've already started a discussion on that in the "identifying reliable sources" project talk page. --sciencewatcher (talk) 23:37, 12 May 2015 (UTC)

At this stage, I did not actually want to add the review, I wanted to bring it up for discussion. That is why the first sentence of this thread is a question. As I am sure you are aware, only the abstract of many science articles on the internet can be viewed. It is permissible to introduce content from viewing the abstract alone, but I think most careful editors would prefer to see the entire article. I think it is perfectly acceptable to bring up the question about the article on the Talk page without having read the entire article. Isn't this one of the functions of a Talk page?DrChrissy 10:58, 13 May 2015 (UTC)

Not without an indication of precisely what material you want to support with the source. It's impossible to make a specific statement about the suitability of a source without knowing what it's going to be used for.—Kww(talk) 11:21, 13 May 2015 (UTC)

Can we not even say whether it is WP:MEDRS compliant?DrChrissy 15:33, 13 May 2015 (UTC)

As has been pointed out above, this source has some problems, so it's probably safe to say it fails MEDRS unless someone has a good argument as to why it should be included. The question is: why are you trying to include studies that say acupuncture works, regardless of quality? Is it because you believe acupuncture works, and you want the article to reflect this? Really you should be looking for high quality reviews that only look at placebo (sham) controlled studies, rather than believing junky science because it fits your preconceived notion that acupuncture works. Any acupuncture trial that doesn't have a sham control is junk science. --sciencewatcher (talk) 17:24, 13 May 2015 (UTC)

A sense of proportion

The bit about "Between 2000 and 2009, at least ninety-five cases of serious adverse events, including five deaths, were reported to have resulted from acupuncture" is meaningless unless we know against what it is being measured. A mention of a country help (eg. tiny San Marino or huge China), but not really scientific. Better would be something like x number of deaths in y number of treatments or some other formula. This is the standard for any treatment vs deaths, whether we are talking about a powerful drug or aspirin. Rui ''Gabriel'' Correia (talk) 02:38, 12 May 2015 (UTC)

It's a meta-analysis, not a primary study, so asking "where?" isn't really a meaningful question. To a first approximation, the best answer would be "everywhere someone collected data." A complete answer would be a list of about 25 countries with some type of frequency distribution (this information can be found in the paper). The paper goes into detail on exactly what the inclusion criteria were. Sunrise (talk) 04:37, 12 May 2015 (UTC)

The number is so marginal that it shouldn't be included at all. There's been discussion about the topic earlier here: Talk:Acupuncture#Safety and weight. I am not quite sure why we didn't go ahead and remove the source already back then, but I find it good that the topic has been brought up for newer inspection. Jayaguru-Shishya (talk) 21:25, 12 May 2015 (UTC)

Yes, this is the number of reports, which is going to be representative of some areas and perhaps not of others. We don't always know and can't anticipate which areas fall into which of those categories. We would have to delve into each study to get a better idea, and then the list will probably be quite large. To say "worldwide" is misleading, because this isn't reports to police in every country during that period, just studies published. Before reverting, I spent some time trying to imagine what wording we could use that would be appropriate, and I came up dry. The closest I can imagine would be "In peer reviewed studies published between X and Y...", which is 1) already implied and 2) not really answering the question "where".   — Jess· Δ♥ 05:54, 12 May 2015 (UTC)

The major problem is that SCAM practitioners typically have no systematic reporting of adverse events at all. Chiropractic is the worst example, but acupuncture and TCM generally are no better really. Guy (Help!) 07:58, 12 May 2015 (UTC)

That's very true. This is one of the major characteristics of alternative medicine. It's a very disparate group of practices and professions without any oversight or control. They make mutually exclusive claims, and there is no system for reporting side effects or any follow up. The one thing they agree on is that mainstream medicine, pharmaceuticals, and MDs are evil. They also don't criticize each other. -- BullRangifer (talk) 14:48, 12 May 2015 (UTC)

One of the other things Acupuncture shares with other alt-med systems is the universal feature, always present ... it doesn't work. Worth remembering when reading all the desperate hand-waving denial here. -Roxy the Viking dog™ (resonate) 15:04, 12 May 2015 (UTC).

JzG, BullRangiger, that might be the case indeed. I don't doubt about that. The talk page is, however, running a risk to turn into a forum instead of discussion about the article content. Anyway, you seem to have a lot of opinions, but mostly you are not supporting them by any sources and there is a risk that someone might mistake those as given facts. Please remember that Misplaced Pages is WP:NOTFORUM. Thanks. Jayaguru-Shishya (talk) 21:35, 12 May 2015 (UTC)

Hi guys, I agree 100% that "where" is not the best tag, as pointed out by Jess and Sunrise, but we are rather limited in suitable tags, unless there are some that I don't know of. Maybe the technical guys will come up with something better. At any rate, the idea was to draw attention to the issue and in that it produced the expected results. Based on your posts and information on the page I have tweaked the text. Perhaps it is my inner/ former journalist that always reads looking for the "when and where" part. By analogy, if an article said "Seventy people were killed in tornados in the past decade", a reader would immediately sense that the information is incomplete. Thanks for your inputs, appreciated. Rui ''Gabriel'' Correia (talk) 16:29, 12 May 2015 (UTC)

I found a similar claim in this book on page 50:

In addition, in a worldwide literature search reported by the World Health Organization in 2002, 193 adverse events following acupuncture (including relatively minor events such as bruising and dizziness) were identified over a 15-year period.

This does not provide a ratio of out of how many treatments, but I think provides a sufficient amount of context. WHO seems like a good place to get for this information, especially because it is global in nature. CorporateM (Talk)

The current source in the lede is more reliable and it is internationally and without language restrictions. QuackGuru (talk) 18:38, 12 May 2015 (UTC)

QuackGuru, I'm not sure I have the investment to dig into this topic at this moment, but I think it needs a closer look. The current source you mentioned looks fine to me at a glance, but its primary conclusion is that there has not been any "truly convincing evidence that acupuncture is effective in reducing pain" with the caveat that many studies that met their standard of rigor had positive results for neck pain. The 95 adverse effects is different than WHO's measurement, because they only documented severe adverse effects, while WHO documented even minor ones; both sources appear to be stating a number of side-effects out of a specific, discrete data-set of evaluated studies and not as an estimate of adverse effects world-wide or as a ratio of treatments. I don't have a specific solution to propose, except that ideally someone will eventually find a source that's a little different. I'm not sure the current number is actually useful without knowing out of how many treatments they occurred out of and neither source appears to state this. It also comes across as too detailed for the Lead, since it already states that it is safe if done properly, and not if done improperly. Perhaps a topic for another day, as I'm still trying to get to the Regulation section. CorporateM (Talk) 19:47, 12 May 2015 (UTC)

2002 is a bit dated. I went ahead and added it to the adverse events sections though.

Current wording: "In 2002, WHO reported 193 adverse events resulted from acupuncture worldwide over a 15-year period." This is from 2002. QuackGuru (talk) 20:48, 12 May 2015 (UTC)

If I understand it correctly, it's reporting that there were 193 adverse effects reported in the studies it analyzed, whereas the text seems to imply this is an estimate for all adverse effects that occurred in the real-world, in total. I'll see if I come across something better. CorporateM (Talk) 21:32, 12 May 2015 (UTC)

If you can't find anything newer than I suggest the 2002 sentence can be deleted. QuackGuru (talk) 21:41, 12 May 2015 (UTC)

@QuackGuru: I'm going to trim it for now. This source I came across says in a single incident in Canada in 2004, almost 1,200 patients may have been exposed to HIV from re-used needles. That would blow these numbers way out of proportion, because these numbers are based on sample sizes from the data used for individual studies. I think the data is misleading to readers, because it sounds as if these are the total number of cases. I will keep my eyes peeled for something better. CorporateM (Talk) 23:48, 12 May 2015 (UTC)

Another new discussion on Quackwatch

Didn't spot this advertised here: Wikipedia_talk:Identifying_reliable_sources_(medicine)#Proposal_to_address_Quackwatch_by_name_in_this_guideline The proposer explicitly says Quackwatch should not be used in this article. --NeilN 14:00, 12 May 2015 (UTC)

This is pretty tiring and classic IDHT behavior. It's also venue shopping. We have editors who favor fringe subjects, and they often complain about MEDRS as a hindrance to their efforts to promote these subjects using shoddy sources with a systemic bias for these subjects. This is yet another attempt to misuse MEDRS to their ends of defeating the use of QW, a source which consistently exposes this bias. They should be topic banned from MEDRS, as their efforts there invariably seek to weaken and not strengthen our use of mainstream sources. Their efforts aren't just detrimental to QW, they are detrimental to the encyclopedia's goals. -- BullRangifer (talk) 14:32, 12 May 2015 (UTC)

I don't think anyone is trying to "defeat the use of QuackWatch". Indeed, QuackWatch stands for its place on certain articles that have missed the eye of mainstream scientific medicine. There is a strong consensus that QuackWatch is not reliable per se, and I think it'll be good to have some of inclusion about that. The fundamental mistake some editors seem to make, is that some sources would be "reliable independent from the context", but as been voiced out by a dozen of editors, the reliability of a source should be evaluated always on a case-by-case basis. Therefore, no source is reliable per se. Jayaguru-Shishya (talk) 21:36, 12 May 2015 (UTC)

It is quite noticeable that the majority of those supporting reduced usage are long-time editors of alt-med articles with a history of primarily supportive material and arguing against inclusion of reality-based sources. Guy (Help!) 22:42, 12 May 2015 (UTC)

the statement "There is a strong consensus that QuackWatch is not reliable per se," is false. Jytdog (talk) 05:31, 13 May 2015 (UTC)

Why did this happen? QuackGuru (talk) 22:44, 12 May 2015 (UTC)

Cultural heritage

Current wording Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points. Many modern practitioners no longer support these concepts and have abandoned the concepts of qi and meridians. Acupuncture is currently used widely throughout China and many other countries, including the United States. It is uncertain exactly when acupuncture originated or how it evolved, but it is generally thought to derive from ancient China. In Chinese history the introduction of acupuncture is attributed to the emperor Shennong. This can be expanded or the body can be expanded.

User:CorporateM, the lede can also focus a bit more on acupuncture as an ancient Chinese tradition. The Acupuncture#History section can also be expanded. QuackGuru (talk) 17:42, 12 May 2015 (UTC)

My understanding is that the practice started around 1000 or 2000 BC and was originally a very spiritual practice in China. I would just throw out a number that it's probably been scientifically evaluated as a medical practice for maybe the last 50 years and existed as a spiritual and cultural practice for a few thousand, so it seems like a substantial WP:RECENTISM issue as well as an overly US-centric view of the world. I was hoping to get to the History section eventually to expand on this topic, at which point I suspect it will become evident that there is in fact a lot of high quality academic sources about the history, culture and spirituality surrounding the practice (or a review of the source material could prove me wrong).

However, right now I'm spending so much time in discussions, I haven't had enough time to devote to actual editing. So hopefully I'll get to it eventually. Right now I'm still focused on the Regulation section, which used exclusiremain in what is a vely primary sources previously. CorporateM (Talk) 19:32, 12 May 2015 (UTC)

Here is a 2006 review that has some information about History. The short citation is <ref name=Ernst2006/>. You could probably find some books on history too. QuackGuru (talk) 19:49, 12 May 2015 (UTC)

Yup, I have an entire pile of books in my closet from bringing History of public relations up to GA and I would expect nothing less here; in that topic there was a renown historian that wrote numerous books covering different time periods. If I'm lucky, I will find something like that for this. I do not know yet how much time I will actually spend here though. For starters, the editing environment is too contentious to be enjoyable, but I do feel the current article is somewhat insulting to Chinese culture/traditions and it is unlikely anyone else will balance this. CorporateM (Talk) 20:03, 12 May 2015 (UTC)

Acupuncture as currently practiced dates back, as far as I can tell, to Mao Zedong (ancient tradition was essentially bloodletting, as far as I can tell). Its resurgence of popularity in the west can be traced back to the Nixon visit.Guy (Help!) 22:40, 12 May 2015 (UTC)

That is absolutely incorrect (the Mao and bloodletting parts, the popularity in the west from Nixon visit is debatable).Herbxue (talk) 19:11, 19 May 2015 (UTC)

@User_talk:CorporateM I can totally understand your lack of desire to remain in such a toxic editorial envionment. Please do not desert this without raising the obvious issue to other external editors/admins.DrChrissy 22:57, 12 May 2015 (UTC)

A sense of proportion II

Jess, please try to understand what I am geting at. Your edit undid everything that the discussion accomplished. QuackGuru, please think about what you want to do before you do it, so we don't have 15 edits to get one word right. It would be appreciated Rui ''Gabriel'' Correia (talk) 20:16, 12 May 2015 (UTC)

"A review of reports from a number of countries covering the period 2000 to 2009 pointed to at least ninety-five cases of serious adverse events, including five deaths resulting from acupuncture."

