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This is the talk page for discussing improvements to the Identifying reliable sources (medicine) page.

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Ideal sources for Misplaced Pages's health content are defined in the guideline Misplaced Pages:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Identifying reliable sources (medicine). PubMed provides review articles from the past five years (limit to free review articles) The TRIP database provides clinical publications about evidence-based medicine. Other potential sources include: Centre for Reviews and Dissemination and CDC

To discuss reliability of specific sources, please go to Misplaced Pages:Reliable sources/Noticeboard or to the talk pages of WikiProject Medicine or WikiProject Pharmacology.

view · edit Frequently asked questions Shortcut WP:MEDFAQ This is an explanatory essay about the Misplaced Pages:Identifying reliable sources (medicine) policy. This page provides additional information about concepts in the page(s) it supplements. This page is not one of Misplaced Pages's policies or guidelines as it has not been thoroughly vetted by the community. Explanatory essay about the Misplaced Pages:Identifying reliable sources (medicine) policy These are some Frequently Asked Questions about Misplaced Pages's guidelines on sourcing for medical content, manual of style for medicine-related articles, and how the guidelines and policies apply to biomedical content. General Does Misplaced Pages have special rules for medical information? Yes, but the guidelines for medical information follow the same broad principles as the rest of Misplaced Pages. Examples of this include the requirement for reliable sources and the preference for secondary sources over primary sources. These apply to both medical and non-medical information. However, there are differences in the details of the guidelines, such as which sources are considered reliable. Why do you have special rules for medical information? Different types of sources have different strengths and weaknesses. A type of source that is good for scientific information is not usually as reliable for political information, and vice versa. Since Misplaced Pages's readers may make medical decisions based on information found in our articles, we want to use high-quality sources when writing about biomedical information. Many sources that are acceptable for other types of information under Misplaced Pages's general sourcing guideline, such as the popular press, are not suitable sources for reliable medical information. (See also: WP:MEDPOP and WP:WHYMEDRS) When do I need to follow MEDRS? MEDRS-compliant sources are required for all biomedical information. Like the policy on the biographies of living people ("BLP"), MEDRS applies to statements and not to articles: biomedical statements in non-medical articles need to comply with MEDRS, while non-medical statements in medical articles do not need to follow MEDRS. Also like BLP, the spirit of MEDRS is to err on the side of caution when making biomedical statements. Content about human biochemistry or about medical research in animals is also subject to MEDRS if it is relevant to human health. Sourcing I used a peer-reviewed source, but it was reverted, and the editor said I needed to use a review. I did, didn't I? Probably not. Most peer-reviewed articles are not review articles. The very similar names are easily confused. For most (not all) purposes, the ideal source is a peer-reviewed review article. Why can't I use primary sources? Primary sources aren't completely banned, but they should only be used in rare situations. An individual primary source may be flawed, such as being a clinical trial that uses too few volunteers. There have been cases where primary sources have been outright fraudulent. Furthermore, a single primary source may produce a different result to what multiple other primary sources suggest, even if it is a high-quality clinical trial. Secondary sources serve two purposes: they combine the results of all relevant primary sources and they filter out primary sources that are unreliable. Secondary sources are not infallible, but they have less room for error than a primary source. This follows a principle that guides the whole of Misplaced Pages. If a company announces a notable new product, Misplaced Pages would not cite a press release on the company's website (a primary source) but instead would cite a newspaper article that covers it (a secondary source). The difference with medical information is that the popular press are not suitable sources. Whenever possible, you should cite a secondary source such as: a review article a meta-analysis a high-quality textbook So if primary sources can be used in rare cases, what are those rare cases? Primary sources might be useful in these common situations: when writing about a rare disease, uncommon procedure, etc., for which no high-quality secondary literature is available, or for which the available secondary sources do not cover all of the information normally included in an encyclopedia article. when mentioning a famous paper or clinical trial that made a recognized substantial impact, as part of a purely historical treatment of a topic. when describing major research that has made a significant impact (i.e., continued and substantial coverage). While recent research results are normally omitted, it is sometimes necessary to include them for WP:DUE weight. In this case, it is usually preferable to read and cite the primary scientific literature in preference to WP:PRIMARYNEWS sources. Later, these primary sources can be replaced or supplemented with citations to high-quality secondary sources. Why can't I use articles from the popular press? The popular press includes many media outlets which are acceptable sources for factual information about current events, sometimes with significant caveats. It also includes media outlets which are discouraged in all cases because the quality of their journalism is inadequate. However, even high-quality media outlets have disadvantages in the context of medicine. Firstly, news articles on medicine will frequently be reporting a new medical primary source, such as the results of a new study. This means that they are effectively acting as a primary source, which as explained above makes those articles generally unsuitable for medical information. These articles also tend to omit important information about the study. If a medical primary source is to be cited at all, the academic paper should be cited directly. Secondly, media coverage of medical topics is often sensationalist. They tend to favor new, dramatic or interesting stories over predictable ones, even though studies that reflect the current scientific consensus tend to be predictable results. They tend to overemphasize the certainty of any result, such as reporting a study result as a conclusive "discovery" before it has been peer-reviewed or tested by other scientists. They may also exaggerate its significance; for instance, presenting a new and experimental treatment as "the cure" for a disease or an every-day substance as "the cause" of a disease. The sensationalism affects both which stories they choose to cover and the content of their coverage. High-quality media outlets can be good sources of non-medical information in an article about a medical topic. Another acceptable use is using a popular press article to give a plain English summary of an academic paper (use the |laysummary= parameter of {{cite journal}} for this). I have a source from PubMed, so that's reliable right? Not necessarily. PubMed is merely a search engine and the majority of content it indexes is not WP:MEDRS. Searches on PUBMED may be narrowed to secondary sources (reviews, systematic reviews, meta-analyses, etc.) so it is a useful tool for source hunting. It is a common misconception that because a source appears in PubMed it is published by, or has the approval of, the National Institutes of Health (NIH), National Center for Biotechnology Information (NCBI), or the US government. These organisations support the search engine but lend no particular weight to the content it indexes. Can I use websites like Quackwatch? Quackwatch is a self-published website by an author who is an expert in problems with complementary and alternative medicine. Whenever possible, you should use a scholarly source instead of Quackwatch. However, if no scholarly sources are available, and the subject is still notable, then it might be reasonable to cite Quackwatch with WP:INTEXT attribution to the POV. Can I cite Chinese studies about Traditional Chinese Medicine? As of 2014, there are concerns regarding positive bias in publications from China on Traditional Chinese Medicine. Such sources should be used with caution. The problem also includes issues with the academic system in China. Can I cite NCCAM (now NCCIH)? Yes, but again only with WP:DUE weight. Unlike other branches of the National Institutes of Health, which are generally accepted as authoritative in their fields, NCCAM has been the focus of significant criticism from within the scientific community. Whenever possible, you should cite the established literature directly. What if I can’t find any MEDRS-compliant sources on a subject? MEDRS contains a section about finding sources which may be helpful. Alternatively, a more experienced editor may be able to help you find them (or to confirm that they do not exist). Neutrality What is a fringe medical claim? A fringe medical claim is one that differs significantly from the prevailing views or mainstream views in the scientific medical community. This is similar to Misplaced Pages's general definition of a fringe claim. A claim can still be a fringe medical claim even if it has a large following in other areas of public life (such as politics and the popular press). How should fringe medical claims be described? When fringe claims have been widely reported in the press, have a large popular following, and/or have a long history, it may be appropriate to describe them in terms of that reporting, popularity, or history. However, weight should be determined by MEDRS-compliant sources, and the context (or lack thereof) should not make implications about medical statements that are not supported by such sources. Guidance on the additional considerations relevant to fringe subjects can be found at WP:FRINGE, as well as at other places such as WP:WEIGHT and WP:EXCEPTIONAL. In the case of alternative medicine, medical statements are often derived from an underlying belief system, which will include many propositions that are not subject to MEDRS. These propositions are subject to the usual sourcing requirements and the usual requirements for determining fringe status. If a treatment hasn't been shown to work, can we say it doesn't work? There are three possible situations: No evidence exists, either became no studies for the treatment have been published, or because the studies published are too small or weak to draw any conclusions. Evidence exists, and it shows no effect. Evidence exists, and it shows an effect. In the first case, we cannot say that it does not work, but we can say that there is no evidence to determine whether it works. After multiple, high-quality independent studies have been published, the understanding may transition from "no evidence" to "some evidence" of either an effect or no effect. You should follow the lead of review articles and other secondary sources for determining when this threshold has been crossed. Reports may conflict with each other. For example, a clinical trial may produce no evidence of an effect, but the treatment's manufacturer might produce testimonials claiming a positive effect. You should follow the lead of review articles and other secondary sources for determining how to balance these claims. Should medical content be attributed? In other words, is it necessary to say in the article's text the source which supports a medical statement (with attribution)? Or can it simply be stated as an unchallenged fact, with the source only mentioned in the citation (without attribution)? A statement without attribution will come across as being a stronger claim than one with attribution. A result or statement from a reliable secondary source should be included without attribution if it is not disputed by any other recent secondary sources. You should do a search to check that the secondary source you are citing is the most up-to-date assessment of the topic. If there have been two recent secondary sources that contradict each other, then you should attribute the disputed findings. On the other hand, if the findings of one or more recent secondary sources are disputed by one or more secondary sources from many years ago, but not by any recent ones, the recent findings can be stated without attribution. You should also take into account the relative weight secondary sources have. For example, Cochrane Collaboration reviews provide stronger evidence than a regular secondary source. In the rare cases where primary sources can be used, they should be attributed. Why not say there is a call for more research? It is common for scientific publications to say something like this, either directly or indirectly. There are several reasons for this. It could be argued that more research is always a bonus, even if the topic has already been thoroughly researched. Sometimes, these statements may be made partly because authors need to convince readers that the topic is important in order to secure future funding sources. As such, saying this does not communicate much information, and it may also mislead readers into thinking that the existing information on a topic is less reliable than it really is. How can Quackwatch be considered a reliable source? As noted above, Quackwatch does not meet the usual standard as a reliable source, but it can be used (with attribution) for information on a topic of alternative and complementary medicine if there are no scholarly sources available for the same purpose. The guidelines on fringe theories includes the concept of parity: if a notable fringe theory is primarily described by self-published sources, then verifiable and reliable criticism of the fringe theory does not need to be published in a peer-reviewed journal. It only needs to come from a better source. Finding and using sources How can I find good sources using PubMed? National Library of Medicine (NLM), PubMed, NCBI, & MEDLINE help, tutorials, documentation, & support Full, searchable list of all tutorials - training materials in HTML, PDF and Video formats YouTube channel for the National Library of Medicine: Tutorial videos from the National Center for Biotechnology Information (NCBI), part of the U.S. National Library of Medicine. Includes presentations and tutorials about NCBI biomolecular and biomedical literature databases and tools. PubMed FAQs PubMed User Guide - FAQs National Library of Medicine (NLM) Catalog NLM Catalog Help - This book contains information on the NLM Catalog, a database which provides access to NLM bibliographic data for journals, books, audiovisuals, computer software, electronic resources, and other materials via the National Center for Biotechnology Information (NCBI) Entrez retrieval system. The NLM Catalog includes links to full text materials and the library's holdings in LocatorPlus, NLM's online public access catalog. NLM Catalog (rev. December 19, 2019). Overview FAQs Searching NLM Catalog Finding journals that comply with WP:MEDRS standards For full comprehensive instructions, go to: Searching for Journals in NLM Catalog Determine if a specific journal is indexed in MEDLINE If you know the full or abbreviated name for a journal, and you want to see if it is indexed in MEDLINE, see the instructions at searching by journal title, which I will also reproduce here: If you know the journal’s exact title, enter it in the NLM Catalog search box followed by the field qualifier . Example: The Journal of Supportive Oncology Results = 1 record retrieved: The Journal of Supportive Oncology If you know the journal’s NLM Title Abbreviation, enter it in the NLM Catalog search box, followed by the field qualifier . Example: n engl j med Results = 1 record retrieved: The New England journal of medicine Review the list of Abridged Index Medicus journals Via a search of the NLM Catalog: List of Abridged Index Medicus journals, also known as "Core clinical journals". Stand alone list: List of current Abridged Index Medicus (AIM) journals (118 journals as of 5 May 2020) Create a list of all Index Medicus journals Search the NLM Catalog using jsubsetim to find all Index Medicus journals (5021 journals as of 29 May 2020); or go directly to the search results for all Index Medicus journals. (Note that immediately above "Search Results" on that page, you can change the default "20 per page" to as many as 200 results per page, and you can change how the results are "sorted", e.g., if you are looking for a specific journal, you can sort by Title, instead of the default.) ====Create a list of all journals indexed in MEDLINE}} Search the NLM Catalog using currentlyindexed to find all journals indexed in MEDLINE (5266 journals as of 29 May 2020); or go directly to the search results for all journals indexed in MEDLINE. (Note that immediately above "Search Results" on that page, you can change the default "20 per page" to as many as 200 results per page, and you can change how the results are "sorted", e.g., if you are looking for a specific journal, you can sort by Title, instead of the default.) MEDLINE, PubMed, and PMC (PubMed Central): How are they different? MEDLINE, PubMed, and PMC (PubMed Central): How are they different? Are there ways to find good sources other than PubMed? Besides being a secondary source, what else indicates a source is of high quality? I found what looks like a good source, but can't access the full text – what next? Most scholarly journals are behind paywalls. Some options to access these articles include visiting a local university library, visiting The Misplaced Pages Library, and WikiProject Resource Requests. Note that paywalled articles are frequently pirated and made available on the open web. When linking to a journal article, care must be taken not to link to such a pirate copy, as such a link would be a copyright violating link in contravention of Misplaced Pages's policy. In general if you find such a copy and it is not accompanied by text explicitly stating that it is made available with the permission of the copyright holder, assume that it is potentially infringing, and do not link to it. This holds for all edits in Misplaced Pages, not just in article space. Google Scholar Search for the title of the article on Google Scholar. On the results page, click on "All n versions" (where n = the number of available versions of that article) at the bottom of a listing. The resulting page might contain PDF or HTML versions of the article. Unpaywall Consult Unpaywall.org for journal articles available without a subscription. Install the UnPaywall extension for Chrome or Firefox to immediately identify articles with a free version. After you install the extension, look to the right side of the page (when you are on the website for an article) for either a grey locked symbol (no free version) or a green unlocked symbol (click on that symbol to access the full text version of the article). Librarian's advice An article by librarian John Mark Ockerbloom, titled, "Why Pay for What’s Free? Finding Open Access and Public Domain Articles" offers helpful suggestions. How do I reference a medical article? Almost all medical articles are indexed by the PubMed search engine and have a Digital object identifier (DOI) assigned to them. All articles included in PubMed are assigned an eight-digit PubMed identifier (PMID). These identifiers can be used to refer to articles, which is preferred to URLs as it makes a reliable link which is resilient to changes beyond our control – i.e. the publisher being acquired by another publisher and it's "normal" web URLs changing as a consequence. Once you have the PMID, there are a number of tools such as this one which you can use to generate a full citation automatically. In article references, the "doi" and "pmid" parameters are preferred to the "url" parameter for such reasons. On Talk pages, when referring to journal articles, is it good practice to make any link using these types of identifier also: Typing "]", where dddddddd is a PMID, will create a link to the indicated article. Any DOI can be turned into a resolvable web address by prepending "https://doi.org/" to it (e.g. https://doi.org/10.1136/bmj.c6801). Conflict of interest Are there special considerations for conflicts of interest for health content? See WP:MEDCOI. What if I am being paid to edit medical content? See WP:PAID. References References Laurent, MR; Vickers, TJ (2009). "Seeking health information online: does Misplaced Pages matter?". J Am Med Inform Assoc. 16 (4): 471–9. doi:10.1197/jamia.M3059. PMC 2705249. PMID 19390105. Schwitzer G (2008). "How do US journalists cover treatments, tests, products, and procedures? an evaluation of 500 stories". PLOS Med. 5 (5): e95. doi:10.1371/journal.pmed.0050095. PMC 2689661. PMID 18507496. Goldacre, Ben (2008-06-21). "Why reading should not be believing". Guardian. Dentzer S (2009). "Communicating medical news—pitfalls of health care journalism". N Engl J Med. 360 (1): 1–3. doi:10.1056/NEJMp0805753. PMID 19118299. Li J, et al The quality of reports of randomized clinical trials on traditional Chinese medicine treatments: a systematic review of articles indexed in the China National Knowledge Infrastructure database from 2005 to 2012. BMC Complement Altern Med. 2014 Sep 26;14:362. PMID 25256890 Further information: "Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries." Vickers, Andrew (April 1, 1998), "Do certain countries produce only positive results? A systematic review of controlled trials.", Controlled Clinical Trials, 19 (2), Control Clin Trials: 159–66, doi:10.1016/s0197-2456(97)00150-5, PMID 9551280 Ernst, Edzard (2012). "Acupuncture: What Does the Most Reliable Evidence Tell Us? An Update". Journal of Pain and Symptom Management. 43 (2): e11–e13. doi:10.1016/j.jpainsymman.2011.11.001. ISSN 0885-3924. PMID 22248792. Qiu, Jane (January 12, 2010), "Publish or perish in China", Nature, 463 (7278): 142–143, doi:10.1038/463142a, PMID 20075887, S2CID 205052380 Some examples: 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" Ockerbloom, John Mark. "Why Pay for What’s Free? Finding Open Access and Public Domain Articles." Everybody's Libraries (23 Oct 2018). Other helpful resources WikiProject Medicine's Talk Page Misplaced Pages:Why MEDRS? v t e Misplaced Pages biomedical editing Editing for medical experts Reliable sources FAQ Why MEDRS? Biomedical information Manual of style Conflicts of interest Plain and simple guide WikiProject Medicine Talk page How to edit Resources Outreach

