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Study on Misplaced Pages's coverage of drug-safety

I'm not a regular here, but thought I'd make note of this if it hasn't been made already. Came across a recent study by Harvard researchers on Misplaced Pages's reliability and speed at updating drug safety information:

• News coverage in the MinnPost
• Study itself in the New England Journal of Medicine. ~SuperHamster Talk Contribs 21:52, 2 July 2014 (UTC)

Yes am in discussion with the FDA regarding possibly collaborating. They are of course a big organization and move slow. On my end I am interested. Others thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:38, 2 July 2014 (UTC)

Ideally one for the Pharmacology project. Overall our response seems good, but with serious lapses at times - so just like WP in general. Isn't there an FDA online list that someone just needs to check at intervals, after we are sure we are up to date? Of course the FDA is not the whole of the story, and no doubt already far better covered than other regulators around the world. On a quick look I couldn't see anything to complain about in their method, which makes a change. Wiki CRUK John (talk) 10:22, 3 July 2014 (UTC)

What we need is someone interested in taking this on. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:28, 4 July 2014 (UTC)

One can sign up for e-mail updates to FDA "Recalls and Safety Alerts" and "MedWatch Safety Alerts" here. I have just done so. If I get a relevant alert, I will at a minimum post a message on the pharmacology project talk page and in addition, update the Misplaced Pages drug page if I have time. Boghog (talk) 09:08, 5 July 2014 (UTC)

From the 2014 Safety Alerts for Human Medical Products, here is a relatively recent example of an FDA alert. Would this edit be an appropriate response? Boghog (talk) 18:42, 5 July 2014 (UTC)

Thanks Bog. If the FDA is interested in a more formal relationship do you want be to involved you? They say it will be a few weeks before they decide. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:47, 7 July 2014 (UTC)

Interesting. Yes, I would be willing to work with them to improve Misplaced Pages drug articles. Boghog (talk) 05:45, 7 July 2014 (UTC)

I'd also be interested in collaborating if such an opportunity presents itself. I've been keeping the articles that I {{maintain}} up-to-date with the FDA's label revisions, safety reviews, and similar updates. That said, it'll obviously be difficult to standardize and maintain the articles that currently lack FDA citations to the FDA's current drug safety information. Seppi333 (Insert 2¢ | Maintained) 19:42, 11 July 2014 (UTC)

external links at Phimosis

Hi folks, an editor at Phimosis has been repeatedly restoring external links to what the editor acknowledges are anonymous Internet chat forums and advocacy websites, as well as one AAP website that does not mention phimosis. The anonymous Internet chat forums and advocacy websites are non-peer reviewed and give medical advice. The reason this editor gives for restoring the external links is that this particular editor finds the websites "helpful" or "useful"; I have pointed out repeatedly in this discussion on the article Talk page that the links fail WP:ELNO, Doc James has also pointed to WP:ELNO. Latest restore of the links by this editor is here. More input would be appreciated. Zad68

Apology

Having had some time to consider the events of the last week, I'd like to offer an apology to Doc James in the same forum in which I took something of a public shot at him. I believe I raised my concerns in an overly emotional and confrontational way, and did a lousy job of enunciating the real basis for my concerns regarding the "P" journal. I'm going to take some time off to reconsider whether and how I can be more effective here.

This note is not intended as a fishing expedition for expressions of any sort from the community, but simply as an acknowledgement that I mishandled my conflict with Doc, who has for the most part been very accomodating of my POV, which on some issues is very different from his own. I'd also like to apologize to the community for the histrionics. (Maybe an SSRI would help.....) Formerly 98 (talk) 21:14, 5 July 2014 (UTC)

Formerly 98 I view your work here as positive. Yes we have a slightly different position on the "P" source but generally I think we are in agreement around most things. Look forwards to seeing you back and working together in the future. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:56, 5 July 2014 (UTC)

Can someone (briefly) catch me up here? What is it that happened? I'm not asking to open wounds here, I'm just wondering if I can help in any way and I'm wondering what is being debated with such intensity. TylerDurden8823 (talk) 05:57, 6 July 2014 (UTC)

The two expert editors, signing at the top of this section, were briefly characterizing some aspects of Pharma and Medicine, namely the possibility of others gaming the processes of the encyclopedia, versus potential clinical value of some contribution, in only a few sentences. But they were thinking several steps ahead of what they actually wrote, and their ideals entangled. (My personal reading: it's all good.) OK? --Ancheta Wis   (talk | contribs) 14:43, 6 July 2014 (UTC)

Ok. TylerDurden8823 (talk) 16:30, 6 July 2014 (UTC)

I do not think we were commenting on gaming the processes of Misplaced Pages. We were discussing the different ways in which systematic reviews are produced and the issues with the various methods. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:24, 7 July 2014 (UTC)

My concern, which I completely failed to enunciate in a way that anyone could understand and respond to, is that Prescrire very clearly makes claims to be more reliable than other sources based on its policy of excluding from its processes not just those with conflicts of interest with respect to a specific topic, but anyone with any relationship with the pharmaceutical industry at all. It was my impression that Jmh49 was specifically endorsing this viewpoint, which was of considerable concern to me given his obvious and well-earned position of influence. As a member of this (pharma associated) group (and one who is somewhat proud of his career and personal accomplishments) I'd find it very helpful to have some clarification on this and whether this is Misplaced Pages Medicine's position going forward. Formerly 98 (talk) 22:59, 7 July 2014 (UTC)

