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{{see|Misplaced Pages:Verifiability|Misplaced Pages:No original research|Misplaced Pages:Manual of Style/Medicine-related articles}}
{{also|Misplaced Pages:Identifying reliable sources (science)|Misplaced Pages:Biomedical information}}
{{subcat guideline|content guideline|Identifying reliable sources (medicine)|WP:MEDRS}}
{{nutshell|Ideal sources for ] material include ]s or ]s in '''reliable, third-party, published''' secondary sources (such as reputable ]s), recognised standard textbooks by experts in a field, or ]s and position statements from national or international expert bodies.<p>'''Cite reviews, don't write them.'''</p>}}
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{{Misplaced Pages:MEDRS/Navigation}}
{{Guideline list}}


] must be ] reliable, ] published ]s, and must accurately reflect current knowledge. This guideline supports the ] with specific attention to what is appropriate for medical content in {{strong|any}} Misplaced Pages article, including those on ]. Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on ].
:''See also: ] and ].''


Ideal sources for biomedical information include: ] (especially ]s) published in reputable ]s, academic and professional books written by experts in the relevant fields and from respected publishers, and ] or position statements from national or international expert bodies. {{strong|]s should generally not be used for medical content}}, as such sources often include unreliable or preliminary information; for example, early lab results that do not hold in later ]s.
Misplaced Pages's medical articles should use reliable published sources. These guidelines supplement the general guidelines at ]. The ideal source would be a general or ] in a reputable ], or a widely recognised standard textbook written by experts in their field. It is also useful to reference seminal papers on the subject, as part of documenting the history of the subject.


See the ] for questions about reliability of specific sources, and feel free to ask at WikiProjects such as ] and ].
==Some definitions==


==Definitions==
:''See also: ]''
{{shortcut|WP:MEDDEF}}
{{Further2|]|]|]}}


=== Types of sources ===
* A ''']''' in medicine is one where the authors participated in research or documented their personal experiences. They examined the patients, injected the rats or filled the test tubes, or at least supervised those who did. Many, but not all, papers published in medical journals are primary sources. Most medical journals have high editorial standards and ensure research papers are ].
In the biomedical literature:
* A ''''']''''' is one in which the authors directly participated in the research and documented their personal experiences. They examined the patients, injected the rats, ran the experiments, or supervised those who did. Many papers published in medical journals are primary sources for facts about the research and discoveries made.
* A ''''']''''' summarizes one or more primary or secondary sources to provide an overview of current understanding of the topic, to make recommendations, or to ] of several studies. Examples include ]s or ]s found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations.
* A ''''']''''' summarizes a range of secondary sources. Undergraduate- or graduate-level textbooks, edited scientific books, lay scientific books, and encyclopedias are tertiary sources.


=== Biomedical v. general information ===
* A ''']''' in medicine summarizes one or more primary or secondary sources, usually to give an overview on a medical speciality. Review papers and textbooks are examples of secondary sources. A good secondary source from a reputable publisher will be written by an expert in the field and be editorially or peer reviewed. Journalists writing in the popular press, and marketing departments who issue press releases tend to write poor secondary source material.
{{See|Misplaced Pages:Biomedical information}}
] requires sourcing that complies with this guideline, whereas general information in the same article may not.


For example, an article on ''Dr Foster's Magic Purple Pills'' could contain both biomedical and non-biomedical claims:
* A ''']''' usually summarizes secondary sources. Encyclopedias, including Misplaced Pages, are tertiary sources.
* ''Dr Foster's pills cure everything.'' {{xt| A biomedical claim! Strong MEDRS (MEDical Reliable Source) sourcing is definitely required here (see ])}}
* ''The pills were invented by Dr Archibald Foster and released onto the market in 2015.'' {{xt|This is ], and it only requires ordinary ]}}
* ''They are purple and triangular, packaged one to a box,''{{fake cn}} ''as no-one ever manages to swallow a second one.''{{medcn}}


==Basic advice==
In general, Misplaced Pages's medical articles should use published reliable secondary sources whenever possible. Reliable primary sources may be used only with great care, because it's easy to misuse them. For that reason, edits that rely on primary sources should only make descriptive claims that can be checked by anyone without specialist knowledge. Any interpretation of primary source material requires a secondary source.


===Avoid primary sources===
==Periodicals==
Per the Misplaced Pages policies of ], ], and ], articles need to be based on reliable, ], published '''''secondary''''' or '''''tertiary''''' sources. For ], the Misplaced Pages community relies on guidance contained in expert scientific reviews and textbooks, and in official statements published by major medical and scientific bodies. Note that health-related content in the general ] should not normally be used to source biomedical content in Misplaced Pages articles. (News sources may be useful for non-biomedical content, such as information about "society and culture"&nbsp;– see ].)


'''''Primary''''' sources should NOT normally be used as a basis for biomedical content. This is because primary biomedical literature is exploratory and often not reliable (any given primary source may be contradicted by another). Any text that relies on primary sources should usually have minimal ], only describe conclusions made by the source, and describe these findings so clearly that any editor can check the sourcing without the need for specialist knowledge. Primary sources should never be cited in support of a conclusion that is not clearly made by the authors (''see ]'').
Periodicals include newspapers, magazines and journals. The very latest research is often published first here. Where an archive is provided however, then many decades of research can be accessed.


===Medical journals=== ===Respect secondary sources===
{{shortcut|WP:MEDPRI|WP:MEDREV}}
{{See|Misplaced Pages:Identifying and using primary sources}}


Primary sources should not be cited with intent of "debunking", contradicting, or countering conclusions made by secondary sources. ] is ], and Misplaced Pages is not a venue for ]. Controversies or uncertainties in medicine should be supported by reliable secondary sources describing the varying viewpoints. Primary sources should not be aggregated or presented without context in order to undermine proportionate representation of opinion in a field. If material can be supported by either primary or secondary sources – the secondary sources should be used. Primary sources may be presented together with secondary sources.
These are a natural choice as a source for up-to-date information for medical articles. They contain a mixture of primary and secondary sources, as well as less technical material such as biographies. Although almost all such material will count as a reliable source, not all the material is equally useful.


Findings are often touted in the popular press as soon as primary research is reported, before the scientific community has analyzed and commented on the results. Therefore, such sources should generally be omitted (''see ]''). Determining ] of studies requires reliable secondary sources (not press releases or newspaper articles based on such sources). If conclusions are worth mentioning (such as large ]s with surprising results), they should be described appropriately as from a single study:
====Core journals====


{{talkquote|"A large study published in 2010 found that selenium and Vitamin E supplements, separately as well as together, did not decrease the risk of getting prostate cancer and that vitamin E may increase the risk; they were previously thought to prevent prostate cancer." (citing {{PMID|20924966}})}}
] is a crude guideline to a journal's authority. If the articles in the top journals tend to be cited most often by other expert authors, then it is not a bad idea to do likewise on Misplaced Pages. The core general medical journals include


Given time a review will be published, and the primary sources should preferably be replaced with the review. Using secondary sources then allows facts to be stated with greater reliability:
* ]
* ]
* ] (JAMA)
* ]
* ] (BMJ)
* ]


{{talkquote|"Neither vitamin E nor selenium decreases the risk of prostate cancer and vitamin E may increase it." (citing {{PMID|29376219}}, {{PMID|26957512}})}}
Core basic science and biology journals include


If no reviews on the subject are published in a reasonable amount of time, then the content and primary source should be removed.
* ]
* ]
* ]


A reason to avoid primary sources in the biomedical field – especially papers reporting results of '']'' experiments – is that they are often not ]<ref name="Loscalzo2012">{{cite journal | vauthors = Loscalzo J | title = Irreproducible experimental results: causes, (mis)interpretations, and consequences | journal = Circulation | volume = 125 | issue = 10 | pages = 1211–4 | date = March 2012 | pmid = 22412087 | pmc = 3319669 | doi = 10.1161/CIRCULATIONAHA.112.098244 }}</ref><ref>{{cite news |last=Naik |first=Gutnam |newspaper=Wall Street Journal |date=December 2, 2011 |url=http://online.wsj.com/news/articles/SB10001424052970203764804577059841672541590 |title=Scientists' Elusive Goal: Reproducing Study Results |name-list-style=vanc}}</ref><ref>'']'s'' </ref> (see also ]) and are therefore unsuitable for use in generating encyclopedic, reliable biomedical content. Scientists at Bayer reported in 2011 that they were able to replicate results in only ~20 to 25% of prominent studies they examined;<ref name="pmid21892149">{{cite journal | vauthors = Prinz F, Schlange T, Asadullah K | title = Believe it or not: how much can we rely on published data on potential drug targets? | journal = Nature Reviews. Drug Discovery | volume = 10 | issue = 9 | pages = 712 | date = August 2011 | pmid = 21892149 | doi = 10.1038/nrd3439-c1 | s2cid = 16180896 }}</ref> scientists from Amgen followed with a 2012 publication showing that they were only able to replicate 6 (11%) of 53 high-impact publications and called for higher standards in scientific publishing.<ref name="pmid22460880">{{cite journal | vauthors = Begley CG, Ellis LM | title = Drug development: Raise standards for preclinical cancer research | journal = Nature | volume = 483 | issue = 7391 | pages = 531–3 | date = March 2012 | pmid = 22460880| doi = 10.1038/483531a | bibcode = 2012Natur.483..531B | s2cid = 4326966 }}</ref> Further, the fact that a claim is published in a refereed journal need not make it true. Even well-designed randomized experiments will occasionally produce spurious results. Experiments and studies can produce flawed results or even fall victim to deliberate fraud (e.g. ''the ] and the ]''.)
====Article type====


=== Summarize scientific consensus ===
Journal articles come in many types: original research, reviews, editorials, book reviews, correspondence, biographies and eulogies. Research papers are, of course, primary sources. A general review of a subject by an expert in the field makes a good secondary source. Such reviews often contain no original research but can make interpretations and draw conclusions from primary sources that no Misplaced Pages editor would be allowed to do. A systematic review is both a primary and secondary source - it sumarizes other papers but it does so in order to research the field and possibly come to a novel conclusion.
{{shortcut|WP:MEDSCI}}
] are the best place to find both primary and secondary sources. Every rigorous scientific journal is ]ed. Be careful of material published in journals lacking peer review or that report material mainly in other fields. (See: ].) Be careful of material published in disreputable journals or disreputable fields. (See: ].)


Misplaced Pages policies on the ] and ] demand that we present prevailing ] or ], which can be found in recent, authoritative ]s, in statements and ] issued by major professional medical or scientific societies (for example, the ] or the ]) and widely respected governmental and quasi-governmental health authorities (for example, ], ], ], and ]), in textbooks, or in scholarly ]s. Although significant-minority views are welcome in Misplaced Pages, such views must be presented in the context of their acceptance by experts in the field. Additionally, the views of ''tiny'' minorities need not be reported.
===Popular science===


Finally, make readers aware of controversies that are stated in reliable sources. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers.
Popular science magazines such as ] and ] sometimes feature articles on medical subjects. Whilst not peer reviewed, their advantage is that the material is explained in plain English.


