Talk:Acupuncture - Misplaced Pages

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Petition regarding this page

Notice of the petition has been given. The other discussion in this section is about the topic and not about improving this article. Closing per WP:TPG Jytdog (talk) 18:58, 3 January 2017 (UTC)

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

change.org/p/jimmy-wales-clean-up-the-wikipedia-acupuncture-page-to-reflect-medical-and-scientific-consensus (site in spam blacklist) - I haven't gone through their claims in detail, but editors experienced on this page may wish to go through and see if they've put forward anything that would be useful - David Gerard (talk) 23:46, 29 December 2016 (UTC)

Thanks but change.org has been considered in the past with an epic response—Misplaced Pages:Lunatic charlatans. Johnuniq (talk) 00:26, 30 December 2016 (UTC)

What does Jimmy Wales have to do with this? Sure he managed to settle the debate with an excellent response last time through, but do they not understand that he doesn't dictate what this (or any) page says? A few of the sources they list are interesting, such as the AHRQ's , which is excellent. On the other hand they're vastly overstating its conclusions, and the report does not "recommend" acupuncture at all. (In fact as a HTA-report it isn't supposed to give recommendations.) The NICE report (available at , their link doesn't work) states that acupuncture may be considered when other treatment is unsuitable or does not work, but that isn't very different from what our article already states. Many of the reports they list are either old and outdated or otherwise inadequate as per WP:MEDRS and WP:DUE. If they try to pressure us in any way I think it should be made known that this action will not result in change — and they are welcome to discuss the page here in civil debate weighing sources against one another. However, creating silly petitions will not sway us. Especially so when their rub seems to be with the labeling if acupuncture as pseudoscience, which is fully backed by the sources included in the article. There's also a precedent set in a 2009 ArbCom case. I will further dive into the sources once I have more time, but for now I suggest we ignore this and combat any of the vandalism it may promote. Carl Fredrik 💌 📧 01:10, 30 December 2016 (UTC)

Carl, interesting point about their medical guidelines. Specifically, which ones are inadequate WP:MEDRS? Which ones have been superseded (which is how a guideline becomes outdated)? And which of the guidelines provided are considered adequate WP:MEDRS?

"The NICE report (available at , their link doesn't work) states that acupuncture may be considered when other treatment is unsuitable or does not work, but that isn't very different from what our article already states." For tension-type headaches, acupuncture is recommended as a first-line treatment for prophylaxis (it's actually the only treatment recommended for prophylaxis) (https://www.nice.org.uk/guidance/cg150/chapter/Recommendations).

"they are welcome to discuss the page here in civil debate weighing sources against one another." Looking at the petition, I think their point specifically was that those who have tried doing that were quickly banned. What you call 'civil debate' has been labelled by others here as 'challenging consensus' and resulted in immediate ban. Looking through the dialogue on this page, I'd be very interested to understand the distinction. Banning too quickly means that commenters are left with no choice but to try to influence through means outside of Misplaced Pages, which isn't ideal.86.153.15.89 (talk) 09:24, 31 December 2016 (UTC)

There has been no such thing as "banning too quickly". Only those who continually show an unwillingness to consider evidence, incapacity to accept consensus and who have acted rashly and disruptively have been banned. The fact is that this is more or less ideal — seeing as trying to exert external pressure will not and can not succeed. Guy's reply below is excellent, but I felt I could not let this slip.Carl Fredrik 💌 📧 12:09, 31 December 2016 (UTC)

"Consider" is not the same as recommend. Nothing in that NICE document is in any way inconsistent with the current article. Note also that it's approaching 5 years old; here's what happened when NICE reviewed the similar guidance for low back pain: . Medical science is getting better at blowing away the dust. Nonsensical therapies, with homeopathy being top of the list, are the inevitable casualties. Guy (Help!) 10:34, 31 December 2016 (UTC)

"Consider a course of acupuncture" is the recommendation for TTH prophylaxis just like "Consider aspirin" is the recommendation for acute headache. None of the recommendations begin with the word "recommend." If you're not sure how medical guidelines work, feel free to ask rather than misinterpret them. It isn't relevant if a clinical guideline is 5 years old as long as it's current, particularly as the evidence has become stronger in the interim.

