Talk:Acupuncture

Menopause syndroms

• Frisk, Jessica W.; Hammar, Mats L.; Ingvar, Martin; Spetz Holm, Anna-Clara E. (30 January 2014). "How long do the effects of acupuncture on hot flashes persist in cancer patients?". Supportive Care in Cancer. 22 (5): 1409–1415. doi:10.1007/s00520-014-2126-2.

• Chiu, Hsiao-Yean; Pan, Chieh-Hsin; Shyu, Yuh-Kae; Han, Bor-Cheng; Tsai, Pei-Shan (7 July 2014). "Effects of acupuncture on menopause-related symptoms and quality of life in women on natural menopause: a meta-analysis of randomized controlled trials". Menopause (journal): 1. doi:10.1097/GME.0000000000000260.

• Dodin, Sylvie; Blanchet, Claudine; Marc, Isabelle; Ernst, Edzard; Wu, Taixiang; Vaillancourt, Caroline; Paquette, Joalee; Maunsell, Elizabeth; Dodin, Sylvie (2013). "Acupuncture for menopausal hot flushes". doi:10.1002/14651858.CD007410.pub2. PMID 23897589. {{cite journal}}: Cite journal requires |journal= (help)
• Cho, S. H.; Whang, W. W. (2009). "Acupuncture for vasomotor menopausal symptoms". Menopause. 16 (5): 1065–1073. doi:10.1097/gme.0b013e3181a48abd. PMID 19424092.
• There is currently MEDRS compliant sources in Acupuncture#Other conditions. One is a 2013 Cochrane review and the other is a 2009 systematic review. QuackGuru (talk) 04:41, 11 July 2014 (UTC)

Commenting on the Chiu paper today, Steven Novella called the results "entirely negative" and concluded ..."A reasonable person can only conclude that acupuncture does not work, and that all the clinical research consistently shows that acupuncture conveys only illusory and nonspecific placebo effects for subjective symptoms." [1]

ScienceBasedMedicine.org is not a reliable source. Anyone is welcome to submit content regardless of credentials. This blog does not even meet WP:RS, much less WP:MEDRS. -A1candidate (talk) 21:49, 15 August 2014 (UTC)

There was a previous discussion about this blog. Editors decided to keep it in the article. User:JzG insisted it was reliable. Mallexikon originally added the source to the article. QuackGuru (talk) 02:34, 16 August 2014 (UTC)

I know, and there was no consensus for it. The blog has no formal peer-review. -A1candidate (talk) 03:06, 16 August 2014 (UTC)

Actually there a previous discussion and editors decided to use the blog in the article. QuackGuru (talk) 03:09, 16 August 2014 (UTC)

There was considerable opposition to using the blog -A1candidate (talk) 03:14, 16 August 2014 (UTC)

You have not provided evidence there was considerable opposition to using it. QuackGuru (talk) 03:16, 16 August 2014 (UTC)

See talk page archives -A1candidate (talk) 03:17, 16 August 2014 (UTC)

I already read the discussion because I was part of the original discussion on this. QuackGuru (talk) 03:19, 16 August 2014 (UTC)

Then you should know that an editor said "A personal website is not RS material", which I fully agree with. -A1candidate (talk) 03:22, 16 August 2014 (UTC)

See Talk:Acupuncture/Archive_13#MEDRS_and_ASF_violations_are_continuing_to_happen_at_ACU_and_TCM for the original discussion. QuackGuru (talk) 03:28, 16 August 2014 (UTC)

Editors observed that "There is strong opposition to including the first here" and "And there was no CON at TCM either." -A1candidate (talk) 09:28, 16 August 2014 (UTC)

Protected edit request on 20 July 2014 2

Due to the apparent debate about neutrality evident in this talk page I would like to add the template "pov-section" under the subsection "Scientific view on TCM theory" - Technophant (talk) 09:56, 20 July 2014 (UTC)

• Given the fact that reviews from high-quality medical journals about the mechanism of acupuncture have been repeatedly removed from this article, I think the POV template is long overdue.

1. A 2008 review article titled Neural mechanism underlying acupuncture analgesia in Progress in Neurobiology, with impact actor of 9.035, was removed.

2. A 2010 review article titled Mechanisms of action for acupuncture in the oncology setting in Current Treatment Options in Oncology, with impact factor of 2.422, failed to be included.

3. A 2011 review article titled Ancient Chinese medicine and mechanistic evidence of acupuncture physiology in European Journal of Physiology, with impact factor of 4.866, was removed.

4. A 2012 meta-analysis titled Characterizing Acupuncture Stimuli Using Brain Imaging with fMRI in PLOS ONE, with impact factor of 3.730, failed to be included

5. A 2013 review article titled Acupuncture in Mayo Clinic Proceedings with impact factor of 5.698 failed to be included.

6. A 2014 review article titled Acupuncture, Connective Tissue, and Peripheral Sensory Modulation in Critical Reviews in Eukaryotic Gene Expression, with impact factor of 2.949, failed to be included

7. A 2014 review article titled Mechanisms of acupuncture-electroacupuncture on persistent pain in Anesthesiology, with impact factor of 5.163, was removed.

There are a lot more sources removed but I don't have time to retrieve all of them. POV tag should stay until they're added back. -A1candidate (talk) 10:55, 20 July 2014 (UTC)

@user:A1candidate - Thank you. Perhaps we are getting somewhere. - Technophant (talk) 11:22, 20 July 2014 (UTC)

I wouldn't thank A1candidate too quickly since (s)he is a professional acupuncturist with a huge COI who really shouldn't be editing these articles so boldly and pushing fringe POV. -- Brangifer (talk) 16:47, 20 July 2014 (UTC)

Even though this comment is struck, I'd like to reiterate that simply being a member of a profession does not cause COI to arise, cf. the "COI?" link in my sig. -Middle 8 (leave me alone • talk to me • COI?) 03:05, 14 August 2014 (UTC)

What do you want to add using what source? I do not see a need for a POV tag at this point in time. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:38, 20 July 2014 (UTC)

Before we even start discussing which reviews, I suggest the following overview statement from a highly authoritative medical textbook:

"The emerging acceptance of acupuncture results in part from its widespread availability and use in the United States today, even within the walls of major medical centers where it is used as an ancillary approach to pain management. Yet its acceptance appears to stem from more than just its communal appeal.

