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Clarification

I have added "counter" to the list of things primary sources should not be used for in this edit . Thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:37, 18 June 2014 (UTC)

agree Formerly 98 (talk) 22:24, 18 June 2014 (UTC)

News reports of lab grown organs or other medical firsts

Articles like Vaginal transplantation, Trachea, Hand transplantation and Face transplant contain references from all kind of newspapers and sites like BBC, CNN, USA Today, The Guardian, Xinhua, The Daily Telegraph, Fox News, ABC News, Yahoo! and so on. Those newspaper articles report important milestones for the history of such achievements. Examples: , .

My question is: What kind of sources are those? Primary or secondary or tertiary sources? What makes such news notable and reliable sources?

Thanks. —  Ark25  (talk) 11:18, 21 June 2014 (UTC)

Those are terrible sources for those claims. Those newspaper articles are indeed secondary sources, but they are not reliable secondary sources for health-related content. Quite often those articles in the press are based on press releases and light reporting following up on them, and don't carefully consider things - claims about "first" this or that in the media are often wrong. I remove them from articles I watch. Jytdog (talk) 11:30, 21 June 2014 (UTC)

For example, a clinical trial of artificial bladders "grown" from autologous cells was published in 2006 - the longest-tracked patient had been followed for 60 months so that transplant happened at least in 2001. Your third source above - the BBC article from 2011 - says in boldface that "Surgeons in Sweden have carried out the world's first synthetic organ transplant." Just dead wrong. Jytdog (talk) 11:39, 21 June 2014 (UTC)

Well, the 2001 transplant was experimental (the patient probably signed some agreement to accept the risks) and maybe the one in 2011 was the first carried out for an ordinary patient? There can be many different and significant artificial bladder firsts, and they are all important milestones.

Still, there are plenty of such references used in Misplaced Pages articles and it doesn't seem that we can find better references to replace them with. Do you remove just the references, or you remove the information they reference too? Or you remove such references and replace them with better ones? Do you watch articles that contain medical firsts? (firsts like: first hearth transplant, first bionic limb and so on). That kind of news are reported in generalist newspapers and websites. I'm not sure when we can expect a peer-review scientific journals to publish such firsts. They are more likely to publish successful experiments firsts than the first operations for regular patients, I think. We are not talking about medical research here. We are talking about medical firsts, based on a lot of previous research and experiments. —  Ark25  (talk) 11:51, 21 June 2014 (UTC)

I give you an example that is dead on and you argue with me? The 2006 study was better than the Swedish study - it was on 5 or six patients, not just one. It is almost as though you haven't read MEDRS - see especially the section called "Respect secondary sources" which deals explicitly with media coverage of health-related science. As that section says reminds folks, we are an encyclopedia - we are not a newspaper and we never want to fall prey to WP:RECENTISM. And of course we can find better references to replace those media articles with. Reviews in the biomedical literature very often recount the history of the fields they are reviewing. They are not easy to find with google but they are easy to find if you look in the right places - MEDRS describes where to look. I'll step back and let other experienced editors weigh in - I am sure you will hear the same from them. Jytdog (talk) 12:14, 21 June 2014 (UTC)

Sorry I didn't meant to make you angry. You are right, the BBC's article from 2011 is talking about windpipe, and instead of saying first synthetic windpipe transplant, it says first synthetic organ transplant. My point is that the BBC news presents an achievement that is most likely an important milestone - even though the article uses a wrong word. Until we find a better source, I think it's best to leave the information in the article (which the wrong word replaced) along with the reference, instead of completely removing both of them. Speaking of RECENTISM - my point is not to focus on recent news, but to present important medical achievements (not studies, not experiments and not research), even if we have to use references from BBC or USA Today. Later, another editor will replace those references with better ones. I think a 3 year old news is not exactly recent, also.

My focus is not on experiments, studies or research (you said Swedish study but it's not a study). My focus is on medical firsts, operations done to regular patients. Those operations are carried out after a lot of previous research and experiments (many of them being firsts). There is a first successful artificial urinary bladder experiment on animals, then the first such experiment on humans, and then there is the first successful operation carried out on a regular patient. And probably there are other first artificial urinary bladder firsts (the first done on a child for example). All of them are important, in my view. —  Ark25  (talk) 15:00, 21 June 2014 (UTC)

It looks like the whole of this guide (WP:MEDRS) is focused on how to treat research, studies and experiments, which is not the kind of information I am asking about. —  Ark25  (talk) 15:05, 21 June 2014 (UTC)

You have not made me angry but it is weird that you come asking questions and then argue with a direct, clear answer instead of asking more questions. Ark the report on the work in Sweden was indeed the report of an experiment. We don't know how long that tissue will last in the patient or what it will do long term, or if we will be able to do that again, many times, in many different people, safely and effectively. Sure it is an achievement, but it is not medicine or even confirmed science yet (the essence of science is repeatability). It is hard for many people to understand why MEDRS exists -- what makes health related content different from and harder to deal with than other content on Misplaced Pages. I am working on a little essay about this, but I recently had a dialogue with another editor on my Talk page about this. It is very rough, but for what it is worth, it is the big block of text in this section. Perhaps that will help you. I didn't point you to this yet so I will now. See Misplaced Pages:Identifying_reliable_sources_(medicine)#Popular_press. The popular press can have a role in health related articles, as described there. But again, I would not consider it reliable for anything hype-y like "first" of anything. Where the cited section says "historical" think about topics like the discovery of how cholera is transmitted, which the NY Times had a nice piece on recently. And as I mentioned, review articles published in the biomedical journals do discuss the history of the field, noting the actual "firsts" - they are the reliable sources for things like that. Jytdog (talk) 15:22, 21 June 2014 (UTC)

It'd be worth reading WP:PRIMARYNEWS, too. Most newspaper stories, especially of the 'this new thing just happened' or 'this new paper was published', are primary sources.

