Wikipedia talk:WikiProject Medicine

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List of archives

Merged Archive WikiProject Preclinical medicine: 1 Merged Archive WikiProject Clinical medicine: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 WikiProject Medicine Archives: Index, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171

Training effect

I was wondering if someone with a medical background and a spare minute or two could take a brief look at the introductory sentence to Training effect (and possibly its corresponding reference) and suggest a proper redirect for neurohumoral and functional capacity. Thanks! Location (talk) 17:25, 9 February 2011 (UTC)

Neurohumor and neurohumoral sound like they might outdated terms for Neurotransmitter/Neuromodulation, on a quick browse Neuron#Action_on_other_neurons seems the sort of thing your looking for, but there are many, many neurology articles - Wikipedia:WikiProject Neuroscience would be a good forum to ask in. As for functional capacity - I'm not sure if there is a general functional capacity that would cover all these systems, as each system will have its own definition. One more thing to consider- the talk page has mention of it and I'm have the same gut feeling that, unless more common us of the term can be shown, it should be merged into exercise Lee∴V (talk • contribs) 12:30, 12 February 2011 (UTC)

Somatosensory Rehabilitation of Pain

It's late here, and I've got visitors so I won't get to this tonight, but Somatosensory Rehabilitation of Pain looks, after a brief scan, like OR to me. The author seems to have done some good work elsewhere. I'll try to focus on it tomorrow but another opinion would be appreciated, if anyone has the time. --Anthonyhcole (talk) 12:17, 10 February 2011 (UTC)

I've left a note on its talk page and its author's talk page outlining some concerns. --Anthonyhcole (talk) 13:59, 11 February 2011 (UTC)

I don't know what to do about this. It is based on the work of one team, most sources are in a foreign language, and on the face of it, it appears not notable enough even for an article. Somatosensory rehabilitation seems to be notable and has one or two textbooks devoted to it; but this concept, somatosensory rehabilitation of pain, appears fringy at best. Wiser/more experienced eyes would be appreciated. --Anthonyhcole (talk) 02:22, 16 February 2011 (UTC)

My eyes may not be any more wise or experienced but it looks to me like something that could be added to the Gate control theory of pain. ITasteLikePaint (talk) 03:13, 16 February 2011 (UTC)

I would oppose mention on Pain, which is an overview of a very large subject. I'll warn the author I intend to nominate it for deletion unless he comes up with some MEDRS-compliant sources. --Anthonyhcole (talk) 04:57, 16 February 2011 (UTC)

LASIK

Comments requested at Talk:LASIK#Requested addition. A user blocked for other reasons has emailed me asking for an addition to this article: he has a clear COI, but the requested addition, which says that the former official who oversaw FDA approval has now submitted a petition to withdraw it, seems factual and sourced. JohnCD (talk) 22:44, 11 February 2011 (UTC)

Break apart "Comparison of MD and DO in the United States"?

There has been a "proposed merge" tag on Comparison of MD and DO in the United States for a couple of years now. We should probably resolve it. Personally, I don't see a huge benefit to maintaining a separate page for the two, as the information could be (and really, is) better included primarily at Osteopathic medicine in the United States, Medical school in the United States, and possibly also Medical education in the United States. NW (Talk) 16:06, 14 February 2011 (UTC)

To give some background, most of the info in the "comparison" article was originally in the articles allopathic medicine and osteopathic medicine in the United States, but the amount of information gathered overburdened both those articles. A third article comparing the two was created as something of a compromise. There is a great deal of published material and commentary on the comparison topic. I agree that the article is not the strongest article on WP, but with some TLC it could be much better. These topics, allopathic v osteopathic, MDs v DOs, etc are so poorly understood, hence their necessity. They also tend to generate instant controversy here on WP, hence the somewhat apologetic tone. Bryan Hopping ^T 08:21, 15 February 2011 (UTC)

Children's feet at AfD

Children's feet is at AfD, apparently as a proposed merge(?). I haven't commented yet, but others might want to. WhatamIdoing (talk) 07:40, 15 February 2011 (UTC)

MEDRS?

