Talk:Low level laser therapy

History and Use

why are there 2 'History and Use'-s? ~Sushi 08:46, 12 July 2006 (UTC)

title indeed ?

I have the same question as the former writer here below. Low Level Laser Therapy is a more commonly used title these days. —The preceding unsigned comment was added by Sissnob (talk • contribs) 10:26, 13 December 2006 (UTC).

title?

Should the title of the article not be "Low Level Laser Therapy" as opposed to "Photobiomodulation"? If they refer to the same concept, there are far more citations to the former on pubmed.—The preceding unsigned comment was added by 216.185.64.86 (talk • contribs) 13:17, August 24, 2006.

Scientific status?

How well established is this technique? Is it solidly established scientifically? If so, more references would be useful. Is it fringe science? Is it pseudoscience? It looks rather like one of the latter two to my eye, but I'm not an expert. From the description and claimed benefits, this technique appears to be distinct from light therapy, but the distinction between the two needs to be discussed.--Srleffler 01:06, 14 September 2006 (UTC)

Got the same feeling and some of the references are deep linked or locked from viewing. --83.94.195.21 (talk) 16:49, 1 January 2010 (UTC)

Damn - I just spent 2 hours preparing a neat response to your concern that this might be a psudoscience and accidentally quit the page and there seems to be no way to recover it

I'm new to Wiki and dont tknow the syntax

I have other things to get on with so I'll be brief

Photobiomodulation is phenomenon supported by hundreds of sustentative peer reviewed papers published in reputable scientific medical journals

you seem to like people at SPIE so start here :http://spie.org/Conferences/Calls/07/pw/bios/index.cfm?fuseaction=BO111

and here

http://spie.org/Conferences/Programs/06/pw/bios/index.cfm?fuseaction=6140

and USA Natioanl Institute of Health

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=PureSearch&db=pubmed&details_term=photobiomodulation[All Fields] OR ("low-level laser therapy"[Text Word] OR "laser therapy, low-level"[MeSH Terms] OR LLLT[Text Word])

My very old and out of date pages

http://www.thorlaser.com/LLLT/index.htm

Upcoming conferences

http://www.thorlaser.com/conferences/

Academia salad 11:31, 17 September 2006 (UTC)

Thanks for your reply. The SPIE conference abstract seems like a good answer to my question: not pseudoscience or fringe science, but still controversial. I'll add these to the article. The Thor links are probably not good references because they have a commercial interest in this technology.--Srleffler 00:01, 18 September 2006 (UTC)

Additional Mechanism

how some of the near infrared treatment works with retinal cells can be found on

"Photomedicine and Laser Surgery" Clinical and Experimental Applications of NIR-LED Photobiomodulation Apr 2006, Vol. 24, No. 2 : 121 -128 Also a keyword search with methanol, infrared, retina is useful. Colinvincent 21:59, 2 April 2007 (UTC)

Scientific status

Low level laser therapy (LLLT)is still controversial, but the reasons for controversy may be changing. At the end of the previous century LLLT had enthusiastic proponents claiming success through unsupported mechanisms in an unlikely number of medical disorders like baldness and smoking. From 2001 there has been a rapid increase in published of LLLT papers in Pubmed from a dozen per year to around 200 but LLLT may stay controversial because of a newly established anti-inflammatory LLLT-mechanism. It may be a threathening perspective and cause for dispute that non-patentable LLLT could become an almost risk-free alternative to commonly prescribed anti-inflammatory drugs. In a systematic review of possible LLLT pain-relieving mechanisms, it was shown that 21 out of 24 controlled laboratory trials reported significant and dose-dependent anti-inflammatory LLLT effects in terms of reduced cytokine levels (PGE2, IL1beta, TNF alfa), reduced mRNA and COX expression in irradiated tissue and reduction of edema and hemorrhagic lesions (Bjordal et al. 2006,Photomed Laser Surg, 24 (2) 158-68. This review has been commented upon by the Bandolier website of the pain research group at Oxford university http://www.jr2.ox.ac.uk/bandolier/booth/painpag/Acutrev/Other/LLLT.html. The comment concluded "This systematic review provides a really useful basis to begin thinking sensibly about how to proceed with research." It seems to be a well-hidden secret that 59 randomized placebo-controlled trials have been performed with LLLT in musculoskeletal pain disorders. There are two Cochrane-based systematic reviews finding limited evidence for LLLT efficacy in rheumatoid arthritis and neck pain (Gross et al. J Rheumatol 2007;34:1083-102), while reviews in the Cochrane Database of Systematic review in low back pain and osteoarthrtis were inconclusive.

link to Cochrane: http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME

The latter Cochrane review has been critically reviewed by Bjordal et al. in Photomed Laser Surgery Oct 2005, Vol. 23, No. 5 : 453 -458.