"First" is probably one of the things that a newspaper is okay for. "First" is a statement of history. It is not a statement of biomedical information. "First person to jump off a skyscraper with a parachute" and "First person to do a new surgery" ultimately need the same kinds of sources. WhatamIdoing (talk) 22:08, 21 June 2014 (UTC)

I hope I don't become a pain in the neck with so many questions. I just want to understand how things work.

I agree, a first hospital operation of its kind (and the second, and the third), although is based on lots and lots of previous research, is still an experiment, because we don't know how it will end up. But it's not a laboratory experiment. It's the first step (or a first attempt) into mainstream, and it's very important milestone.

This guide focuses on studies, experiments and research and that's how it should be, since more than 99% of the information in the medical topics is about the knowledge we extract from experiments. But in my case, I am interested about the history of medical achievements in hospital, not even about the history of any medical topic. And I don't even care which one was the very first. I am interested about the first operations of the same kind, let's say the first 5 or 10 such operations. The information I'm asking about is not about scientific facts (like the correct formula is P=U*I, or like long-chain fatty acids cannot cross the blood–brain barrier) where we need to use secondary sources, but about the historic milestones - basic facts of reality, which are most of the time reported by newspapers. While newspaper articles are much more inclined to make errors (the above article says organ instead of trachea) than academic papers, they can be very useful for having an idea where those milestones are.

Hand transplantation has a long list of such achievements, using newspaper references. When we'll have secondary sources, we will better know which one was the very first, the second, and where the other milestones are and we can adjust the Misplaced Pages article accordingly. But until we can find secondary sources to confirm or to contradict the information in that list, is it ok to use newspapers to add such information? —  Ark25  (talk) 09:05, 22 June 2014 (UTC)

The windpipe thing is clinical research, which is a necessary step in developing treatments. It is definitely more developed than bench research, but is still research. And again I don't know how many times I need to say this, but the press gets firsts wrong all the time with regard to medical "firsts" being reported as they happen. Even Carl Zimmer blew it just the other week when he talked about a "first" in next-gen sequencing with respect to its use to identify an infectious agent - he stated it too broadly. The popular press may be accurate for truly historical firsts (again, like the identification of how cholera spreads, which was a "first") And again and most importantly, review articles in the biomedical literature are way way more reliable than the popular media for this - why are you not responding to this? The only reasons I can see to push for using the popular press instead of review articles, as you are advocating, are: 1) it is easier than using review articles since you can find them via google and 2) WP:RECENTISM. Neither is a good justification. Jytdog (talk) 09:42, 22 June 2014 (UTC)

Maybe I'm slow in understanding certain things but it's not my purpose to irritate anyone. For me it's not important if the 2011 synthetic windpipe transplant is the first or not. From my point of view, the important information is that in 2011 there was a synthetic windpipe transplant done in a hospital and it's one of the first such transplants. That's the information I would be interested to add into the Misplaced Pages article. If it's truly the first or not, it doesn't really matter. We'll find that out later from review articles. Until we find that (it can take decades), we better have that information instead of not having it.

I am in no way advocating for use of popular press instead of review articles. By the contrary. But for me it's easy to find such data in popular press and it's very difficult to find it in review articles. I don't have the skills and time to do find such articles. I haven't even added such information in English Misplaced Pages articles. At least not yet. I advocate that we can use (or should allow the use of) popular press until we find the same (or updated) information in review articles - in such cases of hospital firsts, and not for information about laboratory experiments. And when the information from popular press proves right, instead of replacing the BBC reference with the new one, we should just add the new reference in front of the BBC reference. I noticed that a lot of references from Mayo Clinic are dead links already (e.g. Thermoregulation - and Calciphylaxis - ). Therefore it would be nice to have another backup reference from popular press that tells the same story for every Mayo Clinic link. The same might apply to many other academic articles and to many other review articles. I don't care about recentism, I do not care if such information is about what happened one minute ago or 500 years ago. I just want to know things and to make knowledge available, whenever possible. If the Misplaced Pages rules allows to make a particular information available into an article or at least into a talk page, I will try to add it into Misplaced Pages.

If someone deletes such information (in a Misplaced Pages article) because is referenced from popular press and then someone adds the same information after 20 years, when such information is available/found in review articles, then I find the justification to delete it a worse justification than the one you pointed in 1) (easier to find with Google). In those 20 years we better have some information about the topic instead of none.

Speaking about Recentism, the Trachea article has such a reference from 6 years ago - . Is that recent? I'm not arguing here, I just ask because I really don't know. —  Ark25  (talk) 11:43, 22 June 2014 (UTC)

The Sweden synthetic windpipe transplant is an experiment too, I agree with you. But it's also a public event (takes place in a hospital), unlike laboratory experiments. And is it an important milestone (or at least an important event), even if it fails in the end. Such an event deserves it's place the history of synthetic windpipe transplants, even if it's not the first but it's the third of fifth such event, do you agree with that? —  Ark25  (talk) 14:43, 22 June 2014 (UTC)

Here are my thoughts:

• Let's have historic information, properly placed under ==History==: If a (decent) newspaper says that a historic surgery took place at the Foo Hospital in 2011, then let's have that information (in a suitable article).
• Let's upgrade your skills: It's pretty easy to search http://www.ncbi.nlm.nih.gov/pubmed/ You can go there and search for synthetic trachea. Then, in the left margin, click on "Reviews" under "Article types", and if you want, "Free full text" under "Text availability". That should get you three papers: PMID 24059453, PMID 23184357, and one from 1984(!) that you'll want to ignore.

