Talk:Circumcision

Editorial Judgment

Despite all the heming and the hawing to justify it, "according to policy," the sentence "Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%" can only be included in the introduction by an editorial judgment that consciously slants the introduction in favor of the surgery. Statements to the contrary about "just following sources" and "writing an encyclopidea" don't pass muster. The hiv/aids arguments are the current health scare arguments in favor of circumcvision; assertion of this argument as "strong evidence" by wikipedia itself displays a profound and troublilng contempt for scientific objectivity, as well as condescending scorn for the public reader. Anyway, the English-speaking public are voting against the hiv scaremongering by ignoring it. Wikipedia may panic a few parents into the surgery with its advocacy of the hiv prevention theory; most parents are smart enough to see the absurdity of wikipedias advocacy inthis article. Robert B19 (talk) 00:39, 21 May 2012 (UTC)

Since you've rejected all of the actual arguments made to date in favour of your bad faith theory of deliberate bias, there seems little point in discussing the issue. Jakew (talk) 08:26, 21 May 2012 (UTC)

Are you so certain that the aforementioned editor is the one acting in bad faith? I've found that whenever a wikipedia editor says something similar to "there seems little point in discussing the issue", it is like the Wizard of Oz saying, "The great and powerful Oz has spoken". This is usually the place which most needs to be discussed, and exposed to sunshine. Tftobin (talk) 21:30, 21 May 2012 (UTC)

Please read what you're responding to, Tom. A "bad faith theory of deliberate bias" is a theory that the editors are acting in bad faith by deliberately introducing bias. The key point is that discussion depends upon assuming that other editors are acting in good faith and actually addressing their arguments. Jakew (talk) 11:58, 22 May 2012 (UTC)

Article Talk: pages are for the purpose of discussing article content, not editors. Please review WP:TPYES. Tftobin (talk) 23:25, 22 May 2012 (UTC)

I presume that's directed at Robert B19? Jakew (talk) 07:53, 23 May 2012 (UTC)

Presumption is an awkward game at best, isn't it? Tftobin (talk) 11:38, 24 May 2012 (UTC)

I was already thinking I'd like to see the word "strong" deleted from this sentence. I've just found this article: " (it says it's "open access" but I've only managed to view the abstract) which seems to contradict or partially contradict the sentence. Note in the abstract where it says "the difficulty in translating results from high risk adults in a research setting to the general public". I argue that that supports the idea of removing "strong" and just having the sentence begin with "evidence". I think that one article is enough to support my argument, but here's another one: maybe I can only view the title, but the title seems to say something: "Male circumcision and HIV prevention insufficient evidence and neglected external validity."[1] And here's one; I'm not sure whether I quite understand their conclusion. " the fact that almost 90% of RCTs of interventions for prevention of sexual transmission of HIV have delivered flat results demands careful analysis. " [2] ☺Coppertwig (talk) 17:20, 21 May 2012 (UTC)

Assuming good faith does not mean you have to keep believing in a user's good faith where you have reason to think otherwise. Anyone who's spent enough time watching the endless debates here can easily see there's a very clever pro-circumcision lobby editing here. Egg Centric 16:38, 23 May 2012 (UTC)

Or, to paraphrase, "it's okay not to assume good faith if you don't want to". Jakew (talk) 17:09, 23 May 2012 (UTC)

Do you really think the pro-circumcision lobby is that clever? Or just that blatant, because they know that there in no wikipedia equivalent of a reprimand? Watch. You did not get called out for being off topic, or criticising an editor. Neither did the next editor. Bet I do. That is how things work here, no matter whose attention is brought, or how blatant the rules are bent. Still think it's just a strong interest? Tftobin (talk) 11:28, 24 May 2012 (UTC)

Whether clever is the right word or not (they're certainly not stupid) they're at least knowledgeable enough to use the letter of wikipedia guidelines against the spirit of wikipedia to keep the article pro-circumcision. Egg Centric 14:56, 24 May 2012 (UTC)

I'm not sure what you're getting at Jake. Of course one still has to show good faith about why someone is pro-circumcision, but at the same time biases shouldn't be ignored when they blatantly spill out into editing. I am certain that if a RfC or RfArb were held on this topic and it were looked at by enough editors then this article would be consdierably less pro circumcision. As an experiment, why don't we all come up with a list of mutually agreed users to avoid editing on this topic for two months, vandalism removal aside, and let's see what uninvolved editors have made of the article by then? Egg Centric 14:56, 24 May 2012 (UTC)

