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Low impact factor journal

The impact factor is O.59 according to ResearchGate.

I'd rather delete the fringe journal because we have better sources such as a 2013 Cochrane review in the same section. We should review each journal on a case by case basis. Sometimes fringe journals can fill in the blankets for mundane claims but I think it is unnecessary to include this one. Thoughts? QuackGuru (talk) 18:33, 29 October 2014 (UTC)

QuackGuru, first, I want to commend you for not making a POV edit here. Thank you, thank you, thank you. I know you really don't like or believe in acupuncture so it is refreshing to see you propose deletion of an anti-acupuncture review for the sake of the article's quality, and again, I'm happy to see this behavior. But back to your question. Overall, it seems to me there is a great deal of information that is left out of the article. We need more studies, from everywhere, not less. I think this article needs to be expanded a great deal to include more studies from everywhere and on every topic. There is a rich amount of data we still need to mine. Then I think once we have a robust amount of data on the article, at that point, we trim. For now, impact factor should be a factor in placement, absolutely, but we shouldn't delete anything reliably sourced. Is the journal peer reviewed? LesVegas (talk) 17:32, 5 November 2014 (UTC)

This article should focus on acupuncture and the suggestion to include "more studies" would not meet the higher bar of WP:MEDRS. Recent reviews are most appropriate.

If we allow this low-quality source to stay we would allow over a hundred other low-quality sources to flood the article. There is already "a robust amount of data" in this article. QuackGuru (talk) 19:38, 5 November 2014 (UTC)

QuackGuru, since you're really intent on removing this, fine, that's ok with me. We do have that Cochrane info so I won't fight you on this. But as a general rule, MEDRS doesn't say anything about impact factor. We have to make sure the sources aren't primary, are from peer reviewed journals, are recent (unless there's nothing newer on the subject) but impact factor has no bearing on a source being used or not. Yes, we don't want such sources in the lede, perhaps, and not more prominent than high impact factor sources. But reliable sources should always be allowed! and it's problematic if they're ever removed for any reason. LesVegas (talk) 06:11, 11 November 2014 (UTC)

For the record, I believe that QG is the last person that needs a condescending lecture like that !! -Roxy the dog™ (resonate) 06:16, 11 November 2014 (UTC)

Actually, QG has continually removed many reliable sources I and others have added. I will lecture him, and if the behavior continues, I will report him. LesVegas (talk) 06:27, 11 November 2014 (UTC)

Haha, good luck with that, but watch out for the boomerang catching you on the back of the neck. -Roxy the dog™ (resonate) 19:36, 11 November 2014 (UTC)

This has already been discussed earlier. As Roxy the dog™ said herself: "I don't believe there is a hard and fast rule on impact factor". User Brangifer supported this interpretation: "Correct. There isn't any. There can be many situations where it's not a factor, but in some it might be a decisive one.". I am more than happy to restore sources that have been removed solely on the basis of impact factor when no better reason exists. Please bring to my attention if such cases do exist. Jayaguru-Shishya (talk) 20:04, 11 November 2014 (UTC)

Note. MEDRS asks for independent sources. See Misplaced Pages:Identifying reliable sources (medicine)#Use independent sources. QuackGuru (talk) 20:37, 11 November 2014 (UTC)

Plos One

I thought there was consensus that Plos One is not per se a reliable source, is never a WP:MEDRS, and should only be used if all the authors are experts in appropriate fields. I could be wrong, though. — Arthur Rubin (talk) 20:20, 8 November 2014 (UTC)

Unlike the reference in the section above, I don't think it has negative reliability, just little positive reliability. — Arthur Rubin (talk) 20:22, 8 November 2014 (UTC)

I don't remember any specific discussion whether Plos One is reliable. This source (PMID 24349293) was recently added. QuackGuru (talk) 20:30, 8 November 2014 (UTC)

Think the OP would be better off asking this on the Talk:PLOS ONE. I can't recall any mention on WP or anywhere else, that questions PLOS's reliability. The section about is titled low Low Impact factor but this has nothing to do with WP:MEDRS. PLOS is peer reviewed. However, it does publish a great amount stuff (compared to other journals) that is very little studied. So it is expected that it will have a low impact factor when compared to journals that cherry pick the flavor of the month academic papers. So one must not judge by that metric - alone.--Aspro (talk) 18:45, 9 November 2014 (UTC)

Whether PLOS ONE is a reliable source is completely irrelevant to the article PLOS ONE, so there should be no discussion at Talk:PLOS ONE. WP:RSN may be the appropriate board for discussion, unless there is a specific board for WP:MEDRS questions. In addition, absent evidence to the contrary, the "peer review" in WP:MEDRS should be "traditional" (pre-publication, and probably anonymous) peer review, not the post-publication peer review described for this journal. — Arthur Rubin (talk) 10:38, 11 November 2014 (UTC)

There is no specific discussion of PLOS ONE at WP:RSN; there is a clear consensus that at least two publishers of open-access journals do not have adequate review to be considered reliable, but that is specific to those publishers. PLOS ONE has a different "peer review" model, and, if WP:MEDRS is changed to include non-traditional peer review, it might qualify. — Arthur Rubin (talk) 10:46, 11 November 2014 (UTC)

PLoS Medicine is specifically listed as a "high-quality journal" in WP:MEDRS (although, oddly enough, not specifically stated to be "reliable"); if that represents consensus, I'm tempted to withdraw this comment, until consensus can be confirmed at WT:MEDRS. — Arthur Rubin (talk) 10:52, 11 November 2014 (UTC)

The point about first questioning this at Talk:PLOS ONE is that along the same lines as "given enough eyeballs, all bugs are shallow". It is the first logical step before escalating. Second: PLOS (as far as I can see) does employ "traditional peer review". So, therefore, et cetera, et cetera, WP:MEDRS does not need updating. The difference to other journals perhaps, is that PLOS rely on post publication discussions to decide the importance, rather than leaving it to the foibles of their own editorial team. Did you base your question on the ramblings of a malfarius yellow journalist critic or internet blogger? Guard against letting the tail wag the dog.--Aspro (talk) 14:08, 12 November 2014 (UTC)

Plos One favors quantity (and free access) over quality. It is how itself defines its business model. That should be a red flag. Tgeorgescu (talk) 11:05, 11 November 2014 (UTC)

Your quote:Plos One favors quantity (and free access) over quality. By what evidence do you suggest this? This is like a logical fallacy. A supermarket may have thousands on lines on their shelves but does this mean quantity of their fair are of a lesser quality from the corner shop that 'specializes' on just a few basic items? So much for you red flag!--Aspro (talk) 14:11, 12 November 2014 (UTC)

From the horse's mouth: http://blogs.plos.org/everyone/2012/12/13/plos-one-launches-a-new-peer-review-form/ Tgeorgescu (talk) 00:16, 13 November 2014 (UTC)

I'm curious, if Plos One is unreliable as some suggest, what about Plos Medicine? Same open access, same registration fees, peer review, etc. Is Plos anything unreliable? LesVegas (talk) 00:35, 14 November 2014 (UTC)

I don't know about that, but Plos One stated that its own peer review process is shallow. Tgeorgescu (talk) 02:21, 14 November 2014 (UTC)

I read your link and didn't see Plos One directly state what you claimed, but rather describe the fact that their review process doesn't include the step where literature that does not make a significant advance is editorially rejected. To me, this doesn't create shallow content, and in fact, is a solid check on the centralization of scientific research. Excellent research comes out of this publication. In fact, several nobel laureates have research published in it. But listen, I get it. I understand the need for quality publications in the article here. If I had it my way, we would get rid of any research that does not meet STRICTA/CONSORT reporting standards. But MEDRS says nothing about reporting quality, so I can't justifiably hold that rubric to this article. Likewise, Plos One meets all the requirements Medrs suggests. It's peer reviewed and while their process is different than some other journals, they do have a process. I don't see any reason this journal should be excluded. And earlier, you said there was consensus about it. But clearly, since I'm protesting along with a few others, there isn't consensus. LesVegas (talk) 20:04, 14 November 2014 (UTC)

It's highly respected in many fields and has a solid impact factor of around 3.1, which I think would easily put it in the top 25% of journals. TimidGuy (talk) 11:51, 11 November 2014 (UTC)

Note. MEDRS requires using independent sources. Cheong KB, Zhang JP, Huang Y, and Zhang ZJ are alternative medicine advocates (PMID 24349293). See Misplaced Pages:Identifying reliable sources (medicine)#Use independent sources. QuackGuru (talk) 20:41, 11 November 2014 (UTC)

They may be advocates, I don't know for certain, you would probably be more of an expert there than I would. But if independence is of strict concern, then you would have to remove anything by Ernst since he's an avowed opponent of alternative medicine. When it comes to something like acupuncture, there's always going to be parties that aren't completely neutral or may have stated their opinion at one time or another. My philosophy is pretty libertarian and I'd like the article to encompass everything, not in favor of one side or the other, and have as much rich data as possible. Placement and weight can be debated, but inclusion/exclusion not so much, at least not if we are to follow policies here. LesVegas (talk) 01:14, 12 November 2014 (UTC)

"Many medical claims lack reliable research about the efficacy and safety of proposed treatments or about the legitimacy of statements made by proponents." Statements made by proponents are not independent. See Misplaced Pages:Identifying reliable sources (medicine)#Use independent sources. QuackGuru (talk) 02:10, 12 November 2014 (UTC)

Sure, we could argue about that forever. Fact is researchers always have opinions, deep down, whether they admit to these or not. What matters is, are they following the scientific method? Are the sources reputable, peer-reviewed, secondary, etc? Yes, yes, and yes. But at the end of the day, we have to remember MEDRS is not the law of the land but is just a guideline. NPOV is law of the land, and here is what it has to say:

"Neutral point of view should be achieved by balancing the bias in sources based on the weight of the opinion in reliable sources and not by excluding sources that do not conform to the writer's point of view." LesVegas (talk) 00:14, 14 November 2014 (UTC)

I don't completely agree with anyone else here.
Discussion of whether PLOS ONE is reliable should not be at Talk:PLOS ONE, per WP:TPG. Discussion or whether PLOS ONE is really peer-reviewed might be there, but it would not necessarily relate to our use of "peer-reviewed".
I agree that, even in WP:MEDRS, we may use clearly biased articles if published in (traditional) peer-reviewed journals, as the review is supposed to remove bias affecting the meaning of the article. However, PLOS ONE is not "peer-reviewed" in the that sense, for two reasons: the the "peers" are self-selected, and the reviewers are not supposed to judge whether the result is "interesting", which is how extreme bias is removed in traditional review. The review occurring after publication is irrelevant.
On the other hand, QG is wrong as to the meaning of "independent". If the journal were peer-reviewed, then the articles would be considered "independent" even if written by proponents, because the editors or reviewers would be independent. On the other hand, if not, then QG would be correct in regard WP:MEDRS guidelines. (I thought that WP:SPS had restrictions on using experts' self-published comments on their own work. Apparently, I was mistaken.) — Arthur Rubin (talk) 03:49, 17 November 2014 (UTC)

Arthur, thank you for your interesting points. I do agree that self-selection of peers might be problematic, but since I'm not an expert on scientific journals (and probably most of us here are not) I do think this topic would probably be better discussed somewhere else. I also agree with you that Plos:One talk is not the place to do this, though. But since Plos One articles are cited widely across Misplaced Pages, perhaps a policy or guideline talk page would be better? MEDRS talk maybe? It would be nice if MEDRS was more specific about peer-review. As it stands, there is no truly clear criteria for what is acceptable peer review and what is not. If you take this up there, please let me know, as I would love to be part of that discussion. I have particularly strong opinions on editors squashing research because the results aren't "interesting," and would love to be part of any discussion that brings this up specifically. LesVegas (talk) 17:39, 17 November 2014 (UTC)

I don't know if that's the basis. I've rarely seen papers which are so biased as to be misleading actually published, and I assume that the reason a reviewer would state for rejection is that the authors' statements of their own views is not "interesting", as the claim that they are "inaccurate" would be false. I know that, in the few instances that I was selected as a peer-reviewer, I would have rejected such a paper, even if it was not in the publication guidelines. Other more current peer-reviewers would have to comment as to the reason the reviewer would give, but "so biased as to be misleading" is not commented on by any of the published Plos One reviewing guidelines. Probably WP:RSN would be the appropriate place for initial discussion, as there doesn't seem to be a WP:MEDRSN; although WT:MEDRS might also be appropriate for the general question of the definition of "peer-review" for the purpose of WP:MEDRS. My wife's injury last Saturday is more severe than I had previously thought, so I may not have time to bring this up. — Arthur Rubin (talk) 23:27, 18 November 2014 (UTC)

