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German Acupuncture Trials

German Acupuncture Trials (edit | talk | history | protect | delete | links | watch | logs | views) – (View log · Stats)
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There is insufficient depth and breadth of secondary coverage to warrant a standalone article on this topic (a number of clinical trials on acupuncture in the 2000s). After deletion, a mention of them might be considered for the main acupuncture article, though with other later trials being cited there it is not clear if they would even deserve a mention. Alexbrn 06:43, 20 November 2013 (UTC)

This is an article about 3 very large RCTs which were instigated at the behest of a number of German statutory health insurances. They are notable because on the basis of their result (among other), the Federal Joint Committee (Germany) decided to reimburse acupuncture treatment for low back pain and knee pain. We have one reliable secondary source and three reliable primary sources here. There also is an article about this at the German Misplaced Pages since ages... User:Alexbrn and User:QuackGuru are trying to take this article apart because of anti-acupuncture bias. They already deleted most of the article on the grounds that the sources were not reliable (the primary ones because they are primary, the secondary one - from the Federal Joint Committee itself - because it allegedly was not independent), without consensus. I've appealed to the Misplaced Pages:Reliable sources/Noticeboard already, but the case is still pending. --Mallexikon (talk) 06:56, 20 November 2013 (UTC)
  • Weak keep. The article is a pitful stub, but it shows reliable refs, and Google Book search for "German Acupuncture Trials" gives a number of reliably looking hits. I think the topic could be expanded beyond a stub, and likely has inherent notability. German speakers may be able to comment on German sources. Ping me if there are any major developments and I can revise my vote. --Piotr Konieczny aka Prokonsul Piotrus| reply here 07:44, 20 November 2013 (UTC)
I'd like to point out that it was Alexbrn himself who reduced the article to a stub right before he tried to have it deleted. And there was no consensus about his deletion of sourced material. The discussion about the unreliability of the sources he alleges has just started. --Mallexikon (talk) 08:38, 20 November 2013 (UTC)
Thanks. Removing 90% of referenced article's content, and then AfD-ing it, is problematic enough that a user conduct discussion may be merited somewhere else. --Piotr Konieczny aka Prokonsul Piotrus| reply here 08:55, 20 November 2013 (UTC)
I would support this. petrarchan47tc 18:43, 22 November 2013 (UTC)
  • Delete as it stands, because the article is a WP:COATHOOK for acupuncture promoters. It could be rewritten as something else, but that would require a buttload more reliable secondary sources and a completely different focus. Stuartyeates (talk) 09:06, 20 November 2013 (UTC)
  • Delete Both versions of the edit warred article, the stub and the poorly sourced one. --Roxy the dog (resonate) 09:35,
Note that your iVote was marked as Delete in the Stats. petrarchan47tc 18:43, 22 November 2013 (UTC)
Would be happy with Blue and Scray's suggestion. However once it is summarized it can likely be merged into a section on "society and culture" in the accupucture article.Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:37, 24 November 2013 (UTC)
  • Keep, as it is notable for its direct consequences in the German health care system and the huge debate it triggered. There's sufficient secondary sourcing. And WP:COATHOOK hardly applies since these trials showed quite clearly that verum and sham acupuncture had the same efficiency - which puts it at odds with the beliefs of Traditional Chinese medicine. --Mallexikon (talk) 13:26, 20 November 2013 (UTC)
  • Delete, Misplaced Pages is WP:NOT news; if this information is eventually covered by reliable secondary reviews, it will then be incorporated into acunpuncture. SandyGeorgia (Talk) 15:31, 20 November 2013 (UTC)
    • Reinforce my stance per Bluerasberry, merge the negligible policy content to acupuncture. There is no reason to keep a lot of what most certainly is a medical article because of some press on societal/policy impact. For that, we have WP:MEDMOS#Sections, which allows for a "Society and culture" section in medical articles. Keeping a coatrack will ... keep it a coatrack. What content can be salvaged can be included in the appropriate section at acupuncture. There is unlikely to be more to say on this topic than the policy/societal impact, so the acupuncture article can accommodate that. SandyGeorgia (Talk) 05:39, 24 November 2013 (UTC)