I'm afraid you've misunderstood, Egg. If someone has made an edit or expressed a viewpoint about article content, then there are usually (at least) two explanations for that: a) that they genuinely believe that this would improve the article in a manner consistent with Wikipedia's pillars, or b) that they wish to push a POV. Assuming good faith means choosing explanation 'a' wherever it is a plausible explanation. Feeling fed up with disagreements or otherwise frustrated does not mean that the explanation is implausible. Whether someone is pro- or anti-circumcision is beside the point, as is why they might hold such a view. Jakew (talk) 15:46, 24 May 2012 (UTC)

My guess is that enough people have been called in for an RFC on this article, that there is total RFC fatigue. The time I called for an RFC, as near as I can see there was only one uninvolved editor who responded. Another wikipedia hole in the process, to be exploited, if someone were inclined to do so. Then a new editor comes in, reacts strongly to what they perceive as obvious imbalance, beats their head on the process for a while, and understandably disappears. I agree with the editor who posted above. Whether someone is pro- or anti-circumcision is beside the point, as is why they might hold such a view. Either no one is in a position to change anything here, about the nature of perceived imbalances, or if they are, that ability is being ignored. Tftobin (talk) 19:46, 24 May 2012 (UTC)

a) and b) are not necessarily exclusive. It is possible to believe that an author believes they are improving an article in line with Wikipedia's pillars and to believe that an author is pushing a POV. Egg Centric 15:50, 24 May 2012 (UTC)

As a general rule, I think you may be right, but in this specific context I don't think so. The accusation at the start of this thread was that certain editors were "consciously slant[ing] the introduction in favor of the surgery", which (at least as I read it) means intentionally skewing content away from NPOV, and hence is inconsistent with the assumption of good faith. I've no doubt that many editors believe that other editors' actions are contrary to NPOV, and indeed are consistent with a pattern of POV pushing; certainly I hold such a view regarding several editors (I'm not going to name anyone, so please don't ask). To claim that they do so consciously is an assertion of bad faith editing, and one shouldn't do that. Jakew (talk) 16:19, 24 May 2012 (UTC)

I guess it depends what is meant by POV and consciously. It's possible for an editor to believe their POV is infact NPOV, and therefore believe their edits are entirely in good faith and aimed at fixing POV problems, while in the opinion of another editor those edits are causing POV problems. Egg Centric 16:29, 24 May 2012 (UTC)

Hi Coppertwig. I took a look at the articles. It appears that this is a tricky subject because a number of editors, including yourself, seem to be conflating two different things the Cochrane support says. Cochrane says 1) "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." and 2) "Inclusion of male circumcision into current HIV prevention measures guidelines is warranted, with further research required to assess the feasibility, desirability, and cost-effectiveness of implementing the procedure within local contexts." 1) is a statement about a medical finding, 2) is a statement about how the finding can be used to fight a disease, HIV. The Van Howe article you provided seems to address 2) rather than 1). Meaning, it questions how the medical finding is useful in a general discussion about a program to fight the spread of HIV. I did not at all come away reading the the Van Howe abstract with the idea that 1), the medical finding, was undermined. Certainly not from that short abstract. Please take care to separate these two ideas. The second abstract from Padian et al provided nothing that would warrant a wording change, and I'm not even 100% sure from the timing information I can gather on when each study was release that the Padian article could have been written in response to the Cochrane study. From these two journals, there's nothing that would provide a policy-based reason to change 'strong evidence.' Zad68 17:52, 21 May 2012 (UTC)

The problem may be that people don't understand the difference between an argument and a justification. Editors with limited literary experience (or education) outside of Wikipeida's insular environment may not appreicate the wisdom of Encyclpedia Britannicas impartial approach to the same HIV material, introducting it as follows, "Advocates of circumcision cite studies indicating that..." We wouldn't want the public to conclude that Wikipedia's controversial articles a brawl between streetcorner hustlers with an agenda. Robert B19 (talk) 17:12, 22 May 2012 (UTC)

As I've already pointed out, "Advocates of circumcision cite studies indicating that..." is an excellent way of describing the activities of advocates, but not such a good way of describing the relationship between circumcision and HIV. Jakew (talk) 17:19, 22 May 2012 (UTC)

Since you readily admit that it's a pro-circumcision argument, it might be prudent to re-examine its potential for POV abuse in the lead. An HIV medicine for African tribes seems irrelevant to an English-spoeaking population. We've re-read your previous justifications for inclusion, all of them boil down to a narrow exercise of editorial judgement. Robert B19 (talk) 16:33, 23 May 2012 (UTC)

Where, out of interest, did I "readily admit that it's a pro-circumcision argument"? Jakew (talk) 17:07, 23 May 2012 (UTC)

There's a hillbilly booth at the County Fair that reminds me of these discussions. They grease up a pig and people pay a dollar to catch the pig. Guess what... no sooner they catch it the pig squeals and slips away. Robert B19 (talk) 21:20, 23 May 2012 (UTC)

