Wikipedia talk:Manual of Style/Medicine-related articles

Medical Specialties

I would like to propose that a template for medical specialties is created. I have searched through the Wikipedia articles on medical specialties yesterday. My findings are as follows (with regards to the articles containing these specific sections)

Introduction (although not usually titled as such) (31) (Hepatology, Neurology, Gastroenterology, Pulmonology, Endocrinology, Intensive Care Medicine, Rheumatology, Immunology, Disaster Medicine, Emergency Medicine, General Practice, Geriatrics, Obstetrics and Gynaecology, Palliative Care, Paediatrics, Rehabilitation Medicine, Preventive Medicine, Psychiatry, Medical Genetics, Medical Microbiology, Radiology, Cardiology, General Surgery, Neurosurgery, Oral and Maxillofacial Surgery, otolaryngology, Paediatric Surgery, Plastic Surgery, Trauma Surgery, Urology, Vascular Surgery) History and Key Discoveries (16) (Hepatology, Gastroenterology, Endocrinology, Dermatology, Disaster Medicine, Emergency Medicine, Geriatrics, Opthalmology, Palliative Care, Rehabilitation Medicine, Psychiatry, Cardiology, Medical Genetics, Neurosurgery, Orthopaedic Surgery, Plastic Surgery) Training/Education/Training Across the World (16) (Neurology, Endocrinology, Nephrology, Dermatology, Disaster Medicine, Emergency Medicine, Obstetrics and Gynaecology, Opthalmology, Paediatrics, Rehabilitation Medicine, Radiology, Neurosurgery, Oral and Maxillofacial Surgery, Orthopaedics, Trauma Surgery, Vascular Surgery) Scope of the Specialty/Field of Work/Diseases managed (12) (Hepatology, Neurology, Pulmonology, Nephrology, Proctology, Dermatology, Geriatrics, Psychiatry, Neurosurgery, Orthopaedics, Otolaryngology, Vascular Surgery) Important Procedures/Treatment/Treatment Settings (12) (Hepatology, Pulmonology, Haematology, Nephrology, Rheumatology, Immunology, Dermatology, Psychiatry, Cardiology, Orthopaedic Surgery, Plastic Surgery, Vascular Surgery) Sub-specialties (8) (Dermatology, Obstetrics and Gynaecology, Opthalmology, Paediatrics, Psychiatry, General Surgery, otolaryngology, Urology) Societies/Organisations around the world (7) (Hepatology, Gastroenterology, Nephrology, Emergency Medicine, Medical Genetics, Oral and Maxillofacial Surgery, Otolaryngology) Diagnosis/Investigations (8) (Pulmonology, Nephrology, Oncology, Haematology, Rheumatology, Immunology, Dermatology, Radiology) Disease Classification/Diseases (7) (Hepatology, Gastroenterology, Endocrinology, Nephrology, Rheumatology, Dermatology, Psychiatry) Scientific Research (5)(Pulmonology, Oncology, Rheumatology, Dermatology, Psychiatry) Current Practice Across the World/Current Trends (5) (General Practice, Geriatrics, Palliative Care, General Surgery, Oral and Maxillofacial Surgery ) Notable Practitioners (4) (Nephrology, Opthalmology, Neurosurgery, Oral and Maxillofacial Surgery) Publications/Journals (2)(Hepatology, Rehabilitation Medicine)Definitions (2) (Disaster Medicine, Emergency Medicine) Ethical Issues (2) (Oncology, Psychiatry) Follow-up (1) (Oncology)Equipment (1) (Intensive Care Medicine) Practitioners Description (1) (Psychiatry) Basic Medical Sciences (1) Haematology Profession (1) (Endocrinology) Work (1)(Endocrinology) Tele-practice (1) (Radiology) Philosophy (1) (Rehabilitation Medicine) Who sees the specialist? (1) (Nephrology) Patient Education (1) (Endocrinology)Popular Textbooks (1) (Rehabilitation Medicine) Social Role of Practitioners (1) (Paediatrics)

If the topics were chosen according to the most popular within the articles they would be:- Introduction, History and Key Discoveries, Training/Education/Training Across the World, Scope of the Specialty/Field of Work/Diseases Managed, Treatment, Sub-specialties, Societies/Organisations around the World, Diagnosis/Investigations, Disease Classification/Diseases, Scientific Research, Notable Practitioners, Definitions, Ethical Issues - then the other categories would most likely be relevant to only a minority of specialties Justinmarley (talk) 06:44, 13 July 2008 (UTC)justinmarley I've missed a few - Current Practice/Current Trends, Publications/Journals Justinmarley (talk) 06:50, 13 July 2008 (UTC)

Those articles are exceptionally hard to source properly. I agree that a MEDMOS outline would help. JFW | T@lk 07:15, 13 July 2008 (UTC)

Is there a process to take this forward or does it involve consensus on this discussion page? Justinmarley (talk) 08:47, 13 July 2008 (UTC)justinmarley

I don't understand the question. Are you asking for something like {{Medicine}}, or for an addition to Wikipedia:MEDMOS#Sections? If the first, then you just create it and use it. If the second, then I suggest that you create a subsection here to propose the exact text that you'd like to see in MEDMOS. WhatamIdoing (talk) 17:56, 14 July 2008 (UTC)

Thanks Justinmarley (talk) 05:45, 16 July 2008 (UTC)justinmarley

Proposed Structure for Medical Specialty Articles - Please Comment!

Introduction - Introduction to the subject
Scope - Scope of the specialty
History - History of development of field
Current Practice - Global perspective on current practice
Training - Training around the world
Investigations - Investigations/diagnostics used in specialty
Treatments - Treatments used in specialty
Sub-specialities
Notable Practitioners - Within the field - historical and current
Societies - Global list of relevant societies
Research - Research themes in specialty
Textbooks and Journals - Important textbooks and journals in field
Ethics - ethical issues in field
Justinmarley (talk) 05:59, 16 July 2008 (UTC)

"Introductions" are generally discouraged. That's what the lead is for. JFW | T@lk 06:21, 16 July 2008 (UTC)

Or rather, that's what the lead is. As I think Justinmarley made clear above:

"Introduction (although not usually titled as such)" --Hordaland (talk) 10:15, 16 July 2008 (UTC)

The Notable Practitioners, Textbooks, Journals and Societies could be covered in prose within the History section (i.e., only mention them if historically significant) otherwise they might end up as lists that attract spam or be only of interest to physicians. Do we need a "Current practice" section, when presumably the Investigations & Treatments sections covers that? Could Sub-specialities be covered within Scope? Colin°^Talk 10:29, 16 July 2008 (UTC)

I think that Ethical issues is a better section title than "Ethics". While different fields confront different specific dilemmas, the ethics themselves do not change.

Do we really need a "Textbooks and journals" section? It seems so... web directory-ish. WhatamIdoing (talk) 05:38, 17 July 2008 (UTC)

This is a proposed framework for excellence in articles and is constructed entirely from searching through these articles on wikipedia and counting the popularity of these topics. As such it probably serves as a starting point rather than the finished product. I agree that the notable practitioners section could be subsumed under the history section. The current practice section covers service provision e.g. in different countries and therefore extends beyond investigation and treatment. Sub-specialties could be covered within scope - would we be able to have sub-headings within scope? Textbooks and journals didn't score so highly in the overall count. However, I think that they could go in a separate section and be provided in list form - the reason being that readers would then have a straightforward and very valuable resource for further reading on the topic (in the secure knowledge that practitioners in the field place value on these textbooks. Personally speaking I would find a journals section extremely valuable myself). Although this section is 'web directory-ish', I think that combining these valuable lists with the remainder of the article will make this a powerful resource. Societies relates to current practice i.e. what societies exist that relate to this discipline today. Again this will prove useful for the reader who wants further information and can contact the relevant society. Ethical issues seems fine and probably do vary between the specialties. Obstetrics and Gynaecology (e.g. issues that conflict with religious values) might have different ethical issues to a speciality such as ITU (taking someone off the ventilator). Justinmarley (talk) 06:46, 17 July 2008 (UTC)justinmarley

Modern textbooks and journals that are not in themselves highly notable do not deserve mention in a section of their own. Any such "Further reading" section is for the general reader wanting to learn about Neurology in general, for example, not for the trainee physician wanting to become a neurologist. I can't really imagine why a general reader would be interested in a list of current neurology journals. We aren't a directory, so we don't list societies for the purpose of readers contacting them. Unless you can say something interesting about the society, it probably doesn't deserve mention. It would really help if some knowledgeable editors worked on a Speciality article, bringing it up to a decent standard, so we could have an example that works and serves as a model. Colin°^Talk 17:34, 17 July 2008 (UTC)

Gosh, I see so many problems with this proposed structure that I don't know where to start, so I'll leave it to others and say that I think our current structure is much better. I can't see anything in this proposal that could be well applied to Tourette syndrome, and this proposal actually introduces things like Societies, yikes. SandyGeorgia (Talk) 16:12, 17 July 2008 (UTC)

This proposal is for specialties only. --Steven Fruitsmaak (Reply) 16:16, 17 July 2008 (UTC)

For example? SandyGeorgia (Talk) 16:32, 17 July 2008 (UTC)

Obstetrics and gynecology, for example, right Justinmarley? I agree with others above: Notable people sections aren't great because they're spambait, plus I'd like to see sections that are going to be primarily lists discouraged in favor of prose. So subsuming the notable people under history would be a good idea, because you're going to have to mention the people anyway when you're discussing the events. Similarly, I would subsume 'Societies' under history as well: again it's listy and the notability is questionable if you don't have it in prose (i.e. if it's just the name of the society with no other info). I also agree that the Current Practice section would be unnecessary, and it's so vague we wouldn't be getting consistent stuff with this as a guideline anyway. I'm also in agreement that there shouldn't be a textbooks and journals section: again it's listy, and I don't know if 'it's helpful' is that good of an argument. However, I'm not opposed to a 'Further reading' section. I'm also in favor of renaming 'Introduction' to 'Lead' and linking WP:LEAD. Lastly, I think we'd need to explain what 'Investigations' means if we're going to adopt this as a guideline, it's not clear to me anyway. delldot talk 18:19, 17 July 2008 (UTC)

