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Reanalyses of Randomized Clinical Trial Data

An interesting paper in JAMA which provides a wonderful illustration of why we should insist on secondary sources. Of course, it too is a primary source in some regards... LeadSongDog come howl! 14:39, 10 September 2014 (UTC)

"Reanalyses differed most commonly in statistical or analytical approaches (n = 18) and in definitions or measurements of the outcome of interest (n = 12)." I don't have access to the full text, but isn't that pretty much the definition of post-hoc analysis? The original trial endpoints and statistical analysis are pre-specified as good statistical practice requires. Overall (and admittedly without having seen the full text), this strikes me more as a warning of some of the potential problems with reanalysis of trial data than direct evidence of its benefits (which have been demonstrated in other sources). Formerly 98 (talk) 14:59, 10 September 2014 (UTC)

My understanding is that these were reanalyses of the original study hypothesis (primary outcome), as distinct from post-hoc sub-group analyses. Therefore, such reanalyses aim to verify the published findings by conducting an alternative (improved?) analysis of the original data set. The findings of the paper published in JAMA are relevant to key questions regarding transparency and the desirability of open access to trial data. The accompanying editorial concludes:

The recognition that one trial can potentially lead to different findings and conclusions depending on many discretionary decisions that are made about the data and reanalyses almost mandates that those choices are transparent and described in detail—and that others have the chance to replicate them. Rather than the rare exception, open science and replication should become the standard for all trials and especially those that have high potential to influence practice.

Support, 86.164.164.123 (talk) 18:32, 10 September 2014 (UTC)

The problem is not just retrospective subgroup analysis, nor is it that the newly chosen endpoints and statistical methods are "non-transparent". It is that any non-prespecified analysis of the data creates a problem of multiple hypothesis testing. This is part of why the EMA for a while (I don't know the current status) was pushing for data release only to those who provided advance protocols of what their re-analysis endpoints and statistical methods would be. The issue is similar to why the FDA does not allow companies to substitute "improved" endpoints or statistical analyses for proving efficacy after their data is unblinded.

Interestingly, just today, this news report by Derek Lowe of a biotech suspending development of a drug due to what they call "fraud" by employees who conspired to view unblinded clinical trial data and reformulate the trial endpoints after unblinding of the data to make the drug look better. Formerly 98 (talk) 19:19, 10 September 2014 (UTC)

Evidence of willful malpractice is another matter. Imo, providing open access to data sets is ultimately relevant for transparency (as well as to possible pooled analyses). Quite what credence to give to an alternative analysis, in the light of the methodological questions it will inevitably raise, is a question that must be open to peer review and debate. As of course is the original report of the study design, analysis and interpretation... 86.164.164.123 (talk) 22:53, 10 September 2014 (UTC)

Let me restate that in a way that might be clearer. Its not a subtle question of methodological questions that are equally applicable to the original and re-analysis that I am referring to. I'm specifically referring to the well-established issue of the multiple comparisons problem. This is an important potential source of statistical error and even "cherry picking" for reanalyses that do not prespecify both the endpoints and the statistical method. It is normally not a potential source of these problems in the original analysis because the FDA requires pre-specification of both the endpoints and the statistical plan for any trial designed for regulatory approval. My point is simply that in order to be valid, the reanalyzers need to publically pre-state their analysis plan like Cochrane does and not go on a fishing expedition. (Though even Cochrane has been criticized for deviations from its prespecified analysis)

In general, whatever the flaws in pivotal clinical trials reviewed by the FDA for approval purposes may be, they are all based on efficacy endpoints and statistical analyses that are selected in advance of unblinding of the data, e.g., the investigators are blind to any effect their choice of one endpoint or statistical method vs another will have on the conclusions ("statistical significance") of the study. They cannot cherry pick. This can never be rigorously known to be true for any re-analysis, except in the narrow situation in which patient-level data is released by companies or regulatory authorities only after the re-analyzer pre-specifies an analysis plan. Formerly 98 (talk) 23:17, 10 September 2014 (UTC)

Of course those are all valid points. But ones that do not (imho, at least) militate against the principle and potential of open access, per se (although that would presumably preclude the possibility of prespecified reanalyses, which at present are somewhat rare anyway). 86.164.164.123 (talk) 08:11, 11 September 2014 (UTC)

I wish they were all valid points, but they are not. Not all trials are subject to FDA review (accupuncture practices, for instance). Even when they are, investigators, funders, and journal editors can and do cherry pick. The simple fact is that investigators (or their funders) quite regularly choose not to publish, rather than publish a "failed" trial which merely found the "wrong" conclusion. Simply search through clinicaltrials.gov and you'll see a huge proportion of trials which have not published conclusions, despite being long past their end dates. One sees extraordinary levels of this in trials of homeopathic preparations, herbals, manipulation therapies and many other alt-med interventions. LeadSongDog come howl! 16:59, 12 September 2014 (UTC)

@LeadSongDog: I agree with much of that, but a lot of the studies of non-publication have their own problems, including the COI problem that a paper is always more publishable if you get an "interesting" result, and that many of the authors are seeking to publicize or add support for pre-existing publicly held positions.