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Medicine This page is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at Misplaced Pages talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine Pharmacology This page is within the scope of WikiProject Pharmacology, a collaborative effort to improve the coverage of Pharmacology on Misplaced Pages. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.PharmacologyWikipedia:WikiProject PharmacologyTemplate:WikiProject Pharmacologypharmacology

Add image to WP:MEDASSESS

Wonder what peoples feeling are about adding this type of illustration to the MEDASSESS section. It shows some different ways to balance evidence. I've recently had the feeling that many new editors are having trouble understanding why we use one article over the other, and this would perhaps make it easier to explain why we chose secondary over primary sources.

Please give your thoughts, and I can also prepare more of these images for different pyramids as well. Best, -- CFCF 🍌 (email) 09:20, 3 September 2015 (UTC)

very clear and informative, I think MEDRS would benefit from this/ posted talk/Med--Ozzie10aaaa (talk) 20:09, 3 September 2015 (UTC)

• Interesting. The pyramids differ on some important points about ranking sourcing. Let's use both, say where they are from, explain that conflicting advice is the norm, and also look for other differing views. Something that stands out to me is the idea that "clinical practice guidelines" are more authoritative than systematic reviews. Obviously these become outdated as compared to the latest systemic reviews, and sometimes they are not even evidence based, but I really like that one of the pyramids shows this as the highest authority because in many ways, CPGs are. Thanks for making more than one.

I wonder if we could have one that is "WikiProject Medicine's Ranking of Priority", and dictate to the world how information ought to be evaluated. We use different terms and emphasis. Blue Rasberry (talk) 18:04, 4 September 2015 (UTC)

Our "ranking" depends upon multiple factors. The "pyramid" would look a lot like the table at WP:CANVAS: several unrelated criteria, and being "strong" on Criteria #1 might not outweigh being "weak" on Criteria #2. WhatamIdoing (talk) 18:43, 4 September 2015 (UTC)

I added references in the captions to the images, but I don't really know how to best explain their differences and rationales. I also like the pyramid at which makes a distinction between meta-analysis and systematic reviews. Unfortunately it has too many steps, so I'd have to make a new image for those.

As response to Bluerasberry – CPGs should ideally be at the top, but that isn't always that case. WhatamIdoing – what different criteria do you propose for such a table. I surmise you mean something like this:

-- CFCF 🍌 (email) 23:52, 5 September 2015 (UTC)

Sorry for messing up on the formatting on adding a comment to this section, but I noticed that Medical textbooks are missing from the pyramid. I use texts all the time. Best Regards,

  Bfpage |leave a message  00:06, 23 September 2015 (UTC)

Yes, CFCF, that's exactly the table I have in mind. A comprehensive list of criteria is too long to be useful, but some of the major ones are primary vs secondary, newer vs older, independent vs conflicted, and better evidence vs weaker evidence. WhatamIdoing (talk) 04:14, 23 September 2015 (UTC)

References

1. Dentalcare.com's ranking of
2. SUNY Downstate medical center ranking
3. capho.org Blog

Request for Comment: Country of Origin

There were strong views and evidence from both sides but no consensus on whether diffs given showed "country of origin" (of a study, journal or author) being presented and used as a valid basis for whether a source met RS.

There was consensus however that "country of origin", per se, is not a valid reason to reject a source (and no more valid than "funding sources") hence for the change.

(In some cases editors seem to have misspoken and referred simply to country of origin when they perhaps meant to refer to sourced findings regarding sources affiliated with a country of origin. This change should discourage with that.)

(This addition should NOT be read as a PC ban on any mention of country of origin (or founding source, etc.) when necessary to refer to studies with hard data (as contrasted to stereotypes) that have identified a systematic problem that is normally identified with an affiliated country of origin, as mentioned by Richard Keatinge. Likewise, this addition should NOT be read as a changing the longstanding policy that sources from publications known to routinely publish and fail to retract material proven unreliable may be excluded.)

--Elvey 00:40, 18 October 2015 (UTC)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Should we change MEDRS, which currently reads:

Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions.

to

Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, country of origin, or conclusions.

This proposal is to address only the addition of high-quality sources into the guideline. LesVegas (talk) 23:33, 5 September 2015 (UTC)

Comments

Support Misplaced Pages should never get into the business of discriminating against high quality sources because of where that research might have been conducted or published. However, this has happened before, where multiple Cochrane reviews were rejected while trying to replace an old source with them, partly on the basis that "all but one of its authors were Chinese," and therefore, they must be biased. This is not an isolated incident either, with some editors rejecting all sources published in China not on the basis of case by case analysis of the source's quality, but stating they're published in China and assume they must all be unreliable. Low quality sources that, for instance, are not peer-reviewed, should always be rejected. But MEDRS does not yet make it clear whether or not high-quality foreign sources should ever be rejected on the basis of country of origin, whether it be the authors of a publication or place where high quality research is published. And interestingly, MEDRS currently allows for industry funded research not to be rejected on the basis that it's industry-funded, while it says nothing about a particular country's research. And yet, despite whatever potential problems could exist, it is very clear that industry funded research can be very problematic to add into Misplaced Pages. Just recently, Coca Cola came under fire for funding scientific research showing that Coca Cola doesn’t cause obesity. And bad as that may be, MEDRS currently doesn’t allow us to prohibit such research. It states:

'Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions.'

There are also many well-documented problems with industry-funded research in the way of psychiatric medications failure to warn about cancer risk with certain drugs, as well as showing a huge statistical increase in "positive findings" for various pharmaceuticals.

However, just because there is a documented problem with some industry funded research, that doesn’t mean there is a problem with ‘’’all’’’ industry funded research. And oftentimes, new drugs only have industry-funded research for sources. No other sources can be found. Reasons like that are why it's not permitted to reject high quality sources on the basis of them being industry-funded.

At the same time, some editors currently reject some sources on the basis of them being published in another country. One such example is with acupuncture where a 1998 research report showed that in Hong Kong, Taiwan, Russia/USSR, China and Japan higher reports of positive findings occurred when compared to England. In some ways findings like these could possibly mirror the problems in industry-funded research. And at the same time, as with industry-funded research, it’s difficult to discount all of it on the basis that there is a chance some of the more positive findings might possibly be due to publication bias. Further complicating the issue is that more positive findings might be due to cultural differences in scientific research between various countries, such as ethical dilemmas with using placebos where the Chinese have shown statistical deviations from non-Chinese trials, creating conditions where placebo alone is not ethically justified as a control. There are many other possible confounding factors similar to this which may explain differences for findings between various countries once found within this specific modality. Undoubtedly, this seems to cloud the issue. But making the issue more problematic, for us as editors, is that some of the research mentioned in the Vickers source might not even be of high quality, thus causing making any argument against high quality research moot.

Adding "country of origin" seems to put the wording more in line with Misplaced Pages’s project Countering Systemic Bias, as well as our WP:BIAS policy. By ensuring Misplaced Pages editor-level peer review doesn’t extend to country of origin, it also makes it consistent with our current stance on liberal allowance of sources no matter what types of funding may be received.

UPDATE For anyone who thinks this issue isn't happening at all or was just one isolated incident, let me show proof it is still happening. Within the past few days, an editor rejected research in a high quality journal, Medicine, because the "authors are Chinese." Like it or not, rejecting sources based on ethnic origin of authors is a real problem. We need to examine sources, rejecting or accepting them based on their own merits and nothing else. LesVegas (talk) 20:01, 8 September 2015 (UTC)

LesVegas (talk) 23:51, 5 September 2015 (UTC)

Oppose I see no reason why this proposal is needed. We could also add that we shouldn't oppose inclusion based on authors skin color–because racism is bad, but it isn't needed. Level and quality of evidence is far more important. -- CFCF 🍌 (email) 00:56, 6 September 2015 (UTC)

There have been incidents where high quality sources were rejected for reasons that could've been prevented with amended language, such as this. I modified my first comment, adding in one example of such a rejection, although there have been others. Therefore, it appears it is needed. Let me know if you still think this way after reading the link. LesVegas (talk) 03:16, 6 September 2015 (UTC)

• Question What does "country of origin" in the proposal refer to? The country where the study was conducted, nationality of researchers or subjects, or country where the publishers of the journal or book are located? The first two are fine but perhaps unnecessary as CFCF says above (can LesVegas point to instances where such criterion was cited and prevailed?) If the last, I'll be opposed to the change since assessing the quality of journal and its publishers is crucial for assessing medical and other sources, and neither high-quality nor sham publishers are distributed uniformly across the globe, and we on wikipedia cannot solve this real world problem by simply turning a blind eye to it. Abecedare (talk) 01:04, 6 September 2015 (UTC)

Good question. "Country of origin" is all-encompassing, meaning country of author, country where research was conducted and where it was published. Keep in mind, this RfC is asking about high-quality peer-reviewed publications that meet every other standard of quality in MEDRS. LesVegas (talk) 03:16, 6 September 2015 (UTC)

• Comment This appears to be an attempt to allow Chinese studies about acupuncture published in Chinese journals to be used to support acupuncture. We need to use high quality journals with a reputation for reliability. So oppose the underlying attempt. Doc James (talk · contribs · email) 01:27, 6 September 2015 (UTC)