Since the mid-1970s, biochemical and imaging studies have begun to yield evidence that needling can alter central pain-processing pathways, possibly by triggering release of neural mediators that bind to specific receptors in the brain regions that modulate pain perception."

- Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Google Books)

If we could start by agreeing that some of the most authoritative medical textbooks consider acupuncture to be empirically validated to certain degrees, perhaps we can then proceed to discuss the details. -A1candidate (talk) 13:21, 20 July 2014 (UTC)

It could be so, but the whole research that shows that sham acupuncture works as good as real acupuncture ruins your whole thesis. We could just randomly insert needles and pretend to treat people by doing that. Tgeorgescu (talk) 14:08, 20 July 2014 (UTC)

As for real vs sham acupuncture, see PMID 24595780 -A1candidate (talk) 14:22, 20 July 2014 (UTC)

Sham acupuncture can't be considered a true control because it involves activating the nervous system in some way. There's many, many articles criticizing the way sham controls are used. Take a look at this papers conclusion. - Technophant (talk) 16:20, 20 July 2014 (UTC)

Not done: please establish a consensus for this alteration before using the {{edit protected}} template. A healthy combination of editing and talk page discussion after the protection has expired will probably go farther than a protected edit request. ~Adjwilley (talk) 17:29, 20 July 2014 (UTC)

Can you at least remove that personal attack by User:BullRangifer against me? Such personal accusations are completely false and untrue. -A1candidate (talk) 19:33, 20 July 2014 (UTC)

I have stricken the comment. -- Brangifer (talk) 19:40, 20 July 2014 (UTC)

What do you want to say using Harrison's? Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:57, 21 July 2014 (UTC)

I'll try to make it concise and keep it as short as possible:

1a. Proposed inclusion - There is a growing belief among researchers that acupuncture may be effective.

1b. What Harrison's says - "Although methodological problems continue to plague acupuncture trials, belief has been growing even in academic centers that acupuncture may be effective", as quoted directly from Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Google Books)

1c. Rationale for addition - A fringe theory, by definition, departs significantly from mainstream view. In the case of acupuncture, however, there is a growing belief in academic centers that acupuncture is effective, not fringe.

2a. Proposed inclusion - It is used in some major medical centers as an ancillary approach to pain management.

2b. What Harrison's says - "The emerging acceptance of acupuncture results in part from its widespread availability and use in the United States today, even within the walls of major medical centers where it is used as an ancillary approach to pain management", as quoted directly from Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Google Books)

2c. Rationale for addition - Alternative medicine, by definition, is not part of standard medical care. Acupuncture, however, is "ancillary" when it comes to managing chronic pain and it should not be labelled otherwise

3a. Proposed inclusion - In recent decades, biochemical and imaging studies have begun to yield evidence that needling can alter pain perception in the central nervous system, possibly by triggering the release of neurotransmitters that subsequently bind onto specific receptors in brain regions responsible for pain perception.

3b. What Harrison's says - "Since the mid-1970s, biochemical and imaging studies have begun to yield evidence that needling can alter central pain-processing pathways, possibly by triggering release of neural mediators that bind to specific receptors in the brain regions that modulate pain perception." Harrison's Principles of Internal Medicine. McGraw-Hill. 2011. p. 2-5. ISBN 9780071748902. (Books)

3c. Rationale for addition - This is a scientific fact that has been repeatedly demonstrated numerous times by now. We really need a section for mechanism of action if we are serious about sticking to mainstream science.

Also, would Goldman's Cecil Medicine be an acceptable textbook for an additional source? Once we're done with the textbook basics, we could go on to discuss more specific details as reviewed by high impact factor journals. -A1candidate (talk) 10:44, 21 July 2014 (UTC)

So exactly what text are you wanting to add to what part of the article? Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:46, 21 July 2014 (UTC)

1b "problems continue" "has been growing...may" 1c "...is..." MAY and IS are quite different. If problems continue to plague it seems a clear statement that there is NOT empirical support of the type needed to validate a medical treatment. - - MrBill3 (talk) 11:05, 21 July 2014 (UTC)

Calm down, we're only talking about the beliefs of the academic community which has been growing rather than may be growing. Can we agree on this first? -A1candidate (talk)

It seems there is an effort to inflate the idea that there MAY be some elements of interest to the mainstream academic community while the evidence is still PLAGUED by methodological problems and the theoretical basis is still not validated into a false assertion of a change in the mainstream academic consensus on the validity of the theoretical basis and the evidence for empirical support. As there is no deadline if these concepts are valid surely empirical research not plagued by methodological failures and theoretical bases that are accepted are forthcoming and can be included WHEN this actually occurs. Until then the article should clearly reflect the widespread academic position on these questionable concepts. - - MrBill3 (talk) 13:40, 21 July 2014 (UTC)

Instead of speculating about my motivations to improve the article, you may want to check out what mainstream academic literature says about the topic. Or better yet, read what Harrison's Principles of Internal Medicine says and come back once you're done. Methodological problems has already been mentioned in the article. -A1candidate (talk) 15:28, 21 July 2014 (UTC)

Just want to make a note here that A1's use of medical textbooks here is very promising as is Doc James straightforward question about "what content, and where, do you want to create based on this?" Folks, it doesn't get more mainstream than the most-relied upon medical textbooks like Harrison's and Goldman's Cecil. So everybody breathe a bit here and just go step by step. These are serious sources. A1 step wisely and conservatively in proposing content and quack-fighters put away your knives. Jytdog (talk) 23:24, 21 July 2014 (UTC)

Let me "second that emotion", though I would add a caution; One must keep in mind that authors, even of notable medical textbooks, do include their personal opinions in those books. Sometimes the personal opinions are "pearls" (of crap) included by the authors (with poor crap detectors), sometimes positing hypothetical ideas as if they were fact, and many readers then fall for their words, as if they were firmly established scientific fact, and become fans of the guru author.