However, if the article is kept and once the primary sources are deleted it might be merged into the acupuncture article. We would have to evaluate the article based on secondary sources. QuackGuru (talk) 04:04, 24 November 2013 (UTC)
Note: This debate has been included in the list of Germany-related deletion discussions. • Gene93k (talk) 19:29, 20 November 2013 (UTC)
Note: This debate has been included in the list of Events-related deletion discussions. • Gene93k (talk) 19:29, 20 November 2013 (UTC)
Note: This debate has been included in the list of Law-related deletion discussions. • Gene93k (talk) 19:29, 20 November 2013 (UTC)
Note: This debate has been included in the list of Medicine-related deletion discussions. • Gene93k (talk) 19:30, 20 November 2013 (UTC)
  • Keep. Ample evidence of effect on insurance coverage makes it notable; I'm less equipped to judge medical notability, but the NHS reference, for one, suggests it may also be notable in that area. Yngvadottir (talk) 19:46, 20 November 2013 (UTC)
Unfortunately, the "NHS" content had been added to the article in a misleading way. The NHS runs an information service called "NHS Choices" which routinely reacts items of medical news; here it was giving an equivocal response (not the sure "conclusion" as was written in the article). In reality the NHS position comes from guidance published by the National Institute of Clinical Excellence, and this draws no more on GERAC than on any other set of evidence. Alexbrn 05:09, 24 November 2013 (UTC)
  • Delete and incorporate into acupuncture; it's because of the latter/parent topic that the trials are notable. -- Scray (talk) 20:21, 20 November 2013 (UTC) Keep based on User:Bluerasberry's formulation below (i.e. remove inadequately-sourced medical content, and focus on sociopolitical impact of the trials, where their notability rests). -- Scray (talk) 16:20, 23 November 2013 (UTC)
  • Comment this is currently a massive WP:FRINGE failure by relegating criticism to the bottom of the article. It does also appear to be overly detailed. WP:FRINGE says we need to appropriately marginalise pseudoscience, so delete is my view. Barney the barney barney (talk) 20:26, 20 November 2013 (UTC)
  • Keep: Regardless of any scientific merit of the study, the impact on German insurance policy appears to be notable and well-documented. Balance issues should be dealt with on the article talkpage, not AfD. --Carnildo (talk) 02:28, 21 November 2013 (UTC)
  • Keep but the article does need changes. It should be kept because these clinical trials are notable - the Spiegel and Focus articles are reliable sources and supplemented by others which also seem to be good. This article should not have coverage of acupuncture or opinions on acupuncture - it should only talk about the results of this trial and how those results have been used to influence policy in Germany. This is not a medical article - rather this is an article about a clinical trial and its impact on society and politics. All information without a citation should be removed. Content which is cited only to the report of the research study itself or other primary sources should be removed. Other people in this RfD claim that this article makes statements about acupuncture which are unrelated to this study - if those are here then they should be removed, but I do not see them. Blue Rasberry (talk) 20:43, 21 November 2013 (UTC)
Bluerasberry wrote: "Content which is cited only to the report of the research study itself or other primary sources should be removed." ← yes, but does that leave us with any more than some contemporary news reports/reaction and a few mentions subsequently? I fear not - not enough for a standalone article anyway ... Alexbrn 05:40, 24 November 2013 (UTC)
Alexbrn, if it does, then that is sufficient. The articles in Spiegel and Focus are enough to carry this because those are major publications talking about a topic of public interest. There are more sources besides those. This is a project which has been in the news repeatedly for more than five years, has been promoted by multiple organizations which heavily influence health policy, has affected millions of people, and which has consumed 7 million euros for the project and many more millions in the reaction. Cutting away the primary sources leaves a lot. I have to backtrack about saying no primary sources at all because I reconsidered that Germany might have no equivalent of the United States clinicaltrials.gov to give a third-party opinion about the minimal amount of information which the public ought to have when clinical research is happening in their community. I would want this article and all articles on clinical trials to include study specifications which define the research, but that would not contribute to notability or influence any deletion discussions. If the article is worth keeping then a bit of reference data is worth including, from primary sources or otherwise. Blue Rasberry (talk) 11:29, 24 November 2013 (UTC)