To clarify, it is also not my position that Prescrire is more reliable than other sources such as Cochrane reviews or USPSTF reviews. If we use Prescrire it is important to state that Prescrire is a French perspective. It is also of course just a single perspective. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:28, 9 July 2014 (UTC)

Beware of more quackery

In the past few months, supporters of quackery and mind-body therapies have succeeded in publishing a number of woo articles in various medical journals. Here are some brilliant examples:

1. Annals of the New York Academy of Sciences: Transcendental experiences during meditation practice (December 2013)

2. Nature Reviews Neurology: Effects of meditation in patients with chronic pain (January 2014)

3. Annals of the New York Academy of Sciences: Advances in Meditation Research: Neuroscience and Clinical Applications (January 2014)

4. JAMA: Meditation Programs for Psychological Stress and Well-being (March 2014)

5. Frontiers in Psychology: Meditation as a Therapeutic Intervention for Adults at Risk for Alzheimer’s Disease (April 2014)

6. Frontiers in Aging Neuroscience: Mindfulness and the aging brain: a proposed paradigm shift (June 2014)

7. British Journal of General Practice: Practical tips for using mindfulness in general practice (July 2014)

8. PLOS ONE - The Effects of Mind-Body Therapies on the Immune System: Meta-Analysis (July 2014)

It appears that every 2-3 weeks, another one of such articles are repeatedly thrown into medical literature, for whatever reason I do not know. Does any of them satisfy WP:MEDRS criteria? If not, more eyes may be needed at articles related to meditation or mind-body therapies. Also, now may be a good time to enforce broader and stricter pseudoscience sanctions on Misplaced Pages to prevent fringe POV editors from promoting fringe quackery. -A1candidate (talk) 15:57, 6 July 2014 (UTC)

There's no good reason to label any of that as pseudoscience. There is of course a lot of pseudoscience associated with meditation, but there is nothing unscientific about the idea that behaviors such as focusing attention on one thing for a period of time can produce alterations in brain state that are worth studying and potentially beneficial. I'm not even stating a minority opinion here -- I believe the majority of neuroscientists view this the same way I do. Looie496 (talk) 18:54, 6 July 2014 (UTC)

I think WP:DNFT applies here. Alexbrn 19:22, 6 July 2014 (UTC)

(ec) I gotta go with Looie496 on this. Without going into a deep critique or analysis of the papers listed by A1candidate, we know that patients who are generally relaxed and happy tend to do better than patients who are anxious and depressed, especially with regard to things like pain management. This is pretty basic Psych 101 stuff. Obviously anyone who offers a mechanistic explanation involving the movement of qi from the spleen to the colon is spouting mystical bullshit, but encouraging an internal locus of control can have tangible benefits. (Whether this makes meditation a particularly potent placebo or a genuine intervention is arguably a matter of semantics.) TenOfAllTrades(talk) 19:26, 6 July 2014 (UTC)

The paper in JAMA (the only one I checked) is a systematic review. A systematic review is not generally considered a "woo article", regardless of its subject, and quackery is when you reject the data, not when the data shows that something that you dislike works despite your dislike (or that something you do like doesn't work). WhatamIdoing (talk) 23:20, 6 July 2014 (UTC)

Agree with WAID. A few of these are primary sources. The JAMA meta-analysis concludes "small to moderate reductions of multiple negative dimensions of psychological stress.", "Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior" and "We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies)." so not exactly an endorsement. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:44, 7 July 2014 (UTC)

These are the first two sentences in their conclusion:

"Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress." (emphasis mine)

The words highlighted in italics certainly sound like an endorsement or even a guideline ("be prepared to talk with their patients about the role that a meditation program could have"), although it's good to know that they have acknowledged some limitations in their study. What is more worrying is how JAMA has turned into a sellout advertising board for quackery as demonstrated by a recent commentary (2013):

"For some mind-body approaches, however, there is mounting evidence of usefulness and safety, particularly in relieving chronic pain. A few examples include acupuncture for osteoarthritis pain; tai chi for fibromyalgia pain; and massage, spinal manipulation, and yoga for chronic back pain.

Increasing comfort with this emerging evidence is reflected in practice guidelines from the American College of Physicians, the American Pain Society, and the Department of Defense."

And just a few months ago in March 2014, they endorsed "Acupuncture for Chronic Pain" with a highly dubious claim that "Acupuncture is associated with improved pain outcomes compared with sham-acupuncture", although every skeptic knows that there is ultimately no difference between acupuncture and sham acupuncture.

As User:QuackGuru recently observed, many of these articles, such as this fake meta-analysis pointed out by him, are in fact pseudo-systematic reviews funded by the quackery trade. In contrast to some forms of meditation, there is clear consensus that acupuncture is by every measure pseudoscientific. Why did you, Doc James, tell QuackGuru that you see "no problems with (using) it"?