What I'm trying to say is that many medical textbooks, while considered eligible for RS status, are far from reliable sources for all medical knowledge. While much of the content might be fine information and helpful in practice, such gems of speculation should not be swallowed whole, but should be subject to trumping by better sources. In such cases, it's much better to use properly performed scientific reviews of the mainstream literature. -- Brangifer (talk) 00:48, 22 July 2014 (UTC)

i hear you. the quotes from the textbook are pretty gentle, I don't think this is going to drive huge changes. but some simple straightforward statements in wikipedia'a voice can be confidently generated using these sources, I think...Jytdog (talk) 02:23, 22 July 2014 (UTC)

I agree. 99% of the time we're likely on safe ground. I'm sure that any controversial uses will get noticed and a discussion can deal with it. -- Brangifer (talk) 02:57, 22 July 2014 (UTC)

I'll agree with BR and Jyt. This article receives enough scrutiny to prevent misuse. @A1 to moderate my comment I can agree with content as described by Jyt. - - MrBill3 (talk) 03:28, 22 July 2014 (UTC)

• Thanks for the kind words of encouragement, Jytdog. I really appreciate them! After taking a closer look at the article, I think there is one section that could be updated with the suggested additions and that is the historical development of acupuncture.

If you take a look at the "Modern era" subsection, we have a great deal of information about acupuncture during Mao Zedong's leadership, followed by two paragraphs of anecdotes about how acupuncture gained atention in the West. After the early 1970s, however, we suddenly arrive in 2006 with absolutely no mention of what happened to the historical development of acupuncture during a time period of almost half a century (!)

I think the best place to fill this gap would be the last paragraph, just before the 2006 documentary.

The current text says:

Acupuncture has been the subject of active scientific research both in regard to its basis and therapeutic effectiveness since the late 20th century, but it remains a controversial topic. In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anesthesia....

How the new text (in italics) may look like:

Acupuncture has been the subject of active scientific research both in regard to its basis and therapeutic effectiveness since the late 20th century, but it remains a controversial topic. In recent decades, biochemical and imaging studies have begun to yield evidence that needling can alter pain perception in the central nervous system, possibly by triggering the release of neurotransmitters that subsequently bind onto specific receptors in brain regions responsible for pain perception. (Reference to Harrison's) There is a growing belief among researchers that acupuncture may be effective and it has been used in some major medical centers as an ancillary approach to pain management. (Ref Harrison's)

In 2006, a BBC documentary Alternative Medicine filmed a patient undergoing open heart surgery allegedly under acupuncture-induced anesthesia....

This is obviously not meant to be a final proposal, but I do feel that adding it there would be more appropriate and necessary to fill a huge gap in our documentation of the historical development of acupuncture after the early 1970s.

I'm done with this discussion for now, so if anyone manages to find consensus for my proposed additions, please be bold and edit the article accordingly. -A1candidate (talk) 04:20, 22 July 2014 (UTC)

The latest changes proposed by A1candidate seem reasonable to me. If there is some consensus I don't object to them. Unless someone points to a problem with them I support them. They seem carefully and neutrally phrased. I think they are factual and add some value to the article. The sourcing seems adequate/appropriate. - - MrBill3 (talk) 08:49, 23 July 2014 (UTC)

Read this source: "In conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain."[2] We have a 2011 systematic review of systematic reviews that contradicts the proposal.

This part of the proposal makes little sense: "There is a growing belief among researchers that acupuncture may be effective" QuackGuru (talk) 03:25, 24 July 2014 (UTC)

QG see 1a and 1b above. Jytdog (talk) 03:31, 24 July 2014 (UTC)

"An overview of high-quality Cochrane reviews suggested that acupuncture may alleviate some but not all kinds of pain,[10]"

We should not include text that contradicts high-quality evidence. QuackGuru (talk) 04:01, 24 July 2014 (UTC)

Can you please be more exact? In science, especially medical science, lots of contradictory results do exist. You call one as "high-quality evidence", is the other low-quality then? Jayaguru-Shishya (talk) 20:39, 24 July 2014 (UTC)

I did provide the high-quality evidence.[3][4] I think it is unproductive for me to repeat my previous comments on this talk page when the evidence was clearly presented.

Your continuing to ask questions as you did before.[5][6][7][8] You claimed two were removed per MEDRS without explaining what the violation is. But I did give a reason for removing those two. All you had to do was check the edit history rather than ask questions. See Talk:Acupuncture#Sourced text was deleted. QuackGuru (talk) 21:17, 24 July 2014 (UTC)

Your reference to your very own post here at the Talk Page doesn't answer my question. Please anwer my questio above, thanks. Jayaguru-Shishya (talk) 22:56, 25 July 2014 (UTC)

Cochrane Reviews provide an explanation of the criteria they use for including or excluding particular studies, often with specific details on individual studies. This provides clear reliable third party sourcing for the evaluation of studies. If you identify a Cochrane Review that discusses a source in question I have full text access and will provide relevant information. Additional guidance on evaluating evidence is available at WP:MEDRS.