This paper for example, found that 29% of "large" (large was used as a marker of "importance" for the purposes of this study) clinical trials remained unpublished, and concluded (more accurately, simply assumed) that this 29% corresponded to negative trials that were being covered up for commercial purposes. But if you go to the listing of the unpublished trials in the supplementary material, here is what you find for the first 10 unpublished Industry-sponsored trials.

1. NCT00005918 is just a comparison of an immediate release to an extended release version of stavudine from 2002. Should have been published, but this was a really minor drug and calling the non-publication of this trial a coverup seems a little extreme.
2. NCT00046761 is a 2005 trial of a drug that was never approved. Not exactly a coverup of negative results for marketing purposes
3. NCT00057239 is a 2003 trial of an antidepressant that was dropped from development and never approved.
4. NCT00057382 is a 2003 trial of a cancer drug that was dropped from development and never approved.
5. NCT00062582 is a trial of an approved drug in an indication for which it was never approved. Probably should have been published anyway.
6. NCT00071266 is a trial of an approved combination pill for hypercholesterolemia. It should have been published.
7. NCT00083421 is a trial of an Alzheimers drug that was abandoned and never marketed.
8. NCT00087724 also a trial of an Alzheimer's drug that was abandoned in development and never marketed
9. NCT00097344 is a trial of a breast cancer drug that was abandoned while in development and never marketed
10. NCT00106509 is a trial of an antibiotic that was abandoned in development and never marketed.

So I'd say there are some problems, but I'd look beneath the headlines before concluding that every unpublished trial is a coverup. I for one, would rather see researchers spend their time trying to find new drugs than writing up unsuccessful trials of drugs that will never be marketed. Formerly 98 (talk) 16:05, 19 September 2014 (UTC)

A fascinating and insightful discussion and I would agree with most of what has been said above. However I would disagree about the value of writing up unsuccessful drug trials. There is a lot to be learned from failed drug trials, especially for refractory diseases such as Alzheimer's. The cost for researchers to write up the results of a failed clinical trial are minuscule compared to the cumulative sunk cost of developing that drug candidate. Furthermore the volunteer participants in these trials were put at risk. In my opinion, drug sponsors and journals have a moral responsibility to recoup as much as possible the financial and human capital that went into developing and testing a failed drug candidate by publishing the results. Boghog (talk) 19:35, 19 September 2014 (UTC)

Fair point.Formerly 98 (talk) 23:43, 19 September 2014 (UTC)

WikiProject Medicine and WikiAfrica

This article says Wikipedians are delivering Ebola information in Africa. Blue Rasberry (talk) 21:32, 12 September 2014 (UTC)

Yes, we've been working very hard over at WP:MEDTRANS, and you're very welcome to participate in any way you can, and we have a number of new guides out there showing you what can be done–even for an English-only speaker. We recently hit ~60 languages with a translated Ebola article and you can find all the links here WP:RTTS. -- CFCF 🍌 (email) 07:28, 13 September 2014 (UTC)

P.S. Newsletter with all this and more due out in a few days! -- CFCF 🍌 (email) 07:28, 13 September 2014 (UTC)

Excellent to see this :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:25, 16 September 2014 (UTC)

MEDDATE when no newer sources have been identified

We are having a bit of discussion at Talk:Acupuncture#MEDDATE regarding what the MEDDATE section of MEDRS suggests that we do when sources used by the article are more than five years old but no newer sources have been identified to replace potentially outdated information. Do we summarily remove the source and information cited to it? Do we add a tag such as {{update inline}} or {{medrs}} to indicate to readers that the article may not reflect current understanding? Do we leave it alone until newer sources of similar caliber are identified? This article is covered by WP:FRINGE as well as WP:MEDRS, but the sources in question are all solid medical reviews that are more than five years old. - 2/0 (cont.) 16:49, 14 September 2014 (UTC)

I think that WP:MEDDATE is clear on the matter; we should not remove a medical source simply because it's not published in the last five years or so. Unless, of course, more recent reviews are available. But WP:MEDDATE points out, "Within this range, assessing them may be difficult. While the most-recent reviews include later research results, do not automatically give more weight to the review that happens to have been published most recently, as this is recentism." And it gives space to areas that are less researched, stating that sourcing "may need to be relaxed in areas where little progress is being made or few reviews are being published." My opinion on the particular case you are citing is that "we leave it alone until newer sources of similar caliber are identified." Flyer22 (talk) 16:59, 14 September 2014 (UTC)

How certain are we that nothing has been published about this in the last five years?