The wording starts off with 'A review of reports". You don't need to say it was a review. A word to avoid is "pointed". The previous wording is better written with less words. The part "a number of countries" is ambiguous (original research). QuackGuru (talk) 20:21, 12 May 2015 (UTC)

I restored the original wording until we can come to agreement over which version to use. Will comment more in a moment.   — Jess· Δ♥ 20:24, 12 May 2015 (UTC)

Here was my edit, which used your wording but made it a little shorter. I changed "covering the period" to "between" and removed "from a number of countries". As I expressed above, I'd like to avoid saying "international", "worldwide", "from X,Y,Z countries", etc, because it could misleadingly imply that the reports are representative of that area. "Only 5 deaths in a decade, worldwide? No, only one report on the topic which listed 5 deaths." Your edit wasn't misleading in that way, but as worded it was superfluous. By not listing a country, we're not constraining the data geographically already. I just don't see how "from a number of countries" is helpful. We can still ask the same question: "Which ones?"   — Jess· Δ♥ 20:30, 12 May 2015 (UTC)

Also, I am marginally concerned about saying "a review of reports". Is that the correct weight? We're saying "just one review" says this, but it's actually reported widely, and this "review" is a high quality systematic review, not just some miscellaneous compilation of data. "Were reported" seems more vague, but it's the right weight. Is there another option?   — Jess· Δ♥ 20:33, 12 May 2015 (UTC)

Yes, "review of reports from a number of countries" is incorrect, because it implies that specific countries were chosen, when this is not the case. I also think the shifts in emphasis would need to be discussed. Sunrise (talk) 20:37, 12 May 2015 (UTC)

"Between 2000 and 2009, at least ninety-five cases of serious adverse events, including five deaths, were reported to have resulted from acupuncture internationally." I think we can include the word "internationally" because the text makes it clear that was what was reported. It does not mean only five deaths resulted from acupuncture. QuackGuru (talk) 20:38, 12 May 2015 (UTC)

Notes

@QuackGuru:, somewhere on this Talk page you mentioned that Western journals consider Chinese journals on acupuncture to be unreliable and have results that conflict with their own. I came across this book on the history of acupuncture, written by the head of an acupuncture trade association in the UK. On page 18, he also says that most research on the topic is not of good quality and praises "the West" as having produced better research. This source probably should not actually be used for this, but it was reassuring to see someone outside the US confirm the statement. CorporateM (Talk) 04:45, 13 May 2015 (UTC)

see PMID 25256890 and note the authors. Jytdog (talk) 05:27, 13 May 2015 (UTC)

I have looked at the article and it does not discuss acupuncture per se, it discusses TCM. Sure the individual trials may have studied acupuncture, but I think we need to be careful about the distinction.DrChrissy 10:43, 13 May 2015 (UTC)

Yup, appears to be an actual thing, and not ethnocentrism as I initially presumed. Of course people contributing to that aspect of the page have the difficult task of balancing studies from different areas of the world while only relying on the most high quality studies - I do not envy anyone with that task. CorporateM (Talk) 18:05, 13 May 2015 (UTC)

"The study also found that trials published in non-Chinese journals tended to be of higher quality. Chinese authors use more Chinese studies, which have been demonstrated to be uniformly positive." I got it covered in the article. I recently added the bit about Chinese authors and Chinese studies. QuackGuru (talk) 18:56, 13 May 2015 (UTC)

Hmm...The difference between a scientific, statistical analysis and an insulting stereotype is a matter of whether you say "most" or "9 out of 10" versus "all". I haven't looked at the sources, but I have to imagine there are at least some skeptics even in China and at least some high-quality studies. Unless it meets the requirements at WP:EXCEPTIONAL of a strong consensus among multiple exceptional sources, I would think we should adopt something closer to a generalization, like "most" or "tend to be" but I don't know what is representative of the total body of literature on the subject. CorporateM (Talk) 19:03, 13 May 2015 (UTC)

There are concerns regarding positive bias in publications from China on traditional chinese medicine. The issue also includes the peer review system in China.

1. Li J, et al The quality of reports of randomized clinical trials on traditional Chinese medicine treatments: a systematic review of articles indexed in the China National Knowledge Infrastructure database from 2005 to 2012. BMC Complement Altern Med. 2014 Sep 26;14:362. PMID 25256890
2. "Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries." Vickers, Andrew (April 1, 1998), Do certain countries produce only positive results? A systematic review of controlled trials., Control Clin Trials {{citation}}: Italic or bold markup not allowed in: |publisher= (help)
3. Ferguson, Cat (November 26, 2014), Publishing: The peer-review scam, Nature {{citation}}: Italic or bold markup not allowed in: |publisher= (help)
4. Qiu, Jane (January 12, 2010), Publish or perish in China, Nature {{citation}}: Italic or bold markup not allowed in: |publisher= (help)

Publish or Perish in China, Nature

Rampant Fraud Threat to China’s Brisk Ascent, New York Times

Research Fraud Rampant in China, Christian Science Monitor

Fraud fighter: 'Faked research is endemic in China', New Scientist

Looks good on paper, The Economist

There are several sources that demonstrate a concern about research originating from China. QuackGuru (talk) 19:19, 13 May 2015 (UTC)

"Publication bias is a possible explanation". In other words, it hasn't been studied, has it? We still need a study on publication bias - which is quite basics - before being able to proceed. Cheers! Jayaguru-Shishya (talk) 20:29, 13 May 2015 (UTC)

I would say: Down with the qualitative research, long live the quantitative one! Jayaguru-Shishya (talk) 20:33, 13 May 2015 (UTC)

"The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent, and publication bias is cited as a concern in the reviews of randomized controlled trials (RCTs) of acupuncture." This has been studied. QuackGuru (talk) 20:35, 13 May 2015 (UTC)

That's the Misplaced Pages article you are quoting. So, has there been any studies on publication bias or not? Please report. Thanks. Jayaguru-Shishya (talk) 21:02, 13 May 2015 (UTC)

The studies that refer to publication bias are in the article. Click on the sources if you want to know more about it. QuackGuru (talk) 22:13, 13 May 2015 (UTC)

History

Does anyone have a way to access this source and/or have thoughts on its reliability? The author is the International Research Center for Japanese Studies, which appears to be an "inter-university research institute". I noticed it was cited in a blog post written by a university professor and I'm trying to chase down his sources. CorporateM (Talk) 05:38, 13 May 2015 (UTC)

Isn't that a series on mysticism and philosophy? Guy (Help!) 10:16, 13 May 2015 (UTC)

Regulation

I think I'm almost done with this section as a summary of the main article. The most important country to include is probably China, where the practice originated and is most popular, but search results for regulation of acupuncture in China are polluted, since China is mentioned in every article about acupuncture. Does anyone know what the regulatory body is in China for acupuncture? CorporateM (Talk) 18:41, 13 May 2015 (UTC)

http://www.scmp.com/topics/regulation-acupuncture

http://www.scmp.com/article/601500/hong-kongs-traditional-chinese-medicine-laws-putting-public-risk

Maybe these might help. QuackGuru (talk) 19:06, 13 May 2015 (UTC)

Thanks so much @QuackGuru:!! I think I found what I was looking for. Would have never known to look there myself. CorporateM (Talk) 04:36, 14 May 2015 (UTC)

Bibliography

• Aung, SKH; Chen WPD (2007). Clinical Introduction to Medical Acupuncture. Thieme Medical Publishers. ISBN 9781588902214.
• Barnes, LL (2005). Needles, Herbs, Gods, and Ghosts: China, Healing, and the West to 1848. Harvard University Press. ISBN 0674018729.
• Cheng, X (1987). Chinese Acupuncture and Moxibustion (1st ed.). Foreign Languages Press. ISBN 711900378X.
• Cheng, X (2010). Chinese Acupuncture and Moxibustion (3rd ed.). Foreign Languages Press. ISBN 9787119059945. OCLC 624373192.
• Needham, J; Lu GD (2002). Celestial Lancets: A History and Rationale of Acupuncture and Moxa. Routledge. ISBN 0700714588.
• Singh, S; Ernst, E (2008). Trick or Treatment: Alternative Medicine on Trial. London: Bantam. ISBN 9780593061299.
• Stux, G; Pomeranz B (1988). Basics of Acupuncture. Berlin: Springer-Verlag. ISBN 354053072X.
• Stux, G; Pomeranz B (2012). Basics of Acupuncture. Springer-Verlag. ISBN 9783642491139. OCLC 878966679.
• Wiseman, N; Ellis, A (1996). Fundamentals of Chinese medicine. Paradigm Publications. ISBN 9780912111445.
• Madsen, M. V.; Gøtzsche, P. C; Hróbjartsson, A. (2009). "Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups". BMJ. 338: a3115. doi:10.1136/bmj.a3115. PMC 2769056. PMID 19174438.

I did not restore all of these. I only restored the ones that were interlinked with the references in the reference section. There are the full citations for the short citations. Is there anymore that should be restored? QuackGuru (talk) 19:51, 13 May 2015 (UTC)

I disagree with the need to have a bibliography. Ideally sources included in a Further Reading section are just 1-3 that are the most reputable works on the subject. I have found none so far that would truly qualify. CorporateM (Talk) 04:32, 14 May 2015 (UTC)

This discussion is not about having a bibliography in general. This is about linking the short citations with the full citations. The short citations in the references section link to the long citations in the bibliography section. See Acupuncture#cite_note-21 and see Acupuncture#cite_ref-21 and see Acupuncture#CITEREFSingh_.26_Ernst2008 for examples. QuackGuru (talk) 02:44, 15 May 2015 (UTC)

Removed material

Hello, I had restored this material to the lede and it was removed. Are these associations not notable enough or reliable enough for the article? Is American College of Physicians or the American Pain Society not nearly notable enough to be listed in the lede alongside the words of Quackwatch, per Misplaced Pages:Weight? LesVegas (talk) 20:57, 13 May 2015 (UTC)

Your recent edit was discussed in another thread. See Talk:Acupuncture#Recent changes. The part "have suggested the use of acupuncture for some groups of patients." is possibly SYN. We are using high-quality evidence for effectiveness. Recommendations are poor evidence. QuackGuru (talk) 21:04, 13 May 2015 (UTC)

But I have read through their recommendations and they are based on meta-analyses and systematic reviews. Can you show me where recommendations from societies and groups such as these are poor evidence? Specifically, somewhere in our policies and guidelines? Thank you in advance. LesVegas (talk) 21:17, 13 May 2015 (UTC)

I have read them. They are poor evidence according to MEDRS. We have better sources on the topic. The part "have suggested the use of acupuncture for some groups of patients." is unsourced. Thank you for your collaboration. QuackGuru (talk) 21:24, 13 May 2015 (UTC)

Specifically where in our policies and guidelines does it say they are poor sources? I hope you can be specific and point me to where in MEDRS or elsewhere these are considered poor sources, at least poorer than Quackwatch which we are apparently still using in the lede. LesVegas (talk) 21:31, 13 May 2015 (UTC)

The removed material is appropriate to include. It is the summary of input from experts and is therefore secondary, although not a scientific source.DrChrissy 21:34, 13 May 2015 (UTC)

See WP:MEDRS under WP:MEDASSESS. QuackGuru (talk) 21:36, 13 May 2015 (UTC)

It is not appropriate to include OR in the lede or anywhere. QuackGuru (talk) 21:36, 13 May 2015 (UTC)

Secondary sources are not OR. LesVegas (talk) 21:39, 13 May 2015 (UTC)

I too do not understand what you are referring to as OR.DrChrissy 21:41, 13 May 2015 (UTC)

It is irrelevant the type of source. The text itself "have suggested the use of acupuncture for some groups of patients." is OR. QuackGuru (talk) 21:42, 13 May 2015 (UTC)

Maybe I can help explain. Unless the content is specifically cited in a source it is, in an encyclopedia context, a form of OR. Best is to have a source that says what the text added to the article says, although not in the exact words of course This is a major and possibly boring difference between a research paper for example and an encyclopedia. All we can do is ref the sources. We can't comment on or summarize what we find in multiple sources. I know this can be frustrating and confusing.(Littleolive oil (talk) 21:56, 13 May 2015 (UTC))

Perhaps we can solve this by making direct quotes - dull and boring for readers, but there is information here which readers should be made aware of.DrChrissy 22:02, 13 May 2015 (UTC)

The sources are poor evidence according to MEDRS. Therefore, quotes won't solve the underlining problem. QuackGuru (talk) 22:05, 13 May 2015 (UTC)

edit conflict

Direct quotes are possible if from a specific source per content and if WP:RS/MEDRS and Weight are satisfied. What readers need is not so much an issue for us as WP editors. We have to deal with the sources and what they say. Sometimes that leaves the article short in our minds, but readers are not stupid and are capable of following sources to look further. If multiple MEDRS compliant sources say the same thing we can add that and weight would probably be satisfied. (Littleolive oil (talk) 22:13, 13 May 2015 (UTC))

Might be a good idea to look at the sources per MEDRS and per the content you want to add. Whether they are compliant or not is something that should be discussed among all editors active here.(Littleolive oil (talk) 22:13, 13 May 2015 (UTC))

This content that was proposed recently has no consensus to include again. See Talk:Acupuncture#Recent changes. QuackGuru (talk) 22:21, 13 May 2015 (UTC)

Discussion preceeds consensus. I didn't look at the sources when I added to this thread but was speaking in generalities. However, what's wrong with these sources? Just curious.(Littleolive oil (talk) 22:41, 13 May 2015 (UTC))

This article seems to have "the blink of an eye" as defining the time for consensus to be reached. Some of us live in different time zones - how about waiting a couple of days, listening to discussion, before making such swathing edits.DrChrissy 22:56, 13 May 2015 (UTC)

Swathing edits. Sorry not sure what you mean.(Littleolive oil (talk) 23:34, 13 May 2015 (UTC))

Large scale edits such as this.DrChrissy 09:52, 14 May 2015 (UTC)

• As I explained to Les earlier, it was first added here just 9 days ago, and then within minutes it was challenged and removed, added back, removed (by me), added back, removed again, added back, removed in a subsequent series of edits, added back again, removed again. Restoring it again without a consensus developing for it here on the Talk page can't be described as anything but (relatively slow-motion) edit-warring and it will be treated as such.