I agree with QG that growing belief..may is not appropriate as an encyclopedia with no deadline WP should reflect the conclusions of the highest quality evidence available, Cochrane Reviews and a review of reviews published in a major journal are such evidence. As the research in this field continues if new high quality evidence emerges and receives acceptance in the scientific community it can be added at that time. - - MrBill3 (talk) 00:47, 26 July 2014 (UTC)

This is about the history of acupuncture, not its clinical efficacy. -A1candidate (talk) 00:22, 28 July 2014 (UTC)

"may be effective" is about clinical efficacy. Couching it as a "growing belief" does not exempt the topic of efficacy (be[ing] effective) from MEDRS. Please don't strain good faith. If other editors consider this an acceptable description of the beliefs and appropriate content, I won't stand in the way of progress with reasonable consensus. Apologies for tone, constructive collaboration is appreciated. - - MrBill3 (talk) 02:04, 28 July 2014 (UTC)

Am I missing something? Is there some source in the mix here which describes the "beliefs" of researchers, and how those "beliefs" are changing? Alexbrn ^{talk|contribs|COI} 09:15, 28 July 2014 (UTC)

yes. see discussion of content from Harrison's above, 1a and 1b (just below the red dot with the "i" in it) Jytdog (talk) 10:23, 28 July 2014 (UTC)

Thanks, gotcha. But the source doesn't say belief has been growing among researchers, but that it has "even" been growing in "academic centers". Wouldn't that be because CAM is now more widespread in such centers (what some call the quackademic medicine phenomenon). If there are more irrational people in these centers it naturally follows the "beliefs" there will swell. Not sure how this can be couched neutrally, but the proposed wording ain't it. Alexbrn ^{talk|contribs|COI} 14:46, 28 July 2014 (UTC)

No, the source says that because that is the mainstream scientific consensus. -A1candidate (talk) 02:16, 30 July 2014 (UTC)

A1 I don't think you can bring a source that supports such a broad claim. Again you are just hurting your own cause by being so broad and sloppy. Alexbrn, while I hear where you are coming from, reasonable people can disagree on the why. One could also easily say that academic medical centers are doing it a) to meet a demand (people want it and will come to a place that offers it); b) in an acknowledgement even the most cutting edge medicine cannot adequately manage pain and anxiety, and this is exactly - and only (with a few narrow exceptions for side-effects of treatments and other hard-to-treat and somewhat psychosomatic conditions) - how CAM is deployed in such centers. Not broadly -- not to treat infectious disease or as a primary treatment for cancer - but to assist in managing things like pain and anxiety. I think it reasonable to say that such use - complementary and limited- is pretty darn mainstream. (and here i will trot out the mayo clinic why Mayo uses it, MD Anderson, Memorial Sloan Kettering.... the list of high quality places that offer it goes on and on, and the things they offer it for is consistent. Even if the effect is placebo, it is relatively cheap, very safe, and gives comfort, and those are good things for very sick people. There is a reason that Harrison's discusses it, in the way that it does. I think that this article and related ones would be improved a lot by focusing on what is relatively mainstream and stop fighting quack battles. I think (for what that is worth) we could get a pretty useful article out of that, IF both flanks stopped pressing to dominate and self-limited..... we could work pretty peacefully together on an article with that scope. Jytdog (talk) 02:31, 30 July 2014 (UTC) (added a bit to make this accurate Jytdog (talk) 12:41, 30 July 2014 (UTC))

Hear, hear. "Mainstream = middle ground" is a very promising way to look at articles about CAM's that are used in mainstream (academic) settings. With regard to the "why" of such usage, Ernst has commented along the same lines as Jytdog [9]. The source is 2006, and should not be relied upon for efficacy, but this particular quote remains relevant (and particularly so, I think, given acu's continued use in light of its placebo-ness): "Some clinicians argue that the main point about any medical intervention is that it alleviates the suffering of patients regardless of mechanism and that ‘it is not meaningful to split complex interventions into characteristic and incidental elements’ [157]. If acupuncture alleviates suffering through a powerful placebo effect which theoretically could exceed the total therapeutic effect of conventional therapeutic options, it should be accepted as a useful treatment. Some scientists, however, might find this notion difficult to accept." To say the least!

Ernst continues, pointing to further resolution: "Of course, the scientific study of placebo effects and mechanism is both feasible and important [158–161], and the results of such research may significantly contribute to our understanding of how acupuncture works. But, if nonspecific factors are that relevant, we should not study them with a view to harnessing them for clinical practice in general and not just for acupuncture?" --Middle 8 (leave me alone • talk to me • COI?) 09:46, 30 July 2014 (UTC)

Comment: Just noticed I was unintentionally parroting Jytdog re: both "sides" working together. Well, it's never a bad idea. Actually the best thing is to get beyond the idea of "sides" altogether.... it is possible, just by being steadily source-centric. --Middle 8 (leave me alone • talk to me • COI?) 18:28, 4 August 2014 (UTC)

Ernst may be a very well-respected researcher, but we still have to treat such statements per WP:RSOPINION. I don't quite understand what exactly is the point you're trying to make, so perhaps you may wish to be a little more direct? -A1candidate (talk) 01:40, 1 August 2014 (UTC)

@A1candidate: The main thing I'm getting at (and sorry I was unclear) is that the "let's use acu as a CAM" (pro) side and the "acu is little-or-nothing more than a placebo so why use it at all" (anti) side are looking at the same evidence differently. The anti say that we don't use a drug that's no better than a placebo and the same rules should apply here; there are other ways to invoke the placebo effect besides an invasive (albeit quite safe) intervention, like empathic care. The pro say that the relevant issue is the difference between acu and no-acu, not acu and sham. Even though it turns out that the nonspecific effects are most of the treatment, a lot of patients really like it; even if it's all placebo, it's a humdinger of a placebo, not readily duplicated via other means. This is the view espoused by Vickers and (IIRC) the editorial introducing Vickers, and (implicitly anyway) by the body that acted on GERAC; and it's the view that Ernst is talking about ("Some clinicians argue..."). We could source this up and make a nice "rationale for use" section, I think -- as long as we just lay out each side in an NPOV way and avoid trying to have one trump the other (since both are demonstrably significant). Because both sides are sharing the evidence base. (As for the second part of Ernst's quote, I had in mind Kaptchuk's research, more as an aside.) --Middle 8 (leave me alone • talk to me • COI?) 09:18, 1 August 2014 (UTC)