OK, got it, struck my premature and clueless comment. Sorry for multi-tasking and not digesting carefully, SandyGeorgia (Talk) 19:43, 17 July 2008 (UTC)

Alternate proposal

With the above thoughts in mind, plus stealing ideas from MEDMOS, here's another proposal:

Lead - Introduction to the subject, see WP:LEAD
Scope - Scope of the specialty
Sub-specialities
History - History of development of field, including notable people
Training - Training around the world
Investigations - Investigations/diagnostics used in specialty
Treatments - Treatments used in specialty
Research - Research themes in specialty
Ethical and medicolegal issues - ethical and legal issues in field
See also - avoid if possible, use wikilinks in the main article
Notes
References
Further reading or Bibliography - paper resources such as books, not web sites
External links - avoid if possible

Thoughts? delldot talk 18:30, 17 July 2008 (UTC)

Sub-specialties (if any...) could be indented under Scope. Training looks perhaps misplaced, perhaps to bottom (above See also)? Or Ethical.., Training and Research as last 3. Research may need more frequent revision than the others, major points therefrom being moved up & included in History. --Hordaland (talk) 19:36, 17 July 2008 (UTC)

Yeah, I like the idea of having sub-specialties as a subsection of scope. How about investigations, treatments, training, research, ethical? That way you're keeping the more doing stuff-related topics together and the more abstract things (research and ethics) together. delldot talk 19:53, 17 July 2008 (UTC)

Better. How about "Scope - Scope of the specialty; identify important sub-specialities" rather than a separate subsection for subspecialities? WhatamIdoing (talk) 20:19, 17 July 2008 (UTC)

Hmmm, I just hoped that ethical is a part of doing ;-) No problem with your suggestion, delldot. --Hordaland (talk) 21:11, 17 July 2008 (UTC)

*Blushes* Good point. delldot talk 21:52, 17 July 2008 (UTC)

Scope - do people agree this should be included yes/no (just moving through the above template point by point)Justinmarley (talk) 18:22, 19 July 2008 (UTC)justinmarley

Pretty obviously has to be there. Perhaps someone wants to discuss the name of it - possibly the name of it varies among articles - but the content is necessary. IMO. --Hordaland (talk) 22:20, 19 July 2008 (UTC)

Why not, instead, ask about all the points instead of just one. The last 5 don't need discussion. Could do it as below. (If lousy idea, just delete.) --Hordaland (talk) 22:20, 19 July 2008 (UTC)

Scope, incl. subspecialties

I support this provided subspecialties is included as a subheading Justinmarley (talk) 23:30, 19 July 2008 (UTC)justinmarley

History, incl. people

I support this - should be perhaps towards the end of the document Justinmarley (talk) 23:31, 19 July 2008 (UTC)justinmarley

Logical to have History w/people early-on in these types of articles, I think. Ideally the section gives a timeline of what was known when, which is a helpful and interesting extension of Scope. --Hordaland (talk) 10:02, 20 July 2008 (UTC)

If history is at the beginning of the article then perhaps it should lead onto current practice or current service provision Justinmarley (talk) 18:52, 20 July 2008 (UTC)

Investigations/diagnostics

I support this Justinmarley (talk) 23:31, 19 July 2008 (UTC)justinmarley

Treatments

I support this provided it is written as treatment Justinmarley (talk) 23:33, 19 July 2008 (UTC)justinmarley

Ethical and medico-legal issues

I support this - should it be at the end of the article? Justinmarley (talk) 23:34, 19 July 2008 (UTC)justinmarley

Training

I support this - should there be a breakdown according to different geographical locations? Justinmarley (talk) 23:34, 19 July 2008 (UTC)justinmarley

Research themes

I support this Justinmarley (talk) 23:35, 19 July 2008 (UTC)justinmarley

Service Provision

I propose this as another section Justinmarley (talk) 23:37, 19 July 2008 (UTC)justinmarley

Do you have an example or two from existing articles? What's to be included here?

P.S. Why do you, Justinmarley, always sign your comments twice? The name before the time/date is sufficient, and the way most people do it. --Hordaland (talk) 10:06, 20 July 2008 (UTC)

The GP article (http://en.wikipedia.org/wiki/General_practice) is an excellent example. Thanks for the tip about signing by the way Justinmarley (talk) 18:49, 20 July 2008 (UTC)

Things that make you go "Hmmm" in the night

Editors are invited to consider the dispute at Talk:Liaison psychiatry. WhatamIdoing (talk) 05:52, 18 July 2008 (UTC)

My work on the Liaison Psychiatry article has hit a brick wall because there are no current guidelines on structuring information about specialties. We could use the Liaison Psychiatry Article as a pilot for developing a generic structure which could then be applied to other articles. Having such a structure would in my opinion be extremely helpful for medical articles which from the research I have undertaken and shown above, reveals a heterogenous group of articles. May I make a suggestion of going through the proposed list above, point by point, agreeing consensus on whether it should be included or not Justinmarley (talk) 22:26, 18 July 2008 (UTC)justinmarley

(belatedly) there are actually, I will try and sort something out. Cheers, Casliber (talk · contribs) 06:32, 11 August 2008 (UTC)

I've just written a long, B-class article: Sleep medicine. I tried to use the mal suggested on this Talk page, but could make the order of things fit only just sort of. I ended up with this:

• Intro
• Scope
• History
• Training and certification
• Diagnosis

• Tests and other tools

• Treatment
• [Research themes - not yet done]*
• [See also - none]
• References
• External links

* (Unless I can shorten the whole article appreciably, Sleep research will have to be its own article, just barely referred to here.)

(Still missing: almost anything in the 'round the world department. But that will necessarily be a large part of 'Sleep research'.)

Not to say that this is applicable everywhere, but, in this order, the sections lead into each other in this case. FYI. --Hordaland (talk) 10:54, 11 August 2008 (UTC)

Looks promising, just be bold and run with it. I was a bit hasty in saying there was a specific template, but this shouldn't be too difficult. it is similar to psychiatry..Cheers, Casliber (talk · contribs) 11:15, 11 August 2008 (UTC)

Pathophysiology

A few people have brought up in an article I'm working on that 'pathophysiology' is not a well-known term and might be confusing to lay readers. One has mentioned that it might be a problem for lay readers seeing it as a section header in the table of contents in an article about a disease. Do others agree that this is a problem? What else could it be called if it were to be changed? delldot talk 16:12, 16 July 2008 (UTC)

This is the first time I have come accross this concern in many years. I think that anyone with some experience in comprehension will be able to find out from the context what "pathophysiology" means. As a concept it is difficult to translate - it isn't "cause". "Mechanism of disease" is the terminology used by the NEJM. JFW | T@lk 17:20, 16 July 2008 (UTC)

It's absolutely not the first time I've encountered this problem; in fact, I systematically replace it with "Disease mechanism", with a redirect to pathophysiology. I do the same for etiology and cause. I think we should avoid these terms and adopt this practice of redirecting to them per WP:JARGON. --Steven Fruitsmaak (Reply) 17:29, 16 July 2008 (UTC)

Isn't that why the guidelines call for Pathophysiology or mechanism? SandyGeorgia (Talk) 17:42, 16 July 2008 (UTC)

I like "disease mechanism", but then for trauma articles you're going to have a "mechanism" and a "disease mechanism" section: "mechanism" would cover the physical forces (e.g. rotational or sheer stress), while the section formerly called "Pathophysiology" would cover the cellular events. delldot talk 17:57, 16 July 2008 (UTC)

Suggest 'Biological mechanism' to cover more than diseases, if that's the direction this goes in... LeeVJ (talk) 23:40, 11 August 2008 (UTC)

Biting the bullets

I have been working on hypopituitarism. Annoyingly, I find myself resorting to bullet points because any other way of enumerating facts about the different pituitary hormones just seems wrong. For the "causes" section I have used a table instead, but would value others' opinions on how to best present enumerative information. I am opposed to using level 3/4 headers for 2-sentence paragraphs. JFW | T@lk 13:00, 22 July 2008 (UTC)

Steven Fruitsmaak's view

I'd use boldface, like above. For very brief sections it's an alternative to bullets. I agree this is a though situation. I always have to force myself not to use bullets because it provides such nice structure, yet I managed to do so yesterday in enumerating the causes of coughing (although that list is even longer). --Steven Fruitsmaak (Reply) 17:41, 22 July 2008 (UTC)

Allopathic

User:SesquipedalianVerbiage has named MoS as his authority for introducing errors into the title of a reference. I find no such authorization. Would it be worthwhile adding a section about avoiding the word allopathic, primarily so that we can add a line about never changing direct quotes, titles of references, and so forth? WhatamIdoing (talk) 18:42, 24 July 2008 (UTC)

Seems to me that the word allopathic, with its definition(s) and apparently differing connotations, is not the point here. The approach you suggest could theoretically lead to adding rules about each and every word anyone ever introduces (or avoids) in direct quotes, including quoting of titles. There must be an overriding rule somewhere that such behavior is an absolute no-no; it shouldn't actually have to be stated but it probably is somewhere.

Looks to me that a preceding ref in the same article commits the same sin: it is titled Allopathic medicine, while the word allopathic doesn't appear on the linked page. (It is possible to find it on one of the subsequent pages.)