As an aside, which medical guidelines recommend homeopathy? I wasn't aware of any but it's interesting if you're saying that there are and that now support is being removed.31.51.233.8 (talk) 10:18, 2 January 2017 (UTC)

First, "consider" is not the same as saying it works; second, the guidance on back pain was recently revised and acupuncture removed, so the age of this guidance is relevant. It's likely the next review cycle will see this downgraded still further. Neither of these things goes tot he core of the problem, though, which is that acupuncture is based on refuted doctrines, and supported by poor quality evidence, largely beset with obvious bias and conflicts of interest, and even then shows only tiny effect sizes in a few arbitrary conditions with no indication why these would be physiologically different from the many for which it is shown not to work. The trajectory of evidence is pretty clear. Scientists have become better at removing bias, and the more bias is removed, the more likely a trial is to show no effect. This is entirely consistent with the absence of evidence for any of the core doctrines of acupuncture. Guy (Help!) 10:30, 2 January 2017 (UTC)

""consider" is not the same as saying it works" - Sure, what it means is that NICE performed an exhaustive evidence review and has come to a consensus to recommend acupuncture based on the strength of the evidence and compared to other available treatments. This is evidence that conventional medical organisations disagree that it is pseudoscience, as they don't recommend pseudoscience. Medical guidelines are considered by Misplaced Pages to be high quality MEDRS for a reason, regardless of whether or not their conclusions happen to coincide with your beliefs. Unfortunately, future evidence reviews that have not yet happened that you guess will have conclusions that are magically identical to your particular beliefs are not MEDRS. Current published reviews are, whether or not you personally agree with their conclusions.167.98.3.58 (talk) 09:05, 3 January 2017 (UTC)

NICE accepts current practice with a pretty low bar. If acupuncture were a new treatment it would geta full review; existing treatments also periodically get a full review, and that is what happened with back pain. Guess what? Acupuncture was removed.

We have at present three conditions for which acupuncture is stated to have net positive evidence. Given the number for which evidence is net negative, and given the absence of any credible difference between the many conditions where it's net negative and the few where it's net positive, and given the refuted nature of its fundamental premise, and givent he documented difficulty of rmeoving bias in trials and the equally well documented fact that bias is the strongest predictor of a positive outcome, and given the small effect sizes of most trials, the most parsimonious explanation is that the net positives are false positives, consistent with P=0.05. That's the actuality of it. Guy (Help!) 09:23, 3 January 2017 (UTC)

"NICE accepts current practice with a pretty low bar. If acupuncture were a new treatment it would geta full review" - well now I'm really confused. Acupuncture was a "new" traetment to the NHS when the migraine and TTH review was created.

Now personally, I have been involved in NICE guideline development. However, according to your profile it says that you're Dell employee. Do you have any medical, research, or guideline development background? I just ask because you say a lot things about how NICE guidelines are developed but none of them seem to be true, at least according to my experience or that of my colleagues. For example, when talk about NICE accepting 'current practice with a pretty low bar', what would be an example of the differences in methods and criteria for literature review, evidence syntheses and strength of evidence to support a recommendation? Can you provide a specific example of the point you're making or any evidence to support it? I've simply never come across what you're claiming. It sounds an awful lot like you're making things up to support your opinion about acupuncture.167.98.3.58 (talk) 15:14, 3 January 2017 (UTC)

Misplaced Pages being what it is, we allow anyone to contribute, within limits. You might believe that NICE applies exactly the same standards to existing treatments as it does to new ones or withdrawal of recommendations. That's not what I have concluded from reading the literature. Of course I could be wrong. I'm not an expert, and expertise is not recognised on Misplaced Pages. What is unquestionably true is that the evidence shows no reason to believe qi exists; no evidence for the existence of meridians; no consistency about acupoints between traditions; no mechanism for evidence-based correction of error; it makes no difference where you stick the needles, or even whether you insert them at all; most conditions show net negative evidence; effect size is always small; and the chances of a positive result are mainly down to the scope for bias to creep in. Guy (Help!) 16:09, 3 January 2017 (UTC)