There are several laser associations with member clinicans and researchers. 

World Association for Laser Therapy has a website

www.walt.nu

North American Association for Laser Therapy has also a website

www.naalt.org.

In addition, a useful site for links, research abstracts and LLLT activities is Laserworld at

www.laser.nu.

Both WALT and NAALT have the Medline-indexed journal Photomedicine and Laser Surgery as a common official journal, and PMLS has an impact factor of 1.3 (2005).

Janmagnus57 14:25, 20 May 2007 (UTC)

OR, NOT

Please watch the conclusions, they are violations of WP:OR, and note that wikipedia is not many things, including a how-to manual. Report and cite, do not discuss and conlude. Particularly, do not state that one thing (laser, modality, whatever) is better than another without a) a source, and b) a good reason. WLU 20:37, 2 November 2007 (UTC)

Restored after prod

Since article deleted under prod can be restored on request as a matter of course, I have restored the Photobiomodulation article as Low level laser therapy]]. There's a redirect from the older title. The choice of title was because of the latest Cochrane article, and the clear preference of title in the Medline search [1] .

As for the contents, the most recent Cochrane review, [2] must be included in the references, along with its conclusions: "onclude that there are insufficient data to draw firm conclusions on the clinical effect of LLLT for low-back pain" This is considered of much higher authority than any specialized journal with respect to the consensus in the profession, given that the Cochrane group is widely accepted for the specific purpose of establishing the medical consensus. Other views can of course be mentioned. DGG (talk) 20:48, 2 July 2008 (UTC)

How come my edits have been deleted?

I wrote edits expanding this page with citations and they were erased? Also, links to other web sources were deleted? What's going on here?

"Low level laser therapy has been used in clinical practice for decades — although much more in Asia and Europe than in the U.S. It has been in more widespread use in the U.S. since the 1990’s, and has begun to be used extensively in the past five years as more instruments have become available. [4]"bb 23:14, 7 October 2009 (UTC) —Preceding unsigned comment added by Boodabill (talk • contribs)

Moved to bottom per talk page guidelines. Please see WP:ES, my reasoning is there. Your edits were unsourced, or sourced to non-reliable sources, or added inappropriate external links, which is why I removed them again. Please also have a look at edit warring; I don't think you're edit warring, but we should keep reverts to three at the most and really shouldn't get to that point. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:52, 8 October 2009 (UTC)

Possible sources

• Karu, T, T (1999). "Primary and secondary mechanisms of action of visible to near-IR radiation on cells.". J Photochem Photobiol B 1999 Mar 49(1) 1-17 49 (1): 1–17. doi:10.1016/S1011-1344(98)00219-X. PMID 10365442. 
• Lane N., N (2006). "Power Games". Nature. 2006 Oct 26;443(7114):901-3. 443 (7114): 901–3. doi:10.1038/443901a. PMID 17066004. 

Types and amount of sources

The page should be relying on secondary sources; since this is a medical topic that means review articles and meta-analyses. There were far too many primary sources (single experiments), petri dish and animal models that were extended as if they applied to humans in clinical situations. For actual use as a medical intervention, the uses of LLLT should be verified using review articles and meta-analyses. For basic methodology, which is still quite controversial I believe, we should still restrict ourselves to review articles which summarize entire methods rather than single studies. Single studies are too easily cherry-picked to support single viewpoints, while review articles are more even-handed. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:51, 27 May 2010 (UTC)

This certainly applies to the anon attempting to insert these single studies into the page. Wait until they're replicated, extended, and in particular, summarized by a review article. Chances are Cochrane will produce an update at some point, incorporating these studies when they do so. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:37, 22 July 2010 (UTC)

Cochrane Library review only made some tentative conclusions re low back pain. Thus, its importance should not be overemphasised. There's no prohibition in Wiki against primary sources as published in peer-reviewed journals, especially in a relatively new and growing field such as LLLT.