=== Assess evidence quality ===
===Newspapers===
{{shortcut|WP:MEDASSESS}}
When writing about any ''']''', assessing evidence quality helps distinguish between minor and major views, determine ], and identify accepted ] information. Even in reputable medical journals, different papers are not given equal weight. Studies can be categorized into levels in a ],<ref>{{cite journal | vauthors = Wright JG | title = A practical guide to assigning levels of evidence | journal = The Journal of Bone and Joint Surgery. American Volume | volume = 89 | issue = 5 | pages = 1128–30 | date = May 2007 | pmid = 17473152 | doi = 10.2106/JBJS.F.01380 }}</ref> and editors should rely on high-level evidence, such as ]s. Low-level evidence (such as ]s or ]) or non-evidence (such as ] or conventional wisdom) are avoided. ]s or position statements by internationally or nationally recognized expert bodies also often contain recommendations, along with assessments of underlying evidence (see ]).


{{multiple image|align=center|direction=horizontal|image1=Research design and evidence.svg|width1=400|caption1=<!-- -->|alt2=|alt1=|image2=Research design and evidence - Capho.svg|width2=400|caption2=<!-- -->|footer=There are different ways to rank '''level of evidence in medicine''', but they similarly put high-level reviews and practice guidelines at the top.{{br}}Left: ].<ref name="dentalcare.com">{{Cite web|title = Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions {{!}} Continuing Education Course {{!}} dentalcare.com Course Pages {{!}} DentalCare.com|url = http://www.dentalcare.com/en-US/dental-education/continuing-education/ce311/ce311.aspx?ModuleName=coursecontent&PartID=4&SectionID=-1|website = www.dentalcare.com|access-date = 2015-09-03|archive-date = 4 Mar 2016|archive-url = https://web.archive.org/web/20160304091218/http://media.dentalcare.com/images/en-US/education/ce311/fig02.jpg}}</ref> Right: Canadian Association of Pharmacy in Oncology.<ref name="Capho">{{Cite web|title = The Journey of Research - Levels of Evidence {{!}} CAPhO|url = http://www.capho.org/blog/journey-research-levels-evidence|website = www.capho.org|access-date = 2015-09-03|archive-date = 21 February 2016|archive-url = https://web.archive.org/web/20160221222657/http://www.capho.org/blog/journey-research-levels-evidence|url-status = dead}}</ref>}}
Quality broadsheet newspapers can sometimes report medical news responsibly. Often, however, the distinction between science and pseudo-science is not maintained. Tabloid newspapers are virtually never a suitable source. The dictum "never let the truth get in the way of a good story" applies here more than anywhere.


{{anchor|Best evidence}}The best evidence for '''efficacy''' of treatments and other health interventions comes mainly from ] of ]s (RCTs).<ref>{{cite book |vauthors=Straus SE, Richardson WS, Glasziou P, Haynes RB |title= Evidence-based Medicine: How to Practice and Teach EBM |edition=3rd |isbn=978-0443074448 |location=Edinburgh |publisher= Churchill Livingstone |year=2005 |pages=102–05}}</ref> Systematic reviews of literature that include non-randomized studies are less reliable.<ref>{{cite book |vauthors=Straus SE, Richardson WS, Glasziou P, Haynes RB |title= Evidence-based Medicine: How to Practice and Teach EBM |edition=3rd |isbn=978-0443074448 |location=Edinburgh |publisher= Churchill Livingstone |year=2005 |page=99}}</ref> Narrative reviews can help establish the context of evidence quality.
==Books==


Lower levels of evidence in medical research come from ''primary'' studies (see ]). Roughly in descending order, these include: individual RCTs; ]al studies; prospective ] (non-experimental) studies, such as ] (one type of ]); ] studies; ] (surveys), and other ] studies such as ]; other ] analyses (including ]); and non-evidence-based expert opinion or clinical experience. Case reports and series are especially avoided, as they are ].
===Medical textbooks===


] and early-stage research should not be cited to imply wide acceptance. For example, results of an early-stage ] would not be appropriate in the 'Treatment' section of a disease article because future treatments have little bearing on current practice. The results might – in some cases – be appropriate for inclusion in an article specifically dedicated to the treatment in question or to the researchers or businesses involved in it. Such information, particularly when citing secondary sources, may be appropriate in research sections of disease articles. To prevent misunderstanding, the text should clearly identify the level of research cited (e.g., "first-in-human safety testing").
Medical textbooks published by the academic press are an excellent secondary source. Ensure the book is up-to-date, unless a historical perspective is required.


Several formal systems exist for assessing the quality of available evidence on medical subjects.<ref name=BMJSystematicReviews/><ref>{{cite journal | vauthors = Young JM, Solomon MJ | title = How to critically appraise an article | journal = Nature Clinical Practice. Gastroenterology & Hepatology | volume = 6 | issue = 2 | pages = 82–91 | date = February 2009 | pmid = 19153565 | doi = 10.1038/ncpgasthep1331 | citeseerx = 10.1.1.1041.1168 | s2cid = 6532496 | url = https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1041.1168&rep=rep1&type=pdf | archive-url = https://web.archive.org/web/20210514173216/https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1041.1168&rep=rep1&type=pdf | archive-date = 14 May 2021 | access-date = 14 May 2021 | url-status = live }}</ref> Here, "assess evidence quality" essentially means editors should determine the appropriate ''type of source'' and ''quality of publication''. Respect the levels of evidence: Do not reject a higher-level source (e.g., a meta-analysis) in favor of a lower one (e.g., any primary source) because of personal objections to the inclusion criteria, references, funding sources, or conclusions in the higher-level source. Editors should not perform detailed academic peer review.
===Popular science and medicine books===


===Avoid over-emphasizing single studies, particularly ''in vitro'' or animal studies===
These are usually tertiary sources, but there are exceptions. Some well known and respected popular science authors include ], ] and ].
{{anchor|Animal}}{{Shortcut|WP:MEDANIMAL|WP:MEDINVITRO|WP:IN MICE}}
'']'' studies and animal models serve a central role in research, and are invaluable in determining mechanistic pathways and generating hypotheses. However, ''in vitro'' and animal-model findings do not translate consistently into clinical effects in human beings. Where ''in vitro'' and animal-model data are cited on Misplaced Pages, it should be clear to the reader that the data are pre-clinical, and the article text should avoid stating or implying that reported findings hold true in humans. The level of support for a hypothesis should be evident to a reader.


Using small-scale, single studies makes for weak evidence, and allows for ] of data. Studies cited or mentioned in Misplaced Pages should be put in context by using high-quality secondary sources rather than by using the primary sources.
==Online==


===Reliable references=== ===Use up-to-date evidence===
{{shortcut|WP:MEDDATE}}
{{Also|Template:Update}}
Keeping an article up-to-date while maintaining the more-important goal of reliability is important. These instructions are appropriate for actively researched areas with many primary sources and several reviews, and may need to be relaxed in areas where little progress is being made or where few reviews are published.
* In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones, and editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written. The range of reviews you examine should be wide enough to catch at least one full review cycle, containing newer reviews written and published in the light of older ones and of more-recent primary studies.
* Assessing reviews may be difficult. While the most-recent reviews include later research results, this does ''not'' automatically give more weight to the most recent review (see ]).
* Prefer recent reviews to older primary sources on the same topic. If recent reviews do not mention an older primary source, the older source is dubious. Conversely, an older primary source that is seminal, replicated, and often-cited may be mentioned in the main text in a context established by reviews. For instance, the article ] could mention Darwin's 1859 book '']'' as part of a discussion supported by recent reviews.


There are exceptions to these rules of thumb:
*] provides a lot of useful info with regards to ]s.
* ''History'' sections often cite older work.
*] is a very big and reliable source.
* ] reviews and ] are generally of high quality and are periodically re-examined even if their initial publication dates fall outside the 5-year window.
*] is an excellent reference for ] in medicine.
* A newer source that is of lower quality '''does not supersede''' an older source of higher quality.


===Use independent sources===
===Background reading===
{{shortcut|WP:MEDINDY}}
Many treatments or proposed treatments lack good research into their efficacy and safety. In such cases, reliable sources may be difficult to find, while unreliable sources are readily available. When writing about medical claims not supported by mainstream research, it is vital that ], independent sources be used. Sources written and reviewed by the advocates of ] may be used to describe personal opinions, but extreme care should be taken when using such sources lest more controversial opinions be taken at face value or, worse, asserted as fact. If independent sources discussing a medical subject are of low quality, then it is likely that the subject itself is not ] enough to have its own article or relevant for mention in other articles.


] are commonly sponsored by industry groups with a financial interest in the outcome of the research reported. They may lack independent editorial oversight and ] with no supervision of content by the parent journal.<ref name=ICMJE_recommendations_2015 /> Such articles do not share the reliability of their parent journal.<ref name="supp_quality">{{cite journal | vauthors = Rochon PA, Gurwitz JH, Cheung CM, Hayes JA, Chalmers TC | title = Evaluating the quality of articles published in journal supplements compared with the quality of those published in the parent journal | journal = JAMA | volume = 272 | issue = 2 | pages = 108–13 | date = July 1994 | doi = 10.1001/jama.1994.03520020034009 | pmid = 8015117 }}</ref> Indications that an article was published in a supplement may be fairly subtle; for instance, a letter "s" added to a page number,<ref>{{cite journal | vauthors = Nestle M | title = Food company sponsorship of nutrition research and professional activities: a conflict of interest? | journal = Public Health Nutrition | volume = 4 | issue = 5 | pages = 1015–22 | date = October 2001 | pmid = 11784415 | doi = 10.1079/PHN2001253 | s2cid = 17781732 | url = https://www.cambridge.org/core/services/aop-cambridge-core/content/view/0DC05EE7794D352882D2F089111A0449/S1368980001001069a.pdf/food_company_sponsorship_of_nutrition_research_and_professional_activities_a_conflict_of_interest.pdf }}</ref> or "Suppl." in a reference.
*] has encyclopedic content in plain English from the ].

*].
===Bias===
*] is a UK website which provides an easy access for general practitioners and may be an interesting source.
{{shortcut|WP:MEDBIAS}}
*] has an excellent set of online anatomic preparations.

*
====Personal conflicts of interest====
*
{{more|Misplaced Pages:Conflicts of interest (medicine)}}
* : ] is a UK project, using mediawiki and restricted to qualified people (as a reaction to medical articles in wikipedia that can be edited by anyone). They have some 1600 medical articles.
]
{{shortcut|WP:MEDCOI}}
Use your best judgement when writing about topics where you may have a conflict of interest: citing yourself on Misplaced Pages is problematic. Citing your own organization, such as a governmental health agency or an NGO producing high-quality systematic reviews, is generally acceptable&nbsp;– if the conflict of interest is disclosed, it is done to improve coverage of a topic, and not with the sole purpose of driving traffic to your site. All edits should improve neutral encyclopedic coverage; anything else, such as promoting an organization, is ].

According to the ]&nbsp;– '''conflicts of interest''' (COI) must be disclosed. Editing on topics where one is involved or closely related, especially when there is potential financial gain, is discouraged. Medicine is not an exception. One way to contribute with a COI is to post on talk-pages, suggesting edits. Another alternative is the ] pathway.

