Talk:Acupuncture

Strong Bias towards Skeptic Researchers

Example at the Efficacy section:

Although minimally invasive, the puncturing of the skin with acupuncture needles poses problems when designing trials that adequately control for placebo effects. Publication bias is listed as a concern in the reviews of randomized controlled trials of acupuncture. SKEPTIC POV

Since most trials found "sham" acupuncture may be as efficacious as "real" acupuncture, the validity of traditional acupuncture theories including acupuncture point locations has been questioned. Some research results are encouraging but others suggest acupuncture's effects are mainly due to placebo.SKEPTIC POV

It remains unclear whether acupuncture reduces pain independent of a psychological impact of the needling ritual.

The results of trials researching the efficacy of acupuncture are variable and inconsistent for any condition.SKEPTIC POV

An overview of high-quality Cochrane reviews suggested that acupuncture is effective for some but not all kinds of pain. An overview of systematic reviews found that numerous reviews have shown little convincing evidence that acupuncture is an effective treatment for reducing pain.SKEPTIC POV

Acupuncture is generally safe when administered using Clean Needle Technique (CNT) but there is a low risk of adverse effects, which can be serious including death in rare cases.SKEPTIC POV

5 instances of the skeptic POV dominating the tone, weight 3 references to Ernst, 2 to Colqhoun. These 2 represent the fringe, or outlier POV. If they represented the mainstream, medical POV, then these guys http://www.medicalacupuncture.org wouldn't be around. Where does dry needling, or medical acupuncture fit it? DVMt (talk) 22:21, 9 May 2014 (UTC)

Ah? Who cares were or not these guys are around "http://www.medicalacupuncture.org/" Whether or not evidence supports acupuncture has nothing to do with whether or not some physicians do acupuncture. Lots of MDs promote stupid stuff and have non evidence based practice.

We should be using the original Cochrane reviews IMO rather than this paper [1] Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:39, 9 May 2014 (UTC)

Um, no, that's "strong bias towards reality-based researchers". This is medicine and science we're talking about, any claim has to be proven by its proponents and the more extraordinary it is, the stronger the burden of proof. In medicine, appeal to tradition is tantamount to an admission that it's twaddle. Before the 20th Century we knew next to nothing about human physiology, biochemistry or the mechanism of disease. A system based on the idea that an empirically unverifiable life force flows in empirically unverifiable meridians and is subject to imbalances that can be corrected by inserting needles - oh and by the way ancient texts show this was fleams not needles - could only be anywhere close to right by the most amazing happenstance. In reality, of course, we now know that it doesn't matter where you stick the needle, or even whether you stick it in. That's what we find if instead of asking "how do we show that acupuncture works?", we ask "does acupuncture work?".

Existence of some kind of trade body does not validate the practice. There are medical homeopaths. That does not make homeopathy any more valid. Guy (Help!) 23:05, 9 May 2014 (UTC)

We're not talking about homeopathy which, according to my knowledge has no evidence of effectiveness. Also, we're skipping my main point: overuse of skeptic POV at the efficacy section. We're also dismissing an entire system of healing based on our own Western values as opposed to what the Chinese actually think and do. This is called cultural relativism. Regardless of the mechanism, why are we using 5 skeptic papers to dismiss the increasing body of literature that suggests effectiveness for specific conditions, such as this new systematic review which states "there is high-level evidence to support the use of acupuncture for treating major depressive disorder in pregnancy." http://www.ncbi.nlm.nih.gov/pubmed/24761171. The article, like many other CAM articles over-represents Ernst et al. while watering down (or deleting) sources that suggest otherwise. DVMt (talk) 17:39, 10 May 2014 (UTC)

That is a fringe journal written by the trade. Med Acupunct. 2013 Jun;25(3):164-172 is not an independent source on the subject matter. See WP:FRINGE. Cheers. QuackGuru (talk) 17:45, 10 May 2014 (UTC)

Are you asserting a fact, or your personal belief system? Providing a source would be helpful. There is another systematic review that concludes "Our results are consistent with acupuncture significantly lowers blood pressure in patients taking antihypertensive medications. We did not find that acupuncture without antihypertensive medications significantly improves blood pressure in those hypertensive patients." ( http://www.ncbi.nlm.nih.gov/pubmed/24723957). This and other CAM articles at WP, that have a growing evidence-base, seems to be whitewashing or watering down sources that suggest effectiveness or that contradict the Ernst, whom you acknowledge you're in contact with (https://en.wikipedia.org/w/index.php?title=Talk%3AChiropractic&diff=606080466&oldid=606052541). How are do you explain the fact that it appears that you're acting as a meat puppet for EE? He's directly and personally feeding you with his critical articles offline. Something is definitely awry here. DVMt (talk) 18:05, 10 May 2014 (UTC)

Does Med. Acupunct. have legit peer-review? AIM, it turns out, doesn't, disappointingly: see WT:MEDRS archived discussion. We have to use good journals, no question. If EBCAM has real peer review, great, let's use it. I'm just real cautious after the AIM experience (good on jps to catch that). --Middle 8 (leave me alone • talk to me • COI?) 19:36, 10 May 2014 (UTC)

(e/c) Some thoughts, and forgive me for talking a bit about the subject rather than the article:

a bit long; collapsed for readability

1 is true; study design is confounded by acu being a procedure. I thought that this was something both skeptics and proponents agreed upon (albeit with proponents saying acu is so complex that study design is highly confounded, and the plethora of (-) results are really false negatives aka Type 2 errors). (btw doesn't matter who said it if it's true) 2 is certainly true in the literature that MEDRS considers optimum, even though some proponents feel that the false negative caveat mentioned above has been neglected. Note: IMO, it hasn't been neglected as much as proponents say it has. Not when multiple studies show that nonpenetrating needles, or toothpicks etc., function as well as real needles at acupoints. Not when multiple studies show that penetrating needles at nonacupoints (another kind of sham acu) function as well as penetrating needles at acupoints. Granted, there is potential for Type 2 errors when such studies are carried out using naive practitioners who don't know how to needle properly (a concession has been made in order to blind the practitioner). But there have also been studies of this type (penetrating needles at both acupoints and nonacupoints) using trained practitioners (who insert & manipulate needles properly) -- and blinded evaluators -- THAT ALSO SHOW EQUIVALENCE OF THE TREATMENT AND CONTROL GROUPS. GERAC was such a study. This is strong evidence that the verum acupoints studied are not uniquely active. Note also that in such studies, any unblinding would tend to create false positives aka Type 1 errors. And there have also been studies where practitioners, remarkably, have been blinded through use of ingenious sham needles (note that this just wouldn't work with some practitioners who manipulate needles a lot in order to break up trigger points). Such studies also have shown equivalence between treatment and control groups. Note again that unblinding (of either the patient or practitioner) would tend to lead to Type 1 errors, not Type 2 errors. 3 is true also -- see Cochrane reviews -- and no wonder, given #2 above. It's even true for studies on pain. Now, I would like to see a treatment group comparing real trigger-point release and a control group using some sort of other technique that's equally "noxious" or intense but nonspecific -- say a nice strong "reflexology" session (a nice, twinge-y foot massage, just for good measure avoiding the regions of the foot that are supposed to be reflex areas (per both TCM and Western relexology) for whatever area is being treated with the acupuncture. And then add in *another* treatment group with *both* the acu trigger-point release AND the reflexology. That would tell me something, assuming the control group were really inert. That would help me figure out whether the efficacy for pain seen in the Vickers review is due to verum acupuncture working, or an accumulated bunch of the Type 1, unblinding errors mentioned above. It would also be nice to see a meta-analysis that separated out the results of the sham studies that are prone to the Type 2 and the Type 1 errors, respectively. Bottom line -- still a margin of plausibility for acu working for pain, but the margin has undeniably been growing slimmer over time. Note -- my bias, from my style of treatment which is similar to DVMt's, is that trigger point release is real, and even some skeptic types like Brangifer have, in the past, spoken positively of trigger point release. But it still can and should be studied, and if it doesn't hold up, well, what then? 4 probably shows a need for the text to be rewritten, using the most up-to-date reviews, and accomodating all their conclusions. Still, both sentences are pretty much true summaries of the literature. 5 is true but gives too much weight to DEATH in one sentence.