Please do not revert other editors post/concerns on the talk page. Garycompugeek (talk) 14:44, 24 May 2012 (UTC)

Excuse me--"African tribes"? Surely you don't mean to suggest that clinical trials are conducted on shield-beating Zulu warriors? Or that the language a person speaks affects the mechanisms of HIV acquisition? Morrowulf (talk) 04:47, 25 May 2012 (UTC)

A scientific theorry has to be tested in more than a limited geographical poplation to acheive the credibility that would make it a plausible theory. I suggest you offer us some evidence of other experiemnts that confirm the African experiemtns in other parts of the world. Robert B19 (talk) 16:56, 25 May 2012 (UTC)

Robert please review the long history of discussions regarding modifying this sentence. Consensus was never established for changing it, and the way you changed it made it misrepresent the source cited. Please seek consensus here before changing this contentious sentence. Thanks. Zad68 20:28, 25 May 2012 (UTC)

I assure you that I'm very familiar with all the previous discusions, have read them up the gazoo so to speak. Since you agree that the sentence is contentious, I shall assume that you have no objection to a POV tag on the article while we resolve the dispute, which in the opinion of numerous editors weights the article heavily in favor of circumcision. The problem with the previous discussion is that it never directly addressed the responsibility of editorial judgment in the article, and if the truth must be told, too often the previous arguments were like the pea in a shell game, constantly shifting to avoid responding to specific objections. When all else failed a linkj to a previous argument was deemed the proof of last resort, and we were even treated to a digression about the Kuipers Belt beyond the orbit of Pluto I propose that as men of honor, who have no intent to deceive us or the public, you restate your original editorial motivation to include the HIJV studies in the lead, and how and why you came to that conclusion. Robert B19 (talk) 23:22, 25 May 2012 (UTC)

Thank you, Robert B19, for the succinct synopsis. There is so much dissembling and deflection going on in here, sometimes it is hard to keep one's feet on the ground. That was right on the money. Tftobin (talk) 01:22, 26 May 2012 (UTC)

TFtobin, your patience under fire hsas been admirable. So far they failed to restate their original motivation to include th HIV theory in the lead. Other scientists scoff at such a preposterious theory, incapable of being tested or repliacted anywhere else in the world. They jammed it into the article a while back without conscensus, now kill the clock until objections die of inertia. — Preceding unsigned comment added by Robert B19 (talk • contribs) 18:07, 27 May 2012 (UTC)

Robert, honestly I am having a hard time understanding exactly what information you want from me. It sounds like you want me to talk about my motivation for mentioning Cochrane in the lead? This sounds like a personal question--you want me to explain my motivations for doing something. This does not sound like it is on-topic here at this article's Talk page, so I will not respond here, but as you've asked this question several times now, if you can help me understand what it is you are looking for me to explain, I'll do my best on my User_Talk:Zad68 page. I hope this closes this pursuit of what appears to be an off-topic discussion here. Thanks. Zad68 23:15, 28 May 2012 (UTC)

Not your personal motivation, your editorial motivation, as I said above: "I propose that as men of honor, who have no intent to deceive us or the public, you restate your original editorial motivation to include the HIV studies in the lead, and how and why you came to that conclusion." Robert B19 (talk) 20:47, 29 May 2012 (UTC)

The answer is: Per WP:LEAD. WP:LEAD says, in part, that the lead "should explain why the topic is interesting or notable, and summarize the most important points—including any prominent controversies. The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources...." I just went to scholar.google.com and searched for "circumcision"--not "circumcision AND HIV", just "circumcision." Half of the results that I saw on the first page discussed how circumcision relates to HIV, mentioning both circumcision and HIV together in the search result title. About 20 sentences in the article talk about HIV, including a link to a full other Wikipedia article on the topic. In my editorial judgement, two sentences in the lead that talk about circumcision and HIV look to be right on target to meet WP:LEAD. It would be astonishing to me if HIV were not in the lead for this article. Does this answer your question? Honest question back to you: What is your editorial motivation for removing the HIV studies from the lead (if indeed that is your editorial judgment), which appears to go against WP:LEAD? Zad68 21:21, 29 May 2012 (UTC)

recent revert of modification of "strong evidence" sentence

Robert please review the long history of discussions regarding modifying this sentence. Consensus was never established for changing it, and the way you changed it made it misrepresent the source cited. Please seek consensus here before changing this contentious sentence. Thanks. Zad68 20:28, 25 May 2012 (UTC)

Since I started this ssection I'll repost your comment and answeer it in the Editorial Judgment discussion above. Robert B19 (talk) 23:10, 25 May 2012 (UTC)