Detailed response
The following discussion has been closed. Please do not modify it.
By "The Acupuncture Now Foundation", whose views are obviously entirely neutral. There is a rather obvious reference to lobbying of this group by LesVegas and/or Ellaqumentary. All the points in that petition are, I think, already covered in the article and have been discussed here at length before. The acupuncture page on Misplaced Pages, in a flagrant violation of Misplaced Pages's Neutral Point of View Policy, currently states that "acupuncture is pseudoscience." Wiki's Neutral Point of View policy says, in a nutshell: "Articles must not take sides, but should explain the sides, fairly and without editorial bias. This applies to both what you say and how you say it." This is begging the question. If we were applying this label without the benefit of reliable independent sources then it would be a valid point, but the statement is well sourced. My personal view is that acupuncture is a quasi-religious belief system, and that study of acupuncture is largely pseudoscientific, but the sources are less nuanced. Pseudoscience, according to Misplaced Pages, is determined by medical and scientific consensus. No, it's defined by people who specialise in the demarcation issue. Science usually ignores pseudoscience altogether, and medicine ignores it other than in the specific field of quackademic medicine, aka integrative medicine, otherwise known as SCAM. Throughout the years, volunteer editors have clearly demonstrated that considerable swathes of the mainstream medical and scientific community firmly support the use of acupuncture - position statements, medical consensus guidelines, Cochrane Reviews, and reviews of acupuncture's biological mechanism research clearly demonstrate that the statement 'acupuncture is pseudoscience' is controversial at best, which means that this categorisation of acupuncture violates Misplaced Pages's neutral point of view policy. Editors who attempt to update the article in line with high-quality medical references are consistently banned from editing. This is an attempt to legislate inclusion of specific sources they like. Cochrane reviews have been discussed. They should be viewed in the light of the work of Ioannidis, and also the fact that several (e.g. ) have been withdrawn after comments. The result of any review is highly sensitive to inclusion criteria. It could be argued that all studies from certain countries (notably China) should be excluded: a review found not one single published paper from China that found the intervention under test to be ineffective, and all Chinese studies of acupuncture are positive. Great care is necessary in reviewing sources for inclusion. Medical consensus guidelines that recommend acupuncture include: These are irrelevant. All (most especially the WHO) are the result of True Believers advocating within the bodies concerned, and medicine is not science. These are all highly respected, mainstream medical institutions and they all recommend acupuncture in their consensus statements based on unbiased evidence reviews. Your logical fallacy is: Appeal to authority. Yet, the administrators of the page essential practice denialism and have consistently stated that merely providing evidence that acupuncture has this support is grounds for being banned, for example: "if you continue to claim that acupuncture has mainstream scientific validation, you have no future as an (sic) Misplaced Pages editor." That was a statement by Tgeorgescu () who is not an admin. I clarified here: . Acupuncture does not have mainstream scientific validation. If it did, this argument would not be happening. There is no such thing as qi, no such things as meridians, no evidence that acupoints are significant (and they differ between traditions). There is no convincing evidence that it matters where you put the needles, or even whether you insert them. That's not our problem to fix. In order to maintain the position that the statement 'acupuncture is pseudoscience' is not controversial, even though it clearly is, the administrators who are controlling the acupuncture page are censoring this vast and growing body of evidence that presents a very different reality. They frequently make factually incorrect, unreferenced statements while ignoring and deleting high-quality peer-reviewed systematic reviews that contradict their opinion. It's controversial to say acupuncture is pseudoscience (see above) but it's not our controversy so we can't fix it. In 2014, you said: "Misplaced Pages's policies around this kind of thing are exactly spot-on and correct. If you can get your work published in respectable scientific journals - that is to say, if you can produce evidence through replicable scientific experiments, then Misplaced Pages will cover it appropriately." It is this evidence, from Cochrane, Harvard, the Journal Neuroscience, Plos and many others, that is being systematically censored by Misplaced Pages's administrators. Misplaced Pages is not remotely covering acupuncture appropriately, by your or any reasonable definition. Your logical fallacy is: cherry picking. Not one of those studies refutes the null hypothesis. This is the core point they don't seem to understand. Clinical evidence is by nature probabilistic, and P=0.05 means one in twenty positive results will be false even if all bias is eliminated. There is a great deal of discussion in the literature of just how difficult it is to remove bias in studies of acupuncture, specifically. There is a core difference between medical trials and science. Science tests: is this hypothesis true? Medicine tests: does it look like this treatment works? It is perfectly possible for an entirely bogus treatment to look as if it works. Treatments are withdrawn all the time because it's found they don't. Knee washouts, for example. Very little real science is done on acupuncture - virtually none in fact. The reason it's often described as pseudoscience is that most studies start by stating the validity of acupuncture as an assumption, usually by reference to a fallacy (appeal to tradition or popularity). We fully recognise that there are those who believe acupuncture to be pseudoscience - these are typically members of vocal pseudoskeptical organisations, such as Guerilla Spepticism on Misplaced Pages (most of the editors and admins of the acupuncture Misplaced Pages article are members of such organisations) and a number of highly vocal Skeptical individuals. However, these groups constitute one opinion and do not reflect the overall medical consensus. Their opinion papers and websites constitute much weaker evidence than peer-reviewed evidence syntheses and institutional medical guidelines. Feel free to cite the basic science that shows that qi exists, meridians are a thing, and whihc has led to a convergence on a single set of acupoints in all traditions. In fact I think that last would be pretty persuasive. If every acupuncture group int he world, from every country, collectively reviewed a set of tests and changed their charts, discarding the ancient sacred texts sin favour of new empirical evidence, I think that would probably kill the pseudoscience claim right there. Those Misplaced Pages editors who point out the copious high-quality medically reliable sources that contradict the biased tone of the article are bullied and banned from editing, in a clear act of censorship and abuse of administrative powers. Last week alone, two editors were banned from editing the acupuncture article without having violated a single Misplaced Pages policy. Both editors had merely pointed out the violation of Misplaced Pages's neutral point of view policy, with the support of high-quality, peer-reviewed medical references published in mainstream publications. This state of affairs is completely unacceptable and puts the public at risk by denying access to a balanced and accurate perspective on evidence-based health care options. In the United States, the number one cause of accidental death (more than car accidents) is overdose from prescribed opioids for pain - the Misplaced Pages article misinforms patients, doctors and healthcare policy makers about an effective and safe treatment option for pain, unnecessarily increasing the risk to the public. They were topic banned for refusing to accept consensus. Both were given WP:ROPE, one of them for many months. There is no risk to the public by failing to promote acupuncture. Even its best friends would have to admit, if they were honest, that it's of little benefit. Again, if we were able to see large effect sizes and objective, rather than subjective endpoints, this argument would not even be happening. Misplaced Pages, which is a highly accessed source of medical information by medical professionals and patients alike, has a responsibility to ensure that articles accurately reflect the balance of information available and the appropriate participation of the editorial community through enforcing its guidelines. In the case of the acupuncture article, this process has clearly broken down. Valid, appropriate, evidence-based and referenced perspectives are being systematically silenced so that administrators can present their narrow opinions as scientific consensus. No, it's working as designed. Misplaced Pages habitually shows the door to people who won't take "no" for an answer, especially if the question has already been asked dozens of times and they have no other area of interest. We get bored easily these days. Misplaced Pages: for the sake of accuracy, scientific integrity, and public health, please clean up the administration of the acupuncture article to be in line with your editorial and administrative policies so that the article can reflect best-evidence, not individual bias, and allow editors to remove acupuncture from the Pseudoscience category. Your logical fallacy is: begging the question. So, the substantive request comes down to the oft-repeated and frequently discussed question: should this be in Category:Pseudoscience. My view is that it should not, but that we should mention that study of acupuncture is dominated by pseudoscience. I would put it in Category:Pseudomedicine instead. But that's just my personal view, which, unlike the trypanophiles, I do not misperceive as objective fact. Guy (Help!) 01:09, 30 December 2016 (UTC)