As to "cherry-picking", we must assume good faith. That's what peer-review is for, to prevent such bias. If there are no review articles in certain areas, then primary sources must suffice and be welcomed. (And review articles are not always even-handed.) --Dyuku (talk) 22:20, 22 July 2010 (UTC)

Actually there is - please see WP:MEDRS for both points. The Cochrane Collaboration is among the most respected publishers of evidence-based medicine in the world, and we are not supposed to use primary sources, particularly low-n primary sources, to "prove" points. At best I would give those sources a single sentence but since it's less than 40 people I'd be reluctant to do even that. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:42, 22 July 2010 (UTC)

Who's trying to "prove" points? Certainly not me. Please try to assume good faith. --Dyuku (talk) 22:53, 22 July 2010 (UTC)

Allow me to restate - "Individual primary sources should not be cited or juxtaposed so as to "debunk" or contradict the conclusions of reliable secondary sources, unless the primary source itself directly makes such a claim". Assuming good faith goes both ways - I am not objecting out of spite, I am justifying my edits in terms of my interpretation of wikipedias policies. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:01, 22 July 2010 (UTC)

It is alot harder to achieve statistically significant p values for low n value studies...the pharmaceutical industry doesn't do large n value studies because it likes to spend money they do it because the difference between treatment and placebo (or active comparator) are so samll that you need a large sample size to detect them. The fact that LLLT studies have small n values and highly significant p value is a point in the treatment's favour. Limiting your references to reviews and meta analyses leads to bias. I do agree that in vitro and animal studies should not be included in discussions of human medicine unless they are backed up by human studies. —Preceding unsigned comment added by 174.115.45.149 (talk) 00:30, 23 July 2010 (UTC)

I find the exact opposite, that limiting the research to review articles decreases bias. Doc James (talk · contribs · email) 00:40, 23 July 2010 (UTC)

It really depends on the review/meta analysis. The funding source has a BIG impact. LLLT studies are not usually well funded, unlike the pharmaceutical industry. There is little control over LLLT publications (LLLT studies are usually academic and published regardless of outcome) in contrast the pharmaceutical (healthcare) industry keep a tight control over their studies, creating a negative puiblishing bias (worked in the industry for over 12 years now and saw how studies that failed remained unpublished "data on file". This results in biased literature reviews, and meta-analyses. Prospective double-blind placebo controlled trials avoid this issue and you can look to the p values to determine the study's statistical significance. In LLLT it is very hard to do a good meta- anlysis because the primary studies are so varied in design, apparatus, and methodology, you are stuck comparing apples to oranges. We know that LLLT has a bell shaped dose response curve (skewed)...so you have under-dosed and over - dosed LLLT studies dragging down the positive studies done in the optimum dose range. 174.115.45.149 (talk) 02:01, 23 July 2010 (UTC) —Preceding unsigned comment added by 174.115.45.149 (talk) 01:48, 23 July 2010 (UTC)

Those are precisely the points that a good meta-analysis would take into consideration. The authors' analyses are subject to peer-review and the editorial overview of the publishing journal, and we ought to be leaving criticism of secondary sources to them. Wikipedia works by requiring our editors to judge the quality of secondary sources by the quality of those two processes, and not by substituting our own editorial analysis of the content. The views that those sources present are what we report on, and there's no room here for applying another layer of individual interpretation. --RexxS (talk) 03:14, 23 July 2010 (UTC)

Please don't use "the evil pharmaceutical industry" as a reason to edit anything without a specific source for criticism. May I remind everyone that companies also make lasers and I'm not arguing that you can't use studies funded by "big laser" in the article? Everyone makes a profit from every single intervention. It's explicitly noted that LLLT appears to have a specific dose/wavelength-response relationship and that they're still figuring out the ideal wavelength. And per RexxS, we don't normally get to judge primary and secondary sources - we simply defer to the latter. If another source criticizes the secondary source, that can also be included. I will include a comment about wound healing based on this source, but it will be a very, very general one that places heavy emphasis on the fact that conclusions are both general, preliminary, and the parameters still not positively identified. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:51, 23 July 2010 (UTC)

the Cochrane review problems

Bjordal, J.; Bogen, B.; Lopes-Martins, R.; Klovning, A. (2005). "Can Cochrane Reviews in controversial areas be biased? A sensitivity analysis based on the protocol of a Systematic Cochrane Review on low-level laser therapy in osteoarthritis". Photomedicine and laser surgery 23 (5): 453–458. doi:10.1089/pho.2005.23.453. PMID 16262573. 