  As QG pointed out, this proposed change was brought to the Talk page here Talk:Acupuncture#Recent changes two days ago. One issue raised is that it's too much detail for the lead, Les your comment "Are these associations not notable enough or reliable enough for the article?" or comparisons with the uses of other sources don't address these points and so aren't convincing arguments. Zad68 01:58, 14 May 2015 (UTC)

Thank you for providing those diffs Zad. I was not aware that you removed this material multiple times. If the material is too detailed for the lede, perhaps we could make it less detailed? Do you have any suggestions along those lines? LesVegas (talk) 02:18, 14 May 2015 (UTC)

And it appears as though some editors feel that it adds balance to the lede which heavily relies on critical reviews from Edzard Ernst and statements from Quackwatch. If editors feel that it adds too much detail to the lede, perhaps we could trim other details? We need to achieve balance here. Addition or subtraction are the only ways I know to do it. LesVegas (talk) 02:35, 14 May 2015 (UTC)

I don't see any suggestion that anyone wants to readd the content, but I've only made few cmts here and not sure of all of the discussions. I stopped by to try and help explain OR in this situation. OR can be confusing. IRR is always useful for everyone in this kind of situation. (Littleolive oil (talk) 03:33, 14 May 2015 (UTC))

A1 Candidate wanted to re-add the content and Jayaguru Shishya wanted to as well. They mentioned it in other places. Here, both DrChrissy and I wanted it back in. What are your thoughts about the content Littleoliveoil? LesVegas (talk) 03:45, 14 May 2015 (UTC)

I'll look tomorrow. No opinion at this point. I haven't been keeping up so would have to look at the sources - context, weight carefully. My cmts here were more general.(Littleolive oil (talk) 04:05, 14 May 2015 (UTC))

We do not need to have a "balance" here, LesVegas. We need to clearly state what the mainstream scientific and medical communities think, and acknowledge the existence of fringe, mystical, and philosophical views. We should never, under any circumstances, portray the fringe and mystical views as having equivalence to the mainstream scientific and medical views.—Kww(talk) 10:49, 14 May 2015 (UTC)

• The inclusion of this material is self-evidently disputed. If LesVegas (or anyone else) wants to include it, then start an RfC and let an independent editor judge whether consensus exists. Guy (Help!) 12:03, 14 May 2015 (UTC)

I see a lot of objection from User:QuackGuru, but after all, it all comes to the quality of arguments. And unless you can express yourself well enough, any of your objections carry no weight, I'm afraid. Anyway, this is not the place to learn argumentation skills. Cheers! Jayaguru-Shishya (talk) 18:38, 14 May 2015 (UTC)

The text is clearly original research and does not summarise the body. QuackGuru (talk) 18:56, 14 May 2015 (UTC)

User:QuackGuru, if you want your comment to have any weight, please articulate yourself better. For example: "Recommendations are poor evidence", why they are poor evidence? "I have read them. They are poor evidence according to MEDRS.", why are they poor evidence according to MEDRS? "See WP:MEDRS under WP:MEDASSESS.", what are you exactly trying to say? "The sources are poor evidence according to MEDRS.", why? "The text is clearly original research", why is it clearly original research?

Please learn to express yourself first. Meanwhile, I am afraid, we have to ignore all your null objections. Once you have done that, we can continue the discussion again. Cheers! Jayaguru-Shishya (talk) 20:52, 14 May 2015 (UTC)

They are poor evidence because they are opinions not scientific evidence. It clearly original research because the text is unsourced. QuackGuru (talk) 02:29, 15 May 2015 (UTC)

Lede

"In Chinese history the introduction of acupuncture is attributed to the emperor Shennong." This text should also be in the body under history. QuackGuru (talk) 21:49, 13 May 2015 (UTC)

I disagree. Historians and academics offer dramatically conflicting narratives on when and by who acupuncture was founded. It is misleading to simplify this in the Lead in a way to suggest there is more certainty than there is actually. Also, the source is extremely weak compared to the sources used in the body. It is a list of short one-paragraph biographies and I have not seen Shennong mentioned in much stronger sources. CorporateM (Talk) 05:05, 14 May 2015 (UTC)

You make a fair point. Acupuncture as currently practiced owes at least as much to Mao as it does to Shennong. Acupuncture back then was, according to at least some of the preserved instruments, actually bloodletting, and in any case the appeal to tradition is a fallacy. I don't think this belongs in the lede at all, as it is questionable. Guy (Help!) 11:58, 14 May 2015 (UTC)

I agree with Guy. TCM is a twentieth century creation. However, the practice of acupuncture goes back several thousand years. The historical information QuackGuru is suggesting is not exactly accurate either. In short, historical scholars do not know how long acupuncture has been practiced, but we know it's two thousand years at least, five thousand years likely, ten thousand years possibly. I will see if I can find a reference to this somewhere. Perhaps we could include information on both the historical context and ancient practice of acupuncture as well as the modern creation known as TCM? Or maybe this is all too complex for the lede and we should only briefly summarize it in the lede? LesVegas (talk) 12:46, 14 May 2015 (UTC)

I deleted it from the lede. The 4th paragraph in the lede is now way too short. QuackGuru (talk) 18:55, 14 May 2015 (UTC)

Dated information

"A 2006 review described the 2003 World Health Organization (WHO) report as "erhaps 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 does not add much to the article. At the time it was notable but we now have more current information on effectiveness. QuackGuru (talk) 21:55, 13 May 2015 (UTC)

I note that the Quackwatch article used in the lede is only 1 year younger - can we make the same argument for replacing this?DrChrissy 09:54, 14 May 2015 (UTC)

I'm not persuaded. The WHO report (in reality a crowbar job by true believers that should never have been signed off) is still cited by other true believers as "evidence" that acupuncture is valid because the WHO says so. This is less so now than it was ten years ago, obviously, but it is still a current issue. As currently positioned int he article, I don't think this adds undue weight. Guy (Help!) 11:56, 14 May 2015 (UTC)

I moved it back to the ethics section and included some context. QuackGuru (talk) 18:02, 14 May 2015 (UTC)

Hahaha, according to whom? A Misplaced Pages editor? :-D JzG, I have notified you a multiple times that Misplaced Pages is WP:NOTFORUM. You editing is becoming disruptive. What's next? You'll get intervened with articles on Economics and claim that the material by World Bank is mere propaganda? Jayaguru-Shishya (talk) 18:41, 14 May 2015 (UTC)

According to V and RS. Please read the article and the sources. Simon Singh; Edzard Ernst (17 August 2008). Trick Or Treatment: The Undeniable Facts about Alternative Medicine. W. W. Norton. pp. 277–278. ISBN 978-0-393-06661-6. QuackGuru (talk) 18:45, 14 May 2015 (UTC)

QuackGuru, if you want your Talk Page posts to be considered when concluding the discussion, please learn to express yourself. For example, you could try to articulate yourself by saying: "I think X is inappropriate because the guideline Y says blablabla". Just ambiguously referring to some policy or source won't bring any weight to your post ever so far. Instead, please give a quote to support your claim. Cheers! Jayaguru-Shishya (talk) 20:45, 14 May 2015 (UTC)

I suggest you read the source above and the text in the article. Did you read it yet? QuackGuru (talk) 02:26, 15 May 2015 (UTC)

Suitability of content for this article

It has become apparent on this talk page that some editors are rejecting (potential) content for a wide variety of reasons. Some of these rejections are perfectly acceptable and well within policy/guidelines that have been carefully considered and written by a body of editors (I am mainly referring to WP:MEDRS). However, it has become apparent here, that some rejections are being made for reasons that are not included in guidelines, idiosyncratic, totally opaque and inaccessible to the new or non-specialist editor. There are cases of double standards. For example, it is widely acknowledged that content must be from a reliable source (e.g. journal) and the reliability of the source depends on the context. However, it appears that some editors dismiss or criticise entire sources without knowing the context of any content to be added. Furthermore, content potential is being judged according to the appearance of the names of the authors, the nationality of the authors, or the identity of the editors of the journal in which the content appears. In other words, it feels like "It does not matter what content you want to add, it will be rejected". In my opinion, this is totally unacceptable and needs to be stopped, or, the guidelines changed so this process is transparent and open to all editors. In my view, this type of misleading editorial behaviour has contributed a great deal to the toxic environment on the article page and this talk page. I have included examples below.

Source 1

Source 1 was proposed here..

One comment here was "It is a poster session, it is not peer reviewed, therefore it fails WP:MEDRS" I asked how it was known that it is not peer reviewed but there was no answer. I have been to dozens of science conferences where many of the poster sessions were peer reviewed. I have organised 2 international conferences and poster sessions for both those were peer reviewed.

My conclusion:

(a) WP Editors are being misled that the suitability of content should be based on judgement about the entire journal (proceedings).

(b) WP Editors are (potentially) being misled about whether a source is peer reviewed or not.

• Your conclusion is fundamentally incorrect. See poster session. These are not fully formed research output, they are often tentative, they often provide partial output from work in progress, they are often not peer reviewed at all, and the peer review they do receive is not of the rigour applied by a good journal. Nobody who is familiar with medical research would be unfamiliar with these facts. Ignorance of such basic knowledge is excusable, assertions of bias and malfeasance based on such ignorance, is not. Guy (Help!) 13:53, 14 May 2015 (UTC)

Source 2

Source 2 was proposed here.

One comment here was "The answer is: no, ti is not reliable, because Chinese-authored publications on acupuncture are never negative, so are considered suspect" Guidelines indicate that content should be considered on its own merits.

My conclusion:

(a) WP Editors are being misled by stating that all publications from one nation are suspect.

Your conclusion is fundamentally incorrect. it is an established fact that China, of all countries in the world, has the lowest rate of publication of negative outcomes, and most systematic reviews find a rate of positive outcomes as close to 100% as makes no practical difference. Your lack of understanding of this well known fact was excusable at the time, but is no longer excusable since you have been provided with citations to reliable independent sources that not only back the claim that China essentially only publishes positive results, but which also urge caution in citing Chinese-published studies. We are not qualified to judge the quality of the source, we go by independent sources, and independent sources tell us that Chinese-authored studies are biased. Additionally, JAD has a low impact factor (3.71). Guy (Help!) 13:58, 14 May 2015 (UTC)

Source 3

Source 3 was proposed here.

And rejected, since the journal is of low quality. Your point? Guy (Help!) 14:00, 14 May 2015 (UTC)

Source 4

Source 4 was proposed here.

And rejected, since the journal is of low quality. Your point? Guy (Help!) 14:04, 14 May 2015 (UTC)

Source 5

Source 5 was provided here..

One comment here suggested that the findings were too recent and needed to be confirmed by other studies. However, WP:MEDRS states that suitable content can be found in "...recent, authoritative review articles,...".

Another statement discussed the source as "It's a relatively low-impact factor journal ..." and "Low impact factor is a factor in evaluating eources" was made here. I have been unable to find any guidelines or policy documents that indicate impact factor should be used to assess journals. It is widely acknowledged that low-impact factor journals may contain very high quality articles.

My Conclusion:

(a) WP Editors are being misled that the suitability of content should be based on judgement about the entire journal.

(b) WP Editors are being misled that the impact factor of a journal should be used in the assessment of the suitability of a source.

Your conclusion is fundamentally incorrect. The objections are legitimate, this is a Chinese-authored study in a low impact journal that contradicts a much larger body of research showing overall lack of provable effect in allergies. Guy (Help!) 14:08, 14 May 2015 (UTC)

Source 6

Source 6 was proposed here.

One comment here was "Dodgy authors..., dodgy journal,..."

My Conclusion:

(a) WP Editors are being misled that the suitability of content should be based on judgement about the entire journal.

(b) WP Editors are being misled that the suitability of content should be based on judgement about the authors.

Your conclusion is fundamentally incorrect. The problems with PLoS One are identified in external sources, the authors are well known SCAM advocates. Lewith appeared in front of the House of Commons Science and Technology Committee advocating for homeopathy despite having authored a study showing that the remedies have no effect, and it's all down to the consultation. He substituted belief for fact when assessing evidence, and that casts doubt on his reliability. Claudia Witt also has a history of promoting homeopathy and promoting "real world" outcomes (code for uncontrolled research that credits the placebo effect to the intervention). PLoS One has a low impact factor (3.53). There is no credible reason for using this source, even if you had presented any proposed text based on it, which you did not. Guy (Help!) 14:17, 14 May 2015 (UTC)

Source 7

Source 7 was proposed here.

One comment here was "I have noticed some of the author's names such as Shin Takayama, Michael Simang, Takashi Seki. See Acupuncture#cite_ref-Ernst2012_77-0 for more information on Chinese authors. Could this be a red flag?" This seems to be implying that the source is unacceptable, or should be treated with caution, simply because some of the authors have names which look like Chinese names. In fact, 4 of the authors (including the 2 most senior authors, P. Baeumler and J. Fleckenstein) are from German institutes and the other 2 are from Japanese institutes, not Chinese.

Another comment here was "Relevance unclear, journal questionable and prone to publishing bollocks" The suitability of potential content has been pre-judged according to the perceived quality of the entire journal. I asked this editor what "publishing bollocks" meant - I did not receive an answer that helped me with this enquiry.

My Conclusion:

(a) WP Editors are being misled that the suitability of content should be based on judgement about the entire journal.

(b) WP Editors are being misled that the suitability of content should be based on judgement about the authors.