Just my thoughts FWIW. --Middle 8 (leave me alone • talk to me • COI?) 18:57, 10 May 2014 (UTC)

I will tell you why the skeptical viewpoint is favored by default in science: Mertonian norms. Tgeorgescu (talk) 01:15, 16 May 2014 (UTC)

The skeptical viewpoint shouldn't be confused with dogmatic or cynical viewpoint. Wikipedia is littered with dogmatic skeptics and cynics which is why these holistic/CAM/traditional/alt-med pages never get past the fundamental issue: what SPECIFIC aspect of practice is considered FRINGE and what specific area of practice is considered MAINSTREAM? The whole thing is bogus nor pseudoscience. That term is loosely thrown and broad here and it does wikipedia a great disservice. It leaves the narrative polarized as though there is no middle ground. Dominance is given to skeptic researchers whose weight is thrown around in a false context. Physiotherapists are lobbying hard in the US to get 'dry needling' rights which is to stick needles in the human body for therapeutic benefit. We need to separate fact from fiction, Western vs. Eastern approaches and present all the reviews as they are, without attempts to delete reviews that are supportive of acupuncture for 'x' diagnosis. Perhaps we should get an ArbCom to review this and chiropractic since the same principles and players are at play. DVMt (talk) 03:08, 16 May 2014 (UTC)

To begin to work towards neutrality on this article, the introductory paragraphs should be as neutral as possible. I have attempted to make edits in this spirit and have been reverted by multiple by tag-team editors gaming the system, attempting to have me stumble into a three reverts first. I don't see how we can have a true encyclopedia-worthy article with edits such as these. I, therefore propose the following: a completely neutral, matter of fact description of what acupuncture is in the introductory paragraph. Then, creating a criticism section down the article where those who feel passionately that acupuncture is pseudoscientific can have their voices heard. Once we create that section, then perhaps we can positively work towards neutrality in the rest of the article and hope to have the neutral POV tag removed. Ricflairsbutt (talk) 22:18, 24 May 2014 (UTC) Sock comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

You may want to read Mertonian norms: skepticism is by default the scientific position, adopted professionally by all scientists worth their salt. So, accusing us of skeptic bias means accusing us of being biased in favor of science, which is pretty germane to a pseudoscience label applied to acupuncture. Tgeorgescu (talk) 00:03, 25 May 2014 (UTC)

The official Wikipedia stance: WP:LUNATICS. Tgeorgescu (talk) 00:05, 25 May 2014 (UTC)

A difficulty is that quality research is being pulled from the site if it is supportive of the efficacy or biomedical basis for acupuncture. I have listed numerous studies from prestigious universities and research groups pertaining to individual aspects of acupuncture and it continues to get pulled from the page. I suggest that the so-called quack watch bias is extreme and unscientific. The vast quantity of quality of research to have evolved within the last 18 months is scientific. Double blinded, randomized studies using placebo controls have demonstrated important effective aspects of acupuncture. Moreover, there have been numerous secondary studies to supplement the primary studies. I would not be surprised if this comment is pulled. I would list the research but too often I have done this only to find it has been removed. I suggest a second look at the recent science. I am concerned that the skeptic bias on the acupuncture page overlooks modern science. TriumvirateProtean (talk) 21:04, 31 May 2014 (UTC)

You should take each source to WP:RSN and if it stands up to scrutiny there, it should be included. As per the Quackwatch quote I offered on this talk page, TCM is an accumulation of such diverse, bizarre and convoluted viewpoints that one cannot properly do scientific research with its theories. E.g. there has to be some consensus where the acupuncture points are located, otherwise one acupuncturist from town A will say they are in certain place, an acupuncturist from town B will disagree and say there are somewhere else. Till the acupuncture points are identified with certainty there will be no serious research upon acupuncture points possible, since they could be everywhere on the body and if you use a control group to stimulate a not existing acupuncture point, some acupuncturist will say that is a valid acupuncture point, too, so it voids the very definition of controlled experiment. Tgeorgescu (talk) 23:07, 31 May 2014 (UTC)

Sources on acupuncture with positive results

Greetings! Here are couple of sources dealing with the positive research outcomes with acupuncture that I'd like to suggest to be taken into account in the article:

1. The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): a systematic review of reviews: "Thirty-one studies were included in this review. The majority of included trials comparing true acupuncture and sham acupuncture showed a trend in favor of acupuncture. The combined response rate in the acupuncture group was significantly higher compared with sham acupuncture either at the early follow-up period (risk ratio [RR]: 1.19, 95% confidence interval [CI]: 1.08, 1.30) or late follow-up period (RR: 1.22, 95% CI: 1.04, 1.43). Combined data also showed acupuncture was superior to medication therapy for headache intensity (weighted mean difference: -8.54 mm, 95% CI: -15.52, -1.57), headache frequency (standard mean difference: -0.70, 95% CI: -1.38, -0.02), physical function (weighted mean difference: 4.16, 95% CI: 1.33, 6.98), and response rate (RR: 1.49, 95% CI: 1.02, 2.17). ... Needling acupuncture is superior to sham acupuncture and medication therapy in improving headache intensity, frequency, and response rate." (Sun, Y., Gan, T. J. (2008). Acupuncture for the Management of Chronic Headache: A Systematic Review. Anesth. Analg. 107: 2038-2047)
2. A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis: " A short course of traditional acupuncture for persistent non-specific low back pain in primary care confers a modest health benefit for minor extra cost to the NHS compared with usual care. Acupuncture care for low back pain seems to be cost effective in the longer term." (Ratcliffe J, Thomas KJ, MacPherson H, Brazier J. A randomised controlled trial of acupuncture care for persistent low back pain: cost-effectiveness analysis. BMJ 2006;333:626)

I suggest that these findings will be included into the article in order to have a more balanced view on the subject.

Ps. This also intersects with the Acupuncture and moxibustion as well, so if you haven't, please take a look at that as well! ;) Jayaguru-Shishya (talk) 18:18, 12 May 2014 (UTC)

Agree, these are excellent MEDRS's. There's also this (h/t Puhlaa): Evidence Map for Acupuncture, a medical guideline from the US Dept. of Veterans Affairs Health Services Research and Development Service. --Middle 8 (leave me alone • talk to me • COI?) 02:51, 13 May 2014 (UTC)

[User:Middle 8|Middle 8]] (leave me alone • talk to me • COI?), that's just great! It should be definately included in the article. Jayaguru-Shishya (talk) 15:26, 13 May 2014 (UTC)

Disagreed. We have newer sources for Acupuncture#Cost-effectiveness.

