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Definitions and descriptions

This section is written from an entirely "in universe" perspective. Misplaced Pages articles are expected to include all notable views, but without giving undue weight to fringe views. Since this is a medical article, due weight should be given to mainstream medical opinions. Reading this section, there's no evidence that any such thing exists. Guettarda (talk) 23:07, 16 December 2007 (UTC)

Total nonsense. Editors, I suggest that these comments be totally ignore. Simply is not true. Mainstream medical opinions are ubiquitous and over powering. Nor, is the present balanced view of the article fringe. Furthermore, any and all viewpoints belong in the alternative medicine and complementary medicine articles because of the rules of hypertext document design. Trying to re-create that horribly written alternative medicine article, will not improve this article. -- John Gohde (talk) 11:59, 17 December 2007 (UTC)

"Total nonsense." "totally ignore"....? More ownership issues and lack of collaborative spirit. John, it's time to leave Misplaced Pages or adapt to the environment. You are headed for another block. Your opinion is no more important or valid than any other editor's. -- Fyslee / talk 06:42, 18 December 2007 (UTC)

I was just following the example provided by Ronz.

"Incivility and personal attacks by Fyslee: Fyslee has engaged in incivility and personal attacks ." -- John Gohde (talk) 03:22, 20 December 2007 (UTC)

And what does this have to do with your rudeness and outright rejection of fundamental Misplaced Pages policies? When you decide to move beyond shouting and insults, people might care what you have to say about other people's behaviour. Guettarda (talk) 05:57, 20 December 2007 (UTC)

Simply not true? Have you ever read the WP:NPOV policy? Have you ever read WP:UNDUE? That's what policy says we need to do. As you say: ainstream medical opinions are ubiquitous and over powering; that's why we are rquired to write this article (and all other alternative medicine articles, of course) from a mainstream medicine perspective. We need to give the mainstream views due weight and avoid giving non-mainstream views undue weight. We don't write articles from a sympathetic POV, we write from NPOV. That's a non-negotiable rule of Misplaced Pages. Guettarda (talk) 15:27, 17 December 2007 (UTC)

Simply not true! The mainstream medicine perspective was represented in the article. Nobody represents medicine like academia does. The majority of medicial schools teach CAM. Mainstream Medicine is in favor of CAM. -- John Gohde (talk) 02:46, 20 December 2007 (UTC)

Ooh - bold text and exclamation marks. Yelling is such an effective argument. I don't think I can beat arguments like that. Of course, it still doesn't change a thing - the article violates our core policies, and no amount of shouting (or waving crystals around) changes the fact that CAM is fringe, not mainstream. Guettarda (talk) 05:57, 20 December 2007 (UTC)

Yelling is posting with all uppercase letters. Academia is the cutting edge of medicine, and the research cited in the article clearly documents that CAM has gone mainstream and has been accepted by academia for a quite a long time. As I recall, I was the first editor to edit boldly and document this fact in the alternative medicine article, a long time ago. -- John Gohde (talk) 20:39, 20 December 2007 (UTC)

If CAM is mainstream medicine, then you should have nothing to fear if the article is written from a mainstream perspective. And yes, you are yelling. Guettarda (talk) 05:46, 21 December 2007 (UTC)

The article is presently written from a mainstream perspective. -- John Gohde (talk) 18:14, 21 December 2007 (UTC)

"Complementary and alternative medicine (CAM) is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed."

Starting a section with a paragraph-length quote is inappropriate, especially when it's the first "meat" in the article. The mainstream view is also missing - it should be apparent from the beginning that this is a fringe field.

The National Center for Complementary and Alternative Medicine (NCCAM) defines complementary and alternative medicine as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine". It also defines integrative medicine as " mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness".

Following one in-universe definition with another? Not cool.

The expressions "complementary medicine" (CAM) and "alternative medicine" are not used to describe different methods, only to describe the different settings in which the same methods are often used.

This repeats what the lead says, but this time it's said in a coherent fashion, which is good.

CAM has been described as comprising "a diverse group of treatments, ranging from symptomatic interventions to be used in conjunction with traditional therapies—therapeutic touch or meditation—to unique treatments meant to replace conventional chemotherapy or surgery. CAM includes complex and longstanding fields of study, such as acupuncture, ayurvedic medicine, and homoeopathy, but can also be as straightforward as taking a specific dietary supplement to lower blood pressure or blood lipid concentrations."

While this is true (in universe), it's also true that CAM has been described as follows:

There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking.

and

What most sets alternative medicine apart, in our view, is that it has not been scientifically tested and its advocates largely deny the need for such testing.