From the Abstract:

OBJECTIVE: The aim of this study was to test if a conclusion in a systematic review of low-level laser therapy (LLLT) for osteoarthritis from the Cochrane Library was valid and robust. ...

RESULTS: Only clinicians who had performed LLLT trials with negative results were invited into the review group. ... The statistical analysis held 18 questionable selections such as omissions of trials, data, and subgroup analyses. These selections systematically favored the negative review conclusion.

Without altering the review protocol, the sensitivity analysis of combined results changed to significantly positive for continuous and categorical data when data from all included trials were combined. Further sensitivity analyses with inclusion of valid non-included trials, performance of missing follow-up, and subgroup analyses revealed consistent and highly significant results in favor of active LLLT.

CONCLUSIONS: In this example, the Cochrane review conclusion was neither robust nor valid. --Dyuku (talk) 22:40, 22 July 2010 (UTC)

That is interesting, but in this case I would say not very applicable - the Cochrane Review cited in the page is published in 2008, three years after this study. I've raised the point at WT:MED - more input would be interesting on that point. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:47, 22 July 2010 (UTC)

"Bjordal et al. in Photomed Laser Surgery Oct 2005" has been sitting on this very same talk page since 2007, it seems (see above)... I just did my due diligence... :) --Dyuku (talk) 23:01, 22 July 2010 (UTC)

I have never heard of the journal this was published in but it sounds like it exists to promote low level laser therapy http://www.liebertpub.com/products/product.aspx?pid=128 . The Cochrane collaboration is a world renowned organization whom nearly everyone has heard of. If other major reviews found benefits from LLLT that would give weight to these accusations other wise I would go with Cochrane as it does reflect the mainstream scientific opinion. Doc James (talk · contribs · email) 23:59, 22 July 2010 (UTC)

I have heard of Photomed Laser Surgery and it is a reputable peer reviewed journal...whose topics are diverse and only occasionally include LLLT studies. Sounds like you are new to the field I suggest you look the journal up on-line, and do a little reading. I also read the Cochrane Reviews and despite it's supposed reputation have frequently found there to be biases in their publications. The Lancet is also reputable and published the best meta-anlaysis on the topic so far, that found a RR of improvement of 4.05 for LLLT in acute and chronic neck pain. Dec 2009 Chow et al. —Preceding unsigned comment added by 174.115.45.149 (talk) 00:38, 23 July 2010 (UTC)

The impact factor of this journal is only 1.756. I see no problems with using the Lancet review though. Doc James (talk · contribs · email) 00:41, 23 July 2010 (UTC)

The Cochrane review is from 2005, so it makes sense to be looking for a newer review (particularly given there is a published criticism of it). The Chow 2009 Lancet review seems convincing to support claims about neck pain; Tumility 2010 similarly for tendinopathy (with its caveats); Bjordal 2006 for acute inflammatory pain. It looks like the conclusions of Huang 2009 suggest possible mechanisms for the biphasic dose response, and confirm an effect. It is telling that each of these are cautious; some stress the controversial nature of LLLT in mainstream medicine, and none seem to be certain of mechanism. The impression remains that more research is required before LLLT will become well-understood. I'd strongly suggest jettisoning the over-emphatic claims and re-writing to couch the article in terms closer to those found in the reviews above. --RexxS (talk) 02:49, 23 July 2010 (UTC)

┌────────────────────────────────────────────────────────────────────────────────────────────────────┘The Lancet is already on the page (reference 3, Chow et al 2009, PMID 19913903) and is about neck pain. The Cochrane Review is about low back pain. Very different conditions, much more tissue in the lower back. I wonder if LLLT works basically like the application of heat? Anyway...