Actually, there was an incident where an influential editor opposed the addition of a Cochrane Review because its authors were from China. DocJames, please limit your comments to high quality sources. This is what the discussion is pertaining. LesVegas (talk) 01:52, 6 September 2015 (UTC)

To which Cochrane review do you refer? Doc James (talk · contribs · email) 04:05, 6 September 2015 (UTC)

Actually, several. One of them was a review on fibromyalgia which had several authors that were Chinese. High quality sources should never be rejected on such a basis, don't you think? By the way, upon re reading your comment, are you suggesting Chinese studies or Chinese journals are all inherently low-quality? I certainly hope that's not what you were saying. Tell me I read that wrong. LesVegas (talk) 04:24, 6 September 2015 (UTC)

Yes that Cochrane review is a fine source to use. No I am not saying all Chinese journals are inherently low-quality. Many journals in many places however are low quality. Doc James (talk · contribs · email) 04:29, 6 September 2015 (UTC)

• Agree with Doc James. I have seen zero examples of any attempt to reject high-quality foreign sources on the basis of simply being from another country. The Chinese studies about acupuncture published in Chinese journals were rejected not because they were published in China, but rather that they were not high quality journals with a reputation for reliability. There are plenty of fringe journals pushing pseudoscience in the US and UK, and plenty of good, peer-reviewed science gets published in China. --Guy Macon (talk) 01:48, 6 September 2015 (UTC)

Guy Macon , you might check out the diff below where an editor rejected one such source on this very basis. You can't get much higher quality than Cochrane Reviews, and you can't get much lower editing than to reject one all because "all but one of its authors are Chinese." It's sad we have seatbelt laws and equally as sad we have to tell editors not to reject high quality sources because of things like where they're published, but I'm afraid that's the case. It's exhausting to waste time on such silly matters and doesn't hurt anything to add it in because we're talking about high quality, peer reviewed sources here anyway. LesVegas (talk) 02:34, 6 September 2015 (UTC)

I did check out the diff. As others have pointed out, it does not say what you claim it says. --Guy Macon (talk) 05:39, 6 September 2015 (UTC)

Guy Macon, I've seen you around and know you're a good editor here. I know it's shocking to think another editor would ever argue such a thing, but I was in the middle of that one and I can tell you that's what was meant regarding a set of Cochrane Reviews used to replace old research. Kww argued it shouldn't be used to replace an outdated review per WP:MEDDATE for several reasons, one being that the Cochrane Reviews used Chinese authors. If you would like more details on that, I'm happy to provide them. Again, I know it's hard to believe editors would ever say or argue such a thing, but sadly they do. The other Guy constantly rejects sources because they're Chinese, and you can see for yourself how he stereotypes them as universally unreliable. No regard for peer review in statements like that, just outright rejection of sources because they are Chinese. We shouldn't even have to discuss such matters as ethnicity of authors or place of publication on talk pages, it's distracting and disruptive; editors need to be focusing on quality of individual journals and that's it. LesVegas (talk) 06:09, 6 September 2015 (UTC)

• Comment Pending further info Is this change meant to address a non-hypothetical problem? Excluding a study based solely on country of origin is so strange that I'd be surprised to see that anyone had attempted it, let alone done it successfully, but has it happened? What were the circumstances? When I first saw this RfC, I thought "This looks like it's probably about something else" and DocJames' scenario seems consistent with this. Other comment: What counts as "personal"? Darkfrog24 (talk) 02:07, 6 September 2015 (UTC)

Darkfrog24, you might want to check a diff out where an editor opposed updating an old source with a series of Cochrane Reviews because all but one of its authors were Chinese. Yes, rejection of high quality sources based on country of publication or origin of its authors is a real problem. As long as sources are high quality, issues like country of origin or ethnicity shouldn't matter. LesVegas (talk) 02:28, 6 September 2015 (UTC)

Well this diff doesn't show someone saying, "Exclude these sources because they're Chinese." It's more like Kiwi saying, "I think this guy wants to exclude the sources because they're Chinese," but whatever. I'm changing my comment to mild support. The idea that we shouldn't exclude sources solely on country of origin is so obvious that we all should be doing it already and if a source really is unreliable, there should be other reasons to exclude it. Darkfrog24 (talk) 03:39, 6 September 2015 (UTC)

+support based on the diff linked above, where an editor simply assumed that a study was biased because other studies by other authors of the same nationality had been accused of bias. This is out of line. DES 03:17, 6 September 2015 (UTC)

Darkfrog24 and DES what you see operating in the diff is WP:REDFLAG. The key word in the diff is "suspect"; which is very different from "excluded". Jytdog (talk) 13:50, 6 September 2015 (UTC)

The key phrase in the diff is "I also note that of the supposed refutations, all but one include Chinese researchers on the papers: we've discussed that bias problem extensively, and there's no reason to believe it doesn't apply here" This is drawing a conclusion that the mere presence of Chinese researchers equates to bias. This is not acceptable. DES 13:57, 6 September 2015 (UTC)

DES, thanks for replying. LesVegas and others have been pushing and pushing and pushing to include Chinese sources on acupuncture in our article - the issue has been discussed a zillion times but keeps coming up, and it gets frustrating, and people write things quickly that are easy to misconstrue when diffs are cherry-picked, as LesVegas has done with KWW's statement. Jytdog (talk) 14:07, 6 September 2015 (UTC)

User:Jytdog, would a rule saying, "do not exclude based solely on country of origin" make it harder for you to exclude low-quality or otherwise problematic sources? I'm not familiar with this particular dispute, but it sounds like those sources are no good regardless, so this shouldn't make any difference. Would it help if another line were added elsewhere saying, "Sources that have not survived peer review may be excluded" or "sources from publications known to routine publish and fail to retract unreliable material may be excluded"? Darkfrog24 (talk) 14:34, 6 September 2015 (UTC)

The background facts are:

a1) our article on Acupuncture has been highly contested for a long time and is subject to DS per Arbcom - the core dispute is between science-based editors and believers in acupuncture (as with many alt-med topics);

a2) some acupuncture believers actually try at some level to deal with the relevant Misplaced Pages policies and guidelines (NPOV and particularly PSCI, FRINGE, MEDRS);

b1) Research (and reviews) produced in China about acupuncture (and other TCM) overwhelmingly come to positive conclusions about the efficacy of TCM for various diseases and conditions, and they come to positive conclusions way more often than research and reviews produced in the West.

b2) This discrepancy is explained by believers (in published sources) in various ways (e.g Westerners don't do TCM properly or there are special facts about TCM that make it impossible to conduct sound scientific research on it); scientists have explained this discrepancy in published sources by pointing to the immature level of development of Chinese scientific institutions.

c1) When you put a) and b) together, you get some acu-proponents pushing to use reviews originating from Chinese scientific institutions to support content in our article about the benefits of acupuncture (content that is not supportable with, or even contradicted by, other sources), and science-based editors tending to reject that content and its sourcing - especially when no other sources are brought (see the first bullet of WP:REDFLAG). This has been discussed extensively on this Talk page as well as on the article Talk page and the consensus has been to treat sources about TCM originating from China as "suspect" for the time being - not excluded, but not "green flagged" as high quality. This RfC was posted by an acu-proponent. You can see my response to it below. Jytdog (talk) 15:05, 6 September 2015 (UTC)

Jytdog, what is your opinion on rejecting Cochrane Reviews because its authors are Chinese? Are there no publications in China that are reliable? Do you have a source that all are unreliable and engage in publication bias? Do you think there could be other possibilities for differing results, such as ethical dilemmas with placebo controls in more instances? And since scientists have documented the same issues you complain about in Chinese research, as with industry-funded research, why do you hold a different standard for Chinese sources? LesVegas (talk) 15:22, 6 September 2015 (UTC)

• oppose The framing of serious issues with Chinese research publications on acupuncture as "discrimination" is the worst kind of red-herring, bad-faith, manipulative argument imaginable, especially when Chinese scientists themselves point out the problems. This RfC is the pits. There are solid sources describing the problems:
  • Li J, et al The quality of reports of randomized clinical trials on traditional Chinese medicine treatments: a systematic review of articles indexed in the China National Knowledge Infrastructure database from 2005 to 2012. BMC Complement Altern Med. 2014 Sep 26;14:362. PMID 25256890
  • Vickers, Andrew (April 1, 1998), Do certain countries produce only positive results? A systematic review of controlled trials., Control Clin Trials {{citation}}: Italic or bold markup not allowed in: |publisher= (help)
  • Ferguson, Cat (November 26, 2014), Publishing: The peer-review scam, Nature {{citation}}: Italic or bold markup not allowed in: |publisher= (help)
  • Qiu, Jane (January 12, 2010), Publish or perish in China, Nature {{citation}}: Italic or bold markup not allowed in: |publisher= (help)

The quality will surely improve with time but LesVegas' effort to wave a magic wand and make the actual problems disappear under the banner of "discrimination" runs hard against everything we try to do at WP:MED with regard to using high quality sources. Jytdog (talk) 04:37, 6 September 2015 (UTC)

Jytdog, this RfC is about high-quality sources, not low quality ones which are clearly not allowed. But your inability to differentiate between these two categories and continue stereotyping all Chinese studies and Chinese authors the way you just did isn't surprising since you posted that scientific institutions in China aren't independent or mature, and therefore all of their journals are unreliable. Frankly, comments like that are why RfC's like this exist. But back to the discussion at hand. You never addressed high quality sources, which is what this RfC is pertaining to. You are opposing low quality ones, which we all should oppose on the basis of things like lack of peer-review and things of that nature. But opposing them simply because they are Chinese isn't acceptable, don't you think? LesVegas (talk) 04:57, 6 September 2015 (UTC)

You continue to mischaracterize the situation and to employ circular reasoning. The systemic problems with Chinese research on acupuncture are well documented and so the assumption going in, is that they are not high quality; per Guy's diff they are "suspect." The burden is on the person bringing any such source to show that the specific source is high quality. Per WP:REDFLAG one way that could be done would be to show that sources that are high quality say the same thing. This is not racism, it is dealing with immature level of development of Chinese scientific institutions, just like it is not racist to say that the institutions of Chinese law in the fields of environment and intellectual property are not mature. The air quality in Chinese cities is often poor; copyright infringement is rampant in China; Chinese publications on acupuncture almost always have favorable outcomes. Those are simple statements of fact, reflecting a society in development. They are not essentialist, racist statements - they are existential statements of fact and will change over time, as the situation in China changes. So WP:DROPTHESTICK. And I suggest you be much more careful in deploying this tactic of cherry-picking diffs and trying to discredit editors as racist. Jytdog (talk) 13:50, 6 September 2015 (UTC)

Jytdog, just the other day you said "we do not perform peer review on sources and should never reject industry-funded sources that almost always have positive findings. But Chinese research? Nope, Chinese scientists aren't independent or mature. I'm not trying to characterize you as racist, but frankly by defending one standard for industry-funded studies, and enforcing another for Chinese research while stereotyping all Chinese research as unreliable, never to be evaluated on a case-by-case basis, makes it difficult for me not to find a diff that characterizes you any other way. But let me allow you the opportunity to prove that you're not racist. Simple question: why should we allow one standard for industry funded research despite documented publication bias issues, and another standard for Chinese research, rejecting the notion that we should evaluate Chinese sources or Chinese authors on a case-by-case basis like we do everywhere else? LesVegas (talk) 15:01, 6 September 2015 (UTC)

Your mischaracterization of what I wrote and of MEDRS is malicious, incompetent, or both. This is not about conducting peer review, which involves critiquing the quality and extent of the experiments that were done, the presentation of the resulting data, and the conclusions drawn from the data. This has nothing to do with research funding. And I said nothing about "Chinese scientists" - I addressed institutions. Jytdog (talk) 15:14, 6 September 2015 (UTC) (strike; should not have written that. my apologies. Jytdog (talk) 15:48, 6 September 2015 (UTC))

Oh but it is about conducting a peer review based on industry funding. Those have the same documented issues you complain about in Chinese research, although I would argue, worse, since there are more confounding factors between Eastern and Western cultures (like different scientific ethics) and those can explain reasons for discrepancies in results between East vs. West, not simply publication bias. Simple question: why should we not reject research on the basis that it's industry-funded, but we should reject research because it's Chinese, instead of evaluating it on a case by case basis? LesVegas (talk) 15:33, 6 September 2015 (UTC)

You do not seem to understand what happens during peer review of scientific papers; I explained that above. Jytdog (talk) 15:48, 6 September 2015 (UTC)

We already do evaluate on a case-by-case basis, and since this hasn't been a problem we don't need a clause against it in our guidelines. In order that they be followed–guidelines need to be succinct. We can't indiscriminately add clauses in order to address hypothetical problems or noone will read them–making it far harder to police.-- CFCF 🍌 (email) 05:44, 7 September 2015 (UTC)

On the face of it, the OP appears to want to get his low quality pro-acupuncture sources into our Acupuncture article by claiming they are high quality. I don't think the community is quite that silly. -Roxy the dog™ (Resonate) 10:28, 6 September 2015 (UTC)

Previously uninvolved editor here: 1) Even if the sources were rightly excluded, "they're Chinese" should not be numbered among the reasons for this; their own failings should be enough. Question: Why would "don't exclude based on country" make any difference? 2) Aside from this acupuncture issue, is the argument of exclusion-based-on-country a common enough problem to merit explicitly banning it? Do the words "don't exclude based on country" earn their keep for the space they take up (in Misplaced Pages's already Byzantine rule structure). Darkfrog24 (talk) 14:34, 6 September 2015 (UTC)

