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This is an old revision of this page, as edited by Middle 8 (talk | contribs) at 09:30, 29 January 2015 (busy tag). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

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This user is a scientist. This user is an acupuncturist. This user is a humanist. This user supports the rights of autistic people to speak for themselves. This user has been a member of Misplaced Pages since 2006. This editor is a Veteran Editor and is entitled to display this Iron Editor Star. they This user prefers singular they.

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Please see my conflict of interest declaration for acupuncture and related Chinese medical topics

For my approximate (on the lower side) total edit count on Misplaced Pages, add 5,432 edits to my present edit count

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Acupuncture and Biomedical Correlate

Review request for a review on the acupuncture page, first paragraph. See the Talk page, "Physical correlates of acupoints" section and "Physical correlates of acupoints, Part Two." I am concerned that an ethnocentric bias on the part of editors has prevented a simple edit. The editors stand by some very shaky references and will not accept references from the most prestigious universities in the world, including those in China. At issue, the current article reads inaccurately, "Scientific investigation has not found any histological or physiological correlates for traditional Chinese concepts such as qi, meridians and acupuncture points," and yet I have sourced numerous peer reviewed studies from reputable sources showing MRI brain activity, hemodynamic and oxygen pressure correlates. Please review, I think you will find the research interesting. TriumvirateProtean (talk) 13:33, 22 May 2013 (UTC)

Thanks for the note; I've been very busy and only read it just now. I will have a look, but can't get into anything very intense for another week or so. But I will have a close look. This is an important area and we need to get it right. --Middle 8 (talk) 16:46, 27 May 2013 (UTC)

Note to self and Acuhealth aka TriumvirateProtean: believe it or not, I haven't forgotten about this, which is why I didn't archive it. Besides being occupied elsewhere, I've been waiting for good sources: not just studies, but reviews (per MEDRS). Looks like we have some now. --Middle 8 (leave me alone • talk to me • COI?) 20:09, 11 May 2014 (UTC)

YEAH SCIENCE!!

		The E=mc² Barnstar
		YO BITCHES, this barnstar is awarded to Middle 8, for making poison out of rice and beans, saving our lives in the desert by building a battery out of spare change, and because I went through nearly every edit over the past year on Acupuncture and saw Middle8's profound mastery of scientific understanding. Some of his excellent edits may have been reverted, but they haven't gone unnoticed. Thanks for your excellent contributions! LesVegas (talk) 06:09, 8 September 2014 (UTC)

@LesVegas: WOW! Thanks man, that made my day! Truly appreciated... YEAH BITCH !!! ... cheers! --Middle 8 (contribs • COI) 07:08, 8 September 2014 (UTC)

AE request closed

The result of this AE request, which you filed against JzG, is that both parties are to be warned. Accordingly, you are hereby warned not to file frivolous or vexatious AE requests or to use Misplaced Pages's conduct enforcement mechanisms in an attempt to remove an opponent with whom you are engaged in a content dispute. You are also warned to respect Misplaced Pages policies on neutrality, consensus, and verifiability as well as all other applicable policies. Should you fail to adhere to this warning, there is a high probability that you will face substantive sanctions in the future. This warning will be logged as a discretionary sanction at the appropriate page, as will the warning to JzG. HJ Mitchell | Penny for your thoughts? 01:12, 11 January 2015 (UTC)

(talk page stalker) I'd like to see far more serious sanctions against those such as you who disrupt the project. -Roxy the dog™ (resonate) 12:08, 11 January 2015 (UTC)

Well, Roxy, I'm sure that's mutual, and unless you have something really constructive (or at least interesting or amusing) to say on this page, please don't bother doing so again. --Middle 8 (contribs • COI) 15:56, 11 January 2015 (UTC)

Given that JzG was warned, it's not clear in what sense this was a frivolous request. The warning suggests that there was indeed a behavioral problem. TimidGuy (talk) 12:25, 11 January 2015 (UTC)

TimidGuy, what they warned him for had nothing to do with why I filed the complaint. It turned into a "gotcha" fest, as these things do (I'd forgotten...). I thought AE would be better than that, but it still tends toward the same old B.S. -- a zero-tolerance witch-hunt -- find whatever looks bad, cherry-pick it, and depict it as a "pattern". At least the warning they gave me was justified; I should've inquired about whether such a posting was appropriate, but I was annoyed when I posted it, and had forgotten Bill Murray's advice to the groundhog ("don't drive angry"). ... OTOH, I suppose Guy deserved, in the bigger scheme of things, to get dinged for incivility, because he does do it too much, and unlike me, some people are truly bothered by it. (Gee, maybe that's part of why civility is one of WP:5P, ya think?) It can set a bad example and seems like bullying.

