User talk:Wiki CRUK John

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Wiki CRUK John, you are invited to the Teahouse[edit]

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Hi Wiki CRUK John! Thanks for contributing to Wikipedia.
Be our guest at the Teahouse! The Teahouse is a friendly space where new editors can ask questions about contributing to Wikipedia and get help from peers and experienced editors. I hope to see you there! Writ Keeper (I'm a Teahouse host)

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Training opportunity[edit]

Hi Wiki CRUK John, per our discussion at Anatomical terms of location I'd like to present an easy and accessible training option for trainees. The guidelines for anatomy articles have recently been changed (see WP:MEDMOS#Anatomy), and we are trying to include a "Clinical significance" heading in all anatomy articles. Under this heading subheadings may include imaging, and the names of prominent diseases. An example may be found at Esophagus#Clinical significance or Pudendal nerve#Clinical significance. Diseases are:

  • Presented briefly in general form, with the main features detailed.
  • Cited using a reliable source

I think getting trainees to write these summaries is an excellent training opportunity because:

  • Describing diseases in general form with reliable sources is often easier and less controversial than writing in-depty summaries, making it appropriate for trainees
  • Writing in this way helps users understand the basics (editing, citing, wiki-markup, and wikilinks)
  • This can be done in a short timespan without extensive research
  • It benefits readers, by linking anatomy structures with their medical significance.
  • There is an extensive list of articles in-need, and a lot of vacant wiki-space, so there is a 'Great, I created something!' factor rather than just re-factoring existing information

I would love to hear your thoughts on this. Kind regards, --LT910001 (talk) 10:35, 20 May 2014 (UTC)

Thanks, sounds good! Is the extensive list actual or metaphorical? It may well be a while before this happens, but I will not forget. The terms of location seem simpler to me, but there is a great advantage being able to give different people an article each. Wiki CRUK John (talk) 10:39, 20 May 2014 (UTC)
Great! By "extensive list" I mean any Anatomy article, but WP:ANAT500 is the list of our top 500.--LT910001 (talk) 20:32, 20 May 2014 (UTC)

'Final' video finished[edit]

Welcome to Wikipedia and Wikiproject Medicine

Hey John,

I've cleaned up the transitions and sound on the new medical editor video. I'm still new to video editing but this is as good as it's going to get for a little bit. I saw that you wanted to know when a new version was up, so here you go. Hope it works. Ian Furst (talk) 11:56, 23 May 2014 (UTC)

Thanks - feedback after Tuesday. Wiki CRUK John (talk) 12:25, 23 May 2014 (UTC)

What do you mean by[edit]

"National Institute for Health and Care Excellence" - should be said this is for the UK, or more accurately England and Wales" Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:33, 4 June 2014 (UTC)

Pancreatic cancer[edit]

Wondering on your feedback on the lead. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:01, 8 June 2014 (UTC)

Moving to other account - will look tomorrow Johnbod (talk) 16:52, 8 June 2014 (UTC)

Brain tumor is also ready for you to look over it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:45, 9 June 2014 (UTC)

What do you think of cancer? Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:02, 10 June 2014 (UTC)

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Leukemia[edit]

Have worked on this one. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:35, 18 June 2014 (UTC)

just a few uninvited thoughts[edit]

Hello John :) I think you already realise some of the very real practical obstacles in eliciting expert involvement. But if you were able to devise with CRUK a workable way of stimulating some sort of real, constructive participation, I think that could represent a great human resource. Individuals from teams working on a particular topic will be on familiar first-name terms with an entire corpus of relevant primary and secondary sources; this is especially true if they've been involved in writing a review on the subject. Of course, all humans have POVs, and scientists are no exception. Having a basic understanding of how selection of secondary sources that satisfy MEDRS is used by us as a tool for composition of reliable NPOV content would obviously be essential. As would simplicity of interaction, imo. I feel a start could be finding some simple ways of flagging a) outright blunders; b) areas that need more subtle work, in terms of coverage/completeness, updating, correction, nuance, etc. One thing these guys could probably do rather easily is point to specific MEDRS (eg via the PMID, or by citing Author, Journal, year) that could be consulted for improvements. But doubtless you'll have thought all this through for yourself. In which case, my apologies, 86.128.169.211 (talk) 13:36, 19 June 2014 (UTC)