Dispute at Chiropractic: Is this a systematic review: Chiropractic & Osteopathy 2010, 18:3 doi:10.1186/1746-1340-18-3 http://chiromt.com/content/18/1/3

Review Effectiveness of manual therapies: the UK evidence report

"The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions."

"The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.""[1] Thanks, Ocaasi (talk) 17:45, 15 February 2011 (UTC)

A better question might be, does this study meet WP:MEDRS? I believe it does, however there is an editor will not allow its inclusion anywhere in the chiropractic article.Puhlaa (talk) 18:36, 15 February 2011 (UTC)

Here's the ref from PubMed:

• Bronfort G, Haas M, et al, "Effectiveness of manual therapies: the UK evidence report", Chiropr Osteopat. 2010; 18: 3. February 25. doi: 10.1186/1746-1340-18-3. PMCID: PMC2841070
  "The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories."

Note the change of journal title: Readers should note that in January 2011 the journal’s name changed to Chiropractic & Manual Therapies from Chiropractic & Osteopathy'.[2]

This is about as solid as it gets. It should be put it in the body and the lead updated. This is the most scientifically legitimate of all chiropractic journals. Their research reports are generally quite trustworthy, with few exceptions, and this isn't one of those exceptions.

COI statement: I'm a chiroskeptic and Physical Therapist, and "I approve this message". I agree that QG is continuing to block progress with his stonewalling, IDHT and ownership. It's so bad a systemic problem that I, an expert on the subject, usually avoid the chiropractic articles because of his noxious influence there. (I thought he was still topic banned by ArbCom, but I guess that must have run out. Maybe it needs to be reinstated under the ArbCom sanctions.)

I suggest that fresh eyes visit this section to see what's going on. -- Brangifer (talk) 22:59, 15 February 2011 (UTC)

And I'd strongly second that suggestion. At present we have editors removing content cited to a two-year old reliable secondary source with an edit summary of removed outdated review, 2010 review covers the effectiveness. We seem to have taken MEDRS to the extreme by discarding anything but the latest review, a slippery slope that fails to acknowledge the possibility of disagreement between reliable secondary sources. Editors should not be using guidelines to contradict policy. --RexxS (talk) 03:22, 16 February 2011 (UTC)

Funny, I thought that MEDRS opposed that behavior. Isn't that what "do not automatically give more weight to the review that happens to have been published most recently, as this is recentism" means to you? WhatamIdoing (talk) 04:25, 16 February 2011 (UTC)

Yes, that's exactly what it means to me. It obviously means the opposite to others. --RexxS (talk) 12:12, 16 February 2011 (UTC)

The most recent proposal for a site ban (just two months ago) failed. His supporters were: User talk:Ncmvocalist, User talk:Collect, User talk:Skomorokh, User talk:Mathsci, User talk:Jehochman, NW, User talk:Beyond My Ken, User talk:Enric Naval, User talk:Chartinael, jps, User talk:RexxS, and User talk:Shot info.

I have contacted most of them with an invitation to help resolve this dispute (skipping one who earned a long-term block and a couple who are known to be watching this page). We should not have to deal with these problems every few weeks. WhatamIdoing (talk) 04:48, 16 February 2011 (UTC)

The solution was initially about adding the UK review, not just taking out Ernst. That may have been a misunderstanding. The counter-problem is almost ironic given how prominently Ernst has figured into the article. But that is fine, so long as other sources with similar standing are incorporated as well. Despite the appearance of conflict, there is actually more productive discussion going on now, since a few other reasonable editors have chimed in. Ocaasi (talk) 13:11, 16 February 2011 (UTC)

We have at least three great reviews and should balance all of them. --Doc James (talk · contribs · email) 23:21, 16 February 2011 (UTC)

List of participants

The Signpost is featuring WPMED next month. They typically report basic statistics for WikiProjects, such as the number of participants. If you consider yourself to be a part of WPMED, and you have not yet added your name to the table at WP:WikiProject Medicine/Participants, please do so. WhatamIdoing (talk) 21:31, 17 February 2011 (UTC)