Manipulation of direct quotes in this way is intolerable. (Manipulation by partial quotes out of context is another question which may require discussion.) --Hordaland (talk) 02:24, 25 July 2008 (UTC)

You're right: Presumably such a rule already exists. But where is it? WhatamIdoing (talk) 20:02, 25 July 2008 (UTC)

Mnemonics

How do we feel about external links to mnemonics, such as seen in Auerbach's plexus? WhatamIdoing (talk) 00:16, 27 July 2008 (UTC)

They can probably be deleted, though they could be useful in supporting a mnemonic itself, as in RICE (medicine). --Arcadian (talk) 04:02, 27 July 2008 (UTC)

I appreciate finding them. Given that they are generally just links in an external link section, I would prefer to keep these around. Antelan 04:14, 27 July 2008 (UTC)

We've recently gone through a discussion about mnemonics in general, see this thread. I don't think external links about mnemonics are any different. JFW | T@lk 05:20, 27 July 2008 (UTC)

Whereas mnemonics on WP might be said to inexorably lead to listcruft, the same is not true for mnemonics not on WP. At the same time, one external link to a mnemonic, even if each medical article has one, is not problematic. And despite all this defense of mnemonics, I do not run a mnemonic website. Antelan 07:47, 27 July 2008 (UTC)

Drug navboxes

I've recently noticed that many of our drug navboxes use spaced hyphens ( - ) as list separators, which goes against the Manual of Style (and the conventions of decent typography :). I propose that all drug navboxes be standardized to use {{·}} instead of hyphens (or commas, etc.) Some templates (such as {{NSAIDs}}) already use the middot separator, as suggested in the documentation of {{Navbox}} and Wikipedia:Lists—let's make it a standard. Fvasconcellos (t·c) 17:39, 30 July 2008 (UTC)

Support. --Arcadian (talk) 20:03, 30 July 2008 (UTC)

Support. Much prettier too. JFW | T@lk 20:49, 30 July 2008 (UTC)

Weak support -- consistancy is important, hence my support. But comma-separated lists are more compact and as an example where the use of {{·}} will not look as good (and may mean having to spread the navbox over more lines) is {{Birth control methods}}. David Ruben ^Talk 23:51, 30 July 2008 (UTC)

• Well, that's a valid concern—but the difference is actually barely visible, except in the edit window; compare them both below:

—Fvasconcellos (t·c) 00:09, 31 July 2008 (UTC)

Well, since no one has really voiced any opposition, I'll go ahead and start implementing this. Has anyone though of the wording that will constitute the actual guideline? :) I though of something along these lines:

Navigational boxes should follow a standardized style. Items should be separated by a middot template ({{·}}) followed by a single space; the use of hyphens as list separators is not recommended. As when choosing article titles, drugs should be referred to by their International Nonproprietary Names, using piped links when required. More information about creating navigational templates can be found in the documentation of Template:Navbox.

—Fvasconcellos (t·c) 14:38, 3 August 2008 (UTC)

Are commas still OK as a secondary separator (in parentheses)? I think it makes nesting easier to read. --Arcadian (talk) 12:29, 4 August 2008 (UTC)

I don't see why not. Fvasconcellos (t·c) 14:27, 4 August 2008 (UTC)

Also, could you add something about the punctuation notes (§, ‡, etc) used at the bottom of Template:HIVpharm? I don't know who first introduced them, but I think they're very useful. But if we're going to use them, it would be good to document it as a standard somewhere. --Arcadian (talk) 17:30, 4 August 2008 (UTC)

And also -- this isn't just for the pharm navs, right? I'm assuming this applies for disease and procedure navs too, but I wanted to make sure. --Arcadian (talk) 17:33, 4 August 2008 (UTC)

I believe the footnotes were first introduced by Hopping (talk · contribs), though I'm not sure. I've since taken to using them, as has Carlo Banez, and they are now in place in several templates. There's a "traditional" order of symbols for sequential footnotes, although there isn't much consensus on what it is; Robert Bringhurst recommends asterisk (*), dagger (†), and double dagger (‡), and our article on footnotes has them followed by the section sign (§), double vertical bar or "parallels" (‖), and pilcrow (¶). The Chicago Manual of Style substitutes # for the pilcrow (*, †, ‡, §, ‖, #).

And yes, this would apply to all medicine-related navboxes. Fvasconcellos (t·c) 19:20, 4 August 2008 (UTC)

When will this be added? --Arcadian (talk) 12:26, 21 August 2008 (UTC)

I have added this content. --Arcadian (talk) 16:36, 22 August 2008 (UTC)

Thanks. I seriously neglected this after all the MEDRS hoopla below—will polish the wording tomorrow. Fvasconcellos (t·c) 02:18, 3 September 2008 (UTC)

Addition about primary research vs reviews

User:Leevanjackson added a note about reviews vs primary research. User:Paul gene reverted, saying "unnecessary addition. All changes to guidelines must be discussed on the Talk page first". I reverted again, because I think (a) this is a useful addition, and (b) there is way too much fuss about making changes to this page. If something is obviously a good addition (or even a good faith addition) that is likely to reflect consensus, we don't need to discuss for the sake of discussing. Three words come to mind: WP:BOLD, WP:SNOW, and WP:IAR. Your comments please. --Steven Fruitsmaak (Reply) 23:12, 9 August 2008 (UTC)

I am strongly against it. I do not think WP:BOLD and WP:IAR should be boldly used to ignore others opinions. This addition is obviously not good and unlikely to reflect the consensus. For example, in the field of psychopharmacology the reviews are often written by hacks sponsored by pharmaceutical companies. The only way to obtain objective information is to read the original publications. Paul Gene (talk) 23:58, 9 August 2008 (UTC)

Paul, this has been consensus for months. You are using an exception to prove a rule. A review is reliable (because it is published in the peer-reviewed literature) unless there are clear factors against it. For this, you have been granted editorial judgement. JFW | T@lk 08:11, 10 August 2008 (UTC)

I also agree with Steven that WP:SNOW applies here and that you might need to stop reverting against three independent editors. JFW | T@lk 08:11, 10 August 2008 (UTC)

Several points. First, there have been no consensus on MEDRS on this point, just more loud editors prevailing. Second, MEDRS is far from becoming a guideline. And I do not see why we should abide by what was supposedly decided there. That page was dead for about a year, so nobody was watching it. The recent burst of activity on MEDRS is very limited and they even did not cross post here. Third, the idea that reviews are somehow better than original papers is batty. The pharmacology area, where, in addition, powerful money interests are involved only illustrates the general rule. Fourth, I am all for the editorial discretion, so why do we need this questionable clause? How does it make editing easy? Paul Gene (talk) 10:20, 10 August 2008 (UTC)

I'd like to make two points:

1. This is a style guideline. I purposely split WP:MEDRS off to a separate page: issues of style and issues of sourcing are distinct. Plus, the sourcing issues are more contentious so would have made this style guide less likely to be formally adopted. The "Citing medical sources" already has a link to WP:MEDRS at the top. Therefore, I agree with Paul that this is an unnecessary addition, but for completely different reasons.
2. WP:MEDRS has always preferred secondary sources (and did so when it was part of the draft MEDMOS, which is more than two years ago) and this is in keeping with WP's WP:V and WP:NOR policies, the latter of which says "Wikipedia articles should rely on reliable, published secondary sources." I don't really understand Paul's argument that the industry sponsored secondary sources are betterworse than the (industry sponsored) primary sources. Find some independent sources, then! They'll likely be secondary sources.

If other folk want this statement, as a précis of MEDRS, then I'm happy to include it, as it most certainly does have wide WP consensus behind it. Indeed, if MEDRS said to prefer primary sources, then it would be in opposition to policy and be most certainly rejected by the community. Colin°^Talk 11:07, 10 August 2008 (UTC)

Leevanjackson made a very useful contribution. The paragraph before his addition simply stated that sources were important because some medical topics are controversial. This statement begs the question on what kind of sources is then the most useful. The answer is: find the best secondary source you can find. Links to WP:PSTS and WP:MEDRS are entirely appropriate here.

To answer your specific points:

1. In MEDRS, not only the loudest but also the most experienced contributions (including someone very involved in the featured articles process) have prevailed. If you have a problem with MEDRS, your arena is there and not here.
2. MEDRS was resuscitated because many felt a need for a clear set of rules that could be applied across medicine-related articles. It still attracts edits, and there is quite a lot of support for it becoming an official guideline (see talk page discussions 5-6 August). It was featured in the Signpost. What else do you want?
3. I have taken your point on board about some areas of medicine having reviews that are sometimes biased. That does not invalidate the general rule that primary studies typically provide insufficient context to be useful sources on their own.
4. As I said, there is an element of editorial judgement in the selection of secondary sources. But secondary sources are simply mandatory, as your interpretation of the primary sources might be just as biased from your own perspective. JFW | T@lk 11:17, 10 August 2008 (UTC)

• Here are some quotes from MEDRS discussion showing that there have been no consensus: Paul Gene (talk) 11:29, 10 August 2008 (UTC)

Quoted discussion from MEDRS

WP:MEDRS seems to be at odds with WP:MEDMOS; MEDMOS encourages the use of PubMed references, MEDRS implicitly discourages them. WP:MEDRS states:

In general, Wikipedia's medical articles should use published reliable secondary sources whenever possible. Reliable primary sources may be used only with great care, because it's easy to misuse them. For that reason, edits that rely on primary sources should only make descriptive claims that can be checked by anyone without specialist knowledge. Any interpretation of primary source material requires a secondary source.