The other source is already in the article. Lee, Courtney; Crawford, Cindy; Wallerstedt, Dawn; York, Alexandra; Duncan, Alaine; Smith, Jennifer; Sprengel, Meredith; Welton, Richard; Jonas, Wayne (2012). "The effectiveness of acupuncture research across components of the trauma spectrum response (tsr): A systematic review of reviews". Systematic Reviews. 1: 46. doi:10.1186/2046-4053-1-46. PMC 3534620. PMID 23067573. {{cite journal}}: Unknown parameter |displayauthors= ignored (|display-authors= suggested) (help)CS1 maint: unflagged free DOI (link)

The Evidence Map for Acupuncture cited reviews which we currently use in the article. If there are any missing reviews we should use the reviews directly. QuackGuru (talk) 03:02, 13 May 2014 (UTC)

I agree that we should cite individual reviews, but reviews of reviews -- or medical guidelines, like the VA Evidence Map -- are also considered good MEDRS's. --Middle 8 (leave me alone • talk to me • COI?) 18:25, 15 May 2014 (UTC)

I think you have misunderstood something regarding the publication date of an article. There are currently two articles listed in Acupuncture#Cost-effectiveness, one from 2011 and the other from 2013. The one that I mentioned is from 2012. All of these articles are published by a different set of authors in rather a short period of time, and you can't make a conclusion that those authors who have conducted the latest research would be somehow automatically "the most right". It's typical for human sciences to obtain a large variety of different test results, and that's the reason why a lot of repetition is needed. The latest one available, however, does not signify that it would be somehow more reliable or a better one even. Therefore, it is still very well-grounded to include those two pieces of research in the article. Jayaguru-Shishya (talk) 15:26, 13 May 2014 (UTC)

However, the usual problem applies: what are the chances of someone studying acupuncture in this way, who is not already convinced of its efficacy and seeking to confirm it? Where will negative results get published? How many journals are looking to carry negative results for things that have no plausible mechanism of action anyway? For subjective symptoms, placebo effects, expectation effects, regression to the mean and so on are particularly strong, so do we see much weaker results of objectively measurable outcomes (yes we do) and what does this indicate about whether the intervention actually works (it weakens the conclusions of studies on subjective outcomes). You have to be really careful with reviews like the VA one. They are very often motivated by political pressure for a treatment that has failed to gain acceptance through the orthodox route of unambiguous good quality evidence. It has taken a long time to show that meridians and acupoints are almost certainly irrelevant, and most of the studies involved in these reviews will not have been able to properly blind for whether the needle is inserted or not. Guy (Help!) 09:38, 13 May 2014 (UTC)

@Guy - Given the numerous results showing little evidence for efficacy, somebody has to be publishing them, and it's not just Cochrane. You're certainly right about caveats such as blinding and expectation effects, but it's up to reviewers to account for these, right? On the VA source, IIRC it doesn't deviate hugely from other reviews, and one wouldn't expect unanimity. Author bias is possible, but that's speculative; I don't remember any red flags. Seems like yet another meta-analysis. I think it's reasonable to say that if we're going to exclude positively slanted things just because they're positive, then we're not fairly representing the current state of the literature (and I say this as someone who believes that WP:NOTTRUTH and WP:FLAT shouldn't be taken too far). For example, we saw within the last year both "pro (Wang et. al.) " and "con" (Colquhoun and Novella) editorials in a mainstream journal. (The latter rang truer, but the former didn't really contest a lot of its conclusions.)

As far as why study it at all, one answer I've seen is that it's highly safe and makes people feel better, so the large placebo effect is actually a plus when added to whatever its nonspecific effects may turn out to be. Yes, that would be really perverse logic if used when evaluating a new drug, but the double standard is apparently justified by acu's known lack of side effects and drug interactions. An example of this view is the editorial introduction to the "pro" and "con" editorials above, and I've heard some doctors, whose patients try it and like it, say similar things. Perverse but pragmatic. --Middle 8 (leave me alone • talk to me • COI?) 20:01, 15 May 2014 (UTC)

Publication bias? Yes, that might be true, or then it might be not. We are not here to conduct critical evaluation on such things though in Wikipedia. There are analytical tools however to evaluate possible publication bias, such as the funnel plot etc. It's a very interesting issue still; in an ideal case the scientific community will try to falsify the test results. For example, if opponents of some theory would like to falsify the former results, they would naturally have the incentive to re-run the test setting and publish any negative / statistically insignificant results acquired. When it comes to meta-analyses, of course, it is good for oneself to be aware what studies have been included in the meta-analysis, what have been left out, and why possibly? Anyway, that's a whole different field of research (and a lot of work and data collection!) and we are not here to do that in Wikipedia. Interesting subject though. Jayaguru-Shishya (talk) 15:26, 13 May 2014 (UTC)

Publication bias is not an issue with complementary medicine journals, this also occurs in conventional medicine. Also the suggestion that negative reviews would be buried is pure speculation but there is evidence of this with pharmaceutical companies duping the public [2]. The reality is, acupuncture, like chiropractic, is gaining increasingly researched with better designs and there seems to be a pattern emerging and that acupuncture is useful adjunct with specific diagnoses. This does not validate TCM theory, but it does suggest that needles inserted at various points seems to have a beneficial effect. DVMt (talk) 00:09, 14 May 2014 (UTC)

Guy, not only do I agree with the previous 2 comments, I would also point out that actual scientists, people who do science and whose reputations depend on a truthful explanation of science, would never be so cavalier as to assert that ANYTHING has been absolutely firmly established, ESPECIALLY the absence of phenomena based on an absence of evidence. Even Ernst, who is truly on a mission but nevertheless is a true believer in science, does not make the kind of absolute, religious fundamentalist type conclusions you make about the current scientific lack of evidence for some of the effects of acupuncture and TCM. Your appeal to attack any positive reviews for publication bias is absurd considering there is literally no profit-motive (patents) in the acupuncture profession the way there is in the pharmaceutical industry or even in the realm of surgery. Even with the current natural medicine loving culture we have in the states right now, schools of acupuncture are under pressure to reduce tuition and program length due to debt-to-income ratios. Almost nobody gets wealthy doing acupuncture, so who is driving the publication bias you complain about? Are you at the Vioxx page decrying publication bias? How bout Chantix? Cuz those are truly dangerous areas where money talks louder than science. Acupuncture is simply not such an area. Herbxue (talk) 07:32, 14 May 2014 (UTC)

Ah, a nice dose of common sense! Agreed with the comment above. Some editors are trying to substitute their own personal belief system and white-wash the whole profession or modality as pseudoscientific. With almost 21000 hits at Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/?term=acupuncture) is it still really fair to say there is no scientific aspect about the study of using needles to promote positive physiological change? — Preceding unsigned comment added by DVMt (talk • contribs) 01:02, 16 May 2014 (UTC)

Proper scientists who do real scientists certainly do say that things have been firmly established. The problem here is that there are two parallel threads of research: one conducted by believers, looking to find evidence of the conditions for which acupuncture might work, and the other conducted by non-believers, looking to test the basis of the claims made for and about acupuncture. If you are determined to seek a mechanism by which it works, then you have to allow the possibility that the mechanism is placebo effects, expectation effects and the like: most publications on the mechanisms of acupuncture quietly ignore this rather important question. When you consider that the supposed meridians and acupoints are different between Chinese and Japanese acupuncture, you can't really carry on ignoring this. To quote one source:

Research on the nature of acupuncture points and meridians is often difficult to evaluate because of the diverse nature of the claims made, incomplete data provided in published studies and the variety of parameters involved in the assessment of these claims. Many of the studies purporting to have identified acupuncture points or meridians come from China; the role of publication bias in Chinese literature needs to be considered in light of the fact that no trial published in China from 1966 through 1995 found a test treatment to be ineffective. Obvious contradictions exist between current acupuncture practice and the historical record, as well as on the “correct” number of points and meridians reported by current practitioners of acupuncture. From an empirical standpoint—discrete structures such as acupuncture points and/or meridians would revolutionize the study of anatomy and physiology—no such revolution has occurred. Whatever the clinical efficacy of needling, there is, as yet, no convincing evidence to show that acupuncture points or meridians exist as discrete entities.

That seems pretty neutral to me, albeit not to the taste of acupuncturists. It's also in line with the absence of any credible evidence of anatomy associated with the purported meridians and acupoints.

We should not feel threatened by this sort of thing. There's no reason to believe that ancient wisdom is anything other than wrong in medical matters, the cases of historical remedies, diagnoses and treatments that turn out to be both valid and only recently unambiguously shown to be so, are few and far between. We worked out salycilic acid and quinine quite early in the development of modern medicine. In practice, it does not seem to matter where you stick the needles and it does not seem to matter if you actually insert them. Neither of these is at all surprising given the source of both ideas. I think the question of the non-existence of meridians and acupoints is settled, with only the believers continuing to plough that furrow. I don't think this is a particularly controversial view, other than with believers. Guy (Help!) 18:35, 16 May 2014 (UTC)

Who here is discussing about meridians and acupoints? We're talking primarily about systematic reviews of effectiveness. You're conflating theory and practice. You can get good results with a wrong theory. DVMt (talk) 19:29, 16 May 2014 (UTC)

If there are good results regardless of where you insert the needles, then any idiot could randomly insert needles and claim to provide medical care. Wait, there actually was a MythBusters episode on acupuncture which did precisely this and obtained good results. Tgeorgescu (talk) 11:34, 1 June 2014 (UTC)

If there are good results regardless of where you insert the needles, then any idiot could randomly insert needles and claim to provide medical care.