Also, may I draw people's attention to PMID 20011653 which states "Despite many reports of positive findings from experiments conducted in vitro, in animal models and in randomized controlled clinical trials, LLLT remains controversial in mainstream medicine." This isn't settled yet, and shouldn't be portrayed as such. The results are promising and accumulating, but certainty does not yet exist. Bjordal et al being on the talk page since 2007 doesn't mean it should be included now when there is a newer Cochrane review, we don't get to misrepresent the topic because of missed opportunities in the past. May I point out that the page lists LLLT as effective for many different types of pain, for which there is moderately good evidence? It's not like we're trying to portray this as quackery, just trying to keep page at the best evidence for different conditions. And Cochrane doesn't say "ineffective", it says "not enough positive evidence". They're different things and we shouldn't be falling over ourselves to point out how Cochrane is wrong. I'm not against LLLT at all, but we must wait for the evidence to accumulate rather than running ahead of it. Even Bjordal has made this point.

As a side note, sweet mother of Dog that guy is prolific... Some interesting results are coming out regarding LLLT, but let's wait for a systematic review of them. A review article about LLLT in general is probably forthcoming and should be very interesting. If the newer review makes the same point about the new Cochrane review being flawed, then we can certainly include it.

Also interesting - LLLT appears to be about as supported as acupuncture ([3]) and acupuncture is notorious among some circles (i.e. me and the people who agree with me) for possibly being just an elaborate and dramatic placebo. However, because of the differences between "effective" and "noneffective LLLT (i.e. a good quality placebo) the evidence base is probably ultimately stronger here. Though it's amusing how adding "laser" to a treatment modality makes it sexier :) WLU (t) (c) Wikipedia's rules:^simple/_complex 13:41, 23 July 2010 (UTC)

Also please note this review - "Based on the heterogeneity of the populations, interventions, and comparison groups, we conclude that there are insufficient data to draw firm conclusion on the clinical effect of back schools, low-level laser therapy, patient education, massage, traction, superficial heat/cold, and lumbar supports for chronic LBP." Cochrane is not alone in this criticism. I'll add this reference. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:43, 23 July 2010 (UTC)

Scientific status of LLLT in Wound Care?

Why has the this topic been neglected? There is good double blind placebo controlled evidence but no mention of it here. 174.115.45.149 (talk) 02:10, 23 July 2010 (UTC)

Per WP:MEDRS, we do not like using primary sources - in this case that means single experiments. Single experiments can be biased, or cherry picked to only highlight positive trials, or have a variety of flaws that prevent their use as good science, or simply be flukes due to publication bias. When a review article is produced, then its conclusions can be properly indicated. Wikipedia is not a soapbox to promote a topic, and should not be used to predict the future. When it is clear that LLLT is accepted as a valid treatment for wounds, as indicated by high-quality secondary sources, it can be clearly and prominently included - but we have to wait for that point, not anticipate it. If LLLT is actually useful for wound healing, we will find out with time, never fear. WLU (t) (c) Wikipedia's rules:^simple/_complex 11:19, 23 July 2010 (UTC)

If you are talking about this edit and PMID 19588536 as a source, the detail is way too excessive in the edit, and the single trial, featuring 14 patients in each group, is pretty small to draw a dramatic conclusion. At best I would summarize it as "a small trial found some evidence to support LLLT helping heal diabetic leg ulcers". But I'd much, much rather wait for a larger trial or review article. WLU (t) (c) Wikipedia's rules:^simple/_complex 11:26, 23 July 2010 (UTC)

Bibliography

Bibliography section is a widely accepted feature of Wikipedia. Why did User:WLU remove Bibliography section from this article? --Dyuku (talk) 21:46, 23 July 2010 (UTC)

For individuals who write books and articles, bibliographies are appropriate - this is generally the intent of a bibliography section per the guide to layout. See WP:MOS-BIBLIO for instance. What may be appropriate would be a further reading section - but the choices used are inappropriate. Further reading should not duplicate references - leaving out Tumilty et al 2010. Bjordal we discussed above - it's a criticism of a Cochrane review that has now been supplanted. The rest are good choices for sources, not further reading. These are articles, not books. Further reading is usually books. Deppe 2007 (pmid 17268764) can and should be integrated, as can Sculean 2005 and Cobb 2006. Capon 2003 is too old and there's a newer paper integrated today, Reddy 2004 also duplicates a source added today and doesn't really add much anyway (any article that concludes with "more research is needed" isn't useful for much). Ditto for Posten, 2005 which essentially duplicates Da Silva et al. 2010. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:13, 23 July 2010 (UTC)