(c) WP Editors are being misled that the suitability of a source should be based on the apparent (unresearched?) nationality of a minority of the authors and neglecting to balance this with the affiliations of the other authors.

Your conclusions are incorrect. This is yet another example of piling up the heap of equivocal results and trying to pretend that this amounts to robust evidence. The journal has a low impact factor, we have no need of articles in low impact journals when we have more robust sources already. Guy (Help!) 14:19, 14 May 2015 (UTC)

I disagree with this. Impact factor has no bearing on use of a source or not. I have seen that acupuncture sources with low impact factors sometimes heavily use acupuncture terminology that would make the study unfamiliar to those outside that subject. So, for instance, a journal like Pain might not publish such studies or reviews because their readers wouldn't understand these. So these bigger journals have to publish dumbed down reports instead. In a way these sources are deceptive because they are much lower quality, yet have higher IF ratings. This is one of the many reasons impact factor should have no bearing on whether or not we use a source, and I'm not saying anything that hasn't been talked about elsewhere. LesVegas (talk) 13:27, 15 May 2015 (UTC)

Feel free to propose an edit. Guy (Help!) 16:13, 15 May 2015 (UTC)

You appear to be arguing that acupuncture is simply misunderstood. Pleading that a branch of knowledge isn't properly understood by the broader scientific community is a telltale that the branch of knowledge is fringe science.—Kww(talk) 16:19, 15 May 2015 (UTC)

Source 8

Source 8 was proposed here.

One comment made here was ": Explore? Are you serious? Being published in Explore is more or less a guarantee that something is false or profoundly dubious. The editor is bloody Dean Radin, for FSM's sake." I have not seen any guidelines which discuss whether the quality of journals should be judged on the editor/s. I feel if editors are going to leave comments like this, they should provide supporting evidence.

A second comment here was "Dodgy authors...dodgy journal..."

A further comment here was "...you proposed Explore as a source - it is utterly worthless,..." Again, this is judging the suitability of content on the quality of the entire journal.

My Conclusion:

(a) WP Editors are being misled that the suitability of content should be based on judgement about the entire journal.

(b) WP Editors are being misled that the suitability of content should be based on judgement about the authors.

(c) WP Editors are being misled that journal quality should be based the identity of the editor.

Your conclusion is fundamentally incorrect. Explore is not a reliable source. It is edited by a believer in parapsychological phenomena, Dean Radin, and is packed full of abject nonsense. Source Normalized Impact per Paper (SNIP): 0.613; SCImago Journal Rank (SJR): 0.307; Impact Factor: 0.935. It has published some hilarious bollocks. This is a junk journal and it is an abject failure per WP:RS let alone WP:MEDRS, which has a generally higher bar. Guy (Help!) 14:26, 14 May 2015 (UTC)

Please leave comments below

DrChrissy 10:43, 14 May 2015 (UTC)

About rejecting articles from China: China has bias in favor of TCM enshrined in its Constitution, the country has no real freedom of speech, it is known for shoddy science unrelated to TCM, the Party may dictate what scientists are supposed to conclude (ideology takes precedence over reality). These are big red flags in respect to Chinese research. Tgeorgescu (talk) 13:34, 14 May 2015 (UTC)

Well, this certainly looks like a good justification for a topic ban on DrChrissy, based on extended and ongoing WP:COMPETENCE and WP:IDHT issues. Many editors have made thorough, extensive efforts to explain to DrChrissy

• the problems with the sources he has presented;
• and the problems with presenting sources he has not read; and
• the problems with presenting sources and demanding 'reliability' verdicts without describing how he intends to use those sources in Misplaced Pages articles.

DrChrissy has firmly established his intentions to ignore that advice. Instead of wasting time and filling up this talk page dealing with what is, at heart, a user conduct issue, this should probably be handled at WP:AE. TenOfAllTrades(talk) 13:41, 14 May 2015 (UTC)

Yes, please. This sentence alone is of significant concern: "However, it appears that some editors dismiss or criticise entire sources without knowing the context of any content to be added." I'm completely baffled at how to respond to that on several fronts.   — Jess· Δ♥ 13:47, 14 May 2015 (UTC)

Agree, this is pretty much an admission that all those "Is this source reliable?" sections were pure WP:POINT and weren't really intended to be about the article. Zad68 13:53, 14 May 2015 (UTC)

I think it's clear the DrChrissy's inability to judge sources and to comprehend other editors's judgement about sources is a competence issue, at least in the area of complementary and alternative medicine. A topic ban is warranted.—Kww(talk) 14:23, 14 May 2015 (UTC)

Agree. Editor asks if the source is reliable and takes any negative reply as evidence of bias and malfeasance. This displays a fundamental lack of WP:COMPETENCE to edit in this area. Explore journal as a reliable source. Really? I mean, really? I can't remember the last time anyone suggested that. Guy (Help!) 14:26, 14 May 2015 (UTC)

No. (Catching up.) The tone and many personalized comments in this article are not acceptable in a collaborative situation. I made a couple of cmts and then left for that reason If editors are attacked out of hand because of presumed positions and agendas the result is likely to be that those people feel threatened which will certainly affect the way they edit.

The issues Dr Chrissy is bringing up are the more finely tuned aspects of Policy, open for discussion, prone to misunderstanding and interpretation even with highly experienced editors. Perhaps a tone that does not accuse people of deliberate attempts to create poor content would go along way towards discussion that could reach some amicable conclusion on these issues. There is also a sense of moving the goal posts which can frustrate.

I would agree that some of the concerns with sources are legitimate. For example, Chinese research would have to be scrutinized very carefully per source and per content to even be considered for inclusion. But QW per MEDRS is a equally questionable. Several parties on both sides of the arguments here are making the error seems to me of making generalizations about sources. A source is only reliable per the content it specifically supports. There is no single person that should be topic banned on this article. Dr Chrissy, I do think there are legitimate concerns about some of the sources, but I also think you are trying to collaborate in a difficult situation. I'd think seriously about taking your content concerns to Mediation. But discussions about sources in a general sense can be a waste of time.When looking at sources it can help to look at the source to see if it has the fundamental qualities that would support its use as a RS and the more selective MEDRS but then sources must be considered per specific content.

I may sound patronizing here, and if that is the case I apologize in advance but I am fed up with vitriol. In an ideal WP world we would trying to hold on to editors, to each other, educating each other, listening to each other. It takes years to understand WP and even then there is no end to its nuances. If you don't play nice you can expect the other kids to get their backs up. There are a lot of problems on this discussion and topic banning one editor is an unfair and biased solution. (Littleolive oil (talk) 15:08, 14 May 2015 (UTC))

You need to look at the specific issue under consideration. DrChrissy proposes a bunch of sources, they are rejected, and DrChrissy then brings the whole lot back with unfounded assertions that the rejections are due to bias. Do you consider that Explore is a reliable medical source? Or a reliable source for anything? Guy (Help!) 15:46, 14 May 2015 (UTC)

I wouldn't consider looking at any source outside the context of its use. Guy you just criticized another editor for doing that. I'm not sure what is expected. It looks like every source brought in by a few editors was rejected almost every addition reverted.. Why do you think people won't start to get frustrated. If you reject everything along with pejorative cmts about people and the topic area, you don't breed trust or anything even remotely collaborative. There may be undue harshness in judging some sources and leniency in including others. All of this helps breed a WP swamp. Use of you is not personal to you; its a general you.(Littleolive oil (talk) 16:07, 14 May 2015 (UTC))

It is difficult for any editor to get another blocked, unless their own behavior is impeccable. For example, one could say "hey this guy is a POV pusher" and they may be right, but then other editors would point out "but you're a bully" and they may also be right. Editors are always eager to point out the faults of others in a heated editing dispute, or advocate for a block in order to eliminate those that oppose their edits. Often it is best for editors to simply agree to leave each other alone. Also, from what I've seen so far, I'm not convinced the article-content is actually representative of the source material, but I haven't dug into the controversial aspects as of yet and do not have any particular knowledge of the topic. CorporateM (Talk) 18:49, 14 May 2015 (UTC)

Although I think it'd be advisable to suggest some certain content for each source presented, I made few remarks about the discussion above:

• "WP Editors are being misled by stating that all publications from one nation are suspect.": As far as I am concerned, nobody has brought up any studies demonstrating publication bias with respect to Chinese sources. This doesn't mean, however, that we shouldn't be cautious with these sources, but certainly Chinese publication have not been excluded for good.
• "One comment here suggested that the findings were too recent and needed to be confirmed by other studies": I've heard demands that that a source should be omitted if it's been outdated, but I've never heard that a source should be omitted because it'd be "too recent". Unless anything else pop ups, I'd say that feel free to use that source, providing it's applicable otherwise.
• "I have been unable to find any guidelines or policy documents that indicate impact factor should be used to assess journals. It is widely acknowledged that low-impact factor journals may contain very high quality articles.": Indeed, I am not sure what kind of relapse some of the editors are experiencing, but's this have been widely discussed even earlier. For example, please see this post where I've quoted many of our regular editors over the subject:
• ""Dodgy authors..., dodgy journal,...": Don't know about this really, but it's been discussed here earlier: ?
• "Relevance unclear, journal questionable and prone to publishing bollocks": Not commenting on the peculiar source but generally, comments like this can be ignored straight away since they are more or less bollocks themselves, and carry no weight whatsoever when it comes to concluding the discussion. The quality of arguments, that's what matters in the end.
• "About rejecting articles from China: China has bias in favor of TCM enshrined in its Constitution, the country has no real freedom of speech, it is known for shoddy science unrelated to TCM, the Party may dictate what scientists are supposed to conclude (ideology takes precedence over reality).": Tgeorgescu, thank you. I don't doubt it, but unfortunately we can't regard you as a trusty source for claims like this. When you provide reliable secondary sources, then we can proceed with these claims.
• "it is an established fact that China, of all countries in the world, has the lowest rate of publication of negative outcomes, and most systematic reviews find a rate of positive outcomes as close to 100% as makes no practical difference.": Again, I don't doubt it but if it's an established fact, could you please provide a source to confirm this? I mean some real sound scientific analysis, not any bollocks like "Publication bias is a possible explanation". So is there any or not? I've asked one editor with access to the source to share the article with me so I can check it myself, but I am still waiting to receive the article.
• "The problems with PLoS One are identified in external sources, the authors are well known SCAM advocates. PLoS One has a low impact factor (3.53). There is no credible reason for using this source, even if you had presented any proposed text based on it, which you did not.": Hasn't this been discussed here earlier: ? Anyway, are you referring to any sources, are you just sharing your own opinions here on Misplaced Pages talk pages again? I don't know how to say this any more kindly, but I think nobody cares an F about your opinions. Please refer to some proper sources next time you'll have a chat about it here.
• "The journal has a low impact factor, we have no need of articles in low impact journals when we have more robust sources already.": There's been plenty of discussion already on impact factor, and the result has been that IF cannot be used used alone in determining whether the source is unreliable or not. Cheers! Jayaguru-Shishya (talk) 20:37, 14 May 2015 (UTC)

• If you haven't seen the numerous pointer to the studies about Chinese sources that have been bandied about recently, try http://www.ncbi.nlm.nih.gov/pubmed/9551280. That last comment of yours is blatantly untrue, Jayaguru-Shishya. There's a consensus that they are not the only deciding factor, but certainly no conensus that they "cannot be used". See https://en.wikipedia.org/search/?title=Wikipedia_talk:Identifying_reliable_sources&oldid=662216972#Guidelines_on_journal_impact_factors for the most recent discussion I am aware of. If you are going to participate in these discussions, please pay attention to the material presented and do not blatantly misrepresent the result of discussions.—Kww(talk) 21:56, 14 May 2015 (UTC)

• Thanks for the notice, Kww. I agree, IF is not the only deciding factor, and therefore it should not be used alone to determine whether the source is unreliable or not. At some fields, the impact factor tends to be significantly lower than some other topic areas. Cheers! Jayaguru-Shishya (talk) 22:42, 14 May 2015 (UTC)

Impact factor is not anywhere on the policy/guidelines of WP as an indicator of the quality of a journal or other source of potential content. I inivite any editor to show me evidence to the contrary.DrChrissy 22:56, 14 May 2015 (UTC)

You've already established that you do not know enough about the issue to have a valid, informed opinion. Impact factor alone is not the issue: the issue is that we already have much more significant studies in journals with much higher impact factor, so we have no need to use low-impact sources, especially given everything we know about the cottage industry of SCAM studies. Guy (Help!) 08:03, 15 May 2015 (UTC)

That's true but impact factor does indicate reliability and has become a standard gauge on some science/health related articles. However impact factor alone shouldn't disqualify a source from use dependent on what its being used for.The need is for respectful and reasonable discussion seems to me then go with consensus. Sometimes consensus feels wrong and is wrong but that's the model WP operates under. (Littleolive oil (talk) 23:04, 14 May 2015 (UTC))

Agreed. It's been discussed many times, both here and on MEDRS talk, impact factor has no bearing on whether we can call a source is unreliable. Many sources that cover acupuncture are higher than top anatomy and physiology journals, for example. I've also seen the argument that if a source finds in favor of acupuncture, it's somehow unreliable. That argument is little more than POV pushing, and should be ignored in consensus discussions. LesVegas (talk) 13:13, 15 May 2015 (UTC)

LesVegas, re impact factor has no bearing on whether we can call a source is unreliable--No, that's not what we're saying, neither Olive nor Jaya nor many others are saying that, please don't "agree" with points people aren't actually making. Zad68 13:29, 15 May 2015 (UTC)