These methods are often best when writing about oneself, one's organization or ]&nbsp;– but may be less so when there is a potential conflict of interest in a ]. For example, one may legitimately be an ] on a certain topic&nbsp;– a ] who reads the talk-page will not always have the knowledge to assess the sources properly. Then it is better to follow '''ordinary editing protocol''', disclosing any COI and to be careful ''not'' to overemphasize your own sources.

==Choosing sources==
]'' and other ]s can be useful as sources for images in Misplaced Pages articles. Because the above image was published under the terms of a ], it can be ] to ] and ] on Misplaced Pages. Click on the above image to find its source.]]
===Non-free content===
{{shortcut|WP:NOTONLYFREE|WP:FUTONBIAS}}
{{also|FUTON bias|WP:MEDCOPY}}
A Misplaced Pages article should cite high-quality reliable sources ]. Some high-prestige journals, such as '']'', publish a few freely readable articles even though most are not free. A few high-quality journals, such as '']'', publish only freely readable sources. Also, a few sources are in the ]; these include many U.S. government publications, such as the '']'' of the ].

===Don't just cite the abstract===
{{shortcut|WP:NOABSTRACT}}
When ], it is wise to skim-read everything available, including abstracts of papers that are not freely readable, and use that to get a feel for what reliable sources are saying. However, when it comes to actually writing a Misplaced Pages article, it is misleading to give a full citation for a source after reading only its abstract; the abstract necessarily presents a stripped-down version of the conclusions and omits the background that can be crucial for understanding exactly what the source says, and may not represent the article's actual conclusions.<ref>{{cite journal | vauthors = Li G, Abbade LP, Nwosu I, Jin Y, Leenus A, Maaz M, Wang M, Bhatt M, Zielinski L, Sanger N, Bantoto B, Luo C, Shams I, Shahid H, Chang Y, Sun G, Mbuagbaw L, Samaan Z, Levine MA, Adachi JD, Thabane L | title = A scoping review of comparisons between abstracts and full reports in primary biomedical research | journal = BMC Medical Research Methodology | volume = 17 | issue = 1 | pages = 181 | date = December 2017 | pmid = 29287585 | pmc = 5747940 | doi = 10.1186/s12874-017-0459-5 | doi-access = free }}</ref>

To access the full text of a book or journal article, the editor may need to use the ], visit a medical library, pay to read it, or ask someone at the ] or ] to either provide an electronic copy or read the source and summarize what it says; if none of this is possible, the editor may need to find a different source.

=== Biomedical journals ===
Peer-reviewed medical journals are a natural choice as a source for up-to-date medical information in Misplaced Pages articles. Journal articles come in many different types, and are a mixture of primary and secondary sources. Primary publications describe new research, while review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments. In addition to experiments, primary sources normally contain introductory, background, or review sections that place their research in the context of previous work; these sections may be cited in Misplaced Pages with care: they are often incomplete<ref name=Robinsonetal_2011>{{cite journal | vauthors = Robinson KA, Goodman SN | title = A systematic examination of the citation of prior research in reports of randomized, controlled trials | journal = Annals of Internal Medicine | volume = 154 | issue = 1 | pages = 50–5 | date = January 2011 | pmid = 21200038 | doi = 10.7326/0003-4819-154-1-201101040-00007 | s2cid = 207536137 }}</ref> and typically less reliable than reviews or other sources, such as textbooks, which are intended to be reasonably comprehensive. If challenged, the primary source should be supplemented with, or replaced by, a more appropriate source.

Reviews may be ] or systematic (and sometimes both). ''Narrative reviews'' provide a general summary of a topic based on a survey of the literature, which can be useful when outlining a topic. A general narrative review of a subject by an expert in the field can make a good secondary source covering various aspects of a subject within a Misplaced Pages article. Such reviews typically do not contain primary research but can make interpretations and draw conclusions from primary sources that no Misplaced Pages editor would be allowed to do. ''Systematic reviews'' use sophisticated methodology to address a particular clinical question in as balanced (unbiased) a way as possible. Some systematic reviews also include a statistical meta-analysis to combine the results of several clinical trials to provide stronger quantitative evidence about how well a treatment works for a particular purpose. A systematic review uses a ] methodology to select primary (or sometimes secondary) studies meeting explicit criteria to address a specific question. Such reviews should be more reliable and accurate and less prone to bias than a narrative review.<ref name=BMJSystematicReviews>{{cite journal | vauthors = Greenhalgh T | title = Papers that summarise other papers (systematic reviews and meta-analyses) | journal = BMJ | volume = 315 | issue = 7109 | pages = 672–5 | date = September 1997 | doi = 10.1136/bmj.315.7109.672 | pmid = 9310574 | pmc = 2127461 }}</ref> Systematic reviews and ''meta-analyses'' of randomized controlled trials can provide strong evidence of the clinical efficacy of particular treatments in given scenarios, which may, in turn, be incorporated into ]s or institutional position papers (ideal sources for clinical recommendations). It is normally best to use reviews and meta-analyses where possible. Reviews give a balanced and general perspective of a topic and are usually easier to understand. However, whereas a narrative review may give a panorama of current knowledge on a particular topic, a systematic review tends to have a narrower focus.

Journals may specialize in particular article types. A few, such as ''Evidence-based Dentistry'' ({{ISSN|1462-0049}}), publish third-party summaries of reviews and guidelines published elsewhere. If an editor has access to both the original source and the summary and finds both helpful, it is good practice to cite both sources together (see '']'' for details). Others, such as '']'', publish historical material that can be valuable for ''History'' sections, but is rarely useful for current medicine. Still others, such as '']'', publish speculative proposals that are not reliable sources for biomedical topics.

==== List of core journals ====

The ] provides a list of 114 selected "core clinical journals".<ref name=AIM>{{cite web |title=Abridged Index Medicus (AIM or "Core Clinical") Journal Titles |url=http://www.nlm.nih.gov/bsd/aim.html |publisher=NLM |access-date=17 November 2012}}</ref> Another useful grouping of core medical journals is the 2003 Brandon/Hill list, which includes 141 publications selected for a small medical library<ref>{{cite web |vauthors=Hill DR, Stickell H, Crow SJ |year=2003 |title=Brandon/Hill selected list of print books for the small medical library |publisher=Mt. Sinai School of Medicine |url=http://library.mssm.edu/brandon-hill/small_medical/pdf/brandon4.pdf |archive-url=https://web.archive.org/web/20110807182148/http://library.mssm.edu/brandon-hill/small_medical/pdf/brandon4.pdf |archive-date=7 August 2011 |url-status=dead |access-date=2008-09-16 }}</ref> (although this list is no longer maintained, the listed journals are of high quality). Core general medical journals include the '']'', '']'', the '']'' (''JAMA''), the '']'', '']'' ''(British Medical Journal),'' and the '']''. Core basic science and biology journals include '']'', '']'' and '']''.

====Predatory journals====
{{further|WP:RS#Predatory journals}}
Avoid articles from journals with ]. A journal article is probably not reliable for biomedical claims if its publisher has a reputation for exhibiting "]" behavior, which includes questionable business practices and/or peer-review processes that raise concerns about the reliability of their journal articles. (See also ] and the ] section below for examples of such publishers.<ref name=Beall1>{{cite report |publisher=University of Antwerp, Gezaghebbende Panel |first1=A.I.M. |last1=Jakaria Rahman |first2=Tim C.E. |last2=Engels |title=Predatory open access journals in a performance-based funding model: Common journals in Beall's list and in version V of the VABB-SHW | date=25 February 2015 |url=http://eprints.rclis.org/25046/1/Rahman%20and%20Engels_%202015_Predatory%20open%20access%20journals.pdf |name-list-style=vanc}}</ref><ref name="Beall2">{{cite web|last1=Beall|first1=Jeffrey|date=31 December 2016|title=Potential, possible, or probable predatory scholarly open-access publishers|url=https://scholarlyoa.com/publishers/|archive-url=https://web.archive.org/web/20170111172306/https://scholarlyoa.com/publishers/|archive-date=11 January 2017 |name-list-style=vanc}}</ref>) Other indications that a journal article ''may'' not be reliable are its publication in a journal that is not indexed in the bibliographic database ],<ref>To determine if a journal is MEDLINE indexed, go to , and search for the name of the journal. On the journal page, under the heading "Current Indexing Status", you can see whether or not the journal is currently indexed. Note that journals that have changed names or ceased publication will not be "currently" indexed on MEDLINE, but their indexing status, when they were being published, can be viewed under other headings on that same page.</ref> or its content being outside the journal's normal scope (for instance, an article on the efficacy of a new cancer treatment in a psychiatric journal or the surgical techniques for hip replacement in a ] journal). 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, suggesting wider acceptance in the medical literature despite any red flags suggested here.

An archive of ], an early list of potentially predatory journals, can be found at ; updates are added separately by an anonymous post-doctoral researcher. On Misplaced Pages, the ] compilation (updated twice monthly) and the ] script can be leveraged to facilitate the detection of predatory journals.

Some baseline methods to identify questionable journals have reached consensus in the academic community.<ref name=predatory_def>{{cite journal|first1=Agnes|last1=Grudniewicz|first2=David|last2=Moher|first3=Kelly D.|last3=Cobey|first4=Gregory L.|last4=Bryson|title=Predatory journals: no definition, no defence|url=https://www.nature.com/articles/d41586-019-03759-y|journal=Nature|date=2019|pages=210–212|volume=576|issue=7786|doi=10.1038/d41586-019-03759-y|first5=Samantha|last5=Cukier|first6=Kristiann|last6=Allen|first7=Clare|last7=Ardern|first8=Lesley|last8=Balcom|first9=Tiago|last9=Barros|first10=Monica|last10=Berger|first11=Jairo Buitrago|last11=Ciro|first12=Lucia|last12=Cugusi|first13=Michael R.|last13=Donaldson|first14=Matthias|last14=Egger|first15=Ian D.|last15=Graham|first16=Matt|last16=Hodgkinson|first17=Karim M.|last17=Khan|first18=Mahlubi|last18=Mabizela|first19=Andrea|last19=Manca|first20=Katrin|last20=Milzow|first21=Johann|last21=Mouton|first22=Marvelous|last22=Muchenje|first23=Tom|last23=Olijhoek|first24=Alexander|last24=Ommaya|first25=Bhushan|last25=Patwardhan|first26=Deborah|last26=Poff|first27=Laurie|last27=Proulx|first28=Marc|last28=Rodger|first29=Anna|last29=Severin|first30=Michaela|last30=Strinzel|first31=Mauro|last31=Sylos-Labini|first32=Robyn|last32=Tamblyn|first33=Marthie|last33=van Niekerk|first34=Jelte M.|last34=Wicherts|first35=Manoj M.|last35=Lalu|pmid=31827288 |bibcode=2019Natur.576..210G |s2cid=209168864 }}</ref>

==== Sponsored supplements ====
{{See also|WP:SPONSORED}}

] are often (but far from always) unacceptable sources. They are commonly sponsored by industry groups with a financial interest in the outcome of the research reported. They may lack independent editorial oversight and ], with no supervision of content by the parent journal.<ref name=ICMJE_recommendations_2015>{{Citation| last = Fees| first = F.| title = Recommendations for the conduct, reporting, editing, and publication of scholarly work in medical journals| url = http://www.icmje.org/icmje-recommendations.pdf| date = 2016| access-date = 2019-01-12| archive-url = https://web.archive.org/web/20140305222129/http://www.icmje.org/icmje-recommendations.pdf| archive-date = 2014-03-05| url-status = live |name-list-style=vanc}} {{Webarchive|url=https://web.archive.org/web/20181230102758/http://www.icmje.org/recommendations/browse/roles-and-responsibilities/author-responsibilities--conflicts-of-interest.html |date=2018-12-30 }}, .</ref> Such ] articles do not share the reliability of their parent journal,<ref name="supp_quality" /> being essentially paid ] as academic articles. Such supplements, and those that do not clearly declare their editorial policy and conflicts of interest, should not be cited.