As someone who has a passing familiarity with PLOS - PLOS One is peer-reviewed only for "technical" issues, so they ensure that e.g. the reported results support the conclusion, but they do not evaluate e.g. whether the conclusions are scientifically important. (The post-publication discussion isn't a peer review.) It has some good papers, especially because a few well-known scientists publish exclusively in PLOS One based on principle, but overall article quality can vary a lot. The other PLOS journals, like PLOS Medicine, employ traditional peer review. Sunrise (talk) 06:56, 20 November 2014 (UTC)

Old reference

Hello all! I added a review article from 2011 which compared acupuncture meridians and fascial networks. I rearranged the citation below it for now, which is Ernst 2008. However, it says, "no research has established any consistent anatomical structure or function for either acupuncture points or meridians" which is outdated now, particularly since a 2011 review did just that. But before deleting the old 2008 information, I figured I would bring it to the talk page first. Any objections? LesVegas (talk) 18:07, 11 December 2014 (UTC)

Yes. 2008 is not old compared to 2011. QuackGuru (talk) 18:17, 11 December 2014 (UTC)

4 years is awhile in any emerging science, but yes, I understand that in comparison it's not too bad. However, 2008 is beyond the parameters of the 5 year window which MEDRS recommends, and we have agreed that citations which get outdated based on newer research ought to be removed. That 2008 citation is now nearly 7 years old, which doesn't make it un-usable on that count alone, but since it is clearly in conflict with the more recent research I can't see that it passes the reliability test any longer. MEDRS seems pretty clear that we should remove citations like this. Is there anything else I am missing?LesVegas (talk) 18:57, 11 December 2014 (UTC)

Your using a poor source to argue against a more reliable source. The refs are 3 years apart. QuackGuru (talk) 19:26, 11 December 2014 (UTC)

The journal has a decent impact factor, it's respected in its field, peer-reviewed and the 2008 citation isn't a journal at al, but a book making a dated claim instead. I don't see where you can possibly argue that one source is poor and the other is reliable. According to MEDRS, part of reliability is whether something is dated or not. A book, making a bold claim that is now inconsistent with more modern research, is not reliable any longer. At one time, perhaps, but not in December 2014. LesVegas (talk) 19:41, 11 December 2014 (UTC)

Remember, you wanted the fringe journal in the article. What you wrote was inconsistent with the source. Now the text says "They found that the anatomical basis for the notion of acupuncture points and meridians in TCM has not been determined." QuackGuru (talk) 19:47, 11 December 2014 (UTC)

An impact factor of 2.175 is significant. It is higher than many anatomy and physiology journals. -A1candidate (talk) 20:06, 11 December 2014 (UTC)

The source does not contradict the 2008 source. The text was misleading. I went ahead and fixed it. QuackGuru (talk) 20:14, 11 December 2014 (UTC)

"In this paper, a convergence of evidence from various fields related to fascial anatomy and physiology were reviewed and considered with respect to the possibility that the fascia might be the physical substrate referred to as the meridian system in TCM." I fixed the orginal research. I also fix the misleading text by adding a quote instead: They found that "the basis of the nature and material of acupuncture points and meridians has not been resolved." QuackGuru (talk) 20:14, 11 December 2014 (UTC)

Which the text does not 'conclude. The first line quotes that "it has not been resolved" clearly referencing all the old data, such as the very 2008 source we are talking about. Then they go on to show correlations between meridians and fascia. If Galileo says "The debate about a geocentric universe hasn't been resolved," and then goes on to show his strong argument that Earth revolves around the sun, you can't then say "But Galileo found that the basis for a heliocentric universe hasn't been resolved," as though this were his conclusion. You are clearly taking this out of context. LesVegas (talk) 20:21, 11 December 2014 (UTC)

I quoted the source correctly. I did not quote the first line from the abstract. QuackGuru (talk) 20:26, 11 December 2014 (UTC)

No, that is essentially what the first line of the abstract says. Do you think you're quoting from somewhere else, or are you just not hearing me? LesVegas (talk) 20:33, 11 December 2014 (UTC)

Further, exactly how is the statement, "They found that the human fascial system could be the anatomical basis of acupuncture points and meridians in TCM" original research, when the friggin title of the article is "Review of Evidence Suggesting That the Fascia Network Could Be the Anatomical Basis for Acupoints and Meridians in the Human Body" and the conclusion finds just that, that there is a correlation and fascia may very well be the material basis? LesVegas (talk) 20:38, 11 December 2014 (UTC)

You could not verify the text but I did. See "..., the basis of the nature and material of acupuncture points and meridians has not been resolved." This is not from the abstract. The source said it "...considered with respect to the possibility that the fascia might be the physical substrate referred to as the meridian system in TCM." QuackGuru (talk) 20:46, 11 December 2014 (UTC)

QuackGuru, it is the first line from the abstract! It is again quoted in the introduction in this context, "Although scientific interest in the validity of meridians and acupoints has been growing in the last decade, the basis of the nature and material of acupuncture points and meridians has not been resolved." Please note it is in the abstract and introduction and note the context with which it is used. My point is that you are quoting it as a conclusion.Are you still not hearing me? The title of the article is "Review of Evidence Suggesting That the Fascia Network Could Be the Anatomical Basis for Acupoints and Meridians in the Human Body." The article then quotes, "The VCH and living body imaging studies together indicate that the anatomy of the fascial network in the human body is consistent with the traditional view of the meridian network pattern." LesVegas (talk) 21:07, 11 December 2014 (UTC)

https://www.ncbi.nlm.nih.gov/pubmed/21584283 The abstract does not have that quote. That quote is from the full text and they stated it is not resolved. As for the other text, your quoting part of the context. Read what they wrote at the beginning of the same paragraph what they said under 3. Discussion: "...considered with respect to the possibility..." QuackGuru (talk) 21:17, 11 December 2014 (UTC)

Here is the abstract, in full:

Abstract

The anatomical basis for the concept of meridians in traditional Chinese medicine (TCM) has not been resolved. This paper reviews the evidence supporting a relationship between acupuncture points/meridians and fascia. The reviewed evidence supports the view that the human body's fascia network may be the physical substrate represented by the meridians of TCM. Specifically, this hypothesis is supported by anatomical observations of body scan data demonstrating that the fascia network resembles the theoretical meridian system in salient ways, as well as physiological, histological, and clinical observations. This view represents a theoretical basis and means for applying modern biomedical research to examining TCM principles and therapies, and it favors a holistic approach to diagnosis and treatment.

LesVegas (talk) 21:25, 11 December 2014 (UTC)

The other text, in full is here:

In this paper, a convergence of evidence from various fields related to fascial anatomy and physiology were reviewed and considered with respect to the possibility that the fascia might be the physical substrate referred to as the meridian system in TCM. The anatomy of the fascial network in the human body, as demonstrated through VCH and living body imaging studies, is consistent with the traditional view of the meridian network pattern, and the efficacy of acupuncture has been shown to rely on interactions with the fascia. Additionally, it appears that the fasciae mediate an active mechanical transference role as they provide dynamic connections between and among the muscles and bones. Moreover, the phenomenon of neurogenic inflammation triggered by stimulation of nociceptive receptors in fascial tissues is consistent with the notion that disruption of fascial physiology can have notable consequences on human health. Indeed, it is our view that neurogenic inflammation in fasciae may constitute a form of disruption of meridian energy flow in TCM.

What is out-of-context here? Please show me. LesVegas (talk) 21:29, 11 December 2014 (UTC)

Wow, let us everyone cool down guys. There is no original research, and we can replace the outdated 2008 source with a more recent 2011 one. I just restored a more stable version of the article, but I couldn't help wondering if we needed to go even further back to a better version? After all, many of the recent edits are rather questionable, and don't really justify altering the improvements made earlier. Cheers! Jayaguru-Shishya (talk) 21:55, 11 December 2014 (UTC)

LesVegas was kind enough to alert me on my talk page that I had removed the Bai, et al content. I wasn't aware this had been discussed in this thread, so I'll explain why I removed it. Here is what I removed:

• Despite scientific debate in the validity of meridians and acupoints has been increasing, the premise for the idea of acupuncture points and meridians in TCM has not been determined. A 2011 review, representing a theoretical basis, noted that the human fascial network is consistent with the ancient view of the meridian network pattern, and may be the anatomical basis for acupoints and meridians within the human body. Further, it noted that the efficacy of acupuncture has been observed to depend on interactions with the fascia. It noted that reconstructions of the fascial connective tissues in the body show line-like structures, similar to those of acupoints and meridians/collaterals.Additionally, these fascial strings form a network of lines that are close to the virtual meridians in anatomical location.

My edit summary should be self-explanatory: "rmv content from one source which is not a true "review" of the literature. It's one primary source and speculation, and it violates MEDRS rather grossly.".

What likely fooled people is that the title uses the word "review", but it's not a literature review at all. It's a primary source opinion piece, filled with speculation and "if"-type qualifiers. It's also a lot of content using just one source, a source which doesn't begin to meet our MEDRS standards. If anyone still questions the wisdom of my removal, let's discuss it here, and please ping me. Thanks. -- Brangifer (talk) 04:04, 18 December 2014 (UTC)

1. ^ Bai, Yu; Wang, Jun; Wu, Jin-peng; Dai, Jing-xing; Sha, Ou; Tai Wai Yew, David; Yuan, Lin; Liang, Qiu-ni (2011). "Review of Evidence Suggesting That the Fascia Network Could Be the Anatomical Basis for Acupoints and Meridians in the Human Body". Evidence-Based Complementary and Alternative Medicine. 2011: 1–6. doi:10.1155/2011/260510. ISSN 1741-427X. PMC 3092510. PMID 21584283.{{cite journal}}: CS1 maint: unflagged free DOI (link)

Hi BullRangifer, thanks very much for your thoughtful comments. I noticed the speculation and if type qualifiers as well, and when I originally posted it, like this it was consistent with the "discussion" section at the end of the piece. While they did state that the human fascial network "is consistent" with the ancient view of the meridian system, they certainly do use a lot of "may's" and "could be's". But in my original edit, I wanted it to be very consistent with the spirit of the source. That edit took on several incarnations which I did not approve of and made it known. I'm not sure if those indicators were still present, and probably were not, by the time you altered it, so your revert was probably well justified on those grounds (I dunno, I'll have to go back and check.) Now, one area where I'm afraid that I must disagree is that it is a primary source. In the section on "characteristics of secondary sources" it meets these as it's built from several primary sources, it provides commentary, analysis, interpretation, etc on them, etc. While it's not a systematic review, it is a review, and certainly not primary. MEDRS would classify it as a narrative review, or a literature review, opposed to the systematic reviews we usually see used. But MEDRS does allow for these types of reviews to be used. Actually, MEDRS does even allow for primary studies to be used, but only until secondary sources come about later, if I'm reading it correctly. Anyway, if I'm incorrect in any of this, by all means let me know. LesVegas (talk) 00:30, 19 December 2014 (UTC)

Hello, since the source was a review and there were no further objections here on talk, I have added it back in. Peace! LesVegas (talk) 21:17, 3 January 2015 (UTC)

This change was original research. The source is only speculating. The source said "This view represents a theoretical basis". The source also said "Specifically, if true, then contributions of the fascia...". The word "if" is not a fact. QuackGuru (talk) 00:44, 4 January 2015 (UTC)

Dear QuackGuru, we certainly do not ban the word "if". :-) Anyway, as you said: "This view represents a theoretical basis". That means it represents a theoretical basis. Jayaguru-Shishya (talk) 01:02, 4 January 2015 (UTC)

I agree with Jayaguru's point, and QuackGuru, I addressed this earlier with one of the copy-and-paste statements above. Some of the supporting text is here: The anatomy of the fascial network in the human body, as demonstrated through VCH and living body imaging studies, is consistent with the traditional view of the meridian network pattern, and the efficacy of acupuncture has been shown to rely on interactions with the fascia. Additionally, it appears that the fasciae mediate an active mechanical transference role as they provide dynamic connections between and among the muscles and bones. Moreover, the phenomenon of neurogenic inflammation triggered by stimulation of nociceptive receptors in fascial tissues is consistent with the notion that disruption of fascial physiology can have notable consequences on human health. Indeed, it is our view that neurogenic inflammation in fasciae may constitute a form of disruption of meridian energy flow in TCM and also Based on supportive evidence in the literature, the present paper provides support for a fascia network hypothesis of meridians—that is, the view that the fascia network may be the anatomical basis for acupoints and meridians in the human body. The edit says "may be" which is reflective of the source. LesVegas (talk) 01:13, 4 January 2015 (UTC)