I've changed "Strong evidence" to "One study" - Wikipedia should not be taking the study's conclusions as its own. --NeilN ^{talk to me} 01:55, 26 May 2012 (UTC)

That is inaccurate, it's not "one study from Africa", but a meta-analysis (a very high quality one - a Cochrane review). Yobol (talk) 02:11, 26 May 2012 (UTC)

It's still one analysis. Again, Wikipedia should not be taking the analysis' conclusions as its own. --NeilN ^{talk to me} 02:20, 26 May 2012 (UTC)

All published meta-analyses of RCT data essentially agree on the point, as do the overwhelming majority of reviews, so it should be asserted as fact in accordance with WP:NPOV. For the other published meta-analyses, see Mills et al, Byakika-Tusiime, and Weiss et al; for an overview of reviews see User:Jakew/reviewsumm. It is particularly misleading to characterise the evidence as "One analysis of studies". Jakew (talk) 08:41, 26 May 2012 (UTC)

Question: Do all these analyses analyze the same set of studies? --NeilN ^{talk to me} 13:04, 26 May 2012 (UTC)

All of them include the three RCTs, yes. Every meta-analysis published since they became available has included them, for obvious reasons. Some (Byakika-Tusiime and Weiss et al) also include observational studies in some of the analyses they present; Weiss et al also compare analysis of RCT data with analysis of non-RCT data. Jakew (talk) 14:51, 26 May 2012 (UTC)

What I'm trying to ask is if the other published analyses included other scientific studies and if so, came up with the "38-66%" number. --NeilN ^{talk to me} 14:58, 26 May 2012 (UTC)

Weiss et al, for example, report on a meta-analysis of observational studies: "Circumcised men were consistently found to be at lower risk of HIV infection, and a meta-analysis of the 15 studies that adjusted for potential confounders showed this reduction to be large and highly statistically significant [adjusted risk ratio (RR) 0.42, 95% confidence interval (CI) 0.34–0.54] [14]." They later compare this to the RCTs: "to summarize the protective effects seen in the trials, we conducted a random-effects meta-analysis of results of these three trials, following the recommendations of the QUORUM statement for reporting trials as appropriate [19]. There was no evidence of heterogeneity between the trials (P 1⁄4 0.86), and the summary rate ratio was 0.42 (95% CI 0.31–0.57; Fig. 2), corresponding to a protective effect of 58% (95% CI 43–69%), identical to that found in the observational studies (58%, 95% CI 46–66%) [14]." Jakew (talk) 15:10, 26 May 2012 (UTC)

I'm going to take that as a "yes, analyses looked at other studies besides the ones looked at by the analysis currently referenced in the article." If that's the case, then the wording should be modified and more cites added to support the wording. --NeilN ^{talk to me} 15:48, 26 May 2012 (UTC)

I'm not sure that it would be appropriate, especially in the lead where space is limited, to discuss analyses of lower-quality studies. WP:MEDASSESS seems to support that: "In general, editors should rely upon high-quality evidence, such as systematic reviews, rather than lower-quality evidence, such as case reports, or non-evidence, such as anecdotes or conventional wisdom. ... The best evidence comes primarily from meta-analyses of randomized controlled trials (RCTs)." Jakew (talk) 16:20, 26 May 2012 (UTC)

Jake, but the point remains that if a study has been criticised, the lede should either directly mention the criticism, or the lede should even it out per WP:NPOV. I do not dispute this is a meta-analysis, however it would be unencyclopedic to ignore reviews which have given opposing viewpoints. Pass a Method talk 17:53, 26 May 2012 (UTC)

I've already addressed that point, PassaMethod. The existence of criticism does not by itself mean that we should mention the criticism or omit the criticised material. We must consider due weight. If the criticism represents a major viewpoint held by a comparable number of scientists to those endorsing the criticised material, then yes, we must certainly take it into account. But when the criticism represents the view of a tiny, fringe minority, as is the case here (only 2 of the 60 reviews I found were negative towards circumcision as partial prevention against female-to-male HIV transmission), then to do either of the things you mention would give undue weight to the critics. Jakew (talk) 18:05, 26 May 2012 (UTC)

Jake your definition of "due" is pretty skewed up if you ask me. There are several reviews which dispute your version of the article. As long as you repeat such a selective approach to sources then i think that we will not reach concurrence. Pass a Method talk 18:23, 26 May 2012 (UTC)

Well, I'm sorry that you disagree, PassaMethod, but what I've said above is basically just a restatement of WP:UNDUE, WP:GEVAL, and WP:FRINGE. Jakew (talk) 18:34, 26 May 2012 (UTC)