Detailed response

The following discussion has been closed. Please do not modify it.

By "The Acupuncture Now Foundation", whose views are obviously entirely neutral. There is a rather obvious reference to lobbying of this group by LesVegas and/or Ellaqumentary.

All the points in that petition are, I think, already covered in the article and have been discussed here at length before.

The acupuncture page on Misplaced Pages, in a flagrant violation of Misplaced Pages's Neutral Point of View Policy, currently states that "acupuncture is pseudoscience." Wiki's Neutral Point of View policy says, in a nutshell: "Articles must not take sides, but should explain the sides, fairly and without editorial bias. This applies to both what you say and how you say it."

This is begging the question. If we were applying this label without the benefit of reliable independent sources then it would be a valid point, but the statement is well sourced. My personal view is that acupuncture is a quasi-religious belief system, and that study of acupuncture is largely pseudoscientific, but the sources are less nuanced.

Pseudoscience, according to Misplaced Pages, is determined by medical and scientific consensus.

No, it's defined by people who specialise in the demarcation issue. Science usually ignores pseudoscience altogether, and medicine ignores it other than in the specific field of quackademic medicine, aka integrative medicine, otherwise known as SCAM.

Throughout the years, volunteer editors have clearly demonstrated that considerable swathes of the mainstream medical and scientific community firmly support the use of acupuncture - position statements, medical consensus guidelines, Cochrane Reviews, and reviews of acupuncture's biological mechanism research clearly demonstrate that the statement 'acupuncture is pseudoscience' is controversial at best, which means that this categorisation of acupuncture violates Misplaced Pages's neutral point of view policy. Editors who attempt to update the article in line with high-quality medical references are consistently banned from editing.

This is an attempt to legislate inclusion of specific sources they like. Cochrane reviews have been discussed. They should be viewed in the light of the work of Ioannidis, and also the fact that several (e.g. ) have been withdrawn after comments. The result of any review is highly sensitive to inclusion criteria. It could be argued that all studies from certain countries (notably China) should be excluded: a review found not one single published paper from China that found the intervention under test to be ineffective, and all Chinese studies of acupuncture are positive. Great care is necessary in reviewing sources for inclusion.

Medical consensus guidelines that recommend acupuncture include:

These are irrelevant. All (most especially the WHO) are the result of True Believers advocating within the bodies concerned, and medicine is not science.

These are all highly respected, mainstream medical institutions and they all recommend acupuncture in their consensus statements based on unbiased evidence reviews.