It looks like we haven't done a pass through the list to move inactive participants out of the active list for quite a while. Does anyone have a problem with my updating this with a cut-off of six-months inactivity on WP for "inactive participants" and twelve-months inactivity on WP for "former participants". It doesn't do us any favours to inflate the figures. Colin°^Talk 11:41, 18 February 2011 (UTC)

Agree --Doc James (talk · contribs · email) 17:50, 18 February 2011 (UTC)

Agree, thanks Colin. Graham Colm (talk) 21:51, 18 February 2011 (UTC)

Go ahead, Colin. Axl ¤ [Talk] 10:06, 19 February 2011 (UTC)

OK. I'll work on it this afternoon. I'll set the threshold at 1st September 2010 for Active and 1st March 2010 for Inactive. Colin°^Talk 12:14, 19 February 2011 (UTC)

Yes, please. And bless you for volunteering to take on that dull, time-consuming task. WhatamIdoing (talk) 18:41, 19 February 2011 (UTC)

Pharma policy

Do we have a guideline or policy regarding how pharma companies/employees should edit entries about specific pharma products? NCurse _work 09:20, 18 February 2011 (UTC)

Absolutely. Our WP:COI guideline directly addresses this, WP:NPOV of course, and the WP:NOSHARE policy is relevant. Those link to others that are germane as well. -- Scray (talk) 14:38, 18 February 2011 (UTC)

We haven't written anything more specific. There was a conversation about this a while ago. Here's what I remember from it:

Disclosure of COI is not required by any Wikipedia policy.

• Some editors have voluntarily chosen to disclose a conflict of interest by including their employers' names in their account names, e.g., all these folks from GlaxoSmithKline. More self-identify on their user pages.
• Self-identification is a two-edged sword: You get points from most users for being honest, but a few will use it to harrass editors. See, e.g., User:James Cantor, a world-class expert on pedophilia, who has been chastised by a handful of (minority-view-holding) editors for not re-re-re-re-disclosing his "conflict of interest" every single time he edits certain pages.
• Corporate IP addresses are highly traceable. An employee editing from the office should assume that s/he's hung a big sign on the edit saying "I'm part of a pharmaceutical conspiracy".
• Some employers require disclosure, and a few believe it illegal for their employees to edit these pages. (I believe the idea runs like this: We are legally required to say only X about this product; if we change the Wikipedia page, we are legally required to say only X on the Wikipedia page; if the page says anything beyond X, then we're in violation of the law.) So employees and contractors should check with their employers.

Wikipedia does not prohibit people in the pharmaceutical industry from editing articles. WP:PAID failed. However, there are strategies that reduce conflict:

• Vandalism = bad. As far as we're concerned, anyone is welcome to fix it, even people who work for a pharmaceutical company.
• Correct serious errors, but leave the fine points to others.
• Propose sources and improvements on the talk pages.
• Read WP:MEDRS, especially the bits about not paying too much attention to single studies.
• Read WP:MEDMOS, especially the bits about not providing medical advice, instructions to patients, or dosage information.
• Remember that Wikipedia is not a patient guide or drug formulary. Employees might be in a unique position to provide background and historical information, which we very much want. We'd love for every page about a drug to contain some information about its regulatory status around the world, its development, its manufacturing process, and its commercial history (e.g., which companies have worked on it and what its annual sales are).
• Come here or to WT:PHARM to get help.

Hope this helps, WhatamIdoing (talk) 22:47, 18 February 2011 (UTC)

It certainly does help, WAID. Is there any chance we could give this a more permanent home than the talk page archives? I was thinking of an essay, WP:MEDCOI, that could be worked up into a guideline as part of WP:COI, so that those who need the specific information can find it easily in future. --RexxS (talk) 23:11, 18 February 2011 (UTC)

Sure, we could do that. I think it might be good to expand the other usual issues: being a healthcare professional, academic expert, or a patient does not mean that you have a COI (although you might be biased). It might be fun to include some of the pharmanoia material, too. What do you think? WhatamIdoing (talk) 19:29, 19 February 2011 (UTC)

We would first need to eliminate the "double edged sword" POV: The example given was first written up on COI/N as "MarionTheLibrarian"[3]. The pattern of self-promotion was the problem, not the login. To avoid a fruitless tangent, I think it would be best to simply remove the bullet point.