Actually, I have read that argument in MEDRS talk and have seen that argument many times on this page as well. Basically, the general consensus is that impact factor isn't exclusionary but can sometimes be used as an inclusionary argument. Zad, you might want to read my comment above again. I said IF rating has no impact on whether we can call a source unreliable (exclusionary) and that is what Olive is saying. I haven't read Jaya's recent arguments but I'm sure he'd agree. LesVegas (talk) 13:59, 15 May 2015 (UTC)

Alright we can both agree that IF is one factor (of many) that is useful when considering a source, right? Although I'm not sure I agree with your perspective. An IF of near-zero would indicate that the source is very suspect. An IF standard deviations above the pack (NEJM, Nature) would indicate it's eyebrow-raisingly influential. An IF somewhere in the middle wouldn't be dispositive either way, and there's certainly no value in an argument like "This journal has an IF of 2.3 and that one has an IF of 2.7, therefore..." Can we agree on that? Zad68 14:46, 15 May 2015 (UTC)

But certainly "low impact" plus "fringe claim" plus "claim made by group determined to suffer from bias problems" plus "claim uncorroborated in related journals with higher impact factors" is enough to dismiss the source, isn't it?—Kww(talk) 16:22, 15 May 2015 (UTC)

Kww it looks like you're asking for a response from Les but, Yes, certainly, per WP:EXCEPTIONAL. I'd hope Les agrees. Zad68 16:26, 15 May 2015 (UTC)

Sure I would agree. Exceptional claims do require exceptional sources. The whole source of contention seems to be, what is an exceptional claim and what is an exceptional source? I don't think editors here will ever agree where to draw the line on those questions. Maybe this should be decided via arbitration instead of our talk pages? LesVegas (talk) 18:01, 15 May 2015 (UTC)

German acupuncture trials

Just something I came across while looking at the Reception section. If our Misplaced Pages article on the topic is to be believed, it is one of the largest investigations into the efficacy debate ever done at a cost of 7.5 million Euros. Yet I do not see it anywhere in the article (given the size of the page, it's possible I missed it). It apparently found it to be effective for back pain and knee osteoarthritis (whatever that is), but not for headaches or migraines.

I do not myself even understand the concept/argument for how sticking needles in your skin is suppose to reduce pain (sounds painful itself to me). But maybe someone with greater interest/expertise may want to consider adding it using the sources already collected on the corresponding Misplaced Pages page. Alternatively, I may get to it eventually. CorporateM (Talk) 18:39, 14 May 2015 (UTC)

Hi. Are you referring to reference #295?DrChrissy 20:36, 14 May 2015 (UTC)

These are individual studies, so they are excluded per WP:MEDRS. Reviews discussing these trials are perfectly welcome, however. Everymorning talk 23:06, 14 May 2015 (UTC)

Reviews discussing the effectiveness of acupuncture based on these trials belong at the German acupuncture trials page. QuackGuru (talk) 02:22, 15 May 2015 (UTC)

Yes, citation 295, but it's only currently used to state that the trials caused a 20% increase in acupuncture use; it is very awkward that the actual results of the study are not included, considering they caused a country to change their insurance practices and was one of the largest studies ever done on the efficacy debate. We begin to state its impact, but not explain its results, as if we're dancing around the issue. It has its own article, but I see no reason not to summarize it here. I'm sure there are plenty of sources independent of the study itself that could be used and if not for medical claims, it is important historically. CorporateM (Talk) 08:27, 15 May 2015 (UTC)

Another mechanism source

• Mechanisms of Action for Acupuncture in the Oncology Setting

Seems to meet MEDRS (review article, respected journal, last five years). However, I don't have access to the full text so if someone else does and wants to add stuff from it to this article they are perfectly welcome to do so. Everymorning talk 02:22, 15 May 2015 (UTC)

"This limited review attempts to reveal some possible mechanisms of action for the effects of acupuncture for symptom relief in the oncology setting". In its "attempts to reveal", the paper engages in overt speculation, and doesn't consider the possibility of distraction, a proven reality-based effect of dramatic placebos. I think we need to wait for the findings to be replicated independently. Guy (Help!) 07:57, 15 May 2015 (UTC)

This is great and is a very reliable source and shows possible mechanisms of action our article does not include. Guy is saying for us to exclude the source entirely because these are possible mechanisms, therefore are speculation and not definite. But what is wrong with quoting the source directly? We can say "based on a review, possible mechanisms are..." Although, we would need to quote from the some place other than the abstract. Anyone with access? LesVegas (talk) 14:37, 15 May 2015 (UTC)

@LesVegas, I have access to it. This is the full conclusion (as quoted directly):

"Many acupuncture trials lack western methodologic vigor. What is known from methodologically sound research, however, suggests that acupuncture is effective due to various simultaneous local and systemic biochemical reactions and bioelectric changes. The evidence supports the use of acupuncture for the treatment of symptoms associated with cancer treatment, including pain, neuropathy, anxiety, leucopenia, gastrointestinal complaints, hyperemesis, and fatigue. Research is beginning to emerge on the mechanisms of action behind these effects."

The source clearly mentions the effects of the adenosine A1 receptor under the section "Adenosine", but denialists such as JzG will obviously continue to deny it.-A1candidate 14:48, 15 May 2015 (UTC)

A1candidate, snarky ad hominems like "but denialists such as JzG will..." just make working on this article even harder than it needs to be. I think Guy has a point that this review's conclusions are speculative, but that can be handled by qualifying the wording like "Suggested methods of action for <whatever> are not certain, but include..." and/or using in-text attribution, and also mentioning that the placebo effect is also a suggested explanation (using a good source for that). Zad68 15:03, 15 May 2015 (UTC)

Except none of the respectable sources actually mention "placebo". -A1candidate 15:07, 15 May 2015 (UTC)

Actually a large number of respectable sources do mention placebo. However, it's not easy to offend me with epithets like denialist. I am a homeopathy denialist, a psychokinesis denialist, a remote viewing denialist, an astrology denialist and of course a moon-cheese denialist. My view on acupuncture is that its history is grossly misrepresented by proponents, and irrelevant to its validity anyway; its purported mechanism (qi, meridians) is bollocks, its effect diminishes the more accurately any dummy procedure mimics the "real" thing, it does not seem to matter where you put the needles or even whether you insert them, FMRI effects are delivered just as well by needling a dummy hand as the real thing, and if there is some tiny shred of validity buried in the mountain of baloney and mystical mumbo-jumbo, it will be really interesting to see what it is. Guy (Help!) 16:08, 15 May 2015 (UTC)

Wrong again. Sham and verum acupuncture have different effects on the brain. -A1candidate 16:16, 15 May 2015 (UTC)

{{ping|A1candidate} — Arthur Rubin (talk) 19:45, 18 May 2015 (UTC)

Related practice

Recent (i.e. post-2011) reviews in both veterinary text books and scientific journals indicate that acupuncture can be used for therapeutic or homeostatic effects in animals, especially in the three areas of pain management, geriatric medicine and sports medicine.

This is poorly written. See Veterinary acupuncture#Efficacy. QuackGuru (talk) 02:33, 15 May 2015 (UTC)

I think the tag should stay until the text is rewritten. QuackGuru (talk) 19:16, 15 May 2015 (UTC)

A few sentences

I removed a couple sentences from the "Reception" section, which I also renamed "Adoption" since it primarily had to do with how many people were using acupuncture, as oppose to its reception:

The majority of patients who seek out acupuncture do so for musculoskeletal problems, including lower back pain, shoulder stiffness, and knee pain.<ref name=Ishizaki2010/> In the UK, the ] (NHS) advises that acupuncture is only recommended as a treatment option for chronic lower back pain, chronic tension-type headaches and migraines.<ref name="NHS">{{cite web|url=http://www.nhs.uk/conditions/Acupuncture/Pages/Introduction.aspx|title=Acupuncture|publisher=NHSChoices|accessdate=May 2, 2015}}</ref>

This didn't seem relevant to this particular section, but I wanted to post it here in case it was useful somewhere else. Also, from what I've seen so far, it looked like acupuncture was often recommended for lower back pain, but specifically not for headaches. Given the debate I'm sure accounts differ. Seems like something worth taking a look at before restoring, if it is placed somewhere.

CorporateM (Talk) 09:18, 15 May 2015 (UTC)

I think it was me who introduced the NHS material. I did this because it shows that the National medical service of the UK publicly states that acupuncture is suitable for some conditions. They would not make such a statement without scientific backing. I have thought before that a section "Statements by National health organisations" might be useful. It could go there if this acceptable.DrChrissy 11:09, 15 May 2015 (UTC)

The NHS says:

Currently, the National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraines. NICE makes these recommendations on the basis of scientific evidence.

There is also some evidence that acupuncture works for a small number of other problems, including neck pain and post-chemotherapy nausea and vomiting.

Acupuncture is sometimes used for a variety of other conditions as well, but the evidence is not conclusive for many of these uses.

This will probably change with time, since there is some evidence that the effect on chemo side effects is purely that of distraction therapy, and the evidence for the other indications is weakening over time. There's no real problem quoting this overview, as long as we don't stray into cherry-picking positive statements form it as if they validate needling. Guy (Help!) 15:35, 15 May 2015 (UTC)

See WP:NOTCRYSTALBALL. -A1candidate 15:40, 15 May 2015 (UTC)

Indeed. Which is why I said I have no problem with quoting this source, as long as we don't misrepresent or overstate what it says. Guy (Help!) 16:00, 15 May 2015 (UTC)

You said: "This will probably change with time", which shows that you do not understand our policies. You can acknowledge your error or continue insisting you're correct. -A1candidate 16:08, 15 May 2015 (UTC)

What error did he make? I don't see him advocating quoting his personal opinion in the article, or refusing to use the material. He stated that he thinks it will probably change in time and stated why. Nothing in our policies prevents us from commenting about our opinions during talk-page discussions.—Kww(talk) 18:31, 15 May 2015 (UTC)

Except we are not allowed to comment on our opinions about the suitability of sources! That is staggering double standards.DrChrissy 18:57, 15 May 2015 (UTC)

You certainly are allowed to express opinions on sources. The current discussions surrounding your comments are based on questions and concerns about the quality of the reasoning you use in forming those opinions and your frequent characterizations of other editors as being "uncivil" or "attacking" when, in fact, they are bringing up legitimate questions about your ability to reason sufficiently well to be permitted to edit.—Kww(talk) 19:07, 15 May 2015 (UTC)

My reasoning has been this -

I have found a source which is relevant.

The source appears to be WP:MEDRS compliant

I will check with other editors to see if this source is not suitable for some other reason.

...and all this drama happens.

Where is the flaw in this reasoning? - I have been asking editors a question, not disruptively editing the article.

DrChrissy 19:30, 15 May 2015 (UTC)

Perhaps when you received advice on all those sources and came back and described nearly every piece of advice you had received as "Misplaced Pages editors are being misled ..."?—Kww(talk) 20:11, 15 May 2015 (UTC)

You are misrepresenting what I said...and I am beginning to wonder whether this is deliberate. Please be more careful. I provided diffs for comments of all the advice I received that concerned me. Your statement "...described nearly every piece of advice you had received as "Misplaced Pages editors are being misled" is extremely misleading. It would have been more accurate to have said "Nearly every source you provided led to the conclusion that WP editors were being misled". There is a huge difference. Please stop this extremely disruptive misrepresentation.DrChrissy 20:39, 15 May 2015 (UTC)

The problem is that it led you to that conclusion, but the logic was so faulty that it led to people questioning your competence and whether you were editing in good faith. Certainly you aren't denying that your competence has been questioned, and you aren't denying that people have questioned whether you are editing in good faith, are you?—Kww(talk) 20:53, 15 May 2015 (UTC)

I agree that this is what Dr Chrissy is doing in good faith. I don't think the Chinese discussion was racist. I do know there are many cmts by editors here laced with aggressive incivilities. No editor has the right to suggest another editor can't reason well and so shouldn't be editing. How incredibly un civil and inappropriate to say the least. Discussion assumes people have different views. Not agreeing or having another view or even another way of approaching discussion or content is acceptable and not only acceptable but expected given human beings are individual.(Littleolive oil (talk) 19:52, 15 May 2015 (UTC))

Blocks based on WP:Competence is required are quite common. Not surprisingly, those blocks are usually preceded by discussion about whether the editor involved is sufficiently competent to edit.—Kww(talk) 20:11, 15 May 2015 (UTC)

I agree with Littleolive; both the comments from JzG and DrChrissy were useful. Editors are not forbidden from stating their personal views on Talk and even if they were, pouncing on them is not helpful. I agree that my presumption that we were being ethnocentric (Littleolive used the term racist) appears to - at a glance - have been an ill-founded assumption. There are legitimate sources that question the credibility of chinese sources. I do think though, that we should use sources from all over the world, including China, but this would take extra work to find out which Chinese sources are considered credible, when indeed most are not. Definitely not an easy task. CorporateM (Talk) 20:37, 15 May 2015 (UTC)

Back on topic

There seems to be support to use the NHS to state its position as an important government body in the UK, similar to how we would state the FDA's position, etc. in other countries. When I went to take a look at the source it said acupuncture is used in most pain clinics and hospices in the UK. Is this a controversial claim? Is it reliable for that? I was going to add it to the Adoption section; that is the claim that it is used in most pain clinics and hospices in the UK. CorporateM (Talk) 21:13, 15 May 2015 (UTC)