TCM is largely pseudoscience according to the source presented

Getting back to the NPOV version. Misleading text was restored. This edit replaced sourced text with OR. QuackGuru (talk) 22:11, 11 December 2014 (UTC)

It was summarized, but now I quoted it nearly verbatim because you continue to object and call any degree of summarization OR. LesVegas (talk) 23:58, 11 December 2014 (UTC)

The text you added was about the imaging. It was not the evidence. QuackGuru (talk) 00:46, 13 December 2014 (UTC)

This is getting out of hand at this point. QuackGuru (talk) 23:49, 11 December 2014 (UTC)

What has gotten out of hand is outrageously ridiculous POV edits like this everywhere in the article. We don't engage in disputes using Misplaced Pages's voice. It violates at least three policies in NPOV, and I quoted all of these in the edit summary. Nowhere in the article should statements like this exist, least not in the lede. LesVegas (talk) 23:58, 11 December 2014 (UTC)

Lets get back on track to the last NPOV version here where the text was neutrally written and used a quote form the source. QuackGuru (talk) 00:07, 12 December 2014 (UTC)

Oppose - This is about acupuncture itself, not about TCM. -A1candidate (talk) 00:09, 12 December 2014 (UTC)

On the contrary. Are you saying support when you can't provide a rationale explanation? For example, the sentence is about TCM not acupuncture. QuackGuru (talk) 00:13, 12 December 2014 (UTC)

There is nothing irrational about making sure that acupuncture, not TCM, is discussed in the lede of acupuncture. -A1candidate (talk) 00:15, 12 December 2014 (UTC)

Let me remind you that acupuncture is often accompanied by using TCM. According to your edit summary you thought the sentence was about acupuncture. QuackGuru (talk) 00:22, 12 December 2014 (UTC)

That will only merit a discussion in the lede if acupuncture had no valid mechanism of action, but it does have. -A1candidate (talk) 00:26, 12 December 2014 (UTC)

The sentence was about TCM not acupuncture. QuackGuru (talk) 00:31, 12 December 2014 (UTC)

Acupuncture has a valid mechanism of action. It's misleading to imply otherwise. -A1candidate (talk) 00:35, 12 December 2014 (UTC)

Do you understand the sentence you deleted is specifically about TCM? QuackGuru (talk) 00:38, 12 December 2014 (UTC)

Yes, it's a misleading statement and it doesn't belong there. -A1candidate (talk) 00:40, 12 December 2014 (UTC)

It is misleading, it is written in Misplaced Pages's voice, and is not attributed to the author. Further, it is misleading since it takes sides. Misplaced Pages doesn't engage in disputes, it describes them only. The statement that TCM is pseudoscience is disputed in many places. That one statement violates multiple aspects of NPOV. Just as a refresher, here's just one of the violations from the NPOV policy page:

1) Avoid stating seriously contested assertions as facts. If different reliable sources make conflicting assertions about a matter, treat these assertions as opinions rather than facts, and do not present them as direct statements.

2) An article should not give undue weight to any aspects of the subject but should strive to treat each aspect with a weight appropriate to the weight of that aspect in the body of reliable sources on the subject.

3) Misplaced Pages describes disputes. Misplaced Pages does not engage in disputes. A neutral characterization of disputes requires presenting viewpoints with a consistently impartial tone; otherwise articles end up as partisan commentaries even while presenting all relevant points of view. Even where a topic is presented in terms of facts rather than opinions, inappropriate tone can be introduced through the way in which facts are selected, presented, or organized. Neutral articles are written with a tone that provides an unbiased, accurate, and proportionate representation of all positions included in the article.

4) The tone of Misplaced Pages articles should be impartial, neither endorsing nor rejecting a particular point of view. Try not to quote directly from participants engaged in a heated dispute; instead, summarize and present the arguments in an impartial tone.

5) Biased statements of opinion can be presented only with attribution. For instance, "John Doe is the best baseball player" expresses an opinion and cannot be asserted in Misplaced Pages as if it were a fact.

And further, as A1Candidate said, it's irrelevant because it deals with TCM and this page is acupuncture. While the two are related, broader topics shouldn't be in the lede, least not when they violate multiple NPOV policies. LesVegas (talk) 01:18, 12 December 2014 (UTC)

The article is about acupuncture, not traditional Chinese medicine. Insertions about TCM should be placed to traditional Chinese medicine, and insertions about acupuncture should be kept here at acupuncture. Jayaguru-Shishya (talk) 19:55, 12 December 2014 (UTC)

Acupuncture is often used with TCM. It is largely and no serious dispute exists. QuackGuru (talk) 00:46, 13 December 2014 (UTC)

Copyvio? QuackGuru (talk) 00:46, 13 December 2014 (UTC)

Quackguru, first of all, it is not pertinent to talk about TCM in an acupuncture lede. It is too broad of a subject. Even still, that statement does not belong in the TCM article. It violates all 5 of the aspects of NPOV I mentioned above. It is a clear violation of NPOV. We do not state seriously contested assertions as facts in Misplaced Pages's voice, period. We do not take one side on an issue. To say TCM is pseudoscience just because some POV editor here dug up a citation saying those words, is wrong on many counts. BLP issues aside, we cannot say "Bill Cosby is the most prolific rapist of all time" citing Howard Stern's radio broadcast, using Misplaced Pages's voice. We cannot say "Bill Clinton is a criminal" and cite Rush Limbaugh. There's many, many problems with that.

As for this copyvio accusation, let me remind you you accused me of taking something out-of-context. You also said you weren't quoting directly from the abstract. So that's when I posted the context and posted the abstract, to show everyone else the truth. Now you want to accuse me of a copyvio?? Why do you always insist on turning everything into a battleground? LesVegas (talk) 04:11, 13 December 2014 (UTC)

So this statment belongs to traditional Chinese medicine, not acupuncture. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

No, LesVegas, TCM is obvious pseudoscience. The violation of policy would be to portray TCM as having any merit.—Kww(talk) 04:36, 13 December 2014 (UTC)

Some forms of TCM have a valid mechanism, such as acupuncture. -A1candidate (talk) 08:48, 13 December 2014 (UTC)

This question have popped up every now and then. I agree with Kww to the extent that we should have extreme caution with any claims of medical efficiency of TCM. However, TCM predates what we call as "science" by thousands of years, so personally I find it pretty hard to see how it could possibly be "pseudoscience". Anyway, this is getting a bit off-topic now since this is Talk:Acupuncture, not Talk:TCM. Cheers. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

Really? And what would that be? Yes, the body can sense and react to getting poked by a needle. There is nothing unusual about that. It's the speculative connection between a needle and nonexistent acupoints and meridians, and then claims of healing, that's where the problem lies. For it to then be useful, one needs consistency, predictability, reliability, reproducibility, and objectively verifiable results which are clear to everyone, including nonbelievers. Acupuncture fails miserably on all counts. -- Brangifer (talk) 08:56, 13 December 2014 (UTC)

It's not speculative. Read the article carefully. -A1candidate (talk) 09:06, 13 December 2014 (UTC)

You are confusing two things, A1candidate. Do some of the things that TCM advocates work? Certainly. Does TCM provide any sound explanation for this? No, because TCM is a pseudoscience based on false principles. Not all conclusions derived from false principles are necessarily false: even a stopped clock is right twice a day.—Kww(talk) 15:46, 13 December 2014 (UTC)

You've acknowledged that some forms of TCM (such as acupuncture) works. We should provide the scientific explanation instead of debunking TCM. -A1candidate (talk) 16:18, 13 December 2014 (UTC)

That would appear to be an intentional misreading, so I will say it in a less polite form, A1candidate: each and every explanation provided by TCM is false. It is pseudoscientific to its core, and any effort to portray it as having merit goes against the policies set down by the pseudoscience arbitration decisions. Do not continue to attempt to portray TCM as having validity: it has none. That's a completely different thing from saying that each and every item used in TCM is harmful or fruitless: if someone believed that penicillin works by scaring demons away, he's completely wrong, but that doesn't keep the penicillin from working.—Kww(talk) 16:26, 13 December 2014 (UTC)

TCM may or may not have validity, but acupuncture certainly has. -A1candidate (talk) 16:30, 13 December 2014 (UTC)

I am not sure if I understood this correctly, but whenever we are dealing with claims on medical efficiency, we strictly follow MEDRS. So if there is a reliable MEDRS compliant source that has to offer some positive results, then we can use it. We can't, however, categorially exclude any such sources. And this works in both directions. Probably most of the MEDRS compliant sources report that TCM isn't effective, so if we just follow MEDRS, it will represent the reality as it is.

"...if someone believed that penicillin works by scaring demons away, he's completely wrong, but that doesn't keep the penicillin from working." Heh, well put... but it doesn't prevent us from reporting that penicillin per se does posses beneficial medical properties. If there is a peculiar tradition that indeed believes that penicillin scares demons away, we can report that as the very belief of that tradition, but we have to strictly separate that from the facts concerning the medical efficiency. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

I'll grant that it has enough appearance of validity that people study it, but that doesn't mean that your any of your comments related to the TCM discussion have much merit. The sentence you insist on removing is about the TCM foundation of acupuncture. Acupuncture has its foundation in TCM: that's indisputable. Even if it happens to work in some limited fashion for some limited set of cases, there's no scientific consensus that it does, and no scientific consensus as to what the mechanism would be. You keep arguing "endorphins", but that's a hypothetical explanation supported by an extremely small group of studies.—Kww(talk) 16:44, 13 December 2014 (UTC)

Claiming that TCM is pseudoscience, therefore acupuncture is also pseudoscience because it is based on TCM, is a violation of WP:ORIGINALSYN. Please read WP:OR carefully. -A1candidate (talk) 16:55, 13 December 2014 (UTC)

If the article would say that "Acupuncture has its roots in traditional chinese medicine", going on about TCM would be reasonable. At the moment, the article just suddenly jumps into TCM, even the article indeed is about acupuncutre. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

If the article would say that "Acupuncture has its roots in traditional Chinese medicine", going on about TCM would be reasonable. At the moment, the article just suddenly jumps into TCM, even the article is indeed about acupuncture. The question about "being a pseudoscience", though, is highly controversial for obvious reasons. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

Oh, I have, A1candidate. I'm not in violation in any way, nor is accurately pointing out acupuncture's foundation a violation. You, on the other hand, are apparently attempting to disrupt this article in an effort to promote acupuncture.—Kww(talk) 17:15, 13 December 2014 (UTC)

The source is about TCM, not acupuncture. -A1candidate (talk) 17:17, 13 December 2014 (UTC)

And the sentence you are continuously deleting discusses TCM. If your contention is that we cannot mention the origins of acupuncture in an article about acupuncture, that's clearly a non-starter of an argument.—Kww(talk) 17:32, 13 December 2014 (UTC)

It may be okay to discuss related issues in the main body, but not in the lede. -A1candidate (talk) 17:38, 13 December 2014 (UTC)

A1candidate has got it right here: the source doesn't even discuss acupuncture. It might indeed be that acupuncture has its roots in TCM, and I find it perfectly reasonable to mention that in the article. The article is about acupuncture though, so I find it a bit absurd that we insert claims about TCM using sources about TCM. It's like adding to chemistry out of the blue that "Alchemy is pseudoscience". Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

That certainly appears to be an arbitrary fiat without a foundation in policy or logic.—Kww(talk) 17:49, 13 December 2014 (UTC)

Misplaced Pages is an encyclopedia, not a place to debunk pseudoscience. We consider the needs of the reader first and foremost. -A1candidate (talk) 17:54, 13 December 2014 (UTC)

That's certainly true. Why wouldn't the reader of an article on acupuncture need to know about its foundations?—Kww(talk) 18:34, 13 December 2014 (UTC)

Because we place more emphasis on actual scientific mechanisms and lmost established ess on mythological interpretations. To quote AndyTheGrump at the Aryuveda article: "The (pseudoscience) label cannot be misapplied retroactively. It is impossible to be practice pseudoscience in a pre-scientific era, and accordingly one cannot describe an entire subject spanning well over two thousand years as such. Pseudoscience can only exist once there is a real science for it to imitate.". -A1candidate (talk) 18:40, 13 December 2014 (UTC)