"They're Chinese" is a poor shorthand for a complex discussion and is not how the issue should be discussed nor should that phrase be used as a description of the stance of those opposed to this RfC or who treat sources about TCM produced by Chinese institutions as suspect. I am unaware of this issue arising outside the context of TCM. Jytdog (talk) 15:19, 6 September 2015 (UTC)

I can be more succinct than JD. 1)No. 2)No (to my knowledge). 3)No. -Roxy the dog™ (Resonate) 15:38, 6 September 2015 (UTC)

Oppose. While I agree that certain fringe journals are focused in particular countries, I don't think we should be determining reliability overall by country of origin. However, that can be a first red flag on certain topics for a deeper look. That's why I would oppose this language as I don't think it is needed. If a question on reliability comes up, there will be other qualities we look at for journals as well. There is also potential this language could be abused from a WP:BEANS approach (acupuncture does come to mind), so I think it's better that this is one thing left unsaid, but consensus in discussions on the idea that country or origin alone can't be used can always be linked if someone brings it up. Kingofaces43 (talk) 16:35, 6 September 2015 (UTC)

Strong oppose The focus should remain on the quality of the research and the reliability of the source. Either the research is good, or it is not. Either the source is reliable, or it is not. In what possible way does "country of origin" factor into anything, except to imply that some countries are doing poor quality research and publishing in unreliable sources, and must therefore be held to a lesser standard? TechBear | Talk | Contributions 20:39, 6 September 2015 (UTC)

I agree with you that the focus should always be on the quality of the sources themselves. In MEDRS it states, "Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions". We aren't supposed to reject sources purely on those merits, just simply focus on the quality of the source itself, and yet MEDRS has to be explicit because I can only assume in the past editors have rejected high quality sources because of things like references, inclusion criteria, etc. Given that editors have rejected clearly high quality sources on the basis of nationality of author or country of publication (as seen from the diffs I provided) why haven't we reached a point where we need to explicitly tell editors they need to be focusing only on source quality and nothing else, like country? LesVegas (talk) 22:22, 6 September 2015 (UTC)

Support I have read most of this RFC and debated commenting. Most of the responses do not answer the question. The question is specifically about High quality sources. High quality sources should never be excluded based on the country of origin or nationality of the authors. Low quality sources will be rejected based on the fact they are low quality and this change will not allow them in regardless. I have looked at the diffs and there is a problem in some instances, though how wide spread is hard to say. AlbinoFerret 15:59, 7 September 2015 (UTC)

A blog post by Edzard Ernst, a leading academic in this area, reads in large part:

"In this case, you might perhaps believe Chinese researchers. In , all randomized controlled trials (RCTs) of acupuncture published in Chinese journals were identified by a team of Chinese scientists. A total of 840 RCTs were found, including 727 RCTs comparing acupuncture with conventional treatment, 51 RCTs with no treatment controls, and 62 RCTs with sham-acupuncture controls. Among theses 840 RCTs, 838 studies (99.8%) reported positive results from primary outcomes and two trials (0.2%) reported negative results. The percentages of RCTs concealment of the information on withdraws or sample size calculations were 43.7%, 5.9%, 4.9%, 9.9%, and 1.7% respectively.

The authors concluded that publication bias might be major issue in RCTs on acupuncture published in Chinese journals reported, which is related to high risk of bias. We suggest that all trials should be prospectively registered in international trial registry in future.

I applaud the authors’ courageous efforts to conduct this analysis, but I do not agree with their conclusion. The question why all Chinese acupuncture trials are positive has puzzled me since many years, and I have quizzed numerous Chinese colleagues why this might be so. The answer I received was uniformly that it would be very offensive for Chinese researchers to conceive a study that does not confirm the views held by their peers. In other words, acupuncture research in China is conducted to confirm the prior assumption that this treatment is effective. It seems obvious that this is an abuse of science which must cause confusion.

Whatever the reasons for the phenomenon, and we can only speculate about them, the fact has been independently confirmed several times and is now quite undeniable: acupuncture trials from China – and these constitute the majority of the evidence-base in this area – cannot be trusted."

This gives us a convenient way of identifying a large section of the literature as pseudoscience sensu stricto, and not to be regarded as RS. Richard Keatinge (talk) 16:17, 7 September 2015 (UTC)

Richard, I am glad you are giving this more analysis than others have. I have asked myself the same question- why have variations been noted? While publication bias is one possibility, there are others. For instance, placebo controls are rarely done and for ethical reasons control groups receive actual treatment of some sort. Another possibility is that in China they are performing acupuncture differently. The first time I ever had acupuncture was when I was in China, and after an accident, and I can tell you it was a very different treatment than any of the acupuncture I have had since returning to the US. It is also very different from Japanese acupuncture, or Korean, all of which I have experienced. The Chinese acupuncture I experienced used thicker needles and they adjusted them in such a way that elicited very strong stimulation. It was also done in a hospital, by medical doctors, so I knew in the back of my mind this was legitimate and this gave a different experience overall. The thing is, there are many variables. But worst case scenario, statistics have shown a 24 percent increase in positive findings of Chinese research versus Western research regarding acupuncture. That's still lower than the stats on industry-funded drug trials when compared to independently-funded sources, and yet we have explicit language in MEDRS that we shouldn't reject high quality sources because of funding. So why shouldn't we be consistent? LesVegas (talk) 18:26, 7 September 2015 (UTC)

• oppose it is an attempt to run around the essential purpose of MEDRES: that we only use the highest quality sources. where there is evidence that medical sources from a particular country do not measure up to the standards generally required we should NOT be using them. -- TRPoD aka The Red Pen of Doom 17:05, 7 September 2015 (UTC)
• Support: Adding country of origin to the policy/guideline is appropriate; nothing prevents anyone from applying a rigorous critique to the quality of a particular source. It is important not to mass-categorize entire groups of authors or publications simply by where they originate. It, for example, an academic journal from nation Foo publishes bad science, it can be assessed on its own merits or lack thereof, not the ethnicity of those producing it. Montanabw 23:41, 12 September 2015 (UTC)
• Support. Inclusion should not be arbitrated on account of the author's, nor the content's cultural origin. The opposition makes claims that the guideline amendment is unnecessary, as such is already generally accepted, however I do believe in a differentiation between the two. We need a reference-able guideline to control cultural prejudice, which serves no place on Misplaced Pages. There should be no question of interpretation, the guidelines should be definitive. ExParte 06:18, 13 September 2015 (UTC)
• Oppose quote The framing of serious issues with Chinese research publications on acupuncture as "discrimination" is the worst kind of red-herring, bad-faith, manipulative argument imaginable, especially when Chinese scientists themselves point out the problems. This RfC is the pits. There is an awful lot of bad faith characterisation in this thread. Of course country, nationality etc. should not in itself be a criteria, but if the problem really did exist (which I'm not convinced of by the instances given), this wording would do nothing to solve it but simply distract from the central question of the quality of the source in a POINTY manner. Pincrete (talk) 19:04, 19 September 2015 (UTC)

There were several instances, one where Cochrane Reviews were being suppressed because of Chinese authorship as well as high quality journals such as Medicine where the same objections based on Chinese authorship were made. Since this RfC was on high quality sources only, can you please clarify: when we have obviously high quality sources, do you think country of origin should be an issue at all? LesVegas (talk) 22:50, 19 September 2015 (UTC)

Re country of origin question. Obviously not in itself. I don't ordinarily edit in Med. areas, (summoned by bot), however it is simply an established fact that some sources are less reliable than others in all areas (US Govt. 'collateral damage' figures?). I don't see why 'country' would be identified any more than any other factor. If there is real evidence of rejecting sources solely, or principally, on grounds of ethnicity or provenance, this is not the way to solve it. I was not persuaded that there was such evidence. You (and others) are repeatedly saying these are high quality sources, AS A FACT, but is that not what is disputed? Pincrete (talk) 14:20, 21 September 2015 (UTC)

I have never seen anyone dispute, for instance, that Cochrane Reviews or publications from Medicine, are not high quality publications unless they have Chinese authors in the studies they publish (which has been disputed). In fact, MEDRS says they unequivocally are high quality sources. One aspect that has been disputed is that if they have authors who are Chinese, then that makes them unreliable. My position is that country of origin shouldn't ever be used as an argument to exclude high quality sources. What we instead should be focusing on as editors is if the source passes MEDRS's established high-barometer for reliability and that's it, never rejecting sources because of things like country of origin. Do you agree? LesVegas (talk) 17:14, 21 September 2015 (UTC)

I was invited by a bot to make a comment, I am not either competent or willing to discuss the reliability of specific research. The comment I made is that the examples given do not persuade me that research is being rejected solely or primarily on the grounds of ethnicity or nationality, and that further, if it were, this would not be an effective means of remedying the problem. The provenance of any source, and its reputation for checking, is always a factor in assessing its reliability, whether we are discussing Russia Today, Fox News, Daily Mail, or a Govt. statement. I am in-expert on the protocols of medical trials, but even I know that allowing for 'placebo effect' is a cornerstone of such trials, yet you dismiss this factor above as 'Chinese doctors have an ethical objection'. Fine, then such trials have not been conducted according to long-established medical standards. IF the proof of 'racism' or irrational 'national prejudice' were as clear-cut as you appear to believe it to be, you should be taking this matter to a much higher 'court' in WP than this RfC. I am not persuaded that you are correct. Pincrete (talk) 07:47, 22 September 2015 (UTC)

• Oppose There's no noted problem with this occurring. The objections to Chinese sources for acupuncture and Indian sources for ayurveda is due to noted and repeated bias problems, not due to some imaginary racist motivation.—Kww(talk) 16:05, 23 September 2015 (UTC)

Actually, one of the noted problems was with you, when you deemed a series of Cochrane Reviews suspect because they had Chinese authors. I just wanted to correct the record here. I'll also note you continue to defend this behavior even today. Nobody is saying there's racist motivations on your or anyone's part for doing this, btw, just a wrongful assumption where you believe that because some studies have at one time shown possible (not proven) bias, all are therefore unreliable, even extending to what we consider the highest quality sources like Cochrane. LesVegas (talk) 20:17, 23 September 2015 (UTC)

You confuse "LesVegas is concerned about an issue" with "there actually is an issue".—Kww(talk) 20:57, 23 September 2015 (UTC)

• Oppose. Where there is a proven bias, as in the case of Chinese studies of acupuncture, we should just ignore them. (Off topic, but I also believe we should treat industry-funded reviews with a high degree of skepticism, and should ignore them when good, independently funded reviews are available.) --Anthonyhcole (talk · contribs · email) 02:05, 26 September 2015 (UTC)
• Oppose It's unnecessary to add that kind of language. We accept a source if it's published in reputable journals regardless of their origin. This proposal will only work for POV pushers as an avenue to weasel their not so reliable sources into articles, claiming regional bias. Darwinian Ape 08:50, 30 September 2015 (UTC)

Call for close

This thread should be closed as POV pushing and trolling. When Jytdog wrote "When the institutions that support science in China become independent and mature, their journals will become valuable sources. They are not there yet", only to have LesVegas characterize it as " Chinese scientists aren't independent or mature" -- something Jytdog never wrote or implied -- it became clearly evident that LesVegas is more interested in winning the argument than seeking the truth. Demonizing Jytdog as a racist is trolling, and we should close down this discussion rather than rewarding such behavior with further attention. --Guy Macon (talk) 20:00, 6 September 2015 (UTC)

Oppose closeI find it a little odd that nobody seems to want to answer why we have one standard for industry funded sources (written into MEDRS), and an entire other standard for Chinese sources where we can reject them on the basis of being Chinese and not on their own merits. Nobody has dared answer that question, and here, less than 24 hrs after the RfC was filed, an attempt has been made to close it before anyone answers this obvious and frankly embarrasing inconsistency. How paradoxical to then accuse me of not trying to seek the truth. And please don't accuse me of demonizing Jytdog as racist. He accused me of accusing him of racism, which is not the same thing at all. He said I was finding diffs that made him look racist and I told him essentially that was his problem, not mine. As for institutions, are they faceless, humanless entities or are they made up of human beings? So I suppose the institutions can be immature or not independent, but the scientists and publishers composing the institutions are mature and independent? Really? Especially when Jytdog and other editors are on record rejecting sources because they're Chinese, and not because of, say, lack of peer-review or lack of Medline indexing. If you read Jytdog's many diffs in full context he makes it clear it is impossible for anything Chinese to ever be considered reliable. I have not once seen him state, even here, otherwise. And at the same time he defends the practice of not rejecting sources because of industry-funding that has been documented to skew results, but opposes all Chinese research on acupuncture for those same reasons. I have asked multiple times for an answer, and he ignores it. Please, somebody, can somebody answer it? If we can come to a consensus on how to reconcile that glaring issue, and we can come to a consensus that high quality sources shouldn't be rejected on the basis of ethnicity of author, nor should they be rejected purely because of where they're published, I'm fine with that. When editors reject friggin Cochrane Reviews because authors are Chinese, we have a serious problem. LesVegas (talk) 22:11, 6 September 2015 (UTC)

I'm reminded of MastCell's WP:CGTW#8: Anyone who edits policy pages to favor their position in a specific dispute has no business editing policy pages. Corollary: these are the only people who edit policy pages. Yobol (talk) 22:16, 6 September 2015 (UTC)

• Support close This RfC is an obvious attempt to win a content dispute by declaring that editors objecting to certain sources are racist. Johnuniq (talk) 23:45, 6 September 2015 (UTC)