That's the idea. There are various approaches, several of which will be tried. As well as clinical/scientific expertise, CRUK has a lot of in house experience in communicating medical/scientific information in an accessible way, so there are two main fronts of attacking the improvement of articles. Actually, what generally strikes CRUK people who look at WP medical articles is the accessibility issues, and sometimes a lack of encyclopedic balance, rather than "blunders". At the moment I'm doing preliminary sweeps with relatively specialized in house people, to see if there are obvious issues, before sending the articles for more specialized review. So I'm expecting to present review information of the sort you mention to the medical editors, perhaps not always publicly. Language editing, as we've seen all too clearly recently, is not so conducive to online editing, and I expect I'll do more of that myself, working with writers here. The improvement of specific articles is only one aspect of my role, and I'm also trying to entice specialists to edit themselves, although we know the number who will become regular editors is low. Then there's images, and some research we will be doing. Wiki CRUK John (talk) 09:37, 20 June 2014 (UTC)
That's really, really interesting stuff, John. Including the attention to accessibility issues... I think MEDMOS tries hard, but even with the best of intentions, it's a real problem for us to strike the right balance. (Fwiw, when I made my best attempt in this section to compile reliable information that could be useful and accessible for various types of reader, I found the writing aspect to be a real challenge, and I'm still unsure how accessible the text actually is.) Agree our GA/FA system is not a replacement for traditional peer review -- so constructive expert feedback could be really valuable. I think the idea of behind-the-scenes collaboration is really interesting, especially as it doesn't expect hard-working scientists to come to terms with our quaint ways and confrontational environment. 86.128.169.211 (talk) 12:00, 20 June 2014 (UTC)
Yes MEDMOS is good on what we are not, and "writing for the wrong audience", but not very forthcoming on what we are, beyond: "Wikipedia is written for the general reader. It is an encyclopaedia, not a comprehensive medical or pharmaceutical resource, nor a first-aid (how-to) manual. Although healthcare professionals and patients may find much of interest, these two groups do not by themselves represent the target audience." I'd love to get clearer guidance here before I leave CRUK in mid-December. There's also: "When mentioning technical terms (jargon) for the first time, provide a short plain-English explanation in parentheses if possible. If the concept is too elaborate for this, wikilink to other articles (or Wiktionary entries). For terms related to anatomical position, you can link to Anatomical terms of location, e.g. lateral. Alternatively, if the technical word is not used again in the article, it may be appropriate to use plain English and place the technical term within brackets. The etymology of a word can be interesting and can help the reader understand and remember it. Provide links only where they may help the readers and are reasonably focused on the topic." which is of course very often indeed ignored, and perhaps has some issues as it stands. I think we should inevitably often be saying the same thing twice over, once in full medical terminology, and once in lay terms. There are a number of different ways of doing this - at the word or phrase level (which I presume is what MEDMOS is saying), at the sentence or paragraph level, with one of them in a box of its own. I'd like to agree a broad standardized approach for this, but I think this may be difficult. Wiki CRUK John (talk) 13:25, 20 June 2014 (UTC)
All very interesting points, John. I think this exchange illustrates one of the tricky issues: the need to write for different kinds of reader simultaneously. Personally, I feel that whatever we will always be beyond the grasp of many... unless they've got someone beside them to help explain. Fwiw, that's a scenario I'm currently trying to visualize, especially when working on the lead. Personally, I find it helpful. 86.128.169.211 (talk) 18:15, 27 June 2014 (UTC)

Which page[edit]

Supports "it is second to breast cancer among female-only cancers"? Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:52, 25 June 2014 (UTC)

I guess 1.1 does. Added it with that. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:53, 25 June 2014 (UTC)

CRUK review[edit]

Hi John. How's the upgrading going? Can you point me to a list of the first-reviewed articles, please? If any are being neglected, point me to them and I'll be happy to have a go at one. -Anthonyhcole (talk · contribs · email) 01:51, 8 July 2014 (UTC)

So far just Talk:Pancreatic_cancer#Initial_review_by_CRUK and Talk:Esophageal_cancer#Initial_review_by_CRUK. Lung and brain being done (end of the week I hope), also epidemiology and research aspects separately. Since they've been archived off the Med Project page, I've started a list at Wikipedia:WikiProject_CRUK#CRUK_article_reviews, but will of course notify the project when new ones arrive.
Both the ones put up have had a decent amount of work done since by other editors, for which I'm very grateful. At the same time they clearly need a good deal more before they can be sent for further review. I think I'm going to have to do much of this, but I can't do it all. Wiki CRUK John (talk) 10:02, 8 July 2014 (UTC)
OK. In that case I might start looking into esophageal cancer, if I can get some textbooks. I'm a 110% supporter of what you're up to here. More later. --Anthonyhcole (talk · contribs · email) 12:40, 8 July 2014 (UTC)
That would be great - the papers listed at the review are mostly online, & there's a ton of good stuff there. I think we need to bring out the difference & contrast between the two main types somehow, at least as regards symptoms, causes and epidemiology. I think the treatment (or "management" as I must learn to call it) is very often the same. Wiki CRUK John (talk) 12:48, 8 July 2014 (UTC)
Cool. --Anthonyhcole (talk · contribs · email) 13:31, 8 July 2014 (UTC)
Just a thought. I think you've seen what I've put at the top of Cancer pain - the invitation to comment. Would it be helpful to put a box like that at the top of each of the CRUK articles, explaining that CRUK is managing expert review of the article, and inviting readers to offer feedback in preparation for the review?
On Cancer pain, when they follow the link in the invitation box, the talk page "new section" edit window opens, with the edit summary: "We're particularly interested in hearing what's missing or wrong and whether the article is clear and readable, but any ideas on improvement would be welcome. You can find your comment (and others' comments) and any replies by clicking the "talk" tab at the top of the article." [1]
Would you be willing to talk to some journals and journalists about this, and ask for experts to take an interest in these articles? Personally, I think what you're doing here, John, is the perfect response to the scandal generated by that osteopath study and also the most momentous step in this movement since Larry Sanger said, "Let's try a wiki." It's the birth of reliable Wikipedia, and I think the major journals and newspapers should give significant coverage to this story. --Anthonyhcole (talk · contribs · email) 13:44, 10 July 2014 (UTC)
Thanks - certainly. I was thinking I'd try to get some journos along to the pre-Wikimania meetup, or the conference itself, as that's a news hook, for the UK at least. But I'm happy to talk to any others - I got good media coverage at the Royal Society. Initially I'm just approaching experts who CRUK are in contact with (and that's a lot), but also trying to get the articles to a better state before sending them out, which I think is only fair to the experts, and most efficient. That's what I've found works best with experts in other fields. Lung cancer initial review just up. Wiki CRUK John (talk) 14:05, 10 July 2014 (UTC)
Would you like me to gather some names and contact details of journalists that covered the osteopath beat-up? Could someone at CRUK advise you about which specialist journals to write to? I'd prefer to get the publicity now, as it would hopefully drive experts to help with the articles' preparation. How do you feel about the timing? --Anthonyhcole (talk · contribs · email) 14:17, 10 July 2014 (UTC)
For the UK anyway, CRUK have pretty much all the contacts. I should be inviting now for Wikimania; of course if people want to do something before that's fine. I don't think any of the articles are ready for outside review yet, though I hope by WM they will be. Wiki CRUK John (talk) 09:37, 11 July 2014 (UTC)
Ah. Sorry, I haven't been clear. I'm suggesting doing the press now so as to attract expert editorial input, not reviewers. I understand you and the CRUK are handling the review process. I thought maybe you could mention the articles that are scheduled for expert review to journalists and journal editors in the hope they would pass the names on to their readers, and their readers could help prepare the articles for the CRUK review. --Anthonyhcole (talk · contribs · email) 12:39, 12 July 2014 (UTC)