How elderly are the sources? Are these maybe just six, eight, or ten years old? Or are they from the previous century? WhatamIdoing (talk) 02:32, 15 September 2014 (UTC)

A 2008 review. See Talk:Acupuncture#The_source_we_are_working_with_.5B34.5D. QuackGuru (talk) 02:47, 15 September 2014 (UTC)

(e/cx2) Largely in agreement with Flyer22 here; we should update information as we find newer source of equal or better quality, but not remove material just because it is cited to a review that is 6 years old. Some fields are incredibly fast moving (HIV treatment) in which 5 years may be too old; others have so little research that a 20 year old textbook might be the best source. I would not tag sources that are arbitrarily older than x years as they may still be the best sources available on the subject. Yobol (talk) 02:53, 15 September 2014 (UTC)

I'm not going to look at the source or what it supports or why people are fighting over it. Instead, I'll tell you my general opinion:

• If you've got a review article, and there have been no more recent review articles on that particular point, and the review is less than ten (10) years old, then leave it alone.
• If there are more recent reviews (notice the plural: it means "two or more") on that particular point (not just the field in general), then update or replace to reflect newer sources.
• Otherwise, it's complicated, and we need to talk about specifics.

WhatamIdoing (talk) 15:07, 15 September 2014 (UTC)

The tags were targeting any source older than five years without any objection to the text. Even a 2005 Cochrane review was tagged. They thought sources older than five years should be tagged even if no newer source was found. QuackGuru (talk) 18:41, 16 September 2014 (UTC)

Another discussion about the sources. See Talk:Acupuncture#Regarding_new_consensus_on_MEDDATE.27s_application. QuackGuru (talk) 19:53, 17 September 2014 (UTC)

Ejection fraction edits

Recent edits to Ejection fraction appear to me to have made the article less helpful to the reader. I have no medical background and am not sure how to correct the article. I would be grateful if an editor with a medical background could look over the introduction. Thank you. SchreiberBike talk 05:12, 15 September 2014 (UTC)

Which edits exactly? Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:19, 16 September 2014 (UTC)

Though Lbeben appears to be a medical professional, his edits have been problematic in the past. The second paragraph is wordy and uses too much jargon. Also the historical background in the second paragraph doesn't seem appropriate for the lead. Thanks for your help. SchreiberBike talk 16:54, 16 September 2014 (UTC)

Perfluorooctanoic acid

I raised this article last year but failed to make any headway in cleaning up what looks to be content with a very decided POV built on iffy sources against the backdrop of legal action in the US. Am I seeing that right? would appreciate a sanity check before attempting clean up again ... Alexbrn 18:14, 15 September 2014 (UTC)

Needs some primary sources trimmed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:15, 16 September 2014 (UTC)

Fun clean up job: Splints

Splint (medicine) is pretty weak. I'm sure that anyone who has taken a basic first aid class, or even just spent ten minutes reading online, could improve it easily. WhatamIdoing (talk) 02:27, 16 September 2014 (UTC)

Students 4 Best Evidence edit-a-thon starting now!

Hi everyone,

The Students 4 Best Evidence edit-a-thon is starting now! Join us in the Google Hangout

See the list of students and articles being worked on at the course page. Education Program:Students 4 Best Evidence/Students 4 Best Evidence, September editing campaign () Sydney Poore/FloNight♥♥♥♥ 11:28, 16 September 2014 (UTC)

Thanks to all who joined in! We've had some useful outcomes, not least is the work done on articles - and the confidence gained by the new(ish) editors who have made a small dent in the list of tasks, but have pledged to continue working with this initiative.

Other valuable developments are: a proposed follow-up session towards the end of this term as a joint effort between Cochrane and Cancer Research UK; and an offer from some of the Cochrane reviewers to inform us when they publish new reviews that they feel would interest us. I'm hoping we could make a subpage of WPMED to house a place where the reviewers could leave announcements of new reviews - does that seem like something the regulars here would like to see? Cheers --RexxS (talk) 18:32, 16 September 2014 (UTC)

Edward Tobinick

I am new at editing and am attending the Students 4 Best Evidence Cochrane event in Oxford. I came across this medically questionable active page recommending injection of etanercept for stroke. There are active arguments but they are not being debated on medically relevant grounds. The intervention is without reliable evidence and the author has lost his license to practice medicine in other states. Is it possible to mark this page for examination by the medical project for relevant evidence and accepted practice.AmyEBHC (talk) 13:45, 16 September 2014 (UTC)

The article is nominally a biography but appears to be used as a WP:COATRACK for convincing readers of the subject's belief that injections of Enbrel are good treatments for back pain, Alzheimer's, and stroke (and possibly other things).