Mainstream definitions need to prevail, per Misplaced Pages policy.

Ralph Snyderman and Andrew Weil state "integrative medicine is not synonymous with complementary and alternative medicine (CAM). It has a far larger meaning and mission in that it calls for restoration of the focus of medicine on health and healing and emphasizes the centrality of the patient-physician relationship".

Why does this factoid need to be repeated for a third time?

In a frequently-cited review, David M. Eisenberg used the term "unconventional medicine" to signify "medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals."

While this is a slightly less "in universe" definition, it's lacking in specificity, it completely leaves out the "unproven" and "don't think it needs to be proven" angles. Guettarda (talk) 23:07, 16 December 2007 (UTC)

Eisenberg's definition

Eisenberg's definition is a working definition for the purpose of his survey. It's pretty clear that he isn't trying to define the field, but rather, to demarcate it for the purpose of his study. Thus, it really isn't an appropriate definition for the article to use. Guettarda (talk) 21:53, 17 December 2007 (UTC)

It is just one definition, the definition of a pro-alternative medicine person. Other definitions exist that are objectively defined and stable and are not based on his definition that is based on unstable and constantly changing factors. The following is from a previous section in the alternative medicine article:

Alternative definitions

The terms "alternative medicine", "complementary medicine" and "CAM" are generally understood in terms of their relationship to mainstream medicine, as described above.

Other definitions exist that are based on or include other criteria.

David M. Eisenberg relies on a "usage-based" definition, based on its inclusion in medical school curricula, and defines it as

"medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals."

Marcia Angell, former editor-in-chief of the New England Journal of Medicine, takes exception to his definition and relies on an "evidence-based (EBM)" definition, based on its relation to scientifically proven evidence of effectivity (or lack thereof):

"That is not a very satisfactory definition, especially since many alternative remedies have recently found their way into the medical mainstream....There cannot be two kinds of medicine - conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted."

Others like George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA), and Phil B. Fontanarosa, Senior Editor of JAMA, share Angell's use of an EBM definition:

"There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is 'Eastern' or 'Western,' is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues-namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy."

Richard Dawkins, Professor of the Public Understanding of Science at Oxford, also uses an EBM definition:

"Alternative medicine is defined as that set of practices which cannot be tested, refuse to be tested, or consistently fail tests. If a healing technique is demonstrated to have curative properties in properly controlled double-blind trials, it ceases to be alternative. It simply...becomes medicine." He also states that "There is no alternative medicine. There is only medicine that works and medicine that doesn't work."

The last three professionals use a definition that is based on the objectively verifiable criteria of the scientific method, not one based on the changing curriculums of various medical schools. According to them it is possible for a method to change categories (main stream vs. alternative) in either direction, based on increased knowledge of its effectiveness or lack thereof.

Well-known proponents of evidence-based medicine who study CAM, such as the Cochrane Collaboration and Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, have retained CAM's generally-accepted definition and do not define CAM as Dawkins does. In their view, there can be "good CAM" or "bad CAM" based on evidentiary support.

-- Fyslee 06:32, 18 December 2007 (UTC)

Cassileth reference

I removed the Cassilith ref which was being used to support the following statement:

Contemporary usage of alternative medicine appears to be growing, with more people using complementary and alternative medicine here and in developed countries.

Cassilith's book review does not support the statement that use of CAM is growing. And, since it's five years old, it really isn't "contemporary". Guettarda (talk) 05:43, 21 December 2007 (UTC)

In Misplaced Pages, five years old is contemporary. -- John Gohde (talk) 18:20, 21 December 2007 (UTC)

There are plenty of references from the 1990's in this article. I don't think your "five years old," reasoning is justified. The quote from the article is

"However one regards complementary and alternative medicine, there is little question that it represents a major sociocultural phenomenon. Large numbers of the general public, including many patients, use the products and services of complementary and alternative medicine. In 2000, Americans spent $10 billion on herbs, vitamins, and other dietary supplements. The estimated growth in the number of chiropractors, acupuncturists, naturopaths, optometrists, podiatrists, and other nonphysician clinicians between 1995 and 2005 is double that of physicians. This situation is replicated in most developed countries."

Is it too tangential? Anthon01 (talk) 08:35, 21 December 2007 (UTC)

It's a book review - and it doesn't seem to be a "fact" from the book - it's part of the introductory "set up" by the reviewer. Not exactly a very good source. Guettarda (talk) 06:43, 24 December 2007 (UTC)

Really?