I'm reading up on esophageal cancer, but it'll be another week or two before you see much action on the article. --Anthonyhcole (talk · contribs · email) 04:26, 23 September 2014 (UTC)

Ok, thanks. I'm concentrating on pancreatic first. Wiki CRUK John (talk) 09:43, 23 September 2014 (UTC)

A suggestion[edit]

John, great interaction with you at Pancreatic cancer. I am a curmudgeon, and anyone who gets along with me off the bat is a Wikipedia gem. I'd like to suggest that you have a look at the "Jack Andraka" article, later in the day or tomorrow. (Give me at least a couple of hours from this timestamp, to see the Talk section I add, as a prelude to major editing.) After reading the article, have a look at this source, for balance in scientific perspective: [2]. There are a variety of issues with the article, as my Talk entry (and forthcoming edits) will make clear, but I would appreciate your eventual perspective/edits regarding the fundamental matter of the chosen biomarker, after you see my flurry of major edits appear this week. Cheers. Le Prof Leprof 7272 (talk) 15:24, 14 July 2014 (UTC)

Medical Translation Newsletter[edit]


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Wikiproject Medicine; Translation Taskforce

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Medical Translation Newsletter
Issue 1, June/July 2014
by CFCF, Doc James

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This is the first of a series of newsletters for Wikiproject Medicine's Translation Task Force. Our goal is to make all the medical knowledge on Wikipedia available to the world, in the language of your choice.

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Spotlight - Simplified article translation


Wikiproject Medicine started translating simplified articles in February 2014. We now have 45 simplified articles ready for translation, of which the first on African trypanosomiasis or sleeping sickness has been translated into 46 out of ~100 languages. This list does not include the 33 additional articles that are available in both full and simple versions.

Our goal is to eventually translate 1,000 simplified articles. This includes:

We are looking for subject area leads to both create articles and recruit further editors. We need people with basic medical knowledge who are willing to help out. This includes to write, translate and especially integrate medical articles.

What's happening?


IEG grant
CFCF - "IEG beneficiary" and editor of this newsletter.

I've (CFCF) taken on the role of community organizer for this project, and will be working with this until December. The goals and timeline can be found here, and are focused on getting the project on a firm footing and to enable me to work near full-time over the summer, and part-time during the rest of the year. This means I will be available for questions and ideas, and you can best reach me by mail or on my talk page.

Wikimania 2014

For those going to London in a month's time (or those already nearby) there will be at least one event for all medical editors, on Thursday August 7th. See the event page, which also summarizes medicine-related presentations in the main conference. Please pass the word on to your local medical editors.

Integration progress

There has previously been some resistance against translation into certain languages with strong Wikipedia presence, such as Dutch, Polish, and Swedish.
What was found is that thre is hardly any negative opinion about the the project itself; and any such critique has focused on the ways that articles have being integrated. For an article to be usefully translated into a target-Wiki it needs to be properly Wiki-linked, carry proper citations and use the formatting of the chosen target language as well as being properly proof-read. Certain large Wikis such as the Polish and Dutch Wikis have strong traditions of medical content, with their own editorial system, own templates and different ideas about what constitutes a good medical article. For example, there are not MEDRS (Polish,German,Romanian,Persian) guidelines present on other Wikis, and some Wikis have a stronger background of country-specific content.

  • Swedish
    Translation into Swedish has been difficult in part because of the amount of free, high quality sources out there already: patient info, for professionals. The same can be said for English, but has really given us all the more reason to try and create an unbiased and free encyclopedia of medical content. We want Wikipedia to act as an alternative to commercial sources, and preferably a really good one at that.
    Through extensive collaborative work and by respecting links and Sweden specific content the last unintegrated Swedish translation went live in May.
  • Dutch
    Dutch translation carries with it special difficulties, in part due to the premises in which the Dutch Wikipedia is built upon. There is great respect for what previous editors have created, and deleting or replacing old content can be frowned upon. In spite of this there are success stories: Anafylaxie.
  • Polish
    Translation and integration into Polish also comes with its own unique set of challenges. The Polish Wikipedia has long been independent and works very hard to create high quality contentfor Polish audience. Previous translation trouble has lead to use of unique templates with unique formatting, not least among citations. Add to this that the Polish Wikipedia does not allow template redirects and a large body of work is required for each article.
    (This is somewhat alleviated by a commissioned Template bot - to be released). - List of articles for integration
  • Arabic
    The Arabic Wikipedia community has been informed of the efforts to integrate content through both the general talk-page as well as through one of the major Arabic Wikipedia facebook-groups: مجتمع ويكيبيديا العربي, something that has been heralded with great enthusiasm.
Integration guides

Integration is the next step after any translation. Despite this it is by no means trivial, and it comes with its own hardships and challenges. Previously each new integrator has needed to dive into the fray with little help from previous integrations. Therefore we are creating guides for specific Wikis that make integration simple and straightforward, with guides for specific languages, and for integrating on small Wikis.

Instructions on how to integrate an article may be found here [5]

News in short


To come
  • Medical editor census - Medical editors on different Wikis have been without proper means of communication. A preliminary list of projects is available here.
  • Proofreading drives

Further reading



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If you are receiving this newsletter without having signed up, it is because you have signed up as a member of the Translation Taskforce, or Wiki Project Med on meta. 22:32, 16 July 2014 (UTC)

Disambiguation link notification for July 18[edit]

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Endometrial cancer[edit]

Hi John! I know I said on Doc James' page that I would need a couple weeks to finish up but I've just gone through my last major source for endometrial cancer and am sort of at a loss for where to go from here. Would you or another CRUK person be willing to provide a sort of mid-development review? Thank you so much - and I do understand if you're not available. Best, Keilana|Parlez ici 18:31, 18 July 2014 (UTC)

I'll get on to it on Monday. Johnbod (talk) 00:23, 19 July 2014 (UTC)
I've done a quick review for language etc (US-only figures should say so) & a specialist will be looking at it. Wiki CRUK John (talk) 17:26, 22 July 2014 (UTC)
Thank you so much! Keilana|Parlez ici 18:26, 22 July 2014 (UTC)

Greetings from MrBill3[edit]

Greetings Wiki CRUK John!