In my opinion:

The above (in WP:MEDRS) should be further qualified. Primary sources, IMHO, are accessible to an interested layperson, with the vast amount of credible medical information (e.g. Merck Manual, eMedicine, Medlineplus.org, |Canadian Health Network) out there and the strong base of Wikipedia articles that cover topics in medicine and experimental physiology. Primary sources should be the key references-- secondary sources should be considered supplemental. Primary sources should be explained -- like any good secondary source for the lay public. Good secondary sources base their info from primary sources. I think Wikipedia has enough people with expertise to deliver nuanced interpretations of primary sources that can compete handily with respected secondary sources. Use of secondary sources from PubMed (i.e. review articles) should be encouraged. [...] Nephron T|C 06:12, 24 June 2007 (UTC)

I wonder whether that's an old policy which is now outdated as the 'pedia continues to grow in depth. I don't worry about it myself and often use primary sources as do many others. Have a look at alot of FA nominees.cheers, Casliber (talk · contribs) 06:17, 24 June 2007 (UTC) It seems like a non-sensical sentiment to dismiss pubmed indexed articles as preferred sources. I agree, however, that people who are unfamiliar with some areas will use refs. out of context to prove this or that. The expertise of editors in some of these specialty areas helps to filter the wheat from chafe. Secondary sources like standard medical textbooks, positions of health ministries (eg. FDA, health Canada) etc. can be used to bring contextDroliver 15:37, 24 June 2007 (UTC)

[...]I don't think we should deprecate primary sources (since they're so vital to explaining any medical topic), but I do think we should insist on something along the lines of, "The use of primary sources (e.g. journal articles) is encouraged on medical topics, but interpretations of these sources should hew carefully to that presented by the authors or by reliable secondary sources such as review articles and medical textbooks." This might discourage the inevitable idiosyncratic usage of primary sources while still encouraging their general inclusion. Thoughts? MastCell Talk 15:54, 24 June 2007 (UTC)

[...]The question is: is a reviewer necessarily more credible to comment on the prior science than a researcher discussing a primary study, all else equal? I don't think so -- although there may be a small bias, I don't think the reviewer should be considered immune to these biases. Now, systematic reviews help to eliminate bias by forcing the reviewer to be precise and evaluate all studies -- but these are uncommon, and still susceptible to bias. In summary, more importance should probably be placed on the date of the publication and the comprehensiveness with which it approaches a topic. Very broad reviews are likely to miss important details which specialized papers will discuss. ImpIn | (t - c) 06:44, 28 June 2008 (UTC)

[...]How do you judge what's a quality review? This review is published by the BMJ, but it does not seem high-quality. It is so broad that it offers little, if any, analysis or explanation for why it selected the studies it did. You seem to have this obsession with being mentioned in a review -- but if that review does not explain why it selected the studies it did, it should not be taken as bestowing more credibility on that particular study. The selective citation and discussion of primary studies is an asset when you're trying to report on scientific analysis. II | (t - c) 01:43, 30 June 2008 (UTC)

[...]What makes a review better at evaluating than a primary article? It's the extent of the evaluation and similar studies which matters, not the "review", which whether it is mentioned in a review, which is just a label.[...]I don't agree with the general censorship attitude which is spreading across Wikipedia. MEDRS says that primary studies have less weight; quite right. But several primary studies have more weight, whether they're mentioned in reviews or not. And even only 1 study on a particular subject doesn't mean it shouldn't be included in the article -- nor does MEDRS say that, although people persist in trying to say that such a position is necessary.[..]As far as pushing a point, most reviews are published by people who have published primary articles, hopefully several. Thus they are not immune from bias. II | (t - c)

[...]There is nothing in MEDRS which says you cannot cite primary studies, especially remarkable ones like these. You're actually pushing for a policy which does not exist. The current policy even says that popular press articles can sometimes be cited, and here you're fighting tooth and tail against the addition of remarkable primary studies.

Note: I stand by my censorship comment; whether the censorship is intentional or not, it amounts to censorship. In case you haven't noticed, I'm not at Wikipedia to win popularity contests. You're appealing to your own fictitious policy to keep interesting, encyclopedia worthy-content out of the encyclopedia. Further, this impels other people to do the same, and allows people to justify censorship (recent example). Wikipedia is not conservativopedia; if Einstein had published his paper on Relativity today, we would not want to "wait until it is verified" to note it. There's no reason for that position. There's no rule that a study has to be replicated "or noted in a high-quality review" before it gets noted on Wikipedia. Sure, reviews get greater weight, but when they aren't available, individual studies are citable. Somehow MEDRS even allows for popular press and press releases, as well. II | (t - c) 14:26, 30 June 2008 (UTC)

[...]We should absolutely cite relevant primary studies, but they should not fundamentally drive coverage, particularly of controversial issues.[...] MastCell Talk 19:13, 1 July 2008 (UTC)

[...]I don't understand how/why the introduction/discussion sections of primary articles are categorically "much less reliable" than reviews. In general, what I've read lately suggests the exact opposite. Categorical statements to this effect are misleading. Now, we can all point to examples. I can show you 3-4 poor review articles right now, out of the 5-6 that I've read lately. Many reviews, unfortunately, seem to describe primary articles briefly rather than analyzing them. The reality is that reliability is, as it should be, more connected to the author than the type of publication. This can be assessed by looking at how many papers the author has published on the topic. "Review", "primary article" -- these are simply labels.[...]In general, you may have a better chance of hearing from the real experts, and hearing their in-depth analysis, in the discussion sections of their papers. The subpar "experts" may be more likely to publish reviews than to do "primary research". And these reviews cover such a wide range that often they just describe them in simple sentences, which offers no value over the article's own abstract. II | (t - c) 04:30, 2 July 2008 (UTC)

[...]Thing is: people look to here, and can stonewall you with a few curt words like "look at MEDRS, primary articles are significantly worse, can't do it". In fact, when I tried to put in the above article, SandyGeorgia objected that we need to use reviews.[...]I'd like to hear your reasoning for why we should generally place more weight on the label "review" vrs "primary article" rather than the article's author and content (does it cite lots of sources? does it rigorously analyze those sources? is it understandable by a non-expert?). So far there's been no evidence provided for this general assertion. II | (t - c) 05:28, 2 July 2008 (UTC)

[...]Specifically, I have provided a counterexample to the claim that reviews are more reliable (Hauser is not only a published expert on HRQOL, but his primary paper cites more sources). I can produce many, many more examples if necessary, although my library is fairly weak, and it would take time. Further, I have provided reasoning for why primary articles are often superior: the real experts are publishing primary papers rather than reviews, and these primary papers, since they specifically focus on a single issue, often cite more literature on that topic with more rigorous analysis of the validity of the research. You're operating on assumptions. Please provide evidence (or at least reasoning) for your claim that primary articles are less reliable than reviews. II | (t - c) 06:08, 2 July 2008 (UTC)

[...]I suggested to Eubulides that he look at what the academic community says about reviews. I've found some studies. PMID 1834807 (1991) discusses a system used to rate reviews. This could be of significant use for us, as we need to evaluate reviews. It would be interesting to see where this has gone. Related links in PubMed has a vast amount of related articles. PMID 9496383 (1997) finds that most reviews are hardly systematic (this is a bad thing). PMID 10610646 (1999 - free access) finds the same thing. PMID 17606172 (2007) focuses on meta-analysis, but finds improvement. PMID 16277721 (2005) says meta-analyses are generally poor. PMCID 1602036 (2006) evaluates Cochrane reviews vrs industry reviews -- obviously, industry reviews are worse. PMID 9092319 (1997) is a guide for finding systematic reviews. PMCID 2379630 (1993) specifically compares OR and reviews. It notes that the answers provided by broad reviews should not be accepted uncritically as valid. Conclusion: Certainly, as my original edit to MEDRS reflects, reviews should generally get priority over primary articles -- but people need to recognize the difference in reviews. Most reviews I've seen are not systematic. Here is an example of an overly broad review. These reviews are less reliable than OR in many cases, since they are often both written by an outsider and give cursory attention to many complex issues. Eubulides has argued that systematic reviews should not get priority; this is directly contradicted by the scientists, and does not make good sense.[...] II | (t - c) 10:08, 2 July 2008 (UTC)

I could go either way on this. Just because something is labeled a "review" doesn't mean that it's really a review, much less than it's a good one. I've seen case studies with a sample size of one labeled as reviews. (I know: several of you are horrified. But it does happen.) I'm also not convinced that when Joe Smith, PhD, writes his "review", that it's materially different from the summary that Joe Smith, PhD, put in his ground-breaking, world-changing paper last month. I think that a substantial level of editor judgment is required here. WhatamIdoing (talk) 06:23, 10 July 2008 (UTC)

Generally good (groaning because I got the opposite advice years ago and replaced a lot of review sources with primary sources on Tourette syndrome, and now I'm going to have to spend hours checking and undoing some sources, and often, the review papers are inferior). But ... when a primary research paper is replicated and cited over and over again in every review and is seminal research in the field, and we don't want to lose that source, is it ok to occasionally cite both? In the case of TS, for example, PMID 9651407 is primary research, we have free, full text linked, and it is seminal in the field and widely cited in every important review (there are other examples). I hate to lose the free, full text link in the article. SandyGeorgia (Talk) 20:20, 10 July 2008 (UTC)

I have some significant concerns about this, perhaps mostly because of the way "rules of thumb" turn into sweeping, iron-clad requirements after a few months, and perhaps because I get the feeling that none of you have any connections to people who write reviews and therefore put too much faith in them. Sure, if you're only working on articles about congestive heart failure and colon cancer and other common conditions, then the concepts here make a great starting point. However, this isn't going to work at all for very rare diseases, where a well-written case study from twenty years ago may actually be your most reliable source. Consider ODDD. I know: you've never heard of it. But go search for oculodentodigital at pubmed.gov, and limit your search to the last five years. You'll get thirty-five (35) papers. The only "review" on the disease in the last five years (as opposed to the genetics and physiology that underlie the disease) is actually a case study involving three patients. It's dated 2004. I don't expect a better review to appear in 2009, or even by 2014. My expectation is based on the fact that there have apparently never been any proper reviews published for this condition. And what is the first thing the editor reads here? "Do not cite primary sources" -- the only sources that exist for this disease.

This also isn't going to work well for many aspects of uncommon diseases. For example: consider some third-string treatment for an uncommon cancer. You've got a twenty-year old paper that gives you a success rate. It's the only randomized controlled study ever done using the specific treatment in this specific cancer. The recent review cites this paper and summarizes the conclusions in two words: "poor prognosis." According to this, the actual survival rate is suddenly not important, because the study was done before the review, and the review doesn't re-report the actual numbers. Is that what you really want? To put an expiration date on data?

I also think that citing any study that is mentioned favorably in recent reviews should be acceptable. For one thing, we get more detailed articles that way. For another, if the original article is retracted, then we know what we need to change. A review that cites Hwang Woo-Suk favorably is not going to be retracted just because the world later discovered that this Korean scientist fabricated much of his stem cell research.

As ImpIn points out, this scheme works poorly in cases where the recent reviews only cover certain aspects of a disease. I frequently see very good reviews in terms of treatment, and that also completely neglect epidemiology. It's hard to find epidemiological information for less developed countries. Sometimes the best we can do is a rather old paper. The fact that an American or European author skips over the prevalence of a disease in Africa or South Asia doesn't mean that this kind of information unimportant for our worldwide encyclopedia: it means that the review is incomplete. In very common diseases, nearly all of the reviews are deliberately incomplete: you'd write a review on a specific aspect or sub-type of hypertension, because otherwise your review would be the length of a book. I won't say that the authors are necessarily biased because of this -- but reviews cannot be assumed to be complete.