The combination of these two approaches will often get us decent historical information. (You can also look into the "lay" parameters for {{cite journal}}, which allow you to cite both an academic paper and a related news story. I'd be happy to see someone working on this subject, because the history of surgery is one of the areas that is a bit neglected on Misplaced Pages. WhatamIdoing (talk) 04:49, 23 June 2014 (UTC)

WAID so many times I find you wondrous, including this one. Jytdog (talk) 05:24, 23 June 2014 (UTC)

Thanks for the answer. My English is not perfect. I changed now the I advocate that we should use (..) popular press into I advocate that we can use (..) popular press because that's what I meant to say there. I am not sure that I can have the time to add such historic facts about surgery in the Misplaced Pages articles but maybe I will have the time to notice them on talk pages, to serve as a starting point for those who might have the time to add them later in the article, including for me when I will have more time. WAID means WhatamIdoing, for those who are wondering what that could possibly mean. —  Ark25  (talk) 08:51, 23 June 2014 (UTC)

WhatamIdoing - I did the search that you suggested me to do, and indeed I found the three results you said. And then I searched for "face transplant" and I got 74 results. Most of the results contain things like "Liver transplantation", "kidney transplant" and "renal transplant". Is it possible to get better search results? I would like to see if I could find there references for the 6 face transplants presented in Face transplant#In Turkey. —  Ark25  (talk) 13:34, 26 June 2014 (UTC)

Well, some of them are just going to give you a long list no matter what you do, but one thing to try is this: click on one that seems plausible. Underneath the text of the abstract, there should be a section called "Publication Types, MeSH terms". Click on that, and you'll see a list (sometimes incomplete, so you might have to check a couple) of "subjects" like "Face transplantation". (This is also where you figure out if a paper is a review.) Clicking on your favorite of those subjects will search for only articles with that subject tag (e.g., http://www.ncbi.nlm.nih.gov/pubmed?term=%22Facial+Transplantation%22%5BMeSH+Terms%5D for facial transplantation), which will help eliminate irrelevant papers. In the search box for that search, you can also add things, like the word "Turkey", and you can use the filters on the left sidebar to choose dates and reviews, etc. Using this system, I found that PMID 22894997 mentions face transplants in Turkey (but I don't have a copy of the full paper). WhatamIdoing (talk) 16:30, 26 June 2014 (UTC)

User essay - Why MEDRS?

So I created an essay in my user space about why we need MEDRS, stated in plain language as much as I could. It is waay too long, but it is here: Why MEDRS? Feel free to mess with it. Or ignore it. Jytdog (talk) 20:26, 21 June 2014 (UTC)

Hi Jytdog: Thank you for this essay. There is some good stuff in it. I agree that it is way too long. Could you edit it down please? I suggest in particular that you include less on examples of "biology is difficult" and add a succinct paragraph or two on the implications of this observation to MEDRS. CBHA (talk) 20:07, 25 June 2014 (UTC)

• Support I think this essay is an excellent idea, and something we've needed for a while to direct new editors to. The only objection I have is that it focuses largely on biology and not medicine, and that isn't really something that MEDRS covers. Non-medical biology falls under the essay WP:SCIRS, but that is also a different discussion entirely. -- CFCF (talk · contribs · email) 21:39, 29 June 2014 (UTC)

Thanks for the kind words CFCF. The reason I focused it on biology, is that medicine is to biology as tech is to physics. Medicine is biological technology. It is because our knowledge of biological science is so fragmentary and slim, that medicine is so often such weak technology. (unlike physics/material science, which is very advanced science, which has in turn allowed rapid advances in technology (eg. Moore's law) and almost magical devices like smart phones to come into existence) This is the key thing that so many people cannot wrap their head around. How much doctors don't know, and how little they can actually do in many cases. (the joke about neurologists: Two doctors are up in a balloon and are lost and call down to someone on the ground, "Where are we?" and the guy hollers back "In a ballon about fifty feet off the ground!" One doctor turns to the other and says "Neurologist - told us exactly where we are and didn't help a bit.") I guess I need to make that more clear and maybe focus more on the medical uncertainty itself. On the other hand, I want to make it super clear why bringing a primary source discussing mouse or in vitro work to support health-related content in an encyclopedia is just ludicrous.... Jytdog (talk) 21:59, 29 June 2014 (UTC)

I agree that those are valid points, and I only meant to point out how it's odd we have MEDRS for medical content, but no real guideline for other (non biomedical) biology content, and that your essay makes a strong point for having an equivalent WP:SCIRS guideline (currently only an essay), or maybe even making a new WP:BIORS/alternatively merging any such guidelines with MEDRS.

P.S. Liked your joke :). -- CFCF (talk · contribs · email) 22:16, 29 June 2014 (UTC)

• Support. Agree that an essay like this could serve a real purpose within the community. It would be good to get it nicely focused so that it can address in a concise and easily comprehensible the sorts of questions that Misplaced Pages's broad community of editors commonly entertain. I too am not sure whether "biology is difficult" is the best starting point (isn't biology broadly covered by the SCIRS essay anyway?). Perhaps a key issue here is the fallacy that findings at a microscopic level (or in animals) can be directly extrapolated to human health? 86.128.169.211 (talk) 11:35, 30 June 2014 (UTC)

• Abstain. The problem with 'this' article is not whether we need it or not. The problem is not that we are directly extrapolating anything to human health. We never did. We never will. Sometimes, we let readers decide relevance. The problem iz that it does not call for any thinking. Delete primary sources. Delete studies in glass. Delete double-blind, placebo-controlled study if it found significance where a meta-analysis that included industry funded sources did not. Assume that twenty million abstracts in PubMed are the whole truth. 75.152.119.10 (talk) 10:17, 13 July 2014 (UTC)

• Support useful essay, although could be tightened up. Zad68 23:14, 13 July 2014 (UTC)

News article

There are questions on whether or not this article can be used to support "However, another article in Nature, stated that acupuncture activates the brain, and does more than placebos" here . Thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:01, 25 June 2014 (UTC)

No placebo iz for acupuncture, because you feel treatment: Interviewers can be blind, not subjects. You can do a case-cohort study in this, with matched controls that are about the same before treatment. To do a good job of it, the interview would need to be conducted in writing, because many tonal ways are to let on whether you are case (treated) or cohort (placebo). Hmm. Wait a minute. I wuz going to say that machines could do the interview in an objective manner, and the key words are 'activate brain', so perhaps machines already are doing the interview in the form of Magnetic Resonance Imaging, Positron Emission Tomography, or Electroencephalography. I would say that I am beaten after actually reading the article, except for this question: Doesn't real pain always cause endorphin release from pain moderation centers in the brain? The problem with the article is that it confuses placebo with accupressure: No placebo is for accupuncture. 75.152.119.10 (talk) 10:33, 13 July 2014 (UTC)