Indications that an article was published in a supplement may be fairly subtle; for instance, a letter "S" added to a page number,<ref>{{cite journal |last1=Nestle |first1=Marion |title=Food company sponsorship of nutrition research and professional activities: a conflict of interest? |journal=Public Health Nutrition |date=2 January 2007 |volume=4 |issue=5 |pages=1015–1022 |doi=10.1079/PHN2001253 |pmid=11784415 |s2cid=17781732 |url=https://www.cambridge.org/core/services/aop-cambridge-core/content/view/0DC05EE7794D352882D2F089111A0449/S1368980001001069a.pdf/food_company_sponsorship_of_nutrition_research_and_professional_activities_a_conflict_of_interest.pdf |access-date=12 January 2019 |archive-url=https://web.archive.org/web/20181117105015/https://www.cambridge.org/core/services/aop-cambridge-core/content/view/0DC05EE7794D352882D2F089111A0449/S1368980001001069a.pdf/food_company_sponsorship_of_nutrition_research_and_professional_activities_a_conflict_of_interest.pdf |archive-date=17 November 2018 |url-status=live |df=dmy-all |name-list-style=vanc}}</ref> or "Suppl." in a reference.<ref>See ] of how to identify shill academic articles cited in Misplaced Pages.</ref> However, note that merely being published in ''<u>a</u>'' supplement is not '']'' evidence of being published in a ''<u>sponsored</u>'' supplement. Many, if not most, supplements are perfectly legitimate sources, such as the '']'', '']'', '']'', or '']''. A sponsored supplement need not necessarily have a COI with its medical content; for instance, public health agencies may also sponsor supplements. However, groups that do have a COI may hide behind layers of front organizations with innocuous names, so the ultimate funding sources should always be ascertained.

=== Books ===
{{shortcut|WP:MEDBOOK}}

High-quality textbooks can be a good source to start an article, and often include general overviews of a field or subject. However, books generally move slower than journal sources, and are often several years behind the current state of evidence. This makes using up-to-date books even more important. Medical textbooks published by academic publishers are often excellent secondary sources. If a textbook is intended for students, it may not be as thorough as a monograph or chapter in a textbook intended for professionals or postgraduates. Ensure that the book is up to date, unless a historical perspective is required. Doody's maintains a list of core health sciences books, which is available only to subscribers.<ref>{{cite journal | vauthors = Shedlock J, Walton LJ | title = Developing a virtual community for health sciences library book selection: Doody's Core Titles | journal = Journal of the Medical Library Association | volume = 94 | issue = 1 | pages = 61–6 | date = January 2006 | pmid = 16404471 | pmc = 1324773 }}</ref> Major academic publishers (e.g., ], ], ], and ]) publish specialized medical book series with good editorial oversight; volumes in these series summarize the latest research in narrow areas, usually in a more extensive format than journal reviews. Specialized biomedical encyclopedias published by these established publishers are often of good quality, but as a tertiary source, the information may be too terse for detailed articles.

Additionally, popular science books are useful sources, but generally should not be referenced on Misplaced Pages to support medical statements (see ]). In addition, most ] books or books published by ]es undergo no independent fact-checking or peer review and, consequently, are not reliable sources. However, books published by ]es or the ] tend to be well-researched and useful for most purposes.

=== Medical and scientific organizations ===
{{shortcut|WP:MEDORG}}
Guidelines and position statements provided by major medical and scientific organizations are important on Misplaced Pages because they present recommendations and opinions that many caregivers rely upon (or may even be legally obliged to follow).

Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include the ] (including the ] and the ]), the British ], the U.S. ] and ], and the ]. The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, to public guides and service announcements, which have the advantage of being freely readable but are generally less authoritative than the underlying medical literature.

Guidelines by major medical and scientific organizations sometimes clash with one another (for example, the World Health Organization and American Heart Association on salt intake), which should be resolved in accordance with ]. Guidelines do not always correspond to best evidence, but instead of omitting them, reference the scientific literature and explain how it may differ from the guidelines. Remember to avoid ] by only using the best possible sources, and ] by tying together separate statements with "however", "this is not supported by", etc. The image below attempts to clarify some internal ranking of statements from different organizations in the weight they are given on Misplaced Pages.
] or ''HTA''s are the gold standard when it comes to assessing evidence quality. They take into account various aspects such as effect, risks, economic costs, and ethical concerns of a treatment. They seldom make recommendations, but instead explain most effective treatments and potential hazards and discuss gaps in knowledge. Their name is somewhat of a misnomer as they do not need to concern "technology" as perceived by the public&nbsp;– but rather any intervention intended to improve health.</div>]]

=== Popular press ===
{{shortcut|WP:MEDPOP}}
The popular press is generally not a reliable source for scientific and medical information in articles. Most ] fail to discuss important issues such as evidence quality,<ref>{{cite journal | vauthors = Cooper BE, Lee WE, Goldacre BM, Sanders TA | title = The quality of the evidence for dietary advice given in UK national newspapers | journal = Public Understanding of Science | volume = 21 | issue = 6 | pages = 664–73 | date = August 2012 | pmid = 23832153 | doi = 10.1177/0963662511401782 | s2cid = 36916068 }}<br />{{cite news |last=Goldacre |first=Ben |date=17 June 2011 |url=http://www.guardian.co.uk/commentisfree/2011/jun/17/bad-science-health-reporting |title=How far should we trust health reporting? |work=The Guardian }}</ref> costs, and risks versus benefits,<ref>{{cite journal | vauthors = Schwitzer G | title = How do US journalists cover treatments, tests, products, and procedures? An evaluation of 500 stories | journal = PLOS Medicine | volume = 5 | issue = 5 | pages = e95 | date = May 2008 | pmid = 18507496 | pmc = 2689661 | doi = 10.1371/journal.pmed.0050095 | doi-access = free }}<br />{{cite news |last=Goldacre |first=Ben |date=20 June 2008 |title=Why reading should not be believing |work=Guardian |url=http://www.guardian.co.uk/commentisfree/2008/jun/21/2 }}</ref> and news articles too often convey wrong or misleading information about health care.<ref>{{cite journal | vauthors = Dentzer S | title = Communicating medical news—pitfalls of health care journalism | journal = The New England Journal of Medicine | volume = 360 | issue = 1 | pages = 1–3 | date = January 2009 | pmid = 19118299 | doi = 10.1056/NEJMp0805753 | url = http://content.nejm.org/cgi/content/full/360/1/1 }}</ref> Articles in newspapers and popular magazines tend to overemphasize the certainty of any result, for instance, presenting a new and experimental treatment as "the cure" for a disease or an every-day substance as "the cause" of a disease. Newspapers and magazines may also publish articles about scientific results before those results have been published in a peer-reviewed journal or reproduced by other experimenters. Such articles may be based uncritically on a press release, which themselves promote research with uncertain relevance to human health and do not acknowledge important limitations, even when issued by an academic medical center.<ref>{{cite journal | vauthors = Woloshin S, Schwartz LM, Casella SL, Kennedy AT, Larson RJ | title = Press releases by academic medical centers: not so academic? | journal = Annals of Internal Medicine | volume = 150 | issue = 9 | pages = 613–8 | date = May 2009 | doi = 10.7326/0003-4819-150-9-200905050-00007 | pmid = 19414840 | s2cid = 25254318 | url = http://annals.org/cgi/content/full/150/9/613 }}</ref> For Misplaced Pages's purposes, articles in the popular press are ]. A news article should therefore not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source.

Conversely, the high-quality popular press can be a good source for social, biographical, current-affairs, financial, and historical information in a medical article. For example, popular science magazines such as '']'' and '']'' are not peer reviewed, but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, use common sense, and see how well the source fits the ] and ]. Sources for evaluating health-care media coverage include specialized academic journals such as the '']''. Reviews can also appear in the '']'', the '']'', and others.

=== Other sources ===
]

Press releases, newsletters, advocacy and self-help publications, blogs and other websites, and other sources contain a wide range of biomedical information ranging from factual to fraudulent, with a high percentage being of low quality.

Conference abstracts present incomplete and unpublished data and undergo varying levels of review; they are often unreviewed and their initial conclusions may have changed dramatically if and when the data are finally ready for publication.<ref>{{cite journal | vauthors = Rosmarakis ES, Soteriades ES, Vergidis PI, Kasiakou SK, Falagas ME | title = From conference abstract to full paper: differences between data presented in conferences and journals | journal = FASEB Journal | volume = 19 | issue = 7 | pages = 673–80 | date = May 2005 | pmid = 15857882 | doi = 10.1096/fj.04-3140lfe | doi-access = free | s2cid = 29281534 }}</ref> Consequently, they are usually poor sources and should always be used with caution, never used to support ], and carefully identified in the text as preliminary work.

Medical information resources such as ] and ] are usually acceptable sources for uncontroversial information; however, as much as possible Misplaced Pages articles should cite the more established literature directly. ] is less preferred as it is not possible to reference specific versions of their articles, and archives do not exist.

== Searching for sources ==
{{shortcut|WP:MEDSEARCH}}
]s are commonly used to find biomedical sources. Each engine has quirks, advantages, and disadvantages, and may not return the results that the editor needs unless used carefully. It typically takes experience and practice to recognize when a search has not been effective; even if an editor finds useful sources, they may have missed other sources that would have been more useful or they may generate pages and pages of less-than-useful material. A good strategy for avoiding sole reliance on search engines is to find a few recent high-quality sources and follow their citations to see what the search engine missed. It can also be helpful to perform a plain web search rather than one of scholarly articles only.