So this proves that you haven't read the sources I provided, really. If you'll take a look, you will see that the places where they insert the needles have been controlled already. I'd be surprised to find peer-reviewed studies where such a preliminary thing wouldn't be taken into consideration even.

I don't know about the university where you used to study, Theorgescu, but in mine MythBusters weren't a proper source. Your source based on MythBusters, shall I say, busted! ;) Jayaguru-Shishya (talk) 12:41, 2 June 2014 (UTC)

The argument has been made that Chinese and Japanese acupuncture have vastly different acupuncture points. It could be that nowadays that Chinese acupuncture system is pretty unified, but an argument can be made that it was unified by fiat, namely that Maoist authorities were embarassed by the diversity of Chinese acupuncture systems and have politically decided to teach only one version. In fact, it is hard to see that a medical system enshrined in folksy superstition would produce a clearly identifiable system of acupuncture points, i.e. that acupuncture points could be unequivocally identified through evidence-based medical research, instead of relying upon centuries-old writings for identifying them. E.g. a surgeon knows where to find the liver and this knowledge is objective since there are clear criteria for what is a liver and where to find it inside a body. As far as I know, there are no such clear-cut criteria for establishing acupuncture points otherwise than relying upon folklore. And we know that folklore varies vastly among different regions. Tgeorgescu (talk) 18:07, 9 June 2014 (UTC)

Interesting. This is mostly just speculation on your part but its worth addressing. Its true that the description of acupuncture point location has evolved, but the actual location of major points probably has not. We still use the cun measurement system, which uses divisions of space between anatomical landmarks. What has changed is that the classical texts did not use modern anatomical terminology to describe the points, while modern textbooks do. This is for the sake of accurate and efficient teaching, not "political fiat". There are not really different points in Japanese acupuncture generally, which mostly is rooted in the Nan Jing, a Han dynasty text. There are, however, multiple sub-styles of acupuncture, from various countries, that use unique points chosen with unique criteria. Herbxue (talk) 22:12, 9 June 2014 (UTC)

Cultural Bias

I propose modifying the article to rid it of cultural bias. By definitively characterizing acupuncture as pseudoscience while using only select Western studies to back up these claims, it becomes quite problematic. If modern, scientific studies are required for the article, perhaps studies mostly conducted in modern-day China, opposed to US/Europe would be a better solution. Ricflairsbutt (talk) 19:41, 24 May 2014 (UTC) Sock comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

Please read WP:MEDRS. This is how we determine our refs. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:21, 24 May 2014 (UTC)

My point is that using only modern, western scientific journals to cite claims made in an article on an ancient Eastern healing modality is biased, both selective bias as well as cultural bias. If a credible US publication made one claim and a credible Chinese publication made another, to avoid cultural bias we would have to use the information from the Chinese publication. And, don' t forget, the WHO has considerable data on acupuncture which should be given more weight than US publications.Ricflairsbutt (talk) 21:10, 24 May 2014 (UTC) Sock comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

It was previously discussed by User:JzG and others. The lede has a "strong bias towards reality-based researchers". See Talk:Acupuncture#Strong Bias towards Skeptic Researchers. QuackGuru (talk) 00:45, 25 May 2014 (UTC)

Reality based researchers? Can you please engage in a discussion without using weasel words? Klocek (talk) 01:41, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

The OP's suggestion sounds like it would actually increase the chance of bias, not reduce it. Zad68 03:16, 25 May 2014 (UTC)

If OP could be met with anything other than total dismissal, that would be great. Herbxue (talk) 03:24, 25 May 2014 (UTC)

Chairman Mao had a dog in this fight: [3]. this explains the Chinese bias. According to WP:LUNATICS, Wikipedia does not give on medical issues equal footage to science and ideology. Tgeorgescu (talk) 12:12, 25 May 2014 (UTC)

And Adolf Hitler helped develop commercial sulfa antibiotics. Your point doesn't have anything to do with the OP's argument, which, as I understand it is that there are high quality studies in acupuncture performed in China and that certain claims can't be made when they're in conflict with data from Chinese studies, which should be given stronger weight. Personally, as a person of mixed Asian decent, this article struck me as xenocentric and even a tad bit racist. While I'm sure Wikipedia doesn't exist to coddle everyone's feelings at the expense of quality, I think what has been suggested here is quite reasonable. Studies from today's Chinese researchers would probably be set up and conducted with superior understanding. If you have ever had acupuncture done on you, you understand what I'm saying. One acupuncturist might have excellent technique in needle insertion and stimulation, whereas another is painful and gives you horrible results. Acupuncture is an art-form, and since it originates in China, it stands to reason they would recognize this better. Chinese studies would be more likely to have renowned acupuncturists doing the needling, opposed to Western studies, which might not even use trained acupuncturists at all. Klocek (talk) 12:52, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

We base our content on high quality secondary sources published in well respected journals. If there is continued removal of the current high quality sources than a ban or block may be needed. Chinese researchers are more than welcome to publish secondary sources in respected journals. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:59, 25 May 2014 (UTC)

Woah there, put your gun back into your holster, nobody's saying we should remove high quality sources. The whole point is that certain claims might be disputed when you have two HQ reliable sources with two different conclusions. If that's the case, then can these claims even be made, when one high quality reliable source doesn't support it and happens to be more high quality (conducted in China) than the other, possibly culturally biased source?Klocek (talk) 13:34, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

I agree with you Ricflairsbutt and Klocek, there is currently a strong bias in the article, and I hope it can be fixed in the future. I don't see any reason why modern-day Chinese articles would be any worse than Western articles. If somebody wants to conduct statistical studies about possible publication bias (China vs. West), university is the right place that and we will be waiting enthusiastically the fruits of such researches here in Wikipedia. However, Wikipedia is not the right forum to speculate possible publication bias. So far, I think Chinese articles published in respected journals (Chinese or Western) are just equally good with all the other articles. Personally, I can't any Chinese though ;) Jayaguru-Shishya (talk) 17:36, 25 May 2014 (UTC)

A pseudo-systematic review funded by the trade?

• Vickers, AJ; et al. (2012). "Acupuncture for chronic pain: individual patient data meta-analysis". JAMA Internal Medicine. 12 (Suppl 1): O9. doi:10.1001/archinternmed.2012.3654. PMC 3373337. PMID 22965186.

Read this: "Funding/Support: The Acupuncture Trialists' Collaboration is funded by an R21 (AT004189I from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) to Dr Vickers) and by a grant from the Samueli Institute. Dr MacPherson's work has been supported in part by the UK National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0707-10186). The views expressed in this publication are those of the author(s) and not necessarily those of the NCCAM NHS, the NIHR, or the Department of Health in England."[4]

Is this source reliable or is this publication bias? See diff. QuackGuru (talk) 00:47, 25 May 2014 (UTC)

Reliable source. You seem to be attempting original research. Herbxue (talk) 05:09, 25 May 2014 (UTC)

This is a secondary source published in a good journal that is pubmed indexed thus see no problems with it use.Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:35, 25 May 2014 (UTC)

I agree with Doc James. -- Brangifer (talk) 17:43, 25 May 2014 (UTC)

I agree with Herbxue, Doc James and Brangifer. Jayaguru-Shishya (talk) 17:50, 25 May 2014 (UTC)

Pseudoscience

The article calls acupuncture a pseudoscience, but nowhere in wikipedia's guidelines does this seem to be allowed. Wikipedia:Fringe_theories There is no scientific consensus that acupuncture is pseudoscience, therefore, it is classified as a questionable science. Klocek (talk) 12:05, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