Hey Doc James. Nope, that souce should not be used. That is a news piece covering publication of a primary source, and MEDRS specifically speaks to why we shouldn't use those (as you know). On contentious articles we should strive to use the best sources we can find; reaching for primary sources is a red flag for POV pushing (generally, but especially on contentious articles where everybody should be reaching for sources that people with differing viewpoints will find valid). Back in the archives of the acupuncture Talk page, somebody proposed this as a source, which I thought was great. It is a meta-analysis of fMRI studies of people undergoing acupuncture published in 2012. (I was working on that article until QuackGuru drove me crazy and therefore away, btw.) Jytdog (talk) 22:54, 28 June 2014 (UTC)

I'm not convinced that Nature.com is what we meant by "popular press", although I wouldn't describe it as "another article in Nature", since that will imply a peer-reviewed article to some readers. WhatamIdoing (talk) 19:45, 29 June 2014 (UTC)

I see little doubt about whether acupuncture or accupressure work. There's also a plausible mechanism, so this issue iz not about POV-pushing. There's probably a machine to do accupressure on the head with a technician instead of a neuro-anatomist. Transcutaneous_electrical_nerve_stimulation machines use the same nerve endings, and last time I checked, they require anatomists to operate. 75.152.119.10 (talk) 10:33, 13 July 2014 (UTC)

Differences between WP:MEDRS and WP:SCIRS: is there are line drawn somewhere between the two?

I ask this because I deal with science related articles, and a lot of my background comes from toxicology, veterinary medicine, etc. In these cases we're not dealing with human health, but rather animal health. It would seem pretty clear that WP:MEDRS applies in this situation because we are dealing with medical research, but this does seem to irk some editors when it's cited because it's not human medical research. In animal research, you can move away from more medical topics and get into things like ecology and WP:SCIRS is a better fit, but it's also not a guideline like MEDRS is. Is there a distinct scope to MEDRS where it's meant only for human health? If not, is there a cutoff somewhere in the general biological sciences? I'm not seeing that after reading over the page since the spirit of the page seems to be aimed at any kind of medical research or health claims. With that in mind, should we clarify in the page text what MEDRS actually applies to? There's definitely a blurry line between medical and natural sciences in some cases, so I'm not sure how a good statement of scope could be easily done.

In all honesty though, it seems that MEDRS and SCIRS hold very similar standards for saying what is a reliable scientific source. If I'm dealing with plant health, the same aspects of what's a reliable source in animal medicine still apply (e.g. primary vs. secondary literature). However, plant health is even further removed from human health, so someone could claim MEDRS isn't applicable, and I'm not aware of any guidelines that are as informative as MEDRS in that case. For editors that get really hung up on what medicine actually pertains to, should we be adding some clarification in the guideline by having a nonrestrictive list of example fields (toxicology, veterinary medicine, etc.)? Maybe there’s a better way to address editor questions of whether MEDRS really applies an article, but I thought I’d float the question out there since I’m sure other folks have run into similar issues. Maybe there's some convention other folks have followed for this kind of gray zone that might be worth spelling out somewhere?

I know some editors are uncomfortable with the MEDRS guideline (maybe because it's a new concept to some), so there can be cases where someone might want to avoid the guideline by saying the topic technically isn't within the scope. In a case like that, I'm wondering how do we concisely point out what a reliable source is for scientific content in general without people getting hung up on the name of medicine or natural sciences? Is there something that can be done in this guideline? Maybe work on getting SCIRS to guideline status (might be tough looking at previous discussions), or maybe something at WP:RS instead? Maybe it's entirely splitting hairs and MEDRS just gets informally applied to all "hard sciences" (not going to touch where that cutoff is) in practice, but since some of the questions apply to this page, and others are interrelated with SCIRS and RS, I figured I'd start by asking here and seeing if certain questions might be more appropriately addressed here or at the other pages. Kingofaces43 (talk) 16:51, 27 June 2014 (UTC)

I don't think you're alone in having a hard time separating when these different guidelines are applicable. There is currently ongoing discussion over at WT:MED#Issues with alt med articles & Misplaced Pages talk:Surrogate endpoint, although they might not primarily focus on this distinction it has been brought up. The difference as I see it is that WP:MEDRS is applied far more vigorously due in part because of the strong commitment from the WP:MED community. I think there should be a clear distinction between MEDRS and SCIRS in the lede of both guidelines and think this would be a good time to bring up the discussion, when there is already so much discussion concerning MEDRS.

I think we need to define what a medical article is. When you think about it, it isn't so very straight forward. Anatomy and physiology are in part arguably closer to biology than medicine, even if medicine builds on them. -- CFCF (talk · contribs · email) 12:10, 29 June 2014 (UTC)

It is not a question of a "medical article" but rather health/biomedical content in any article. The lead of MEDRS was written carefully to cover a wide scope of content. And yes MEDRS evolved because there is so much bad content out there, and so many editors who come to WP wanting to push that content into articles, and so many people look to WP for health information, that the community needed a way to manage the crush and live up to its mission of providing reliable information to the public. On the scope issue, see for example this response from Colin who I understand was part of the group who originally drafted MEDRS in response to that need, and especially this comment by him too, and this comment by WhatamIdoing who I understand was also part of that team. These issues come up all the time and the archives are rich with discussion of them. Colin doesn't show up here much anymore much but WAID does, and what each of them have to say generally provides really great insight into the experience and reasoning by which the community got here. And look at this article from mercola.com for example -- do you see how they use primary sources and claims about biochemistry to make really outrageous health claims? That is what we have to contend with in the health arena. Jytdog (talk) 14:48, 29 June 2014 (UTC)

The issue however is not how sources are (ab)used outside of WP but how they are used/should be used within.--Kmhkmh (talk) 15:00, 29 June 2014 (UTC)

the point of my bringing the mercola article was twofold: first, to show the kind of thing that editors bring here and want to cite as a reliable source and that we need to keep out... and secondly, to show the way that what might appear to be basic science research (biochemistry etc) can be abused to generate health claims and thus why the lead of MEDRS is purposefully written broadly. Jytdog (talk) 15:14, 29 June 2014 (UTC)