We should stress that Wikipedia policies apply equally to all Wikipedia editors. However, having audience-specific guides for what policies new editors should be particularly aware of couldn't hurt.

Getting back onto the topic of placement, is there a location where its target audience (pharma industry editors) would find it easily? (If they needed to search for it, they might find it only after wading through a number of the specific policies. This would reduce the value of the guide.) BitterGrey (talk) 19:56, 19 February 2011 (UTC)

Wikipedia:Conflicts of interest (medicine) is a bluelink now. WhatamIdoing (talk) 21:53, 19 February 2011 (UTC)

Could I ask others to look this over and join in the discussion there? My relationship with WhatamIdoing hasn't been good since he made a clear accusation of ill will against me[4]. He's just performed a mass revert back to his own version, which doesn't seem very civil. BitterGrey (talk) 00:10, 20 February 2011 (UTC)

I glanced at the discussion. I have to agree with WhatamIdoing: substance over procedure. If you have a problem with an external link, start by mentioning what the problem is from a substance perspective - that is, concerns you would raise regardless of who added the link. II | (t - c) 01:40, 20 February 2011 (UTC)

ImperfectlyInformed, the dif about the EL was just to convey WhatamIdoing's documented prejudice here. My main issue is with the tabular form, which implies that there is a caste system within Wikipedia where some policies only apply to lesser editors like you and me: That pharma employees don't really need to cite sources, while patients should busy themselves with vandalism cleanup. My quickly-reverted edit changed this table to three lists, with all Wikipedia policies applying to everyone equally. This is a matter of substance.

Of course, if no other editors get involved, Wikipedia content will be determined by the one who is willing to the be least civil and take the most liberties with Wikipedia policy. BitterGrey (talk) 05:43, 20 February 2011 (UTC)

I don't think you have accessed the right forum if you have a problem with WhatamIdoing. This thread is about COI disclosure in medical content, not about individual behaviour. WhatamIdoing is one of our most hardworking editors, so you are very unlikely to be getting a helpful hand. I see no incivility in the diff you mentioned, and the suggestion that WhatamIdoing would have been incivil makes me roll of my chair laughing. JFW | T@lk 07:35, 20 February 2011 (UTC)

Could we focus on the content being discussed today? I realize that most here are more familiar with WhatamIdoing than with me, which means my odds of getting neutral input are slim. What I'm doing might seem laughable. I'm not paid by a pharma or medical interest, so those hoping to ignore me while advocating their position and goals have called me an advocate. Per WhatamIdoing's table, a good edit for an advocate will be "Adding sourced information about social movements and effects" (e.g. making edits to the Oprah article) and to avoid "Promoting tiny minority viewpoints." Per WhatamIdoing's table, matters of substance (editing information about a product, the profession, health issues, or treatments) are reserved for those who can profit from it, expert or not, referenced or not.

I'm hoping to preserve the neutrality of Wikipedia, with Wikipedia policies applying to everyone equally. I accept that there is a caste system in practice in Wikipedia, but I do not think it should be reinforced. I can see how this effort might seem laughable. BitterGrey (talk) 15:00, 20 February 2011 (UTC)

Bittergrey, the tone of your edits here is off-putting (IMHO) but I think you do have valid concerns. I think it's most appropriate to direct discussion of the COI(med) essay to that talk page, and avoid further discussion of editors themselves. -- Scray (talk) 18:56, 20 February 2011 (UTC)

Thanks Scray. I responded to ImperfectlyInformed's comment above in hopes of keeping the discussion that I started there from getting diverted onto some procedural tangent. WhatamIdoing has yet to respond to any of my attempts at discussion on this topic. Perhaps JFW is correct in that everyone supports WhatamIdoing loyally, to the point of dismissing the possibility that he might have been uncivil as laughable ("roll of my chair laughing" to be exact). I then, however valid my concerns about the content might be, would be the butt of that joke. BitterGrey (talk) 19:51, 20 February 2011 (UTC)