Thank you for your contributions to WP.

Just thought I'd drop a note Re: our discussion on Cancer screening. I couldn't agree more that there are too few content-adders (sounds like a dangerous snake, I prefer "prose writers"). I do aspire to improving my writing skills and finding the time and drive to add more in content to articles. Despite the fact I am a Registered Nurse in Intensive Care who avidly studies evidence based medicine and critical care medicine in general, I find writing on medical topics challenging (Bios seem much easier to me).

What I do a lot of on WP is verification. I find the sources cited, format them "properly" (IMO with a modicum of respect for CITEVAR) and do my best to provide links that give free access or point users in the best direction for them to find their access options. I also frequently actually read the sources (I have a variety of means of access). It is truly shocking to me how frequently I find sources misrepresented or plainly used to support facts they don't contain. With an interest in both medicine and fringe topics I find myself working on articles that are heavily discussed on talk pages require close attention to MEDRS, or have a single primary editor. To comply with policy (and foster consensus) I frequently post suggestions to talk pages rather than editing boldly.

I also consider myself a fairly competent researcher but don't always have the time or motivation to edit and write prose so I often add references I have found a "Further reading" section (new or existing). I appreciate greatly the work of prose writers and post articles I think are important or in need of revision to Project Medicine Talk or the Fringe Theories NB. I hope my work on sources is of help to those who would do the writing and perhaps over time some editors will find that when I post an article I have facilitated editing by improving sources.

Thanks for pointing to US centrism, I will keep it in mind when researching (I'm thinking WHO, NHS and EU) and editing.

Best wishes and happy editing. - - MrBill3 (talk) 19:10, 18 July 2014 (UTC)

Many thanks - yes MEDMOS should really have something about nationally-biased editing (usually US but not always). I want to get a page together with a variety of good sources for RS info from the major Anglophone countries, & internationally. For example, for cancer the European Society for Medical Oncology produces guidelines for treatment that are online & authoritative, and have been published in Annals of Oncology. Another thing to do. Wiki CRUK John (talk) 10:11, 21 July 2014 (UTC)
Thanks for your work on Cancer screening. When you have a page with more global resources please ping me (and/or post a notice on Proj Med Talk). I look forward to expanding the international nature of my research. Best. - - MrBill3 (talk) 21:15, 21 July 2014 (UTC)
Will do, probably on the project. I think it will build over a while - Anthony Cole can add Australia, Doc James Canada etc. Wiki CRUK John (talk) 21:17, 21 July 2014 (UTC)

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Brief chat this morning?[edit]

Hi. We'll probably see each other around anyway, but can I have a brief word before 11:00 am? I'll be in Costa's coffee shop from 10:00, or can track you down if you tell me where you'll be. --Anthonyhcole (talk · contribs · email) 09:19, 10 August 2014 (UTC)

Key for photo?[edit]

File:Diagram showing where the lymph nodes are in the neck CRUK 384.svg note to self Johnbod (talk) 17:11, 13 August 2014 (UTC)

Talk:Medcan Clinic#Notability[edit]

You are invited to join the discussion at Talk:Medcan Clinic#Notability. Cheers!

P.S. I thank you for the input you have provided at Talk:Medcan Clinic already. —Unforgettableid (talk) 09:42, 18 August 2014 (UTC)

CRUK images[edit]

Hi John! I just wanted to let you know that I've put about 3/4 of the images -all of the obvious ones - uploaded by CRUK into the appropriate articles. Do you know if any more images will be uploaded in the future, or is this it? Thanks so much, Keilana|Parlez ici 04:16, 25 August 2014 (UTC)

No, we've had all the body diagrams they have now, but any new ones should be uploaded. Also there will be other types of images, such as infographics. Thanks again for all your work on these! Wiki CRUK John (talk) 12:35, 26 August 2014 (UTC)

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Precancerous condition[edit]

Hello, I happened upon your edit for article "Precancerous condition" and noted that you had added the statement "After 2005 both the terms [precancer and carcinoma in situ, presumably] have been clubbed together and is now known as potentially malignant lesions." I could not find evidence to support this statement, and was wondering if you could clarify or provide a reference. I have removed the statement in the meanwhile. Thanks! Dr G (talk) 20:42, 6 September 2014 (UTC)

I didn't add it, just closed it up to the preceding text rather than being a para by itself. [6]. Wiki CRUK John/Johnbod (talk) 20:46, 6 September 2014 (UTC)

Some baklava for you![edit]

Baklava - Turkish special, 80-ply.JPEG Thank you for thinking so carefully about the way to portray the prognosis in diseases with poor survival rates. Considering the patient and their family as an audience is really important in these situations. I'm glad that you are around helping write medical articles. Sydney Poore/FloNight♥♥♥♥ 04:47, 26 September 2014 (UTC)

Reviews by subject experts of anatomy articles[edit]

Hi CRUK John, I know you have previously mentioned some reviews of medical articles by subject experts. Are those reviews difficult to arrange? I was wondering if, over the course of the next year or so, Cancer Research UK would be able to arrange for several reviews of anatomical articles. Anatomical literacy is an important component in how people understand cancer care and the materials delivered to them. Reviews could be of some of our most popular articles (WP:ANAT500), which receive in aggregate now about 27 million views / month. What do you think about this suggestion? I would love to hear from non-Wiki users about some of our articles. Unlike Medicine, which may in fact have fairly well fleshed-out articles, these reviews would also be able to offer some key points about how articles could develop. Looking at sympathetic nervous system made me come here, as I could not help thinking what a subject expert would have to say about this. What are your thoughts about this? Kindly, --Tom (LT) (talk) 03:08, 11 November 2014 (UTC)

emailed reply Wiki CRUK John (talk) 15:30, 11 November 2014 (UTC)