Yes but using sources in proper or improper fashion is somewhat of separate issue. Because the problem is not the primary but its improper use. You can abuse secondary sources as well, though I agree it harder to do that. My point however is that should focus more on the appropriate use of reliable sources rather than handling it indirectly by categorically excluding primary sources.--Kmhkmh (talk) 18:27, 29 June 2014 (UTC)

It might be wortwhile to note that WP:MEDRS is guideline whereas WP:SCIRS is merely an essay.--Kmhkmh (talk) 14:56, 29 June 2014 (UTC)

Kingofaces43 there are processes for promoting essays to guidelines, and guidelines to policy. I am not familiar with them but WAID or other much more experienced editors may be. As to where the line is, we have both seen people say things like "the health of bees is not subject to MEDRS" which I really struggle with, since the difficulties are very similar. The topic of whether MEDRS should apply to veterinary medicine has been brought up and never resolved. I would favor MEDRS making reference to vet med. I will draft a proposal for everybody to consider... let's try again! Jytdog (talk) 17:23, 29 June 2014 (UTC)

The spirit of MEDRS is that we do not give false information about medicine to people who may rely on it. Of course we are not supposed to do that for any subject. But unless someone can show that a specific statement is medical information, MEDRS guidelines do not apply. Content policy, if followed, should be sufficient. Sources policy dictates that articles are primarily based on secondary sources and that the best sources are used. NPOV requires that articles provide proper weight to different aspects of subjects and opinions. So if a single study shows that a certain diet may increase your cat's life by ten years, it should not be added unless there is strong support for the finding among veterinarians. TFD (talk) 18:59, 29 June 2014 (UTC)

Colin started MEDRS; I joined in later.

I wonder if it would be possible to merge MEDRS and SCIRS? The structure is very similar. There's also WP:SCICITE, whose value I question (but perhaps I just don't appreciate it enough).

On the original question, I'd use SCIRS for ecology statements like "a spill of scarychemicol was blamed for the drop in amphibian reproductive success at Lake Wobegon" or "bumblebees communicate by wiggling their abdomens". I'd use MEDRS for anything that a typical reader might believe was related to human health. WhatamIdoing (talk) 20:11, 29 June 2014 (UTC)

and i should say that in my experience with them, Colin has generally been more hardcore in applying MEDRS, while WAID has generally been more flexible, especially with regard to use of primary sources. (not sure if you would agree, WAID, but that is my perception). But WAID, if we merged SCIRS and MEDRS, where would that leave animal health matters as per your two examples? How would we handle that? Jytdog (talk) 20:59, 29 June 2014 (UTC)

I think merging the guidelines/essay is an excellent idea. I've come across the argument that something is biology/physiology/neuroscience/research, and not really medicine or clinically related, and therefor MEDRS shouldn't apply, one to many time. As said, much is similar, but it won't be a walk in the park merging them either, but I fully support it and would do my best to help out. -- CFCF (talk · contribs · email) 21:14, 29 June 2014 (UTC)

The problem however is that depending on the context that is actually a valid argument and therefore probably a reason for not merging those 2.--Kmhkmh (talk) 21:21, 29 June 2014 (UTC)

Merging them might not be good idea, at least if it supposed to cover all areas of science and if it supposed the medical aspects only I see no reason for merging, there we can simply use MEDRS as it is.--Kmhkmh (talk) 21:18, 29 June 2014 (UTC)

WhatamIdoing, here's an interesting intersection from my neck of the woods. Take toxicology as an example. What makes a toxicological source reliable is based upon things we're familiar with in health in general (e.g. dose-response, biologically relevant doses, efficacy of a drug/pesticide, etc.) and reliability of experimental results are determined through proper experimental design, replication, inclusion in secondary sources, etc. Basically what we find reliable in toxicology for sources isn't really any different than what we have in MEDRS right now (likely because toxicology plays a large role in medical research, human or otherwise). Ultimately toxicology will always come back in some form towards assessing the health of an organism. Where exactly would this topic fall then? It's definitely used in ecology in some areas, but we're still talking about health and medicine in various forms in the end. MEDRS currently doesn't specify it's intended just for human health, but I don't see any reason why it should only apply to human health either. The qualities that make a human medical source reliable typically are going to be the same ones we use in veterinary medicine as well. Veterinary medicine can be broad too as it covers not only traditional farm livestock, but insects (bees especially), wildlife veterinarians, etc. I'd even argue that many other branches in the life sciences use those same qualities for reliable sources too, so I'd agree with folks who think SCIRS and MEDRS should be merged as there's a lot of redundancy in the two, but I'd rather get the seemingly simpler question of where veterinary medicine fits in to MEDRS before worrying about even tougher things to work out. Kingofaces43 (talk) 06:27, 3 July 2014 (UTC)

Forgive me if this seems pedantic, but what makes a source reliable in toxicology is whether it's published by an outfit with a reputation for fact-checking (e.g., anything with regular peer-review) and the other qualities listed at WP:NOTGOODSOURCE. Things like whether it used biologically relevant doses is (a) something that makes it good or not, and (b) not something that editors should be determining on their own (that job belongs to the secondary sources that we hope editors will cite). WhatamIdoing (talk) 21:00, 3 July 2014 (UTC)

Oh no, I definitely agree with what you said. I didn't intend to lump reliable vs. good sources together both as something editors should be addressing, but rather that what makes a source good in the scientific realm are qualities like good experimental design, biologically relevant treatments, etc., that means the primary source gets cited (ideally) by secondary sources, and then we at Misplaced Pages consider the source reliable. Basically I was getting at those inner workings that happen in the science realm before we start considering information's role in Misplaced Pages. The two are intertwined, so sorry if what I was getting at wasn't clear. What makes a source good for scientists, or rather specifically what issues come up from focusing too much on a primary journal article are why we have guidelines like MEDRS for specifying what is reliable at Misplaced Pages. MEDRS does a good job of giving a brief background on what makes a source good or bad for the medical community and how issues there with a source translate into reliability issues here at Misplaced Pages.