• comment Some high-quality sources have disputed the methodological strength of this African study. Therefore the word "strong" should definitely be out of the lede. Pass a Method talk 07:32, 26 May 2012 (UTC)
  • Similarly, some "high-quality" (in the same limited sense) sources have disputed the strength of the evidence linking HIV and AIDS. By your argument, we should therefore say that "Some analyses say that HIV causes AIDS". To do so would give undue weight to a fringe source, just as it would do here. Jakew (talk) 08:23, 26 May 2012 (UTC)

The only issue I have with Zad68's current wording is why is something that specific in the lede? The intro paragraph should give a brief overview of the topic, touching on major concepts, and not delve into details. --NeilN ^{talk to me} 14:34, 27 May 2012 (UTC)

I'm afraid that making it any less specific would open it up to complaint about how the findings are characterized. How would you phrase it, "Circumcision is very effective against FTM transmission"? There needs to be one sentence in the lead that summarizes the most important part of the findings about how circumcision affects FTM HIV transmission, as there's about a dozen sentences in the article about it. I don't see any other way to mention it in the lead and have any possibility for it to be stable. Zad68 15:59, 27 May 2012 (UTC)

inability to reach anything approaching consensus

Exactly what is supposed to be done? There is a two month argument, and a doctor (or near doctor) calls for dispute resolution. As it is about to expire, with no consensus in sight, I call for an RFC. One outside editor responds, with mention of "war in a teacup with WLawyers circling overhead." and "I know better than to read it again". Clearly, the wikipedia structure is not working so far. Exactly, what is the next step, when an RFC fails to resolve anything? The Arbitration Committee? Tftobin (talk) 01:40, 26 May 2012 (UTC)

TransporterMan gave a good overview of the options in the DRN thread; see here. Jakew (talk) 07:30, 26 May 2012 (UTC)

Time to move on to step 4 then? I just can't see a compromise solution ever being reached. Maybe that's too pessimistic... Egg Centric 15:20, 26 May 2012 (UTC)

I'm not opposed to another RfC, but I think we need to try to learn from the previous RfC. Specifically, how can we attract input from more outside editors? I've seen a couple of unsuccessful RfCs recently; neither were neutrally phrased, and in one case it wasn't even clear what the RfC was asking about. It's easy to understand why volunteers would find these characteristics off-putting — I would. So I think we need to take care with the RfC question, to ensure that it's neutral, straightforward, easy to answer, and very, very clear. A little neutral publicity (of the acceptable kinds, such as neutral messages at WT:MED and other places) might help, too. But that's secondary to getting the question right, so I suggest that if we are going to RfC again, we collaborate on the question in advance. Jakew (talk) 18:17, 26 May 2012 (UTC)

I agree. Personally I would like a very broad RfC on all aspects of the article, paticularly reviews of the relevant science. I also want one that won't turn into a witch-hunt. Consequently I'm not sure to what extent, if any, editors' habits should be considered. Egg Centric 22:14, 26 May 2012 (UTC)

I wonder if there is a way to correlate editors, with both successfully resolved RFCs, and unsuccessfully resolved RFCs? If the same editors are involved in unsuccessfully resolved disputes over and over, this may be an indication that they are simply not prone to consensus. Tftobin (talk) 01:48, 27 May 2012 (UTC)

(Redacted) Egg Centric 11:21, 27 May 2012 (UTC)

Egg, come on, you've been here long enough to know that article Talk pages are absolutely not the place for this. Would you please remove this very, very off-topic item from this article's Talk page. If you absolutely must follow up on this, I see that Jakew is accessible by email. Zad68 02:31, 27 May 2012 (UTC)

Guys, this talk page is most certainly not the place to be discussing this. Take it elsewhere. I should note that further speculation or discussion of this topic, especially insinuations and speculations about why a fellow editor has or has not taken legal action off-wiki, is governed by our policy on living persons and is frankly, unseemly. You all should know better, and if I see further disruption along this line, I'll take it to administrators. Yobol (talk) 02:07, 27 May 2012 (UTC)

I'm going to go one step further than Yobol. Tom, you watched User:AlexanderLondon get indef-blocked by an admin for harrassing Jakew, in large part for making reference to an off-Wiki attack page. You followed that up with a personal attack against Jake, and another admin called you on it, describing it as a personal attack, and reverted your edit. You now make another personal attack against Jake, making reference to the same site AlexanderLondon referenced when he harassed Jake, by implying that if the attack site's information were false, Jake would sue, so it must be true. This is easily worth a trip to WP:ANI. Tom, please remove immediately the harassing personal attack you have written here about Jakew, and please do not ever again do this. Zad68 02:26, 27 May 2012 (UTC)