It looks like the article recently received some significant changes that removed negative information and added a lot of praise. The page has been protected due to edit warring twice in the last two months.

The person who removed it was technically correct: proper (in this case, newspaper-type) sources for the governmental disciplinary actions like this one should be used instead of court documents. It might have been better to WP:PRESERVE the accurate information and improve the source than to blank it, but that's not actually required.

I'm not entirely convinced that the subject is notable. It's difficult to find properly published sources that both (a) aren't written by him and (b) say more than a couple of sentences about him. This criticism of his research isn't proof of notability, and descriptions on blogs like Science-Based Medicine and QuackWatch aren't, either.

AmyEBHC, thanks for letting us know about this problem. I candidly cannot recommend that you try editing this as your first introduction to Misplaced Pages. I think this is going to need to have attention from multiple highly experienced editors (and maybe admins). WhatamIdoing (talk) 22:16, 16 September 2014 (UTC)

Have trimmed a bunch of primary sources making medical claims. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:49, 17 September 2014 (UTC)

Thanks, James. I was doing the Cochrane training with User:RexxS and User:HenryScow, & suggested Amy post here rather than doing anything herself. Prima facie it seems a clear case of medical POV-pushing and promotion using the cover of the protection we give to WP:BLPs. Wiki CRUK John (talk) 10:18, 17 September 2014 (UTC)

Another brand new account has just showed up. Many need some protection this article may. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:24, 18 September 2014 (UTC)

Misplaced Pages:Articles for deletion/Edward Tobinick (2nd nomination). I don't think this guy is notable enough for an article. It's been to AfD before in 2006, and I don't think it was wisely closed then (the argument he was going to be as notable as Pasteur hasn't quite come true). Alexbrn 03:47, 18 September 2014 (UTC)

There seem to be related problems at:

• Etanercept#Experimental and off-label uses
• Alzheimer's disease research#Etanercept
  Alexbrn 05:34, 18 September 2014 (UTC)

Addressed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:56, 18 September 2014 (UTC)

Anyone looking for a project? Look at Throat culture

Throat culture needs some serious serious work...... NickCT (talk) 14:35, 16 September 2014 (UTC)

I just worked on it a bit. It definitely needs a lot more work, but this should be a good start. The article needs considerable expansion and needs WP:MEDRS-compliant references (currently sporting zero). Another thought-this might be a good project for students 4 best evidence if anyone is still looking for a project. TylerDurden8823 (talk) 17:45, 16 September 2014 (UTC)

Misplaced Pages:Administrators' noticeboard/Incidents#Proposal: six month interaction ban between Flyer22 and zzz

Opinions are needed on the above linked discussion. I and the other editor edit medical articles. Flyer22 (talk) 01:56, 17 September 2014 (UTC)

A WP:Permalink for the discussion is here. Flyer22 (talk) 01:58, 17 September 2014 (UTC)

Yes a strange situation. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:23, 17 September 2014 (UTC)

Recreational drug use

Has been changed significantly. Wondering what others thoughts are per Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:59, 17 September 2014 (UTC)

Notice of intention - working on clinical coding articles

As several of the below articles are under the WP:MED umbrella (and as a coder there being a potential WP:COI), I thought it best to declare here that I intend to start cleaning up the articles around clinical coding in the near future.

I'm currently looking at a structure similar to below:

• Clinical coder - the specific occupation.
• Clinical coding - new (currently a redirect) - the practice of applying codes from a classification to a health service encounter (irrespective of the practitioner).
• Medical classification - the tools used in clinical coding.

as this seems to reflect the separation between practitioner, mechanisms and implements used in other articles around occupations.

Related articles that may also need work during or afterwards:

• Medical billing
• Diagnosis code
• Procedure code
• Pharmaceutical code
• Topographical code
• Case mix
• Diagnosis-related group

For various reasons, including the COI, I'm going to assume that all should this be done in sandbox; with consensus/fresh eyes being sort when ready to publish. However, I need to ask; do articles have their own sandbox area? If not, is it possible to have multiple sandboxes in my user space? Little pob (talk) 13:05, 17 September 2014 (UTC)

Yes it is possible to have many sandboxes in your own userspace.