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Removing hidden refs from the lead[edit]

Not sure why you are removing these? Doc James (talk · contribs · email) 21:16, 12 November 2014 (UTC)

Yes, I suppose they were for the translation project, which I only realized part way through. I had killed that ref ("Pancreatic Cancer Treatment (PDQ®) Patient Version". National Cancer Institute. 2014-04-17. Retrieved 8 June 2014.") to use higher quality MEDRS ones, and so the refs were meaningless. Also FAC doesn't like hidden stuff, usually anyway. The text has also changed somewhat. Hope it's not a problem - they could always use an earlier version. Wiki CRUK John (talk) 22:41, 12 November 2014 (UTC)
I've seen your edit now, which has left a big error message at ref 1. Wiki CRUK John (talk) 22:52, 12 November 2014 (UTC)
Okay will fix the ref. We want to use the most recent version for translation. Using earlier versions is exceedingly hard to manage. Doc James (talk · contribs · email) 23:15, 12 November 2014 (UTC)
I did not make these changes by reverting. Please look at the changes more closely. Doc James (talk · contribs · email) 23:40, 12 November 2014 (UTC)
It's 11.45 and I'm going to bed. Where have all my changes gone then? I'll look at it tomorrow. Wiki CRUK John (talk) 23:45, 12 November 2014 (UTC)

You are referring to these edits[7]. You will note:

  1. ^ Hardison, Brooke Layne (23 April 2010). "The Financial Burden of Cancer". NCI. Retrieved 8 June 2014. 

Doc James (talk · contribs · email) 23:51, 12 November 2014 (UTC)

If you are referring to the changes by Henry most of those are still there aswell.[8]
I did move it to 4 paragraphs. And added a second sentence on the definition so that cancer was linked in the lead. Doc James (talk · contribs · email) 23:54, 12 November 2014 (UTC)
  • Firstly, can we not discuss an article in 2 places at once. I removed, and will removed again, the "financial burden" because it is too old, does not accurately represent the source (the figure is actually something different), and seems too dubious, local and meaningless a figure to include in the lead. I note there seems to be no equivalent figure in more recent NCI coverage. Most articles, and most MEDRS, avoid these rather dubious figures, which are mainly designed for use in political lobbying. Just because you don't understand a change is not a good reason to revert it! You should ask why it was done. Wiki CRUK John (talk) 11:12, 13 November 2014 (UTC)

Pancreatic cancer[edit]

Page is looking good.
Complimenti!
109.157.83.50 (talk) 13:55, 16 November 2014 (UTC)

Thanks, and for the edits. I'm working myself up for a rant on the referencing issue though (if you saw other edits before yours). I've been meaning to ask how you think Oeso is doing? Still waiting for the research bit, but otherwise close? Wiki CRUK John (talk) 10:31, 17 November 2014 (UTC)
Cheers John. ...erm, I've been trying to look at my lifestyle to try to control my acid reflux. So perhaps I'm better off at the moment helping out at the PC page, though I haven't abandoned EC (a little bit goes a long way, I find). As regards referencing, I think you know my thoughts on some of the issues. The recent changes seem to me to be generally rather good. Personally I feel that sourcing to specific pages in standard journal articles [and maybe book chapters] would be hellishly burdensome, and of very limited use, if any, to our readers - especially as concepts are often outlined, reported and discussed on multiple pages within the article. However, we do need to include the appropriate codes (PMC etc) or other available full-text links. 2c fwiw, 109.157.83.50 (talk) 15:40, 17 November 2014 (UTC)

I'm done making edits for now by the way, so enjoy not getting edit conflicts, if I happened to trigger any for you. Best. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 16:55, 18 November 2014 (UTC)

Thanks. Actually I didn't have any - perhaps not the same for you. Cheers Wiki CRUK John (talk) 16:57, 18 November 2014 (UTC)

IAR again...[edit]

Sorry about that revert John, never nice I know. Despite being tight on time I did at least engage on the PR page, and the issue is a real one. See, for example, this - the cartoon is a classic among epidemiologists. I think we really do need to be cautious in our claims and wording (per WP:VnT, or per WP:GIGO?). Absolutely no criticism of you personally - I think you've doing a really commendable job on the page. Support! 109.157.83.50 (talk) 18:49, 18 November 2014 (UTC)

Web user research apparently shows that a large proportion of readers can't grasp %s, and of course a large proportion of MED editors can't grasp that or similar findings .... Wiki CRUK John (talk) 20:14, 18 November 2014 (UTC)
Sorry John, not altogether sure what you're on about there (though I'm not surprised that many users struggle to understand certain uses of percentages). 109.157.83.50 (talk) 22:12, 18 November 2014 (UTC)
Ah, perhaps I understand... Fwiw, personally, I don't think we'll ever be able to write for everyone (I have some fairly representative gf people in mind). On the whole, I think we all find it intuitively harder to grasp things like percentage changes than straightforward proportions - as in 4 out of 5 cats prefer Whiskeys (Shome mishtake, shurely? - Ed). 109.157.83.50 (talk) 22:29, 18 November 2014 (UTC)
It's much worse than that actually, per the research. Wiki CRUK John (talk) 16:12, 20 November 2014 (UTC)
Without seeing the research, it's hard for me to comment on specifics. However, I am absolutely sure that we can't communicate directly with all of the people even some of the time. And you know how much I'm in favour of clarity, and of writing for a "general readership", in line with (imo) excellent principles of WP:AUDIENCE. As far as Wikipedia is concerned, my own feeling is that if we follow those principles then the sort of general readers we are aiming to get through to will be able to provide verbal explanations to people for whom even relatively basic reading/number comprehension is a real challenge. Not ideal, I know... And, yes, I do think this sort of research can be quite revealing, and helps put our communication efforts into a broader context. The issue is certainly a highly relevant one in the light of Wikipedia's stated mission to provide reliable knowledge that is freely available to all. It'll be interesting to hear, in due course, Henry's take on these matters (and Henry2 too!). 109.157.83.50 (talk) 18:12, 20 November 2014 (UTC)