Remember, we're only talking about JAMA so far. I think the problem is far worse at some other reputable journals -A1candidate (talk) 07:21, 7 July 2014 (UTC)

User:A1candidate maybe you should quote what QG actually state which was "A pseudo-systematic review funded by the trade?" And yes I do not see a problem with using it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:40, 7 July 2014 (UTC)

User:A1candidate - I'm more skeptical to overbearing claims such as yours: although every skeptic knows that there is ultimately no difference between acupuncture and sham acupuncture., than something from a systematic review. To me this sounds far more like you are disregarding evidence against your viewpoint. -- CFCF 🍌 (email) 10:01, 7 July 2014 (UTC)

I'm with CFCF here: woo is when you say that anything that you've decided is "alternative" can't work because you magically know that it doesn't work. Science is when you say that the evidence suggests that (in this case) meditation might have some value for some situations, so therefore you agree that it might not be completely worthless.

In this case, the possibility for benefit seems so highly plausible to me that it's odd there was ever any truly serious question about it: Meditation practices a core mental skill, described in our article on the subject as "training attention and awareness in order to bring mental processes under greater voluntary control", that a person with anxiety often needs to improve, namely being able to focus on whatever task is at hand instead of letting the mind wander off into whatever is worrying you. Acquiring the basic mental skills to focus on whatever you choose, rather than being incapacitated by uncontrolled worrying, does not sound like "woo" to me. WhatamIdoing (talk) 15:17, 7 July 2014 (UTC)

The OP was being sarcastic. Alexbrn 15:45, 7 July 2014 (UTC)

I'm not being sarcastic when I say that a putative review which includes in its abstract the phrases "... the integration of transcendental experiences and the unfolding of higher states of consciousness ... This integrated state, called Cosmic Consciousness in the Vedic tradition ... Transcendental experiences may be the engine that fosters higher human development." is a woo paper, despite being published by NY Academy of Sciences. I accept that your mileage may vary, of course. --RexxS (talk) 16:00, 7 July 2014 (UTC)

I meant the OP who started this section. Alexbrn 16:41, 7 July 2014 (UTC)

The OP presented a mixed bag of sources in a way that is difficult to discuss, imo, in a forum thread of this type. 109.156.204.159 (talk) 17:25, 7 July 2014 (UTC)

We can discuss these one by one but agree this list of some good and not so good sources is difficult to approach. It also depends on what text they are being used to support. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:46, 7 July 2014 (UTC)

When a prestigious journal publishes a pseudoscientific article/review

I feel that what User:RexxS pointed out is a very important point: This paper deals with topics that appear to be pseudoscientific ("cosmic consciousness"), yet it is published by a well-established academic journal - The Annals of the New York Academy of Sciences - which has a considerable impact factor. The question I want to ask is this:

Where do we draw the line to separate science from pseudoscience?

The same journal, in the same issue, also published a systematic review claiming to have found preliminary evidence that "meditation can offset age-related cognitive decline". Are we supposed to accept or reject this claim? How can we be sure that the editors of the Annals of the New York Academy of Sciences aren't deliberately publishing pseudoscientific reviews? -A1candidate (talk) 19:32, 7 July 2014 (UTC)

This review states " Growing evidence suggests that cognitive training programs may have the potential to counteract this decline. On the basis of a growing body of research that shows that meditation has positive effects on cognition in younger and middle-aged adults, meditation may be able to offset normal age-related cognitive decline or even enhance cognitive function in older adults." followed by "Studies involved a wide variety of meditation techniques and reported preliminary positive effects on attention, memory, executive function, processing speed, and general cognition. However, most studies had a high risk of bias and small sample sizes."

This could be summarized as "Low quality evidence suggests a possible benefit from meditation with respect to age-related cognitive decline". This is hardly revolutionary. We know that learning a second language can be beneficial as may mind games. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:28, 7 July 2014 (UTC)

There is no bright line that separates science from pseudoscience. We are here to accurate report the positions of reliable sources not to determine "truth" Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:30, 7 July 2014 (UTC)

...So unlike with homeopathy in the case of (various types of) meditation active therapeutic effects are biologically plausible. (At the same time, I do agree with RexxS that parts at least of that conference supplement are really rather wooey.) 109.156.204.159 (talk) 20:53, 7 July 2014 (UTC)

I agree with A1candidate that this is a real matter for concern. How do we "know"?