@A1candidate: more.... but I apologize for digressing; for now, suffice it to say I agree with your proposed additions. Not all mainstream researchers, but some; a "growing belief" doesn't imply universality, so the wording is fine. --Middle 8 (leave me alone • talk to me • COI?) 06:38, 2 August 2014 (UTC)

Yes, it's difficult to find a middle ground when it comes to such a controversial issue. The good news is that there are lots of authorities whose job is to determine what is factually correct and what isn't. Our job as editors of Wikipedia would be much easier if we could simply stick to their consensus instead of relying on the opinions of Ernst, Vickers, or any other notable individuals. They may be excellent researchers, but they only speak for themselves, not the scientific community as a whole. However, I agree with you that both sides are esentially looking at the same evidence differently. -A1candidate (talk) 02:53, 11 August 2014 (UTC)

Well-said. The closer we can get to MEDRS that meet WP:RS/AC, the better. For sources less strong than that (and particularly editorials), we should be wary speaking in WP's voice. --Middle 8 (leave me alone • talk to me • COI?) 02:59, 14 August 2014 (UTC)

Restoring edit of confirmed sockpuppet

I previously explained the source was invalided: "The most recent meta-analysis appearing in Fertility and Sterility on acupuncture was reevaluated in view of the marked heterogeneity of interventions, controls, data analysis, and timing of interventions in the trials that were included. After removing some of the trials and data based on more rigorous standards for a high quality meta-analysis, a significant benefit of the intervention could no longer be shown."[10]

• Meldrum, David R.; Fisher, Andrew R.; Butts, Samantha F.; Su, H. Irene; Sammel, Mary D. (2013). "Acupuncture—help, harm, or placebo?". Fertility and Sterility. 99 (7): 1821–1824. doi:10.1016/j.fertnstert.2012.12.046. ISSN 0015-0282. PMID 23357452. If editors want to use the journal Fertility and Sterility we would use the 2013 source not the invalided 2012 source, anyhow.

This edit restored the edit by a confirmed sock account without discussion or consensus. See Talk:Acupuncture/Archive_13#A_massive_revert_-_What_just_happened.3F. I explained it in my edit summary. User:Kww previously explained the policy covering the block evasion. QuackGuru (talk) 18:50, 28 July 2014 (UTC)

Unfortunately, our policies do not prohibit restoration of such material. It also does not allow you to continue to remove it simply because it was added by a sockpuppet originally. You have to discuss the edit on its own merits.—Kww(talk) 19:27, 28 July 2014 (UTC)

As stated by QuackGuru:

Per policy: WP:BAN#Bans apply to all editing, good or bad. User:Kww previously explained the policy covering the block evasion....

If, for example, user QuackGuru got banned, it doesn't mean that any sources used by QuackGuru could no longer be used in the article. I think there is faulty logic here. Jayaguru-Shishya (talk) 21:05, 28 July 2014 (UTC)

I previously explained, there was a problem with the source. QuackGuru (talk) 22:38, 28 July 2014 (UTC)

I added the 2013 source that shows the 2012 source was invalided.[11] QuackGuru (talk) 19:38, 28 July 2014 (UTC)

Agree that WP:BAN no longer enters into it, and that the 2013 source (Meldrum) must be cited if we're going to mention the 2012 source (Zheng). I don't think this edit is the way to go about it; it's too granular and doesn't cite the 2012 source at all. Why not just say something like "a 2012 review found that acupuncture may be a useful adjunct to IVF, but those conclusions were rebutted by a 2013 review", and leave it at that? Here's a try. If "rebut" is too strong a word, someone else can fix. Trying to keep it simple; the article isn't aimed at specialists. --Middle 8 (leave me alone • talk to me • COI?) 06:06, 29 July 2014 (UTC)

If these are indeed quality edits, I don't mind adding them back in. I've been a participant at "project" systemic bias and several of us over there think these types of pages need a lot of work to balance them out. Could somebody show me where these edits are?LesVegas (talk) 16:16, 30 August 2014 (UTC)

"A 2012 systematic review found that acupuncture may be a useful adjunct to IVF,[94]" The same 2012 source was restored. QuackGuru (talk) 17:36, 31 August 2014 (UTC)

Reception: survey of rheumatologists

I added [12] some V RS material [13] about a survey of rheumatologists' views on CAM's, including acu. This was quickly rv'd [14] with the ES "Not sure this is due, or even RS - and the title is too broad.".

1. I don't get the UNDUE objection. Views of docs are germaine to the section Acupuncture#International_reception, and rheumatologists treat pain. We had another doctor survey for a long time until it got outdated.
2. The journal is AFAIK MEDRS and is used elsewhere in the article & 'pedia [15].
3. I don't get the title objection ("What rheumatologists in the United States think of complementary and alternative medicine: results of a national survey"). Too broad? They asked about acu, spinal manip'n and four other things.

Discussion? To be honest, I can scarcely think of a less controversial cite. --Middle 8 (leave me alone • talk to me • COI?) 06:47, 29 July 2014 (UTC)

Primary research in a fringe journal telling us what "rheumatologists in the United States think" (or rather, thought, in 2010) can't be broadened into a universalized statement about how "physicians" (section title) have received acupunctur. Giving a section to the reported view of this group of people would in any case be undue. Alexbrn ^{talk|contribs|COI} 06:57, 29 July 2014 (UTC)

This needs to meet RS, not MEDRS, and as far as such surveys go, it looks fine. Per your link, Orac doesn't like a recent editorial, but that doesn't mean it's a fringe journal.

Re section titles: the source is an example of acu's reception among physicians. Under Acupuncture#Government_agencies, we cite only NIH and NHS, but we're (obviously) not saying that they're representative of all such agencies. If there's a better way to present the information, great, but we shouldn't leave out a source on A just because we lack sources on B through G.