Treating people with Ayurveda in the 21st century is pseudoscience, because there is science-based medicine, which has removed the need for such bogus, superstitious treatments. Besides, there are purported scientific mechanisms for acupuncture, there is no scientific consensus that acupuncture would be based upon some scientific mechanism, nor which scientific mechanism would that be. Tgeorgescu (talk) 22:23, 13 December 2014 (UTC)

If it doesn't imitate science, it won't matter which century you're referring to. -A1candidate (talk) 23:54, 13 December 2014 (UTC)

Wasn't this discussed just recently at Talk:Ayurveda? Correct me if I'm wrong, but wasn't the outcome that Ayurveda is not pseudoscience (for the very obvious reason that it pre-dates what we call "science"). Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

Pretending to effectively treat people is a medical claim, and in the 21st century medicine is a science, so all medical treatments based upon ancient superstition are pseudoscience, unless they are scientifically shown to be effective. Tgeorgescu (talk) 00:43, 14 December 2014 (UTC)

In the 21st century Ayurveda is bereaving people of evidence-based treatment, so it is an alternative which is opposed to science. When there was no such thing as modern science, obviously there was no such thing as "alternative opposed to modern science". Tgeorgescu (talk) 00:49, 14 December 2014 (UTC)

The term "pseudoscience" has a definition of its own, and I don't think this is one of them. I understand where you are getting at Tgeorgescu, but we shouldn't use the term "pseudoscience" loosely. We are discussing the medical efficiency of Acupuncture / TCM largely in the articles, and the reality makes justice here; both acupuncture and TCM have at most cases provided to be ineffective, and that't what we report in both articles. If there are, however, MEDRS compliant studies that suggest positive results on the efficiency, sure we can report them. If you are afraid that the article will get biased in favour of acupuncture / TCM, you can rest easy: the very reality and MEDRS ensure us that no such bias will be born. Should there be an unreliable source in the article(s)? Remove it. For these two reasons the article will be just fine. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

If there were a consensus that acupuncture was effective, that would be one thing. There's consensus that there's enough reason to investigate effectiveness, but no consensus that it is effective or via what mechanism that it would be effective if it is.—Kww(talk) 00:59, 14 December 2014 (UTC)

There is consensus that it is effective for some conditions (albeit a very limited number) and there is consensus that it involves stimulating the nerves and the release of neurotransmitters. -A1candidate (talk) 09:38, 14 December 2014 (UTC)

More like there are some studies that showed some signs of effectiveness. There's not a general consensus that it is effective.—Kww(talk) 15:24, 14 December 2014 (UTC)

It is effective for some conditions -A1candidate (talk) 15:42, 14 December 2014 (UTC)

A meta-review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias says it all: there's no consensus that it is completely ineffective, but no consensus that it is effective, either.—Kww(talk) 15:46, 14 December 2014 (UTC)

That review is from January 2009. We need to use reviews published within the last five years. -A1candidate (talk) 16:41, 14 December 2014 (UTC)

You have a source that speaks to some massive sea-change in terms of studies? The situation remains much the same: glimmers of hope, signs of effectiveness, but no consensus that it actually is effective or how it would be effective.—Kww(talk) 17:13, 14 December 2014 (UTC)

The old review you cited included 13 trials with 3025 patients, while a newer review includes 29 trials with 17922 patients and concludes that "Acupuncture is effective for the treatment of chronic pain". --A1candidate (talk) 17:57, 14 December 2014 (UTC)

We can follow MEDRS. It'll be just fine. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

One study does not create a general consensus. I'll stand by my assessement of these sources: there are studies that indicate effectiveness, there's a consensus among the medical community that there's enough evidence of effectiveness to warrant further study, but there is not, at this point, a general consensus as to it being effective, how it would be effective, or what it would be effective for.—Kww(talk) 13:45, 15 December 2014 (UTC)

A sytematic review is not just "one study" but takes into account many dozens. The consensus is that is is effective for treating chronic pain. You can verify that in most medical textbooks and reference works. -A1candidate (talk) 14:09, 15 December 2014 (UTC)

I know precisely what a systematic review is. It doesn't create a general consensus.—Kww(talk) 14:33, 15 December 2014 (UTC)

The consensus is in medical textbooks -A1candidate (talk) 15:07, 15 December 2014 (UTC)

Kww, what I see are essentially two major issues with this sentence being in the lede.

Issue #1 As A1Candidate says, this article is not about TCM, it is about acupuncture. Some people mistakenly believe the two are somewhat interchangeable, that acupuncture is always part of TCM, but it's not. Acupuncture predates TCM, which is a style based on several different classical lines of thought, mixed in with some Western medicine concepts. In fact, there are dozens of different acupuncture styles: there's family lineage-based styles like Worsley 5 Element style, or Tung style, there's classical styles that were orally transmitted 5,000 years ago and were recorded 2,000ish yrs ago, during the Warring States period. They do not resemble TCM style acupuncture whatsoever. As a matter of fact, in classical-style, the tools used are the "9 needles" one being strikingly similar to a scalpel and was used to drain accesses almost exactly the way they are done now in the West. There's Japanese styles of acupuncture and Korean styles, and they are widely practiced, very popular and do not share any relationship to TCM in philosophy, diagnosis, or method of treatment. So do you see why it is really, really wrong to criticize TCM in the lede on acupuncture? It would be like criticizing Protestantism in the lede on Christianity. Yes, there are plenty of reliable sources that criticize Protestantism, but quoting these sources wouldn't stick for a second on a page like Christianity (unless it was overrun with very zealous Catholics:)

Issue #2 Misplaced Pages forbids us to state seriously contested assertions as facts. When different reliable sources make conflicting assertions about a matter, we are supposed to treat these assertions as opinions rather than facts, and we are never to present them as direct statements, such as "TCM is largely pseudoscience with no valid mechanism of action for many of its treatments." Just because a source says it, doesn't mean we can use it. NPOV forbids it in this context. Listen, for the record, I do not believe TCM is pseudoscience. I'm not a practitioner, but something of a lay-scholar on Classical Chinese Medicine, with a formal education in Chinese language and cultural history. I receive acupuncture treatments constantly, and have tried many different styles. TCM was the first style I tried, while I was living in China. While, today, I don't have great affection or even much respect for "TCM", I definitely don't believe it's pseudoscience, and there's plenty of sources, in part of whole, that say otherwise. But it's not what I think that matters here. It's Misplaced Pages's policy. I know of reliable sources that essentially say, "TCM is superior, in many regards, to western medicine and successfully treated many diseases before Western medicine even discovered them". Would I even think about putting a quote like that into the article? After all, the source says it. But it's against policy to use it like that. You're using Misplaced Pages's voice to say this. You can't do that. Neutral point of view policy is very, very clear on this. LesVegas (talk) 22:53, 14 December 2014 (UTC)

Issue 1 at least is debatable. However, issue 2 is laughable: there's no serious contest to TCM being pseudoscience. As explained multiple times in this discussion, that doesn't mean that every treatment derived from TCM is ineffective, simply that the explanation provided by TCM has no foundation in reality.—Kww(talk) 13:45, 15 December 2014 (UTC)

I explained it in my edit summary the problems with the previous text. This text was about the imaging and was not the summarised evidence. I tagged some MEDRS violations. QuackGuru (talk) 05:23, 14 December 2014 (UTC)

I'm sorry I just now noticed this comment. This whole section is somewhat disorganized, it's difficult to wade through the muck and see responses. I'm glad you see that issue #1 is debatable. To me, issue #2 is still very debatable, especially since this citation is from an article in Nature, representing the opinion of one author and not a large scientific consensus. If there was a large body of scientists who agreed TCM=pseudoscience, then we could quote this consortium in the current manner. But there isn't such a body, that I'm aware of, plus there actually are citations from Chinese government's national medical institutes, which are on par with the NIH or CDC, which always talk very positive about the scientific validity of TCM, and those views are not being expressed in this rather broad statement that's written in Misplaced Pages's voice. Anyway, since we have at least some common ground here, here's what I propose: I want to make sections on various styles of acupuncture (Japanese, Classical, Family-Lineage based, TCM, etc.) and within the TCM section we can have this comment, but only attributed to its source, Nature, not in Misplaced Pages's voice. Then, we can add an notable MEDRS-compliant opposing views stating that TCM has scientific validity for balance. I've always wanted to expand the article to include various styles of acupuncture anyway so this accomplishes several tasks. What do you think? LesVegas (talk) 00:49, 19 December 2014 (UTC)

I think you already know that discretionary sanctions apply to the apology of pseudoscience. Don't parse words in order to deny obvious facts. TCM is and will remain pseudoscience, since it appeals to mystical "energies" (in physics there are no energy fields, there are just force fields, which are abstractions). Tgeorgescu (talk) 13:36, 19 December 2014 (UTC)

I think that your goal is to make TCM sound as if it has validity. There's no aspect of TCM that isn't pseudoscience. The Nature review does reflect scientific consensus.—Kww(talk) 13:56, 19 December 2014 (UTC)

There are some aspects of TCM that have some scientific basis such as acupuncture and some forms of herbal medicines. -A1candidate (talk) 14:07, 19 December 2014 (UTC)

Making a quick catch-up with the recent discussion:

1. Appeals to mystical "energies"? Maybe. Pre-dates science? Definitely. With due all respect, Tgeorgescu, I don't quite follow your logic here.
2. Kww, instead of good-for-nothing speculation, I'd like to suggest that all the editors follow MEDRS, so we will avoid the problems. If the reality is that TCM is inefficient, then naturally our MEDRS compliant sources will express that.
3. Reporting the Nature source, we can phrase it as: "According to an editorial in Nature'..." or something like that. It should solve the problem.

Dear fellow editors, I'd like to remind you all that this is Talk:Acupuncture. The right venue to discuss TCM related issues would be at Talk:traditional Chinese medicine. Cheers! Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

Even a broken clock is right twice a day. Tgeorgescu (talk) 14:30, 19 December 2014 (UTC)

TCM is not a household appliance. -A1candidate (talk) 14:34, 19 December 2014 (UTC)

Of course not, it is pseudoscience. -Roxy the dog™ (resonate) 14:42, 19 December 2014 (UTC)

Show me a good review article that makes that conclusion. -A1candidate (talk) 14:45, 19 December 2014 (UTC)

We are going in cycles here, aren't were? Repeating the same comment multiple times doesn't make it any better. Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

I'll ask in good faith, A1candidate: do you have an ESL difficulty that made it difficult for you to understand Tgeorgescu's meaning?—Kww(talk) 14:52, 19 December 2014 (UTC)

No, but I do have low tolerance for people who debate with unsuitable metaphors. -A1candidate (talk) 15:04, 19 December 2014 (UTC)

A1candidate, it's a perfectly suitable metaphor. No one is claiming that TCM is intentionally wrong, or that the people that developed it did so with the intention of creating dangerous and ineffective treatments. As a result, they may have some practices that have some degree of validity. That doesn't mean the theoretical underpinnings have any validity at all.—Kww(talk) 16:09, 19 December 2014 (UTC)

The claim that "all aspects of TCM are pseudoscientific" is not supported by scientific literature. If you disagree, do show me a good review article that says something along that line. -A1candidate (talk) 16:56, 19 December 2014 (UTC)

The burden is on you: show a source for any effective treatment that indicates the theoretical underpinning of TCM provided a valid scientific explanation of the effect. Not a source that says "this particular herb may be effective", but a source that says "this particular herb may be effective, and the TCM theory of five phases/chi/meridians/qi provides an accurate explanation of why it is effective". You won't be able to find anything, because the theoretical foundation of TCM is pseudoscience.—Kww(talk) 19:26, 19 December 2014 (UTC)

Actually, the scientific validation of TCM concepts and therapies is done by government and mainstream health agencies in China, Singapore, Taiwan, Japan, etc. In fact, worldwide, there's much more agreement that TCM isn't pseudoscience than the opposite. I'm afraid that in this matter, as A1Candidate said, you need to show a source strong enough to back up the claim that TCM is definitively pseudoscience. The citation does not support the claim. Essentially, editors here are invoking WP:BLUE, but wrongly. "It's obviously pseudoscience, we don't have to support it with any more than an opinion piece in a magazine." If the claim was so easy to support, there would be no shortage of high quality sources and you wouldn't have to use a magazine article. As it stands, it's OR and doesn't pass the verifiability test. LesVegas (talk) 19:34, 19 December 2014 (UTC)