To be fair, older articles do sometimes contain a section called Bibliography (not in the sense of WP:MOS-BIBLIO), which contains general references that have been used in writing the article, or for giving the reader a source for the background to the article – a kind of half-way house between Further reading and References sections – and perhaps that what Dyuku was thinking of. Nevertheless, sources in such sections are generally used multiple times in the article along with {{Harvnb}} referencing, and – as WLU points out – not duplicating full citations already used in the article. If Dyuku thinks that sources may be useful in expanding the article, I'd always recommend listing them here, on the talk page, where editors can discuss how best to make use of them. --RexxS (talk) 23:20, 23 July 2010 (UTC)

Do you mean splitting the footnotes and references section, like satanic ritual abuse? I normally use that only when there is a book cited in the article, multiple times to different pages; I'd never use it for a journal article because they tend to be short so tracking down a verification isn't that hard. But perhaps that's an idiosyncrasy. Anyway, in this case the articles are very much run-of-the-mill easily integrated into the body - I've pasted them below:

• Tumilty, S. .; Munn, J. .; McDonough, S. .; Hurley, D. A.; Basford, J. R.; Baxter, G. D. (2010). "Low Level Laser Treatment of Tendinopathy: A Systematic Review with Meta-analysis". Photomedicine and Laser Surgery 28 (1): 3. doi:10.1089/pho.2008.2470. PMID 19708800.  Already integrated
• Bjordal, J.; Bogen, B.; Lopes-Martins, R.; Klovning, A. (2005). "Can Cochrane Reviews in controversial areas be biased? A sensitivity analysis based on the protocol of a Systematic Cochrane Review on low-level laser therapy in osteoarthritis". Photomedicine and laser surgery 23 (5): 453–458. doi:10.1089/pho.2005.23.453. PMID 16262573.  About a Cochrane review that has now been replaced
• Deppe, H.; Horch, H. H. (2007). "Laser applications in oral surgery and implant dentistry". Lasers in Medical Science 22 (4): 217. doi:10.1007/s10103-007-0440-3. PMID 17268764.  Is about lasers in general, not LLLT specifically, perhaps full text might be more useful
• Sculean, A.; Schwarz, F.; Becker, J. (2005). "Anti-infective therapy with an Er:YAG laser: influence on peri-implant healing". Expert Review of Medical Devices 2 (3): 267. doi:10.1586/17434440.2.3.267. PMID 16288590.  Integrated, but is this about lasers in general or LLLT specifically?
• Cobb, C. M. (2006). "Lasers in Periodontics: A Review of the Literature". Journal of Periodontology 77 (4): 545–564. doi:10.1902/jop.2006.050417. PMID 16584335.  Integrated (and equivocal)
• Capon, A; Mordon, S (2003). "Can thermal lasers promote skin wound healing?". American journal of clinical dermatology 4 (1): 1–12. doi:10.2165/00128071-200304010-00001. PMID 12477368.  Da Silva is from 2010 and shows no real progress has been made
• Reddy, G. K. (2004). "Photobiological Basis and Clinical Role of Low-Intensity Lasers in Biology and Medicine". Journal of Clinical Laser Medicine & Surgery 22 (2): 141–141. doi:10.1089/104454704774076208. PMID 15165389.  This appears to add absolutely nothing to the article - it's from 2004, the abstract only mentions wound healing (which Da Silva indicates is still equivocal) and concludes only that more research is needed
• Posten, W; Wrone, DA; Dover, JS; Arndt, KA; Silapunt, S; Alam, M (2005). "Low-level laser therapy for wound healing: mechanism and efficacy". Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 31 (3): 334–40. doi:10.1111/j.1524-4725.2005.31086. PMID 15841638.  Superseded by Da Silva as well

Some are still, in my opinion, superseded by newer sources and therefore not worth including. Others could be integrated with relatively little effort, I may do so in a bit (others are of course welcome). All are so specific that I'd be reluctant to include them as a general reference, with a possible exception for Reddy, 2004. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:06, 24 July 2010 (UTC)

Have a look at Brougham Castle for example. It has Footnotes, References, Bibliography using mainly Harvard referencing. Or the section naming and referencing style in Carucage. Other articles have similar sections but name them differently, like Buckingham Palace or Oxygen toxicity. I personally also use the same scheme as you for citing multiple pages from the same source, and I'd agree that it's most useful for books, so you're by means idiosyncratic in your usage. The point remains that a section called Bibliography was not uncommon in older articles, often those not using inline citation templates, so you can see how Dyuku may have been confused about the purpose of such a section.