I removed the offending entry which you have so vividly described. Was I actually talking about anyone by name, in the quickly reverted entry on Alexander London's talk page? Are you so certain? As I explained to Bbb23, when I said, "Lies get exposed, and corrected, over time", I was not referring to an individual. Tftobin (talk) 04:14, 27 May 2012 (UTC)

A correction: User:Bbb23 who gave you this warning, is not an admin. Zad68 02:59, 27 May 2012 (UTC)

(edited: found five warnings, not three) Tom, for the record, I note that other have as well warned you against making personal attacks. By my count, you have now been warned on five separate occasions against making personal attacks against your fellow editors:

• #1 from Jayjg on 22 April
• #2 from Jakew on 23 April
• #3 from Rip-Saw on 11 May
• #4 from Bbb23 on 23 May
• #5 from Yobol and myself on 26 May

There is a continued pattern of personal attacks continuing after warnings, including today's attack after the 4th warning. Zad68 03:17, 27 May 2012 (UTC)

Do as you please. It isn't like I haven't been personally attacked by some of these people. I've had my comments outside of wikipedia cut and pasted into this very talk page, against the WP:Harrassment policy. I've had some of them agree not to personally attack, only to personally attack within a day. Tftobin (talk) 04:14, 27 May 2012 (UTC)

I have opened an incident report at WP:ANI regarding this incident. Zad68 04:25, 27 May 2012 (UTC)

• comment Out of curiosity, is this disagreement still about the word "African" in the lede? Pass a Method talk 20:44, 26 May 2012 (UTC)

• It's more about how to present the Cochrane findings and criticism of those findings, see the 2 Talk topics I opened below. Zad68 15:17, 27 May 2012 (UTC)

Talk:Circumcision/FAQ

hello. the faq listed at the top of this talk page only covers the title (circumcision versus genital mutilation). with 72 archive pages, surely the faq should be longer? -badmachine 02:50, 27 May 2012 (UTC)

Citing Cochrane

A concern has been expressed that the "strong evidence" sentence shouldn't be presented in Wikipedia's voice unattributed. However the attempts to address this concern have ended up mis-citing or mis-characterizing Cochrane. The Cochrane review isn't just "a study," it's a meta-analysis of several studies, with heavy statistical analysis and corrections for confounding factors. Per WP:MEDRS and other Wikipedia policy, this sort of meta-analysis of large bodies of data is "Wikipedia gold"--from WP:MEDRS: "Ideal sources for such content includes general or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies." We have exactly this. In my editorial judgment, the cites we have are strong enough to make a statement about the evidence in Wikipedia's voice. I feel like if this article were ibuprofen instead of circumcision, and we had the same kinds of sources, the article would say "Ibuprofen reduces pain by 40%" or whatever, without qualification or controversy, or even the need to say "Meta-analyses of studies show that there is strong indicates that indicates ibuprofen reduces pain by 40%." So for at least the time being, I am offering a compromise that attributes the results to Cochrane, and accurately characterizes both that kind of study Cochrane is, and the results. There is a second issue of discussing criticism of the Cochrane study in the article, and I'll open a separate Talk page topic about that. Zad68 14:39, 27 May 2012 (UTC)

experimental research results for Ibuprofen have been replicated and confirmed everywhere in the world, acorss all boundaries cultures peoples; the HIV benefit of circumcision has been subjected to no rigorous skepticism and experiemtnal testing. And, yes, we're still waiting for your explanation about the initial editorial motivation to include these tribal studies as final ande absolute fact for the introduction. Robert B19 (talk) 18:33, 27 May 2012 (UTC)

Agree with Zad68. This seems like a reasonable compromise, as Cochrane reviews are widely held as high quality reviews. Yobol (talk) 21:00, 27 May 2012 (UTC)

Its far from a reasonable compromise. Try again. Pass a Method talk 22:29, 27 May 2012 (UTC)

Perhaps you could explain what your objections are, and without the snark. Yobol (talk) 22:37, 27 May 2012 (UTC)

The reason i hesitate to make a new compromises is that you guys sometimes make it even less neutral than the previous ones. In order for us to reach an agreement, Yobol, Zad68 and Jakew need to ask themselves why so many editors have long complained about the biased state of the lede. I have edited hundreds of articles and the circumcision lede yesterday was by far the most non-neutral article i've seen. It is still non-neural now. Anyody so myopic to be unable to have seen the extreme bias in yesterday's lede I am unable to have a conversation with since we are obviously living on different planets. Pass a Method talk 23:00, 27 May 2012 (UTC)

So instead of addressing directly the attempt at compromise, you declare everyone who has ever disagreed with your position as the problem, and refuse to engage in the conversation? Why exactly are you here on the talk page if you aren't willing to discuss the article? Yobol (talk) 23:05, 27 May 2012 (UTC)