Oppose close - I do not think it is appropriate that everyone is focusing on the editor instead of answering the basic question this thread is asking - some of those opposed to the policy edit proposed asked some version of "why would country of origin matter?" Well, exactly, it shouldn't matter. And yet sources are rejected because "they're Chinese" and that is wrong. If there were reliable ways of gauging the quality of the research, each review can evaluated on its own merit, as it should be. The fact that the authors are Chinese shouldn't even come up, but it frequently does. So, we have a problem.Herbxue (talk) 14:12, 7 September 2015 (UTC)

Note to closer: Herbxue also has argued for using sources stemming from Chinese institutions in acupuncture articles and claimed discrimination with regard to applying REDFLAG to them Jytdog (talk) 14:50, 7 September 2015 (UTC)

Actually read that link again: I say "fine" to rejecting Chinese journals that do not have a reputation for quality, what I call "outrageous" is rejecting a review in a mainstream journal because the authors names are Chinese, and yes that actually occurred, and thus we have a true problem.Herbxue (talk) 15:25, 7 September 2015 (UTC)

You continue to conflate systematic problems with Chinese science on acupuncture with racism. This is not OK. Please provide me with any diff where you express an acknowledgement of the problem (there is not one in that diff btw - you acknowledge occasional problems, not institutional ones) I very much agree that the issue is not about individual Chinese scientists. Jytdog (talk) 15:59, 7 September 2015 (UTC)

Focusing on individual editors is taking the focus away from the debate. I have acknowledged problems I saw with TCM research firsthand in China, but I do not generalize them, and I do not believe there is adequate evidence to claim there is a "systematic" problem with "Chinese research". For me the issue here is whether Chinese researchers are inherently unreliable, and I don't believe WP editors can say that they are without evidence showing individual journals or educational institutions to be unreliable. If a particular review appears to be of low quality, then that in itself is reason not to use it. But if it appears to have solid methodology, I don't think it should be rejected on the basis of being "Chinese". Herbxue (talk) 21:20, 7 September 2015 (UTC)

• Support close Despite what our resident acupuncturist says, we should not use unreliable sources, (which is what they are) wherever they come from. -Roxy the dog™ (Resonate) 14:28, 7 September 2015 (UTC)

• This might have been an interesting RfC and it asks some very real questions in terms of sources. I would have been interested in pursuing the ideas presented here from all sides however, once again, discussion is shut down with name calling and personal accusations so that mature discussion is thrown out.(Littleolive oil (talk) 14:35, 7 September 2015 (UTC))

Note to closer: Littleolive oil also has argued for using sources stemming from Chinese institutions in acupuncture articles and per this agrees with Herbxue who commented above Jytdog (talk) 14:50, 7 September 2015 (UTC)

Thank you for including a link which belies what you mean to be an accusation and attack and links to my cmts which you paraphrase inaccurately.(Littleolive oil (talk) 15:17, 7 September 2015 (UTC))

• • I am becoming increasingly concerned with Jytdog's constant attacks and his inaccurate representations of editors and what they are saying and doing.(Littleolive oil (talk) 15:28, 7 September 2015 (UTC))

Naming you as an alt-med advocate is not a personal attack; it is a description that is easily supportable with diffs. And as I noted here, you are the one making blatant misreprentations here, as did LesVegas as noted in post opening this section. I don't know what you think this drama-mongering gains for you. Jytdog (talk) 16:36, 7 September 2015 (UTC)

Just so you know, being an alt-med advocate and being an editor who wants to make sure alt-med is treated neutrally and fairly on Misplaced Pages are two completely different things. LesVegas (talk) 18:08, 7 September 2015 (UTC)

Jytdog. No diif or diffs support overarching, sweeping generalizations regarding other people. Making false statements about people is a personal attack on those people and what they are and stand for. Misplaced Pages is not the real world, a place in which people are multifaceted and carry on their lives in complex ways. Do you realize that the use of exercise and the studies on its impact on health are relatively new. Is this alternative medicine and if so how many sensible people in the world today support this alternative medicine. If I use antibiotics but support exercise does this make me a supporter of alternative medicine. You are constantly making statements which attach motive and meaning to people and their actions. What do I get out of this. Nothing expect that I am tired of seeing false narratives created by editors which in the end are used and applied to sanction. It is possible to disagree with people and to even be aware that our own perspectives are based on our own point of view. Discussion which does not attack but attempts to understand and compromise can go along way towards creating good articles. You have once again made statements about me which are false with no proof whatsoever. You are creating a false narrative about another editor. You know nothing about what I support and do not support. This the third time. (Littleolive oil (talk) 17:25, 7 September 2015 (UTC))

Oppose close RFC's should run 30 days, this one is only 2 days old. Regardless if some are reading into the question something it doesnt say, it needs to run its course. AlbinoFerret 16:04, 7 September 2015 (UTC)

Support close, this RfC is going nowhere and is sufficiently ill-framed that it stands minimal chance of producing anything useful. Richard Keatinge (talk) 16:19, 7 September 2015 (UTC)

• Oppose close: RfC was simple, and straightforward concept; IDHT problem of editors reading more into it than exists notwithstanding. Montanabw 23:41, 12 September 2015 (UTC)

• Oppose Close. This proposition brings up a valid point. Country of origin should not be, in general, a criteria for inclusion of a medicinal article. It doesn't matter what the purpose of presentation was, this should be a part of the guidelines. What's the issue with additional guidelines for inclusion arbitration? ExParte 05:34, 13 September 2015 (UTC)

• Country of origin should not be a blanket basis for condemnation across all possible subjects, but it might be for specific countries in specific subjects. It would certainly be the case for the subject and country being discussed be on the evidence a reason for at least the greatest skepticism. The prosposed modification is too great. The cases will need to be discussed individually. DGG ( talk ) 20:11, 13 September 2015 (UTC)
• Support close … This RfC is an obvious attempt to win a content dispute by declaring that editors objecting to certain sources are racist. and , this RfC is going nowhere and is sufficiently ill-framed that it stands minimal chance of producing anything useful. This seems like a lot of airing of bad feeling on the part of those who want different standards to apply to Alt Meds. Pincrete (talk) 19:12, 19 September 2015 (UTC)

This problem is still occurring

I have seen comments suggesting editors here never rejected sources because their authors are Chinese, despite diffs, so allow me to provide one more. Just yesterday, an editor did just that, rejecting a high-quality source because it had Chinese authors, so clearly this is a serious and ongoing problem that must be dealt with. This editor rejected research in a high quality journal, Medicine, because the "authors are Chinese," and therefore assumed to be incapable of not being biased Like it or not, rejecting sources based on ethnic origin of authors is a real problem. Sources in low quality journals should be rejected based on their own lack of merits. Sources in high quality journals should be accepted on their own merits. But sources should never be excluded for embarrasing reasons like this and it is a shame that in 2015 we have to have to write explicit language into our guidelines to keep behavior like this from happening. LesVegas (talk) 20:18, 8 September 2015 (UTC)

I think you're grossly oversimplifying a significant issue. It has been recognized for some time that research in certain countries tends to be uniformly positive about acupuncture, to the extent that it raises serious questions about publication bias. This line of thought is not—as you try to portray it—a form of racism among Misplaced Pages contributors. The relevance of national origin of research has been expounded both qualitatively and quantitatively in the reputable scholarly literature, going as far back as Vickers et al., 1998, who found that trials from China, Japan, Hong Kong, and Taiwan were uniformly positive about acupuncture and urged caution in integrating these almost-certainly-biased results into systematic reviews or meta-analyses. More recently, a systematic review conducted by Chinese authors in 2014 found striking evidence of publication bias in studies on acupuncture reported in Chinese journals. I think it's worth having a serious discussion about this, but your post is pretty much the opposite of serious discussion. MastCell  17:56, 21 September 2015 (UTC)

MastCell, I'm all for having a serious discussion on this and hope you are too. For the record, I never claimed racism was a factor here, and my rather long-winded complex posts, if you read them, should show that I haven't oversimplified anything. In fact, we have written into MEDRS not to deny sources based on how they're funded, and yet we have extensive documentation of publication bias regarding industry funded research. No such bias has ever been proven with Chinese research, merely speculated as one of many possibilities for difference in findings. Why would we treat Chinese research different than industry funded research? A subject which, by the way, has much more extensive documentation of bias! That said, when editors reject Cochrane Reviews because they have Chinese authors, or reject obviously high quality Western-published journals because they have Chinese authors, maybe they're just belligerent POV pushers rather than racists. But they put their POV above all else and that's a problem. LesVegas (talk) 21:25, 21 September 2015 (UTC)

But this has never happened, your diffs don't support it. CFCF 💌 📧 00:09, 22 September 2015 (UTC)

Ummm, there is a diff at the top of this very thread where an editor objected to a journal article in Medicine because its authors were Chinese. Did you not see that? LesVegas (talk) 00:22, 22 September 2015 (UTC)

The diff doesn't say that, it speaks of 'a well documented bias' and expands later. Mis-quoting people doesn't strengthen your case. In other areas of WP should we not be allowed to say that govt X, TV station Y or news outlet Z, has 'a well documented bias' and should therefore be treated with extreme caution ? Pincrete (talk) 07:56, 22 September 2015 (UTC)

Pincrete, I am sorry I forgot to show the actual source, but, anyway, here is the source that was removed. As you can see, it is a high quality journal that just so happens to have Chinese authors who did the meta-analysis. The diff in question was trying to apply the "well-documented bias" to this meta-analysis and systematic review. There is another one where the same thing happened regarding several Cochrane Reviews used to update an old claim. They just so happened to have Chinese authors and that's a problem. LesVegas (talk) 22:43, 22 September 2015 (UTC)

When you actually read the conclusions in that paper they say very little, and above all they comment on the lack of qualitative studies in the field. It states "Finally, the included RCTs were all conducted in China, so more studies are needed" and "Reporting biases could not be detected by funnelplot due to lack of adequate RCTs."
From the entire paper a single positive sentence was taken and copied verbatim into Misplaced Pages (amounting to copyright violation). Maybe the article has a role in the sources, but it did not properly support the statement it was used to support and the comment you linked reflects that. CFCF 💌 📧 23:12, 22 September 2015 (UTC)

CFCF, I agree with most of what you said above. Yes, it was a copyright violation. And yes, the quote wasn't fully representative of the source. And by the way, I didn't add the quote or source, that was another editor. I had nothing to do with it beyond watch it get removed. But the reasons it was removed were wrong. Removing it or amending it for reasons you stated are perfectly fine. I have no problem with that. Editors shouldn't be supporting removal of sources because the authors are Chinese. I hate to belabor the point, but you said above that it never happened and my diffs don't support it, so I just have to clear my name here. LesVegas (talk) 02:27, 23 September 2015 (UTC)

The article states it is a problem that their study has included so many chinese studies, so I find nothing wrong with the comment you've linked. CFCF 💌 📧 07:23, 23 September 2015 (UTC)

CFCF Do you have access to the full article? Would you mind posting what they say re Chinese studies? It was not in the free text they provided. LesVegas (talk) 20:08, 23 September 2015 (UTC)

LesVegas, I am not competent to assess the virtues or weaknesses of specific medical research, my opinion on that would be valueless. However, specific pieces of research are not the subject of this RfC, rather a general principle. Pincrete (talk) 08:25, 23 September 2015 (UTC)

Question for Kww

User:Kww is mentioned repeatedly above, and it doesn't look to me like anyone has pinged him about this or given him a fair chance to explain his off-the-cuff comment that most of the "authors are Chinese" on a particular source. (Does that refer to their race? Their citizenship? Where they were trained? Where they're currently working? A quick guess based upon last names? It could mean almost anything.) IMO it would be fair to let him have his say if he's interested. WhatamIdoing (talk) 04:32, 23 September 2015 (UTC)

The diff shows an edit by Guy (JzG). The history of Talk:Acupuncture says Kww hasn't posted there since July. Johnuniq (talk) 04:53, 23 September 2015 (UTC)

Yes I'd love for him to explain himself because I and other editors could never get an explanation back when I confronted him about it. But as I understand it, he doesn't edit much anymore since his desysopping, correct? LesVegas (talk) 15:00, 23 September 2015 (UTC)

Actually I just looked at his edit history and I see he occasionally and casually edits here and there still, so maybe we can finally get an explaination on the specifics. LesVegas (talk) 15:03, 23 September 2015 (UTC)

I don't respond much unless pinged. The diff you are providing is JzG's, but I'll defend it. The bias of Chinese medical journals and Chinese studies submitted to Western medical journals is well-documented. For such sources to discover beneficial effects to acupuncture isn't particularly surprising, nor is it likely to indicate that acupuncture has any particular effect beyond placebo. There are similar problems with sources related to ayurveda. While I understand the slippery slope of racism, it's also important for us to note that associated with some of the rituals that are misrepresented as medicine there are one or two countries that have a vested interest in portraying that ritual as if it were effective. As for Les Vegas's proposal above, I don't think anyone is attempting to remove sources due to a personal objection to the country of origin: it's due to well-documented and objectively provable objections to the country of origin.—Kww(talk) 16:03, 23 September 2015 (UTC)

Thanks for the reply, Kevin; I appreciate it. Thanks also to John for pointing out that I had the wrong diff. I apologize for the sloppy post; I meant this diff. WhatamIdoing (talk) 16:12, 23 September 2015 (UTC)