In 2002, the growth estimate during the years 1995 to 2005 in the USA and other developed countries for the number of chiropractors, acupuncturists, naturopaths, and other nonphysician clinicians was double that of physicians.

To begin with, this really isn't English. But what's far more problematic is that assertion that this estimate was made in 2002. Cassilith doesn't cite a source for this estimate, so there's no way of telling when this estimate was made. In addition, of course, if we want to report 1995-2005 growth rates, we should be reporting growth rates, not estimates. Guettarda (talk) 06:51, 24 December 2007 (UTC)

Relationship or Migration

Let decide what it's going to be? "Relationship between alternative and conventional medicine" or "Migration from alternative to medicine." Either that or we can keep bouncing back and forth. Maybe give equal time to both. ;) Anthon01 (talk) 04:09, 22 December 2007 (UTC)

Migration from alternative to medicine -- John Gohde (talk) 04:20, 22 December 2007 (UTC)

We're writing in English. "Migration from alternative to medicine" is gibberish. Guettarda (talk) 06:52, 24 December 2007 (UTC)

a more detailed review of a footnoted reference

Here's a link that may be useful:

http://findarticles.com/p/articles/mi_qa3859/is_200401/ai_n9362735

It's a longer book review of the book that is summarized in one paragraph in this reference used in the article:

Cassileth, Barrie R. (2002). "The Role of Complementary & Alternative Medicine: Accommodating Pluralism.". NEJM 347: 860-861.

I'm posting it here in case anyone wants to check it out. --Jack-A-Roe (talk) 08:38, 22 December 2007 (UTC)

Clarification please

N.B.: (These questions are just for John. Give him a good chance to answer the questions before entering this discussion. Please respect this.)

Hi John. I'd like to "pick your brain," so to speak, and get a better understanding of what you mean in this edit summary:

• "This is the CAM article. Not the alternative medicine article. The topics are completely different. See NCCAM and actually study the website." (My emphasis.)

To start this off, let me state where I'm "coming from" on this particular matter. Since all CAM methods are alternative medicine methods and techniques (and nothing else), how can CAM and alternative medicine be "completely different" topics? Of course it's a given to those who really know this subject (as we both do extremely well), that CAM includes only a few alternative medicine methods, not all of them, but still nothing other than them.

Complementary and Alternative Medicine (CAM) is an umbrella term for the two manners in which alternative medicine methods are most commonly used:

1. Alternative medicine methods used "Complementary" to mainstream methods:

(a) in combination with them;

(b) in cooperation with them;

(c) by agreement with an (normally) MD, or the MD themselves using them;

(d) often legally because an MD is allowed to practice experimental medicine, although the MD can still be prosecuted for fraud, malpractice, and practicing substandard medicine.

(e) This is the "Collaboration model."

2. Alternative medicine methods used as "Alternatives" to mainstream methods:

(a) instead of them;

(b) often in opposition to them;

(c) often opposed by MDs;

(d) often illegally because of violations of "unlicensed practice of medicine" laws, consumer protection laws, and marketing laws.

(e) This is the "Competition model."

Now what do you think of all this? I have noticed that you have repeatedly claimed that there was a difference and I have been quite puzzled about why you do this.

Please answer these two questions:

A. How can they be "completely different" topics?

(We are talking about precisely the same methods, and the only difference is the setting (a through e).)

B. What is your strategy?

(There must be a reason for your repeated insistence on trying to separate the inseparable, which you claim are "completely different" topics.)

-- Fyslee / talk 06:48, 12 December 2007 (UTC)

I, of course, have already specified above in great detail everything that you are asking for. Yet, I see yet again an absolute total failue to point out one thing that is specifically wrong with this article. -- John Gohde (talk) 12:46, 12 December 2007 (UTC)

I wouldn't ask two questions if I saw such answers, or was satisfied with them. I have seen alot of repetition of the claim that they are different, but seen no evidence for the claim, and repetition doesn't make the claim true. Please answer both of the questions. You are welcome to copy and paste from above the things you believe apply as previous answers or information. Maybe I missed something. -- Fyslee / talk 15:11, 12 December 2007 (UTC)

I am still awaiting answers. -- Fyslee / talk 05:38, 14 December 2007 (UTC)

I entered this discussion long before this entire section of personal attacks was written. My arguments are given above. It is a simple matter of reading the written word above. It is currently section #13.1 which is located between the solid, thick, horizontal bars. -- John Gohde (talk) 14:27, 13 December 2007 (UTC)