Hi, I was just looking at your recent edit summary about "symptoms". Yes, agreed about depression, as in "feeling depressed". But not for Trousseau sign/syndrome - something people couldn't specifically complain of, as in "I've got a [whatever] ache", etc. Cheers, 109.157.83.50 (talk) 15:58, 20 November 2014 (UTC)

ok Wiki CRUK John (talk) 16:12, 20 November 2014 (UTC)

Management of cancer[edit]

If you haven't already, could you review my recent minor edits to the above article? I would appreciate the benefit of your greater familiarity with the material. Cheers, Basie (talk) 19:56, 24 November 2014 (UTC)

Referencing is always great. Most of this article seems to have been written by Doc James a long time ago, before we were so ambitious on sourcing. So the text seems sound, but it would be great to ref it all & lose those tags. No doubt you know WP:MEDRS; despite what it says, in practice, for a very general overview like this, top websites like ACS, NCI, NHS Choices & CRUK are easy to find & use, & vastly preferable to no source, and perhaps to a journal one from eg 2008. Actually my personal knowledge of cancer is thin & recently-acquired, but I have access to people who do know. Best, Wiki CRUK John (talk) 21:26, 24 November 2014 (UTC)

FAC[edit]

Hello there! I undid your addition of Pancreatic cancer to the FAC page, since you missed a couple of steps in the nomination process. Please see steps 3 and 4 under "Nomination procedure" at Wikipedia:Featured article candidates. You got the template on to Talk:Pancreatic cancer correctly, but you have to click the red link to create the nomination page before you place it in the list. Let me know if you have any questions. --Laser brain (talk) 15:07, 1 December 2014 (UTC)

It doesn't explain that sequence, which would be helpful. Wiki CRUK John (talk) 15:14, 1 December 2014 (UTC)
Not sure what to do now - can you sort it out? Wiki CRUK John (talk) 15:15, 1 December 2014 (UTC)
Yes, I have re-added your nomination to the list. Everything is set. --Laser brain (talk) 15:22, 1 December 2014 (UTC)
Thanks! Wiki CRUK John (talk) 15:26, 1 December 2014 (UTC)

Disambiguation link notification for December 3[edit]

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senza parole[edit]

Don't know what to say, John. I'm sorry for the disruption, but I really don't feel I have anything to apologise for. I felt I'd done everything in a non-conflictual way... I hope Sandy comes round to see that. I've always had a lot of time for her contributions. :) 86.164.164.29 (talk) 19:15, 3 December 2014 (UTC)

Indeed, don't let it worry you (I was concerned it might). All blown over I hope, though not the views on the substantive MOS issues, where there seems to be a large gap on accessibility. Wiki CRUK John (talk) 23:39, 3 December 2014 (UTC)

Lung cancer staging diagrams[edit]

There are ongoing problems with the lung cancer staging diagrams that I pointed out three months ago. [9] & [10] Axl ¤ [Talk] 10:40, 8 December 2014 (UTC)

See the changes at the article, and comments on the talk page. Does this resolve the issues? Wiki CRUK John (talk) 15:38, 5 January 2015 (UTC)

History section[edit]

I've done my best to fill some of the gaps (per JFW's FAC point). Of course, you'll probably feel that the prose needs some simplification. Best, 109.158.8.201 (talk) 15:57, 18 December 2014 (UTC)

Thanks for this. Wiki CRUK John (talk) 14:59, 5 January 2015 (UTC)

Pancreatic cancer, "Mechanism"[edit]

Floating the idea that the header, "mechanism" might be better as "precursors". I am not making the change without discussion given the advanced state of the article. However, "mechanism" could refer to almost any aspect. "Precursors" seems to be what the section is specifically addressing. Within the section it is clear that progression is not inevitable. FeatherPluma (talk) 13:50, 30 December 2014 (UTC)

Yup, or something like that... (and maybe we should have something actually on the biological mechanism). I see you'll be back after the 5th. Hope you're enjoying a good holiday in the meantime. Buon anno! 86.181.67.166 (talk) 18:03, 1 January 2015 (UTC)

Likewise for your 2015. Change made (on a fly by visit). FeatherPluma (talk) 16:56, 3 January 2015 (UTC)

I'm fine with that, if it sticks. Not everyone will be, I suspect. Thanks, Wiki CRUK John (talk) 14:59, 5 January 2015 (UTC)
Ping FeatherPluma - but does that nice heading really work for all the discussion of causative mutations, such as in the PanNet subsection... :-/ (sorry) 86.181.67.166 (talk) 20:34, 5 January 2015 (UTC)

Yes, I believe it does. Is there a specific aspect about which you have a reservation?FeatherPluma (talk) 23:03, 8 January 2015 (UTC)

Thanks for that FeatherPluma. Hum, I was thinking of precursor *lesions* [11] ...And perhaps the gene mutations (here) could be considered molecular lesions and therefore biological precursors? (And I suppose MEN1 syndrome can be considered a functional precursor.) So if you think this usage[?] is ok, then I'm really happy to agree :) 86.181.67.166 (talk) 00:17, 9 January 2015 (UTC)

OK, I see the references. My first impression is there is "definitional promotion" therein, but please let me mull it over - I'll post in 24 - 36 hours. Thanks. FeatherPluma (talk) 00:34, 10 January 2015 (UTC)

Thanks, FP. Maybe no need for that... I see the current Dictionary of Epidemiology (ed. Porta) – sorry, I really should have thought of looking there before... – provides a suitably broad definition for our purposes - PRECURSOR: A condition or state preceding pathological onset of a disease; sometimes detectable by screening... [12] I think that confirms your suggestion is an excellent one all round. 86.181.67.166 (talk) 10:02, 10 January 2015 (UTC)

Agreed. Thanks, 86, for undergirding this in a detailed way. FeatherPluma (talk) 16:21, 13 January 2015 (UTC)

"Resectable"[edit]

John :), please see my edit summary here. Because a treatment – even if it's the only potentially curative one – is technically possible (ie feasible/doable), doesn't mean it's necessarily the best thing to do for the patient. This is an area where insights from nurses (@WhatamIdoing: ping) is key.