It would be controversial to use it as a sign of scientific legitimacy, yes. The NHS also provides for homeopathy, and used to claim that this was based on effectiveness. While the current material from the NHS is unflattering towards homeopathy, they still provide it. It's clear that the NHS decisions are influenced by politics as much or more than they are by science.—Kww(talk) 21:26, 15 May 2015 (UTC)

There's a handy phrase to describe your evidence-free allegations of the NHS - It's called a crackpot conspiracy theory. -A1candidate 22:10, 15 May 2015 (UTC)

You can't come up with a more authoritative voice about what the NHS offers than the NHS itself: "there are several NHS homeopathic hospitals and some GP practices also offer homeopathic treatment". As I said, they are unflattering towards it, but they provide it. Are you arguing that they began to do so despite realising it was completely ineffective? That's a bit harder to research, but I'm certain I can find the original decisions relating to how they started to do so.—Kww(talk) 23:18, 15 May 2015 (UTC)

Exactly. The NHS also provides mainstream medical services and we wouldn't say these are illegitimate because they provide homeopathy as well. Basically, we quote what the NHS says and inform readers that the services are provided by the NHS to UK citizens. And we leave editorializing out because that's original research. I believe facts associated with the NHS are notable enough for the lede, as are recommendations from other notable medical bodies. LesVegas (talk) 23:31, 15 May 2015 (UTC)

As always, it would nice if you would argue with statements I had actually made. I never said that a service was illegitimate because it was provided by the NHS, or that all services provided by the NHS are illegitimate. I said that because the NHS provides homeopathy, it would be controversial to use the fact that the NHS provided a service as evidence for scientific legitimacy. Because of the existence of such a conspicuous counterexample, it's not an uncontroversial relationship.—Kww(talk) 23:50, 15 May 2015 (UTC)

@Kww - Please do find the original decisions and show us your sources. That will be a much more constructive contribution. -A1candidate 00:28, 16 May 2015 (UTC)

I'm surprised: I had thought that they were integrated later, but they were apparently a part of the NHS since its founding: http://www.britishhomeopathic.org/what-is-homeopathy/homeopathy-and-the-nhs/. I was able to find an explicit statement that being effective is not a requirement in order to get NHS funding: "There naturally will be an assumption that if the NHS is offering homeopathic treatments then they will be efficacious, whereas the overriding reason for NHS provision is that homeopathy is available to provide patient choice". That PDF is worth reading: it's the government's explanation of their belief that giving patients a choice is a higher priority than being certain that those choices are scientifically valid.—Kww(talk) 00:44, 16 May 2015 (UTC)

You found statements saying homeopathy isn't effective but that the NHS funds it anyway, but it would be OR if we applied this to acupuncture, unless they said the same about acupuncture. If they did, we can quote that. But as it stands, we should quote whatever the source says and not add anything to it. Let's not butter it up or char it either way. But it's notable and deserves to go into the article, preferably in the body and lede. LesVegas (talk) 01:03, 16 May 2015 (UTC)

Why do you feel it's important information beyond our current statement that 4,000,000 acupuncture treatments were provided in 2009? Wouldn't including it run the risk of having readers conclude that it was being recommended by an organisation that only recommended effective treatments? If we do include it, I would want to include a qualifier that the NHS explicitly supports placebo-only treatments.—Kww(talk) 01:13, 16 May 2015 (UTC)

Actually, the NHS addresses the placebo issue so any statements about the NHS what their findings on acupuncture and placebo should be direct statements from the source here, attributed and in-context. The NHS recommendation provides both a depth and a notability that our article can use. We source Quackwatch in the first paragraph of the lede. And we're still using statements from the encyclopedia of pseudoscience, as well as quotes from bloggers, but we can't use the NHS as a source anywhere? Really? LesVegas (talk) 01:59, 16 May 2015 (UTC)

The purpose of quoting them would appear to be an appeal to authority: "because the UK funds acupuncture, acupuncture must be worth funding." Even if we don't explicitly say it, that's the expected take-home message. We need to be careful in our presentation to ensure that the reader doesn't make that connection, because it's unjustified. The easiest way is to not mention it at all.—Kww(talk) 02:40, 16 May 2015 (UTC)

Kww, Misplaced Pages is not a SOAPBOX, nor is it CENSORED. We only report what our notable sources say, and we do not indicate to the reader how they should feel about it. We do not appeal to authority and cannot control what readers think, but simply allow sources to speak for themselves. Our job is to ensure this happens. LesVegas (talk) 02:50, 16 May 2015 (UTC)

Just to confirm, are we talking about this web-site? If so, it has a subsidiary page which states "There is some scientific evidence acupuncture has a beneficial effect for a number of health conditions." I can not see the harm in using these Medical organisation statements. We can simply quote them with attribution. I would be in favour of having statements from several countries in a separate, perhaps boxed-quotes, section. I think this would be of great value to the reader.DrChrissy 11:37, 16 May 2015 (UTC)

I am not attempting to include anything that reliable sources don't say. However, I don't understand the purpose of adding this section. The article certainly isn't lacking in information. The only explanation left is that you have a desire to indicate that an authority approves of acupuncture. If that isn't your motivation, what precisely is your motivation.—Kww(talk) 14:39, 16 May 2015 (UTC)

Is it wrong to want to include that a National authority approves of (some types) acupuncture?DrChrissy 14:56, 16 May 2015 (UTC)

Kww, my motives are doing what you have always suggested, citing the mainstream point of view. I hardly think the NHS is less mainstream than Quackwatch, the Encyclopedia of Pseudoscience and other sources like that which we use in the lede. My motivation is that we should use the highest quality sources possible. If we leave this out, we're not, and if anyone ever makes the argument that this article is strongly biased it's easy to win. The rest of the Misplaced Pages community would frown if they ever suspected we were trying to keep the most reliable of sources off the page in favor of lower quality, partisan ones. Anywho, those are my motivations, not that it matters what anyone's motives are. At the end of the day, what matters is that we have the best article with the highest quality of sources possible. And that should be everyone's motivation here. LesVegas (talk) 15:02, 16 May 2015 (UTC)

Moving forward, I support DrChrissy's idea to create a section in the article that includes government bodies and the statements they give regarding acupuncture. This can include all of the medical organizations we have and their recommendations. Once we hammer that out, we can figure out how to add it to the lede and what to take out. LesVegas (talk) 15:12, 16 May 2015 (UTC)

I have no objection to a list of countries that provide acupuncture services to their citizens, along with a citation to a reliable source supporting each entry. It's not a particularly important fact about acupuncture, so I would object to a large series of quote boxes and similar methods of providing undue emphasis on the material.—Kww(talk) 17:15, 16 May 2015 (UTC)

To include recommendations that is not scientific evidence is poor evidence. It was rejected to include this type of information in the lede and body. QuackGuru (talk) 17:20, 16 May 2015 (UTC)

Kww, but according to our article guidelines is also valid to include the fact that the NHS weighed the scientific evidence regarding acupuncture and mention what their statements and conclusions were. We need to do this especially since we use lower quality sources to characterize the scientific evidence elsewhere in the article, per Misplaced Pages: Balance LesVegas (talk) 18:14, 16 May 2015 (UTC)

Oh sorry, I just noticed that you only objected to box quotes and that sort of undue emphasis. I agree, no box quotes are desirable. LesVegas (talk) 18:32, 16 May 2015 (UTC)

I have no objection to stating that the NHS claims to have evaluated scientific evidence. I would object to stating that such examination actually drove the decision as a fact (or even an implication).—Kww(talk) 19:31, 18 May 2015 (UTC)

Goldman-Cecil Medicine

25th edition of Goldman-Cecil Medicine has just been released. Acupuncture is mentioned numerous times:

• Page 141 of Chapter 30: In Figure 30-3. acupuncture is included as a descending modulator of pain. It is listed separately from placebo.

• Page 182 of Chapter 39: "Acupuncture has been shown to have various physiologic effects on the body, including stimulation of endorphins and various brain centers."

• Page 2347 of Chapter 400: In Figure 400-5, acupuncture is included in the medical algorithm for treating neck pain. It is classified under "options for short-term relief".

• Page 997 of Chapter 148: "HCV also can be transmitted by tattooing, piercing, or acupuncture if standard precautions are not implemented."

I propose that some of this information be included under clinical practice. -A1candidate 21:33, 15 May 2015 (UTC)

We already mention treatment of neck pain, endorphins, pain treatment, the possibility that acupuncture has effects separate from placebo, and its role in spreading hepatitis. Why do we need new sources for this? Are the current sources we have inadequate in some way?—Kww(talk) 21:45, 15 May 2015 (UTC)

Yes, they are inadequate due to the following reasons:

• No mention of acupuncture as a descending modulator of pain
• Duration of relief for treatment of neck pain is not mentioned
• Type of hepatitis transmitted is omitted

-A1candidate 22:06, 15 May 2015 (UTC)

I agree this information is superior to what we have in the article already and would be a good replacement where we have overlap and a good addition where we don't. LesVegas (talk) 23:17, 15 May 2015 (UTC)

We already have better information in the section. QuackGuru (talk) 23:22, 15 May 2015 (UTC)

Please define exactly how it is superior so that we can consider your input. A1 made specific points regarding duration of pain relief for neck pain, descending modulation, and type of hepatitis. I would start by addressing the specifics of those, and adding how the information we have is "better". LesVegas (talk) 23:36, 15 May 2015 (UTC)

I would just note you've left out all but one of the negative or equivocal statements involving acupuncture, and the one negative statement you did include is already in the article.

• Chapter 30, pg 142: "Pain is the most common indication for CAM therapies. Some of the most popular CAM modalities are acupuncture, chiropractic, and yoga, all of which have been shown to be beneficial in certain contexts. However, the effect size tends to be modest for these treatments, and there is little evidence to support one modality over another or against conventional medical treatments."
• Chapter 129, pg 832: "Unproven treatments include...acupuncture"
• Chapter 400, pg 2375: "True acupuncture appears no better than sham acupuncture."

There are a few more. Sunrise (talk) 23:57, 15 May 2015 (UTC)

As per Kww's argument, these are already mentioned in the article and there is no need to mention it again. -A1candidate 00:02, 16 May 2015 (UTC)

I think it's pretty clear that Kww's comment is in response to your own quotes, not the quotes that hadn't been mentioned yet at that point in the discussion. Sunrise (talk) 00:16, 16 May 2015 (UTC)

And I think it's equally clear that I'm using his arguments to help you understand why I did not quote everything from the book. -A1candidate 00:21, 16 May 2015 (UTC)

I think that what I actually said will speak for itself. I didn't object to your not having quoted everything; I objected to which quotes you chose, because the effect was a misrepresentation of the book's acupuncture-related content. Sunrise (talk) 03:35, 16 May 2015 (UTC)

Miller's Anesthesia

• Miller's Anesthesia. Elsevier. 2014. ISBN 0702052833.

User:Sunrise, if you have time can you take a look at Miller's Anesthesia for some quotes? QuackGuru (talk) 17:33, 16 May 2015 (UTC)

I would say that on balance Miller's is more positive than Goldman-Cecil. That said, it still contains caveats and qualifications that were omitted when it was being cited in the discussion above. For example, the "key points" summary for chapter 40, the same chapter being quoted above, only mentions acupuncture in the statement "Other complementary therapies, including acupuncture and music therapy, have become increasing popular, although less is known about their effectiveness." Most of the book is actually online (search results for acupuncture) - you can probably select which quotes you would like better than I can. :-) Sunrise (talk) 01:30, 18 May 2015 (UTC)

I added information about the contrasting acupoints. QuackGuru (talk) 02:27, 18 May 2015 (UTC)

Acupuncture in western education

It ocurred to me that like the section which used to be called "Reception", we could include either within that section or standalone, something indicating that acupuncture is taught at the tertiary level in western countries. Something like -

In the UK, acupuncture is now taught at many main-stream universities, including-

University of Hertfordshire

London South Bank University

Middlesex University London

Lincoln college

University of Westminster

University of Greenwich

Coventry University

University of Bridgeport*

Keele University

Manchester Metropolitan University

University College Dublin

Glyndwr University

Of course not all of these examples would be used - but we could select some.

DrChrissy 17:07, 16 May 2015 (UTC)

Numbers

"Between 2000 and 2009, at least ninety-five cases of serious adverse events, including five deaths, were reported to have resulted from acupuncture." For the same sentence the numbers should be spelled out. I disagree with this edit. QuackGuru (talk) 00:49, 18 May 2015 (UTC)

Sources

The current article has the following text:

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. David Gorski said in 2010 that "Probably the most common form of pseudoscience to wend its way into what should be bastions of scientific medicine is acupuncture."

The sources include a publication by John Hopkins, about how it is now providing acupuncture services, a blog that allows anyone to submit content and appears to have an editorial agenda to advocate against alternative medicine, and some kind of guest blog written by the same folks with a "opinion" tag on it.