By the way, the source isn't an outlier. That 54% favorable number accords with the 2005 survey we used to cite. And here's another we can use: [16]. Doctors' opinions are (a) noteworthy and (b) sometimes lag those of scientists. That's why this isn't an efficacy (MEDRS) claim (but is relevant to the topic). --Middle 8 (leave me alone • talk to me • COI?) 09:23, 29 July 2014 (UTC)

We have a simlar issue at chiropractic where are using a survey made in 2003 about the views held by chiropractors in North America. There we are saying that: "A 2003 profession-wide survey found "most chiropractors...".

I don't see any problem here with being undue or too broad.

Ps. Isn't a 2003 survey somewhat outdated? Jayaguru-Shishya (talk) 10:08, 29 July 2014 (UTC)

Hey J-S, yeah, agree '03 is rather out-of-date.... ah, but for opinions within the profession, not such a big deal imo. For reception among MD's/DO's let's see what editors there think of the 2010 rheumatology source. --Middle 8 (leave me alone • talk to me • COI?) 22:05, 29 July 2014 (UTC)

The source is not from a 2003 survey. We are using a 2014 secondary source to verify the claim at chiropractic.

The alternative medicine source is not a quality source for controversial claims. QuackGuru (talk) 18:55, 30 July 2014 (UTC)

Per recent proposed sources and discussion about the use of acu in mainstream settings, the contention that a significant percentage of doctors have a favorable view of acu is no longer controversial. The exact number varies from survey to survey, which is expected; Ernst '06 mentions a source or two that found about a 25% favorable rating. I haven't yet retrieved the other one I mentioned above. There are undoubtedly others. I'll post later with more proposed sources and wording. --Middle 8 (leave me alone • talk to me • COI?) 06:48, 2 August 2014 (UTC)

Seems it is another primary source. QuackGuru (talk) 01:26, 4 August 2014 (UTC)

Which isn't a major problem given that it's used as an RS and not a MEDRS. --Middle 8 (leave me alone • talk to me • COI?) 18:34, 4 August 2014 (UTC)

See WP:SECONDARY. QuackGuru (talk) 19:30, 4 August 2014 (UTC)

We are using a 2003 survey at Chiropractic: "McDonald WP, Durkin KF, Pfefer M et al. (2003). How Chiropractors Think and Practice: The Survey of North American Chiropractors. Ada, OH: Institute for Social Research, Ohio Northern University. ISBN 0-9728055-5-9.[page needed] Summarized in: McDonald WP, Durkin KF, Pfefer M (2004). "How chiropractors think and practice: the survey of North American chiropractors". Semin Integr Med 2 (3): 92–8. doi:10.1016/j.sigm.2004.07.002. Lay summary – Dyn Chiropr (2003-06-02).

The 2014 source you are referring to is a Huffington Post blog referring to the very same source, removal of which has been discussed at Chiropractic (talk). (The 2014 source: Gunther Brown, Candy (July 7, 2014). "Chiropractic: Is it Nature, Medicine or Religion?". The Huffington Post.)

Anyway, if you don't find the source reliable, please discuss it first before making any removals. IMHO, the edit can be restored. Cheers! Jayaguru-Shishya (talk) 19:13, 30 July 2014 (UTC)

So QG is saying that a research article is primary and therefore not OK as RS, but it becomes OK if the Huffington Post mentions it? --Middle 8 (leave me alone • talk to me • COI?) 18:40, 4 August 2014 (UTC)

Brangifer thought the Huffington Post source is RS. Talk:Chiropractic#Problem with WP:WEIGHT.3F. The other source is being used for context. QuackGuru (talk) 19:30, 4 August 2014 (UTC)

A Huffington Post blog even. Jayaguru-Shishya (talk) 10:52, 5 August 2014 (UTC)

Article all over the place

This article looks like it was written by some sort of amateur not sure what to say. The article is full of contradictions and statements that negate each-other. Does anyone know of a good book to read over to get a proper felling for this topic. All that is here is this guy said this and that guy said that - the valuable info is surpassed by what looks like an academic fight happening out in the article. -- Moxy (talk) 09:34, 29 July 2014 (UTC)

Anesthesia & Analgesia editorials

This editorial [17] -- Acupuncture#cite_note-Colquhoun2013-9 -- by Colquhoun and Novella is a good critical summary of the literature, but since it's an editorial I'm not sure where it ranks in the MEDRS scheme of things, and it's cited a lot. And its "counterpoint" editorial, the "pro" editorial by Wang et. al. [18], isn't cited at all. (Both were invited by the publication Anesthesia & Analgesia.) To fix this sourcing and weight problem, I think we should mainly try to cite to sources cited by the editorial(s) (and they're very good places to find MEDRS's and RS's), and should specify that they're a pair of invited editorials. To what degree we cite to them directly, I'm not sure: I would say yes, cite them, but sparingly. (I suppose we can use either or both of them for WP's voice, too, as long as we're not contradicting the other. Right now we cite to Colquhoun for saying in WP's voice that findings on efficacy are "variable and inconsistent" for any condition.) --Middle 8 (leave me alone • talk to me • COI?) 10:19, 31 July 2014 (UTC)

I agree that it's a violation of NPOV to cite Colquhoun many times and completely omit Wang. I think your suggestion of using them sparingly is good. TimidGuy (talk) 10:38, 31 July 2014 (UTC)

That's a good point, I agree. Jayaguru-Shishya (talk) 10:49, 31 July 2014 (UTC)

Both Steven P. Novella and David Colquhoun are notable experts on the topic. The source by Wang et. al is not notable and does not seem it would add anything to the article. QuackGuru (talk) 17:57, 31 July 2014 (UTC)

Both sources are from the same journal. Either the journal is reliable and we include both, or it's unreliabale and we remove both. -A1candidate (talk) 19:32, 31 July 2014 (UTC)