Finally, this advice is completely wrong for history sections, for what ought to be perfectly obvious reasons.

Yes, I know: you only meant this to apply to certain "actively-researched areas with hundreds of primary sources and dozens of reviews". But it's not actually that obvious to those who don't already know what you intended to accomplish. The first thing the editor reads is "Do not cite primary sources." As written, I don't think that this communicates what I think you want to say.

I don't mind stating a general preference for recent reviews, although I still prize editor judgement and a good final product over mindless compliance with rules. I could probably support a system of rules like this if it were clearly stated that this guidance only applies to the sections of an article that deal with current practice in diseases where proper reviews are readily available. I might also add that primary papers aren't bad in themselves, so long as they don't actively contradict all of the recent reviews. Fundamentally, I think that if we're going to publish this, then the caveats and restrictions need to go first, not last, and they need to be stated more strongly than the guidance. For example, "Do not cite primary sources..." should be "Consider citing a recent, comprehensive review in a reputable journal instead of older primary sources." The section might begin with the sentence about this advice only applying to articles on actively-researched areas with hundreds of primary sources and dozens of reviews, although the general principles might be applicable in some less common diseases. WhatamIdoing (talk) 02:52, 11 July 2008 (UTC)

Colin: I have the unpopular habit of citing many primary sources, and I really don't see why you would cite a review if you mention a study from 1999. That's very confusing for readers.The reason I mix reviews with a lot of primary sources is because is usually start writing with 2 to 3 review articles or books, UpToDate etc, and for most specific statements (especially high quality evidence, e.g. RCT or meta-analysis in high-ranking journal) I cite the same primary sources as the review cites. This might be "wrong" but I myself would prefer to read an article which cites a lot of primary high-quality evidence rather than a handful of reviews. --Steven Fruitsmaak (Reply) 12:31, 11 July 2008 (UTC)

Please, Paul, let's move this discussion where it belongs: over to WT:MEDRS. Colin°^Talk 12:21, 10 August 2008 (UTC)

Paul asked me to comment on this discussion. I suspect that he expects me to support his view. He loses that bet.

I support the rule as stated in MEDRS. My concerns (carefully selected parts of which are quoted above) have been adequately addressed.

I have no objection to the MEDRS version of WP:PRIMARY being briefly summarized here with a link to MEDRS. I saw and approved of the addition to this page when it was made. Since there is only one (1) editor who objects to this, and many that support it, I have restored the addition.

While this was the obvious page to start this discussion, I also second Colin's suggestion that anyone who wants to discuss MEDRS rules should continue the discussion on MEDRS's talk page -- or even at WP:No original research, because that's where this rule *really* lives. WhatamIdoing (talk) 17:57, 10 August 2008 (UTC)

I've pointed out several times that primary articles are undeniably secondary sources for much of their information, but it just doesn't seem to stick. It is better to call them "original articles" to avoid stating a falsity. There is a discussion ongoing at WT:OR that even the primary research in original articles can be called secondary, because the real primary source in these cases is the data. Reviews are good, but I agree with WhatamIdoing that we need to make the caveats clear from the start, so we don't confuse people into thinking that reviews are categorically better than original articles. I also think we should promote analysis of reviews through some of guidelines used by researchers themselves. Overly broad reviews are not great sources, and reviews which seem to cherrypick from the literature from the literature are even worse. I ran into this over at Alzheimer's disease, where there was a great 2007 review of the aluminium connection from the Journal of Alzheimer's, which looked at 20 epidemiological studies, 15 of them positive, and concluded that there is a clear role. It was contradicted by an extremely broad 2007 review from Occupational Health which stacked 3 aluminium studies, all negative, on top of its analysis of electromagnetic fields, solvents, and everything else. There's also a problem of some reviews not adding much value to original articles, just citing them. In that case, I'd prefer to cite the original article, and I think there are a lot of people that agree with me. Citing both may be good as well. II | (t - c) 19:13, 10 August 2008 (UTC)

We are aware of your position, ImperfectlyInformed. Could you now please go discuss this on WP:MEDRS? With regards to your aluminium example: how often do I need to repeat that editorial judgement is needed in selecting reviews, and that in your case both reviews should be cited? JFW | T@lk 19:39, 10 August 2008 (UTC)

JFD, it was you who brought this debate to MEDMOS. Moreover, when in violation of the guidelines you made this addition, you stated that a consensus has been formed about reviews being better that the original research papers. Now you assert that you are aware of II's position, so you are aware that there is no consensus. Perhaps, you should revert yourself. Paul Gene (talk) 20:11, 10 August 2008 (UTC)

WhatamIdoing, my bet was that you would present a reasonable argument whether pro- or contra- the addition. I lost it. I would gladly discuss the problems of primary vs secondary sources at MEDRS, but the problem was that the addition was made to this page. I do not see the reason why this a page (an established, years-old guideline) should abide by the decisions made at MEDRS page, which is essentially an essay, and which was all but dead until a month ago. Paul Gene (talk) 20:24, 10 August 2008 (UTC)

Eh? It was Leevanjackson who added the précis of MEDRS, not JFD. Also, nothing that II says disagrees with:

Where possible, it is preferable to reference review articles or other secondary or tertiary sources instead of primary sources

Note the "or other secondary...sources", which includes the "background" section of a primary research article (even though there have been well-argued points made that such sections aren't first-choice secondary material). I've actually just noticed the "or tertiary sources" bit, which isn't actually what WP:MEDRS says. I'd recommend that clause is dropped as tertiary sources (while permissible) are not encouraged on WP. Colin°^Talk 20:32, 10 August 2008 (UTC)

JFW returned it so he supports guidelines violation. I actually think that full paragraph in MEDRS sounds better than what leevan posted here. Your note brings back my point that he should have posted the addition here before changing the MEDMOS guideline. I also voted against giving WP:MEDRS guideline status - it is too raw Paul Gene (talk) 20:47, 10 August 2008 (UTC)

I was the third editor to support the addition, after Leevanjackson and Stevenfruitsmaak. Do pay attention. It's just that I have perhaps been more vocal in opposing your stance here. I have justified why we need guidance on sources here, and on MEDRS you are the first editor to oppose its approval as an official guideline. And that because you think a small proportion of secondary sources in your field of interest might be biased. It would be useful if you could try to see the bigger picture. JFW | T@lk 21:30, 10 August 2008 (UTC)

Sorry guys, didn't think it would cause an argument quoting from one of the main style guides! I read this style guide a while ago and happily edited away finding primary refs, but when an article came to GA review the point was raised that it did not use enough secondary refs, so had to trawl through all the old edits and refs finding better reviews - a few turned up better facts and made it clear that the occasional primary source, taken out of context with other research, can be very misleading... I changed the wording to be 'where possible' to reflect the projects preference - maybe I should have added 'and appropriate' too. The intention was to lead editors, reading to this level of the guide, in the rough general direction, to save them the time I wasted :( The arguments should really be raised in the broader guidelines, since they'd have to be accepted there to be applicable at all, wouldn't they? Also I'd like to edit out the 'or tertiary' since it is wrong but am afraid to cause further bother! peace LeeVJ (talk) 22:37, 10 August 2008 (UTC)

I don't really mind saying that reviews are preferable, and I agree with Colin that tertiary should be dropped from it. II | (t - c) 23:08, 10 August 2008 (UTC)

For the record, I am perfectly fine with the addition. This seems to be de facto practice for many editors, and certainly is for me; I always try to use high-level evidence from recent (secondary) sources when building content, and fall back on primary sources when secondary ones are scarce or could be less informative than primary ones (for historical information, etc.). MEDMOS is a guideline, and, as such, does not trump common sense :) Fvasconcellos (t·c) 00:10, 11 August 2008 (UTC)

Paul gene left a post on my talk page and asked me to comment. I share Paul's concern about the influence of industry on the medical literature. That stated, I think reviews are better because they more often reflect consensus.

There are a lot of papers that are on the margins and lay people, if selectively reading and referencing, may totally get the wrong impression (if reading just the primary literature). The best example of this, IMHO, is Bjorn Lomborg's book The Skeptical Environmentalist. Another example is the role of vaccination in autism-- I personally think it is hooey to be frank, but there are a few papers that show the association (which is temporal) and suggest causality.

Stated differently, if one picks and chooses from the primary literature one can draw erroneous conclusions. Scientists and medical doctors don't have a perfect batting average-- some studies have problems. Reviews and meta-analyses examine the primary literature, look for consensus and attempt to get an overview. In the context of Wikipedia, reviews are the most appropriate choice. If only one reference is added-- a review is better than the primary literature. Personally, I think there is a place for primary sources but it should be limited (e.g. large studies -- Framingham Heart Study, Women's Health Initiative, Randomized Aldactone Evaluation Study (RALES), articles in leading journals with disclosure rules that have not faced severe criticism like PMID 11172175 --which the The National Inquirer used to poke at Bill Clinton post-CABG).