If the answer is that we must re-examine the credibility of a journal (that was previously considered well-established and reliable) whenever it publishes something that seems woo to some editors, I think this sets us up to do a lot of original research, and makes the acceptability of a particular journal subject to the views/prejudices/interests of the currently active editors. Wanderer57 (talk) 20:34, 7 July 2014 (UTC)

Sorry I am not seeing the issue. We just summarize high quality sources. If the are high quality sources that disagree with each other than we state that. No OR needed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:43, 7 July 2014 (UTC)

If a high quality source publishes something that "some" editors see as "woo", is it still a high quality source? Wanderer57 (talk) 03:15, 8 July 2014 (UTC)

If a high-quality source publishes something that knee surgeons disagree with, is it still a high-quality source? I think so—and whatever the game, whatever the rules, the rules are the same for both sides. If a journal is still, overall, a good source despite publishing something controversial about conventional medicine, then it's still a good source despite publishing something controversial about alternative medicine. WhatamIdoing (talk) 06:26, 8 July 2014 (UTC)

Even if we generally accept the journal, what about the controversial article itself? I'm referring to this one on transcendental experiences during meditation, in particular. It may not be a systematic review, but it's still a secondary source published in a reputable scientific journal. -A1candidate (talk) 08:09, 8 July 2014 (UTC)

Not list as a secondary source by pubmed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:41, 9 July 2014 (UTC)

The article in question is part of an apparently proceedings-based issue, and as such was likely subject to limited scientific peer-review scrutiny. I certainly wouldn't suggest refusing content from conference proceedings and journal supplements out of hand, regardless of circumstances, as that would mean discarding good, pertinent content that sometimes isn't so readily accessible, or even available, elsewhere. But in the spirit of MEDRS I feel this category of publication might be worth flagging in a nuanced way. 109.156.204.159 (talk) 08:16, 9 July 2014 (UTC)

I've been meaning to ask about that, there are a number of sources, notably Annual Reviews which are not pubmed-indexed as Reviews. What do we do with them? -- CFCF 🍌 (email) 07:37, 9 July 2014 (UTC) Not relevant to this case, completely different question. -- CFCF 🍌 (email) 07:39, 9 July 2014 (UTC)

A1candidate asked "Even if we generally accept the journal, what about the controversial article itself? I'm referring to this one on 'full transcendental experiences during meditation', in particular."

What about the article? If you mean "can it be used as a source?", I think the answer is "it depends on what statement from the article is being used and also the context for which it is being considered." Wanderer57 (talk) 16:14, 9 July 2014 (UTC)

Remember that there is wp:NODEADLINE. Waiting until other authors can respond to the paper is a reasonable alternative. Depending on the publication cycle and review speed of the journal, this may be several months. LeadSongDog come howl! 17:20, 9 July 2014 (UTC)

User:Muffinator

Please consider joining the feedback request service. An editor has requested comments from other editors for this discussion. This page has been added to the following list: Misplaced Pages style and naming When discussion has ended, remove this tag and it will be removed from the list. If this page is on additional lists, they will be noted below.

Is changing text from

• "200 children without autism." to "200 allistic children"
• "normal individuals" to "neurotypical individuals"
• "matched controls" to "matched neurotypicals"
• They are also changing ASD to autism.

We have unfortunately lost the person who has written much of our autism content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:30, 7 July 2014 (UTC)

If you know a more appropriate alternative to "allistic", please add it, because "without autism" doesn't make any sense and we have already determined consensus on person-first language.

"Normal" is not a diagnosis and is frankly presumptuous. There is no reliable source to say those individuals were normal. Neurotypical is an accurate medical term whose inclusion makes the article more informative. Replacing "controls" with "neurotypicals" similarly clarifies who we are talking about. If there's a strong reason to keep the word control, call them neurotypical controls to differentiate from a possible control group of more autistic people.

A person on the autism spectrum is autistic. That's why it's called the autism spectrum. "Person with ASD" should be replaced with "autistic person", as per the consensus determined on Talk:Autism. Muffinator (talk) 06:40, 7 July 2014 (UTC)

Lets gets other opinions on these word changes.

ASD includes both autism and Aspergers syndrome thus changing it to just autism is not exactly correct. Yes the DSM 5 have merged these diagnosis into autism spectrum disorder but that is still not simply autism.

There was weak support for changing "person with autism" to "autistic person" and I am fine with that. However that was not the only thing you have been changing in your edits thus the reverts. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:55, 7 July 2014 (UTC)

In this context, by "autism" you mean "classic autism". ASD, classic autism, and Asperger Syndrome are all forms of autism. The fact that old references use outdated terminology is not a good reason to prevent Misplaced Pages from updating. Misplaced Pages has its own style guide and does not latch onto references like a chameleon. If I see something wrong while working on a different issue, I'm inclined to correct both of them. If you have a problem with only one part of an edit, you can change that part, or revert and reintroduce the "good" changes. Just reverting is disruptive. At the very least you could provide an explanation of which parts were problematic, I'll check my notifications and put the "good" parts back.Muffinator (talk) 07:02, 7 July 2014 (UTC)

Can you direct me to the Misplaced Pages guideline page that mentions "private language"? Given that articles on Deaf culture use "hearing person", "allistic" is not unprecedented. Muffinator (talk) 07:02, 7 July 2014 (UTC)

Have changed the article on Deaf culture. Hearing person is poor English but at least a person can figure it out. Allistic gah.