Anyway, I agree with your assessment of the eight sources above, although I think Reddy 2004 is getting a bit long-in-the-tooth now. --RexxS (talk) 02:06, 24 July 2010 (UTC)

Just a passing comment: The section title 'Bibliography' is being discouraged as confusing. Apparently, people in different academic fields (and perhaps also in different countries?) have incompatible ideas about what should be found under that title. As I understand it, the historians see 'Bibliography' and think, Ah, here's the list of sources consulted in building this article -- and the humanities folks see the same title and think, Finally, someone has assembled a complete list of every reputable work written on this subject. So the community is giving up on finding the One True Meaning, and is encouraging people to choose alternate headings. WhatamIdoing (talk) 02:41, 24 July 2010 (UTC)

Thanks for the comments. Ya, I looks at the examples given and shudder - begging for standardized titles. But that wasn't the use of the section on this page. I can understand the impulse but none of those articles are appropriate for such a section. Quite clearly, like a news story in an external links section, it's simply being used as a holding pen for sources that should simply be integrated. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:35, 24 July 2010 (UTC)

My main concern was that the article should include some important literature/refs not mentioned in the main text. I posted this under 'Bibliography' section, not being aware that the use of 'Bibliography' sections is being discouraged by the style gurus. So it seems that 'Further reading' sections are being recommended instead. Fine with me! :) So then I'm providing the same titles under the 'Further reading' section. All these titles are relevant, and should be included in the article.

Just now there's been a big discussion on how the use of review articles (i.e. secondary sources) is being strongly recommended. So, great, I'll cite you a whole bunch of review articles. And all of this is being blanked because of some stylistic quibble? Why did the User:WLU simply not correct the name of the section, as he could have done? Why was the whole thing simply deleted? This sort of an aggressive, take-no-prisoners editing style is extremely unproductive IMHO.

Yes, it is better for these refs to be eventually incorporated into the main article, sure. But let's not create the situation where the perfect is the enemy of the good. I would certainly like to see more collegiality in this editing process. --Dyuku (talk) 19:44, 24 July 2010 (UTC)

Then integrate them if they are important. Post suggested references on the talk page, not on the main page. WLU (t) (c) Wikipedia's rules:^simple/_complex 07:42, 25 July 2010 (UTC)

I've integrated the few that I found relevant (Cobb, 2006, Sculean 2005). The rest were either old, or inappropriate - and even Cobb/Sculean are basically another "we think it's useful, but haven't identified the wavelength or proven it works." I've included my comments on each study above. The field, if progressing, is doing so rather slowly but there is still some evidence of progress. I don't know if it's pure quackery (even Barrett doesn't say so) but it's not at the point that it can be considered a miracle cure, and doesn't need a set of eight equivocal literature reviews in its further reading section. WLU (t) (c) Wikipedia's rules:^simple/_complex 08:09, 25 July 2010 (UTC)

Reference to Blood irradiation therapies

The article Blood irradiation therapies deals extensively with LLLT. I placed a one-sentence quote from Blood irradiation therapies article to LLLT article, and it was removed. What's the problem now? --Dyuku (talk) 21:50, 23 July 2010 (UTC)

WP:PROVEIT. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:21, 23 July 2010 (UTC)

Blood irradiation therapy is also borderline quackery with a substantial following in Russia and China with few English language publications. Pubmed turns up 10 results for "blood irradiation therapy", with one review article from 1993 in China. The other sources are mostly from the 1950s, the only one that isn't is again from China. Nothing necessarily wrong with results from China, but they're hard to review, and China has a tendency of producing no negative results for therapies they've got a hankering for. Quackwatch lists a couple BIT providers as quacks [4]. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:29, 23 July 2010 (UTC)

Perhaps you simply don't know where to look, or under which search terms. I found this meta-analysis from 2008,

• Zhao, S. D.; Liu, T. C. Y.; Wang, Y. F.; Liu, S. H. (2008). Meta-analysis on intravascular low energy laser therapy. pp. 728012. doi:10.1117/12.823336. 