Personally, I don't always cite review articles-- but this is not on principle. I like to cite open access work-- something I worked on getting into citing sources‎[1] --with agreement of a majority... but was reverted many times[2] by someone that spends more time on WP than I do. Often, it is convenience-- I find primary articles that say what I read elsewhere (in a book I have)... so, I use 'em. Nephron  T|C 03:24, 11 August 2008 (UTC)

• Guys, thank you for commenting on this issue. I see that I was wrong about there being no consensus on the secondary sources. Your comments also dispel the personal attacks by JFW who suggested on my Talk page that I was somehow trying to stack the voting. I think apologies are in order. Additionally, we see here that most of the editors are opposed to the inclusion of tertiary sources. That proves my main point that all edits to guidelines must be first discussed on the Talk page. Without such discussions, boldly ignorant text of poor editorial quality gets included into the guidelines. Please, let's respect the work of many editors who put these guidelines together and avoid such edits. Thank you Paul Gene (talk) 11:04, 12 August 2008 (UTC)

Tertiary sources have their place, and we aren't rejecting them -- just not encouraging them. A medical dictionary is a tertiary source and also an excellent source for the definition of a medical term. WhatamIdoing (talk) 18:44, 12 August 2008 (UTC)

I was voicing what I thought were legitimate concerns. That is not a personal attack, and consequently no apologies will be extended. JFW | T@lk 22:10, 12 August 2008 (UTC)

Sorry, but I do require an apology though... Please direct personal comments on my editing to my talk page. In response : I am respectful of editors, you're ALL fantastic ! :), but sometimes what seems an obvious and uncontroversial edit may be considered contentious by specialists, and I believe being WP:BOLD prevents stagnation and can always be reverted anyway, so I won't stop:- but I will try to be more careful in future ;) LeeVJ (talk) 23:51, 12 August 2008 (UTC)

Other than the recent addition of tertiary sources, the page seems fine now. SandyGeorgia (Talk) 15:25, 13 August 2008 (UTC)

oopsie, backwards, tertiary is gone now, good; we may occasionally use them, but not optimal. SandyGeorgia (Talk) 15:27, 13 August 2008 (UTC)

Sections for birth control articles

I have proposed a standardized section order for birth control articles (like currently exist for diseases and drugs) at Wikipedia talk:WikiProject Medicine/Reproductive medicine task force#Section order and naming in contraception articles. I hope that such a standard would also be useful for some medical devices or tests, but even restricted to the contraception articles consistent formatting should improve our quality and readability. It is just a proposal at this point and I'm not attached to any particular order; any comments would be welcome. Lyrl^Talk _C 01:12, 11 August 2008 (UTC)

Paul gene

Paul gene (talk · contribs) has now come along and expanded on the summary of WP:MEDRS. I think the additions completely misrepresent previous consensus at MEDRS:

• Previous-work sections in primary papers are useful as secondary sources
• Editorial judgement should be used to choose between primary and secondary sources.

Paul's problem is that he doesn't trust secondary sources, because they might be biased. But I think consensus at MEDRS has been that neither of the above points apply. "Previous work" sections tend to be fairly focused on one particular aspect of a disease or phenomenon, and very often do not discuss problems with previous studies in sufficient detail.

What I have previously tried to explain is that there is really no alternative for secondary sources. They are crucial. Sometimes it is acceptable (or even necessary) to cite primary studies, but always with a supportive secondary source that confirms the relevance of the primary study. If there are several secondary sources, it is up to the editor to apply editorial judgement in deciding which one is more suitable (i.e. less likely to be biased). JFW | T@lk 00:53, 15 August 2008 (UTC)

Agreed. SandyGeorgia (Talk) 01:03, 15 August 2008 (UTC)

After your colon, you have two bullet points. Are you saying those bullet points are the consensus at MEDRS, or that Paul is misrepresenting them as the consensus? Because I think the former is true, but the latter is not. The diff. Paul is simply stating what is stated on MEDRS: previous work sections are secondary sources (primary articles can have a lot of secondary information), and editorial judgment is necessary. That's what his change is. If you're opposed to that, then why did you allow it to be added to the MEDRS article? Primary articles are secondary sources for lots of information. That is indisputable. The question is whether they are good secondary sources, and I think that in many cases they are. As I've showed, and in my limited (and perhaps Paul's more broad experience), previous work sections often go into more detail than a review on the previous studies, and their flaws. When you're studying something specific, you will naturally discuss the specific relationships with previous studies and their findings. In reviews, you're more likely to skip the fine details. I support Paul's change. II | (t - c) 01:05, 15 August 2008 (UTC)

I knew you would support Paul, and I think it goes without saying that my bullet points summarised Paul's stance rather than MEDRS. I think there are two issues: does Paul's edit reflect consensus, and should MEDRS contain these points. I think the answer to both questions is "no". I continue to oppose your position on using "previous work sections" as secondary sources. They are secondary sources, but bad ones. They may contain lots of information, but much of the time the actual context will only be supplied by a review that is written with the intent of being a review. With regards to the fine details, since when do we need to include fine details on Wikipedia? JFW | T@lk 01:46, 15 August 2008 (UTC)

The two caveats I inserted are important, and they are necessary to include here insofar as the secondary vs. primary guidelines prescription is included.

• First, the definition of the secondary sources adopted at MEDRS includes the previous work sections of the research papers. This definition, which differs from the definition at WP:NOR, was instrumental in achieving the consensus at MEDRS and it does represent the consensus at MEDRS. Thus is must be presented here and a simple reference to WP:NOR would not suffice.
• Second, there are many exceptions to the "secondary sources are preferred" rule. Thus, in the process of adoption of this rule, through several discussions, many editors at MEDRS insisted that editorial judgment is essential. I believe that the importance of the editorial judgment should be made explicit. This will help the less experienced editors and will also prevent some of the editors from blindly following this rule and thus creating problems for others. The text of the caveat - "Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment, and should be discussed on article talk pages." - is taken verbatim from WP:NOR. It represents wide consensus of the WP editors; moreover, it was placed at WP:NOR following the same reasoning as I am presenting here. Paul Gene (talk) 01:35, 15 August 2008 (UTC)

MEDRS goes further than NOR, and for good reasons too. Because abuse of sources is the hallmark of pseudoscientists, and setting strict standards is a very useful tool in keeping them at bay. You must symphathise with that. There is not a single word on the WP:MEDRS page that supports the use of "previous work" sections. There is also no consensus for such a statement; I am really curious where you have found this consensus you are referring to.

I stated that editorial judgement is applied only when choosing secondary sources. Again, MEDRS goes further than NOR here and for the good reason that it is not too difficult to twist a primary source to your advantage if you're a crank. So I take your points about NOR but I submit that MEDRS is stricter for reasons I have stated. Incidentally, MEDRS presently has the scope to deal with the kind of sources you don't like (reviews written by drug company pawns). JFW | T@lk 01:46, 15 August 2008 (UTC)

Type CTRL-F on the MEDRS page, and then type previous work. This was discussed and nobody raised a fuss. There are many, many cases in which the only reviews available are shoddy or out of date. Also, the fine details are very important. The "devil is in the details" is an apt cliche. Also, how does MEDRS have that scope? II | (t - c) 01:56, 15 August 2008 (UTC)

Don't be so obvious please. The page states unequivocally that "previous work" sections are regarded as less reliable. I'm not keen to have the same discussion with you again and again, because it is really too straightforward for words. MEDRS most certainly has the scope it has because it carries wide support (apart from Paul, because the discussion happened when he wasn't watching). JFW | T@lk 02:06, 15 August 2008 (UTC)

What do you mean by so obvious? II | (t - c) 02:10, 15 August 2008 (UTC)

You are presenting the use of "previous work" sections as uncontroversial and supported by MEDRS, while the guideline itself actually says pretty much the opposite. That's what I mean by "so obvious". JFW | T@lk 02:15, 15 August 2008 (UTC)

The change under discussion would give license to all-too-common abuses in medical articles, and should be rejected for that reason. Also, as a matter of procedure, this was a controversial change made without discussion on the talk page; that's not the right way to go about things here. Eubulides (talk) 02:12, 15 August 2008 (UTC)

Eubulides, I wonder where you were when I tried to revert a controversial change made without discussion on the talk page. Paul Gene (talk) 10:13, 15 August 2008 (UTC)

This conversation is no longer about MEDMOS. This conversation is about Paul Gene's dislike of the MEDRS guidance. This conversation should therefore be continued at WT:MEDRS instead of here. WhatamIdoing (talk) 17:58, 15 August 2008 (UTC)

Fully agree with WhatamIdoing. Paul, you do yourself no favours by lecturing us on "discussion prior to editing of guidelines" and then breaking this rule. And removing text ("instead of primary sources") while calling the edit "necessary additions" isn't fair play. Colin°^Talk 19:44, 15 August 2008 (UTC)

WP:NOR vs. WP:MEDRS

I understand that JFW disagrees with WP:NOR. He disagrees with the definition of secondary sources given by WP:NOR. He disagrees with the sentence "Deciding whether primary or secondary sources are more suitable on any given occasion is a matter of common sense and good editorial judgment, and should be discussed on article talk pages." As a matter of procedure WP:NOR is a Wikipedia policy and thus trumps the essays like WP:MEDRS. WP:NOR represents much wider consensus than the "consensus" of several editors grouped around WP:MEDRS. But of course you are going to boldly ignore the policies when it is convenient for you. Paul Gene (talk) 10:25, 15 August 2008 (UTC)

MEDRS is a guideline that is in the process of approval. It elects to be stricter than NOR, for good reasons. That's what I said above, and I'm repeating it here to refresh your memory. That is not "boldly ignoring policies", that is setting standards. I'm surprised you are singling me out, but that's probably because I have been more forceful than others. JFW | T@lk 13:10, 15 August 2008 (UTC)

And experience in the field is part of good editorial judgment. It would not surprise me if, in general, selective use of primary sources were a more serious problem in some fields than in others; those fields should be more cautious. Septentrionalis PMAnderson 15:25, 15 August 2008 (UTC)

I'd like to know why this discussion about content keeps happening at the style guideline talk page. N.B.:

• We do not change MEDRS through a discussion at MEDMOS.
• Style guidelines are secondary to content guidelines. Wikipedia is not best served by having its style guidelines contradict its content guidelines.

I conclude that anyone who wants to actually change the guidance about medical sources will promptly take his concerns to MEDRS and leave this page alone.

The only question that really needs discussing here is whether this style guideline accurately reflects the minimum amount of text (not "my personal view of what the consensus might be") at MEDRS necessary for a newbie editor to have half a chance at getting things right. I'd say that the current, very minimal text is about right. WhatamIdoing (talk) 17:57, 15 August 2008 (UTC)

Again, I agree with WhatamIdoing that this minimal amount of text is a reasonable "nutshell" of MEDRS. In fact MEDRS doesn't have a "nutshell" banner so if folk want to discuss that then you know where to go.

Can we please, please move sourcing discussions to the relevant talk page. Perhaps this page is being used as it is a guideline and the other isn't (yet). I am most perplexed about this perceived need to contaminate this guideline page or, indeed, to suggest that MEDMOS/MEDRS are in conflict with WP:NOR. Two sentences from WP:NOR actually summarise MEDRS nicely:

Wikipedia articles should rely on reliable, published secondary sources. [full stop!] … Primary sources that have been published by a reliable source may be used in Wikipedia, but only with care, because it is easy to misuse them.