The same way, why call astrology a pseudoscience when there are people aiming to transform astrology into hard, empirical science? Tgeorgescu (talk) 12:21, 25 May 2014 (UTC)

If there are high quality reliable sources that say it is a pseudoscience so should we. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:39, 25 May 2014 (UTC)

DocJames, Have you read [[Wikipedia:Fringe_theories]? It addresses your point. Just because some high quality reliable resources say it's a pseudoscience, doesn't mean the article can claim it. There is no scientific consensus. Hell, even in the article we have conflicting research and meta-analyses. Acupuncture, therefore falls into wikipedia's classification of questionable science, not pseudoscience. Klocek (talk) 13:11, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

If there are conflicted sources than we say "X state it is pseudoscience, Y describes it as..." Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:13, 25 May 2014 (UTC)

But that's not what the guidelines on Fringe Theories say to do. It says Wikipedia's definition of questionable science, opposed to pseudoscience, is that there are conflicted sources. Therefore, to follow Wikipedia's guidelines, it would need to read "Acupuncture is a questionable science, with X saying this, Y saying this".Klocek (talk) 13:21, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

We follow the sources, and they say pseudoscience. -- Brangifer (talk) 17:19, 25 May 2014 (UTC)

I understand that one source says pseudoscience, but Wikipedia's guidelines state that the very definition of questionable science is that there isn't scientific consensus and therefore, we cannot broadly and definitively characterize something as pseudoscience. Further, one cannot make a broad claim of consensus with one editorial backing it up.Klocek (talk) 18:04, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

Exactly - one editorial expressing an opinion is being used to establish a statement of fact. Its bullshit. Doc James has it right, just say "sos and so says its pseudoscience" - then the notable opinion is included and we don't grossly over-simplify an issue that is obviously not cut and dry (seeing as it has been the dominant subject of debate here and at TCM for what seems like an eternity.) Herbxue (talk) 21:19, 26 May 2014 (UTC)

TCM theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. TCM practitioners disagree among themselves about how to diagnose patients and which treatments should go with which diagnoses. Even if they could agree, the TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care.

— Stephen Barrett, M.D., Be Wary of Acupuncture, Qigong, and "Chinese Medicine"

Wikipedia sees Quackwatch as an authoritative source for such claims, so, again it is a fact that acupuncture and TCM are pseudoscience. Tgeorgescu (talk) 21:37, 26 May 2014 (UTC)

In Taiwan to a quarter of traditional Chinese medicines there were seemingly added standard medicines (which are available on prescription). Among them there were dangerous substances, such as phenytoin (an anti-epileptic), glibenclamide (lowers blood sugar) and corticosteroids.

— prof. dr. Martijn B. Katan, Wat is nu gezond? 1st ed., p. 146

Quoted by Tgeorgescu (talk) 02:03, 27 May 2014 (UTC)

Yeah, we all know what quack watch says and that SOME people here consider it a reliable source. That misses the point. Your second post doesn't make a lick of fucking sense at all.Herbxue (talk) 06:51, 27 May 2014 (UTC)

You think any source you disagree with is unreliable? QuackGuru (talk) 07:13, 27 May 2014 (UTC)

The Katan quote (which I have translated from Dutch) simply says that some TCM medicines are effective because they incorporate allopathic drugs. It says this and that such substances are dangerous when added in tea and herbs, instead of being prescribed by a MD and properly dosed. Tgeorgescu (talk) 12:48, 28 May 2014 (UTC)

An alternative translation is:

In Taiwan a quarter of traditional Chinese medicines were found to apparently incorporate (prescription) drugs. Among them there were dangerous substances, such as phenytoin (an anti-convulsive), glibenclamide (lowers blood sugar) and corticosteroids.

— prof. dr. Martijn B. Katan, Wat is nu gezond? 1st ed., p. 146

Quoted by Tgeorgescu (talk) 16:41, 28 May 2014 (UTC)

Quackwatch as a Source

Stephen Barrett is a de-licensed MD who failed his board exam. On what planet are his words regarding anything medically related considered reliable? Ricflairsbutt (talk) 20:54, 27 May 2014 (UTC) Sock comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

Wow, since when QuackWatch has been a peer-review journal? Jayaguru-Shishya (talk) 04:08, 28 May 2014 (UTC)

Barrett de-licensed is an old canard, it has been debunked over and over. Tgeorgescu (talk) 12:44, 28 May 2014 (UTC)

Opening paragraph

In an effort to resolve the neutral POV tag, I had made several high quality, well-referenced changes to illustrate other POV's. These high quality edits were reverted wholesale, without any discussion by what appears to be a team of editors. I would like to open discussion to resolving this issue. Klocek (talk) 17:07, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

Thanks for not continuing an edit war. That never works. I have left some instructions about edit warring and BRD on your talk page.

Discussion of each change is the way to go. You're editing the WP:LEAD, and the lead should always follow changes to the body. Changes to the body will need to be accepted first, and sometimes that will entail minor tweaks of the lead, but not always. That's why changing the lead is often very controversial, so it's really a bad place to start, especially when you're deleting long-standing content which is based on properly sourced content in the body of the article.

Much of your editing looks like special pleading and whitewashing, so be careful. Start here by suggesting an edit, including its source. Then we can work on it. A consensus version has the advantage of being accepted by more editors, who will also protect it. -- Brangifer (talk) 17:17, 25 May 2014 (UTC)

I couldn't find anything wrong with the sources you used and indeed, they seem to be of a high quality. I can't see any reason why the edits you made couldn't be remained at the article, but I agree with BullRangifer: maybe you could start from the body of the article first? As long as the source doesn't fail, it is more than welcome to be used in the article. Jayaguru-Shishya (talk) 17:23, 25 May 2014 (UTC)

Thanks for your suggestion and for confirming the sources I used. I'll take your advice and add to the body first. Klocek (talk) 17:59, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

I agree that some of your sources might be okay, but when you make so many edits, which also include deleting properly sourced content you don't like, then it's much easier to start all over and take it a bit at a time, using discussion to guide us. -- Brangifer (talk) 17:41, 25 May 2014 (UTC)

The "properly sourced" content I think you're referring to is one editorial from Nature magazine which is supposed to support the claim that "acupuncture is largely considered to be pseudoscience. One editorial cannot support such a broad consensus, especially when, even in this very article, there are contradictory claims. That is why I deleted it. Furthermore, here are the Wikipedia guidelines regarding the use of the term pseudoscience:

Pseudoscience: Proposals which, while purporting to be scientific, are obviously bogus may be so labeled and categorized as such without more justification. For example, since the universal scientific view is that perpetual motion is impossible, any purported perpetual motion mechanism (such as Stanley Meyer's water fuel cell) may be treated as pseudoscience. Proposals which are generally considered pseudoscience by the scientific community, such as astrology, may properly contain that information and may be categorized as pseudoscience."

"Questionable science: Hypotheses which have a substantial following but which critics describe as pseudoscience, may contain information to that effect; however it should not be described as unambiguously pseudoscientific while a reasonable amount of academic debate still exists on this point."