I am not addressing anything else in this article. I am addressing a statement you have made and I want answers to two questions. It's as simple as that. BTW, there is nothing that can even remotely be construed as a personal attack in this section. Please answer the questions. -- Fyslee / talk 23:59, 15 December 2007 (UTC)

Still waiting

I am still waiting for clarification. It's only two simple questions. -- Fyslee / talk 15:43, 22 December 2007 (UTC)

"Fyslee is cautioned: Fyslee is cautioned to use reliable sources and to edit from a NPOV. He is reminded that editors with a known partisan point of view should be careful to seek consensus on the talk page of articles to avoid the appearance of a COI if other editors question their edits." See more ...

Also, see my argument in section 13.1. -- John Gohde (talk) 19:21, 22 December 2007 (UTC)

I stand by my above reply. See sections 13.1-1.1 & 13.1-1.2 as well as the recap in sections 13.1.1, 13.1.1-1 & 13.1.1-2 for the answer which I have explicitly explain above. I have absolutely no intentions of repeating myself on this topic which I have already throughly explained above. -- John Gohde (talk) 23:02, 22 December 2007 (UTC)

I don't see anything that reads like a personal attack by Fyslee in this section. Regarding the arbitration ruling, that's a distraction and doesn't apply to this conversation. I'm interested in your replies to the content of his questions. --Jack-A-Roe (talk) 21:26, 22 December 2007 (UTC)

??? I did not complain about a personal attack. The ruling applies here because in my humble opinion, Fyslee has a history of trying to force his/her point of view upon articles. That is exactly what Fyslee is trying to do here. Fyslee has "a known partisan point of view." -- John Gohde (talk) 21:42, 22 December 2007 (UTC)

I am positively questioning all edits made by Fyslee because of his/her "known partisan point of view." -- John Gohde (talk) 21:55, 22 December 2007 (UTC)

The reason I mentioned "personal attack" was in response to your note in this section at timestamp 14:27, 13 December 2007 (UTC) when you wrote: "I entered this discussion long before this entire section of personal attacks was written." I don't see the personal attacks you were referring to.

Regarding Fyslee's "known partisan point of view" I'm aware of the situation. But everyone has a POV one way or another, the question for Misplaced Pages is that person's behavior, not their beliefs; and I don't see any problems with that here. For him or her to ask you about your ideas on the topic seems well within policy. Mentioning the arbitration ruling is not appropriate in this context. A "cautioned" sanction is not an scarlet letter someone must wear for all to see and be reminded of every time there is a small disagreement.

It's clear from your user page that you also have a "known partisan point of view", so I'm sure you understand how it's possible for editors to have a personal POV and still edit articles in a balanced manner. You and Fyslee may be on opposite sides of this debate, but that does not mean it has to feel like a fight. The best thing to do is to focus on the content and not discuss the editors at all, unless there is a breach of policy that needs specific attention. --Jack-A-Roe (talk) 22:12, 22 December 2007 (UTC)

It is even clearer to me that I cannot respond to your comments in any meaningful way without being accused of making a personal attack. Yet you started out your comments with "I don't see anything that reads like a personal attack." I would suggest that if all the editors with your "known partisan point of view" would STOP accusing me of making personal attacks and would STOP trying to force their "known partisan point of view" upon the article; this very article would have had a GA rating by now. -- John Gohde (talk) 22:29, 22 December 2007 (UTC)

I did not accuse you of personal attacks. Not at all, I don't know where you got that idea. I mentioned I did not see any personal attacks by Fyslee in this section of the conversation. Regarding my POV, I have no idea of what you're talking about on that either. I've only edited the article a few times. I'm not involved in this topic and have no agenda - other than fairly representing a balanced cross-section of the sources and relating them accurately. The only reason I entered a comment here at all is that I'm interested in your response to the contents of the questions posed by Fyslee, and it seemed to be the topic was diverted away from the content, for no reasons.