The claims made in this excerpt of Misplaced Pages text are borderline WP:EXCEPTIONAL and should have multiple, high-quality, secondary sources. We do not accept crowd-sourced or opinion content anywhere and rarely accept blogs that aren't by journalists. I don't see this content as acceptable based on the currently used sources. CorporateM (Talk) 18:05, 18 May 2015 (UTC)

We certainly allow blogs from notable people to source statements made by those people, so long as those statements are attributed. The real question is whether David H. Gorski's opinion is sufficiently notable to include.—Kww(talk) 18:35, 18 May 2015 (UTC)

I do not think Gorski is a credible source. He suggests that genetically engineered organisms are created using age-old forced hybridization rather than new technology, and writes off any need for concern about GM safety with this argument. It appears there is a POV that surpasses his commitment to representing scientific fact, unless we are to assume he suffers from some mental ineptitude, which he clearly does not. (102:00) petrarchan47คุก 02:29, 20 May 2015 (UTC)

You mean that he's an unreliable source because he understands genetics and doesn't suffer from anti-GMO hysteria? I would consider that to be a good attribute.—Kww(talk) 04:14, 20 May 2015 (UTC)

Text about ethics should be in the ethics section. Gorski is a reliable source. We had this discussion before about Gorski. QuackGuru (talk) 22:02, 20 May 2015 (UTC)

WP:NPOV

Not having edited here previously I don't know how much this has been discussed in the past and I'm sure that those on a certain side of the debate will not want to admit it. But there is at least significant parts of this article (and possibly more, not having had the chance to read it through entirely) that have an entirely blatant POV problem. The Ethics section for example is full of opinions stated as facts in Misplaced Pages's voice, non-impartial language and is pretty much entirely one-sided. Perhaps the one-sided part reflects the sources, but I doubt it. For instance the first paragraph is dedicated to broadcasting to the world in Misplaced Pages's voice that UK doctors who recommend acupuncture are failing in their duty of care towards patients. But the UK NHS doesn't seem to take this position, neither presumably do the UK medical authorities.

I'm also not sure about the the part of the following sentence highlighted in bold: "TCM theory and practice are not based upon scientific knowledge, and acupuncture is described as a type of pseudoscience." Is there actually a consensus amongst sources that it is a type of pseudoscience? This is likely highly controversial so we need to reflect the sources here please, not strong editor opinions. We only have one single citation which is inadequate for a controversial issue. I do not know what the majority of sources say but I did notice when I read the UK NHS information that their evidence committee, NICE, have found accupuncture effective for some types of treatment. Thus they seem to avoid describing it as pseudoscience and say instead that "it is often seen as a form of complementary or alternative medicine (CAM), although it is used in many NHS general practices, as well as the majority of pain clinics and hospices in the UK". I've tried searching for position statements by other leading bodies but they seem to be hard to come by.

Another issue is the use of multiple citations to web sites that are as biased as possible such as Quackwatch without any opposing views which very likely exist to a relative degree of prominence.Levelledout (talk) 00:22, 19 May 2015 (UTC)

It's true that "position statements by other leading bodies ... seem to be hard to come by". That's typically the problem with things that leading scientific bodies don't take seriously. In fact, it's a great indicator that something isn't worth taking seriously. As for the NHS, they readily admit that they will fund pure placebos: their decisions as to what treatments to offer are swayed by political concerns.—Kww(talk) 18:44, 19 May 2015 (UTC)

Levelledout thank you for posting your observations. It is true that the opinions of Quackwatch, Ernst, and Novella are greatly amplified relative to the available literature on this subject. That is by choice of a dedicated group of editors who feel compelled to amplify certain voices and silence others. Quackwatch is not an appropriate source, but many editors love it. The Nature source, authored by who knows, is given absurd weight. The scientific literature is mixed and plagued by methodological problems, a subject that is treated with an appropriate, dispassionate tone in the UK NHS link you provided. Unfortunately, dispassionate does not describe the editing culture here on wikipedia. It is very dysfunctional here, so I appreciate uninvolved editors coming by to point that out.Herbxue (talk) 19:03, 19 May 2015 (UTC)

Support OP Most of the ethics section appears to read like an essay or have nothing to do with Ethics. I trimmed much of it and moved some of it like the WHO report to other sections, but QuackGuru moved it back. CorporateM (Talk) 21:53, 20 May 2015 (UTC)

It is about ethics. For example "Acupuncturists have cited the report as evidence of their approach of being therapeutic, and people have been convinced that acupuncture must work for a wide range of conditions because it was endorsed by WHO." How is that not about ethics when the report was most obviously over-optimistic overview of acupuncture? The part "Many physicians in the UK appear to recommend alternative medicine, which raises ethical issues." is about ethics too.

Posadzki, P.; Alotaibi, A.; Ernst, E. (2012). "Prevalence of use of complementary and alternative medicine (CAM) by physicians in the UK: a systematic review of surveys". Clinical Medicine. 12 (6): 505–512. doi:10.7861/clinmedicine.12-6-505. ISSN 1470-2118. PMID 23342401. Did you delete this 2012 systematic review by accident or on purpose? QuackGuru (talk) 22:29, 20 May 2015 (UTC)

So when it's convenient it's absolutely fine to present minority opinions as mainstream gospel truth then? I'm talking about the UK information which is not supported by the NHS, NICE or presumably the UK medical authorities. By the way editor opinion of the NHS is irrelevant.Levelledout (talk) 23:16, 20 May 2015 (UTC)

You are going to have to be explicit as to what you are talking about. Do you mean that we should not frame recommending placebos as an ethical issue? Or that you think that it's a minority view that acupuncture is primarily a placebo? Or what? For what it's worth, both Ernst and Vickers, responsible for the two most widely cited reviews of the effectiveness of acupuncture on pain, agree that the any actual effect of acupuncture is smaller than the placebo effects.—Kww(talk) 23:56, 20 May 2015 (UTC)

I'm saying that it would seem to be a minority view that UK doctors who practice acupuncture are failing in their duty of care towards patients or otherwise acting unethically. It shouldn't be presented as the majority view and certainly shouldn't be presented as fact.Levelledout (talk) 00:16, 21 May 2015 (UTC)

Where does it state that conclusively? All I can see directly referencing acupuncture is language like "raises ethical questions", and the only place it makes an unequivocal statement is about prescription of pure placebos being unethical. The latter is a majority view: the only question is whether acupuncture is pure placebo or whether it has some actual effect.—Kww(talk) 00:28, 21 May 2015 (UTC)

"Many physicians in the UK appear to recommend alternative medicine, which raises ethical issues. Physicians have a duty of care requiring that each patient be treated with the best treatment for a given condition and situation." Either that is implying that doctors who use acupuncture are possibly breaching their duty of care or it isn't in which case the text is redundant and irrelevant.Levelledout (talk) 00:46, 21 May 2015 (UTC)

I don't see a reason to call out the UK specifically and I especially don't see a reason to call out one individual specifically, in a way that is very hostile and reads like a major BLP problem/personal attack. However, we should certainly cover as part of the efficacy debate that many doctors that feel it is ineffective feel that those prescribing it are preventing patients from seeking legitimate forms of treatment, relying on the placebo effect or selling a sham. That is one significant viewpoint that I think can be covered in an encyclopedic manner. CorporateM (Talk) 00:53, 21 May 2015 (UTC)

So long as you bear in mind that acupuncture being primarily placebo is the mainstream scientific opinion and phrase your changes accordingly. While there are certainly political and social pressures to provide acupuncture as a treatment option, there's no scientific basis for doing so: the most favourable well-controlled studies describe an effect smaller than derived from Tylenol, which is why there are questions about whether the effect exists at all. As for being negative about Brian Berman's study? It's nearly impossible to be excessively negative about that study.—Kww(talk) 01:09, 21 May 2015 (UTC)

People that prescribe treatments which the scientific consensus holds to have little or no benefit are "possibly" breaching their duty of care. So long as the article doesn't state that they are definitely breaching their duty of care, I don't see the problem. Are you claiming that prescribing acupuncture as if it were an effective treatment is uncontroversial? That's certainly not true.—Kww(talk) 01:13, 21 May 2015 (UTC)

@Kww: With respect, I'd prefer if we stayed focused on one subject at a time. It's a very large article and it's hard to make progress when every time a very specific subject of discussion is raised, editors show a habit of re-visiting the aspect of the article in which they have a strong opinion and is most controversial. I am not a doctor and haven't read any of the sources on this topic, so I do not have anything to contribute to that discussion at this time. Anyways, I will take a look at the sources and see if we can get something more encyclopedic, if similar comments are already on the page, etc. CorporateM (Talk) 01:46, 21 May 2015 (UTC)

My comment was a direct reply to the statement it was replying to (00:46, 21 May 2015 (UTC)), CorporateM, with no topic drift whatsoever. Levelledout was complaining about the implication that UK doctors were breaching a duty of care, and I was explaining that his logic was faulty and that the sources supported the implication. I'm glad that you admit that you haven't got a background in this topic nor have you read any of the sources on the topic. Could you perhaps take the time to do the fundamental research necessary to competently comment upon acupuncture before making any more changes? After all, we are all entitled to opinions, but no one is entitled to an uninformed opinion.—Kww(talk) 04:27, 21 May 2015 (UTC)

This is an egregiously wrong characterization of the nature of Misplaced Pages; the absolute ideal is that our articles would be edited by non-experts with no opinion. Editors that approach an article with a pre-conceived opinion tend to argue, edit and research with an emphasis on making the article reflect their views, rather than merely following the sources. Of course we often fall short of this ideal, but it's entirely in the wrong direction to ask an editor to form an opinion before editing or to emphasize sharing their opinion. What I may have an opinion on eventually, is what general characterization is "representative of the total body of literature" - I can have opinions about what the sources say and what sources are reliable - that is the nature of our work here. And it often means adding or accepting content that we don't agree with, but is part of documenting the debate. CorporateM (Talk) 04:52, 21 May 2015 (UTC)

There is no way to understand what constitutes due or undue weight without an overview understanding of the topic, CorporateM. Otherwise, editors wind up reacting to "oooh, that quote sounds nasty" without understanding that the nasty quote may reflect scientific consensus. That's especially true of articles about pseudoscience and alternative medicine, where the largest quantity of sources range from unreliable to fraudulent.—Kww(talk) 05:05, 21 May 2015 (UTC)

Regarding the prior Ethics section, citation 285 appears to be about the use of placebos in the elderly and is already covered elsewhere in the article. Citation 284 does not appear to say anything about ethics. I will keep looking through the other sources, but it is looking like this section was fabricated as a personal essay, as expected. CorporateM (Talk) 02:28, 21 May 2015 (UTC)

Formerly citation 75 from this section is clearly identified as an op-ed. That's enough to satisfy me. I'll try to keep hammering away at the History section, as time allows. CorporateM (Talk) 02:32, 21 May 2015 (UTC)

Late edits

Greetings! It sure has been hectic here lately, hasn't it? Anyway, some of the edits caught my attention:

1. Here, QuackGuru made an edit where he - according to his ES - reverted, changed, and added material. I'd like that User:QuackGuru next time divides his edits to removals, edits, and additions separately. Especially since your Edit Summaries don't address the edit's you've made. I kept the ref improvements though.
2. Here QuackGuru reverts a valuable edit by CorporateM. IMHO, material about efficiency does not belong to Ethics section, even if the word "ethics" is mentioned once or twice.

Cheers! Jayaguru-Shishya (talk) 15:21, 21 May 2015 (UTC)

See Talk:Acupuncture#Recent changes. You restored the original research and other problems. QuackGuru (talk) 18:15, 21 May 2015 (UTC)

Cultural heritage

Does "acupuncture is recognized by UNESCO as part of the world's intangible cultural heritage" deserve mention in the lede? -A1candidate 18:18, 21 May 2015 (UTC)

The lead should summarize the body, and should reflect its weight. There is only a one-sentence mention of this in the entire article. Copying that one sentence into the lead does not reflect the weight of the body.   — Jess· Δ♥ 18:25, 21 May 2015 (UTC)

No. I can't see any reason that such a minor point deserves space in the article summary.—Kww(talk) 18:38, 21 May 2015 (UTC)

"In 2010, acupuncture was recognized by UNESCO as part of the world's intangible cultural heritage." This does not add much to the history section. So what it was recognized. QuackGuru (talk) 19:18, 21 May 2015 (UTC)

• No. Acupuncture is claimed to be a medical treatment. If you want to drop that pretence and correctly characterise it as a shamanic ritual, then we can talk again. Guy (Help!) 23:07, 21 May 2015 (UTC)
  • Rather than say acupuncture was recognized by UNESCO... it would be better to explain the shamanic rituals in detail. There are much better sources that go into detail about this. See Talk:Acupuncture#Sources for history. QuackGuru (talk) 06:16, 22 May 2015 (UTC)

My first inclination is that something along those lines may warrant inclusion in the Lead, which should identify why the subject is notable. However, so far, I have not found similar statements in high-quality secondary sources by academics. By time the History section is finished, we should have a better idea on whether something that is representative of the body of literature would include something along those lines. I have not seen anything about shamanism in the sources. I do note that the current Lead does not appear to have anything about History, which is generally the most important part of an encyclopedia. CorporateM (Talk) 17:47, 22 May 2015 (UTC)

Off-Wiki canvassing

I have now received several off-wiki emails from editors encouraging me to make edits that are either supportive, or critical, of acupuncture. I don't have the time/interest to respond to all of them, but I want to remind editors of Misplaced Pages:Canvassing, which includes a section on "Stealth canvassing". It is not appropriate to contact users covertly off-wiki in order to persuade them to join your side of the argument. Please knock it off. I presume other editors involved in the page have had similar experiences... CorporateM (Talk) 05:08, 22 May 2015 (UTC)

Sources for history

• See here.