Given these guidelines, the term shouldn't be used. Clearly, with many high quality studies, meta analyses and scientific support of acupuncture's efficacy, it should undoubtedly be termed "questionable science" instead of pseudoscience. Anyway, that's the reason for my removing that statement and source. Klocek (talk) 17:57, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

Issues include: 1) use of non pubmed indexed sources 2) use of the journal medical hypotheses that is not a reliable source 3) one of the publications was retracted 4) issues with caps 5) issues with the refs being poorly formatted so that other editors have trouble following them up

Klocek you are at 5 reverts and have a warning on your talk page. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:49, 25 May 2014 (UTC)

no, I'm at 2 reverts for the content under discussion, and so are you. Klocek (talk) 18:53, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

And regarding the issues you cited, 1) we have a non pubmed source in the lead, nature magazine, an editorial at that, as the support for "largely considered pseudoscientific" and yet you reverted my improvement. Clearly, you could care less about pubmed sourcing and only about bullying me. 2) so medical hypothesis isn't reliable. There's plenty of additional citations provided. Perhaps you could edit it out specifically instead of making broad wholesale reverts to my work. 3) again, see 2, 4) and again 5) and again. Perhaps you need to read Wikipedia's guidelines on making helpful edits. Klocek (talk) 19:00, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

Just to clarify are you stating that User:BullRangifer agrees with your proposed edit? Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:06, 25 May 2014 (UTC)

Yes, that user made the suggestion of changing the body instead of the lead, and did not object to the sources...same with Jayaguru-Shishya Klocek (talk) 19:17, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

And I noticed you didn't reply to any of my retorts. It would be nice if you would return the kindness I presented to you and use this talk page for civil debate. Klocek (talk) 19:20, 25 May 2014 (UTC) Sockmaster comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

Okay lets wait for BullRangifer's reply. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:06, 25 May 2014 (UTC)

While I did mention the primacy of article content before the lead, I also wrote this, as well as clear advice on Klocek's talk page:

• "Start here by suggesting an edit, including its source. Then we can work on it. A consensus version has the advantage of being accepted by more editors, who will also protect it."

There is nothing in my comments which allows for continued edit warring, so the block for edit warring is entirely proper. Lack of collaboration is part of the problem here. Trying to force one's edits through, against the objections of other editors, never works. It's a common mistake made by newbies. I hope that Klocek learns something from this. One can even be 100% correct, and even have all the RS on one's side, and still get blocked. I'm not implying that's the case here, but telling it like it is. One must collaborate or one has no success. -- Brangifer (talk) 20:54, 25 May 2014 (UTC)

Brangifer your complaints about this editor's practices sound much more applicable to the editing of Quackguru Herbxue (talk) 07:01, 27 May 2014 (UTC)

You have a lot of explaining to do. QuackGuru (talk) 07:15, 27 May 2014 (UTC)

Um, was my edit summary not clear?Herbxue (talk) 17:30, 27 May 2014 (UTC)

I did add in-text attribution to the lede. Stop making excuses. QuackGuru (talk) 17:32, 27 May 2014 (UTC)

Oy, mea culpa. I assumed it was the same block of text we have been arguing about, and didn't realize you had edited it. My apologies.Herbxue (talk) 17:42, 27 May 2014 (UTC)

There was already enough in-text attribution (characterized) in the lede before your change. The body makes it clear it was Nature: "Nature found TCM to be largely pseudoscience, with no valid mechanism of action for the majority of its treatments.[4]" QuackGuru (talk) 18:18, 27 May 2014 (UTC)

Well, given that we don't really even have consensus to use the word in the lede at all, it is at least a minimally acceptable compromise to include it, with clarity about it originating in Nature.Herbxue (talk) 00:07, 28 May 2014 (UTC)

I tried to reorganize this section as bit as it was all over the place and jumped too quickly into criticisms - they should be noted, but not as quickly as the third sentence of a large article. The efficacy/criticisms could still be reworked a bit for flow, but i think this is step in the right direction at least! 76.175.164.190 (talk) 19:28, 1 June 2014 (UTC)

Original research?

This change was OR. CONCLUSION:There was little evidence that different characteristics of acupuncture or acupuncturists modified the effect of treatment on pain outcomes.[5] QuackGuru (talk) 19:54, 25 May 2014 (UTC)

It's not only OR, but actually devious. We follow the sources, and this one said "little". Good catch. -- Brangifer (talk) 20:56, 25 May 2014 (UTC)

About nature source

I check the source from nature which define the TCM as pseudoscience. This source is [6]. Actually this article tries to refute another article which is also from nature [7]. The second one describe some opinion, one of them is to use system biology as a way to assess the usefulness of tcm. I just wonder whether it is good to use one article in nature as the view of nature journal while ignore others which are also from nature. Despite article [8] which is also from nature 448 in 2007, I see another article from journal nature [9] which describe the usefulness (for dementia) of TCM. This article was published in 2010 and stated " Sound therapeutic effects promote more scientists, domestic and abroad, to study extracts from herbal medicines. Today, a great number of compounds from herb extracts have proven to be multi-targeted, low toxicity and potent in alleviating dementia." It seems there are many articles which present different idea in nature [10]. I wonder whether to add all of these sources from nature to keep neutrally. I hope someone can check all of these articles from nature journal [11]. Now I think one editorial in nature is a neutral description in this article but whatever, add the website link for the reference is a good way for reader to follow up the source.

Thank you, you make an important point - does one article constitute the consensus view of Nature on the subject? Does Nature's view constitute the consensus of something larger (the "scientific community", the "medical profession")? Even if it did (hint, it doesn't), would that justify stating the opinion as fact? No. This is a case of cherry picking and blowing one statement way out of proportion leading to a weight problem, and a POV problem. Just state, in the body of the text, "An editorial in Nature labeled TCM pseudoscience" - problem solved. Herbxue (talk) 17:36, 27 May 2014 (UTC)

I thought the sentence needed to be modified slightly because, as you pointed out, Nature magazine hasn't completely come to the conclusion that it's pseudoscience. The article cited actually was, as you said, a rebuttal to another article in Nature that was supportive of acupuncture. Ricflairsbutt (talk) 20:50, 27 May 2014 (UTC) Sock comments stricken. -- Brangifer (talk) 00:01, 2 June 2014 (UTC)

I am the user who start this section. My point is to neutrally indicate that“this is one editorial in Nature” because natural magazine has many articles which present different viewpoint.In the first paragraph, I added many articles from nature which have other view. For example, one of this [12] described the effective of TCM for dementia. — Preceding unsigned comment added by 72.33.63.1 (talk) 21:31, 4 June 2014 (UTC)

I noticed your post, but unfortunately the article you cited was on herbal treatment of dementia. I added an article from Nature on acupuncture which should meet your needs. Milliongoldcoinpoint (talk) 22:33, 23 June 2014 (UTC)

Extremely

Were in the text did this work come from in this edit [13]? Please provide a direct quote from the text as I do not see it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:37, 2 June 2014 (UTC)

Original research again

"Thirty-eight acupuncture trials were identified. Most studies (22/38 = 58%) found no statistically significant difference in outcomes, and most of these (13/22 = 59%) found that sham acupuncture may be as efficacious as true acupuncture, especially when superficial needling was applied to non-points."[14] The recent edit replaced source text with OR. The source does not claim 58% found that sham acupuncture may be as efficacious as true acupuncture. The "majority of" is the correct explanation. QuackGuru (talk) 20:47, 22 June 2014 (UTC)

How would you suggest it read? When you made your edit, it read "The majority of studies" which could imply that the majority of all studies everywhere state that sham equals acupuncture and that's not the case at all. Reading it again, I see the outcomes state that only 13 of the 38 studies found that sham equals acupuncture, so there is no way the word most could be used as far as I can see. Milliongoldcoinpoint (talk) 21:23, 22 June 2014 (UTC)

If we do the math, 13 out of 38 actually equals 34%. If we changed 58% to 34% would that be original research, or should we just state 13 out of 38 instead?Milliongoldcoinpoint (talk) 21:26, 22 June 2014 (UTC)

It is not our job to question reliable sources. "The majority of" is sourced per WP:V. It should read without the OR you added. It is better to summarise the source. I added the specific numbers to the body of the article. QuackGuru (talk) 21:47, 22 June 2014 (UTC)

It is our job to quote sources accurately and not out of context. To say "the majority of studies" without saying that it is the majority of studies within only one review, is misleading. And as a matter of fact it's not even the majority of studies within that one review. They have two sections of statistics, one group and one group within that group. Again, how should it read? I'm more than willing to compromise here, but let's not take what a source says out of context. Milliongoldcoinpoint (talk) 21:49, 22 June 2014 (UTC)

"A systematic review found that the majority of "sham" acupuncture..." The text is currently not misleading.