I disagree with JFW (in a good way) that "MEDRS goes further than NOR"; it simply helps one apply the above advice. Colin°^Talk 19:56, 15 August 2008 (UTC)

The pathogen vs. the disease

We really need to make a decision here. How do we separate the article about the pathogen from the article about the disease? It happens time and again, and we have discussed it here without resolution. But if we're really going to clean up articles, we need to firm up the policy. I'm working on Heliobacter pylori, the bacteria, some have theorized, that might be responsible for gastric ulcers (I'm not going to argue one way or the other about it). So, is the article about the bacterium? Or is it about gastric ulcers? If it's about a pathogenic bacteria, how do we follow MEDMOS, or do we follow some microbiology MOS (if there is one). Do we merge the gastric ulcer article to H. pylori? If this were the only problem, maybe we could figure it out. But honestly, do we need a chickenpox and Varicella zoster virus article? We merged shingles to Herpes zoster. But honestly, the two zosters are the same virus with two different manifestations. So they are same virus causing the same disease. H. pylori causes only one disease, but gastric ulcers may have multiple causes. I'm going to reorganize H. pylori to fit MEDMOS, but I'm not sure that makes complete sense.

We need advice here. And let's make a decision, not discuss endlessly, then the everyone moves on to another issues, and this lays fallow. OrangeMarlin ^{Talk• Contributions} 20:06, 30 August 2008 (UTC)

So, in the first step of cleaning up the article to maintain its FA status, I have to determine if "Classification" means taxonomic or disease. And the system falls apart. OrangeMarlin ^{Talk• Contributions} 20:09, 30 August 2008 (UTC)

And I just looked up Poliomyelitis, which was just promoted to FA vs. poliovirus, which isn't FA. No help there. OrangeMarlin ^{Talk• Contributions} 20:14, 30 August 2008 (UTC)

And now, Influenza vs. Orthomyxoviridae. So I'm guessing we have a policy, which helps with the article. OrangeMarlin ^{Talk• Contributions} 20:17, 30 August 2008 (UTC)

In general, I favor keeping disease articles separate from microorganism articles. If they are both quite small, then a merge might be acceptable, but there are so many non-overlapping things to say about each that in general I think separate is better.

I don't think you should reorg H. pylori to fit MEDMOS. I think you should make it fit the (limited) suggestions at Wikipedia:WikiProject Prokaryotes and protists, and parallel Escherichia coli. The possibly relevant sections there, BTW, are:

1. Strains
2. Biology and biochemistry
3. Normal role
4. Role in disease
5. Laboratory diagnosis
6. Antibiotic therapy and resistance
7. Vaccination
8. Role in biotechnology
9. Model organism

It might be relevant to add things like veterinary connections or routes of transmission. Would it be helpful to create such a list here? I haven't found anything similar at any of the relevant projects. We could invite them to help us create such a list. WhatamIdoing (talk) 01:40, 31 August 2008 (UTC)

I agree with WhatamIdoing -- the pathogen and the disease should be kept separate. A disease may involve multiple pathogens, and a pathogen may cause multiple diseases. Merging them together is not a sustainable solution. --Arcadian (talk) 03:14, 31 August 2008 (UTC)

GrahamColm and I struggled with this issue on Rotavirus, which is an article about the virus and the disease it causes. I even produced a draft version of a split into two articles: one virus, one disease. It worked but so does the combined one, which Graham preferred. I think often the split works best as WP likes to classify things and stick info boxes on them. I don't think the chicken pox articles would be improved by a merge. Unless there's a specific name for the ulcers/cancer caused solely by Heliobacter pylori, your stuck with describing those within the article. So I don't think there's a hard rule. Colin°^Talk 09:17, 31 August 2008 (UTC)

If a pathogen is only known for causing one disease, and that disease is only caused by that pathogen (e.g. measles/measles virus) then that's fine; only size restriction is then a determinant. Any other combination necessitates separate articles, with the "pathogen" article containing brief but relevant content about the disease and vice versa, with copious cross-references using the {{main}} template. JFW | T@lk 11:29, 31 August 2008 (UTC)

Sections for medical tests

I ran across ACTH stimulation test today (you are invited to join the fun: a really nice, relatively Wiki-inexperienced editor has done some good work there) and it made me think that we could use a suggested article order for medical tests. Presumably the same information should be covered in each of them. Here's my protolist, which you can change as you see fit:

1. Types (if more than one kind or variant of this test)
2. Indications (including contraindications)
3. Preparation
4. Test procedure
5. Adverse effects
6. Interpretation of results (including accuracy/specificity)
7. Mechanism (how the test works, if it's interesting)
8. Legal issues (such as whether special counseling is mandated, if any)
9. History (of the test)

As a general guide, it needs to be flexible enough to cover a handful of articles. I have considered a semi-random selection of tests from Category:Medical tests in thinking about this: Arterial blood gas, Bone mineral density, Fluid deprivation test, Pap test, Pregnancy test, and Skin allergy test in forming my suggestions and think that it probably covers them all.

What do you think? WhatamIdoing (talk) 22:11, 31 August 2008 (UTC)

I like the order, except perhaps mechanism. I reckon that should go before preparation, just like 'pathophysiology' comes before stuff like diagnosis on diseases. —Cyclonenim (talk · contribs · email) 22:19, 31 August 2008 (UTC)

Looks good, not sure, but could Indications be included in Interpretation? Agree mechanism should be earlier in listLeeVJ (talk) 22:24, 1 September 2008 (UTC)

Yep. agree interpretation should be further up the list, otherwise looks ok. Cheers, Casliber (talk · contribs) 00:33, 2 September 2008 (UTC)

DSM IV-TR vs ICD 10

Hey all, the former is becoming lingua franca in psychiatric diagnosis with many studies in Europe and England using it rather than ICD 10. Unfortunately I cannot find a &(%$(%^##^@%( reference to confirm this. This becomes an issue when working up conditions like borderline personality disorder and major depression for FAC, as much of the research (eg on MDD) then doesn't fit with the article parameters if we use ICD10s depressive disorders. I am proposing we amend the Wikipedia:MEDMOS#Naming_conventions to add DSM IV-TR in the realm of psychiatric disorders. Cheers, Casliber (talk · contribs) 00:52, 2 September 2008 (UTC)

Concur; in the case of Tourette syndrome, there is no reason to refer to ICD-10's frightful long title. SandyGeorgia (Talk) 01:01, 2 September 2008 (UTC)

Per PMID 16220218, "DSM-IV is the most widely used diagnostic classification system in research, whereas ICD-10 is more widely used clinically." --Arcadian (talk) 04:37, 2 September 2008 (UTC)

I don't have access to the full text, but the abstract suggests that they are referring only to Denmark. SandyGeorgia (Talk) 04:46, 2 September 2008 (UTC)

I, too, have only seen the abstract. One could argue that it applies only to Denmark, but it certainly appears to me to be intended to apply universally (at least within Europe). --Hordaland (talk) 07:07, 2 September 2008 (UTC)

It is a relatively obscure journal, so I do not have the access to it, too. From the abstract, it appears to be a value judgment on the part of authors, part of the background section. According to the newly-minted WP:MEDRS guidelines, previous work "sections are typically less reliable than reviews". The most recent study specifically concerned with the relative frequency of use for DSM and ICD (PMID 18408417) found that DSM is used about 5 times as often as ICD. Paul Gene (talk) 10:55, 2 September 2008 (UTC)

I've updated it as there seems to be solid consensus support for this. Colin°^Talk 11:10, 2 September 2008 (UTC)

Just to note, that Danish study is only summarizing the findings of a 2002 article that it cites - International surveys on the use of ICD-10 and related diagnostic systems EverSince (talk) 17:55, 2 September 2008 (UTC)

Anatomy

Should appropriate parts of Wikipedia:WikiProject_Anatomy/Guidelines be merged into this document? WhatamIdoing (talk) 03:30, 2 September 2008 (UTC)

Yes. JFW | T@lk 23:07, 2 September 2008 (UTC)

Here are the bits that I think might be useful (note that I've copyedited a fair bit and would appreciate error correction):

Naming conventions

• Most articles on human anatomy use the international standard Terminologia Anatomica (TA), which is the American English version of the Latin. Editor judgment is needed for terms used in non-human anatomy, developmental anatomy, and other problematic terms. The online version of Dorland's Medical Dictionary at Mercksource.com has terms that conform (look for 'TA' after the word).

Sections

• Clinical relevance (for discussing diseases and other medical associations with the structure)
• Etymology
• Development (for discussing developmental biology, i.e. embryological/fetal, associated with structure)
• Comparative anatomy (for discussing non-human anatomy in articles that are predominantly human-based)

Not sure where to stick this

• • Please include the Latin (or Latinized Greek) name of the subject, as this is very helpful to interwiki users and for people working with older scientific publications.
  • Etymologies are often helpful. Features that are derived from other anatomical features (that still has shared term in it) should refer the reader to the structure that provided the term, not to the original derivation. For example, the etymology section of Deltoid tuberosity should refer the reader to the deltoid muscle, not to the definition 'delta-shaped, triangular'. The etymology in Deltoid muscle, however, should identify the Greek origin of the term.

Any other sections? Any suggestions for where to put the where-and-why of etymology? WhatamIdoing (talk) 05:31, 5 September 2008 (UTC)

"Subclinical variation"? Also, the paragraph at Wikipedia_talk:WikiProject_Anatomy/Guidelines#Paired_structures might be useful to integrate. --Arcadian (talk) 17:55, 9 September 2008 (UTC)

Summary style

I always expect WP:SUMMARY to actually say something about summarizing information. (It doesn't; WP:SUMMARY is largely about how to comply with WP:SIZE by splitting an article when it gets to be too long.) I've seen several medicine-related articles that go into all sorts of details about the study after study (all primary literature, of course). It's all "prospective observational trial with 233 participants enrolled and 218 completing the study" -- not an encyclopedia article, in other words. The current version of Wilderness diarrhea#Degree of risk is a good (bad) example.