Being a coder is not really a COI. IMO you should be able to edit the articles directly without concern. Drop us a note here and we will be happy to look at your work. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:37, 17 September 2014 (UTC)

Working for/with a particular coding system might represent a COI, though as I think there is relatively muted competition between the various systems which different countries/organization use (is this right?) it may not be too serious. I agree you should be able to edit directly, but you need to declare your potential COI. You've done this on your user page, which is great, as well as here. You might also consider a note declaring it on the talk page of articles you intend doing major work on, especially if your edits might be considered controversial. And/or in your first edit summary on a page. You could ask here for a check when pretty much finished with an article. But it doesn't seem a very controversial area, not that I'd know. Best of luck! Wiki CRUK John (talk) 14:06, 17 September 2014 (UTC)

Being an expert or professional is not usually considered a conflict of interest. You might like to read WP:MEDCOI. WhatamIdoing (talk) 14:32, 17 September 2014 (UTC)

Can someone please look at these two articles?

• Ankaferd BloodStopper
• Hüseyin Cahit Firat

Some medical claims which I don't think are well sourced. --NeilN 23:27, 17 September 2014 (UTC)

Not sourced at all, Neil, if we require MEDRS-compatible sourcing. I've gently revised the first and commented on the two talk pages. They probably both ought to be gutted down to whatever can be reliably sourced (assuming the latter survives). --RexxS (talk) 23:00, 18 September 2014 (UTC)

Thanks very much RexxS. I can usually judge the reliability of sources pretty well but when it comes to medical studies, I prefer to leave it to expert volunteers. --NeilN 23:12, 18 September 2014 (UTC)

Useful free sources

Mostly WHO stuff but in an easy to access format. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:51, 18 September 2014 (UTC)

Health claims

We have an interesting situation here Pantyhose#Risks were a bunch of health claims are made using poor quality sources. Attempted to add a Lancet review and a user have removed it twice without joining the discussion here Talk:Pantyhose#Risks. Peoples thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:02, 19 September 2014 (UTC)

Agree that the sources are poor quality. Removed some of them and asked for medical citations compliant with WP:MEDRS. Also asked for a few clarifications with respect to who is making these health claims. TylerDurden8823 (talk) 03:00, 20 September 2014 (UTC)

Unusual citation activity in Monoclonal antibody

Would someone please check this series of recent edits? I get worried when I see low volume numbers on things that have plenty of articles in journals with high volume numbers, but maybe that's just me. EllenCT (talk) 01:29, 20 September 2014 (UTC)

they were funky, thanks. fixed. Jytdog (talk) 04:30, 20 September 2014 (UTC)

Is a MEDRS suggesting systemic bias suitable to establish noteworthyness of non-MEDRS secondary sources?

Regarding the discussion at Talk:Environmental impact of hydraulic fracturing#WP:WEIGHT of new study: "Proximity to Natural Gas Wells and Reported Health Status" (2014), I believe (PMID 24413211) is a WP:MEDRS which may establish the noteworthyness of secondary news source coverage of . If this is incorrect, please explain why.

Also, which articles at 7 are WP:MEDRS? Is 8? EllenCT (talk) 02:44, 20 September 2014 (UTC)

i don't understand what the section header means. As for specific questions... Your link 5 is not an article about health, it is about lobbying/politics/jurisprudence and is indexed that way by medline as you can see here. Your link 6 is a WP:PRIMARY source and not what MEDRS calls for (and notewothyness has nothing to do with MEDRS). your link 7 is a blank search page. your link 8 is WP:PRIMARY and not what MEDRS calls for. Jytdog (talk) 03:23, 20 September 2014 (UTC)

The medline link says the article is a "Review" in Reviews on environmental health and its abstract says "money can buy favors and determine policies that are often counter to the public interest and can even lead to failure to protect the health of the public" (emphasis added.) Is the article about health and lobbying/politics/jurisprudence both? EllenCT (talk) 07:47, 20 September 2014 (UTC)

yes medline reports the title of the article. it doesn't classify it as health-related review - the classifications are jurisprudence, etc as I mentioned above. Jytdog (talk) 12:29, 20 September 2014 (UTC)

To what extent does the subject matter of the journal bear on the question? EllenCT (talk) 18:23, 20 September 2014 (UTC)

Primary studies should rarely be used in articles because we need secondary sources to establish their significance. (You have not provided secondary sources.) Remember the warning for opinion polls, "these numbers are accurate within 5% 19 out of 20 times?" Primary studies have similar problems and need corroboration before they become accepted or rejected. Sometimes too they are attacked on methodology. TFD (talk) 04:23, 20 September 2014 (UTC)