Bluerasberry, are you familiar with the "Society and culture" section per Misplaced Pages:MEDMOS#Sections ? For what reason would the negligible salvageable text about policy not be included in a Society and culture section at acupuncture? SandyGeorgia (Talk) 05:42, 24 November 2013 (UTC)
This is not an article about a medical topic so medmos does not apply in that way. All the medicine can be stripped out of this article and a major research project remains, and one can still talk about participants, funding, media reactions, and many other things having nothing to do with medical practices. This article should not make medical claims about acupuncture, so medmos guidelines about keeping medical content out of non-medical articles do apply. Users should go to acupuncture to read about the medicine. Blue Rasberry (talk) 12:45, 24 November 2013 (UTC)
You say it is not an article about a medical topic but the current article is a medical article about the trial itself. Using a source to describe itself is obviously a gross WP:WEIGHT violation. The GERAC trial itself is being used in the article to describe the trial itself. We must use sources independent on the subject matter. Using a primary study from six years ago is obviously a gross WP:MEDRS violation. Editors think it is okay to use any source they like and continue to ignore policy. The primary sources are being misused to describe in extreme detail about the trial itself, among other low level details. The article is littered with too many primary sources that do not show it is notable. For example, The Joint Fed. Committee is a primary source because they were part of the event. Even if the The Joint Fed. Committee was a WP:SECONDARY source there are now newer sources on the topic. That means The Joint Fed. Committee fails MEDRS and SECONDARY. The Joint Fed. Committee study is also being used to discuss the trial itself. The article should be mainly about how the results of the trial influenced policy in Germany. The trial itself in not what this article is supposed to be about. The details about the trials itself is not notable and not the direction of an encyclopedia entry. Editors have turned the article into their own personal WP:COATHOOK article. An editor thinks identifying a primary source is pointy. The editor's explanation on the talk page makes no sense. All the medicine cannot be stripped out of this article because editors at the article think it is a medical article. If the non-notable medical claims are removed from the article there may only be a few sources on how a clinical trial impacted the society and politics. The current state of the article makes it impossible for editors at the AFD to determine if the topic is notable. Two articles in Spiegel and Focus are not enough to claim this article is notable. Again, the primary sources are being used in this article to make statements about the acupuncture trial itself to discuss medical information that is unrelated to how a clinical trial impacted society and politics. Do you see the unrelated medical information and do you think that information must be removed? QuackGuru (talk) 18:33, 24 November 2013 (UTC)
QuackGuru (talk · contribs) is right. WP:FRINGE. Barney the barney barney (talk) 18:43, 24 November 2013 (UTC)
Yes, I have heard this from another anti-acupuncture editor as well: Acupuncture allegedly is WP:FRINGE - since "WP:FRINGE applies to all Alternative medicine articles on WP by definition" . Without being an acupuncture proponent, I strongly object to this view. I mean, just read the Acupuncture#Pain section: there's over half a dozen meta-reviews there finding evidence that acupuncture is effective. I personally agree that the clinical benefit is too small to bother. But how can you compare this to things like Creationism? --Mallexikon (talk) 02:51, 25 November 2013 (UTC)
I am not "anti-acupuncture" but I am anti-quack (which is relevant, I suppose). So, you are saying that a medical system that claims to cure a wide variety of human ailments by sticking needles into certain parts of the body to control an undetectable energy called "qi" is not fringe? Seriously .. Alexbrn 09:01, 25 November 2013 (UTC)
Primary sources are continuing to be dumped all over the article to make medical claims that is unrelated to the impact on society and politics. Blue Rasberry, do you support the primary sources being use to make medical claims? Editors think the article is about the trial itself and not necessarily about "how a clinical trial impacted society". QuackGuru (talk) 19:12, 24 November 2013 (UTC)