] is an excellent starting point for locating peer-reviewed medical . <!--i.e., WP:MEDPRI, WP:MEDANIMAL, and WP:MEDDATE respectively--> It offers a free search engine for accessing the ] database of biomedical research articles offered by the ] at the ].<ref>{{cite journal | vauthors = Greenhalgh T | title = How to read a paper. The Medline database | journal = BMJ | volume = 315 | issue = 7101 | pages = 180–3 | date = July 1997 | doi = 10.1136/bmj.315.7101.180 | pmid = 9251552 | pmc = 2127107 }}</ref> PubMed can be searched in a variety of ways.<ref>{{cite web |title=PubMed User Guide |url=https://pubmed.ncbi.nlm.nih.gov/help/ |website=PubMed |access-date=14 May 2021 |language=en}}</ref><ref name=PubMedTutorial>{{cite web|title=PubMed tutorial: filters|url=http://www.nlm.nih.gov/bsd/disted/pubmedtutorial/020_210.html|publisher=NLM|access-date=17 November 2012}}</ref> For example, clicking on the "Review" tab will help narrow the search to review articles. The "Filters" options can further narrow the search, for example, to ], to ]s, and/or to freely readable sources. Once you have a PMID from Pubmed, you can plug that PMID into to get a correctly written citation. Although PubMed is a comprehensive database, many of its indexed journals restrict online access. Another website, ], provides free access to full texts. While it is often not the official published version, it is a peer-reviewed manuscript that is substantially the same but lacks minor copy-editing by the publisher.<ref>{{cite journal |journal=] |year=2007 |volume=20 |issue=3 |pages=203–15 |title=Open access and accuracy: author-archived manuscripts vs. published articles |vauthors=Goodman D, Dowson S, Yaremchuk J |doi=10.1087/095315107X204012 |s2cid=44572906 |url=http://dlist.sir.arizona.edu/1968/01/OAandA%5FGDY.pdf |access-date=2008-10-24 }}</ref>

When looking at an individual abstract on the PubMed website, an editor can consult "Publication Types", "MeSH Terms", etc. at the bottom of the page to see how the document has been classified in PubMed. For example, a page that is tagged as "Comment" or "Letter" is a ] (often not peer-reviewed). The classification scheme includes about 80 types of documents.<ref name=PubMedTypes>{{cite web|title=PubMed: Publication Types|url=https://pubmed.ncbi.nlm.nih.gov/help/#publication-types|publisher=NLM|access-date=16 April 2024}}</ref> For medical information, the most useful types of articles are typically labeled "Guideline", "Meta-analysis", "Practice guideline", or "Review". Even when an article is one of the most useful types and recently published, it can be helpful to check the journal on ] and other databases as well as the status and ] of authors if they make extraordinary claims. There is ], but it is useful to compare the authors to others in the same field of study.

== Templates ==
* {{tl|Medical citation needed}} – adds: ''some text.''{{Medical citation needed}}
* {{tl|Medical citation needed span}} – adds: {{medical citation needed span|''some text.''}} (same as above, except the text is highlighted)
* {{tl|Unreliable medical source}} – adds: ''some text.''{{Unreliable medical source}}
* {{tl|Primary source inline}} – adds: ''some text.''{{npsn}}
* {{tl|More medical citations needed}} – maintenance tag for articles lacking reliable medical sources
* {{tl|Reliable medical sources please}} – a note for user talk pages with links to this page
* {{tl|Reliable sources for medical articles}} – for talk pages

== See also ==
* ]
* {{section link|Misplaced Pages:Reliable source examples#Physical sciences and medicine}}
* ]
* ]
* {{section link|Misplaced Pages:Identifying and using style guides#Topical academic style guides}} (essay)
* ], an essay about why this guideline exists
* ], Frequently Asked Questions about MEDRS
* '']''
* ]. ''The Misplaced Pages Signpost'' (2008-06-30)
* ]
* ], a bot-compiled listing of potentially unreliable publications cited by Misplaced Pages (see ] for details)
* ], a ] which highlights potentially unreliable citations.

== References ==
{{reflist}}

== Further reading ==
* {{cite book |author= Greenhalgh T |title= How to Read a Paper: The Basics of Evidence-based Medicine |publisher= BMJ Books |edition=3rd |year=2006 |isbn=978-1405139762}} The Greenhalgh citation in '']'' is taken from an earlier version of this book, which was . Other parts of that serialization include:
** {{cite journal | vauthors = Greenhalgh T | title = How to read a paper. Getting your bearings (deciding what the paper is about) | journal = BMJ | volume = 315 | issue = 7102 | pages = 243–6 | date = July 1997 | doi = 10.1136/bmj.315.7102.243 | pmid = 9253275 | pmc = 2127173 }}
** {{cite journal | vauthors = Greenhalgh T | title = Assessing the methodological quality of published papers | journal = BMJ | volume = 315 | issue = 7103 | pages = 305–8 | date = August 1997 | doi = 10.1136/bmj.315.7103.305 | pmid = 9274555 | pmc = 2127212 }}
** {{cite journal | vauthors = Greenhalgh T | title = How to read a paper. Statistics for the non-statistician. I: Different types of data need different statistical tests | journal = BMJ | volume = 315 | issue = 7104 | pages = 364–6 | date = August 1997 | doi = 10.1136/bmj.315.7104.364 | pmid = 9270463 | pmc = 2127256 }}
** {{cite journal | vauthors = Greenhalgh T | title = How to read a paper. Statistics for the non-statistician. II: "Significant" relations and their pitfalls | journal = BMJ | volume = 315 | issue = 7105 | pages = 422–5 | date = August 1997 | doi = 10.1136/bmj.315.7105.422 | pmid = 9277611 | pmc = 2127270 }}
** {{cite journal | vauthors = Greenhalgh T | title = How to read a paper. Papers that report drug trials | journal = BMJ | volume = 315 | issue = 7106 | pages = 480–3 | date = August 1997 | doi = 10.1136/bmj.315.7106.480 | pmid = 9284672 | pmc = 2127321 }}
** {{cite journal | vauthors = Greenhalgh T | title = How to read a paper. Papers that report diagnostic or screening tests | journal = BMJ | volume = 315 | issue = 7107 | pages = 540–3 | date = August 1997 | doi = 10.1136/bmj.315.7107.540 | pmid = 9329312 | pmc = 2127365 }}
** {{cite journal | vauthors = Greenhalgh T | title = How to read a paper. Papers that tell you what things cost (economic analyses) | journal = BMJ | volume = 315 | issue = 7108 | pages = 596–9 | date = September 1997 | doi = 10.1136/bmj.315.7108.596 | pmid = 9302961 | pmc = 2127419 }}
** {{cite journal | vauthors = Greenhalgh T, Taylor R | title = Papers that go beyond numbers (qualitative research) | journal = BMJ | volume = 315 | issue = 7110 | pages = 740–3 | date = September 1997 | doi = 10.1136/bmj.315.7110.740 | pmid = 9314762 | pmc = 2127518 }}
* {{cite book |vauthors=Straus SE, Richardson WS, Glasziou P, Haynes RB |title= Evidence-based Medicine: How to Practice and Teach EBM |edition=3rd |isbn=978-0443074448 |location=Edinburgh |publisher= Churchill Livingstone |year=2005}}
* {{cite web |title= Users' Guides to Evidence-Based Practice |url=http://cche.net/usersguides/main.asp |date=2001 |access-date=2014-07-09 |publisher=Centre for Health Evidence |archive-url=https://web.archive.org/web/20140719235748/http://www.cche.net/usersguides/main.asp |archive-date=19 July 2014 |url-status=dead}} This is derived from a prepublication version of a series published in ''JAMA''.
* {{cite book| vauthors = Bobick JE, Berard GL |title=Science and Technology Resources: A Guide for Information Professionals and Researchers|url=https://books.google.com/books?id=CrzfzYiG8OoC&pg=PA2|date=30 April 2011|publisher=ABC-CLIO|isbn=978-1591587941}}
* {{cite book|vauthors =Garrard J |title=Health Sciences Literature Review Made Easy|url=https://books.google.com/books?id=CSbfIcjQUcsC&pg=PA30|access-date=16 September 2012|date=25 October 2010|publisher=Jones & Bartlett Publishers|isbn=978-1449618681}}
* {{cite book |vauthors = Gray M |title= Evidence-Based Health Care and Public Health: How to Make Decisions About Health Services and Public Health |edition=3rd |year=2009 |isbn=978-0443101236 |location=Edinburgh |publisher= Churchill Livingstone}}
*

{{Misplaced Pages biomedical editing}}

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]
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Latest revision as of 21:42, 12 December 2024

Wikimedia project page

Further information: Misplaced Pages:Verifiability, Misplaced Pages:No original research, and Misplaced Pages:Manual of Style/Medicine-related articles See also: Misplaced Pages:Identifying reliable sources (science) and Misplaced Pages:Biomedical information
Blue tickThis page documents an English Misplaced Pages content guideline.
Editors should generally follow it, though exceptions may apply. Substantive edits to this page should reflect consensus. When in doubt, discuss first on this guideline's talk page.
Shortcut
This page in a nutshell: Ideal sources for biomedical material include literature reviews or systematic reviews in reliable, third-party, published secondary sources (such as reputable medical journals), recognised standard textbooks by experts in a field, or medical guidelines and position statements from national or international expert bodies.

Cite reviews, don't write them.

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Biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge. This guideline supports the general sourcing policy with specific attention to what is appropriate for medical content in any Misplaced Pages article, including those on alternative medicine. Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on identifying reliable sources.

Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals, academic and professional books written by experts in the relevant fields and from respected publishers, and guidelines or position statements from national or international expert bodies. Primary sources should generally not be used for medical content, as such sources often include unreliable or preliminary information; for example, early lab results that do not hold in later clinical trials.

See the reliable sources noticeboard for questions about reliability of specific sources, and feel free to ask at WikiProjects such as WikiProject Medicine and WikiProject Pharmacology.

Definitions

Shortcut Further information: Primary, secondary, and tertiary sources, Identifying and using primary sources, and Party and person

Types of sources

In the biomedical literature:

  • A primary source is one in which the authors directly participated in the research and documented their personal experiences. They examined the patients, injected the rats, ran the experiments, or supervised those who did. Many papers published in medical journals are primary sources for facts about the research and discoveries made.
  • A secondary source summarizes one or more primary or secondary sources to provide an overview of current understanding of the topic, to make recommendations, or to combine results of several studies. Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations.
  • A tertiary source summarizes a range of secondary sources. Undergraduate- or graduate-level textbooks, edited scientific books, lay scientific books, and encyclopedias are tertiary sources.

Biomedical v. general information

Further information: Misplaced Pages:Biomedical information

Biomedical information requires sourcing that complies with this guideline, whereas general information in the same article may not.

For example, an article on Dr Foster's Magic Purple Pills could contain both biomedical and non-biomedical claims:

  • Dr Foster's pills cure everything. A biomedical claim! Strong MEDRS (MEDical Reliable Source) sourcing is definitely required here (see WP:MEDASSESS)
  • The pills were invented by Dr Archibald Foster and released onto the market in 2015. This is not biomedical information, and it only requires ordinary RS
  • They are purple and triangular, packaged one to a box, as no-one ever manages to swallow a second one.

Basic advice

Avoid primary sources

Per the Misplaced Pages policies of neutral point of view, no original research, and verifiability, articles need to be based on reliable, independent, published secondary or tertiary sources. For biomedical content, the Misplaced Pages community relies on guidance contained in expert scientific reviews and textbooks, and in official statements published by major medical and scientific bodies. Note that health-related content in the general news media should not normally be used to source biomedical content in Misplaced Pages articles. (News sources may be useful for non-biomedical content, such as information about "society and culture" – see WP:MEDPOP.)