I'd also query the wording of this sentence: "The most crucial decision to be made after diagnosis is whether surgical removal of the tumor is possible, as this is the only cure for this cancer." Suggest "appropriate" (or something similar) instead of "possible".

The source says: "Although the best chance of long-term survival for patients with localized pancreatic cancer is through complete resection of the primary lesion, the systemic nature of pancreatic cancer at diagnosis, the impact of pancreatectomy on quality of life and the relatively low chance of long-term survival must all be taken into account when selecting patients who will most benefit from surgery." [13]

Have to run now, 86.181.67.166 (talk) 19:53, 6 January 2015 (UTC)

I hadn't seen this wording before, and immediately thought it very misleading through over-vagueness. There is no need to introduce a new reference, which only very briefly touches on this, and at that page does not go into the point you are making at all. Plenty of the existing MEDRS sources cover this in far greater depth. I expect you've seen how Sandy Georgia is on the warpath about "paid advocacy" sources, and they certainly aren't needed for this. I've rejigged, using Bond-Smith & also below, though i see I'm repeating a point that was already there. On the other point, I've changed to "possible and appropriate". It already said "The general health of the person must also be assessed, though age in itself is not an obstacle to surgery." Wiki CRUK John (talk) 20:24, 6 January 2015 (UTC)
Ok John. I see you've been burning the midnight oil. Best, 86.181.67.166 (talk) 23:03, 6 January 2015 (UTC)
I'm still not convinced that it's correct just to say that resection "will normally follow, if the patient is fit enough..." The source you've cited says: "For patients unwilling or not medically fit enough to undergo major pancreatic surgery, alternatives include... These are palliative procedures..." In other words, the patient may opt out (as an informed decision). 86.181.67.166 (talk) 23:45, 6 January 2015 (UTC)
Btw, I completely fail to see what ethical involvement of charities such as CRUK or MacMillan that share certain key objectives with Wikipedia can have to do with "paid advocacy" editing (commented here). Individual personalities aside, I don't think such claims (or other similarly unfounded ones), no matter how strongly reiterated, should be allowed to influence our work. 86.181.67.166 (talk) 23:23, 6 January 2015 (UTC)
I'm not a nurse. We've got (just) a few around, including User:Basie. I do advocate for representing that perspective, and 86.181 has correctly identified this as one of those times when that perspective is appropriate. Not everyone wants maximal, or even average, intervention for a disease like that. In fact, physicians themselves often refuse it.
I wonder sometimes if providing basic information about each treatment is a good idea. Instead of "this is the first treatment", we would say, "this is the first treatment, it's a major surgery that results in a one-week hospital stay and a month recovering at home. It raises long-term survival from 5% to 15%". I also wonder in these cases, if it is more appropriate to reverse the statistics: "Without this surgery, 95% of patients will die in the next five years; with it, 85% of patients will still die." Most people don't actually 'hear' the "85% die" bit when you tell them "15% survive". WhatamIdoing (talk) 03:48, 7 January 2015 (UTC)
Interesting. I agree communication with people in some way personally affected is key here, and feel strongly about the need to distinguish between objective evaluations like 'resectability' and shared decision-making involving life choices. That was the reason I thought the MacMillan ref (intended link) could be appropriate.
Apologies WAID for the rl misrepresentation (my misunderstanding). I find this really relevant, but I'm a bit concerned that a user talk page is perhaps not the most appropriate venue for the conversation. With the ongoing FAC it's hard to know where to post, and what starts off mainly as an interpersonal clarification can easily morph into something else. 86.181.67.166 (talk) 12:15, 7 January 2015 (UTC)
I don't mind if WhatamIdoing gets the nod as an honorary nurse ;) My field is rather specific (kids/babies) but there's a common thread which the use of percentage survival rates does not encompass very well. These surgeries are a big deal: even with a 'gain' from a mortality point of view, non-lethal sequelae can have a devastating effect on quality of life. I don't work with the population that get Whipples, but I know its reputation as a major procedure. I always worry when parents and family members hear percentages in isolation, and I'm not surprised that physicians frequently turn down treatment.
BTW John, I hope you don't find the current examination of paid editing too frustrating. I've always found your contributions thoughtful and balanced. Cheers, Basie (talk) 22:00, 7 January 2015 (UTC)
  • (following & responding to all the above) 86, if you're going to have a party, the article talk or FAC might be a better place!
I think the difficulty & arduous nature of the surgery & dangers of the post-operative period are well-covered in the article in the appropriate sections. The issues around the patient's decision (I think we're allowed to talk of patients on talk) are under-represented, I agree, partly because the general/surgical clinical sources mainly used pass over them pretty quickly, when they mention them at all. But the staging section is not the place for that, nor does the MacMillan page seem a very good link to me - a rather better one would be the Am Cancer Soc pdf used for the "prognosis" table, which is a 65 page document that goes into much more depth.
It would be very useful if anyone could point to good journal papers that address the patient's dilemma faced with the offer of surgery, not to mention chemo/radio.
On the charity/advocacy ref issue, I've commented on this elsewhere, but in general I support giving preference to textbooks and secondary journal sources MEDRS-style, although the better websites can be the best sources in certain contexts, especially reporting epidemiology stats, which don't typically get published in journals, and where in both the US & UK the best approach to the cancer stats at least is through the top "advocacy" sites, which use specialists to make the government-collected figures accessible in a detailed form to those who are not professional epidemiologists (so including most medical professionals).
One problem with using bare charity/advocacy web-pages is that the better they are the more often they change (and "minor" changes may not get reflected in a "last updated" note, if there is one). I've been caught out a couple of times by this on this article.
Thanks, Basie for your kind words. I'm happy so say that so far I think I've managed not provoke any adverse comments about my own edits, and I'm conscious that the whole issue of medical COI editing fully deserves the scrutiny it gets. I've said elsewhere that the spec for my project envisaged a different balance, compared to what has happened, between actual substantive editing by the Wikipedian in residence and support to other editors in their editing. As it has turned out, there has needed to be somewhat more of the former, because there has been somewhat less of the latter.
I certainly take WhatamIdoing's point about the prognosis figures, but I would point out that 15% and 5% are not I think the actual figures for this precise scenario, though I don't know what those are. The first is presumably too high, as it includes the markedly lower rates for stage II (7 & 5% per the figures used lower - ACS ones, NB also "These numbers come from the National Cancer Data Base and are based on patients diagnosed between 1985 and 2004." - so one would hope current ones are better.), although all those doctors and others who don't have surgery etc are in these, but also those in low-volume centres who do. The 2nd (5%) is surely too high. Then there are other treatments to factor in. I don't think I've seen figures that distinguish between similar cases choosing and refusing surgery - presumably these exist & would be in papers specifically addressing this question. Of course if anything this strengthens WhatamIdoing's point, but also shows that better sources are needed to cover it properly.