The thing that does bother me is the IDHT in the face of MEDRS's that disprove skeptics' assumptions about scientific opinion. It sometimes seem like they can't imagine that the consensus in the skeptical blogosphere could possibly be different from the consensus in the scientific community. It doesn't compute. They think the burden is on other editors to prove there isn't a consensus that, say, acupuncture is as discredited as homeopathy. It's pervasive, and nowhere more apparent in Kww's Arbcom filing, where an imaginary "consensus" is simply asserted. Same thing in Kww's and others' initial comments at Talk:Acupuncture here.... but to Kww's credit, he seemed to back off his more extreme comments (which were that we should exclude any reviews with positive findings, including Cochrane-level reviews). --Middle 8 (contribs • COI) 15:56, 11 January 2015 (UTC)

fwiw, I think Roxy's post was infelicitous piling on. But I also think, Middle 8, that the AE posting was poor judgement. Not sure what drove you to do that but there was no chance that was going to fly, and that, along with the ill-formed RfC/U on QuackGuru, are establishing a pattern that is going to stick to you; you have pooped in your own back yard twice now. I'm sorry to see that. Jytdog (talk) 16:12, 11 January 2015 (UTC)

@Jytdog: It was bad judgement... like Bill Murray said. And I apologized to Guy (but your comment is still accurate, unfortunately -- part of it's my fault, but there are also double standards on Misplaced Pages). Re consensus, see my comment at Kww's ArbCom request (which is a response mainly to his comment), or read the last few posts between me and Kww at the bottom of talk:Acu to get an idea what I'm talking about. Briefly: If what you're saying is consensus extended to all conditions, that would be reflected in reviews. But there's real disagreement over whether or not it works for pain and nausea -- and I recognize that that pool of possibility may also dry up, but that's where we are now. In a few years maybe the literature will be like homeopathy, but as long as there are invited pro-and con editorials, and an IPD meta-analysis, there is obviously mainstream debate -- see NHS etc., which reflect that. --Middle 8 (contribs • COI) 22:14, 11 January 2015 (UTC) edited 23:26, 11 January 2015 (UTC)

Actually, what I said in the first place was that we shouldn't include a laundry-list of individual reviews, because there's always a pressure from people to include the ones that are slightly positive and that distorts the perspective of the article. Similarly, we shouldn't list the few that find acupuncture is harmful, because those are also clearly false negatives. Include the scientific consensus, which is that acupuncture has no substantial effect beyond the placebo effect, and leave it at that. There's no doubt in my mind that there is a scientific consensus that acupuncture is a placebo, and you have even agreed with that stance: "The benefit (if it is real and not an artifact of bias) is small or modest ... nobody who is reality-based disputes that". So why do you argue that there is not a scientific consensus? Why doesn't a phrasing like "the benefits of acupuncture are non-existent or trivial" sum it up adequately?—Kww(talk) 16:18, 11 January 2015 (UTC)

fwiw, Kww, in my view this is messier than most people will actually acknowledge and deal with. One reason I appreciate Middle 8's perspective on Acu is that he actually deals with that. There are a set of difficult, hard facts here that there is no room in the acu article for, due to POV-pushing on both sides, namely:

• acu is indeed based on pre-scientific principles. If anybody claims today that "qi" and "merdians" have any reality, they are doing pseudoscience
• conventional medicine fails to help people sometimes, especially with regard to pain, which we still do not understand very well on basic scientific levels and even today we lack drugs and devices that effectively help some people who are in pain
• clinical studies have shown benefit of acu in some populations of people who are still in pain when doctors have done their best with conventional medicine. the placebo issues don't matter, clinically. the risk is tiny and compared to actually doing nothing extra, some people who are otherwise in pain are helped by this extra procedure. that is what matters.
• the use of acu as a complementary medicine in the situations mentioned above is discussed in medical textbooks (it doesn't get more mainstream than that) and is widely practiced. some of that is driven by market demand but medical centers wouldn't offer it if there wasn't some rationale (the clinical evidence) for it

I believe that Middle 8 gets all that, which is rare around here. A reasonable article about acu would be anchored on those facts and I think if Middle 8 had the article to himself, it would look that way. But you get acu-proponents constantly making insane claims about acu and the quack-fighters pushing back way too hard. The article is a wasteland, and there is no way to make the extremes step away. So I stepped away. That's my view, again, fwiw. (and none of this excuses Middle 8's poor judgement in bringing the AE) Jytdog (talk) 16:36, 11 January 2015 (UTC)

I agree that the social issue of whether a placebo is worth paying for confounds the issue, but it doesn't confound it much in my eye. If someone with chronic hives is helped by a sugar pill, I'm not about to endorse putting any statements that say that sugar is effective for the treatment of hives into sugar. Similarly, if the placebo effects of acupuncture help someone with chronic nausea, that doesn't make me inclined to put any statements into the article that says it helps with nausea.—Kww(talk) 16:49, 11 January 2015 (UTC)

I hear what you are saying. Part of why I emphasized that the placebo issues don't matter is that I was talking to you, and you are pretty solidly in the quack-fighter camp, and the placebo thing is what you reflexively reach for when talking about indications where acu has shown benefit over doing nothing extra. (btw I have the greatest respect for the work quack-fighters do, and I do a lot of that myself). In my view the quack-fighter camp way, way overplays the placebo thing - the data about placebo in indications where acu has shown benefit over doing nothing extra are messier than you all acknowledge. But anyway, thanks for reading what I wrote. Good luck! Jytdog (talk) 17:02, 11 January 2015 (UTC)