Primary sources should NOT normally be used as a basis for biomedical content. This is because primary biomedical literature is exploratory and often not reliable (any given primary source may be contradicted by another). Any text that relies on primary sources should usually have minimal weight, only describe conclusions made by the source, and describe these findings so clearly that any editor can check the sourcing without the need for specialist knowledge. Primary sources should never be cited in support of a conclusion that is not clearly made by the authors (see WP:Synthesis).

Respect secondary sources

Shortcuts Further information: Misplaced Pages:Identifying and using primary sources

Primary sources should not be cited with intent of "debunking", contradicting, or countering conclusions made by secondary sources. Synthesis of published material advancing a position is original research, and Misplaced Pages is not a venue for open research. Controversies or uncertainties in medicine should be supported by reliable secondary sources describing the varying viewpoints. Primary sources should not be aggregated or presented without context in order to undermine proportionate representation of opinion in a field. If material can be supported by either primary or secondary sources – the secondary sources should be used. Primary sources may be presented together with secondary sources.

Findings are often touted in the popular press as soon as primary research is reported, before the scientific community has analyzed and commented on the results. Therefore, such sources should generally be omitted (see recentism). Determining weight of studies requires reliable secondary sources (not press releases or newspaper articles based on such sources). If conclusions are worth mentioning (such as large randomized clinical trials with surprising results), they should be described appropriately as from a single study:

"A large study published in 2010 found that selenium and Vitamin E supplements, separately as well as together, did not decrease the risk of getting prostate cancer and that vitamin E may increase the risk; they were previously thought to prevent prostate cancer." (citing PMID 20924966)

Given time a review will be published, and the primary sources should preferably be replaced with the review. Using secondary sources then allows facts to be stated with greater reliability:

"Neither vitamin E nor selenium decreases the risk of prostate cancer and vitamin E may increase it." (citing PMID 29376219, PMID 26957512)

If no reviews on the subject are published in a reasonable amount of time, then the content and primary source should be removed.

A reason to avoid primary sources in the biomedical field – especially papers reporting results of in vitro experiments – is that they are often not replicable (see also replication crisis) and are therefore unsuitable for use in generating encyclopedic, reliable biomedical content. Scientists at Bayer reported in 2011 that they were able to replicate results in only ~20 to 25% of prominent studies they examined; scientists from Amgen followed with a 2012 publication showing that they were only able to replicate 6 (11%) of 53 high-impact publications and called for higher standards in scientific publishing. Further, the fact that a claim is published in a refereed journal need not make it true. Even well-designed randomized experiments will occasionally produce spurious results. Experiments and studies can produce flawed results or even fall victim to deliberate fraud (e.g. the Retracted article on dopaminergic neurotoxicity of MDMA and the Schön scandal.)

Summarize scientific consensus

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Scientific journals are the best place to find both primary and secondary sources. Every rigorous scientific journal is peer reviewed. Be careful of material published in journals lacking peer review or that report material mainly in other fields. (See: Martin Rimm.) Be careful of material published in disreputable journals or disreputable fields. (See: Sokal affair.)

Misplaced Pages policies on the neutral point of view and not publishing original research demand that we present prevailing medical or scientific consensus, which can be found in recent, authoritative review articles, in statements and practice guidelines issued by major professional medical or scientific societies (for example, the European Society of Cardiology or the Infectious Disease Society of America) and widely respected governmental and quasi-governmental health authorities (for example, AHRQ, USPSTF, NICE, and WHO), in textbooks, or in scholarly monographs. Although significant-minority views are welcome in Misplaced Pages, such views must be presented in the context of their acceptance by experts in the field. Additionally, the views of tiny minorities need not be reported.

Finally, make readers aware of controversies that are stated in reliable sources. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers.

Assess evidence quality

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When writing about any health effect, assessing evidence quality helps distinguish between minor and major views, determine due weight, and identify accepted evidence-based information. Even in reputable medical journals, different papers are not given equal weight. Studies can be categorized into levels in a hierarchy of evidence, and editors should rely on high-level evidence, such as systematic reviews. Low-level evidence (such as case reports or series) or non-evidence (such as anecdotes or conventional wisdom) are avoided. Medical guidelines or position statements by internationally or nationally recognized expert bodies also often contain recommendations, along with assessments of underlying evidence (see WP:MEDORG).

There are different ways to rank level of evidence in medicine, but they similarly put high-level reviews and practice guidelines at the top.
Left: Procter & Gamble. Right: Canadian Association of Pharmacy in Oncology.

The best evidence for efficacy of treatments and other health interventions comes mainly from meta-analyses of randomized controlled trials (RCTs). Systematic reviews of literature that include non-randomized studies are less reliable. Narrative reviews can help establish the context of evidence quality.

Lower levels of evidence in medical research come from primary studies (see WP:MEDDEF). Roughly in descending order, these include: individual RCTs; quasi-experimental studies; prospective observational (non-experimental) studies, such as prospective cohort studies (one type of longitudinal study); case control studies; cross-sectional studies (surveys), and other correlation studies such as ecological studies; other retrospective analyses (including retrospective cohort studies); and non-evidence-based expert opinion or clinical experience. Case reports and series are especially avoided, as they are uncontrolled.

Speculative proposals and early-stage research should not be cited to imply wide acceptance. For example, results of an early-stage clinical trial would not be appropriate in the 'Treatment' section of a disease article because future treatments have little bearing on current practice. The results might – in some cases – be appropriate for inclusion in an article specifically dedicated to the treatment in question or to the researchers or businesses involved in it. Such information, particularly when citing secondary sources, may be appropriate in research sections of disease articles. To prevent misunderstanding, the text should clearly identify the level of research cited (e.g., "first-in-human safety testing").

Several formal systems exist for assessing the quality of available evidence on medical subjects. Here, "assess evidence quality" essentially means editors should determine the appropriate type of source and quality of publication. Respect the levels of evidence: Do not reject a higher-level source (e.g., a meta-analysis) in favor of a lower one (e.g., any primary source) because of personal objections to the inclusion criteria, references, funding sources, or conclusions in the higher-level source. Editors should not perform detailed academic peer review.

Avoid over-emphasizing single studies, particularly in vitro or animal studies

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In vitro studies and animal models serve a central role in research, and are invaluable in determining mechanistic pathways and generating hypotheses. However, in vitro and animal-model findings do not translate consistently into clinical effects in human beings. Where in vitro and animal-model data are cited on Misplaced Pages, it should be clear to the reader that the data are pre-clinical, and the article text should avoid stating or implying that reported findings hold true in humans. The level of support for a hypothesis should be evident to a reader.

Using small-scale, single studies makes for weak evidence, and allows for cherry picking of data. Studies cited or mentioned in Misplaced Pages should be put in context by using high-quality secondary sources rather than by using the primary sources.

Use up-to-date evidence

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Keeping an article up-to-date while maintaining the more-important goal of reliability is important. These instructions are appropriate for actively researched areas with many primary sources and several reviews, and may need to be relaxed in areas where little progress is being made or where few reviews are published.

  • In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones, and editors should try to find those newer sources, to determine whether the expert opinion has changed since the older sources were written. The range of reviews you examine should be wide enough to catch at least one full review cycle, containing newer reviews written and published in the light of older ones and of more-recent primary studies.
  • Assessing reviews may be difficult. While the most-recent reviews include later research results, this does not automatically give more weight to the most recent review (see recentism).
  • Prefer recent reviews to older primary sources on the same topic. If recent reviews do not mention an older primary source, the older source is dubious. Conversely, an older primary source that is seminal, replicated, and often-cited may be mentioned in the main text in a context established by reviews. For instance, the article Genetics could mention Darwin's 1859 book On the Origin of Species as part of a discussion supported by recent reviews.

There are exceptions to these rules of thumb:

  • History sections often cite older work.
  • Cochrane Library reviews and NICE guidelines are generally of high quality and are periodically re-examined even if their initial publication dates fall outside the 5-year window.
  • A newer source that is of lower quality does not supersede an older source of higher quality.

Use independent sources

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Many treatments or proposed treatments lack good research into their efficacy and safety. In such cases, reliable sources may be difficult to find, while unreliable sources are readily available. When writing about medical claims not supported by mainstream research, it is vital that third-party, independent sources be used. Sources written and reviewed by the advocates of marginal ideas may be used to describe personal opinions, but extreme care should be taken when using such sources lest more controversial opinions be taken at face value or, worse, asserted as fact. If independent sources discussing a medical subject are of low quality, then it is likely that the subject itself is not notable enough to have its own article or relevant for mention in other articles.

Symposia and supplements to academic journals are commonly sponsored by industry groups with a financial interest in the outcome of the research reported. They may lack independent editorial oversight and peer review with no supervision of content by the parent journal. Such articles do not share the reliability of their parent journal. Indications that an article was published in a supplement may be fairly subtle; for instance, a letter "s" added to a page number, or "Suppl." in a reference.

Bias

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Personal conflicts of interest

Further information: Misplaced Pages:Conflicts of interest (medicine)
People most interested in improving only a single article may have a connection to its subject.
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Use your best judgement when writing about topics where you may have a conflict of interest: citing yourself on Misplaced Pages is problematic. Citing your own organization, such as a governmental health agency or an NGO producing high-quality systematic reviews, is generally acceptable – if the conflict of interest is disclosed, it is done to improve coverage of a topic, and not with the sole purpose of driving traffic to your site. All edits should improve neutral encyclopedic coverage; anything else, such as promoting an organization, is not allowed.

According to the conflict of interest guideline – conflicts of interest (COI) must be disclosed. Editing on topics where one is involved or closely related, especially when there is potential financial gain, is discouraged. Medicine is not an exception. One way to contribute with a COI is to post on talk-pages, suggesting edits. Another alternative is the articles for creation pathway.

These methods are often best when writing about oneself, one's organization or company – but may be less so when there is a potential conflict of interest in a research field. For example, one may legitimately be an authority on a certain topic – a volunteer who reads the talk-page will not always have the knowledge to assess the sources properly. Then it is better to follow ordinary editing protocol, disclosing any COI and to be careful not to overemphasize your own sources.

Choosing sources

Montage with central stripe reading "PLoS MEDICINE". Other images are orange segments, a woman in a blue shawl carrying a food package labeled "USA", a pregnant woman holding hands with a child, a hand holding several different pills over a lap covered by a colorful dress, patients in a hospital, and pills on a leaf.
PLoS Medicine and other open access journals can be useful as sources for images in Misplaced Pages articles. Because the above image was published under the terms of a Creative Commons license, it can be uploaded to Wikimedia Commons and used on Misplaced Pages. Click on the above image to find its source.

Non-free content

Shortcuts See also: FUTON bias and WP:MEDCOPY

A Misplaced Pages article should cite high-quality reliable sources regardless of whether they require a fee or a subscription. Some high-prestige journals, such as JAMA, publish a few freely readable articles even though most are not free. A few high-quality journals, such as PLoS Medicine, publish only freely readable sources. Also, a few sources are in the public domain; these include many U.S. government publications, such as the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention.