Your logical fallacy is: Appeal to authority.

Yet, the administrators of the page essential practice denialism and have consistently stated that merely providing evidence that acupuncture has this support is grounds for being banned, for example: "if you continue to claim that acupuncture has mainstream scientific validation, you have no future as an (sic) Misplaced Pages editor."

That was a statement by Tgeorgescu () who is not an admin. I clarified here: . Acupuncture does not have mainstream scientific validation. If it did, this argument would not be happening. There is no such thing as qi, no such things as meridians, no evidence that acupoints are significant (and they differ between traditions). There is no convincing evidence that it matters where you put the needles, or even whether you insert them. That's not our problem to fix.

In order to maintain the position that the statement 'acupuncture is pseudoscience' is not controversial, even though it clearly is, the administrators who are controlling the acupuncture page are censoring this vast and growing body of evidence that presents a very different reality. They frequently make factually incorrect, unreferenced statements while ignoring and deleting high-quality peer-reviewed systematic reviews that contradict their opinion.

It's controversial to say acupuncture is pseudoscience (see above) but it's not our controversy so we can't fix it.

In 2014, you said: "Misplaced Pages's policies around this kind of thing are exactly spot-on and correct. If you can get your work published in respectable scientific journals - that is to say, if you can produce evidence through replicable scientific experiments, then Misplaced Pages will cover it appropriately." It is this evidence, from Cochrane, Harvard, the Journal Neuroscience, Plos and many others, that is being systematically censored by Misplaced Pages's administrators. Misplaced Pages is not remotely covering acupuncture appropriately, by your or any reasonable definition.

Your logical fallacy is: cherry picking. Not one of those studies refutes the null hypothesis. This is the core point they don't seem to understand. Clinical evidence is by nature probabilistic, and P=0.05 means one in twenty positive results will be false even if all bias is eliminated. There is a great deal of discussion in the literature of just how difficult it is to remove bias in studies of acupuncture, specifically.

There is a core difference between medical trials and science. Science tests: is this hypothesis true? Medicine tests: does it look like this treatment works? It is perfectly possible for an entirely bogus treatment to look as if it works. Treatments are withdrawn all the time because it's found they don't. Knee washouts, for example.

Very little real science is done on acupuncture - virtually none in fact. The reason it's often described as pseudoscience is that most studies start by stating the validity of acupuncture as an assumption, usually by reference to a fallacy (appeal to tradition or popularity).

We fully recognise that there are those who believe acupuncture to be pseudoscience - these are typically members of vocal pseudoskeptical organisations, such as Guerilla Spepticism on Misplaced Pages (most of the editors and admins of the acupuncture Misplaced Pages article are members of such organisations) and a number of highly vocal Skeptical individuals. However, these groups constitute one opinion and do not reflect the overall medical consensus. Their opinion papers and websites constitute much weaker evidence than peer-reviewed evidence syntheses and institutional medical guidelines.

Feel free to cite the basic science that shows that qi exists, meridians are a thing, and whihc has led to a convergence on a single set of acupoints in all traditions. In fact I think that last would be pretty persuasive. If every acupuncture group int he world, from every country, collectively reviewed a set of tests and changed their charts, discarding the ancient sacred texts sin favour of new empirical evidence, I think that would probably kill the pseudoscience claim right there.

Those Misplaced Pages editors who point out the copious high-quality medically reliable sources that contradict the biased tone of the article are bullied and banned from editing, in a clear act of censorship and abuse of administrative powers. Last week alone, two editors were banned from editing the acupuncture article without having violated a single Misplaced Pages policy. Both editors had merely pointed out the violation of Misplaced Pages's neutral point of view policy, with the support of high-quality, peer-reviewed medical references published in mainstream publications. This state of affairs is completely unacceptable and puts the public at risk by denying access to a balanced and accurate perspective on evidence-based health care options. In the United States, the number one cause of accidental death (more than car accidents) is overdose from prescribed opioids for pain - the Misplaced Pages article misinforms patients, doctors and healthcare policy makers about an effective and safe treatment option for pain, unnecessarily increasing the risk to the public.

They were topic banned for refusing to accept consensus. Both were given WP:ROPE, one of them for many months.

There is no risk to the public by failing to promote acupuncture. Even its best friends would have to admit, if they were honest, that it's of little benefit. Again, if we were able to see large effect sizes and objective, rather than subjective endpoints, this argument would not even be happening.

Misplaced Pages, which is a highly accessed source of medical information by medical professionals and patients alike, has a responsibility to ensure that articles accurately reflect the balance of information available and the appropriate participation of the editorial community through enforcing its guidelines. In the case of the acupuncture article, this process has clearly broken down. Valid, appropriate, evidence-based and referenced perspectives are being systematically silenced so that administrators can present their narrow opinions as scientific consensus.