Wiki CRUK John (talk) 14:29, 8 January 2015 (UTC)

We're probably looking in the wrong places to find "the patient's dilemma". We probably need to track down, say, a medical sociologist who specializes in hospice or end-of-life subjects. Or maybe even an economist, according to the third entry in this series, since the decision of what to do is fundamentally behavioral economics.
We should probably expect to find a book (maybe one from university press), not a journal article. It happens that I've just picked up one that talks about end-of-life care, but it's focused on labor studies, so it's probably not going to be useful. WhatamIdoing (talk) 23:49, 8 January 2015 (UTC)

Arbitrary break[edit]

  • Suggest: "...will normally follow, if the patient is fit enough for a major operation is willing to undergo this major operation and is thought to be sufficiently fit". I believe that better represents the cited source. 86.181.67.166 (talk) 00:34, 9 January 2015 (UTC)
Support - addresses several aspects well. FeatherPluma (talk) 01:29, 10 January 2015 (UTC)
I've now made the change, per the cited source. 86.181.67.166 (talk) 10:37, 10 January 2015 (UTC)
  • Following the conversation above, I've made the following change [14]:

    The most crucial decision to be A key assessment that is made after diagnosis is whether surgical removal of the tumor is possible (see [[#Staging|Staging]])...

    The cited source contains statements such as "the optimal treatment first and foremost depends on careful accurate staging" but makes no mention that I can see of a "most crucial decision", or words to that effect.

    Please feel free to move this – I wouldn't know how – to FAC; I've already apologised for the fact that this discussion inadvertently ended up here.) 86.181.67.166 (talk) 12:58, 11 January 2015 (UTC)

It's no party[edit]

John, kindly realize that in no way have I been having "a party"... For me it's not fun - these are serious questions, especially since FAs are intended to represent Wikipedia's best work, and therefore effectively serve as a model. Fyi, I put considerable thought into how I might communicate the substance of these concerns while doing my best not to offend the sensibilities of a hard-working colleague such as yourself, when I know you're under pressure. I have been putting work into this page in support of the collaboration you've been building with CRUK, which I think can be very valuable. Please also understand that as a professional medical writer I feel an inner responsibility to raise issues like this. And it hasn't always been easy... I've been effectively pushed off the FAC page for absurd (imo) reasons, on which occasion you kindly defended my contributions there. And I've genuinely tried to be discreet, following Sandy's expressions of discomfort, while continuing (like you) to do my best for the article and the serious subject matter it presents. I explained above why I was raising the issue on this page. But, as so often unfortunately on Wikipedia, damned if one does, damned if one doesn't, it seems... When (frankly) I might actually be rather enjoying myself quietly editing in other fields... or pursuing other interests off Wikipedia altogether. 86.181.67.166 (talk) 18:14, 8 January 2015 (UTC)

John, please feel free (of course) to collapse or remove this indigestive vent. 86.181.67.166 (talk) 10:05, 10 January 2015 (UTC)

Arbitrary (wiki)break[edit]

To like or not to like? (eg here) 86.181.67.166 (talk) 09:51, 14 January 2015 (UTC)

I've reverted. Apart from what I said in my edit summary: "rvt - actually this is just wrong, apart from the grammar (did you see how it looked?). The edges are examined, to see if there is a clear margin. The "margin" cannot be examined", your version talked about "the edges ("margins") of the removed tissue, ...", but the margin (if any) is on the remaining tissue not removed. Wiki CRUK John (talk) 10:11, 14 January 2015 (UTC)
Yes, John, I did actually notice your edit summary... "grammar"?? I suppose you're referring to the inadvertently left over brackets, which had already been fixed with an edit summary of "oops! ". But that's really beside the point... 86.181.67.166 (talk) 10:38, 14 January 2015 (UTC)
  • Fyi, I haven't been able to reach you by phone at CRUK. I wanted to defuse this communication issue, which I find particularly frustrating given your apparent reluctance to engage here on-wiki (e.g. in this deeply felt thread). Anyway, you know how to contact me. 86.181.67.166 (talk) 10:18, 14 January 2015 (UTC)
Fine - talk soon :) 86.181.67.166 (talk) 11:07, 14 January 2015 (UTC)

FYI[edit]

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Congratulations on Pancreatic cancer[edit]

Congratulations for geting Pancreatic cancer promoted to Featured article.

I apologize for not being there to explicitly support; I was on a short break. It was clear though that all my comments had been answered.

See you soon in more medical articles. --NikosGouliaros (talk) 08:21, 17 January 2015 (UTC)

No worries! Thanks for both your very detailed reviews!, Best Wiki CRUK John (talk) 15:44, 18 January 2015 (UTC)