Don't just cite the abstract

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When searching for biomedical sources, it is wise to skim-read everything available, including abstracts of papers that are not freely readable, and use that to get a feel for what reliable sources are saying. However, when it comes to actually writing a Misplaced Pages article, it is misleading to give a full citation for a source after reading only its abstract; the abstract necessarily presents a stripped-down version of the conclusions and omits the background that can be crucial for understanding exactly what the source says, and may not represent the article's actual conclusions.

To access the full text of a book or journal article, the editor may need to use the Misplaced Pages Library, visit a medical library, pay to read it, 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 none of this is possible, the editor may need to find a different source.

Biomedical journals

Peer-reviewed medical journals are a natural choice as a source for up-to-date medical information in Misplaced Pages articles. Journal articles come in many different types, and are a mixture of primary and secondary sources. Primary publications describe new research, while review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments. In addition to experiments, primary sources normally contain introductory, background, or review sections that place their research in the context of previous work; these sections may be cited in Misplaced Pages with care: they are often incomplete and typically less reliable than reviews or other sources, such as textbooks, which are intended to be reasonably comprehensive. If challenged, the primary source should be supplemented with, or replaced by, a more appropriate source.

Reviews may be narrative or systematic (and sometimes both). Narrative reviews provide a general summary of a topic based on a survey of the literature, which can be useful when outlining a topic. A general narrative review of a subject by an expert in the field can make a good secondary source covering various aspects of a subject within a Misplaced Pages article. Such reviews typically do not contain primary research but can make interpretations and draw conclusions from primary sources that no Misplaced Pages editor would be allowed to do. Systematic reviews use sophisticated methodology to address a particular clinical question in as balanced (unbiased) a way as possible. Some systematic reviews also include a statistical meta-analysis to combine the results of several clinical trials to provide stronger quantitative evidence about how well a treatment works for a particular purpose. A systematic review uses a reproducible methodology to select primary (or sometimes secondary) studies meeting explicit criteria to address a specific question. Such reviews should be more reliable and accurate and less prone to bias than a narrative review. Systematic reviews and meta-analyses of randomized controlled trials can provide strong evidence of the clinical efficacy of particular treatments in given scenarios, which may, in turn, be incorporated into medical guidelines or institutional position papers (ideal sources for clinical recommendations). It is normally best to use reviews and meta-analyses where possible. Reviews give a balanced and general perspective of a topic and are usually easier to understand. However, whereas a narrative review may give a panorama of current knowledge on a particular topic, a systematic review tends to have a narrower focus.

Journals may specialize in particular article types. A few, such as Evidence-based Dentistry (ISSN 1462-0049), publish third-party summaries of reviews and guidelines published elsewhere. If an editor has access to both the original source and the summary and finds both helpful, it is good practice to cite both sources together (see Citing medical sources for details). Others, such as Journal of Medical Biography, publish historical material that can be valuable for History sections, but is rarely useful for current medicine. Still others, such as Medical Hypotheses, publish speculative proposals that are not reliable sources for biomedical topics.

List of core journals

The Abridged Index Medicus provides a list of 114 selected "core clinical journals". Another useful grouping of core medical journals is the 2003 Brandon/Hill list, which includes 141 publications selected for a small medical library (although this list is no longer maintained, the listed journals are of high quality). Core general medical journals include the New England Journal of Medicine, The Lancet, the Journal of the American Medical Association (JAMA), the Annals of Internal Medicine, The BMJ (British Medical Journal), and the Canadian Medical Association Journal. Core basic science and biology journals include Nature, Science and Cell.

Predatory journals

Further information: WP:RS § Predatory journals

Avoid articles from journals with a poor reputation for fact-checking and accuracy. A journal article is probably not reliable for biomedical claims if its publisher has a reputation for exhibiting "predatory" behavior, which includes questionable business practices and/or peer-review processes that raise concerns about the reliability of their journal articles. (See also WP:RS#Predatory journals and the #References section below for examples of such publishers.) Other indications that a journal article may not be reliable are its publication in a journal that is not indexed in the bibliographic database MEDLINE, or its content being outside the journal's normal scope (for instance, an article on the efficacy of a new cancer treatment in a psychiatric journal or the surgical techniques for hip replacement in a urology journal). 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, suggesting wider acceptance in the medical literature despite any red flags suggested here.

An archive of Beall's List, an early list of potentially predatory journals, can be found at Beall's List – of Potential Predatory Journals and Publishers; updates are added separately by an anonymous post-doctoral researcher. On Misplaced Pages, the CiteWatch compilation (updated twice monthly) and the Unreliable/Predatory Source Detector script can be leveraged to facilitate the detection of predatory journals.

Some baseline methods to identify questionable journals have reached consensus in the academic community.

Sponsored supplements

See also: WP:SPONSORED

Symposia and supplements to academic journals are often (but far from always) unacceptable sources. They are commonly sponsored by industry groups with a financial interest in the outcome of the research reported. They may lack independent editorial oversight and peer review, with no supervision of content by the parent journal. Such shill articles do not share the reliability of their parent journal, being essentially paid ads disguised as academic articles. Such supplements, and those that do not clearly declare their editorial policy and conflicts of interest, should not be cited.

Indications that an article was published in a supplement may be fairly subtle; for instance, a letter "S" added to a page number, or "Suppl." in a reference. However, note that merely being published in a supplement is not prima facie evidence of being published in a sponsored supplement. Many, if not most, supplements are perfectly legitimate sources, such as the Astronomy & Astrophysics Supplement Series, Nuclear Physics B: Proceedings Supplements, Supplement to the London Gazette, or The Times Higher Education Supplement. A sponsored supplement need not necessarily have a COI with its medical content; for instance, public health agencies may also sponsor supplements. However, groups that do have a COI may hide behind layers of front organizations with innocuous names, so the ultimate funding sources should always be ascertained.

Books

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High-quality textbooks can be a good source to start an article, and often include general overviews of a field or subject. However, books generally move slower than journal sources, and are often several years behind the current state of evidence. This makes using up-to-date books even more important. Medical textbooks published by academic publishers are often excellent secondary sources. If a textbook is intended for students, it may not be as thorough as a monograph or chapter in a textbook intended for professionals or postgraduates. Ensure that the book is up to date, unless a historical perspective is required. Doody's maintains a list of core health sciences books, which is available only to subscribers. Major academic publishers (e.g., Elsevier, Springer Verlag, Wolters Kluwer, and Informa) publish specialized medical book series with good editorial oversight; volumes in these series summarize the latest research in narrow areas, usually in a more extensive format than journal reviews. Specialized biomedical encyclopedias published by these established publishers are often of good quality, but as a tertiary source, the information may be too terse for detailed articles.

Additionally, popular science books are useful sources, but generally should not be referenced on Misplaced Pages to support medical statements (see #Popular press). In addition, most self-published books or books published by vanity presses undergo no independent fact-checking or peer review and, consequently, are not reliable sources. However, books published by university presses or the National Academy of Sciences tend to be well-researched and useful for most purposes.

Medical and scientific organizations

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Guidelines and position statements provided by major medical and scientific organizations are important on Misplaced Pages because they present recommendations and opinions that many caregivers rely upon (or may even be legally obliged to follow).

Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include the U.S. National Academies (including the National Academy of Medicine and the National Academy of Sciences), the British National Health Service, the U.S. National Institutes of Health and Centers for Disease Control and Prevention, and the World Health Organization. The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, to public guides and service announcements, which have the advantage of being freely readable but are generally less authoritative than the underlying medical literature.

Guidelines by major medical and scientific organizations sometimes clash with one another (for example, the World Health Organization and American Heart Association on salt intake), which should be resolved in accordance with WP:WEIGHT. Guidelines do not always correspond to best evidence, but instead of omitting them, reference the scientific literature and explain how it may differ from the guidelines. Remember to avoid WP:original research by only using the best possible sources, and avoid weasel words and phrases by tying together separate statements with "however", "this is not supported by", etc. The image below attempts to clarify some internal ranking of statements from different organizations in the weight they are given on Misplaced Pages.

Guidelines are important on Misplaced Pages because they present recommended practices and positions of major authorities.
* Health technology assessments or HTAs are the gold standard when it comes to assessing evidence quality. They take into account various aspects such as effect, risks, economic costs, and ethical concerns of a treatment. They seldom make recommendations, but instead explain most effective treatments and potential hazards and discuss gaps in knowledge. Their name is somewhat of a misnomer as they do not need to concern "technology" as perceived by the public – but rather any intervention intended to improve health.

Popular press

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The popular press is generally not a reliable source for scientific and medical information in articles. Most medical news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits, and news articles too often convey wrong or misleading information about health care. Articles in newspapers and popular magazines tend to overemphasize the certainty of any result, for instance, presenting a new and experimental treatment as "the cure" for a disease or an every-day substance as "the cause" of a disease. Newspapers and magazines may also publish articles about scientific results before those results have been published in a peer-reviewed journal or reproduced by other experimenters. Such articles may be based uncritically on a press release, which themselves promote research with uncertain relevance to human health and do not acknowledge important limitations, even when issued by an academic medical center. For Misplaced Pages's purposes, articles in the popular press are generally considered independent, primary sources. A news article should therefore not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source.

Conversely, the high-quality popular press can be a good source for social, biographical, current-affairs, financial, and historical information in a medical article. For example, popular science magazines such as New Scientist and Scientific American are not peer reviewed, but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, use common sense, and see how well the source fits the verifiability policy and general reliable sources guidelines. Sources for evaluating health-care media coverage include specialized academic journals such as the Journal of Health Communication. Reviews can also appear in the American Journal of Public Health, the Columbia Journalism Review, and others.

Other sources

Reliable sources must be strong enough to support the claim. A lightweight source may be acceptable for a lightweight claim, but never for an extraordinary claim.

Press releases, newsletters, advocacy and self-help publications, blogs and other websites, and other sources contain a wide range of biomedical information ranging from factual to fraudulent, with a high percentage being of low quality.

Conference abstracts present incomplete and unpublished data and undergo varying levels of review; they are often unreviewed and their initial conclusions may have changed dramatically if and when the data are finally ready for publication. Consequently, they are usually poor sources and should always be used with caution, never used to support surprising claims, and carefully identified in the text as preliminary work.

Medical information resources such as WebMD and eMedicine are usually acceptable sources for uncontroversial information; however, as much as possible Misplaced Pages articles should cite the more established literature directly. UpToDate is less preferred as it is not possible to reference specific versions of their articles, and archives do not exist.

Searching for sources

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Search engines are commonly used to find biomedical sources. Each engine has quirks, advantages, and disadvantages, and may not return the results that the editor needs unless used carefully. It typically takes experience and practice to recognize when a search has not been effective; even if an editor finds useful sources, they may have missed other sources that would have been more useful or they may generate pages and pages of less-than-useful material. A good strategy for avoiding sole reliance on search engines is to find a few recent high-quality sources and follow their citations to see what the search engine missed. It can also be helpful to perform a plain web search rather than one of scholarly articles only.