Sorry, link 7 should have been NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy Volume 23, Number 1 / 2013 (Special "Fracking" Issue: FREE Content) -- which of those articles are WP:MEDRS? And link 8 appears to me to be a review of more than 38 primary source studies. Why is it primary and not secondary? If it is secondary, is it WP:MEDRS? EllenCT (talk) 07:29, 20 September 2014 (UTC)

Link 8 appears to me to report the results of a survey of 108 individuals (p 59), though referring to many other studies. That's very primary. Johnbod (talk) 12:36, 20 September 2014 (UTC)

Indeed, its discussion of these references is its most secondary part:

14. T. Colborn et al., “Natural Gas Operations from a Public Health Perspective," Human & Ecological Risk Assessment 17 (5) (2011): 1039-1056, doi: 10.1080/10807039.2011.605662.

15. L. M. McKenzie et al., “Human Health Risk Assessment of Air Emissions from Development of Unconventional Natural Gas Resources,” Science of the Total Environment 1 (424) (2012): 79-87, doi: 10.1016/j.scitotenv.2012.02.018.

16. M. Bamberger and R. E. Oswald, “Impacts of Gas Drilling on Human and Animal Health,” New Solutions: A Journal of Environmental and Occupational Health Policy 22 (1) (2012): 51-77, doi: 10.2190/NS.22.1.e.

The only question that remains is which of these articles are literature reviews, or better yet, we could summarize all of their secondary sections, right? EllenCT (talk) 18:32, 20 September 2014 (UTC)

Hi, I'm not seeing any of these articles as review articles. And we can not take the finding of each review and combine them to create our own review. There is more to high quality reviews than the summary of findings. They do a vigorous review of data sets looking for similarities, biases, and COI among other things. And then base the results on the combination of factors. Sydney Poore/FloNight♥♥♥♥ 19:05, 20 September 2014 (UTC)

Some of them have more substantial review sections than others. What is the proper course of action to take when articles about both policy and health are unlikely to be incorporated in a systematic review? E.g. if we wanted to adapt the data from depicted in ? Does WP:OI ("so long as they do not illustrate or introduce unpublished ideas or arguments") allow that? EllenCT (talk) 22:51, 20 September 2014 (UTC)

from my perspective none of the sources you have brought are suitable per MEDRS for sourcing content about effects of fracking on health. Whether they are suitable for other content (e.g. policy, law, lobbying, or politics) is a question for different board. Please be careful not to WP:COATRACK health content in any policy/politics/legal/lobbying content that gets generated based on these sources, if any of them are found suitable for policy etc. Jytdog (talk) 23:12, 20 September 2014 (UTC)

Topics intersect. EllenCT (talk) 08:08, 21 September 2014 (UTC)

When MEDRS reviews are unavailable

When there are no MEDRS-quality review articles on a topic, but an abundant number of peer-reviewed sources which include literature review sections and would otherwise fit the MEDRS criteria except for the fact that they are not primarily literature reviews, is there any actual specific prohibition on using those review sections as if they were MEDRS-quality? Isn't that established long-term practice here? EllenCT (talk) 18:00, 21 September 2014 (UTC)

you will find a range of opinions on that. some say if there are no reviews at all then the subject shouldn't be discussed in WP at all. others would reach for something like a review of the literature found in the discussion of introduction section of a WP:PRIMARY source but even in that case most would say that strong statements should not be made based on such weak sources. i would tend to agree with the position that WP should be silent if there are no MEDRS quality reviews at all but cannot judge without more details. Jytdog (talk) 18:13, 21 September 2014 (UTC)

Who are the "some" that say that topics on which there are no reviews should not be discussed? EllenCT (talk) 21:34, 21 September 2014 (UTC)

I do not see anything in MEDRS that prohibits it. Often writers of original studies will summarize the existing literature before explaining their own research. I do not see anything wrong with using these, particularly when review studies have not been written or are outdated. The same source can be both a primary and secondary source depending on its use. TFD (talk) 19:47, 21 September 2014 (UTC)

Well, MEDRS technically doesn't "prohibit" anything, and WP:IAR is still a policy. But on the assumption that the goal is to have the best possible material supported by the best possible sources, then MEDRS does strongly discourage this, because these mini-reviews tend to be biased. It's not always the case that the authors deliberately include only sources they agree with, but they've got limited space, so they focus on the prior work that explains or justifies their own work. The incompleteness results in (varying degrees of) bias. WhatamIdoing (talk) 21:11, 21 September 2014 (UTC)

that is, as usual, perfectly stated WAID. this is what i meant by "weak". Jytdog (talk) 21:30, 21 September 2014 (UTC)

Is doing so a long-established practice when editing health-related articles in which there are no WP:MEDRS review articles? EllenCT (talk) 21:34, 21 September 2014 (UTC)