@Kww: - re your above comment beginning with "Actually, what I said...": time out, I call IDHT. You didn't quote the second part of what I said that differentiates our positions: "What is debated is whether it is clinically relevant...". To answer your question, why not say instead that some scientists conclude (insert your quote), and that others agree with the possible exception of pain and nausea? That's how the NHS did it: see the evidence page, archived 2012 version (scroll down to "Positive evidence", penultimate paragraph). Also note that in the archived page, it says the NICE found acu to be effective for lower back pain only, while today they add tension headache and migraine. It may be that acu really is a mild analgesic above placebo: I tend to suspect not, to be honest, but the evidence is consistent with that. When groups like the NICE say so, we have to reflect that. Don't we? --Middle 8 (contribs • COI) 22:38, 11 January 2015 (UTC) 23:40, 11 January 2015 (UTC)

The people that you've quoted as believing that acupuncture's effects are clinically relevant are including the placebo effect. Whether recommending a placebo is ethical is a question for another day. Who is arguing that there is a substantial effect above and beyond the placebo effect?—Kww(talk) 00:35, 12 January 2015 (UTC)

I'm not at all sure of your premise; how do you know this? Pretty sure the NHS is going off Cochrane reviews and the like, and they all use sham as a control. --Middle 8 (contribs • COI) 00:42, 12 January 2015 (UTC)

Vickers is pretty clear about it: I'm not aware of any reliable review that indicates a substantial delta between sham and actual, while there are certainly studies that show substantial deltas between doing nothing and performing acupuncture. That's why it's quite possible to have people concerned with financial value recommend its use while people that are concerned primarily with whether it has any actual physical effect say that it has little to none.—Kww(talk) 01:01, 12 January 2015 (UTC)

Kww just popping in here to comment on the above, where you seem to think there are two kinds of people in the world (the battleground mentality us/them) - those who love money (?) and those who love evidence. The group I tried to point out above is completely left out; namely those who want reasonable options for people still in pain after conventional medicine has done all it can. And what I hear from you is a big whopping "who cares". Maybe you think that is unfair, but I don't see you thinking like a doctor who has patients that need help. Can you please, pretty please, think orthogonally to the battle for just a bit, and see that it matters that acu does something for those patients, compared to doing nothing extra? Jytdog (talk) 00:39, 15 January 2015 (UTC)

It doesn't matter to how an encyclopedia describes it, Jytdog. We don't plant information into articles about placebos so that it is easier to deceive people receiving placebo treatment into thinking that they will be helped. That path would lead to an incredibly strange article on sugar, for example, describing all the maladies that sugar pills are effective for.—Kww(talk) 01:19, 15 January 2015 (UTC)

mmmm no. first of all it is not mainstream medical practice to give people sugar pills. as i noted above, acu has become mainstream as complementary (not alternative) medicine in some pain indications. But the deeper thing in what you write, really goes to what the editors working on any given article decide the scope will be, and specifically with regard to MEDRS, whether they choose to emphasize consensus practice or EBM, which are sometimes quite different. (i am not saying that they are different for these pain indications, btw) You can see how the difference between EBM and consensus practice, played out on the tamiflu article for example. It was insanely weighted toward a Cochrane review (where the lead Cochrane person is a notorious crank) -- see here and after I and some others pushed back it looked like it does now, which is Oseltamivir, with more weight on what is mainstream medical practice. (there is an RfC on it here and you can see where the consensus is going) As it stands now the acu article is (in my view) the ugly result of a battle, that gives no information on how acu is actually used. The clinical perspective is entirely absent and it is not very useful for anybody as an encyclopedia article. If the editors involved could agree to end the battle and just focus the scope on mainstream medical practice, the article would look very different. But that would require the pro-acu "lunatic charlatans" to back way the hell off things like using acu to actually treat cancer (oy), and would require the quack-fighters to put away their EBM swords. I don't see the pro-acu gang doing that anytime soon (they are if anything pushing harder lately) so I completely understand that the quack-fighters cannot walk away from an EBM focus which is their best weapon. So the article will remain as it is for the forseeable future. But focusing it on what is mainstream medical practice would probably be as useful a weapon... as it is, there is enough quackademic medicine via clinical trialling to give the pro-acu people some ground on which to fight; focusing on what is actual mainstream practice would take that ground away altogether. Anyway, good luck to you! Jytdog (talk) 01:36, 15 January 2015 (UTC)

Oh man, I didn't notice this AE request at all. I haven't ever had dealings with Guy, so I probably wouldn't have had much pertinent to offer anyway. But I have seen editors claim something is "X, Y or Z" and when you point out reliable sources that say it's actually "A, B or C" they ignore it and not only repeat their original claims but edit accordingly. That can be a problem on the encyclopedia, and it would be nice to get a ruling on IDHT conduct like that. Do you think Arbcom handle something like that? LesVegas (talk) 00:32, 15 January 2015 (UTC)

Thank you

That was a nice thing you did, and I do appreciate it. Guy (Help!) 22:46, 27 January 2015 (UTC)

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