If you are planning on more controversial changes best to get consensus before hand. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:22, 7 July 2014 (UTC)

That response did not answer the question. Is there a guideline page explaining "private language" or did you just make the controversial change from "hearing person" to "person with normal hearing" without getting consensus first? Muffinator (talk) 07:44, 7 July 2014 (UTC)

Use of the term 'neurotypicals' without wikilinking it is very hard to justify as it's against Misplaced Pages:Use plain English and in the context of an experimental design 'control' is a much better description of their role. The Andrew_Wakefield example should use the same terminology as Wakefield does, because it's talking about a person's beliefs and the further we take it from their terminology the more OR it is. The Autism changes just look wrong --- I still have no idea what the "ability to demonstrate" change is about. Stuartyeates (talk) 07:12, 7 July 2014 (UTC)

I believe you are referring to an example in which the word neurotypical was wikilinked earlier in the article. I figured there was no need to link it twice. "Ability to demonstrate comprehension" is a more accurate description as comprehension itself is immeasurable except through self-reporting; this applies in more contexts than just autism. Do we really need to have disputes and consensus over every minute change in wording? If that's the case, we should set up a lock an all articles so that all edits need administrator approval. Muffinator (talk) 07:30, 7 July 2014 (UTC)

Added RFC tag because an interest in "other opinions" was expressed. Muffinator (talk) 07:30, 7 July 2014 (UTC)

My opinion is that the Talk:Autism dicussion, which didn't mention other pages and was closed with a "a relatively weak consensus" is no basis to change a the language in a large number of articles. Stuartyeates (talk) 08:04, 7 July 2014 (UTC)

Muffinator has also brought this to ANI Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:29, 7 July 2014 (UTC)

Autism is at the very least the most popular article about autism. More importantly, consensus is consensus. If you have an issue with the discussion being deemed a consensus, take it up with the user who closed the discussion. Muffinator (talk) 08:41, 7 July 2014 (UTC)

• Re: RFC: Could it be clarified what exactly opinions are being sought for? The four items at the top of the discussion, or more/other than that? In terms of "allism/allistic", that is clearly inappropriate -- it's a confusing, very obscure neologism with no widespread official acceptance at all; it wasn't even "added" to WP or Wiktionary till a few days ago, and even then without a single source. The neurotypical vs. normal debate has more basis in definitive usage, but even then, Stuartyeates' recommendation that WP use the terminology of the cited articles makes a good degree of sense; I don't personally see any real basis for confusion what "normal" or "control" means here. "Autism" is not the same as ASD, that much should be clear to anybody -- one is a spectrum, the other is a specific (autism is always classic autism unless otherwise noted). Softlavender (talk) 08:01, 7 July 2014 (UTC)

That was what I was wishing people to weight in on. Thanks. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:32, 7 July 2014 (UTC)

Strongly agree with Softlavender, and even if it wasn't for those strong arguments there is no consensus for such a broad change. -- CFCF 🍌 (email) 10:07, 7 July 2014 (UTC)

"Allistic" is clearly a neologism without clear definition or wide linguistic acceptance in the English language. It would be inappropriate to insert the word into wide use on Misplaced Pages without significant discussion and broad community consensus. NorthBySouthBaranof (talk) 10:17, 7 July 2014 (UTC)

Having written extensively on ASD:

1. "allistic" is an inappropriate term and should not be used
2. "neurotypical" is the most correct term in lieu of "normal" (because normal cannot be defined)
3. "ASD" is more correct than "autism", unless you're talking the rare cases of full-bore, far end of the spectrum Autistic
4. "matched controls" is a scientific term, and must be kept for scientific consistency

So in short, the changes are mostly wrong, but one might just be right the panda ɛˢˡ” 11:32, 7 July 2014 (UTC)

• Or simply "matched controls" (the matching is an aspect of the study design). 109.156.204.159 (talk) 13:40, 7 July 2014 (UTC)

Allistic is POV jargon. Neurotypical is unhelpful to people who are unfamiliar with the subject. Non-autistic or people without an autism diagnosis (because not all allegedly neurotypical people actually are neurotypical) is a better choice.

One other reason for avoiding neurotypical is that it's based on a false dichotomy: a person can have neurological problems that are not ASD-related. A person with schizophrenia or multiple sclerosis is, as a matter of physical facts, neurologically atypical, even if that person has no significant ASD-related symptoms at all. WhatamIdoing (talk) 15:29, 7 July 2014 (UTC)

Support for 'non-autistic'. --Hordaland (talk) 16:26, 7 July 2014 (UTC)

Agreed, 'non-autistic' seems like the correct phrasing, which neither places value judgments nor assumes. NorthBySouthBaranof (talk) 18:59, 7 July 2014 (UTC)

If you are going to use a word like "neurotypical" on wikipedia, you will need to define it at the first instance in the article using brackets. Since that definition will probably use the word "normal" it seems a bit pedantic to me, but I am unfamiliar with the topic. If hte literature uses the term then support. 92.40.94.138 (talk) 17:59, 7 July 2014 (UTC)

We should be using plain English as much as possible. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:28, 7 July 2014 (UTC)

I agree with Doc James on this one. Dbrodbeck (talk) 19:00, 7 July 2014 (UTC)

Writing as a layman, ie., an editor without any medical credentials, the first three of the four changes mentioned above (from "children without autism." to "allistic children", from "normal individuals" to "neurotypical individuals", and from "matched controls" to "matched neurotypicals") confuse the sentences they appear in. If it is important for precision of language to distinguish (eg) between "normal" and "neurotypical", an extra sentence or two should be added to make the distinction. Wanderer57 (talk) 20:59, 7 July 2014 (UTC)