With all that in mind, what I'm ultimately asking is whether, as an example within toxicology, a topic like cattle toxicology should be be covered by MEDRS when human toxicology obviously is? Both are medical fields. The inner workings of the scientific research and the validity of findings that eventually can lead into acceptance or rejection by the scientific community, and what eventually translates into whether a source is reliable on Misplaced Pages are not substantively different as far as I've seen. In the end, I'll be a happy camper if two questions get discussed here and hopefully lead into whether MEDRS is better intended to have a limited scope within certain branches of medicine, or if it is actually set up to be applied more widely within science research than some people think:

1. Does MEDRS apply to non-human branches of medicine?

2. If not, why?

Thanks, Kingofaces43 (talk) 21:57, 3 July 2014 (UTC)

I don't think that the community has an answer to your question.

One possible concern is whether vet med goes in for review articles as much as human med does. We don't really want to restrict the number of sources down to the point that you can't write an article about (for example) cattle diseases in the first place. WhatamIdoing (talk) 00:59, 9 July 2014 (UTC)

Agree: It is important to use the "best" sources, but sometimes those sources are not the best possible. Don't want to make the perfect into the enemy of the good. An analogous situation to this is some edit warring I have seen in the organic food articles, where MEDRS was used not only for medical claims, bur for other claims regarding, for example, water pollution, which clearly was beyond the scope of MEDRS. I have also seen the policy similarly abused to include studies paid for by Monsanto, but exclude other sources clearly acceptable per WP:RS and WP:SCIRS. Another problem I have seen is the pseudoscience wars where instead of simply putting due weight on fringe theories, MEDRS was used to exclude any discussion of different views and as a result created a wholly biased article stating that the entire concept is, essentially, worthless. This would not be a worry for, say, tinfoil helmets, but it is when you run across people who apply MEDRS to new things that haven't had a lot of peer-reviewed studies done yet, such as veterinary chiropractic and such. Montanabw 20:00, 14 July 2014 (UTC)

Is including content because of a lack of reviews taking priority over WP:FIVEPILLARS though, namely the spirit of WP:IINFO and WP:NOTE for encyclopedic content? One of the core foundations of Misplaced Pages is that we are using reliable sources, and we don't include information simply because it is there. I'm a little iffy on changing standards across topics because one isn't written about as much in reviews (seems like a notability issue more than anything). I haven't particularly seen issues with with the lack of available secondary sources in veterinary topics (we typically have plenty of review papers in general), so maybe we're bumping up against notability issues more than reliability in this context? Kingofaces43 (talk) 15:24, 15 July 2014 (UTC)

TFD, I definitely agree that the points on content policy you mentioned should be sufficient (although it is difficult to get across to some editors). You mentioned showing that we need to show that a statement is medical information to apply MEDRS, but what exactly is medical information? Medicine definitely isn't limited to human health in the real world, and MEDRS isn't specifically singling out human health the way it is currently written since it simply addresses medicine and not human medicine specifically (although it is written with some examples of it, but much of the guideline isn't that specific). Now I will say that many people do mistakenly assume human health is being talked about when the word medicine or health is used, which is probably why there has been a little contention on this topic. Because of that though, we can have people rejecting MEDRS on non-human health related topics even though the reliability of sources are essentially determined the same way as human health sources in the real world. It seems like that unintentional bias of associating health source reliability just with human topics makes discussions much more difficult in other health related content areas. That's where my concern lies. It's definitely doable to go through normal content policies and guidelines, but it does seem like it can lower the bar a bit and muddle the discussion when MEDRS is ignored for some health related content.Kingofaces43 (talk) 06:27, 3 July 2014 (UTC)

SCIRS looks a great deal like MEDRS for the very good reason that I structured the former to follow the latter. Last time I tried to put in the legwork to get the essay up to guideline status, drama ensued. Anyone is welcome to try, as many of the same concerns apply there as here. - 2/0 (cont.) 15:42, 14 July 2014 (UTC)

Re a recent change to wording / meaning

A change of wording (by NuclearWarfare) here that currently appears in the Biomedical journals subsection seems to me to be significant. The change is from

Research papers that describe original experiments are primary sources; however, they normally contain previous-work sections that are secondary sources (these sections are often incomplete

to

Research papers that describe original experiments are primary sources; however, they normally contain sections that place their research in the context of previous work. These sections may be considered secondary sources for the purpose of this guideline, but note that these sections are often incomplete

The current wording seems to me to imply that such content may be considered an acceptable secondary source under certain circumstances. I feel the wording and positioning of this statement needs some attention to avoid unintended interpretations. So I made this edit for the sake of clarity, which hasn't actually survived (just for the record, backstory details here). Either way, such changes to the wording seem to me to have some substantial implications, and probably require consensus (or otherwise) to be reached here.

Fwiw, I don't have strong feelings on this, though I too would tend to support a flexible approach in such situations (I think). 86.128.169.211 (talk) 19:12, 29 June 2014 (UTC)

NuclearWarfare is correct: previous-work sections (that exceed a couple of sentences) are (usually) secondary sources. (The presence of analytical statements is key.)

The thorny question is really whether we want to advertise this fact to editors. Advertising it to editors like NuclearWarfare would be an excellent idea. NW's groks due weight and is already attuned to the risks of using these sections. Advertising it to a very inexperienced editor or a POV pusher would probably not be such a good idea. We may end up with refspam, creeping reliance on primaries, and cherry picking. I don't know what to recommend here. WhatamIdoing (talk) 19:53, 29 June 2014 (UTC)

Per WAID's considerations, I had two main thoughts about how we might handle the actual wording:

• that it's probably better to discuss use of research papers after (rather than before) talking about reviews;
• it's perhaps a good idea to specify rather clearly the sort of situation in which it's appropriate to source information contained in a research paper.