As for the corrected quote, note that my primary objection was that even taken at face value, the sources didn't support the proposition Les Vegas was making: "not effective for a wide range of conditions" isn't contradicted (or even particularly weakened) by evidence of positive effect for a narrow range of conditions. I didn't get into a detailed analysis of the sources themselves. I will say, however, that it's a fair bet that Z Zheng, CCL Xue, J Shang, X Shen, J Xia, X Zhu, L He, and J Song being among the reported researchers in a small handful of reviews represents a reasonable foundation to suspect bias. If there was actually a meaningful claim being made, I'd scrutinize the sources more carefully.—Kww(talk) 16:29, 23 September 2015 (UTC)

Thank you for the explanation. Kww's answer goes right to the heart of the matter. If authors have Chinese names, we should suspect bias even if it's in a Cochrane Review, as if Cochrane is incapable of vetting the material themselves, but we, the lowly Misplaced Pages editor are. Frankly, I'm really not surprised. LesVegas (talk) 20:04, 23 September 2015 (UTC)

Nor should you be. What's surprising is that you would think that we should close our eyes to an indication of bias noted in reliable sources. Note that I did not reject the sources outright, but was arguing primarily on the basis that your conclusions didn't follow from their statements even if we presumed they were completely accurate.—Kww(talk) 20:54, 23 September 2015 (UTC)

Yes, I recall very well. Your primary argument was that the Cochrane Reviews didn't support replacing a 6 year old claim with an update. Your secondary argument was that they might be unreliable anyway because they have Chinese authors. That's what is being disputed here. Please note that the wording of the MEDRS amendment in this RfC says "do not reject high quality sources because of x,y,z...or country of origin." It does not say do not reject high quality sources if they are being used to support a claim that isn't supported by those sources, or is more accurately supported by another source. Policies elsewhere already cover those objections. LesVegas (talk) 21:41, 23 September 2015 (UTC)

If you had found material that actually supported an update, I would listen. Once again, "not effective for a wide range of conditions" and "is effective for condition x, y, and z" are not contradictory. They are barely related. The original source surveyed the impact on over thirty conditions and you found a source that weakened the position on, at most, two of those conditions. As for your propensity for misinterpreting sources and using them to support claims they don't support, I hope this debate makes that problem more obvious to a wider variety of editors. Your motivation for requesting this change has been noted by numerous editors: you are upset that people want to see corroboration in other sources when you can only offer Chinese sources supporting a claim about acupuncture. Given the noted bias problems, that's a quite reasonable demand. If something is actually true, Western sources will eventually catch up.—Kww(talk) 22:08, 23 September 2015 (UTC)

You're back to omnisciently assuming my motivations again. Just for the record, my motives are simply to encourage editors to examine source quality and not reject them for paltry reasons like the last name of their authors. LesVegas (talk) 22:21, 23 September 2015 (UTC)

Examination of source quality does require taking bias considerations into account. Your requested modification is basically a demand to ignore one potential source of bias. As for omniscience? No, pretty much any observer of your edits and discussions will come to a similar conclusion.—Kww(talk) 22:38, 23 September 2015 (UTC)

"Examination of source quality does require taking bias considerations into account" is just another way of saying high quality sources that we never question anywhere else for any other claims might not be high quality at all if we see it has Chinese authors, whom we ought to be suspicious of because they might be biased. Thank you for making your position clear, over and over again. LesVegas (talk) 23:03, 23 September 2015 (UTC)

I support being suspicious of any biased source (including Coke-paid researchers on the effects of soda pop on obesity , ayurvedists on the benefits of heavy metal poisoning, Christians on the historical existence of Jesus of Nazareth, among many other examples a quick search of my edit history will uncover).—Kww(talk) 23:58, 23 September 2015 (UTC)

You shouldn't attempt to fix the inconsistency in the wrong direction: two wrongs don't make a right and all that.—Kww(talk) 04:15, 24 September 2015 (UTC)

The question of industry funding was discussed at length very recently on this very page. There, WP:DNFT was invoked and I think it now applies here too. Time to close. Alexbrn (talk) 04:24, 24 September 2015 (UTC)

You can ignore a problem or inconsistency, you can IDHT, but editors shouldn't be insulted for pointing out problems. And previously, that was invoked by an editor who much of the Misplaced Pages community has complained about for GMO advocacy and personal attacks and I have no reason to doubt that his invoking DNFT wasn't a great illustration of both his advocacy and insults. I can certainly see why a GMO advocate doesn't want to limit industry funded sources in any way. This same editor also believed Chinese sources should be limited rather inconsistently. But I expected much better from you, Alexbrn, than to ignore and insult and hope this embarrassing inconsistency just goes away. And as much as I deeply disagree with Kww on this issue, I at least have to respect and admire his consistency here. And we should be consistent, one way or another. While I think the best way with our policies is to allow high quality sources regardless of industry funding or country of origin (because it's too hard to say that because some have been bad, all are bad), we cannot have one set of guidelines for some sources and another set of guidelines for others. I know it's uncomfortable for some editors to admit this partisan application, but If we bury our heads in the sand and pretend it's not inconsistent, that won't magically make it consistent. LesVegas (talk)

You've illustrated the problem quite nicely: there's no particular correlation between the conflict of interest inherent in the Coca-Cola funded obesity research and the general agreement of all responsible researchers that GMO as currently practiced presents no health or public safety issues. While I abhor the inconsistency, I can understand why people would see a slippery-slope problem on the funding issues. After all, most good research is funded by people connnected with science, and science pretty much rules out the anti-vax, anti-GMO, pro-ayurveda, and pro-acupuncture camps, giving those people an incentive to object to nearly all research as being biased in one way or the other.—Kww(talk) 00:05, 25 September 2015 (UTC)

Well, I don't claim to be an expert on the latest in all things biotech, but I know Monsanto funds much biotech safety research and even when" purely independent research" is touted in the press it's often funded by The American Society for Nutrition whose own website says is funded by Monsanto. They fund the science all over the place. And this idea that industry-funded research was only a problem with Coke today and big tobacco in yesteryears is not accurate at all. What I do know is there is well documented issues with pharmaceutical industry funded research in the way of psychiatric medications and in failing to warn about cancer risk with certain drugs, as well as in showing a huge statistical increase in "positive findings" for various pharmaceuticals just to name a few. They were all connected with "science" yet clearly have shown worse issues than the Chinese because they're not explainable by a slew of confounding factors from an entirely different culture and a medicinal art many researchers have openly admitted is very difficult to study anyway. I see no argument for why we should treat Chinese studies differently than those paid for by Monsanto, Merck or the Marlboro Man. LesVegas (talk) 19:29, 25 September 2015 (UTC)

It's a balancing act: whether an individual drug does or does not create a cancer risk is something with gradations of bias that can range from damning (a study by the manufacturer that contradicts all other studies would need to be treated with great suspicion, for example) to minor (a study by a research group funded by multiple sources, including the manufacturer, which falls in line with similar studies by groups not involving the manufacturer). In the case of Chinese studies of acupuncture, we're dealing with a group that tends not to publish negative results, refuses to use standard placebo-based methodologies, and comes to conclusions that researchers using more rigorous research techniques cannot reproduce. There's no reason to suspect that the results are accurate, and every reason to suspect that the results are due to flawed research and reporting. There's nobody arguing to exclude all Chinese research, just to avoid relying on a known trouble spot: Chinese studies of treatments based on Chinese folk remedies and superstitions. Is there anyone objecting to Chinese studies of pharmaceutical treatment of tuberculosis or anything like that? I think not.—Kww(talk) 23:01, 25 September 2015 (UTC)

Actually, negative results in China weren't seen in 1998, they are now. But sure, in more recent times it's noted with different results seen in US studies. Some of that could be publication bias, some of that could be due to other factors. Fact is, we don't know. But industry funded pharmaceutical results are also seen to have much better results than independent research shows and those are comparing results within the same country. We have one variable to deal with there, not countless, so it makes publication bias much more likely a factor than is the case with the Chinese. I'm talking hard facts and statistics here, not your opinions of Chinese culture or your opinions of alternative medicine, but documented facts alone. And by the documented facts alone, even in the worst case-scenario with the lowest quality published research in China, Chinese studies on acupuncture have actually less possibility of publication bias than industry funded pharmaceutical studies do from the standpoint of variables. Any reasonable person examining facts alone and not swayed by opinions or POV must agree with this. And yet we specifically allow industry funded pharmaceutical studies on Misplaced Pages, and some of these same editors want to reject Chinese studies on acupuncture. LesVegas (talk) 16:59, 26 September 2015 (UTC)

Do we all understand the outcome here?

So we have a bit of a procedural issue with RFCs, which is that one editor lists almost all the expired RFCs at WP:ANRFC, so that some busy WP:NAC can carefully add a colored box and a closing statement to each of them. I think this is an ongoing WP:NOTBURO problem, a waste of time for most RFCs, and sometimes even an insult to the participants' good sense and ability to understand their own conversations, but let me ask just to be sure:

Does anybody here need any outside help in figuring out whether or not this discussion shows support for the proposed addition of the words "country of origin" to that sentence in this guideline at this time?

If nobody actually needs any help with understanding the outcome, then perhaps we can prevent him from wasting someone's time with telling us what we all already know. WhatamIdoing (talk) 17:49, 6 October 2015 (UTC)

Country of origin

We do reject sources because they are from a specific country because there are sources that are poor sources and there are bias sources. According to the close the country of origin is a legit consideration where RS have identified it as an issue. There have been hard data (as contrasted to stereotypes) that have identified a systematic problem that is normally identified with an affiliated country of origin. Therefore, this edit seems to contradict the close. QuackGuru (talk) 17:00, 20 October 2015 (UTC)

The close that I wrote said no such thing. Besides, the suggestion that the edit that the close clearly and directly indicates is appropriate nonetheless contradicts the close by some extreme, odd interpretation is utterly nonsensical. Get the point. Discussion closed. --Elvey 03:34, 24 October 2015 (UTC)

User:Elvey, perhaps you would come back and clarify a few things for us. For example, you wrote "We cannot override WP:V or WP:RS." In what way would rejecting some sources, on some subjects, from countries with a strong reputation for the low quality their sources, constitute "overriding" WP:V or WP:RS? WhatamIdoing (talk) 21:35, 20 October 2015 (UTC)

Reread Albino's comment. To what end do you seek clarification? --Elvey 03:34, 24 October 2015 (UTC)

I am flummoxed as to why that single comment is singled out as of more weight than those of multiple other editors. This seems to me a very questionable closure. CFCF 💌 📧 12:02, 24 October 2015 (UTC)

I think that would likely be because Albino's comment stated that multiple editors were ignoring the fact that we are talking about high quality sources and some editors opposed low quality sources, which wasn't the purpose of the RfC. LesVegas (talk) 12:53, 24 October 2015 (UTC)

It still completely fails to address the actual need for the addition. No discussion has been shown about not including high quality sources based on country of origin, this is a red herring and a useless bloating addition. CFCF 💌 📧 10:02, 26 October 2015 (UTC)

This discussion centres around attempts by SPA editors to crowbar low quality sources supporting various degrees of efficacy not shown in high quality sources of ALT-Med articles, particularly Acupuncture. Other attempts have been made, to WP:MEDRS for example. Characterising mainstream editors as racially prejudiced by SPA's has been happening for a while now, and is a particularly nasty tactic. -Roxy the dog™ (Resonate) 10:20, 26 October 2015 (UTC)

While I am surprised my comment was mentioned. I am not surprised with the close. My comment did point the problem with some of the responses. They were off topic. A problem that looks like its repeating down here. The RFC question specifically was about High quality sources. Low quality sources will be rejected regardless of what country they are from because they will not even pass WP:RS. AlbinoFerret 13:54, 26 October 2015 (UTC)

Are there examples of editors rejecting high quality sources because of racial prejudice? -Roxy the dog™ (Resonate) 14:30, 26 October 2015 (UTC)

A couple were mentioned during the RFC. I did point out I was unsure if it was widespread, but even if it isnt very widespread its a bad thing that should be stopped. It hurts the project in rejecting even a few high quality sources and makes the project look bad focusing in the ethnic angle. I think those editors who are concerned this will allow low quality sources in shouldt worry, low quality will always be excluded. Just point out the problems with the source that make it low quality and dont point out where they came from. Doing that give those pushing them a reason to argue. AlbinoFerret 14:46, 26 October 2015 (UTC)

I think this might work: "While country of origin per se is not a suitable reason to reject a source, it is appropriate to consider in cases where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries."

1. See discussion at here.

QuackGuru (talk) 20:31, 26 October 2015 (UTC)

While that may be what you want in the section, it does not say what the closer said. Here is the section:

"This addition should NOT be read as a PC ban on any mention of country of origin (or founding source, etc.) when necessary to refer to studies with hard data (as contrasted to stereotypes) that have identified a systematic problem that is normally identified with an affiliated country of origin, as mentioned by Richard Keatinge. Likewise, this addition should NOT be read as a changing the longstanding policy that sources from publications known to routinely publish and fail to retract material proven unreliable may be excluded."