The text is sourced but you are questioning the source again. To say "the majority of" is accurate according to the source.[15] QuackGuru (talk) 21:55, 22 June 2014 (UTC)

Well, not to quibble, but now it reads as though that one systematic review stated that the majority of all sham studies equal acupuncture. That's not the case. The majority of the studies they reviewed stated that, not the majority of all studies. Do you think it might read better if we state, "One systematic review found that the majority of the trials in the review stated sham acupuncture..." ?Milliongoldcoinpoint (talk) 22:14, 22 June 2014 (UTC)

A systematic review found that the majority of "sham" acupuncture may be as efficacious as "real" acupuncture, and, therefore, the validity of traditional acupuncture theories including acupuncture point locations has been questioned.[13] The text is accurate but you are still questioning the source. There is no need to add extra words to question the source.

Other sources are summarised the same way in this article. For example: A 2011 Cochrane review found that there is insufficient evidence to determine whether acupuncture is an effective treatment for cancer pain in adults.[76] QuackGuru (talk) 22:30, 22 June 2014 (UTC)

Well, I don't want to make a bigger issue out of it than it deserves. We can leave it as you edited for now. I still hold that it's a fairly unique source in that there are two levels of data in the conclusion, and we aren't even accurately representing what the source state but rather making broad sweeping statements about sham studies in general. But I'm curious what other editors have to say. Milliongoldcoinpoint (talk) 23:59, 22 June 2014 (UTC)

We should use the actual numbers, and clearly state which review those numbers come from.Herbxue (talk) 14:24, 23 June 2014 (UTC)

I have to agree with QuackGuru here, it does not say that 58% of trials found that "sham" acupuncture may be as efficacious as "real" acupuncture. However, it neither says that "the majority of sham acupuncture may be as efficacious as real acupuncture". What the source says is that 58% were statistically insignificant. Therefore, such conclusion cannot be made (for the obvious lack of statistical significance).

When studying further these statistically insignificant studies (22 studies which is the majority, while only 16 could demonstrate statistical significance), however, "sham acupuncture may be as efficacious as true acupuncture". We cannot make a conclusion though that "the majority of sham acupuncture may be as efficacious as real acupuncture". That doesn't override the statistical insignificance. Jayaguru-Shishya (talk) 15:14, 23 June 2014 (UTC)

I'd like to see the more detailed methodology, but in my understanding "most of these (13/22 = 59%) found that sham acupuncture may be as efficacious as true acupuncture" means that in those 13 studies out of 22, sham acupuncture was as efficacious as - or even more efficacious than - true acupunture [even though the difference is statistically insignificant, i.e. the result can be due to statistical randomness at the given risk level]. Therefore, I'd suggest that let's keep it A systematic review found no statistically significant difference between true acupuncture and sham acupuncture... etc. etc. Jayaguru-Shishya (talk) 15:38, 23 June 2014 (UTC)

What about if we quote all the relevant numbers? It could then read, "In a systemic review, 13 of 22 studies found that sham may be..."?Milliongoldcoinpoint (talk) 15:53, 23 June 2014 (UTC)

I would prefer that - give the results clearly, thus not allowing a POV summary statement either way.Herbxue (talk) 15:57, 23 June 2014 (UTC)

Ok I changed it, and this looks perfect now. Thanks for everyone's input!Milliongoldcoinpoint (talk) 18:39, 23 June 2014 (UTC)

I restored it to what it was before will this is discussed. This is not need "13 of 22 studies found that". Additionally we should be paraphrasing instead of using quotes as our text is supposed to be CC BY SA. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:37, 23 June 2014 (UTC)

We could shorten to "A systematic review found no difference between true acupuncture and sham acupuncture..." Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:39, 23 June 2014 (UTC)

I agree. No difference doesn't mean that there weren't any difference in the studies at all; what it means is that even though there was difference, it wasn't statistically significant. Jayaguru-Shishya (talk) 20:51, 23 June 2014 (UTC)

Yes, the lede should be a summary. I reverted the proposal to discuss first. I'm not sure which version is better. The extreme low level details about the numbers do not belong in the lede or the body. QuackGuru (talk) 20:57, 23 June 2014 (UTC)

I reverted it back to your edit[16] which I found was good. I have no opinion about the lede or body, though. Sometimes I'm just scared that too much information is packed up to the lede, but I don't have a comment on that on this one. Jayaguru-Shishya (talk) 21:03, 23 June 2014 (UTC)

I reverted it back to your edit[17] which I found was good. I have no opinion about the lede or body, though. Sometimes I'm just scared that too much information is packed up to the lede, but I don't have a comment on that on this one. Jayaguru-Shishya (talk) 21:03, 23 June 2014 (UTC)

I would agree that it's not all that bad now, it's not completely out of context like it originally was. But the source uses the word "may" instead of just the current, definitive "no difference." I believe they might have worded it such to reflect the substantial number of studies that said otherwise. It wasn't 100-0, or even 90-10, it was 13-9. To keep all editors happy, I'm changing it to read, "A systematic review found there may be no difference between true acupuncture and sham acupuncture..."Milliongoldcoinpoint (talk) 21:30, 23 June 2014 (UTC)

You added OR to the article again. QuackGuru (talk) 23:56, 23 June 2014 (UTC)

Could you please explain how it is OR when the source clearly says, "and most of these (13/22 = 59%) found that sham acupuncture may be as efficacious as true acupuncture, especially when superficial needling was applied to non-points." It says "May be" so I think not saying it is OR. I'm afraid we have to agree to disagree.Milliongoldcoinpoint (talk) 01:28, 24 June 2014 (UTC)

The source does say "that sham acupuncture may be as efficacious as true acupuncture" but we are not discussing that part in the lede. We are summarising a different point in the lede.

A systematic review found that the majority of "sham" acupuncture may be as efficacious as "real" acupuncture, and, therefore, the validity of traditional acupuncture theories including acupuncture point locations has been questioned.

If you want to add "may be" to the lede this text is supported by the source. QuackGuru (talk) 01:51, 24 June 2014 (UTC)

"...sham acupuncture may be as efficacious as true acupuncture... <- and there was found no statistically significant differences in those studies (n=22). Therefore, one cannot make any conclusion from that. Jayaguru-Shishya (talk) 11:45, 24 June 2014 (UTC)

I'm not sure I'm following you. You said "may be" is in the source. Why do you object to using it in the lede?Milliongoldcoinpoint (talk) 03:34, 24 June 2014 (UTC)

The part "may be" is sourced for the text the majority of "sham" acupuncture "may be" as efficacious as "real" acupuncture. The part there "may be" no difference between "true" acupuncture and "sham" acupuncture is not supported by the source. These are two separate points. QuackGuru (talk) 03:42, 24 June 2014 (UTC)

Thank you for clarifying. To me, saying "as efficacious" and "no difference" are the exact same thing. I'm curious what others think?Milliongoldcoinpoint (talk) 04:09, 24 June 2014 (UTC)

Popular press peice

This is a popular press peice [18] Thus removed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:42, 23 June 2014 (UTC)

Does not appear to be pubmed indexed or a review. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:43, 23 June 2014 (UTC)

This text [19] was supported by a pubmed indexed source [20] Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:50, 23 June 2014 (UTC)

I thought it was a secondary source since the article commented on pubmed cites, but I agree the bar must be higher for this article. There are non pubmed, non review sources everywhere. I removed one above it and think I'll get to work on some more!Milliongoldcoinpoint (talk) 23:01, 23 June 2014 (UTC)

Careful fellas, there's tons of these kind of sources in here. We need to be clear about what kind of text can be supported by such sources and what cannot. I would recommend identifying the text you feel is unsupported by reliable sources and discussing here. Herbxue (talk) 23:19, 23 June 2014 (UTC)

Doctor James, you removed this edit [21] was supported by these two pubmed indexed sources [22] [23] At the top of this page, it says I should assume good faith. I will also assume good faith for this edit I had to correct of yours here [24]Milliongoldcoinpoint (talk) 01:41, 24 June 2014 (UTC)

Since I added a well sourced article from Nature which was backed up by two pubmed indexed sources, and it was removed, I propose adding it again. Are there any objections to its inclusion?Milliongoldcoinpoint (talk) 13:13, 24 June 2014 (UTC)