1. Yoshiaki Omura (2003). Acupuncture Medicine: Its Historical and Clinical Background. Courier Corporation. p. 13. ISBN 978-0-486-42850-5.
2. Jean-Marie Abgrall (2000). Healing Or Stealing?: Medical Charlatans in the New Age. Algora Publishing. pp. 52–. ISBN 978-1-892941-51-0.

https://books.google.com/books?id=cpjgoazGIC4C&pg=PT610&dq=History+of+Acupuncture&hl=en&sa=X&ei=mcheVfbtO4S8ggSJrYHgBg&ved=0CC8Q6AEwADge#v=onepage&q=History%20of%20Acupuncture&f=false

https://books.google.com/books?id=dbemhYH3aiQC&pg=PR56&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=NsNeVYH-K8XUsAWVtoD4Dg&ved=0CE0Q6AEwBQ#v=onepage&q=Origins%20of%20Acupuncture&f=false Acupuncture may have originated from India?

https://books.google.com/books?id=e7SMFvj1dbMC&pg=PA14&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=sMVeVbfxKYmhNs3jgeAL&ved=0CGEQ6AEwCTgK#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=RUlRPxA6O9YC&pg=PA403&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=EcZeVc7lH8iMNv3ngegN&ved=0CC8Q6AEwADgU#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=5m6CKTEr3I0C&pg=PA42&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=EcZeVc7lH8iMNv3ngegN&ved=0CEYQ6AEwBDgU#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=jT-qMFvLpZ4C&pg=PA161&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=xcZeVZexDIGLNoK5gLAE&ved=0CEIQ6AEwAzge#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=q6VtAAAAMAAJ&q=Origins+of+Acupuncture&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=xcZeVZexDIGLNoK5gLAE&ved=0CFMQ6AEwBjge

https://books.google.com/books?id=BxD1AgAAQBAJ&pg=PA77&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=xcZeVZexDIGLNoK5gLAE&ved=0CGAQ6AEwCDge#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=yTx6kPjXt3EC&pg=PA500&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=KMdeVYrKAsGTNorCgvAD&ved=0CDwQ6AEwAjgo#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=Ztq89bhQxPMC&pg=PA15&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=tMdeVc3lEcnFgwSpgoGwCQ&ved=0CDoQ6AEwAjg8#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=dMEoAwAAQBAJ&pg=PT8&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=-sdeVee2D8uoNsqDgMAP&ved=0CD4Q6AEwAzhG#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=L5SZAgAAQBAJ&pg=PA5&dq=History+of+Acupuncture&hl=en&sa=X&ei=bMheVZjcIsiwggS8i4CABw&ved=0CGAQ6AEwCTgU#v=onepage&q=History%20of%20Acupuncture&f=false

https://books.google.com/books?id=XIdlPEUcrPIC&pg=PT20&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=tMdeVc3lEcnFgwSpgoGwCQ&ved=0CFUQ6AEwBzg8#v=onepage&q=Origins%20of%20Acupuncture&f=false

https://books.google.com/books?id=dupNBAAAQBAJ&pg=PA52&dq=Origins+of+Acupuncture&hl=en&sa=X&ei=UsdeVYaqEcSagwS30YHoAw&ved=0CFAQ6AEwBjgy#v=onepage&q=Origins%20of%20Acupuncture&f=false

I might search for more sources. QuackGuru (talk) 06:51, 22 May 2015 (UTC)

Thanks QuackGuru. You probably made a similar observation, but when I did some Google Books searches previously, most of what I found were written by acupuncturists or acupuncture advocates, as oppose to historians and journalists. Often I had a hard time finding more information about the author to determine which category they fell into. Books almost always have the most high-quality and in-depth histories though, so I think sorting out the 1-3 most reliable books about acupuncture's history is an endeavor worth pursuing.

I've gotten to the part of the History section where the spiritual beliefs about acupuncture (chi energy, yin yang, etc.) have started emerging. I'm not set on the best way to word it, but for now I've just made sure they are identified as "spiritual beliefs". I think this approach is respectful to Asian heritage/culture, avoids repeating other sections and makes it clear enough to any of our readers not intelligent enough to realize that "chi energies" is obviously not a scientific principle. I'm sure as the History section progresses to the scientific era, we'll be able to document shifting perceptions. CorporateM (Talk) 07:08, 22 May 2015 (UTC)

Survey: How should we present the clinical practice guidelines for acupuncture?

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How should we present the clinical practice guidelines for acupuncture? Consider the following two versions:

A1candidate 23:51, 22 May 2015 (UTC)

The relevant practice guidelines are

• http://annals.org/article.aspx?articleid=736814
• http://journal.publications.chestnet.org/article.aspx?articleid=1685298
• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722580/
• http://oto.sagepub.com/content/152/2/197.full
• http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1932775
• https://www.ncbi.nlm.nih.gov/pubmed/23420266?dopt=Abstract

—Kww(talk) 00:37, 23 May 2015 (UTC)

• You seem to have left out PMID 25701863 added by DrChrissy.
• And why did you not mention PMID 23420266 at all?

-A1candidate 00:48, 23 May 2015 (UTC)

Added the geriatric guideline that I had inadvertantly omitted. At first blush, the veterinary reference doesn't appear to have been misrepresented, so I left it alone. If I've missed some way in that the strength of the recommendation has been misportrayed, let me know.—Kww(talk) 00:55, 23 May 2015 (UTC)

None of the references were misrepresented. At least not in the previous version. -A1candidate 01:04, 23 May 2015 (UTC)

• Previous version is far more concise and readable. It is obviously not perfect and may require some slight modifications to better reflect the guidelines, but it is certainly better than the current version as it summarizes the practice guidelines of medical organizations and gives appropriate emphasis on the clinical recommendations and consensus statements of medical organizations. On the other hand, the current version distorts the statements found in the original guidelines and places undue weight on the fact that these recommendations are far from strong. It should be reverted back to the previous version before the entire section becomes impossible to understand. -A1candidate 23:51, 22 May 2015 (UTC)
• Current version. The previous version was grossly misleading, as it implied that these societies were actually recommending acupuncture. More careful review of the guidelines themselves make it clear that most of them were providing extremely weak recommendations under extremely limited circumstances and that none of them were recommending acupuncture as the primary course of treatment. Even the word "suggest" is too strong: these guidelines provide extremely tepid support for the use of acupuncture. Every qualifier that I added accurately reflects the source guidelines themselves. By the way, a "religion" and "sociology" RFC? In what way is this anything other than a medical and scientific issue?—Kww(talk) 00:00, 23 May 2015 (UTC)
• Can you add the citations into the collapsed sections above? CorporateM (Talk) 00:29, 23 May 2015 (UTC)
  • The refs are now included. -A1candidate 00:34, 23 May 2015 (UTC)

Thanks. I started looking through a few of them and noticed that the journals being cited are published by the organizations themselves. Is there any debate/disagreement as to whether these are primary sources? CorporateM (Talk) 01:07, 23 May 2015 (UTC)

Not that I'm aware of. There's been some debate as to whether clinical guidelines are worth including at all, but a clinical guideline inherently is a direct statement by the organisation itself, so a primary source, correctly attributed to the source organisation, is probably the best way to go.—Kww(talk) 01:10, 23 May 2015 (UTC)

(ec, responding to Kww) (edit: in response to CorporateM's question as well) I wouldn't make that a general principle, though. It's very different from e.g. a company's press release - in some circumstances, sources like these can represent a statement of the general expert opinion on a subject, so (without saying anything about the current situation) I think it's potentially reasonable to dispute that. In some cases such statements may be more than "typical" primary sources, which is at least partially why clinical guidelines are included in WP:MEDRS as acceptable sources (when "from nationally or internationally recognised expert bodies"). It's the same reason that, for example, the IPCC is a strong source for statements of fact about climate change - it's agreed that it's best to treat it as if it's secondary or tertiary. There's a high standard to meet for that, but the discussion would have to analyze who the authors are. Sunrise (talk) 01:36, 23 May 2015 (UTC)

No. At least from the perspective of WP:MEDRS, I believe they are generally considered to be secondary sources (similar to review articles) since their recommendations are based on primary studies. PubMed also categorizes them as "Review", so there's no way Kww and others can argue that this isn't the case. -A1candidate 01:13, 23 May 2015 (UTC)

• Comment: It's hard for me to say without a stronger familiarity with our standards in medical topics/sourcing, but my instinct is to suggest deleting the entire bit. Looks like primary sources pieced together into an advocacy piece intended to make it look like a lot of organizations either oppose or support acupuncture depending on the version. I would need strong secondary sources to know if these organizations have an agenda, if their clinical advice is considered credible, and so on. Given that the scope of this article is very large, I would expect better sourcing to be available. That being said, I might defer to the better judgement of an impartial editor more experienced in this subject area and would consider that if the sources are acceptable, something in-between the two versions is probably the most obvious approach. I can put something together for discussion if the sources are deemed acceptable. CorporateM (Talk) 02:19, 23 May 2015 (UTC)

CorporateM please actually read MEDRS, particularly the definitions section where secondary sources are defined. Clinical guidelines issued by major medical bodies are gold standard MEDRS sources. Jytdog (talk) 10:54, 23 May 2015 (UTC)

@Jytdog: First of all, please stop emailing me with all these loaded comments about how I'm "destroying my credibility" with you, unless I essentially agree with you. I have already previously asked editors to stop doing this here in case you didn't see it. This is extremely inappropriate bullying, covert manipulation and bordering on harassment. I insist you knock it off. Any further private communications will merely be copy/pasted publicly, where all discussion should take place.

In other news, Jytdog does appear to be correct. MEDRS says "medical guidelines or position statements published by major health organizations" are secondary sources. Correcting me the usual way would have worked just fine. I'm busy this weekend and my interest in the medical aspect is limited, so I don't know if I will have the time/interest to sufficiently investigate the source material in order to cast a vote. However, given Jytdog's conduct, this raises significant questions about the integrity of this discussion if other editors are engaging in similar off-wiki lobbying, bullying and collusion. CorporateM (Talk) 15:55, 23 May 2015 (UTC)

• Current version: I think that the sources are ok (stated with attribution). Further, one should not cherry-pick quotes from them, but render their whole evaluation of acupuncture and the doubts they have about the evidence for it. Tgeorgescu (talk) 02:22, 23 May 2015 (UTC)

• Comment Between the two the current version is more informative and less promotional. But this RFC seems a little malformed.-Serialjoepsycho- (talk) 04:18, 23 May 2015 (UTC)

• Current version or delete. The current text is better written and closer to what the sources said. The previous text was a huge SYN violation. Removing the SYN tag without fixing the problem is not how to improve our articles. We do have solid evidence in the effectiveness section. The recommendations are weak evidence. We have better sources on the topic. QuackGuru (talk) 05:27, 23 May 2015 (UTC)

• current version it is more acurate--Ozzie10aaaa (talk) 08:50, 23 May 2015 (UTC)

• current version - With regard to the ASA, the source actually says, after reviewing the evidence and finding it poor (as described in the "Current version"): "ASA and ASRA members agree and consultants are equivocal with regard to whether acupuncture should be used for nonspecific, noninflammatory low back pain. Recommendations for acupuncture. Acupuncture may be considered as an adjuvant to conventional therapy (e.g ., drugs, physical therapy, and exercise) in the treatment of nonspecific, noninflammatory low back pain." the so-called "previous version" (which lasted for about a half hour) was created by this edit by the OP which rendered that as "acupuncture may be considered in the treatment of patients with nonspecific, noninflammatory low back pain". After some back and forth the current version was arrived at. The killer thing to me, is that even the OP backed off the "previous version" in this diff and this dif (in another piece of this section) as part of that back and forth. On the basis of those diffs it appears that the OP himself does not support the version linked to as "previous". Jytdog (talk) 10:53, 23 May 2015 (UTC) (add note that ASA reviews the evidence - edit shown with underline Jytdog (talk) 12:17, 23 May 2015 (UTC))
  • I backed off in an attempt to compromise. I support most, if not all, of my own edits. -A1candidate 11:11, 23 May 2015 (UTC)

your own edits that I linked to, were made as part of the WP:CONSENSUS making process that led to the current version. This RfC is repudiation of that and is a waste of time in my eyes. Even you, via your subsequent edits, do not support the "previous version.' And I will add, since you chose to argue with me, that your edit creating the "previous version" is so far away from the source that it was either incompetent or tendentious; there is no chance that the "previous version" will be accepted in this RfC. Please withdraw this RfC. Jytdog (talk) 12:16, 23 May 2015 (UTC)

• Current version The previous version hides all the nuance in the position statements and gives a stronger endorsement than they actually provide. The previous version is also technically an original synthesis, Second Quantization (talk) 11:15, 23 May 2015 (UTC)
• Current version. As a disclaimer, I am not fully familiar with Misplaced Pages's standards for medical sources (though I have recently read the MEDRS thing). Also, my wife is someone who has acupuncture treatment (for symptomatic relief only) and appears to benefit from it, and I myself use acupressure techniques for controlling occasional headache and for relaxation - but as a statistically meaningless sample of only two, I have no way of knowing whether we receive physical medical benefit, placebo benefit, or psychological benefit. With that in mind, I think Misplaced Pages treads dangerous ground if it tries to summarize clinical practice guidelines into generalities, risking venturing into the realms of synthesis, and I think the 'previous version' does do that (and I think it presents a more positive whole than the parts themselves warrant). If any clinical practice guidelines are to be presented at all, I think they should be as close as practical to actual quotations from the various bodies themselves. And so I very much favour the 'current version' if there has to be a version at all. Mr Potto (talk) 15:52, 23 May 2015 (UTC)

Discussion

The recommendations from the organisations are lower-quality sources compared to other sources currently in the effectiveness section. QuackGuru (talk) 07:19, 23 May 2015 (UTC)

with regard to evidence yes things like Cochrane reviews are better, but clinical guidelines are also gold standard MEDRS sources. Jytdog (talk) 11:05, 23 May 2015 (UTC)

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