I am quite disappointed to see that the same arguments keep popping up over and over again. I can hardly see how the theoretical fondation of TCM could be pseudoscientific as TCM pre-dates what we call as "science". However, this article is till about acupuncture, and issues regarding traditional Chinese medicine should be discussed at talk:traditional Chinese medicine. Time to move on ladies and gentlemen? Cheers! Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

As I have suggested, it is more a problem of physics than of medicine: there is no such thing as an energy field. Tgeorgescu (talk) 20:16, 19 December 2014 (UTC)

If you need a source: http://www.csicop.org/si/show/acupuncture_magic_and_make-believe Tgeorgescu (talk) 20:21, 19 December 2014 (UTC)

That's not a scientific source. The magazine is not indexed in scientific databases and it has no impact factor. It's not even owned by a reputable academic publisher -A1candidate (talk) 20:28, 19 December 2014 (UTC)

• Kww, see PMID 24122014 for herbs and PMID 21870056 for acupuncture. -A1candidate (talk) 20:18, 19 December 2014 (UTC)

Unfortunately, I don't see that this source could be used. Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

Tgeorgescu, I understand your point, but that still doesn't substantiate the claim with the source. There's policies being violated here. The only substantiation for the sentence in question is the preconceived notions of a few editors here, and that's no substantiation at all. We have to rely on sources. But, listen, since you've made this an academic debate, on physics, I wouldn't mind adding a brief lesson in Chinese language here and how it relates to your point. The Chinese character for Qi is steam arising from rice. That's the "energy" which "Qi" means. That's the exact same "energy" we use in physics. The whole energy nonsense in TCM is really overblown by a bunch of hippies and European vitalists who are responsible for the misconception. It has no true academic basis in the Chinese language. LesVegas (talk) 20:48, 19 December 2014 (UTC)

Energy is measured in Joules, so how many Joules of Qi does one have? The CSICOP article on acupuncture has been reprinted somewhat differently in Shermer's Encyclopedia of Pseudoscience. And what better sources are there telling us what amounts to pseudoscience? As pointed at User:Jytdog/Why MEDRS?, biology or medical articles don't usually handle pseudoscience or make claims that a treatment would be pseudoscientific. So the only people busy with identifying pseudoscience are debunkers like Shermer. Tgeorgescu (talk) 21:33, 19 December 2014 (UTC)

Debunker websites are not MEDRS compliant sources. -A1candidate (talk) 22:29, 19 December 2014 (UTC)

See WP:REDFLAG. Obviously a society that systematically does what they can to ward of badness will find some remedies that at least help to make people feel better, however the claims about energy and what-have-you are pseudoscience because they are claims about how stuff works that are not supported by sources that are reliable for scientific matters. Per REDFLAG, strong sources are not needed to debunk unreliable claims. Johnuniq (talk) 23:02, 19 December 2014 (UTC)

Agree. Tgeorgescu, I have one simple advice for you: should you make a claim on medical efficiency, please lean to MEDRS compliant source. It will save you a lot of trouble. Cheers! Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

Tgeorgescu, precisely how much dopamine is secreted in the state of joy? Same language, you're just talking emphasis on quantitative versus qualitative. And listen, Shermer has his opinions as does that author for Nature. Does Shermer represent worldwide scientific consensus? There's standards on Misplaced Pages, especially when over one half of the world says it's science. REDFLAG certainly doesn't apply if insurance companies reimburse for acupuncture, (and not for gemstone healing or chakra balancing) and it receives favorable mentioning by the NIH and NHS. Not when the scientific validation of TCM concepts and protocols are done in mainstream academia and policy-making health organizations all over Asia. When all you can do is find a couple of little non MEDRS compliant references that think it's pseudoscience, you're on shaky ground. But listen, I'm sure some editors will never be convinced. I suppose we'll have to file an RfC to sort the matter out. LesVegas (talk) 23:19, 19 December 2014 (UTC)

The existence of dopamine convinced organized skeptics. The existence of Qi didn't. There is a way of identifying dopamine, a way of knowing what it is made of, its molecular mass is known, there aren't such things for Qi. Tgeorgescu (talk) 02:56, 20 December 2014 (UTC)

Misplaced Pages's purpose is to summarize scientific literature. It's not for pushing the POV of "organized skeptics" and other dubious groups. -A1candidate (talk) 09:51, 20 December 2014 (UTC)

Organized skeptics = the scientific community. That's what CUDOS means. Tgeorgescu (talk) 00:20, 21 December 2014 (UTC)

This dubious "scientific community" has yet to publish any scientific articles to support your WP:FRINGE claims. -A1candidate (talk) 02:18, 21 December 2014 (UTC)

Hilarious! Organized skepticism=one of the five norms of doing science, per Robert K. Merton. There is nothing fringe about dopamine being identifiable and measurable, the WP:FRINGE/PS stuff is the claim that Qi would be real, identifiable and measurable (in Joules?). Tgeorgescu (talk) 16:04, 21 December 2014 (UTC)

The fringe claim is that all aspects of TCM are based on pseudoscience. Merton is not a scientist but a sociologist, a profession which I generally have very low opinion of. -A1candidate (talk) 16:19, 21 December 2014 (UTC)

Tgeorgescu I'll ask you one last time in good faith: Please show me a scientific source, prefably an MEDRS compliant review, that explicitly states that all aspects of TCM are pseudoscientific. Thanks -A1candidate (talk) 16:23, 21 December 2014 (UTC)

Per User:Jytdog/Why MEDRS? that would be a highly unusual source ("People who are not experts in the field have no way of knowing which research papers have been left in the dust by the scientific community. These papers are not retracted nor are they tagged in any way. They just sit there, ignored."). Per WP:REDFLAG no such source is needed. About Merton: sociologists are busy with the scientific study of science, so you cannot leave them out if you want to scientifically understand science. Tgeorgescu (talk) 16:28, 21 December 2014 (UTC)

WP:REDFLAG does not say that we can assert non-scientific claims without citing a source. On the contrary, all assertions that are likely to be challenged should be well-sourced. User:Jytdog/Why MEDRS? is not a WP guideline but an unrelated, user-generated essay that has little to do with this discussion. Would greatly appreciate if you stop pushing the POV of Merton and other sociologists because I have no interest in them. -A1candidate (talk) 17:16, 21 December 2014 (UTC)

WP:REDFLAG says that extraordinary evidence has to exist in order to affirm in Misplaced Pages's voice that the existence of Qi would be plausible. By default, it belongs to mystical vagaries. So TCM is now pseudoscientific because it advocates medicine relying upon mystical vagaries instead of evidence-based medicine. Tgeorgescu (talk) 18:57, 21 December 2014 (UTC)

This discussion is not about qi. -A1candidate (talk) 19:40, 21 December 2014 (UTC)

...or believes pre-dating science? Jayaguru-Shishya (talk) 19:42, 21 December 2014 (UTC)

That's kind of the point, isn't it? TCM is based on beliefs that predate science, and no one has come up with a sound scientific basis for it. Efforts by dubious journals to pretend that it has a scientific basis place it into the modern category of pseudoscience, even if it began as something more accurately described as "folk belief". Acupuncture itself, while founded in TCM, seems to have some limited effect, but there's no consensus as to when it is actually effective. There isn't even a strong consensus that the effects it has aren't explained by the placebo effect. As for the relationship between TCM and acupuncture, I don't think anyone here is disputing that acupuncture's origins lie in TCM, are they?—Kww(talk) 19:54, 21 December 2014 (UTC)

Which dubious journals are you referring to? -A1candidate (talk) 21:20, 21 December 2014 (UTC)

Hi Kww, did you notice my earlier suggestion for improving the flow of the text?

If the article would say that "Acupuncture has its roots in traditional Chinese medicine", going on about TCM would be reasonable. At the moment, the article just suddenly jumps into TCM, even the article is indeed about acupuncture. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

What do you think? Cheers! Jayaguru-Shishya (talk) 19:59, 22 December 2014 (UTC)

It already states "Traditional acupuncture involves needle insertion, moxibustion, and cupping therapy. It is a form of alternative medicine and a key component of traditional Chinese medicine (TCM). ". Why do we need a stronger linkage to justify discussing TCM?—Kww(talk) 21:29, 22 December 2014 (UTC)

Indeed, it is a key component of traditional Chinese medicine, but does it derive from TCM? I tried to look for a source, but I couldn't find any so far. If we just had a source that would clearly say that acupuncture stems from TCM, it'd be quite natural to express that the very foundation of acupuncture (TCM) is pseudoscience per se. But now we are jumping out of the blue to state that "TCM is largely pseudoscience with no valid mechanism of action for many of its treatments.". Whether we will have a source that will tie this loose comment to the general context, or then we will move it to the article it belongs (whichs is traditional Chinese medicine, obviously). Merry Christmas folks! Jayaguru-Shishya (talk) 17:13, 23 December 2014 (UTC)

Finding Merton's position upon organized skepticism unreasonable is a symptom of lacking even a basic understanding of how science is being done. Tgeorgescu (talk) 01:19, 22 December 2014 (UTC)

I don't find it unreasonable, I simply have no interest in sociology and I request that you stop bringing it to this discussion. -A1candidate (talk) 01:32, 22 December 2014 (UTC)

It was not a point about sociology, it was a point about how science gets done, in any empirical science. Tgeorgescu (talk) 01:35, 22 December 2014 (UTC)

Science is based on the scientific method. All hypothesis (including the hypothesis that TCM is pseudoscientific) must be tested for validity before it's accepted. -A1candidate (talk) 01:53, 22 December 2014 (UTC)

Every scientific claim is considered unproven until there is enough evidence for it. In this case the scientific claim that TCM would be scientific is considered invalid until proven valid (instead of being considered valid until proven invalid). That's what the philosophic burden of proof means. According to Karl Popper scientists are always busy with debunking the theories of other scientists. So the most well established philosophy of science concurs with the judgment of organized skepticism. Scientists take nothing for granted, they always apply critical thinking skills to any scientific paper they read. In sciences which rely upon experiments, only repeated, reproducible experimental results really prove something, see e.g. the OPERA experiment and how reluctant was the physics community to accept it as valid (even when they did not knew that the results were due to a bad cable). Tgeorgescu (talk) 02:15, 22 December 2014 (UTC)

I'm not claiming that TCM is scientific. -A1candidate (talk) 04:19, 22 December 2014 (UTC)

Kww I am disputing that acupuncture has its origins in TCM. That would be like saying the practice of prayer has its origins in big Protestant mega-churches. The style known as "TCM" was created in the 1950's under orders from Mao who appointed a commission composed of Western trained Chinese medical professionals and scholars who had a knew very little about the acupuncture classics. They blended it with Western medical organ concepts, and the whole end result is radically different from the styles of practice which came before it. It would be more accurate to say that acupuncture has its origins in classical texts such as the "Huang Di Nei Jing Su Wen" (Yellow Emperor's Inner Classic) although in this text we read acupuncture needles had been used for many years prior to it. So, in other words, the practice of acupuncture predates "TCM" by at least a couple thousand years. There's so many other styles. TCM style is predominate in modern day China, and that's about it. Nobody who lived under Imperial rule in China ever practiced it. So in addition to modern Chinese, modern Chinese-American practitioners practice it, but, from my experience, most Western-born acupuncturists do not (even the ones who graduate TCM-style schools.) There's so many other styles of acupuncture anyway, there are Japanese styles, Five Element style (very popular in California and the North-East, from my experience), classical style based on the previously mentioned text, and there's even modern trigger point styles used by chiropractors and physical therapists. Scholastically, this article is kinda embarrassing in its mentioning of TCM as the style in which acupuncture originated; it's not even close to being accurate. And that's not to disparage anybody who thinks TCM is thousands of years old, either. When I first found out about acupuncture in China, that's what I thought as well. It's a common mistake, but why perpetuate it on this encyclopedia? "TCM" is a misnomer as well. It's not "Traditional" because it's only been around since 1950, it's not even really "Chinese" because, it's heavily influenced by Western medical concepts. If there were a "TCM bias tag" on Misplaced Pages, II would put it at the top of this article, because the whole thing is written around just this style alone. LesVegas (talk) 01:04, 23 December 2014 (UTC)

The source is not a review, but speculation, and we don't do that on WP, per WP:NOT/ If ifs and buts were candy and nuts, it would be Christmas every day. Furthermore, the source is a rather low impact journal, not the type of source that would suffice for extraordinary claims per WP:REDFLAG. Dominus Vobisdu (talk) 23:31, 4 January 2015 (UTC)