Why was it removed? What did the edit summary say? -Roxy the dog (resonate) 13:55, 24 June 2014 (UTC)

Hello, the edit summary said "trimmed primary source". Doc James removed it, and you can read his reasoning above, and my reasoning below that.Milliongoldcoinpoint (talk) 14:15, 24 June 2014 (UTC)

Well, the Nature article looks ok as a primary source to support clearly-attributed statements. We've been using other articles from the same source, why is it "popular press" now? Herbxue (talk) 16:54, 24 June 2014 (UTC)

Since there was support and no objections to it, and since we all agree that Nature is a worthy source, I put it into the article. Milliongoldcoinpoint (talk) 03:37, 25 June 2014 (UTC)

Here is the source [25]. It is not pubmed indexed. It is a "news" article. Not a review article. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:56, 25 June 2014 (UTC)

Agree with JMH. Its a news article written by a freelance journalist (do a search on the author's name). This is very different from a peer reviewed review article written by an expert in the field. Formerly 98 (talk) 04:17, 25 June 2014 (UTC)

Well, it did meet Wikipedia's secondary source criteria for medical articles, but if the editors here feel everything needs to be peer reviewed and backed w a pmid,that's fine too, I added another nature source that has a pmid. Thanks for the input. Milliongoldcoinpoint (talk) 05:05, 25 June 2014 (UTC)

Not sure why this was added or if the text is sourced. The source says: "The editor of Nature China reports on his first visit to a traditional Chinese medicine practitioner to find out how this ancient practice is dispensed in the twenty-first century — and to see if anything can be done to relieve his back pain."[26] QuackGuru (talk) 07:07, 25 June 2014 (UTC)

So far the strong claim could not be verified. QuackGuru (talk) 21:04, 25 June 2014 (UTC)

As long as we are not applying a double standard. I have been complaining about articles like the Matuk article being used to say TCM is not concerned with anatomy, or the Slate article being used to say that Mao invented TCM. Those were (wrong, and) of the same or lower level of reliability as this Nature article. Please be careful to not be cherry picking here.Herbxue (talk) 16:09, 25 June 2014 (UTC)

Mao invented TCM? LOL! What is this, somebody trying to open the gate for conspiracy theories to Wikipedia perhaps? =D Jayaguru-Shishya (talk) 16:20, 25 June 2014 (UTC)

Original research in the article again

Background information from recent misleading edits or replacing source text with OR: Milliongoldcoinpoint recently made some controversial edits. The word "some" is OR. The specific number 58 is OR. This edit added extreme low level details to the lede when the lede should be a summary. The part "may be" is OR. Sourced text was repeatedly deleted source material[27][28] but there was a compromise to use in-text attribution. There is a new account making controversial edits and there is another account that are doing very similar things to this article like adding OR[29] or low level details to the lede. Middle8 also recently made some controversial edits. Do I hear quacking?

The source says: "Serious complications after acupuncture continue to be re-ported. Many are not intrinsic to acupuncture, but caused by mal-practice of acupuncturists. This might explain why surveys of adequately trained therapists failed to yield such complications[28,147,149]. Most of the case reports originated from Asia (Tables 2–4), possibly reflecting the fact that, in Asia, acupuncture is more widely practised than elsewhere. Alternatively, it might be due to more Asian therapists being poorly trained[113]."[30]

The lede says" "Serious adverse effects (including death in rare cases[5]) are known[10], but have not been reported in surveys of adequately-trained acupuncturists.[5]"

The body says "A 2011 overview of systematic reviews (without language restrictions) found that serious complications following acupuncture have continued to be reported, but not in surveys of adequately-trained acupuncturists."

There are problems with the changes. For example, the part "but have not been reported in surveys of adequately-trained acupuncturists.[5]" and "but not in surveys of adequately-trained acupuncturists." seems like original research.

Was sourced text replaced with OR? We are going to have to review these recent edits. For example, see this diff. QuackGuru (talk) 16:30, 24 June 2014 (UTC)

Just use the actual friggin numbers from the source! Why are we still discussing this? Why are you edit warring AGAIN? Over such a minor issue. Sheesh. Herbxue (talk) 19:51, 24 June 2014 (UTC)

* QuackGuru, please do have the respect to explain why some specific edit(s) is/are OR in your opinion. Otherwise, we can't really be of any assistance.

* I find Middle8's edits to improve this article. No complaints about those IMHO. Jayaguru-Shishya (talk) 20:31, 24 June 2014 (UTC)

@ QG, you said that my wording "seems like original research", and you ask if sourced text was used. Have you compared my edits with the source? I used the very same wording, with only minor changes in grammar (for the sake of good prose) that I do not believe affect the meaning. Ernst says that serious complications (serious adverse effects) have not been reported in surveys of adequately-trained acupuncturists. That's what the article said too, both before and after my edits, which were meant to clarify and highlight this important aspect of safety. I also followed Xu's wording. No need to ask whether or not I might have, just look it up. And just what do you mean by "the duck test"? Are you accusing me of sock- or meat-puppetry with this article? --Middle 8 (leave me alone • talk to me • COI?) 06:38, 25 June 2014 (UTC)

Ersnt said "Many are not intrinsic to acupuncture, but caused by mal-practice of acupuncturists. This might explain why surveys of adequately trained therapists failed to yield such complications[28,147,149]. I think you did add OR/misleading text to the article and low level details to the lede. There has been too many recent controversial edits by more than one account on this article. I didn't notice a serious problem with the previous text. QuackGuru (talk) 06:59, 25 June 2014 (UTC)

That doesn't support your OR claim in any way (let alone your implicit sock accusation). Ernst's quote states as fact that "surveys of adequately trained therapists failed to yield such complications". Also he says that this fact may or may not explain his observation about malpractice, but whether it does or not, it's still a statement of fact in a MEDRS, and there's no OR. --Middle 8 (leave me alone • talk to me • COI?) 07:32, 25 June 2014 (UTC)

"Serious adverse effects (including death in rare cases) are known..." The wording can be improved. Saying Serious adverse effects are known does not tell the reader anything. Putting text in parentheses (including death in rare cases) is weird in the lede.

When Ersnt said it might explain... it that does not mean it is now fact. The low level misleading details do not belong in the lede. Ersnt never said but the surveys...etc. QuackGuru (talk) 07:50, 25 June 2014 (UTC)

Again, "might explain" part doesn't affect the truth-value of "surveys of adequately trained therapists failed to yield such complications". The latter is a statement of fact and not misleading. Please move on. As for "Low level detail", that's something you often bring up but it isn't in WP:PAG; please support your argument with something that is. --Middle 8 (leave me alone • talk to me • COI?) 08:25, 25 June 2014 (UTC)

I still can't find any OR in Middle8's edits, and I have to disagree with QuackGuru here: I think the edits helped to improve the article. Jayaguru-Shishya (talk) 10:21, 25 June 2014 (UTC)

There was an objection to the misplaced text but it was restored against consensus. QuackGuru (talk) 20:51, 25 June 2014 (UTC)

Surveys are not a great source of evidence. Thus we should separate these points into two sentence. Not notable enough for the lead. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:00, 25 June 2014 (UTC)

Oops, yep I realized this after looking at the sources Ernst cites for his statement (papers by himself a/o White). When he said "surveys" he was talking about surveys of practitioners as opposed to literature surveys of case reports involving adequately-trained acu'ists. thanks for fixing. .... oops, I see there's been an edit war, anyway am going to go back to the correct version.[31] --Middle 8 (leave me alone • talk to me • COI?) 04:42, 26 June 2014 (UTC)

Supporting text

This was added "However, another editorial in Nature found the actual practice of TCM to be modernized, well accepted, and scientific". A few issues

1. Where does it state it is an editorial?
2. What quotes from teh article supports the text in question? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:20, 25 June 2014 (UTC)

I could not verify the strong claim. QuackGuru (talk) 04:41, 26 June 2014 (UTC)