In this version (diff here) I felt I was probably interpreting both NW's thoughts and broader consensus (though I accept I should probably have discussed here before making the actual change). 86.128.169.211 (talk) 20:27, 29 June 2014 (UTC)

WhatamIdoing, maybe one thought would be to add in a stipulation that in the cases of contentious topics, primary sources are a no go when even citing the introduction as a form of secondary literature? That way we could allow primary literature introductions in cases where it's something that should be cited from a journal, but isn't anything likely to be in an area where a POV pusher could really do damage. If I'm citing a paper that lists in its introduction what pathogens penicillin has been used against, that would seem like a non-issue, but cherry picking a fringe paper that mentions a link to autism with vaccinations in its introduction would definitely be a cause for concern. So basically say primary sources can be used with caution in this sense, but if anyone raises a fuss, it's gone.

This is just a potential solution, but determining what would be a contentious topic would be subjective, so I'm not sure how feasible the idea would be. This could allow some flexibility where we can error on the side of caution, and just say that if someone at all disputes the addition of a primary source's content, it's then contentious and shouldn't be used. If we’re going to have some ambiguity in the guideline, I’d at least say have that wiggle room skewed towards the use of secondary sources rather than make it easy to put in primary sources. Personally I’d prefer just secondary sources for the reasons you mentioned above, but maybe this approach might work? Kingofaces43 (talk) 18:28, 14 July 2014 (UTC)

That's an interesting way to address the problem. I think it would work, at least if people are challenging it for actual/specific reasons, rather than the sort of "I challenge every sentence followed by a primary source from here to infinity" thing that we see every now and again. It's not very different in spirit from the line that we use at WP:ELBURDEN, which is that any external link that's is disputed should be removed: assume that it's fine, remove if there are indications that it's not. However, it's a bit more complicated, given that we're supporting article information. A weak source is sometimes better than no source.

NuclearWarfare, what do you think? Do you think that there's a risk of this being gamed? I'm a little bit worried about people adding REFSPAM, and moderately worried about people fussing that the source isn't good enough, but not being willing to replace it with a better one themselves. WhatamIdoing (talk) 22:44, 14 July 2014 (UTC)

Grok, now there's an interesting phrase that I haven't heard of before. I like it.

Anyway, as to the point raised by Kingofaces43 (had a hard time not reading that as "King of faces," which weirded me out a little): it's a defensible position. And I know how easy it is for "citogenisized" mistakes to spread even just within in the professional literature, because peer reviewers and editors often don't seriously review the background sections. But I think it's taken a little bit far. I just added some content to the ] article last week that summarized the latest state of the meniscectomy literature. For that, I largely relied on the background sections of the major RCTs that have been published in the area (all in either the major general medical journals or the major speciality journals, so high quality sources). This information simply hasn't been well synthesized in reviews yet. It's a little too new (~seven years since the original trials started being published) and a little too controversial (partly because the observed data has high variance) for treatment guidelines. But I think it is still important for Misplaced Pages to reflect the consensus in the broader field. This change would take it a little too far in prohibiting that, at least as I read it. How about something like the following: Research papers that describe original experiments are primary sources; however, they normally contain sections that place their research in the context of previous work. These sections may be used in Misplaced Pages with care. As they are often incomplete, such citations challenged in good-faith by another editor should be replaced by a more comprehensive source . I'd welcome input. NW (Talk) 01:42, 15 July 2014 (UTC)

I would amend it to Research papers that describe original experiments are primary sources; however, they normally contain sections that place their research in the context of previous work. These sections may be used in Misplaced Pages with care. As they are often incomplete, such citations challenged in good-faith by another editor should be removed or preferably replaced by a more comprehensive source if possible. Verifiability and reliability of content are what makes up core policy for Misplaced Pages's content standards, so I'd rather see it be harder to add information from primary sources (although still possible). The purpose of this set up is to raise the bar of reliability for any content or topic considered contentious (which seems like it should be the case anyways), and to allow the possibility of primary sources in less contentious topics where there likely wouldn’t be a dispute anyways.

What I’m not sure about though is how this would affect the quality of articles depending on how active editors are. In other words, would it be easier for poor quality content and sources to creep in for lesser known topics, or is this happening already since they aren’t checked as often anyways? This approach would basically endorse that we accept lower quality evidence for some articles, but require more for others. I'm a little split on that thought. I think this is good in contentious topics so that we can stick to high quality sources and avoid a lot of the issues that come from POV, reliability, and other common problems in those discussions, but I’m not so sure about essentially endorsing what seems like a lesser standard for potentially less checked topics. Maybe it’s not really that different than what typically goes on now though? Kingofaces43 (talk) 15:08, 15 July 2014 (UTC)

@Kingofaces43: You're right that it's always best to use the highest quality sources possible, even for lower profile articles, but part of the consequences of certain topics being lower profile is that the highest quality sources don't always exist. I think that your phrasing is fine. Perhaps we can do more to emphasize that we really do mean that the challenge must be in good faith as to the editor's concern about The Truth factualness of the statement. NW (Talk) 21:30, 19 July 2014 (UTC)

If you two wanted to take a baby step towards this, rather than plunging forward (which I'm not opposed to), then you could limit its application to "subjects, such as rare diseases, for which review articles and reference works are not abundant". Alternatively, you could try it out for a while and see what happens. We can always remove this statement if it proves to cause problems.