No, it's working as designed. Misplaced Pages habitually shows the door to people who won't take "no" for an answer, especially if the question has already been asked dozens of times and they have no other area of interest. We get bored easily these days.

Misplaced Pages: for the sake of accuracy, scientific integrity, and public health, please clean up the administration of the acupuncture article to be in line with your editorial and administrative policies so that the article can reflect best-evidence, not individual bias, and allow editors to remove acupuncture from the Pseudoscience category.

Your logical fallacy is: begging the question.

So, the substantive request comes down to the oft-repeated and frequently discussed question: should this be in Category:Pseudoscience. My view is that it should not, but that we should mention that study of acupuncture is dominated by pseudoscience. I would put it in Category:Pseudomedicine instead. But that's just my personal view, which, unlike the trypanophiles, I do not misperceive as objective fact. Guy (Help!) 01:09, 30 December 2016 (UTC)

Small nit: "Clinical evidence is by nature probabilistic, and P=0.05 means one in twenty positive results will be false even if all bias is eliminated." This is wrong. P=0.05 means one in twenty results will be positive even if all bias is eliminated - if there is only random chance at work. If there is only random chance at work, all positive results will be false, not just one in twenty. The proportion of false positives among the positives is not constant, but it can be computed using the Bayes formula. This misunderstanding is very common, and it is probably one of the causes of belief in things like acupuncture: "we have that many positive results, and only 5% of them are false positives, so there is an effect". --Hob Gadling (talk) 10:42, 2 January 2017 (UTC)

You're right, of course. I meant that one in twenty could still be false, but your vwersion is better and clearer. Guy (Help!) 13:10, 2 January 2017 (UTC)

no new sources brought to actually support changing the article; WP:NOTFORUM
The following discussion has been closed. Please do not modify it.
I understand that this petition has little likelihood to result in change, however the often repeated claim that labeling acupuncture as pseudoscience is "well sourced" is a bit of a stretch - one is an anonymous editorial that flippantly throws out the term and doesn't even make a clear argument for its use (Nature), and the others are personal opinion blogs. There are far more studies and reviews that show the value of acupuncture in pain relief than there are showing that pseudoscience is an appropriate descriptor. My only point here is that just because you or I have a source to support a statement does not mean it is appropriate to make that statement in wikipedia's voice.Herbxue (talk) 17:52, 30 December 2016 (UTC) This cited source: Baran GR, Kiana MF, Samuel SP (2014). Chapter 2: Science, Pseudoscience, and Not Science: How Do They Differ?. Springer. pp. 19–57. doi:10.1007/978-1-4614-8541-4_2. ISBN 978-1-4614-8540-7. various pseudosciences maintain their popularity in our society: acupuncture, astrology, homeopathy, etc. `{{cite book}}`: `\|work=` ignored (help) seems to be neither a flippant editorial nor a blog, so your comment appears to misrepresent things. It is well sourced (and not contradicted in RS) - Misplaced Pages can't help it if acupuncturists don't like reality. Alexbrn (talk) 17:58, 30 December 2016 (UTC) A brief (dare I say flippant) statement by engineers in a book about the role of technology in healthcare. Maybe. Better source than the previous ones, but still not one that involves a thoughtful exploration of what acupuncture is. This would be like a business textbook quipping about the pharmaceutical industry and using it to support a statement like "drug companies prioritize profit over safety". I think it is cherry picking, or flippant use of a statement in a work that does not really concern itself with the nature of acupuncture practice or underlying assumptions. Herbxue (talk) 20:08, 30 December 2016 (UTC) That is just one of many. There is an excellent book by Caleb W. Lack PhD and Jacques Rousseau out this year called: Critical Thinking, Science, and Pseudoscience: Why We Can't Trust Our Brains. Unfortunately I don't have access to it right now, but it makes very clear the lack of scientific underpinning in acupuncture. We could pile on sources, the only issue here is WP:OVERCITE. Why we only have two sources is because there are really no sources refuting the statement, and there's no need for more than two strong sources. Carl Fredrik 💌 📧 20:24, 30 December 2016 (UTC) I disagree, I think you should pile on if you have something more substantive than the passing remarks you describe as strong sources, especially considering this comes up for debate quite often (I have brought it up myself in the past, but did not have anything to do with it being brought up this time). Herbxue (talk) 20:37, 30 December 2016 (UTC) It doesn't need great discussion because it's an obvious commonplace that this stuff is pseudoscientic: it isn't debated seriously. Acupuncturists getting upset about reality does not count as "debate" - we follow the sources. Alexbrn (talk) 20:40, 30 December 2016 (UTC) We are discussing the use of a pejorative label, not a matter of fact. You don't see much debate in general about what is and isn't pseudoscience anywhere other than wikipedia, so I don't think "obvious commonplace" describes this situation at all outside of the bubble of wikipedia. Its just that you want to call something a mean name, adding nothing of substance to the readers understanding other than that the editors have made a value judgement and backed it up by citing other writers that loosely used a pejorative label in passing. Herbxue (talk) 22:27, 30 December 2016 (UTC) You could put the references inside a note if you want to add more and not have it look cluttered. Sizeofint (talk) 02:12, 31 December 2016 (UTC)