Hi Dominus, this point was discussed in this edit above. You might not have seen it because this thread is quite disorganized. BTW, journal impact factor has no bearing on whether or not a source can be used. If it's low, then we place it lower than journals with a higher impact factor but we don't disregard the source. Regardless, it actually does have a rather solid impact factor, higher than many other journals we source from regularly on this and other articles. It is also definitely a secondary source since it comments on primary ones, but, anyway, I go into that in further detail in the diff I provided. LesVegas (talk) 23:55, 4 January 2015 (UTC)

Well it looks like Bull Rangifer and I came to the same conclusion, and no, I don't buy your case. It does not conform with our policies and guidelines on sourcing or NPOV. Dominus Vobisdu (talk) 00:05, 5 January 2015 (UTC)

Actually, I made these points after Bull Rangifer's explanation and showed that it was a review, per Misplaced Pages's definition. He never responded, even after pinging him, so I assume he gave up his objection. Would you mind explaining your objections in greater detail than "I don't buy your case"? And which policies and guidelines, specifically, does it not meet? What part of NPOV does it violate? Again, please be as specific as possible because it's hard to understand where your objections lie when you are this vague and abstract. I'm sorry to make you go through this much effort but I really want to engage in a thoughtful discussion with you on this matter, instead of edit warring ad-nauseum. Also, did you read my points? Specifically, what did you think about my point regarding MEDRS's definition of a "review", and how it defines literature and narrative reviews? LesVegas (talk) 03:35, 5 January 2015 (UTC)

Citation out of context

The citation: "TCM has been described as mainly pseudoscience, with no logical mechanism of action for the majority of its treatments" has bee largely discussed at RfC: Is the Nature article an appropriate source for the claim it is attached to?. As several editors have brought up, the citation is taken out of context. The paragraph in whole says the following:

So if traditional Chinese medicine is so great, why hasn't the qualitative study of its outcomes opened the door to a flood of cures? The most obvious answer is that it actually has little to offer: it is largely just pseudoscience, with no rational mechanism of action for most of its therapies. Advocates respond by claiming that researchers are missing aspects of the art, notably the interactions between different ingredients in traditional therapies.

There are multiple issues with respect to using the source:

1. The editorial does not say that traditional Chinese medicine is pseudoscience. Moreover, it just lists that as a possibility.
2. The paragraph is bringing forth the both sides, and it gives pretty much equal weight for both.
3. Nature is not using their own voice claiming that TCM would be pseudoscience, it is merely describing that as the position of opponents.
4. When restoring the context, it is mainly about TCM; this article is about acupuncture, and acupuncture that article does not discuss (cf. "...interactions between different ingredients in traditional therapies.")

I'd like to suggest removing the entries - that have been backed up by the Nature editorial - concerning the pseudoscience question. We don't need to force an out-of-context citation that doesn't fit the article when there are better sources available. For the evident, there must be. Jayaguru-Shishya (talk) 01:15, 11 January 2015 (UTC)

I think the consensus at the recent discussion at Talk:Traditional Chinese medicine contradicts you, and most of us think that the editorial is clearly describing TCM as pseudoscience. The remainder of the editorial makes it pretty clear that the "advocates" can't be taken seriously. Later in the same editorial, you can find the text "But it seems problematic to apply a brand new technique, largely untested in the clinic, to test the veracity of traditional Chinese medicine, when the field is so fraught with pseudoscience.". That's not a suggestion that it's possible that it may be pseudoscience, that's a direct statement that the field is fraught with pseudoscience. You phrased this as a suggestion, so may I make a suggestion of my own? I would like to suggest that the next time you want to misrepresent the contents of a source, you should refrain from doing so.—Kww(talk) 04:43, 11 January 2015 (UTC)

Consensus? I counted all the votes, and it seems that 10 editors supported, and 10 editors opposed. One of the supports was a "weak support", which is pretty ambiguous. There were also two votes (Yobol and Matthew Ferguson 57) that were rather ambiguous as well.

As we very well know, "consensus is not a vote". What matters is the quality of arguments. According to WP:CON:

The quality of an argument is more important than whether it represents a minority or a majority view. The arguments "I just don't like it" and "I just like it" usually carry no weight whatsoever.

Taking this into account, it seems there is a majority opposing the RfC (7-10). We don't give any weight for "I just don't like it". Cheers! Jayaguru-Shishya (talk) 15:18, 11 January 2015 (UTC)

Neither can we give much weight to people that either intentionally or unintentionally misread the quote. The review doesn't just "list as a possibility" that TCM is pseudoscience, it directly states that the field is "fraught with pseudoscience". Recognizing that TCM is based on superstition goes beyond just "not liking it".—Kww(talk) 17:45, 11 January 2015 (UTC)

Weight violation

I deleted the WP:MEDRS violations. They are not reviews. I also fixed the wording for the 2011 review and added safety information from a review. I also fixed the formatting for refs in the other conditions section. QuackGuru (talk) 08:46, 14 December 2014 (UTC)

I previously explained the text that was recently added was about the images. The misleading text was asserted in Misplaced Pages's voice and was not the conclusion the source made. I also explained the problem with the wording for another sentence. I explained this in my edit summary the wording for the 2011 review but no specific objection was made by other editors. The MEDRS violations were restored along with other non-neutral text. The formatting for the sources in the other conditions sections were fixed but it was reverted without explanation and sourced text to a review in the safety section was also deleted without explanation. This shows an editor blindly reverted because the editor deleted information from the safety section. QuackGuru (talk) 05:22, 15 December 2014 (UTC)

The contents I careless deleted during I revert the deletion from you had been re-added. Now the problem got solution. Miracle dream (talk)

There are still other problems with your edits such the MEDRS violations. I went ahead and restored the other sentence you deleted to the correct section and fixed the refs again. QuackGuru (talk) 20:41, 15 December 2014 (UTC)

"A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity." This was a cut and past. See Acupuncture#Headaches and migraines.

"A 2014 Australian clinical study involving 282 men and women showed that needle and laser acupuncture were modestly better at relieving knee pain from osteoarthritis than no treatment, but not better than simulated (sham) laser acupuncture." This was a cut and past. See Acupuncture#Extremity conditions.

"According to NCCAM, results of a systematic review that combined data from 11 clinical trials with more than 1,200 participants suggested that acupuncture (and acupuncture point stimulation) may help with certain symptoms associated with cancer treatments." This was a cut and past. See Acupuncture#Cancer-related conditions.

There is no need to use a poor source when we are citing systematic reviews and Cochrane reviews. This is a WP:weight violation (and possible MEDRS violation) IMO. Rather than cite NCCM we should cite the systematic review itself and high-quality reliable sources. See WP:SAYWHEREYOUREADIT. QuackGuru (talk) 23:00, 15 December 2014 (UTC)

In the context of an article already bloated with weak positive studies, seemingly included in order to cast doubt on the consensus view that the weak positive results are fully consistent with the null hypothesis, I agree that Cochrane review is all we should need here. Guy (Help!) 09:52, 17 December 2014 (UTC)

@ JzG: Where is the proof that this is the consensus view let alone a majority one? Source(s) meeting WP:RS/AC? On the contrary, the best MEDRS we have (Vickers, an IPD meta-analysis) finds for efficacy for several kinds of pain; the sources criticizing it don't even come close to being at the same level as MEDRS's; and contrary to the assertions of acu-critics, there are other mainstream sources that accepted it (Medscape outweighs Novella and Gorski). See my comment at recent ArbCom request , and feel free to provide rebuttal. Based on your respective comments, you or Kww apparently fail to understand the literature or WP:MEDRS. For example, it appears (from what you consider to be sci consensus) that you seem to think that a bunch of blogs by alt-med critics, which are barely MEDRS's, outweigh sources like Medscape and a peer-reviwed IPD meta-analysis. --Middle 8 (contribs • COI) 12:21, 8 January 2015 (UTC) (edited to add diff 13:09, 8 January 2015 (UTC))

No, Middle 8, I don't think blogs "outweigh" MEDRS sources. What I do think is that if you study a placebo often enough, you will wind up with a group of MEDRS sources that are false positives: slightly flawed studies that hint at some kind of effectiveness. Combine that with politically-motivated organisations like NCCAM, and it's easy to construct an article that either falsely gives the impression that acupuncture has medical validity, or, at the very least, an article that is so bloated with cherry-picked references that the reader has a hard time picking up on the fact that it has no medical validity. I think the whole "evidence" novella we have here should be replaced with a short summary, something close to "the benefits of acupuncture are likely nonexistent, or at best are too small and too transient to be of any clinical significance". Our current style of "this study found inconclusive ..." followed by "this study found inconclusive ..." followed by "this study found inconclusive ..." serves to do nothing but highlight false positives and obscure the central point: repeated studies of acupuncture have not found any substantial and repeatable effect relative to placebos.—Kww(talk) 13:39, 8 January 2015 (UTC)

@ Kww - I partially agree with you re waffling about inconsistent results: we should be concise and explicit where uncontradicted sources themselves report inconsistent results (i.e. some trials being positive, some not, as is so with Cochrane reviews do for most conditions). In those cases, we should simply list those conditions in a single paragraph or sentence and be done with it. We do so in the section Acupuncture#Other_conditions and perhaps could put other conditions there, or create another section if needed. (Note that some of the wordiness in the efficacy section and elsewhere is due to one editor, an very active acu-critic, who is very dug in with their stance that virtually any paraphrasing is OR.) That said, when multiple sources (MEDRS's i.e. reviews) contradict one another, we must so indicate, even if you and/or Novella disagree. That's because not all MEDRS agree with Novella; he could be wrong about the few conditions where there is debate. Again, a number MEDRS that disagree with him are as strong or stronger MEDRS than his editorial or his blog posts, so we can't frame the former the way the latter would. That's the state of the literature, which we are obliged to depict per NPOV. --Middle 8 (contribs • COI) 14:10, 8 January 2015 (UTC)

Sticking to notable medical publications should take care of that. It is not our job to speculate whether the peer review procedure of some respected journals are wrong, or if someone thinks that a mistake must have happened. No twisting the sources in either way, I'd say. When it comes to blogs, wasn't it concluded that blogs could be used on a case-by-case basis if the blog complements claims that have been backed up by sound MEDRS?

The paraphrasing issue has been noticed by several editors already, and we can start working on that one too. Important is that we avoid plagiarism by not including pieces of text too close to the source. "Be bold", of course, but I'd like to encourage editors to also include such problematic passages here on the Talk Page for public view so that a larger audience could easily work on them. Cheers! Jayaguru-Shishya (talk) 17:09, 9 January 2015 (UTC)

Previously, I don't know much about the rule for MEDRS. Hence, I don't know what is the difference between the reliable source required in this article and in others. For other articles, it must be an undoubtedly reliable source which is from official organization from U.S. government. However, I don't know the rule in this article. Hence, I wait others comments.

Now user User:BullRangifer opened a discussion in Misplaced Pages talk:WikiProject Medicine#NCCAM as a MEDRS?.I knew User:BullRangifer thought NCCAM was unbelievable. User:QuackGuru, you also joined in that discussion , I don't know why you opened a new discussion. From I read by now,it seems it hard to say source from NCCAM is MEDRS violation. The comment made me believe this is someone wrote like this" says: "Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include....U.S. National Institutes of Health"

Based on this comment, I read the . It clearly said "include the U.S. National Academies (including the Institute of Medicine and the National Academy of Sciences), the British National Health Service, the U.S. National Institutes of Health" It means the rule of MEDRS thought the source from U.S. National Institutes of Health is MEDRS compliant. As we know, NCCAM is a part of U.S. National Institutes of Health. It made me very confused every source from NIS is MEDRS compliant why NCCAM is MEDRS violation. Then for the ongoing debate in Misplaced Pages talk:WikiProject Medicine#NCCAM as a MEDRS?. It seems someone really agreed that NCCAM is MEDRS compliant, such as User WhatamIdoing. By now, the discussion is ongoing. It means consensus hasn't been reached.

For the contents I cited, I use the comments from User WhatamIdoing

• • In the instant case, the statement says, "A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity."
  • The source cited was What the Science Says About the Effectiveness of Acupuncture-For Heaache from National Center for Complementary and Alternative Medicine.
  • The relevant contents of the NCCAM website are, "A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity"—word-for-word what the NCCAM webpage says. (There's no copyvio here, because there's no copyright in US government works.)
  • Is this webpage reliable for these contents (i.e., for describing the contents of some other source)? Yes.
  • Would the underlying "analysis of data in... acupuncture studies" be exactly the sort of meta-analysis that MEDRS promotes? Yes. Or, at least, it is presumably the sort of source that MEDRS holds in highest esteem, although it's possible that there would be some serious failing (e.g., not ever having been published).
  • In particular, it would be really silly to say that it's excellent for a Misplaced Pages editor to read that meta-analysis and write his own description of it, but that it's impossibly bad to have actual professionals read that study and write a description of it. Amateurs are not always better than professionals, especially when it comes to evaluating something technical. Also, if your information comes from NCCAM, then WP:SAYWHEREYOUGOTIT applies, and you aren't permitted to cite the original meta-analysis (unless and until you obtain the paper and read it).