Another article in need

Pontocerebellar hypoplasia is in serious need of expert attention, if anyone is up for it. Nikkimaria (talk) 04:26, 20 September 2014 (UTC)

TylerDurden8823 and I have made a start, but it could do with some solid secondary sources and further sections - Diagnosis, Screening, Management, Epidemiology, History are the obvious ones. I've dropped 3 secondary sources onto the talk page if anybody cares to do a little more work on the article. --RexxS (talk) 22:10, 20 September 2014 (UTC)

GA reassessment of Traditional African medicine

I've initiated a reassessment, my reasons are described here: Talk:Traditional African medicine/GA2. Page was created as part of an educational assignment in 2010 and marked as GA two weeks afterwards. Would any other users like to contribute? --Tom (LT) (talk) 06:13, 20 September 2014 (UTC)

1. Street, R.A.; Stirk, W.A.; Van Staden, J. (2008). "South African traditional medicinal plant trade—Challenges in regulating quality, safety and efficacy". Journal of Ethnopharmacology. 119 (3): 705–710. doi:10.1016/j.jep.2008.06.019. ISSN 0378-8741. PMID 18638533.
2. Müller, Adrienne C.; Kanfer, Isadore (2011). "Potential pharmacokinetic interactions between antiretrovirals and medicinal plants used as complementary and African traditional medicines". Biopharmaceutics & Drug Disposition. 32 (8): 458–470. doi:10.1002/bdd.775. ISSN 0142-2782. PMID 22024968.
3. Ncube, Bhekumthetho; Ndhlala, Ashwell R.; Okem, Ambrose; Van Staden, Johannes (2013). "Hypoxis (Hypoxidaceae) in African traditional medicine". Journal of Ethnopharmacology. 150 (3): 818–827. doi:10.1016/j.jep.2013.10.032. ISSN 0378-8741. PMID 24184189.
4. Gruca, Marta; van Andel, Tinde R; Balslev, Henrik (2014). "Ritual uses of palms in traditional medicine in sub-Saharan Africa: a review". Journal of Ethnobiology and Ethnomedicine. 10 (1): 60. doi:10.1186/1746-4269-10-60. ISSN 1746-4269. PMID 25056559.{{cite journal}}: CS1 maint: unflagged free DOI (link)
5. Chitindingu, Ethel; George, Gavin; Gow, Jeff (2014). "A review of the integration of traditional, complementary and alternative medicine into the curriculum of South African medical schools". BMC Medical Education. 14 (1): 40. doi:10.1186/1472-6920-14-40. ISSN 1472-6920. PMID 24575843.{{cite journal}}: CS1 maint: unflagged free DOI (link)

The references are not properly formatted in the Notes section. The lede does not summarise the body. More sources are needed to update the article. The article easily fails GA. QuackGuru (talk) 07:44, 20 September 2014 (UTC)

Thanks, I've copied these to the reassessment page for posterity. --Tom (LT) (talk) 22:26, 20 September 2014 (UTC)

There will be an effectiveness and safety section in the article and it will be summarised in the lede. QuackGuru (talk) 23:48, 20 September 2014 (UTC)

WP:Good article criteria do not require "properly formatted" references.

Someday I should just make a template for this. Maybe getting spammed with the same template several times would help squash this persistent myth. WhatamIdoing (talk) 21:14, 21 September 2014 (UTC)

WP:PULSE August/September double issue soon out!

I'm currently fleshing out the content on the Pulse newsletter. If anyone would like to help please feel free to polish upon it up until it is released. I've provided much of what is there, and am working on the medical translation parts, but if anyone want to add anything else, please do! Misplaced Pages:WikiProject_Medicine/Newsletter/August_2014
Ping LT910001, Bluerasberry
-- CFCF 🍌 (email) 16:23, 20 September 2014 (UTC)

Ping, Wiki CRUK John, maybe you'd like to leaf over it and add something? Thanks!

I really want to get this out in the next few days, and it desperately needs varied content. I've done my best, but some of it is outdated, and could use input from others here! -- CFCF 🍌 (email) 13:56, 21 September 2014 (UTC)

Misplaced Pages:Administrators' noticeboard/Incidents#Proposal that User:Protonk's removal of my (Flyer22's) WP:Rollback rights be overturned

Opinions are needed on the above linked discussion. A WP:Permalink regarding it is here. It concerns this WikiProject because I revert a lot of WP:Vandalism and other unconstructive edits at medical articles. Flyer22 (talk) 23:04, 20 September 2014 (UTC)