no new sources brought to actually support changing the article; WP:NOTFORUM

The following discussion has been closed. Please do not modify it.

I understand that this petition has little likelihood to result in change, however the often repeated claim that labeling acupuncture as pseudoscience is "well sourced" is a bit of a stretch - one is an anonymous editorial that flippantly throws out the term and doesn't even make a clear argument for its use (Nature), and the others are personal opinion blogs. There are far more studies and reviews that show the value of acupuncture in pain relief than there are showing that pseudoscience is an appropriate descriptor. My only point here is that just because you or I have a source to support a statement does not mean it is appropriate to make that statement in wikipedia's voice.Herbxue (talk) 17:52, 30 December 2016 (UTC)

This cited source:

Baran GR, Kiana MF, Samuel SP (2014). Chapter 2: Science, Pseudoscience, and Not Science: How Do They Differ?. Springer. pp. 19–57. doi:10.1007/978-1-4614-8541-4_2. ISBN 978-1-4614-8540-7. various pseudosciences maintain their popularity in our society: acupuncture, astrology, homeopathy, etc. {{cite book}}: |work= ignored (help)

seems to be neither a flippant editorial nor a blog, so your comment appears to misrepresent things. It is well sourced (and not contradicted in RS) - Misplaced Pages can't help it if acupuncturists don't like reality. Alexbrn (talk) 17:58, 30 December 2016 (UTC)

A brief (dare I say flippant) statement by engineers in a book about the role of technology in healthcare. Maybe. Better source than the previous ones, but still not one that involves a thoughtful exploration of what acupuncture is. This would be like a business textbook quipping about the pharmaceutical industry and using it to support a statement like "drug companies prioritize profit over safety". I think it is cherry picking, or flippant use of a statement in a work that does not really concern itself with the nature of acupuncture practice or underlying assumptions. Herbxue (talk) 20:08, 30 December 2016 (UTC)

That is just one of many. There is an excellent book by Caleb W. Lack PhD and Jacques Rousseau out this year called: Critical Thinking, Science, and Pseudoscience: Why We Can't Trust Our Brains. Unfortunately I don't have access to it right now, but it makes very clear the lack of scientific underpinning in acupuncture. We could pile on sources, the only issue here is WP:OVERCITE. Why we only have two sources is because there are really no sources refuting the statement, and there's no need for more than two strong sources. Carl Fredrik 💌 📧 20:24, 30 December 2016 (UTC)

I disagree, I think you should pile on if you have something more substantive than the passing remarks you describe as strong sources, especially considering this comes up for debate quite often (I have brought it up myself in the past, but did not have anything to do with it being brought up this time). Herbxue (talk) 20:37, 30 December 2016 (UTC)

It doesn't need great discussion because it's an obvious commonplace that this stuff is pseudoscientic: it isn't debated seriously. Acupuncturists getting upset about reality does not count as "debate" - we follow the sources. Alexbrn (talk) 20:40, 30 December 2016 (UTC)

We are discussing the use of a pejorative label, not a matter of fact. You don't see much debate in general about what is and isn't pseudoscience anywhere other than wikipedia, so I don't think "obvious commonplace" describes this situation at all outside of the bubble of wikipedia. Its just that you want to call something a mean name, adding nothing of substance to the readers understanding other than that the editors have made a value judgement and backed it up by citing other writers that loosely used a pejorative label in passing. Herbxue (talk) 22:27, 30 December 2016 (UTC)

You could put the references inside a note if you want to add more and not have it look cluttered. Sizeofint (talk) 02:12, 31 December 2016 (UTC)

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

He-said-she-said

Herbxue, one of our more assiduous trypanophile editors, is keen to include the following:

Andrew Vickers, lead author of the original 2012 paper and chair of the Acupuncture Trialists' Collaboration, rejects that analysis, stating that the differences between acupuncture and sham acupuncture are statistically significant.ref name=Vickers2013/>