I don't know whether it's Ok to use other Users' comment. If it is some rule violation, please notice me and I will delete these comments from User WhatamIdoing. However her comments is some kind of what I agree with.

I made a conclusion here. The rule at least what I read in clearly said source from U.S. National Institutes of Health is MEDRS compliant. Then NCCAM is part of U.S. National Institutes of Health. It should be compliant based on this rule. Then there is an ongoing discussion in Misplaced Pages talk:WikiProject Medicine#NCCAM as a MEDRS?. The consensus hasn't been reached. Hence,you cannot get the violation from this discussion. I think users can join the discussion in that page instead of this one. Then some reason why NCCAM is MEDRS violation like "NCCAM is populated and operated mostly by pro-AM people" " Even Cochrane reviews are becoming dubious sources, so even with reviews we must be wary" "Our MEDRS guideline is much better than the standards of NCCAM and most peer reviewed medical journals. We should be proud of that and not lower our standards." from User:BullRangifer made me feel like a wiki academic research result by wiki Users which I thought it's totally an original research. 17 December 2014‎ Miracle dream (talk)

NCCAM was set up by believers in woo, is designed to produce evidence supportive of woo, and has a history of publishing credulous articles about woo. That said, for the expenditure of something like one and a half billion dollars, it has yet to validate a single alternative treatment. And its latest rebranding suggests it's not even going to try any more. Guy (Help!) 23:21, 20 December 2014 (UTC)

Hmm... Moving from the level opinions to the level of evidence-backed claims, NCCAM is set up by the U.S. Federal Government. As far as I understand, its focus is on objective investigation on the usefulness of CAM; trying to present only positive results is not part of their agenda. Small quotes from their website:

The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government's lead agency for scientific research on complementary and alternative medicine. We are 1 of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services.

On their mission and objectives (emphasis added):

The mission of NCCAM is to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care. Develop and disseminate objective, evidence-based information on complementary and alternative medicine interventions.

"Woo studies" will most likely have "woo results", or even employ "woo methods". If there is some publication bias in favour of pro-CAM research results, though, I am quite sure there are studies about that available. There are different statistical methods, such as funnel plot, that scholars employ in order to study the presumed publication bias. If a national body like NCCAM would blatantly exhibit such bias, it'd surely have been studied and reported. Cheers! Jayaguru-Shishya (talk) 17:31, 21 December 2014 (UTC)

"A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity." There is a lack of consensus for this text. See Acupuncture#Headaches and migraines. We are currently using better sources including a Cochrane review in this section.

"A 2014 Australian clinical study involving 282 men and women showed that needle and laser acupuncture were modestly better at relieving knee pain from osteoarthritis than no treatment, but not better than simulated (sham) laser acupuncture." There is a lack of consensus for this text. See Acupuncture#Extremity conditions. We are currently using better sources including a Cochrane review in this section.

"According to NCCAM, results of a systematic review that combined data from 11 clinical trials with more than 1,200 participants suggested that acupuncture (and acupuncture point stimulation) may help with certain symptoms associated with cancer treatments." There is a lack of consensus for this text. See Acupuncture#Cancer-related conditions. We are currently using better sources including a Cochrane review in this section.

See Misplaced Pages:Identifying reliable sources (medicine)#Medical and scientific organizations: "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 Institute 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 range from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature."

I think the key word is reputable, according to the wording of MEDRS. For example, the reputations of NIMH and NCI are significantly different than that of NCCAM. Therefore, the question is clearly due weight. Since it is not clear that NCCAM (see National Center for Complementary and Integrative Health#Criticism) is a reputable organisation we should leave the text out of the Acupuncture#Effectiveness section, especially when effectiveness is bloated with a number of better sources. QuackGuru (talk) 23:05, 31 December 2014 (UTC)

Maybe you didn't notice the very comment above? Cheers and Happy New Year! Jayaguru-Shishya (talk) 00:36, 1 January 2015 (UTC)

• Sigh... the problem here is that both proponents and opponents of acupuncture are trying to use this article to "prove" that their view point is correct. The solution is to avoid doing so... and that goes for both sides of the debate. It is fact that proponents make all sorts of claims about the benefits of acupuncture... it is fact that many if not most of those claims are refuted by the medical community. That is really all the article needs to say. There is no need to go into details and site studies to "prove" and "disprove" that acupuncture works.

The debates that keep cropping up at this article would be resolved if Misplaced Pages treated alternative medicine topics the way we treat religious topics. We should discuss the topic in terms of belief... state who believes what (cited by sources supporting the fact that they believe it), but stop there. Have some respect for the fact that different people believe different things... and don't try to "prove" that those beliefs are true or correct. In terms of belief... a statement like "Acupuncture cures cancer" is really not all that different than a statement like "Jesus died for our sins." Blueboar (talk) 15:47, 1 January 2015 (UTC)

It appears editors who have concerns with the source at project medicine are User:BullRangifer, User:Stuartyeates, and User:Tgeorgescu. See Wikipedia_talk:WikiProject_Medicine/Archive_57#NCCAM_as_a_MEDRS.3F. The tags were removed right after I made this comment. This was not a response to my previous comment. We should remove the poor evidence because we are using much better sources. We should not use poor evidence to argue against higher-quality evidence. We should strive to use the best evidence rather than continue to bloat the sections with bad sources. QuackGuru (talk) 21:44, 1 January 2015 (UTC)

Why is there a need for "evidence" at all... we don't bother to provide "evidence" in religion articles... we present the fact of belief, and leave it at that. The same can be done here. Blueboar (talk) 23:00, 1 January 2015 (UTC)

"Jesus died for our sins" isn't falsifiable. "Acupuncture heals many diseases" is falsifiable. Tgeorgescu (talk) 19:45, 2 January 2015 (UTC)

Just to let everyone know, the issue of NCCAM sources has been resolved on the wikiproject medicine talk page where it received broad support amongst uninvolved editors because it is part of the NIH. The NIH is explicitly mentioned in MEDRS as a reliable source. I hope this resolves any misunderstanding and keeps these sources from being tagged in the future. LesVegas (talk) 21:07, 3 January 2015 (UTC)

Les, I disagree with you on a lot of things, but this is the first time I have caught you blatantly lying. There's nothing in the linke you have cited that could even be misunderstood as "broad support amongst uninvolved editors". Nothing at all.—Kww(talk) 21:13, 3 January 2015 (UTC)

Kww, it appears MiracleDream, Tgeorgescu, MrBill3 and Brangifer are involved editors who posted their opinions about it. That leaves Whatamidoing and Mast Cell as the ones I meant who were uninvolved as I don't believe they have edited here before. Am I wrong here? Anyway, I would appreciate if we could all keep from calling each other liars before hearing the other party out. No big deal, I forgive you, I just don't want the talk page to turn into more of a battleground environment than it already is. For the record, here are a couple of comments from these uninvolved editors:

I personally have a pretty dim view of NCCAM (although it has improved somewhat over time from its especially inauspicious beginnings). That said, NCCAM clearly meets our sourcing bar as described in WP:MEDRS; it's part of the NIH and thus falls under "reputable major medical and scientific bodies". MastCell Talk 21:42, 17 December 2014 (UTC)

I agree. In the end, we have to choose between publishing what established (perhaps "entrenched" would be a better word) editors believe is The Truth™, or publishing what the sources say, giving the various viewpoints in due proportion to their prominence. If you're doing the latter, then you have to take NCCAM on the same footing as NIMH or NCI. WhatamIdoing (talk) 00:04, 18 December 2014 (UTC)

Anyway, I hope that clears things up, KWW. Peace!LesVegas (talk) 21:33, 3 January 2015 (UTC)

In what universe does two editors constitute "broad support" in a discussion where you had to discard twice as many opinions? I stand by my characterization: you are intentionally misrepresenting the contents of the discussion.—Kww(talk) 23:09, 3 January 2015 (UTC)

His statement says broad support amongst uninvolved editors. You are taking it out of context -A1candidate (talk) 23:29, 3 January 2015 (UTC)

2 for 2 is not "broad support" under any definition of the term.—Kww(talk) 23:36, 3 January 2015 (UTC)

Taking a quick glance at the discussion, I don't see any uninvolved editor opposing NCCAM per se. In any case, it's the strength of the arguments that counts, not the number of votes. -A1candidate (talk) 23:41, 3 January 2015 (UTC)

Actually, Kww, there was a third editor, an anonymous one who also supported it. But that's beside the point. It appears an involved editor, Brangifer, took the question to the WikiProject Medicine page as a sign of good editing, since said user was involved in the removal of the NCCAM sourcing. Brangifer asked, Miracle Dream also involved, also chimed in, and uninvolved and respectable editors replied that NCCAM is the NIH and therefore MEDRS. As is usually characteristic of this article, a number of involved editors also made their way to the argument but I'm not counting those names. The whole purpose of posting on a page like ProjectMedicine talk is to get an outside POV and that outside POV was unanimously in favor of the sources. I'm glad Brangifer took the issue to this page instead of edit warring. I'm also glad uninvolved editors chimed in. And, anywho, I stand by what I said. These editors (except the anonymous one) repeatedly and passionately argued their points as well. No other uninvolved dissenting opinions weighed in on the meat of the issue, so that's why I said what I said. You said there's nothing that could even be "misunderstood" as broad consensus, do you still stick by that? Kew, listen, I should probably address an issue with you: on John's talk page you said that you wanted me and other editors banned even though we use good behavior. You think my POV is dangerous, and I suppose this could be seen as an issue where you're trying to smear me in hopes of achieving your goal. Call me whatever you want, it's fine, but this is the last response you will hear from me on this issue. Ultimately, talk pages are for discussing the article and this is already enough of a battleground zone. I'm only going to respond to the actual point at hand here on out. LesVegas (talk) 00:12, 4 January 2015 (UTC)

I think your fervent defense of your misrepresentation of facts speaks pretty much for itself, and any reader that comes across your statement will quickly recognize that you were misrepresenting the discussion. Yes, I do consider editors that misrepresent sources and discussions to be a danger to the encyclopedia, and find it a shame that other admins are deceived by the polite facade. It really does come down to petty things like this: describing statements by two editors as "broad support" isn't a difference of opinion, it's a lie. That you would repeat it magnifies the sin, and that A1candidate defends it makes him an accomplice.—Kww(talk) 00:22, 4 January 2015 (UTC)

Wow wow wow... let's keep the cool, shall we?

Les, I disagree with you on a lot of things, but this is the first time I have caught you blatantly lying. Kww(talk) 21:13, 3 January 2015 (UTC)

WP:CIVIL is something we all absolutely have to follow, isn't it?

As far as I am concerned, I clarified in this edit that NCCAM is an organization set up by the U.S. Federal Goverment, and that "its focus is on objective investigation on the usefulness of CAM; trying to present only positive results is not part of their agenda.".