I have been wondering whether we should address this by adding a paragraph to WP:MEDMOS#Audience. I'm not really sure how to say "You are supposed to be writing an encyclopedia here", but perhaps something that makes these points would do:

Information about clinical trials and other medical investigations should be reported in an encyclopedic fashion, at a level of detail that is appropriate for the general reader. Generally, this requires a focus on the main results instead of details of study design. Do not write your own comprehensive review of the scientific literature.

I'm sure that it could be much better put. In fact, I'm pretty sure that with a solid night's sleep, I could do better. What do you think? WhatamIdoing (talk) 06:52, 4 September 2008 (UTC) (who is finally off to bed)

There's a big difference, though, between a trial of 2,000 patients, 200 patients and 20 patients. And there's a big difference between a prospective and retrospective trial. These differences can be important when you have different trials with conflicting results. See for example the article on Management of skin and soft-tissue infection in the 4 September 2008 NEJM. If I'm reading an article, I'd like to have that degree of specificity. That's especially important when you're writing about a controversy with less-than-perfect evidence.

That's the level of detail you'd see in, say, WebMD, which is written for both doctors and an intelligent general audience. Nbauman (talk) 07:24, 5 September 2008 (UTC)

I agree with both of you. WP should mostly state facts with encyclopaedic confidence cited via footnotes to secondary sources. Explicit mention of study after study is a warning sign that the editor may be trying to build a case themselves, especially when directly sourced to the primary studies rather than to a quality secondary source. That Wilderness article cites both primary studies and also good reviews -- but largely ignores the reviews, which repeatedly claim that although backpackers in the US get diarrhoea, it almost certainly isn't from drinking surface water and so water sterilisation shouldn't be the focus of health campaigns (personal hygiene is the problem). The article needs work because the text disagrees with the best sources. If the editors stick to the secondary sources, it becomes much easier to write confident text on the risk and not distract and overload the reader with studies they don't have the tools to interpret.

The History section of an article is an obvious place for seminal studies to be mentioned in detail. Elsewhere, if a study is explicitly mentioned at all, then I agree this should generally be kept brief. However, sometimes detail is required for honesty (as Nbauman points out)—it was small scale; uncontrolled; only looked at the US; had no long-term follow-up—or because it is actually interesting. For example, the fact that the hikers spent an average of "139 days" on the trail made me go "woa, that really is a long hike" where some readers might think 5 days was a long hike. While that fact could have been simplified to "several months", the duration is important and "long" wouldn't have been adequate. Having said that, I think WhatamIdoing is right that those explicit studies probably don't need to be mentioned at all and the conclusions in the reviews should have been presented instead.

In the proposed text, the first sentence actually seems to encourage mention of studies ("should be reported"). Even "main results" focusses too much on one primary study rather than moving the focus to what secondary sources, reviewing the literature, say. I like the last sentence. How about something like:

Editors should not attempt to write their own comprehensive review of the literature. Instead, state the facts, conclusions and opinions found in reliable sources. The primary studies that helped form those conclusions and opinions are often not required to be explicitly mentioned, outside of a History section, unless they are particularly interesting or where details of the study's limitations are important to the reader.

I'm not saying the above is ready for inclusion, just some thoughts. Colin°^Talk 10:23, 5 September 2008 (UTC)

Nbauman, I agree that the size of a study can be important, but that information can be contextualized instead of being reported in detail. 200 people is a rather small study for Hypertension. The same number of participants would be an unbelievably large study for ODDD (243 cases ever reported in the literature; approximately 100 cases believed to be living at any time). Therefore I favor using descriptive words, like "large" or "small", or by signaling the informed editor's general level of confidence in other ways: "Wilderness diarrhea is most often caused by poor handwashing and dishwashing techniques,^{[review][review]} although some researchers believe that improper disinfection of water is also a significant cause.^[primary]

The bigger issue, however, is that in most of these cases, the primary literature requires special description specifically because it is weak, and therefore the correct response is to exclude it entirely.

Thinking about other pages that have this problem, such as Freeman-Sheldon_syndrome#Cause, advice to not duplicate bibliographic information in the text might be helpful to new editors. FSS (a rare disease) has a lot of sentences that begin with "Toydemir et al (2006) showed that...", which is poor style, even if for such a rare condition these 20-person studies are appropriately sized. This has been a problem in previous versions of Da Costa's syndrome as well. WhatamIdoing (talk) 19:51, 5 September 2008 (UTC)

The "Toydemir et al (2006) showed that..." style comes from copying the style in some scientific papers. Another aspect of scientific papers that gets copied is directly citing primary studies and we already have a guideline for that :-). Perhaps we need some advice to editors who are over-familiar with that style in either their reading or writings. However, just because you see bad style in certain articles, doesn't automatically mean we need some explicit guidance against it. Legislating against all misdemeanours can cause more problems than it is worth. Is this a widespread problem and have people faced any difficulty when correcting it?

In your example, you need to be careful with the "although some researchers believe" doesn't break WP:WEIGHT. Far better to have that second statement also attributed to the same reviews. And if those reviews thoroughly dismiss the idea, then so should WP (perhaps by not mentioning it). Colin°^Talk 20:19, 5 September 2008 (UTC)

ME/CFS therapies move

Should ME/CFS therapies be moved to Therapies for chronic fatigue syndrome? Is there a better title? Treatment for..., CFS treatment? Not super familiar with the diagnosis but I do know the naming is controversial in the community. Suggestions? WLU (talk) Wikipedia's rules^(simplified) 11:40, 9 September 2008 (UTC)

Also note ME/CFS treatment, I'm not sure of the difference between the two (would one be better named "management"?) From my reading of the leads, therapies is about management while treatment is about causes. Irrespective, having a slashed page title seems odd, and probably interferes with some syntax somewhere as well as being unnecessary. WLU (talk) Wikipedia's rules^(simplified) 11:49, 9 September 2008 (UTC)

Also turned up ME/CFS nomenclatures, same slash problem. Even if there are multiple names and none are problematic, the slash is not a good solution; if the umbrella term is CFS, that should be the lead rather than a slashed compromise. WLU (talk) Wikipedia's rules^(simplified) 11:55, 9 September 2008 (UTC)

I believe that the "ME" and "CFS" camps are emotionally invested in the choice of names, with mentioning both here seen as a compromise. As I understand it, "ME" means "this is a strictly biological illness, probably due to an infection and certainly not the least bit psychiatric in nature." ME advocates think that non-sufferers believe that CFS is due to character flaws and/or psychiatric problems (e.g., atypical depression), which they find insulting. WhatamIdoing (talk) 18:44, 9 September 2008 (UTC)

All those articles with "ME/CFS" in the title are forks of the main article. Any attempt to move them will lead to an edit war. I totally agree with WhatamIdoing's assessment of the situation. JFW | T@lk 18:50, 9 September 2008 (UTC)

Ya, I figured as much, but CFS is what is used on wikipedia. A good article discussing the controversy about naming and bio versus psychogenic should be reflected in one of the articles (CFS controversies?). I don't make a habit of editing to avoid hurting people's feelings. Perhaps mentioning the controversy prominently in the lead would head off criticisms. It's a poor compromise in my mind, and confusing since the main article isn't ME/CFS. Edit wars can always be dealt with via page protection.

Question, how much does the academic literature reflect the disagreements WAID summarizes? Can a decent article be drafted by drawing on the professional literature and not the grey or taupe literature? WLU (talk) Wikipedia's rules^(simplified) 20:18, 9 September 2008 (UTC)

The article currently lists mostly management therapies, but it also contains one coping strategy which is not a therapy, i.e. the title does not match the content. Note that therapies taking the biological/neurological approach, while not in the article, do exist, but these are for treatment rather than management. I think that is the most important distinction to be made here (treatment v management). Regards, Guido den Broeder (talk, visit) 19:42, 10 September 2008 (UTC)

My overall concern is the ME/CFS use in the title rather than the therapies versus treatments though the distinction between the two is not well made by the names. A better distinction would be captured by using management and treatment and probably reduce confusion due to the titles being essentially synonyms. Guido, do you see a risk of moving one to chronic fatigue syndrome management and the other to chronic fatigue syndrome treatment? Does WAID's comment make sense given your experience and knowledge of the condition? Mostly I think the ME/CFS part should be replaced with just chronic fatigue syndrome. WLU (talk) Wikipedia's rules^(simplified) 21:36, 10 September 2008 (UTC)

WhatamIdoing's perception of what advocates think is erroneous. Typically, advocates want a name that is a good indication of the illness; CFS is not. Advocates don't think that badly about non-sufferers in general at all.

Now, the title of any article should always match the content, and vice versa. From a Wikipedia point of view, it is perfectly OK to create articles named CFS management and CFS treatment as long as that's what they contain and there can be similar articles named ME management and ME treatment. To the average reader, however, this could be a tad confusing. Therefore, my suggestion would be to have one article called 'ME/CFS management' (rather than only therapies) and one called 'ME/CFS treatment' and see to it that each address both psychological and biological approaches. That has the additional advantage that it can be a lot clearer to the reader that CBT in particular can have different aims. Guido den Broeder (talk, visit) 22:01, 10 September 2008 (UTC)

The issue of whether CFS or ME is better or worse has been settled as far as I'm concerned - wikipedia uses CFS. The CFS controversies or CFS naming page should address issues of which is preferred by who and why. But on wiki, we use CFS. I'll move the pages to "CFS management" and "treatment" respectively. WLU (t) (c) ^{(rules - simple rules)} 22:20, 10 September 2008 (UTC)

I'll start the equivalent articles on ME then. Guido den Broeder (talk, visit) 22:38, 10 September 2008 (UTC)

No, Guido, we've already been through this. CFS is the official name, and it is the name used on wikipedia. Currently ME redirects to CFS. The alternative names are discussed in the CFS article. It doesn't make sense to create sub-articles for ME therapies and ME treatments. --Sciencewatcher (talk) 00:06, 11 September 2008 (UTC)

Actually, ME is the official name. It's the name under which the disorder has been classified in the ICD since 1969. Guido den Broeder (talk, visit) 00:09, 11 September 2008 (UTC)