• Has any organization which advocates for the autism community every published a manual of style for journalists? Has any such manual of style been identified or sought? Muffinator, do you know anything about this? Can you recommend any organization which might have published guidance on this that we could copy instead of developing it ourselves? Blue Rasberry (talk) 14:36, 8 July 2014 (UTC)

• The Autistic Self Advocacy Network and the Autism Women's Network are prominent advocacy groups which advocate for Autistic-first language. Muffinator (talk) 14:43, 8 July 2014 (UTC)

In my view that doesn't justify it as the de facto terminology for Misplaced Pages. Just as the National Stroke Association pushed for brain attack, a patient group organization can not simply change our vocabulary. Misplaced Pages should use terminology used by the most prominent sources, and not that of patient groups, however noble their motives. Misplaced Pages is not the place to drive a crusade for or against use of any terminology. At best we could state that portions of the autistic community choose to use this terminology.-- CFCF 🍌 (email) 07:35, 9 July 2014 (UTC)

The fact that certain terminology is used by the relevant groups may not necessarily be a reason for Misplaced Pages to adopt it, but the fact that certain terminology is more accurate and more neutral than what was previously used is a reason for Misplaced Pages to adopt it. I offer these two groups as sources for what User:Bluerasberry requested. Muffinator (talk) 08:05, 9 July 2014 (UTC)

CFCF {u|Muffinator}} I wrote to ASAN asking if they had a manual of style for journalists. They publish a statement on why they use "Identity-first language", but at the bottom of that statement, they list other activists in the field who use "people-first language". Regardless of what scientific sources say, I would rather use what the community itself uses if we can establish that this community has consensus among the people who talk about such things. Because of the diversity in viewpoints on this topic, it seems undecided. I will see how they reply to my email about their recommendations for writing. If there is a recommended way in the ASD community, then I think we should follow that, but if there is a lot of controversy in the community, then I would say that Misplaced Pages cannot take a strong position. Muffinator, it is my opinion that the strongest argument that you could make is listing which organizations use language you suggest. I see no such list anywhere, but such a list would be the evidence that Wikipedians would want to see. Whatever ASAN says I will share also. Blue Rasberry (talk) 10:28, 9 July 2014 (UTC)

X with autism or autistic X?

There's a discussion at Talk:Autism#Individuals with autism about whether to use "child with autism", "autistic child" or both. The former appears in PubMed about 25 times as often as the latter. --Anthonyhcole (talk · contribs · email) 13:51, 8 July 2014 (UTC)

I suggest we use whatever is most commonly used in the professional literature. -- CFCF 🍌 (email) 07:35, 9 July 2014 (UTC)

Crick after DNA

After Crick's success in understanding the secret of life (see his autobiography What Mad Pursuit), he naturally turned to the next open problem: consciousness, which he worked on for the rest of his life. His collaborator, Christof Koch, completed their last paper together Crick, Francis; Koch, Christof (2005). "What is the Function of the Claustrum?". doi:10.1098/rstb.2005.1661. {{cite journal}}: Cite journal requires |journal= (help) Now, 10 years later, Mohamad Z. Koubeissi MD, et al. (2014), Journal of Epilepsy and Behavior, while seeking to cure a woman's epilepsy, have learned that electrical stimulation of the claustrum reversibly turns off her consciousness, while leaving her wakefulness intact. Turning off the electrical stimulation returned her consciousness. Crick and Koch point out that the claustrum enjoys reciprocal connections to the rest of the brain, including V1, in the visual system.

From the viewpoint of scientific method, the Crick & Koch 2005 paper contains a cautiously worded hypothesis, while Koubeissi, et al. 2014 constitute a crucial experiment, because the Koubeissi experiment describes a reversible method, while Crick & Koch describe a theory which will likely prove fertile for decades, just as the DNA story has proven. The length of the fertile period exemplifies the Lakatos criterion for the 'strength of a scientific programme'.

My question for the MED project is: although Crick & Koch 2005 is labelled a 'review', and therefore a secondary source, does it qualify as MEDRS? What is needed for the concepts which are implicit in Koubeissi , et al. 2014 to qualify? --Ancheta Wis   (talk | contribs) 09:51, 8 July 2014 (UTC)

Crick's hypothesis seems to be noteworthy enough to be covered, though the hypothesis itself is primary material so is best approached through secondary sources. The current claustrum article is not in the best shape. Alexbrn 10:20, 8 July 2014 (UTC)

The cautious observation I refer to (p.6 of the 10 page pdf) is "There are remarkably few microelectrode investigations of claustral receptive-field properties and almost none in awake animals." -- Crick and Koch 2005, which Koubeissi 2014 has kindly supplied. --Ancheta Wis   (talk | contribs) 10:42, 8 July 2014 (UTC)