Im willing to discuss the article, but seeing how previous discussions have gone, im not optimistic. I sort of feel like trying to compromise with people who defended yesterdays version is like trying to convince Joseph McCarthy to support free trade. It is a lot more difficult than you think. Pass a Method talk 23:10, 27 May 2012 (UTC)

So discuss. What is wrong with the wording as proposed? Yobol (talk) 23:12, 27 May 2012 (UTC)

I have some reservations about it, but I think Zad68's edit is an acceptable compromise. Jakew (talk) 07:12, 28 May 2012 (UTC)

Criticism of Cochrane

There has been expressed a desire to include some content on the criticism of the Cochrane study and its findings. There are enough sources out there that this topic in and of itself is notable. I would like to open a discussion about what to include, and where. I observe that this article Circumcision is already too long. It is the 1,638th largest of several million articles (putting it easily in the top 0.1% largest articles), and as it currently stands is over 140,000 raw bytes, and so is probably WELL into the Wikipedia recommendation to be divided up--"Readable prose size > 100 KB: Almost certainly should be divided," see WP:SIZERULE. According to Wikipedia guidelines, including WP:UNDUE, the article would be actively made worse by adding a large section about the criticism of this one source of data supporting maybe a dozen sentences in the article. I suggest that a new article be created, something along the lines of Criticism of medical analysis of circumcision, that a one-sentence summary along the lines of "Various sources and studies have criticized the methodology and findings of Cochrane and other studies," along with a "See also" linking to that new article. Thoughts? Zad68 15:10, 27 May 2012 (UTC)

I think it's a good idea to consider where might be a good place to put this material. However, WP:CRITICISM discourages "criticism of" articles, and for good reason, I think, as it's very hard to maintain NPOV with such a scope. I see no reason why this material shouldn't be included in medical analysis of circumcision or circumcision and HIV, where there is plenty of space. A section of circumcision and HIV would probably be the best option. In this article, I'd like to point out that we do already cite criticism in the body ("Some have challenged the validity of the African randomized controlled trials, prompting a number of researchers to question the effectiveness of circumcision as an HIV prevention strategy.[95][96]"); does that wording need to be changed? Jakew (talk) 15:51, 27 May 2012 (UTC)

Outdated HIV and circumcision studies

On review of some of the studies we are using, I note that we are using out-dated sources (reviews from 1999, etc). Certainly systematic reviews that discuss HIV transmission that came out before the recent randomized controlled trials are out of date (and per WP:MEDRS, any studies more than 5 years old is out of date - some of these are much longer than that). I will be removing these studies at some point in the future. Yobol (talk) 22:41, 27 May 2012 (UTC)

Spring cleaning is always a good idea. Most of the older reviews can easily be replaced with more modern sources. I suggest making exceptions for the reviews of complications by Kaplan (1983) and Williams and Kapila (1993), since although these are old, the information that we list is unlikely to be out of date, and I don't think there are more recent sources with the same level of detail. Jakew (talk) 08:04, 28 May 2012 (UTC)

1RR proposal

I invite editors to comment on a 1RR limit proposal here Pass a Method talk 07:01, 29 May 2012 (UTC)

I've removed the RfC tag as it's being misused. Please limit placing that tag to above the actual discussions, not notifications on other pages about the discussion. elektrikSHOOS (talk) 23:26, 30 May 2012 (UTC)

Questions that need to be asked about HIV in lede, an alernative proposal and thoughts on 'context'

Just for reference I will reproduce what we say about HIV in the lede as it stands:

One analysis of studies done in Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%,[15][16] and studies have concluded it is cost effective in sub-Saharan Africa.[17] The WHO currently recommends circumcision be part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV.[18] Some organizations have discussed under what circumstances circumcision is ethical.[19][20]

It seems to me nobody has picked up on the real bias shown by Jake. That is the decision as to what to include in the lede.

These are the questions we must ask:

Should we say anything at all about HIV in the lede?

What should we say about HIV?

Should we put the percentage reduction (the results of the cochrane study). Why? This is where Jake has shown bias.

There is also the question of context. Anyone who mentions the word context is wikilawyered and pointed to a certain rule where you cannot conflate sources as this is original research. But like I said before, the choosing of what goes in the lede is a form of original research because you, the wiki editor, are deciding from all the subtopics of circumcision which is deemed most important to put into the lede. Then there is how you phrase the information and the order it is put in - again the wiki user's personal thoughts - akin to original research. To make these decisions you have to have some original thought, no? So stop wikilawyering when anyone mentions the word context. You are being hypocritical if you do.

Regarding circumcision and Africa, currently we have a sentance:

"The WHO currently recommends circumcision be part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV".