(←) Shall we regard this thread as a pointer to have a discussion on the other page then? I see little point carrying on over here. JFW | T@lk 00:25, 21 February 2011 (UTC)

Abortion again

If any fresh eyes were available, I'd be grateful for a sanity check at Abortion. The short story is that I reverted the addition of a piece of text sourced to a recent primary source, on the grounds that the secondary source already there covered the issue; it was then re-inserted by the OP; and then removed and re-inserted by Doc James. I've tried to raise what I see as a clear violation of MEDRS on the talk page, but to little effect. Any comments one way or the other would be appreciated, because either I or a bunch of others are failing to understand MEDRS. --RexxS (talk) 21:26, 18 February 2011 (UTC)

In the news

Google News listed CFS as a top story just now. See this on a Lancet study, which (reportedly) proves the conventional wisdom wrong. It's probably worth keeping an eye on some of the Chronic fatigue syndrome articles for a few days. WhatamIdoing (talk) 21:45, 18 February 2011 (UTC)

Why was the conventional wisdom that exercising wouldn't help people with Chronic fatigue have more energy? Wasn't the idea that people can improve their health or vitality through inactivity basically dead decades ago? Ocaasi (talk) 22:29, 18 February 2011 (UTC)

According to the article, "pacing" (doing less because you don't feel like doing anything) is what the patient organizations have been pushing. WhatamIdoing (talk) 22:49, 18 February 2011 (UTC)

I have read for years that exercise improves CFS and rest worsens symptoms. I remember a study that found forced bed rest in health college students resulted in CFS after 2 weeks in a large proportion. And forced exercise in those with CFS resulted in improvement in many. That patient groups where recommending rest I did not know. Doc James (talk · contribs · email) 16:14, 20 February 2011 (UTC)

Question about vagotomy

There is a question on the Miscellaneous WP:Reference desk that could probably do with an answer from someone with some understanding of anatomy and surgery! What is the nerve of latarjet and is it preserved in vagotomy?

This could also be a spur to improve our relevant articles, since I see no mention of the nerve(s) of Latarjet anywhere in the encyclopedia. 86.161.110.118 (talk) 20:18, 20 February 2011 (UTC)

Relevant material On Latarjet is at http://download.videohelp.com/vitualis/med/stomach.htm (near the bottom) and the answer to the question is at Resection of Terminal Vagal Branches to Parietal Cell Mass in the Treatment of Duodenal Ulcer (NIH.GOV) --Red King (talk) 21:00, 20 February 2011 (UTC)

560 pages of disease statistics for the US from the CDC 2010

• http://www.cdc.gov/nchs/data/hus/hus10.pdf

--Doc James (talk · contribs · email) 03:09, 22 February 2011 (UTC)

Wikipedia medical content

It seems to me it is time for a policy governing medical claims in Wikipedia articles. Particularly, I'd like the right to delete any claim about the safety, efficacy or strength of evidence for a health intervention that is not supported by a WP:MEDRS source, with exemption from 3RR sanctions, along the lines of BLP violations. I believe our present stance, allowing dubious claims to stand during drawn-out AfD or talk page discussion, is reckless. If I've missed something, if this is explicitly covered elsewhere, please point me to it. --Anthonyhcole (talk) 05:28, 22 February 2011 (UTC)

I completely support this. We should also state clearly when a particular use of a drug is off-label or in the absence of good evidence.

I also think that we need to tighten up on claims of adverse events and side-effects that lack a reliable source. We have a lot of drug articles that are stuffed to the brim with anecdotal reports from unhappy users, often with the flimsiest of sources. I am actually amazed that drug companies have (on the whole) not mobilised people to tidy up articles about their products. They would find themselves supported by policies if they did. JFW | T@lk 07:08, 22 February 2011 (UTC)