QG, the Federal Joint Committee (Germany) is an independent body that decides over which therapies are reimbursable by the statutory health insurances in Germany and which not. It did not set up the GERAC trials or even ask for them. I explained this to you a couple of times already now: , , . The report they published about the GERAC trials thus is a secondary source - and probably the most important one in this article since based on this report, they decided that acupuncture is reimbursable (in certain conditions). --Mallexikon (talk) 02:09, 25 November 2013 (UTC)
See WP:SECONDARY: Primary sources are original materials that are close to an event, and are often accounts written by people who are directly involved. The dated Joint Fed. Committee report is part of the event because they decided to reimburse acupuncture treatment for low back pain and knee pain. That makes them a primary source because they are part of the event. The low level details about the trial itself are not important because this is not supposed to be a medical article. QuackGuru (talk) 02:28, 25 November 2013 (UTC)
God damn it! The Federal Joint Committee is the body that approves what new cancer medication will be paid for by the statutory health insurances next year! They are NOT part of GERAC, the just reviewed and evaluated them (together with a couple of other acupuncture trials)! What "event" do you keep mumbling about? --Mallexikon (talk) 03:30, 25 November 2013 (UTC)
There seems to be consensus here that if this article stays, it should focus on the historical event which was the granting of a certain status to acupuncture in Germany which qualified it as eligible for insurance claims. The committee that was central to this decision was a prime participant and the documents it emitted are primary documents. We need secondary sources with independent commentary on what happened. Alexbrn 09:10, 25 November 2013 (UTC)
I don't see a problem in using an independent source other than the Federal Joint Committee regarding information about the FJC's own decisions. But regarding GERAC itself, the FJC's paper constitutes a highly reliable secondary source (a review of several acupuncture trials, actually). Why are you trying to deny this? --Mallexikon (talk) 11:17, 25 November 2013 (UTC)
It's not independent of the events and so far from ideal except maybe for the most mundane facts, or things which are otherwise validated by good secondary sources; for anything in the biomedical space (details of the trials e.g.) it fails WP:MEDRS and cannot be used. (But as has been said by others, there should be no biomedical content in this article anyway). Alexbrn 11:40, 25 November 2013 (UTC)
There is an article about Healthcare in Germany. The section about Healthcare in Germany#Regulation can cover how the trial impacted healthcare in Germany. It is redundant to have a separate article about the trials unless you want to keep a Misplaced Pages:COATHOOK article. QuackGuru (talk) 00:50, 25 November 2013 (UTC)
Here is another example of primary sources used in the article to discuss the trial itself. Any attempt to delete any medical information about the trial itself is being restored. So this is not an article about "how a clinical trial impacted society". QuackGuru (talk) 01:34, 25 November 2013 (UTC)
Is there anyone still questioning the notability of the article? The entire discussion seems to have gone off track and I don't see how this is supposed to be a coatrack article as you claim, since it only describes these studies and the consequences of them. -A1candidate (talk) 10:49, 25 November 2013 (UTC)
It's a coat rack. Take for example the statement (in Misplaced Pages's voice, mark you) that the osteoperosis osteoarthritis trial result "amounts to significant superiority of acupuncture and sham acupuncture over standard treatment, but no statistical significant efficacy difference between real and sham acupuncture". This is an out-of-date medical trial being laundered through a non-WP:MEDRS source, in the face of subsequent reliable secondary medical commentary (Howick) which tells us that trials such as these cannot reliably be used to deduce clinically significant results. What we have in this article is a smörgåsbord of bogus health information and POV-pushing; this needs to go. Alexbrn 11:53, 25 November 2013 (UTC)
Did you mean "osteoarthritis" instead of "osteoperosis"? In any case, the sentence which you're quoting appears to be taken from the results of the trials. Whether these results are out-of-date or not isn't the issue here. -A1candidate (talk)
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