What it appears Elvey is saying , and Elvey can correct me if I am wrong, is this close is not a ban on discussing problems with sources in a discussion of a source that talks about them. It doesnt appear to be a loophole to insert arguments about a source, based on a country, just because other crappy sources have come from there. What might be better to say is "It is better to look at the quality of a source, if the source is of low quality it should be excluded." AlbinoFerret 20:58, 26 October 2015 (UTC)

Your proposal "It is better to look at the quality of a source, if the source is of low quality it should be excluded." is not about country of origin. QuackGuru (talk) 21:01, 26 October 2015 (UTC)

See the specific part of the close. See "when necessary to refer to studies with hard data (as contrasted to stereotypes) that have identified a systematic problem that is normally identified with an affiliated country of origin, as mentioned by Richard Keatinge." QuackGuru (talk) 21:02, 26 October 2015 (UTC)

Thats because the RFC has already said that country of origin is not a valid exclusion. I assumed that country of origin is added to the list of other things that should not be considered. The whole purpose of that section appears to be to tell people to look for high quality sources, then some things that should not be considered. I propose adding a sentence at the bottom to direct editors to, instead of looking at the country or funding, to look at the quality. AlbinoFerret 21:07, 26 October 2015 (UTC)

Yes, it says not to stop discussions about a topic that discusses low quality sources, not a loophole to allow discussions that we have already said should not take place like excluding a source based on ethnic origin. AlbinoFerret 21:09, 26 October 2015 (UTC)

You said "Thats because the RFC has already said that country of origin is not a valid exclusion." That what was written and that was what was added.

"While country of origin per se is not a suitable reason to reject a source, it is appropriate to consider in cases where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries." QuackGuru (talk) 21:11, 26 October 2015 (UTC)

You are adding a loophole that I dont believe the closer added. Lets wait for them to chime in as I have pinged the closer in a few posts ago. AlbinoFerret 21:14, 26 October 2015 (UTC)

Albino Ferret is right, in fact, it would violate the spirit of every single RfC done across wikipedia if we always added a reference tag and then just put whatever summary those opposed wanted. Adding in a summary of whatever you want to be read as a caveat is gaming an RfC outcome. Besides, the RfC wasn't about "should we say 'country of origin' and then have these caveats?" it was about the wording, "country of origin" specifically. And, to that, the answer was "yes," it needs to be added in. But since the consensus reading did mention other specifics and since some editors are persistent in wanting something else, I figured a link where readers could see the full consensus read/closing comments would be the best compromise. LesVegas (talk) 21:25, 26 October 2015 (UTC)

The outcome of the RfC is not constrained to be binary. It's intended to gauge consensus, and the closer found consensus to include 'country of origin', but with the caveat that it might be a legitimate consideration where "hard data" demonstrate a concern about biased literature. MastCell  22:52, 26 October 2015 (UTC)

The point is that the addition is completely useless, and not supported by the RfC. QuackGuru – while I agree with the intent of your clarifications the fact is we are just introducing bloat. If any policy is to be taken seriously it needs to be succinct, and can't include hypothetical clauses that have never been proven to be needed. CFCF 💌 📧 22:48, 26 October 2015 (UTC) 

When the RfC is a question asking "should we add 'country of origin' to this list?", and the consensus reading says "Yes" removing it entirely is going against consensus. LesVegas (talk) 23:09, 26 October 2015 (UTC)

We're trying to get some clarification of some of the major issues with the close and a possible new clause, it isn't something we will do on a whim–we need to have a agree on what (if anything) to include. We should wait until clarification of what Elvey meant in the close summary. Currently the meaning of the text is very murky, and as such it may be challenged for not adequately summarizing the consensus. CFCF 💌 📧 23:15, 26 October 2015 (UTC)

WP:MEDASSESS and hierarchies of evidence

In a recent WikiProject Medicine discussion, I noted that WP:MEDASSESS largely follows an evidence-based medicine approach, but that there are many valid critiques of the EBM movement (examples given in that discussion). I note Pearce et al. (2015) says:

"the notion of ‘hierarchies’ of evidence within evidence-based medicine is no longer prevalent in the literature, being replaced by more nuanced typologies of evidence demonstrating how different research methods are appropriate for answering different types of research question ."

72. OCEBM Levels of Evidence Working Group. The Oxford Levels of Evidence 2. Oxford: Oxford Centre for Evidence-Based Medicine; 2011. 73. Howick J, Chalmers I, Glasziou P, Greenhalgh T, Heneghan C, Liberati A, et al. Explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence (Background Document). Oxford: Oxford Centre for Evidence-Based Medicine; 2011.

Perhaps we are a bit behind the times now in following a "pyramid" hierarchy and should work on some alternative text.

Here has the set of papers, all open access, that includes Pearce et al., a series edited by Trish Greenhalgh. Bondegezou (talk) 16:32, 14 September 2015 (UTC)

Yes, we need to address this. I've been thinking about it for a long time—not because there's something "wrong" with the evidence hierarchies, but because they're only useful for some kinds of information. You will never see a systematic review of randomized controlled studies on what the current name of body part is. It'd be silly. And yet we have editors who believe that this is the be-all and end-all of all sources, and that it's better to cite a systematic review that mentions something like that in passing than to cite a more authoritative source, e.g., a reputable anatomy textbook.

But I think it's going to take a lot of re-writing, and I've got limited time for it. WhatamIdoing (talk) 04:20, 23 September 2015 (UTC)

I'll try to find time, but the issue in the case you've linked is not that EBM is weak, but that it does not apply to all fields. CFCF 💌 📧 07:07, 23 September 2015 (UTC)

Writing for Misplaced Pages on scientific topics is not "doing" peer reviewed science, more especially it is not authoring reviews. It is, or should be, non-credible mostly-pseudonymous editors reporting on where the existing consensus of scientists lies. This is the underlying reason that we cannot use our own individual assessment of primary sources, even the experts among us. The result is that we cannot simply adopt a ranking hierarchy intended for use by experts: we must have published sources behind our application of wp:WEIGHT, as inconvenient as that may be when we all know the primary source is right.LeadSongDog come howl! 13:06, 23 September 2015 (UTC)

One of the (multiple) problems that we create with mindless application of a "no primary sources!" rule is that we exclude interesting information as a result. Primary sources need to be given due weight, which doesn't always mean excluding them. For very rare diseases, due weight might even mean emphasizing them—because the options are sometimes scholarly primaries or non-scholarly secondaries, and the "scholarly" part can matter more than the "secondary" part. We need to stop painting ourselves into a corner by declaring a subject notable because independent secondary sources exist, and then refusing to permit any sources at all to be used: all the academic sources get rejected on the grounds that they're primary or too old, and all the secondary and recent sources get rejected on the grounds that they aren't peer-reviewed.

Also, encyclopedia articles aren't just summaries of current mainstream scientific consensus. They should also include (largely scholarly, largely mainstream) views from multiple disciplines, such as:

• history (why does the word cancer come from crabs?),
• law (where is this drug legal?),
• business (how much money did they make selling this?),
• economics (what would happen to the global economy if depression disappeared?),
• sociology (why does this affect wealthy countries more than poor ones?),
• religion (can this surgery be done bloodlessly?),
• culture (why do people bring you dinner if your child has cancer, but not if he has autism?),
• practical life (can a heart attack make you too weak to lift a pot of coffee?),

and other subjects. None of that is science, and all of it belongs in a medicine-related encyclopedia articles. WhatamIdoing (talk) 16:08, 23 September 2015 (UTC)

MEDRS has exceptions for all those (including primary sources for rare diseases)–so I don't see the issue here.
As I understand it the problem is that misinformed editors are mass-tagging for example 6 year old studies as unreliable. While that is a major issue, it isn't an issue with the current rules.
As for notability I don't understand, would you care to clarify? CFCF 💌 📧 22:05, 23 September 2015 (UTC)

On notability: Notability, in the form of the WP:GNG, basically requires the existence of two or more secondary sources. MEDRS, however, "requires" (in the minds of our most zealous defenders of the wiki) the exclusive use of scholarly secondary sources for WP:Verification. This means that it is possible to have an article about, e.g., an experimental drug, that is WP:Notable (because multiple non-scholarly secondary sources exist) but which produces endless disputes about the lack of "MEDRS-compliant" sources (because zero scholarly secondary sources exist). We are handling this poorly. WhatamIdoing (talk) 17:57, 6 October 2015 (UTC)

MEDDATE

Here's an approximate idea of what I'm thinking about MEDDATE issues.

Does this seem approximately like what you all would expect to find if you were looking for sources? (On the fourth line, it may help to know that hypertension does not seem to be a common complication of cystic fibrosis.) WhatamIdoing (talk) 18:22, 6 October 2015 (UTC)

I like the idea of a table of different variants like this, but it's going to need some work. There are a couple of issues here:

 1. Ideal source are obviously always new up to date systematic reviews regardless of topic area

 2. Do we use number of reviews to determin which are major/minor topics and how do we know ehn a topic falls under any of these groups?

 3. How do we determine if reviews/articles have been published? You have WebOfScience and Scopus for this but very few editors have access. Pubmed doesn't really cut it.

 4. The wording "regardless of absolute age" is problematic because all you need to do is go back to a 1970s East German source and you can promote a wealth of alt-med diseases. I'd be more comfortable is we used something akin to Orphanet to determine what rare diseases are - many old purported diseases are just that, and aren't considered real today.

 5. "any primary sources" is far to inclusive

 6. Best possible sources don't depend on subject but rather how much research has been performed - this means that even some very rare diseases have quite significant bodies of research.

CFCF 💌 📧 20:31, 6 October 2015 (UTC)

I agree that it needs work; that's why I posted it.  ;-)

1: Ideal sources are not always systematic reviews. The ideal sources for treatment efficacy are systematic reviews – assuming any exist – but systematic reviews are not the ideal source for 90% of article content.

2 and 3: I think that the number of reviews available might be one reasonable metric for major/minor (and all the things in between). We can base this on PubMed and treat it as a rebuttable presumption: if I find nothing in PubMed, but you've got access to Scopus and find more, then you can share your information with me. By the way, here are some quick numbers:

• "Hypertension" is mentioned in 12,730 (tagged) reviews on PubMed in the last five years, and is present in the title of 3,162.
• "Breast cancer" is mentioned in 6,447 and in the title of 3,741.
• "Pneumonia" is mentioned in 2,808 and in the title of 695.
• "Cystic fibrosis" (a heavily researched rare disease) is mentioned in 1,543 and in the title of 692.
• "Preeclampsia" is mentioned in 779 (plus more under the hyphenated spelling "pre-eclampsia") and in the title of 279.
• "Down syndrome" is mentioned in 469 and in the title of 160.
• "Kidney cancer" is mentioned in 225 (plus 174 non-duplicates for "renal cancer") and in the title of just 64 (plus 51 for "renal cancer").
• "Wilson disease" is mentioned in 62 and in the title of 17 (plus more for "Wilson's disease").
• "Oculodental digital dysplasia" (incredibly rare disease) is mentioned in zero.

(These are all quoted-phrase searches on PubMed, merely for illustration rather than ideal searches for these subjects.)

As a quick rule of thumb, then maybe this would work: If there are more than 100 hits among reviews published on the subject in the last year, then you should probably be using the "major" criteria for the bulk of your sources. If there are less than 100, then that might not be possible (because "hits" ≠ "reviews actually about the subject"). Or we could build it based on in-title searches: Use good reviews if you've got more than a couple dozen, but when you've only got 20 (or fewer) to choose from, the fact is that the available sources might not cover all of the material that ought to be in the article. For example, there is exactly one review that has both "cystic fibrosis" and "hypertension" in the title during the last five years, and if you need to source a sentence about non-pulmonary hypertension (perhaps to mention the need to control hypertension in advance of getting a lung transplant), then there are zero recent reviews available on that exact subject.

However, I think that most experienced editors are going to have an easy time deciding where a subject falls on the scale. If I have no trouble discovering sources, then it's a major topic. If my searches come up empty, then it's not. You should be using the best of what you've got, unless and until someone demonstrates that better ones; conversely, when better ones don't exist, then you should not be hassled by people who care about the date on the paper more than they care about the content of the article.

4. Bad sources are bad sources. Age is not the sole, or even main, determinant of whether a source is bad.

5. Bad sources are bad sources. Primary vs secondary status is not the sole, or even main, determinant of whether a source is bad.

6. Best possible sources do depend on the subject, because the subject determines how much research has been published. I believe that you meant to say that the best possible sources don't depend upon disease prevalence.  ;-) Also, it's necessary to write these rules to work for non-disease subjects, such as drugs and surgical techniques. WhatamIdoing (talk) 22:00, 6 October 2015 (UTC)

While I appreciate the thinking behind this proposal, I suspect that it will make things worse rather than better. As we all know, there is already a tendency – usually but not always editors who aren't familiar with how to read and use the published literature – to treat MEDRS as a series of yes/no checkboxes that must be met, rather than as a set of rules of thumb which a skilled editor might consider in evaluating a given source-assertion-context triple. (See also the related problem of editors who think that "reliability" is a magical inherent trait possessed by a source, without regard for how or where that source is being used. And editors who had WT:MED watchlisted earlier this year will be familiar with the individual who thought evaluate this article meant make a complete list of its citations older than 5 years and declare them not MEDRS-compliant, regardless of context.)

Creating a more-specific-looking set of criteria increases the tendency for slavish adherence to the letter of the rule rather than to the purpose of the rule. Saying that "most experienced editors are going to have an easy time deciding where a subject falls on the scale" misses the likely source of the problem— most experienced and competent editors already grasp the need for flexibility in applying MEDRS' guidelines. Where a question about a source arises under these new criteria, the discussion will be diverted from the central question of whether or not the source-assertion-context triple at hand is appropriate, and into bickering over whether a particular topic and area are major/major, major/minor, minor/major, or minor/minor. Once that binary categorization is achieved, there will be blind counting of number of reviews or blind adherence to the five-year criterion—which is the same problem we already encounter. And since the new criteria look more specific and 'scientific', then we're probably going to have more trouble dislodging individuals from their mistaken belief that these rules of thumb are etched in stone. TenOfAllTrades(talk) 11:49, 16 October 2015 (UTC)

Thanks for the thoughtful comment.