If one seriously wants to question a governmental organization and their objectivity, please do present some sources. If there is some criticism/bias, it sure has been investigated by statistic methods in academic literature. If it has not been studied, well there is an obvious reason why it has not been studied. Of course, there still exists the "conspiracy section", but Misplaced Pages isn't a place for that kind of nonsense. Cheers! Jayaguru-Shishya (talk) 00:48, 4 January 2015 (UTC)

FWIW, I would have opposed that as well had I seen it. The basic idea is that NCCAM is not accepted as an authority by the scientific community to the same degree as other branches of the NIH (which should indeed be treated as reputable authorities). In response to the request for sources, I searched the Nature and Science archives (search terms: NCCAM criticism, NCCAM reputation, etc) and found:

• Nature Reviews Cancer: "the subject of rancorous scientific and political debate over its mission and even continued existence"
• Clinical Rheumatology: "The criticism repeatedly aimed at NCCAM seems justified, as far as their RCTs of chiropractic is concerned. It seems questionable whether such research is worthwhile."
• Nature News: "still draws fire from traditional scientists", "Many US researchers still say such funding is a waste of time and money."
• Science News: " is a political creation"; "This kind of science isn't worth any time or money" (quoting Wallace Sampson)
• Science Policy Forum: " was created by pressure from a few advocates in Congress"; "NCCAM funds proposals of dubious merit; its research agenda is shaped more by politics than by science; and it is structured by its charter in a manner that precludes an independent review of its performance"; "NCCAM is unable to implement a research agenda that addresses legitimate scientific opportunities or health-care needs"

Of course some of these also say some good things about NCCAM, e.g. saying that they've gotten better in recent years, and I also found a couple of articles that are generally positive (while acknowledging the criticism). Likewise I found other critical sources that are weaker or make mainly indirect statements. This set of links is just to demonstrate the point. :-) Sunrise (talk) 02:24, 5 January 2015 (UTC)

Thanks Sunrise! That's exactly what I mean, sources to back up claims :-) Anyway, I took a quick look over the sources, and it seems that only one of them is publicly available. Besides the exact quotes, of course, the reader needs to know the exact material, many times the whole text too. Anyway, the Nature News source that I was able to access though, says the following things (boldings mine):

Well, for better or worse, the Nature News source isn't exactly MEDRS compliant, and has been refused here even earlier. I'll see if I can access the rest of the sources through my University network at better time though, this weekend at the latest. Or if you don't mind, would you care sending me those studies? =P Cheers! Jayaguru-Shishya (talk) 17:00, 5 January 2015 (UTC)

I hatted the quotes to make the page easier to read (I hope you don't mind!) I'm happy to send you the articles/post more context/post links if you can't access them yourself.

I completely agree that the sources contain both positive and negative statements. Like I said, my comment was only intended to illustrate that plenty of negative statements exist. This is sufficient to prove the point: NCCAM is frequently criticised in high-quality publications in a way that the other NIH branches are not.

Also, the question of the reliability of NCCAM is AFAIK not itself subject to MEDRS; i.e. we can use high-quality non-MEDRS sources (such as Nature News) to help determine whether a source is MEDRS. Regardless, there are MEDRS sources in the list. :-) Sunrise (talk) 01:45, 6 January 2015 (UTC)

Greetings Sunrise! Could you do that? I would truly appreciate it! I'll email you here through Misplaced Pages so you'll get my email address!

With that Nature News source, it reresented just individual opinion by this guy named Steven Novella. :P Cheers! Jayaguru-Shishya (talk) 15:35, 6 January 2015 (UTC)

Just a note -- I agree that Sunrise's quotes demonstrate a significant view among scientists that NCCAM is of dubious reliability. But they don't necessarily indicate a general level of skepticism across the scientific community as a whole. Sunrise's quote "The basic idea is that NCCAM is not accepted as an authority by the scientific community to the same degree as other branches of the NIH" could be taken as saying the former and/or the latter, and I don't agree that the quotes support the latter. Regards to all. --Middle 8 (contribs • COI) 20:54, 8 January 2015 (UTC)

So you are inclined to reject an accurate statement because you believe it may imply another statement? Can you provide a wording to say that "The basic idea is that NCCAM is not accepted as an authority by the scientific community to the same degree as other branches of the NIH" that you wouldn't reject with such an argument?—Kww(talk) 21:02, 8 January 2015 (UTC)

@ Kww -- No, the burden is on those who want to assert anything more than the significant view supported by Sunrise's quotes. Same idea with regard to pain and nausea: given sources indicating a significant view (and equally-good sources that disagree), editors are tending to make the unjustified leap that those same sources prove consensus. --Middle 8 (contribs • COI) 22:25, 8 January 2015 (UTC)

@Jayaguru-Shishya: I haven't received your e-mail. On the Nature News source, it's a regular article (not opinion or newsblog), so it's subject to editorial review. This makes it no less reliable (quite a bit more actually, in this context) than a regular article in the New York Times or Washington Post.

@Middle 8: Yeah, saying it's a significant view is all I was trying to establish (well, that and the corollary on source reliability). No ambiguity intended! I hoped my last few sentences would make that clear, but perhaps not. @Kww: From the first sentence of Middle 8's comment, I'm pretty sure they're agreeing. :-) Sunrise (talk) 01:12, 9 January 2015 (UTC)

Well, agreeing up to the point of it actually making a difference in article content. Then there seems to be a certain reticence to actually treat NCCAM as a less reliable source of information or describe it as such.—Kww(talk) 01:57, 9 January 2015 (UTC)

Greetings Sunrise! Did you receive my email already? :P Anyway, if I remember right about using "Nature News", it was here at acupuncture or traditional Chinese medicine where it got discarded as a source? Well, I believe that other editors are wiser with this one, so I leave it up to them :-) I'll try to have a look at a better time. Jayaguru-Shishya (talk) 17:15, 9 January 2015 (UTC)

In March 2009 a Washington Post staff writer reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine, quoting one of them, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, saying "One of our concerns is that NIH is funding pseudoscience." They argued that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and have shown little or no effect. See Alternative_medicine#cite_ref-Brown2009_185-1. QuackGuru (talk) 07:11, 11 January 2015 (UTC)

Salzberg doesn't like the NCCAM? Well, it must not be a MEDRS, then, that surely settles it. --Middle 8 (contribs • COI) 14:58, 11 January 2015 (UTC)

No single scientific consensus on efficacy for pain or nausea

Lately I've seen some comments suggesting there is a single scientific consensus on acupuncture's efficacy overall (i.e. for any condition). That stance isn't supportable; disagreement remains on pain and nausea (but not most other conditions, where consensus is "no good evidence for efficacy" and/or "good evidence for no efficacy". (There is of course a certain range beyond which there's no disagreement; no major MEDRS argues for a large effect size, AFAIK.)

See e.g. above from JzG/Guy (diff) and at Arbcom from Kww (diff). Both assert a general consensus covering all conditions, yet neither meets the burden of evidence, and can only show the existence of a significant view (which nobody ever doubted). That's because there are multiple excellent MEDRS's that disagree with one another. For pain, Vickers' review contradicts the Ernst's recent ones, and if anything Vickers is a stronger MEDRS than Ernst. It's the strongest type of the strongest MEDRS: a meta-analysis using individualized patient data (IPD), which is the most rigorous approach, the "gold standard", a way to find information other good reviews have missed . Far from being generally discredited as skeptics tend to assume (from within the bubble of the skeptical blogosphere?), Vickers was accepted by other good sources, e.g. the well-respected Medscape .

For more, see my comments at Arbcom (diff) responding to Kww, and at WP:AE (diff 1; (diff 2). No hard feelings toward either editor, of course; apart from this misreading of the literature, they're both highly clueful (and I hope it's obvious that I raise the issue for its own sake, not to be vexatious). Anyway, I was able to provide sources at least as strong as the sources Guy and Kww did, proving that there is >1 significant view on nausea and pain. But again: there's no discernible consensus view for either condition (and I'm not even sure there's a discernible majority view). And there will be no consensus as long as excellent MEDRS's disagree with one another. --Middle 8 (contribs • COI) 22:10, 8 January 2015 (UTC)

There are two distinctions to be made. First, the claim that it does relieve pain or nausea would require a strong consensus, as it's a remarkable claim and there is no consensus as to exactly how it could do either of those things. Second, the claim that the both views are equally supported by "excellent MEDRS's" is questionable: NCCAM's reliablity is in question, and many of the other supporting studies come from China, where there is certainly a political pressure to find positive results. The bias of Chinese studies is also supported by reliable sources.—Kww(talk) 23:42, 8 January 2015 (UTC)

I agree with Kww partly. I consider it's even more likely that there are studies about the possible publication bias concerning NCCAM (a Federal Government's agency in the U.S.); the Chinese language itself might set certain barriers when it comes to studies conducted in Chinese language. I remember some publication bias studies concerning Chinese scientific literature in the field of economics; it was research called "Meta-analysis of China’s business cycle correlation", and there was also studied whether the Chinese publications had any bias concerning the research. Well, as I said, the language-barrier might be a quite restrictive one; the study was carried out, thanks to the help of a Chinese research assistant.

However, claims on medical efficiency do require MEDRS compliant secondary sources. The scientific literature will discuss the consensus, that's not something we need to speculate. Cheers! Jayaguru-Shishya (talk) 17:21, 9 January 2015 (UTC)

@Kww - re your #1, it's simple; we just weight sources properly. If we have two reviews of comparable quality (good methodology, good journal), and one finds evidence for nausea and another doesn't, we just summarize and present them, and mechanism isn't really relevant (there are lots of possibilities, none of which require invoking qi). Most of the time, in this topic area, reviews will tend to be negative, but when they're not, we don't have to reinvent the NPOV wheel.

re #2 - you're right, it all depends on the source. For pain, Ernst and Vickers are both at the highest level, so again, we just present them side-by-side. --Middle 8 (contribs • COI) 20:16, 9 January 2015 (UTC)

No, when one journal is making an an extraordinary claim without plausible explanation and the other one doesn't, we go with the one that doesn't and dismiss or downplay the one that does. That's weighting sources properly. Your method highlights false positives because, unsurprisingly, it's those false positives that people are so eager to include.—Kww(talk) 22:10, 9 January 2015 (UTC)

Agree with KWW, per WP:REDFLAG and WP:GEVAL. Extraordinary claims require extraordinary sourcing, and in this case the burden of proof is on the side making the extraordinary claim, not the scientific default of non-effective. Dominus Vobisdu (talk) 22:53, 9 January 2015 (UTC)

Kww, as much as I appreciate your enthusiasm to the article, that's certainly something we should leave for the scientific research to decide. If we have a notable source, it is not our job in Misplaced Pages to speculate on the quality of their peer review process. If positive results do exist, then we will include within the range of proper weight naturally. Cheers! Jayaguru-Shishya (talk) 23:36, 9 January 2015 (UTC)

As above, Jayaguru-Shishya, no. Such an approach will invariably drift towards overemphasis of false positives. That's why WP:REDFLAG and similar concepts exist. Our role as editors is to compensate for source bias.—Kww(talk) 02:02, 10 January 2015 (UTC)

Incidentally, User:Middle 8, I would consider Vicker's "Although the data indicate that acupuncture is more than a placebo, the differences between true and sham acupuncture are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to therapeutic effects" and Novella's "the benefits of acupuncture are likely nonexistent, or at best are too small and too transient to be of any clinical significance" to be in substantial alignment, differing primarily in the value judgement of whether a trivial impact is worth paying for, not in whether the impact is trivial. Vicker's judgment continues that "Even though on average these effects are small, the clinical decision made by physicians and patients is not between true and sham acupuncture but between a referral to an acupuncturist or avoiding such a referral". i.e. the value of acupuncture including the placebo effect is enough that he considers it worth the payment. There's no controversy that if there is an actual, non-placebo based benefit derived from acupuncture, it's small. There is a scientific consensus on that point. No reputable source is claiming that there is a substantial benefit relative to placebos.—Kww(talk) 02:36, 10 January 2015 (UTC)

That is a reasonable (and intelligent) observation. Saying that we should exclude Cochrane reviews whose conclusions we don't accept is not (reasonable). The benefit (if it is real and not an artifact of bias) is small or modest (like Advil or Zofran): nobody who is reality-based disputes that. What is debated is whether it is clinically relevant, and a "yes" conclusion in a meta-analysis is not to be treated as a Fortean phenomenon. --Middle 8 (contribs • COI) 09:03, 11 January 2015 (UTC) edited21:03, 11 January 2015 (UTC)

What I've been arguing is that this giant rack of reviews does nothing but obfuscate the issue. Our section on effectiveness should be clear, because consensus is clear. Something like

The physiological benefits of acupuncture are non-existent or trivial. Most, if not all, of the benefits are derived from the placebo effect, where ineffective treatments appear to have an impact because the patient believes it will have an impact.

We add citations to both the studies that think placebos are worth paying for and those that don't, but we don't bring in text that gives the false impression that acupuncture is effective. Then we kill off this giant list of studies that hint at trivial effect because they serve no purpose but to mislead the reader. —Kww(talk) 15:19, 11 January 2015 (UTC)

Kww -- We agree that the section on efficacy badly needs pruning (and I believe we agree that the Safety section also needs pruning). We disagree on weighting the positive conclusions. Your italicized sentence pretty much reflects the consensus for most conditions, and we know this because the best reviews are in agreement. But we can't infer that this consensus fully extends to pain and nausea, because the best reviews are not fully in agreement. Reviews are what indicate consensus, or lack thereof. What else would indicate consensus? --Middle 8 (contribs • COI) 21:59, 11 January 2015 (UTC)

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