I agree. QuackGuru, you said that Wang et. al is not notable, can you give us any explanations for that? They are both from the same Journal and shall be both included to the article. Jayaguru-Shishya (talk) 20:40, 31 July 2014 (UTC)

I previously explained both authors are notable experts on the topic while the other article seems not notable. Can you give an explanation if you think it is notable? Many sources are from the same journal but we don't include all or nothing. When we cite notable authors, we are citing the mainstream POV. QuackGuru (talk) 01:14, 1 August 2014 (UTC)

Some sources may be considered reliable for statements as to their author's opinion, but not for statements asserted as fact without an inline qualifier. See WP:RSOPINION. -A1candidate (talk) 01:32, 1 August 2014 (UTC)

QuackGuru, no you didn't explain anything. You just said that "Wang et. al is not notable" without giving any explanation. Can you please support your claim? Anyway, I'll be out for this weekend so happy weekend everyone! ^^ Jayaguru-Shishya (talk) 04:07, 1 August 2014 (UTC)

I previously asked: Can you give an explanation if you think it is notable? QuackGuru (talk) 04:50, 1 August 2014 (UTC)

QuackGuru Please quote the policy or guideline that says that a source or author must be WP:NOTABLE in order to be used as a source. I do not believe you will find anything, but am interested to see if you can. You may have other reasons to object, but let's deal with the one you have stated. Thanks. Jytdog (talk) 12:37, 1 August 2014 (UTC)

I believe QG did provide an explanation Novella and Colquhoun are notable experts on the topic, published multiple times in a variety of sources, cited as experts on the topic in multiple sources etc. Sources are evaluated individually, every article in a particular journal does not recieve the same due weight, nor is an article considered reliable based solely on the journal it is published in. The NPOV policy at WP:DUE also provides explanation of the weight due to mainstream scientific / academic view. This actually has all been explained in this thread. IDHT is tendentious. - - MrBill3 (talk) 07:21, 1 August 2014 (UTC)

(e/c) MEDRS says nothing about the notability (WP:N) of authors. It says "experts in the relevant field". Most MEDRS's are written by people who are experts but not notable. (See WP:ACADEMIC.) There is nothing in MEDRS that gives preference to Colquhoun & Novella's editorial over Wang et. al.'s. However, it doesn't give much preference to editorials in general. They are only mentioned once, and are not mentioned at all in WP:MEDASSESS. Which is why we should use them sparingly, at most.

apropos of MrBill3's comments: Yes, of course we take DUE into account. But these are a solicited pair that are given equal prominence by the journal. They agree on the evidence base and disagree on what it means (i.e. the observed effects are small; is that small margin real or just artifact). Brangifer argued awhile ago that there is no unified mainstream scientific view on acu, which I think is pretty obvious given that some academics are busy using acu as a CAM while others denounce such use as "quackademic medicine". [19] So these editorials represent views within a spectrum (which might be closer to an RS than a MEDRS use). I think their main strength is as gateways to high-quality MEDRS's; maybe we can glean a few more meta-analyses. --Middle 8 (leave me alone • talk to me • COI?) 08:28, 1 August 2014 (UTC)

See WP:FRIND: "The best sources to use when describing fringe theories, and in determining their notability and prominence, are independent reliable sources. In particular, the relative space that an article devotes to different aspects of a fringe theory should follow from consideration primarily of the independent sources. Points that are not discussed in independent sources should not be given any space in articles. Independent sources are also necessary to determine the relationship of a fringe theory to mainstream scholarly discourse.

This is also a WP:WEIGHT issue. On Wikipedia, we continue to represent the mainstream spectrum. We should keep this ship on course. QuackGuru (talk) 17:40, 1 August 2014 (UTC)

Template:U:QuackGuru, thanks for providing the basis in policy and guideline for the "notability" objection to a source. I have no idea what that means so I cannot have a rational conversation with you about it, other than to say what I wrote below. With respect to "notability" used with respect to a source, I just opened a subthread at Wikipedia_talk:Fringe_theories#First_sentence_needs_improvement to discuss changing this, or making sense of it. So I will not be responding further to this for now. Jytdog (talk) 17:54, 4 August 2014 (UTC)Template:U:QuackGuru, I was moving to fast this morning. WP:FRIND says nothing about a source or author being "notable" so your argument about that has no basis. We are left with the question about whether everything about acupuncture is fringe. Everything about acu is not Fringe, as other sources on this page have demonstrated. some uses of acu are mainstream. So you cannot shoot down every source with WP:FRIND - if it discusses mainstream uses of acu, that no more fails WP:INDY than an oncologist writing an article about cancer. With respect to the invited article, it is as good as the other. Jytdog (talk) 20:33, 4 August 2014 (UTC)

See Wikipedia:DUE#Undue_weight and see Wikipedia:Neutral_point_of_view/FAQ#Pseudoscience. QuackGuru (talk) 02:43, 5 August 2014 (UTC)

OK, so let's be clear, QuackGuru, you are contending that the entire field of acupuncture is WP:FRINGE and that no part of it is mainstream, is that correct? Jytdog (talk) 03:05, 5 August 2014 (UTC)

QuackGuru, please have the respect to point out what you are exactly trying to say rather than make obscure references to Wikipedia Policies. Thanks. Jayaguru-Shishya (talk) 10:47, 5 August 2014 (UTC)

Right, the ship has sailed with regard to some uses of acupuncture in some settings, which have become mainstream. Not the whole field and definitely not many uses, but use of acu as CAM as an adjunct for relief of some pain conditions, nausea from chemo, and a few other things. Please stop treating this like it is black and white. QG it is just as wrong and POV for you to deny this, as it is for others to claim mainstream validity for the whole field and for its model of the body. Jytdog (talk) 17:53, 1 August 2014 (UTC) (including a missing word! Jytdog (talk) 04:58, 2 August 2014 (UTC))