Part of the problem is structural: We want to tell people to do X if they're looking for new sources/creating new material, but X plus Y if they're evaluating whether an existing statement is okay. As in: If you're writing a new article, then use the best sources you can possibly lay your hands on. But if you're trying to figure out whether Source X verifies Statement 1, then "the best sources" aren't required. You need one that is good enough, but it only has to be barely good enough.

What do you think about killing any mention of five years at all? WhatamIdoing (talk) 21:29, 20 October 2015 (UTC)

I'm certainly open to the idea. The five-year rule of thumb (and its chronic misinterpretation as an iron-clad commandment) may be causing more problems than it solves, these days.

We generally prefer more recent sources, all other things being equal. But all other things are never exactly equal, and what qualifies as "more recent" varies a lot depending on the field, the content, and the context. I think we (Misplaced Pages editors) sometimes fall down when we over-prioritise recent publication dates over other measures of source quality and reliability. TenOfAllTrades(talk) 02:26, 21 October 2015 (UTC)

Actually, we don't necessarily prefer more recent sources, because of WP:RECENTISM. We do tend to prefer the most recent reviews, of course, because they can consider the impact of more recent primary sources. The "five-year rule of thumb" came into being when it was suggested that in many fields a review cycle (the time between consecutive major reviews) took roughly that amount of time. It's obvious that there is considerable variance in the time before a particular major review becomes superseded by an equally important successor, and unless editors take the time to find the most recent high-quality review, the rule of thumb becomes counter-productive. We really need to be saying something like "In many topics a review conducted more than five to ten years ago will have been superseded by more up-to-date ones, and editors should try to find those", rather than suggesting we reject a perfectly good source solely on the grounds of its age. --RexxS (talk) 15:21, 21 October 2015 (UTC)

The best evidence

This is about this attempted clarification. I usually begin with the assumption that User:CFCF is right, so I went to see what I could learn about the subject.

Here's the list of circulatory-related Cochrane reviews—all 591 of them. There are two about diagnosis, two labeled as "overview", and 587 are interventions (treatment or prevention). Both overviews are about treatments; an "overview" is essentially a systematic review that leans heavily on previous Cochrane reviews. That's 99.66% about treatments.

Here's the list of pregnancy-related Cochrane reviews. There are 553. One is an overview of interventions. One is about prenatal diagnosis of Down syndrome. For that subject, 99.64% of systematic reviews are about treatments.

I picked cardiology because I don't know much about subject, and pregnancy because it was the least disease-like condition in the list. I got very similar results from both. I haven't checked any others, but I suspect that they will be very similar. And basically my results are: with a truly minuscule number of exceptions, systematic reviews are about treatments.

Therefore I think that it's fair to say, as a first approximation, that if you want good evidence about treatments, then you should look for meta analyses and systematic reviews, but if you want anything else, you probably need to look for something else. "The best evidence" is never a source that doesn't exist.

Here's the problem that we need to solve: We have editors quoting WP:MEDRS#Best evidence as a requirement for everything in an article. A couple of weeks ago, one of them quoted this sentence to complain about a ==Further reading== list! I know we have a tendency to shrug our shoulders and say, "Oh, well, people are going to quote things out of context", but the fact is that well-written guidelines should make that as difficult as possible. That's how I've written WP:External links over the years, for example, and abuse of that guideline is quite minimal now. I think that narrowing the scope of that sentence, to explicitly acknowledge what we were thinking about back in the day, will help editors to use the advice correctly, and to stop using it inappropriately.

Also, I know that I gave silly examples in the edit summary, but there are serious ones: For example, PubMed has exactly zero systematic reviews and meta-analyses about the reliability of Pregnancy tests in humans during the last 10 years. Zero. There are US$1.68 Billion in sales each year,, representing more than 100 million tests, and there are zero meta-analyses or systematic reviews on the subject. Why don't such papers exist? Because they'd be pointless. It's not an area of research. Real experts use reference works, not review articles, to source information about that subject. But if we don't find ways to make it hard to quote that line inappropriately, then we'll continue to have editors misunderstanding the limited scope of that sentence and therefore we'll continue to have creating disputes over whether the best sources in existence are "MEDRS-compliant".

I am, as always, open to other solutions. But I think we need to be clearer that meta-analyses and systematic reviews are only appropriate for some parts of an article. WhatamIdoing (talk) 22:21, 20 October 2015 (UTC)

Just as one point of clarification, Cochrane reviews focus on treatments because it's part of their mission statement: "to help you make informed choices about treatment," " using high-quality information to make health decisions," etc. Other review series might have only a minority of treatment-related articles, e.g. many of the medically relevant Annual Reviews journals. Sunrise (talk) 05:05, 21 October 2015 (UTC)

WhatamIdoing - I've previously not seen the need to specify in this sense, because I've feared that anyone who is confused enough to go looking for meta-analysis for the boundaries of the scapula should be kept away from WP, but then again we have few tools to make sure they do.
The point I've been trying to make is that systematic reviews and meta-analysis are just as important to epidemiology and certain diagnostic procedures, and that treatments are not unique in this fashion. I guess you can argue that getting those right could be considered a part of getting the treatment right, but I don't thing we should be to restrictive in saying only treatments are like this.
Maybe a compromise could be akin to changing:

The best evidence is mainly from meta-analyses of randomized controlled trials (RCTs)

     to

For most topics the best evidence comes from meta-analyses or systematic reviews. For treatment and diagnosis the best sources are meta-analyses of randomized controlled trials (RCTs), while for epidemiology the best sources may be (...). For topics such as anatomy or physiology such sources will likely not be relevant and up-to-date textbooks or literature reviews will be better.

I think we could do well to source such a paragraph - I'm going to add it to my to-do list. CFCF 💌 📧 16:48, 21 October 2015 (UTC)

Something along those lines would be great. WhatamIdoing (talk) 22:41, 21 October 2015 (UTC)

For each

Here's the list of topics we might cover on a disease article, with a list of what I think the go-to sources are (for some hypothetical median disease):

• Classification: Narrative reviews and textbooks
• Signs and symptoms: Narrative reviews and textbooks
• Causes: Narrative reviews and textbooks for most things ("AIDS is caused by HIV infection"), plus meta-analyses and systematic reviews for risk factors that aren't widely known or accepted.
• Mechanism: Narrative reviews and textbooks
• Diagnosis: Position statements, narrative reviews and textbooks for most diagnostic information (e.g., "To diagnose HIV infection, use an HIV test"), plus meta-analyses and systematic reviews if you are discussing whether a diagnostic method works (e.g., "Is a screening mammogram worth it?").
• Prevention or Screening: Narrative reviews and textbooks for most things ("Measles can be prevented by getting the vaccine"), plus meta-analyses and systematic reviews in the unlikely case that you are discussing something disputed ("Alcohol consumption causes one-sixth of breast cancer cases in the UK").
• Treatment: Y Meta-analyses and systematic reviews for efficacy/what ought to be done. Position statements, narrative reviews and textbooks for what's actually done.
• Outcomes or Prognosis: Narrative reviews and textbooks
• Epidemiology: Narrative reviews, textbooks, reference works (e.g., a WHO report on disease prevalence), meta-analyses and systematic reviews.
• History: Non-medical sources (e.g., books on the history of medicine).
• Society and culture: Non-medical sources (e.g., plain old books, especially if it's written by a sociologist).
• Research directions: Narrative reviews, statements from interested groups, even op-eds (with INTEXT attribution).
• Special populations, such as Geriatrics or Pregnancy or Pediatrics: All of the above, depending on what you're saying about the population.
• Other animals: All of the above, depending on what you're saying about animals.

I don't know if your list would be the same, but it looks like I'd make a meta-analysis or a systematic review my first choice for only one section, and I'd choose one as supplemental material for about a third of the sections—or, to put it another way, not "for most topics". In particular, my approach appears to be to prefer a meta-analysis or a systematic review only when I'm citing its conclusions, rather than its background section. The background section of a systematic review or a meta-analysis is not automatically better than the background section of any other paper.

Anyway, I tried this out as an exercise, and learned something about my thinking. Perhaps it would be an interesting exercise for other people, too. WhatamIdoing (talk) 23:09, 21 October 2015 (UTC)

Like it, will respond. Please remind me if I haven't said anything in a week. ;) CFCF 💌 📧 10:11, 26 October 2015 (UTC)

For "Classification" sections we normally accept ICD-10 by default, though further sources are often needed to clarify. Textbooks are satisfactory because classification moves slowly. If the article differs markedly from ICD-10, we should probably require multiple secondary sources per wp:REDFLAG. Reliance on DSM-V without other classification references may be more controversial, but at least it is regarded as one notable source.
For the "Epidemiology" sections of disease articles, papers such as PMID 26063472 by the Global Burden of Disease Study collaboration are practically indispensable.
For the "History" sections, specialized journals such as J Hist Med Allied Sci, Bull Hist Med or Ann Med Hist are often useful.LeadSongDog come howl! 19:01, 26 October 2015 (UTC)

Publication bias

There is publication bias from Chinese journals. QuackGuru (talk) 22:56, 26 October 2015 (UTC)

While you guys are arguing about this, there are gazillions of bad sources still littering medical articles. When I ask for help here I am routinely ignored. Abductive (reasoning) 05:49, 27 October 2015 (UTC)

Post at WT:MED, not WT:MEDRS–this is the wrong forum to ask for help. Also as far as I can recall you've gotten support each and every time you posted there. CFCF 💌 📧 10:07, 27 October 2015 (UTC) 

Clarifying "biomedical"

Opinions are needed on these matters: In July, Minor4th and GregJackP (who is currently retired) argued that WP:MEDRS does not apply to domestic violence (or rather domestic violence against men), based on their definition of "biomedical." WP:Med editors argued that WP:MEDRS does apply to domestic violence, and Jytdog and I argued that WP:MEDRS does not only concern biomedical content. I stated, either way, domestic violence concerns biomedical content since it involves physical and mental harm. I was also clear that various high-quality medical sources list or cite domestic violence as a medical topic. You can see all of that in this section and when scrolling down to other sections. Guy Macon also showed up to give his view of what biomedical means and that WP:MEDRS didn't apply in the case of domestic violence. BoboMeowCat soon showed up to support the view that WP:MEDRS applies to domestic violence (whether against women or men). Although GregJackP came around to acknowledging that WP:MEDRS applies to some aspects of domestic violence, Minor4th still seems to believe it doesn't apply at all, as is clear in the current Misplaced Pages:Reliable sources/Noticeboard#Domestic Violence article discussion. A WP:Permalink for it is here. The latest editor to state that WP:MEDRS doesn't apply to domestic violence is Ryk72, as seen here; I replied to Ryk72 here, stating, in part, "Domestic violence is not simply a cultural topic, nor simply a legal topic. It is a medical, legal and cultural topic. If the content is legally or culturally-based, then WP:MEDRS is not likely to apply. If the content is health-based, then WP:MEDRS does apply."

In August, as seen here and here, WhatamIdoing emphasized "biomedical" over "medical." I then linked "biomedical", stating, "If we are going to stress 'biomedical,' then we should link to it, since, as seen at Talk:Domestic violence against men, editors commonly do not understand what biomedical entails." Jytdog later linked the Misplaced Pages:Biomedical information essay, as seen here. The main dispute for whether "biomedical" applies to domestic violence is the epidemiology material. I've stated that epidemiology material should be WP:MEDRS-compliant; this view is also currently supported by the "What is biomedical information?" and "The best type of source" sections at the Misplaced Pages:Biomedical information essay. Domestic violence is very much a part of medical literature, as FloNight can also attest to, and we have Template:Reliable sources for medical articles at the top of the Domestic violence article talk page. So, yes, some commentary from editors of the WP:MEDRS guideline/talk page would be helpful to clear up these matters. Flyer22 Reborn (talk) 06:29, 28 October 2015 (UTC)

Well, that's an incorrect statement of my view. MEDRS applies to medical information - not to sociology issues. Simple as that. I mean, think about the actual purpose of having a more restricted MEDRS guideline for reliable sources - it's so we get the science of medical issues right. We might need MEDRS for describing the medical aspects of post-traumatic stress disorder, but we don't need MEDRS to describe underreporting or crime statistics or public perception, etc. Minor4th 12:32, 28 October 2015 (UTC)

Minor4th, looking at the discussions at Talk:Domestic violence against men, you make it seem like you believe that WP:MEDRS doesn't apply to domestic violence at all. As for your comment here in this section, statistics in this case fall under epidemiology, which is not simply a sociology issue. It's not much different than statistics for suicide, which require WP:MEDRS-compliant sourcing. So we disagree about WP:MEDRS not applying to statistics. And like I just stated at the WP:Reliable sources noticeboard, "ither way, with the exception of GregJackP (mentioned ), the only editors so far to claim that domestic violence doesn't require WP:MEDRS-compliant sourcing have been men's rights editors and those involved with the Gamergate controversy article; I doubt that's a coincidence. It's common for such editors to want us to forgo high-quality medical sources for obvious POV-pushing reasons." I see no valid reason not to use a high-quality or good-quality textbook or review article for domestic violence rates, which are WP:MEDRS-compliant, as opposed to a primary source or a single study that is not representative of what the medical literature generally reports on the matter. Flyer22 Reborn (talk) 12:45, 28 October 2015 (UTC)

• Misplaced Pages essays about reliable sources
• Project-Class medicine pages
• NA-importance medicine pages
• All WikiProject Medicine pages
• Project-Class pharmacology pages
• NA-importance pharmacology pages
• WikiProject Pharmacology articles