• In my view, the Crick & Koch paper meets MEDRS, but the views in it are admittedly speculative, so if they are referred to in Misplaced Pages, it should always be with wording such as "Francis Crick and Christof Koch proposed that ...". In other words, it should be made clear that these are the views of specific people rather than mainstream ideas. As a source of background information about the claustrum the paper can definitely be used, although in a few respects it is already out of date. A better source for background info is http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983483/. The Koubeissi paper is absolutely a primary source. My personal opinion is that their findings are not nearly as important as some people make them out to be, and in any case they were obtained from a single human subject and certainly need to be replicated. Looie496 (talk) 13:04, 8 July 2014 (UTC)

Note: I've commented more extensively on this on my personal web site, see Comments on Koubessi et al.: Have we learned anything new about the role of the claustrum in consciousness? if you are interested. Looie496 (talk) 15:11, 8 July 2014 (UTC)

Nice. Thanks. --Anthonyhcole (talk · contribs · email) 14:26, 9 July 2014 (UTC)

Acupuncture again

I apologise for bringing this before you again, but I'm being tag-team reverted by two SPAs on Acupuncture.

In this edit, Middle 8 (an acupuncturist) removed the text:

• "Example text"

with an edit summary claiming that the source doesn't support the statement. The source, Acupuncture: Does it alleviate pain and are there serious risks? A review of reviews, states:

• "Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham."

I restored the text, but have been reverted by Herbxue.

Debate continues on Talk:Acupuncture #Another convenience break, but there's no common ground. I'd appreciate more eyes on this, please, as the local editors seem intent on diluting any content that doesn't present acupuncture in a positive light, even impeccably sourced text. --RexxS (talk) 15:46, 8 July 2014 (UTC)

It is not true that I am whitewashing, only being accurate. Please read the whole paragraph that the statement comes from. The authors are clearly referring to one PRIMARY source. Why would they use past tense if they are drawing a general conclusion? Why is the statement not found in the abstract, or in the paragraph starting "In conclusion, …" in the body? Because it is not the conclusion of the 2011 systematic review of reviews, it is a reference to one study. Herbxue (talk) 16:25, 8 July 2014 (UTC)

You can see what I'm up against? It's not true that the review authors are referring to one source - and it wouldn't even matter if they were. We prize secondary sources because the authors make judgements about what sources are important and here we have an editor trying to tell us we can't use the unambiguous conclusion I stated above because the previous two sentences in the review examined particular primary sources. This has to stop. --RexxS (talk) 17:13, 8 July 2014 (UTC)

According to this previous comment by User:Herbxue the systematic review of systematic reviews is referring to a 2009 review. Now he claims it was a primary source. But that is totally irrelevant. We should not question reliable sources like this. QuackGuru (talk) 18:35, 8 July 2014 (UTC)

I did not say Ernst'11 is a primary, the statement in question refers to the finding of 1 primary source.Herbxue (talk) 19:18, 8 July 2014 (UTC)

Exactly. It's how Ernst describes one trial, not the overall findings of his review of reviews. (tl;dr version of my long post below... but there you can read the relevant excerpt) --Middle 8 (leave me alone • talk to me • COI?) 19:38, 8 July 2014 (UTC)

So, here is the deal. There's this thing called "context". Nothing against RexxS, but he's failing to grasp that in context, the quote "Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham" is the review's description of one trial, not its overall conclusion about the literature. (doi for Ernst '11: .) This becomes obvious when Ernst begins by noting that "The majority of the early reviews arrived at negative conclusions , while the majority of the 57 recent reviews were positive. Yet there are many contradictions and doubts...." So, right off the bat you can see that this review-of-reviews finds more reviews than not that find efficacy for acupuncture. Still with me?

Now, Ernst does not believe these results will hold. He believes that the reviews that he has reviewed are all subject to bias, etc., because the trials that they review are not well-designed. He explains this by discussing two more recent (as of 2011), well-designed studies, and that is the context RexxS isn't grokking (emphasis mine):

Obvious enough? RexxS also confounds the issue by failing to grasp that "efficacy" is shorthand for "efficacy beyond placebo", i.e. a stronger response to true acu than sham acu (the latter being the control). I wish RexxS had taken the time to learn the basics of this topic areas before editing, and read more carefully (he had trouble with the same source earlier, re SAE's ). Instead he's ABF'd all around, disrupted the talk page, put those of us who are clueful in a WP:CHEESE situation, and devolved into personal attacks. Oh, and he hasn't been tag-team reverted. But whatever. Just another tricky day. The source says what it says. --Middle 8 (leave me alone • talk to me • COI?) 19:15, 8 July 2014 (UTC)

• I'm with User:RexxS on this one. Stuartyeates (talk) 20:25, 8 July 2014 (UTC)

That's just wishful thinking, Middle 8. Ernst et al have surveyed the literature concerning acupuncture and pain; they found two areas, LBP and osteoarthritis, where good quality reviews showed that acupuncture shows some effectiveness. They then write the paragraph quoted. That's the context and Middle 8 is willfully ignoring it. The paragraph above refers to the finding in the reviews and then goes on to contrast two high-quality RCTs that showed for LBP and osteoarthritis that "true" acupuncture was no more effective than "sham".