In response to a comment above, there are types of basic information that people expect an article to contain (e.g., basic information about signs and symptoms, epidemiology, diagnostic process, typical treatment), regardless of whether that information happens to be present in a review or reference book that was published in the last five or ten years. WhatamIdoing (talk) 23:48, 19 July 2014 (UTC)

Science by press release in Neonicotinoid article

See here. I posted there, instead of here, because this guideline is not written to clearly read on veterinary medicine. But the issues are similar. Jytdog (talk) 12:24, 1 July 2014 (UTC)

Surse de încredere (medicină)

Hello. I'm pleased to announce you that a carefully translated, adapted and slightly completed version of the WP:MEDRS was adopted as ro.wikipedia guideline. Our Misplaced Pages may be small, but is now the 4th to have such a page. However, there are some notable differences as well. I considered more appropriate dividing the section Choosing sources into only 2 simple subsections: medical and non-medical sources. I believe that in an attempt to offer as much as possible, MEDRS stepped over the bounds of "general guideline" and penetrated a bit too much into the research field. It's a good thing, no doubt, but I would rather see such information in an additional page like an essay or supplement. --Winter (talk) 00:49, 9 July 2014 (UTC)

Great to hear that you have found it useful. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:55, 9 July 2014 (UTC)

Prediabetes

The contents of the Prediabetes article seems to be outdated, see here. Count Iblis (talk) 17:41, 16 July 2014 (UTC)

Issues with alt med not being able to maintain NPOV

Surely there has to be some compromise between a strict legalistic view of MEDRS and the mandate to have a neutral point of view. We could show that while the medical consensus is this, other opinions do exist. This in no way would affect the accuracy of the medical information in the article, indeed it would enhance it. An example is being played out in Acupuncture with a growing body of evidence on the mechanisms of how it works being whitewashed because an outdated reviews says there are none. One solution is to hold the content dealing with research and possible mechanisms of action to the standard of WP:SCIRS while the content that could be used as medical advice retaining the MEDRS standard. - Technophant (talk)

I don't believe that MEDRS can be re-written to eliminate POV pushing. WhatamIdoing (talk) 04:03, 20 July 2014 (UTC)

There's not really a discrepancy between MEDRS and NPOV. NPOV stipulates that we not give undue weight. Using unreliable sources for content is a kind of POV issue, namely when using primary studies because they typically don't describe the scientific consensus. Basically if the consensus is indeed changing, you should be able to source that in appropriate secondary sources. Without that secondary source, weight cannot really be assigned, which violates NPOV. Simply having an opinion exist isn't grounds for including it on Misplaced Pages. If that weren't the case, we wouldn't have WP:Fringe specifying that certain opinions be excluded. Kingofaces43 (talk) 04:39, 20 July 2014 (UTC)

Some examples of this kind of white-washing is this and this. I found a reliable secondary source that does acknowledge that opinions are changing. See this article from the WSJ. It says "Scientists are also finding parallels between the ancient concepts and modern anatomy. Many of the 365 acupuncture points correspond to nerve bundles or muscle trigger points. Several meridians track major arteries and nerves." Critics however have rejected using this source because of MEDRS.

I don't have evidence that consensus is changing, however there's credible research by reputable scientists published in respectable journals such as the Journal of Pain. When these ideas are picked up on by a major news organization, researched and fact-checked, the standard of reliability should be met, however the popular interpretation of MEDRS doesn't allow this. Something is wrong here. - Technophant (talk) 04:47, 20 July 2014 (UTC)

The main issue appears to be where you are using the journal articles as primary sources you are citing, and the WSJ isn't a reliable source for synthesizing primary literature. Technically, the news organization is picking up on the primary study and is not what is considered a scholarly secondary source. When it comes to scientific content, that doesn't particularly give weight to such studies. It's other scientists citing the studies and indicating validity in their own papers, especially reviews, that are needed. There isn't anything wrong with that, that's just the nature of how scientific publishing is done. The main issue is that primary studies require interpretation, and news organizations are not particularly adept at doing that, and we as editors are not allowed to do that even if we are a scientist that publishes in journals as well. For someone not too familiar with scientific publishing who has already learned the general guidelines of Misplaced Pages for reliable sources, this can definitely be confusing, and you're not the first to have difficulty with this topic. Hopefully that clears things up for you a little bit. Kingofaces43 (talk) 05:13, 20 July 2014 (UTC)

I propose this change to Acupuncture#Scientific view on TCM theory: "A 2008 review of research did not find a consistent anatomical structure or function for either acupuncture points or meridians. However, a 2010 article in the Wall Street Journal stated that "Many of the 365 acupuncture points correspond to nerve bundles or muscle trigger points. Several meridians track major arteries and nerves." That does not put undue weight to recent research and allows to reader to look into this and make their own decisions. - Technophant (talk) 06:02, 20 July 2014 (UTC)

That's a horrible proposal. You're proposing to allow a nonscientific source like a newspaper article trump a scientific review of research. The very sentence construction is designed by you to lead the reader to believe that because a newer source says something different than an earlier source, it's more likely to be true, and you set up and create the reader's expectation by using "however".

That's a textbook example of POV editing and synthesis. This proposal is very telling about your mission here at Misplaced Pages, and it's not a good one. No wonder you're running into trouble everywhere you spam your complaints. You are becoming an enormous time sink. -- Brangifer (talk) 07:12, 20 July 2014 (UTC)

• Proposal to change policy to say "When it comes to reviews of medical research, use the guidelines contained in WP:SCIRS instead." - Technophant (talk) 06:08, 20 July 2014 (UTC)

Dead in the water. The point of discussing research as you want to, is that it goes toward health claims; if it didn't, you wouldn't be pushing to include it. When Misplaced Pages discusses health issues, we have a responsibility to provide the public solid information based on the scientific consensus, as well as that can be established. WP arrived at this place through a lot of hard work and difficult discussions. What you propose opens the door not only to issues you care about, but buckets of woo -- things like HIV/AIDS denialism, Vitamin C megadosage, Magnet therapy, etc etc. As per Thomas More in Robert Bolt's A Man for All Seasons: "do you really think you could stand upright in the winds that would blow then?" Jytdog (talk) 06:43, 20 July 2014 (UTC)

I can't stand upright in the winds that blow now. It's very discouraging to attempt to add information to article in a way that would be perfectly acceptable in any other scientific article and have it reverted and insulted by multiple editors claiming to be using the "correct" interpretation of medrs. Until the policy is rewritten Misplaced Pages will continue to have a conservative bias- - Technophant (talk) 06:54, 20 July 2014 (UTC)

• Project-Class medicine pages
• NA-importance medicine pages
• All WikiProject Medicine pages
• Project-Class pharmacology pages
• NA-importance pharmacology pages
• WikiProject Pharmacology articles