I think it should be excluded as WP:UNDUE - Vickers published a pro-acupuncture review which was criticised, and this is his response saying the tiny effect sizes are statistically significant but failing entirely to address the actual point made, which was that they are clinically irrelevant. It's a non-sequitur and special pleading from someone committed to promoting acupuncture. Guy (Help!) 22:47, 3 January 2017 (UTC)

I looked at Vicker's review, and I'm rather shocked by the disconnect between the results and the conclusion. The results were that acupuncture is no different from sham treatment, no matter how you vary the acupuncture, (except that "moar needles = moar results!" which can't possibly have anything to do with the placebo effect...) So yeah, UNDUE by a long bit. Sorry about forgetting my <sarcasm></sarcasm> tags in that last sentence. I figured you guys can puzzle out where they belong. MjolnirPants Tell me all about it. 14:22, 4 January 2017 (UTC)

NICE

NICE is being held out as an arbiter of truth based on the current guidelines for migraine etc. which say to "consider" acupuncture. I think it's worth looking at what NICE said about acupuncture and back pain at the time this guidance was written:

Your doctor should offer you a choice of one of the following treatment options:

An exercise class that is appropriate for your particular needs.
A course of manual therapy, which will include manipulation of the spine.
A course of acupuncture.

Your doctor may offer you another of these options if the chosen treatment doesn't result in much improvement in your back pain.

Fast forward to March 2016:

The draft guideline recommends exercise, in all its forms (for example, stretching, strengthening, aerobic or yoga), as the first step in managing low back pain.

Massage and manipulation by a therapist should only be used alongside exercise because there is not enough evidence to show they are of benefit when used alone.

The draft guideline also recommends encouraging people to continue with normal activities as far as possible.

The draft guideline no longer recommends acupuncture for treating low back pain because evidence shows it is not better than sham treatment. Paracetamol on its own is no longer the first option for managing low back pain. Instead, the draft guideline recommends that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin should be tried first. Weak opioids, such as codeine, are now only recommended for acute back pain when NSAIDs haven’t worked or aren’t suitable.

That's science for you. The evidence develops to better exclude bias and confounding, and if it turns out a treatment doesn't work after all, well, so be it. Has this stopped acupuncturists and chiropractors form continuing to offer treatment for low back pain? Of course not. It's always legitimate to ask: what evidence will cause you to change your mind? In the case of acupuncturists, I honestly believe there is no evidence that will cause them to question their fundamental assumptions. It is resistant to refutation, for the same reason as homeopathy and any other religious dogma.

Hence the issues seen on this talk page. Science says one thing, belief says another. Misplaced Pages goes with the science. Sorry, guys. Guy (Help!) 11:01, 4 January 2017 (UTC)

Change.org again

Per WP:TPG the purpose of this page in Misplaced Pages is to discuss specific changes to this article. It is not to discuss petitions on another website nor for general discussion of the topic nor how WP works. Jytdog (talk) 18:21, 4 January 2017 (UTC)

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

The Change.org petition lists the many problems with this article. I come here and see you editors locking discussion about it. Now NICE is being accused of being problematic. NICE is made of scientists who the NHS takes recommendations from. If you editors want to be on the opposite side of scientific officials, and pretend to have a scientifically backed article, shame on you. — Preceding unsigned comment added by Playalake (talk • contribs) 15:00, 4 January 2017 (UTC)

Did you bother to read the section above this? Saying that "NICE is being accused of being problematic" here is straight up bullshit: editors have had it explained to them that NICE is not the end-all on medical matters, that NICE isn't anywhere near as supportive of acupuncture as pro-acupuncture editors are claiming, and that recommendations for practical medicine (i.e. making people feel better) don't distinguish between treatments that only work through the placebo effect and treatments that are only as effective as the placebo effect. That is nothing like anyone accusing NICE of being "problematic". Furthermore, the article is well-sourced. Try checking out some of the sources used in it to figure out why the article says the things it says, instead of coming here with your preconceived notions about truth and trying to impose them upon the facts. MjolnirPants Tell me all about it. 15:27, 4 January 2017 (UTC)

OK I see that they have updates now, but still are waiting to issue their final statement. But before their update, I'm curious about something. How did Misplaced Pages cover NICE? Can someone tell me this? And NICE isn't the only thing that updates. So do Cochrane Reviews and they have since moved toward more positive statememts than your encyclopedia covers. Why does Misplaced Pages update NICE findings but not Cochrane findings? — Preceding unsigned comment added by Playalake (talk • contribs) 16:50, 4 January 2017 (UTC)

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

Unanswuestions

You editors prefer to censor questions than answer them. I won't bring up other websites, but my questions remain unanswered. How did Misplaced Pages cover NICE before they updated? And why is everyone here quick to update based on NICE, but not care to update many Cochrane Reviews?

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