So, please, stop discussing editors, and focus on improving the content of the article. Since there are mutiple POV's there needs to be some discussion so we can fairly balance the presentation. Productive discussion requires mutual respect between all parties. --Jack-A-Roe (talk) 22:42, 22 December 2007 (UTC)

References

1. O’Connor BB, Calabrese C, Cardeña E, Eisenberg D, Fincher J, Hufford DJ, Jonas WB, Kaptchuk T, Martin SC, Scott AW, Zhang X (Panel on Definition and Description, CAM Research Methodology Conference, April 1995). (1997). "Defining and describing complementary and alternative medicine". Alternative Therapies. 3 (2): 49–57.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
2. "What is Complementary and Alternative Medicine (CAM)?". Retrieved 2006-07-11. NCCAM
3. Kamerow D. (2007). "Wham, bam, thank you CAM". Brit Med J. 335: 647.
4. ^ Alternative medicine meets science. Fontanarosa P.B., and Lundberg G.D. JAMA. 1998; 280: 1618-1619.
5. ^ Alternative medicine--the risks of untested and unregulated remedies. Angell M, Kassirer JP. N Engl J Med 1998;339:839.
6. Snyderman, R.; Weil, A. T. (2002-02-25). "Integrative Medicine: Bringing Medicine Back To Its Roots". Archives of Internal Medicine. Retrieved 2006-07-11. {{cite journal}}: Cite journal requires |journal= (help)CS1 maint: multiple names: authors list (link) PMID 11863470
7. David M. Eisenberg
8. ^ Unconventional Medicine in the United States -- Prevalence, Costs, and Patterns of Use. Eisenberg D, et al. N Engl J Med 1993; 328:246-252.
9. alternative medicine Function: noun: "any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain." ; retrieved from Merriam-Webster Online on 5 August 2006.
10. Simonyi Professorship web site
11. A callous world. Richard Holloway. Book review Richard Dawkins A Devil's Chaplain. The Guardian, February 15, 2003.
12. Dawkins, Richard (2003). A Devil's Chaplain. Weidenfeld & Nicolson. {{cite book}}: More than one of |author= and |last= specified (help)
13. The Cochrane Collaboration Complementary Medicine Field, www.compmed.umm.edu/Cochrane/index.html. Retrieved 5 August 2006.
14. The HealthWatch Award 2005: Prof. Edzard Ernst Complementary medicine: the good the bad and the ugly. www.healthwatch-uk.org/awardwinners/edzardernst.html, retrieved 5 August 2006
15. "Complementary medicine is diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine." Ernst et al British General Practitioner 1995; 45:506
16. ^ Cassileth, Barrie R. (2002). "The Role of Complementary & Alternative Medicine: Accommodating Pluralism". NEJM. 347: 860–861. Cite error: The named reference "Cassileth" was defined multiple times with different content (see the help page).

What the heck is going on?

I for one cannot tell what the heck has been updated on this talk page without spending all day on it. Can the editors please put the new comments on the very bottom of this page? -- John Gohde (talk) 18:49, 22 December 2007 (UTC)

Someone requested new comments be added above the references section. I've never seen that done on a talk page before, it does seem a bit confusing. Then again, complicated talk pages are always confusing because they have multiple discussions going on at the same time in several places. You could check the talk page history and look at a comparison since the last time you edited - that will show you all the changes added after that. --Jack-A-Roe (talk) 22:24, 22 December 2007 (UTC)

The post a comment feature of Misplaced Pages puts new comments on the very bottom of the page. I see no reason why this talk page should be any different. -- John Gohde (talk) 01:08, 25 December 2007 (UTC)

No problem, just as long as the refs code isn't deleted, since we do use it on this page. This page is used for discussing edits and their references (the legitimate purpose of an article talk page!), and in the process of developing finished products it's important to be sure the codes are working properly. We can just move the section to the bottom once in awhile. -- Fyslee / talk 02:47, 25 December 2007 (UTC)

The post a comment feature is only practical when starting a new section. Otherwise the edit button to the right of each section heading is the button to use. -- Fyslee / talk 02:51, 25 December 2007 (UTC)

Guilty by association

This page will turn into an extension of Quackwatch if left to the devices of editors who are anti-alt med. Although I agree with much of the criticism of alt med therapies, I do believe that there are some therapies that have some merit. The fact that every non-conventional therapy could fit under alt med could make some of the better aspects of alt med get lump together with the worse. Remember many conventional therapies and some of the biggest money makers have turned out to be not so hot after completion of RCTs. And most conventional modalities have never been subject to RCTs, the standard by which CAM therapies are being held up to. My point is that a reader trying to find out information about CAM will not be served well if all they get is a rehash of Quackwatch and 'pseudoskeptics.com.' It might make sense to distinguish between the 'fringe of the fringe' and more 'conventional alternatives.' Anthon01 (talk) 21:14, 26 December 2007 (UTC)

• Former good article nominees
• NA-Class Alternative medicine pages
• NA-Class Skepticism pages
• NA-importance Skepticism pages
• WikiProject Skepticism articles