PubMed is an excellent starting point for locating peer-reviewed medical literature reviews on humans from the last five years. It offers a free search engine for accessing the MEDLINE database of biomedical research articles offered by the National Library of Medicine at the U.S. National Institutes of Health. PubMed can be searched in a variety of ways. For example, clicking on the "Review" tab will help narrow the search to review articles. The "Filters" options can further narrow the search, for example, to meta-analyses, to practice guidelines, and/or to freely readable sources. Once you have a PMID from Pubmed, you can plug that PMID into this tool to get a correctly written citation. Although PubMed is a comprehensive database, many of its indexed journals restrict online access. Another website, PubMed Central, provides free access to full texts. While it is often not the official published version, it is a peer-reviewed manuscript that is substantially the same but lacks minor copy-editing by the publisher.

When looking at an individual abstract on the PubMed website, an editor can consult "Publication Types", "MeSH Terms", etc. at the bottom of the page to see how the document has been classified in PubMed. For example, a page that is tagged as "Comment" or "Letter" is a letter to the editor (often not peer-reviewed). The classification scheme includes about 80 types of documents. For medical information, the most useful types of articles are typically labeled "Guideline", "Meta-analysis", "Practice guideline", or "Review". Even when an article is one of the most useful types and recently published, it can be helpful to check the journal on DOAJ and other databases as well as the status and publishing track of authors if they make extraordinary claims. There is no magic number, but it is useful to compare the authors to others in the same field of study.

Templates

See also

References

  1. Loscalzo J (March 2012). "Irreproducible experimental results: causes, (mis)interpretations, and consequences". Circulation. 125 (10): 1211–4. doi:10.1161/CIRCULATIONAHA.112.098244. PMC 3319669. PMID 22412087.
  2. Naik G (2 December 2011). "Scientists' Elusive Goal: Reproducing Study Results". Wall Street Journal.
  3. Nature's Challenges in Reproducibility initiative
  4. Prinz F, Schlange T, Asadullah K (August 2011). "Believe it or not: how much can we rely on published data on potential drug targets?". Nature Reviews. Drug Discovery. 10 (9): 712. doi:10.1038/nrd3439-c1. PMID 21892149. S2CID 16180896.
  5. Begley CG, Ellis LM (March 2012). "Drug development: Raise standards for preclinical cancer research". Nature. 483 (7391): 531–3. Bibcode:2012Natur.483..531B. doi:10.1038/483531a. PMID 22460880. S2CID 4326966.
  6. Wright JG (May 2007). "A practical guide to assigning levels of evidence". The Journal of Bone and Joint Surgery. American Volume. 89 (5): 1128–30. doi:10.2106/JBJS.F.01380. PMID 17473152.
  7. "Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions | Continuing Education Course | dentalcare.com Course Pages | DentalCare.com". www.dentalcare.com. Archived from the original on 4 March 2016. Retrieved 3 September 2015.
  8. "The Journey of Research - Levels of Evidence | CAPhO". www.capho.org. Archived from the original on 21 February 2016. Retrieved 3 September 2015.
  9. Straus SE, Richardson WS, Glasziou P, Haynes RB (2005). Evidence-based Medicine: How to Practice and Teach EBM (3rd ed.). Edinburgh: Churchill Livingstone. pp. 102–05. ISBN 978-0443074448.
  10. Straus SE, Richardson WS, Glasziou P, Haynes RB (2005). Evidence-based Medicine: How to Practice and Teach EBM (3rd ed.). Edinburgh: Churchill Livingstone. p. 99. ISBN 978-0443074448.
  11. ^ Greenhalgh T (September 1997). "Papers that summarise other papers (systematic reviews and meta-analyses)". BMJ. 315 (7109): 672–5. doi:10.1136/bmj.315.7109.672. PMC 2127461. PMID 9310574.
  12. Young JM, Solomon MJ (February 2009). "How to critically appraise an article". Nature Clinical Practice. Gastroenterology & Hepatology. 6 (2): 82–91. CiteSeerX 10.1.1.1041.1168. doi:10.1038/ncpgasthep1331. PMID 19153565. S2CID 6532496. Archived from the original on 14 May 2021. Retrieved 14 May 2021.
  13. ^ Fees F (2016), Recommendations for the conduct, reporting, editing, and publication of scholarly work in medical journals (PDF), archived (PDF) from the original on 5 March 2014, retrieved 12 January 2019 Conflicts-of-interest section Archived 2018-12-30 at the Wayback Machine, .
  14. ^ Rochon PA, Gurwitz JH, Cheung CM, Hayes JA, Chalmers TC (July 1994). "Evaluating the quality of articles published in journal supplements compared with the quality of those published in the parent journal". JAMA. 272 (2): 108–13. doi:10.1001/jama.1994.03520020034009. PMID 8015117.
  15. Nestle M (October 2001). "Food company sponsorship of nutrition research and professional activities: a conflict of interest?" (PDF). Public Health Nutrition. 4 (5): 1015–22. doi:10.1079/PHN2001253. PMID 11784415. S2CID 17781732.
  16. Li G, Abbade LP, Nwosu I, Jin Y, Leenus A, Maaz M, Wang M, Bhatt M, Zielinski L, Sanger N, Bantoto B, Luo C, Shams I, Shahid H, Chang Y, Sun G, Mbuagbaw L, Samaan Z, Levine MA, Adachi JD, Thabane L (December 2017). "A scoping review of comparisons between abstracts and full reports in primary biomedical research". BMC Medical Research Methodology. 17 (1): 181. doi:10.1186/s12874-017-0459-5. PMC 5747940. PMID 29287585.
  17. Robinson KA, Goodman SN (January 2011). "A systematic examination of the citation of prior research in reports of randomized, controlled trials". Annals of Internal Medicine. 154 (1): 50–5. doi:10.7326/0003-4819-154-1-201101040-00007. PMID 21200038. S2CID 207536137.
  18. "Abridged Index Medicus (AIM or "Core Clinical") Journal Titles". NLM. Retrieved 17 November 2012.
  19. Hill DR, Stickell H, Crow SJ (2003). "Brandon/Hill selected list of print books for the small medical library" (PDF). Mt. Sinai School of Medicine. Archived from the original (PDF) on 7 August 2011. Retrieved 16 September 2008.
  20. Jakaria Rahman A, Engels TC (25 February 2015). Predatory open access journals in a performance-based funding model: Common journals in Beall's list and in version V of the VABB-SHW (PDF) (Report). University of Antwerp, Gezaghebbende Panel.
  21. Beall J (31 December 2016). "Potential, possible, or probable predatory scholarly open-access publishers". Archived from the original on 11 January 2017.
  22. To determine if a journal is MEDLINE indexed, go to this website, and search for the name of the journal. On the journal page, under the heading "Current Indexing Status", you can see whether or not the journal is currently indexed. Note that journals that have changed names or ceased publication will not be "currently" indexed on MEDLINE, but their indexing status, when they were being published, can be viewed under other headings on that same page.
  23. Grudniewicz, Agnes; Moher, David; Cobey, Kelly D.; Bryson, Gregory L.; Cukier, Samantha; Allen, Kristiann; Ardern, Clare; Balcom, Lesley; Barros, Tiago; Berger, Monica; Ciro, Jairo Buitrago; Cugusi, Lucia; Donaldson, Michael R.; Egger, Matthias; Graham, Ian D.; Hodgkinson, Matt; Khan, Karim M.; Mabizela, Mahlubi; Manca, Andrea; Milzow, Katrin; Mouton, Johann; Muchenje, Marvelous; Olijhoek, Tom; Ommaya, Alexander; Patwardhan, Bhushan; Poff, Deborah; Proulx, Laurie; Rodger, Marc; Severin, Anna; Strinzel, Michaela; Sylos-Labini, Mauro; Tamblyn, Robyn; van Niekerk, Marthie; Wicherts, Jelte M.; Lalu, Manoj M. (2019). "Predatory journals: no definition, no defence". Nature. 576 (7786): 210–212. Bibcode:2019Natur.576..210G. doi:10.1038/d41586-019-03759-y. PMID 31827288. S2CID 209168864.
  24. Nestle M (2 January 2007). "Food company sponsorship of nutrition research and professional activities: a conflict of interest?" (PDF). Public Health Nutrition. 4 (5): 1015–1022. doi:10.1079/PHN2001253. PMID 11784415. S2CID 17781732. Archived (PDF) from the original on 17 November 2018. Retrieved 12 January 2019.
  25. See this discussion of how to identify shill academic articles cited in Misplaced Pages.
  26. Shedlock J, Walton LJ (January 2006). "Developing a virtual community for health sciences library book selection: Doody's Core Titles". Journal of the Medical Library Association. 94 (1): 61–6. PMC 1324773. PMID 16404471.
  27. Cooper BE, Lee WE, Goldacre BM, Sanders TA (August 2012). "The quality of the evidence for dietary advice given in UK national newspapers". Public Understanding of Science. 21 (6): 664–73. doi:10.1177/0963662511401782. PMID 23832153. S2CID 36916068.
    Goldacre, Ben (17 June 2011). "How far should we trust health reporting?". The Guardian.
  28. Schwitzer G (May 2008). "How do US journalists cover treatments, tests, products, and procedures? An evaluation of 500 stories". PLOS Medicine. 5 (5): e95. doi:10.1371/journal.pmed.0050095. PMC 2689661. PMID 18507496.
    Goldacre, Ben (20 June 2008). "Why reading should not be believing". Guardian.
  29. Dentzer S (January 2009). "Communicating medical news—pitfalls of health care journalism". The New England Journal of Medicine. 360 (1): 1–3. doi:10.1056/NEJMp0805753. PMID 19118299.
  30. Woloshin S, Schwartz LM, Casella SL, Kennedy AT, Larson RJ (May 2009). "Press releases by academic medical centers: not so academic?". Annals of Internal Medicine. 150 (9): 613–8. doi:10.7326/0003-4819-150-9-200905050-00007. PMID 19414840. S2CID 25254318.
  31. Rosmarakis ES, Soteriades ES, Vergidis PI, Kasiakou SK, Falagas ME (May 2005). "From conference abstract to full paper: differences between data presented in conferences and journals". FASEB Journal. 19 (7): 673–80. doi:10.1096/fj.04-3140lfe. PMID 15857882. S2CID 29281534.
  32. Greenhalgh T (July 1997). "How to read a paper. The Medline database". BMJ. 315 (7101): 180–3. doi:10.1136/bmj.315.7101.180. PMC 2127107. PMID 9251552.
  33. "PubMed User Guide". PubMed. Retrieved 14 May 2021.
  34. "PubMed tutorial: filters". NLM. Retrieved 17 November 2012.
  35. Goodman D, Dowson S, Yaremchuk J (2007). "Open access and accuracy: author-archived manuscripts vs. published articles" (PDF). Learned Publishing. 20 (3): 203–15. doi:10.1087/095315107X204012. S2CID 44572906. Retrieved 24 October 2008.
  36. "PubMed: Publication Types". NLM. Retrieved 16 April 2024.

Further reading

Misplaced Pages biomedical editing
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