This is a waste of space. Instead of this we should talk about what has happened since that recommendation was made. Take for instance this article: UNAIDS and the US President's Emergency Plan for AIDS Relief (PEPFAR) have launched a five-year plan to have more than 20 million men in 14 eastern and southern African countries undergo medical male circumcision by 2015 as part of HIV prevention efforts. To me, we should definitely have something about the efforts by governments and big organisations like the UN to carry out circumcision programmes in Africa. Currently the general reader knows nothing about the massive effort to increase circumcision in Africa. About what is currently going on. So this is what I am saying about bias. It is subtle. Why put the results of the Cochrane study before a sentence about the scale up of circumcision in Africa?

So, an alternative proposal:

There are efforts to scale up circumcision Africa in the belief that it will reduce HIV.(link to http://www.malecircumcision.org/index.html for example) Studies have been done, largely in Africa, which indicate circumcision reduces the risk of HIV.(link to cochrane) Circumcision opponents question the validity of the studies (link to one of the anti-circ reviews), question the ethics of mass circumcision in Africa(link) and think there are better methods of HIV prevention.(link)

To me this is a lot better - more interesting and informative for the general reader and less biased.

Another point. Why pay so much heed to the words of big organisations? The choice of which organisations in particular to pay so much heed to is again akin to original research because you, the wiki user, are using your own personal thoughts to decide how important each organisation is. I think we need to stop showing so much reverence to big organisations like the UN and WHO. We shouldn't necessarily think that because the UN says it, then that is that, it is the majority view and any other view should not be given equal weight. In this instance the UN/WHO is basically the researchers who carried out the studies. So what I am saying is that in a lot of areas where Jake thinks the debate is done and dusted, the pro-circ view is the majority view, that is wrong. We should have equal weight. If we except this then I think there would be a lot less disputes here. Tremello (talk) 06:56, 30 May 2012 (UTC)

First of all, Tremello, comment on content, not the contributor. You've claimed that "I've" shown bias twice in the above text; presumably you think I wrote this material. In fact, I didn't, but that's a moot point. Don't make this personal.

Next, regarding whether HIV should be discussed in the lead, I refer you to Zad68's excellent comment.

Next, you claim that bias has been shown in including the percentage reduction, but you haven't explained why that's biased.

Next, you argue that "the choosing of what goes in the lede is a form of original research because you, the wiki editor, are deciding from all the subtopics of circumcision which is deemed most important to put into the lede". This doesn't seem a very constructive argument because, if applied to its logical extent, it would mean that the article would be an empty page.

Next, you claim that referencing the WHO's recommendations "is a waste of space", but you haven't said why.

Next, you ask "Why put the results of the Cochrane study before a sentence about the scale up of circumcision in Africa?" The answer is that we need to explain that circumcision has an effect against HIV before we explain why people are doing anything about it.

Next, you propose: "There are efforts to scale up circumcision Africa in the belief that it will reduce HIV.(link to http://www.malecircumcision.org/index.html for example) Studies have been done, largely in Africa, which indicate circumcision reduces the risk of HIV.(link to cochrane) Circumcision opponents question the validity of the studies (link to one of the anti-circ reviews), question the ethics of mass circumcision in Africa(link) and think there are better methods of HIV prevention.(link)". There are several problems with this; the most glaring problem is that is gives far too much weight to circumcision opponents.

Next, you say "I think we need to stop showing so much reverence to big organisations like the UN and WHO". I disagree. The UN and WHO are extremely influential, having led directly to policy decisions by multiple countries. They're cited in large numbers of sources.

Next, you say "So what I am saying is that in a lot of areas where Jake thinks the debate is done and dusted, the pro-circ view is the majority view, that is wrong. We should have equal weight." Equal weight would be undue. Only a tiny minority of secondary sources are negative towards circumcision as partial protection against female-to-male HIV transmission. See User:Jakew/reviewsumm. Jakew (talk) 10:11, 30 May 2012 (UTC)

The WHO/UNAIDS is a highly respected organization and is exactly the type of high quality source we should be using. As to "equal weight", you should read WP:WEIGHT. We weight what the reliable sources weight. In this case, Cochrane and the UN are the highest quality sources we have, so we give them the most weight. Yobol (talk) 15:39, 30 May 2012 (UTC)

The guidance at wp:MEDRS is clear. We should work from the best quality sources available. Systematic reviews published by the Cochrane Collaboration are explicitly identified as such. LeadSongDog come howl! 06:56, 31 May 2012 (UTC)

A Cochrane review is not just "One analysis of studies" This is the foremost evidence based research organization in the world and there analysis hold more weight than most. Doc James (talk · contribs · email) 08:54, 31 May 2012 (UTC)