They then state an important conclusion for this review of reviews: "Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham." We don't know how many reviews or studies were examined by Ernst et al to reach that conclusion, but that isn't our concern as Misplaced Pages editors. Middle 8 and Herbxue would have us believe that it was just the two primary sources that they looked at - but offer nothing more than their own analysis to justify that claim. Even so, no matter what sources led Ernst et al to reach that conclusion, it does not weaken it as it is a significant conclusion of a reliable secondary source; and it cannot be grounds for removing it from the article.

As for "efficacy" is shorthand for "efficacy beyond placebo", I've never heard such absolute rubbish presented in any debate. That is pure fabrication in a desperate effort to shore up an indefensible viewpoint. That's the quality of debate I'm struggling to make progress with.

Middle 8 is an acupuncturist with an obvious conflict of interest in the presentation of acupuncture in the most positive light. Herbxue is an SPA with over 100 of his 138 article edits to TCM or acupuncture. Is anyone here able to read that paper and explain to them that they need to respect secondary sources? I've tried and all I get is personal attacks from them. --RexxS (talk) 22:23, 8 July 2014 (UTC)

I suggested "At least two recent high-quality randomized controlled trials found that for reducing pain real acupuncture was no better than sham" with citation to Ernst (not the individual papers). Even that weakened version was rejected. It seems to me that reasons are actively being sought for removing the material. vzaak 02:51, 9 July 2014 (UTC)

That seems like a good proposal – surely unobjectionable. And yes, the WP:ADVOCACY long in evidence around this article make it a depressing timesink. Alexbrn 02:59, 9 July 2014 (UTC)

@Vzaak:, @Alexbrn: Please. Of course we discuss sham = true (a.k.a. lack of efficacy), and yes in the lede, but we do it properly, with good sec and tert sources. A little better than citing two RCT's from Ernst, I think. Try Colquhoun and Novella '13 , top of p. 1361 et passim. As for using WP's voice? Yes if sources are uncontested. But Novella and Colquhoun's "anti" editorial is countered by Wang et. al.'s "pro" , and we also have other good MEDRS finding contesting (pain, nausea), so no we don't use WP's voice for this -- not now. Hence my objection to Ernst '11 as it was cited: wrong source, wrong wording, right idea. My gawd, what a POV push -- he wants to cie stronger MEDRS than RCT's for sham = true! (cut to Alexbrn and Vzaak scratching their heads, trying to figure out where they're being conned, and finding illumination in the cryptic acronyms "AGF" and "NPA") --Middle 8 (leave me alone • talk to me • COI?) 06:14, 9 July 2014 (UTC)

@@Middle 8: – Editorials are not "stronger MEDRS" than findings validated in systematic review. A "cryptic acronym" you and some other editors of the page would do well to acquaint themselves with is "WP:COI". The issue is not good faith, the issue is that acupuncturist editors are blind to their bias, which is why COI-tainted editing is generally frowned on. Alexbrn 06:30, 9 July 2014 (UTC)

@Alexbrn: Colquhoun is a thorough and up-to-date bibliography of systematic reviews covering dozens of RCT's, but if you think those two RCT's from 2009-10 are exceptionally awesome, be my guest. Plus, it's not as if we exactly neglect efficacy in the lede; just those special words "sham" and "true" (which indicate the exact same thing) have been absent. Re COI, you know I took my own case to COI/N. Since then you've been IDHT-ing about the fact that global consensus on COI isn't the same as yours. Your continuing to bring it up is unproductive and tendentious, especially since you routinely do so in lieu of commenting on my edits. Which is the definition of NPA. If you continue like this, I will raise it as a discretionary sanctions issue. Another editor already got warned. --Middle 8 (leave me alone • talk to me • COI?) 09:27, 9 July 2014 (UTC)

No, I did not raise your COI "in lieu" of anything - I directly addressed your claim about content - about what is higher in the MEDRS scheme. Systematic reviews are not beneath editorials, as you incorrectly wrote. I then responded to your self-confessed "snark" (you give yourself licence to make personal comments while complaining about any you receive). Identifying a COI is not however "an attack" – COI-tainted editing is an important issue here as it can damage the consensus-forming process. I am aware you have been to COI/N, and you were soundly told there that as someone who makes money from acupuncture, you did indeed have a COI. On your userpage, you choose to represent the thread as having "closed with no finding of COI", a summary which ... wants for candour. Alexbrn 10:17, 9 July 2014 (UTC)

I don't have a COI on WP, and that's been obvious for months per COI/N, in light of which your repeatedly "identifying" one is tendentious. Having a profession is not, ipso facto, an indication of COI, and that's the policy we follow, nowithstanding the opinions of editors who don't understand/like it. See the "COI?" link in my sig for more, and a rebuttal of your generalization about acu'ist editors. Commenting on the contributor gratuitously is out of line, and you've done so in the past , as well as above (re Colquhoun & Novella). (BTW, that editorial is a good place to find sec/tert sources, not a replacement for them.) There's no snark in my comments on these issues. The snark I refer to is at Talk:Acu, when I said sarcastically that it was a CPUSH to cite sec/tert sources was CPUSH). --Middle 8 (leave me alone • talk to me • COI?) 18:25, 9 July 2014 (UTC) copy edited 00:25, 10 July 2014 (UTC)

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