Further discussion of this should go to Blood irradiation therapy talk page. But in general, I would recommend you follow some simple procedures, such as,

1. Be civil to other users.
2. Assume good faith.
3. Don't revert good faith edits.
4. Be gracious.

You, on the other hand, seem to follow slash-and-burn policy: delete everything, and let God sort them out... --Dyuku (talk) 19:13, 24 July 2010 (UTC)

That's a conference presentation, which is not considered a WP:MEDRS. WLU (t) (c) Wikipedia's rules:^simple/_complex 07:40, 25 July 2010 (UTC)

LOW LEVEL Energy?

.3 to 19 J/cm sq.? At 19 J/cm sq., depending on the laser wavelength, you can easily burn a person! —Preceding unsigned comment added by 132.183.44.160 (talk) 13:37, 13 May 2011 (UTC)

Quackwatch

Quackwatch is considered a reliable source, and it clearly states that it considers LLLT to be little more than a heat delivery mechanism. Claiming they are wrong without a reference, particularly given LLLT is a poorly-supported intervetion with no clear treatment indications, is inappropriate. Sources can not simply be removed because a person disagrees with them. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:47, 13 September 2011 (UTC)

Who decides who and what is a "reliable source" on wikipedia? Is this decided on a page by page basis? Specifically, why does a blog named quackwatch.com written by a person with an MD after his name, but who is not currently licensed to practice medicine, considered more reliable than other bloggers and physicians who have used low level lasers in their practice and know their efficacy through years of experience treating patients? Lesisko (talk) 08:00, 5 March 2012 (UTC)

Why was the text I added deleted - and is not acceptable with added references?

On January 7, I added this paragraph to this page:

"In 2002, Erchonia Medical became the first company to obtain FDA approval for a low level laser, after submitting randomized double blind sutides with placebo control establishing its efficacy to treat chronic neck and shoulder pain. Erchonia has obtained a total of five FDA approvals for its low level lasers: for pre-liposuction fat emulsification and post-surgical pain swelling and bruising - 2004; for moderate acne - 2005; for post breast augmentation pain - 2008; for non-invasive body contouring - 2010. Each of these FDA approvals were obtained pursuant to randomized double-blind studies with placebo control."

My additions were deleted. I am assuming they were deleted because I did not provide cites to support these statements. I have added four links to online copies of the FDA clearance letters that confirm the assertions made. I have a copy of the fifth FDA clearance letter, for acne, but do not yet have an online link to it. Is my revised addition below, with the online links added, sufficient to make it onto the page? If not, what else do you need? Thanks.

In 2002, Erchonia Medical became the first company to obtain FDA clearance for a low level laser to treat chronic neck and shoulder . http://www.erchonia.com/sites/default/files/k012580_0.pdf Erchonia has obtained a total of five FDA approvals for its low level lasers: for pre-liposuction fat emulsification and post-surgical pain swelling and bruising - 2004 (http://www.erchonia.com/files/uploads/1/file/K041139_EML.pdf); for moderate acne - 2005; for post breast augmentation pain - 2008 (http://www.erchonia.com/sites/default/files/K072206.pdf); for non-invasive body contouring - 2010 (http://www.erchonia.com/files/uploads/1/file/K08209%20Non-Invasive%20Body%20Contouring%20(Correction%20from%20FDA).pdf). Each of these FDA approvals were obtained pursuant to randomized double-blind studies with placebo control.Lesisko (talk) 07:49, 5 March 2012 (UTC)

Today I changed the page to include a history of FDA clearances that Erchonia Medical obtained for its low level lasers; added description and reference to online article in The Lancet supporting efficacy of low level lasers for neck pain; and added descriptions and references to two articles published on Wound Healing and Post-Operative Wound Healing.

The way this page is being edited, it appears that the editors have a bias against the efficacy of low level lasers. I will be happy to provide copies of articles and FDA clearances that prove the efficacy of Erchonia low level lasers. I can also forward pictures and videos that show the rapid healing effects created by Erchonia lasers. By obtaining FDA clearances pursuant to original research, Erchonia has achieved the gold standard that allopathic medicine requires. Erchonia lasers work differently from the other low level lasers in the market. Their lasers work at 635 nm wavelength (its acne laser has one diode at 635 nm and the other diode at 405 nm), while lasers from other companies work at 810 nm and above. A person cannot legitimately argue against the efficacy of Erchonia low level lasers at 635 nm given the FDA clearances and published research. Before deleting any new content I have added, please give me an opportunity on this talk page to respond to any objections anybody has to the additions i have posted. Thank you.Lesisko (talk) 23:37, 7 March 2012 (UTC)