With this edit, Chillum removed the above notification from our talk page. I am appalled that someone who is not an active member of this project should have the nerve to attempt to dictate what is seen on this page and what is not. I have therefore restored the notification in the firm belief that members of WPMED are perfectly capable of making their own minds up on an issue such as the one that Flyer22 has tried to bring to our attention. --RexxS (talk) 01:52, 21 September 2014 (UTC)

Please read WP:CANVAS before getting all appalled. Also please reduce your sense of ownership of this page. Chillum Need help? Type {{ping|Chillum}} 02:08, 21 September 2014 (UTC)

What arrogance. You come here, removing posts in direct contravention of WP:TPO and then are rude enough to assume that just because I don't agree with your ridiculous interpretation of WP:CANVAS that I haven't read it. This page is for discussing issues of interest to WPMED; get some clue before you turn up here trying to throw your weight around. --RexxS (talk) 02:37, 21 September 2014 (UTC)

Ownership of a page? This page is for the benefit of the people involved in the project! It is ridiculous to assume a non-member could make the distinction of what is important for the project and what is not. The exact same thing happened over at WT:ANAT, and someone else had to restore the message. -- CFCF 🍌 (email) 14:00, 21 September 2014 (UTC)

interesting points regarding ownership of page. appears many articles suffer from this. however i don't think this aggressive tone in some comments here is helpful to anyone. can someone instead perhaps outline clearly and calmly what the main issues are.Docsim (talk) 14:27, 21 September 2014 (UTC)

Maybe User:Chillum was just trying to bring more attention to Flyers post by removing it and generating further interest from this community? Anyway would strongly recommend they NOT do this again. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:34, 21 September 2014 (UTC)

The removal of the canvasing what brought to the attention of ANI where it is agreed the canvassing was inappropriate. I have already explained that canvas allows posts to place directly related to the dispute. I don't see how this page was directly related to someone losing their rollback rights. Recommendations that fly in the fact of policy cannot really be taken by me.

Membership is not a requirement to edit here. When someone is spamming many posts all over it is appropriate for an admin to reverse those, even if it is a page where people don't like outsiders doing things. Again, I acted appropriately. I don't get what all of the fuss from you people is all about. Chillum Need help? Type {{ping|Chillum}} 15:59, 21 September 2014 (UTC)

• No, you didn't. But I'm not surprised that a few other members of Team Misplaced Pages Project Police at ANI have been willing to pretend you did, and that you believe them. Your (and their) gross misapplication of WP:CANVASS to prevent wider scrutiny of Protonk's bad removal of Flyer22's rollback flag fortunately failed. LHM 16:14, 21 September 2014 (UTC)

While consensus here is that your edits were inappropriate. That flyers comment was related as it effects the function of our project and thus his comment was within policy. Thus recommend you not persist. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:17, 21 September 2014 (UTC)

hi im new

I've been helping on the talk page and with other editors for the,, "Ebola virus west Africa outbreak" article, is that within the scope of what the wikiproject medicine does?,,or is there something else I should do?,,,,--Ozzie10aaaa (talk) 00:05, 21 September 2014 (UTC)

Hello and welcome to WikiProject Medicine! The article "Ebola virus epidemic in West Africa" is indeed in the scope of this WikiProject. If you look at the top of the article's talk page, you should see a list of WikiProjects that have an interest in the article. As an aside, if you see an article that you think should be tagged for this WikiProject but isn't, you can add this yourself on the article's talk page. You don't need any special permission to do this. If in doubt, you are welcome to ask on this page. Axl ¤ 08:34, 21 September 2014 (UTC)

thank you,,,--Ozzie10aaaa (talk) 11:28, 21 September 2014 (UTC)

Comparison of bipolar disorder and schizophrenia

Just came across this...am in two minds about it but leaning towards deleting it - none of the sources are about comparison and not much crops up on google scholar that would apply. Doesn't mention schizoaffective disorder either...what do folks think? Cas Liber (talk · contribs) 20:54, 21 September 2014 (UTC)

Some well-sourced compare-and-contrast material could be very interesting to some readers and help educate them about the differences. Should it be its own page, or small part of each article? Hmm, I could go either way with that. WhatamIdoing (talk) 21:21, 21 September 2014 (UTC)

Misplaced Pages talk:Articles for creation/Cordocytes

Dear medical experts: The above old AfC submission needs more independent sources, but is the topic notable? Should the draft be kept and improved? —Anne Delong (talk) 21:23, 21 September 2014 (UTC)

Misplaced Pages talk:Articles for creation/Corneal Inlay

Dear medical experts: I'm pretty sure this is a notable topic. Is the content appropriate, and are the references reliable? —Anne Delong (talk) 21:29, 21 September 2014 (UTC)