Despite having veered off the precise topic of this thread Jytdog has made a good point and done so well. I tend to agree while validation for the field and it's theoretical basis is still clearly lacking, it seems there is some mainstream acceptance of it's use as an adjunct. True NPOV would mean the article should include this without giving undue weight or mischaracterizing it. This should be approached in a collaborative and cooperative manner. - - MrBill3 (talk) 04:07, 2 August 2014 (UTC)

MrBill3, QuackGuru said: "I previously explained both authors are notable experts on the topic while the other article seems not notable."[20]

He said that "I previously explained", but the diff he presented isn't saying anything else than: "The source by Wang et. al is not notable..."[21]

QuackGuru is making a claim, so I am looking forward to him supporting his claim. So far, I thing he has failed to explain why Wang et. al would not be notable. Jayaguru-Shishya (talk) 20:04, 3 August 2014 (UTC)

notable is the wrong question. Jytdog (talk) 21:30, 3 August 2014 (UTC)

We should use review articles instead of editorials

I don't understand why there's such a long discussion. How about using none of these editorials and replacing it with review articles instead? All of them are from journals dealing with anesthesiology and pain research:

• Acupuncture Analgesia: I. The Scientific Basis (2008) in Anesthesia & Analgesia with an impact factor of 3.422

• Acupuncture analgesia: Areas of consensus and controversy (2011) in Pain (journal) with with an impact factor of 5.836

• Acupuncture and related techniques in ambulatory anesthesia (2013) in Current Opinion in Anaesthesiology with an impact factor of 2.526

• Acupuncture for Acute Low Back Pain: A Systematic Review (2013) in The Clinical Journal of Pain

• Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain (2014) in Anesthesiology (journal) with an impact factor of 5.163

Remove the editorials, replace with reviews. -A1candidate (talk) 02:30, 11 August 2014 (UTC)

Well-said. Editorials are not very strong as MEDRS; as I mentioned above, they're not even mentioned in WP:MEDASSESS. --Middle 8 (leave me alone • talk to me • COI?) 02:59, 14 August 2014 (UTC)

Outstanding issues

Acupuncture and placebo

• Acupuncture, psyche and the placebo response (2010) in Autonomic Neuroscience: Basic and Clinical with an impact factor of 1.846

• Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta-analyses (2010) in Pain Practice with an impact factor of 2.183

The first review found some evidence that "biological differences" exist between a placebo response and sham acupuncture. The second review concluded that "acupuncture is more than a placebo". Are there any recent reviews that suggest otherwise? -A1candidate (talk) 02:31, 11 August 2014 (UTC)

Nocebo

Article fails to discuss the nocebo effect of acupuncture:

• Clinically meaningful nocebo effect occurs in acupuncture treatment: a systematic review (2014) in Journal of Clinical Epidemiology with an impact factor of 5.332

-A1candidate (talk) 02:31, 11 August 2014 (UTC)

Allergy

Article fails to mention acupuncture treatment for allergic diseases:

• Acupuncture for allergic rhinitis: a systematic review (2009) in Annals of Allergy, Asthma & Immunology with an impact factor of 2.746

• Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis — An overview about previous and ongoing studies (2010) in Autonomic Neuroscience: Basic and Clinical with an impact factor of 1.846

• Acupuncture for allergic disease therapy – the current state of evidence (2014) in Expert Review of Clinical Immunology with an impact factor of 3.342

-A1candidate (talk) 02:31, 11 August 2014 (UTC)

Mechanism of acupuncture

Article fails to mention mechanism of acupuncture:

• Neural mechanism underlying acupuncture analgesia in Progress in Neurobiology, with an impact factor of 10.301

• Mechanisms of action for acupuncture in the oncology setting (2010) in Current Treatment Options in Oncology with an impact factor of 3.240

• Mechanism of acupuncture on neuromodulation in the gut--a review (2011) in Neuromodulation (journal) with an impact factor of 1.785

• Acupuncture, Connective Tissue, and Peripheral Sensory Modulation in Critical Reviews in Eukaryotic Gene Expression with an impact factor of 2.949

• Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain (2014) in Anesthesiology (journal) with an impact factor of 5.163

-A1candidate (talk) 02:32, 11 August 2014 (UTC)

Acupuncture and the brain

Article fails to mention acupuncture's effect on the brain:

• Characterizing Acupuncture Stimuli Using Brain Imaging with fMRI - A Systematic Review and Meta-Analysis of the Literature (2012) in PLOS ONE with an impact factor of 3.534

• Inserting Needles Into the Body: A Meta-Analysis of Brain Activity Associated With Acupuncture Needle Stimulation (2013) in The Journal of Pain with an impact factor of 4.216

-A1candidate (talk) 02:32, 11 August 2014 (UTC)

We might add a bit about contraindications for certain points, i.e. the "fordidden points" during pregnancy like LI4, SP6, and GB21. I don't remember the source that mentioned that but AFAIK it was a MEDRS. --Middle 8 (leave me alone • talk to me • COI?) 03:09, 14 August 2014 (UTC)

These studies are of the brain's reactions to the body being poked with sharp things. They don't lay the foundation for the effectiveness of acupuncture, just that the brain does, indeed, react to the body being poked with a sharp object. I'm not aware of anyone that denies that.—Kww(talk) 13:37, 13 August 2014 (UTC)

No, they do. Read the meta-analyses carefully. -A1candidate (talk) 13:56, 13 August 2014 (UTC)

Please provide exact quotes from the meta analysis which you find relevant, something that tells us more than is already obvious, which is that every spot in the body has areas in the brain which not only control it but also areas which react to anything which affects it. That's too basic and "duh". What do you have from that source which we can use? -- Brangifer (talk) 23:58, 13 August 2014 (UTC)

e.g. (bold text indicates subsection header): Acupuncture at non-acupuncture points in close proximity to acupuncture points" Two third (64%) [15], [23]–[37] of 25 studies showed that acupuncture treatments were associated with more activation, mainly in the somatosensory areas, motor areas, basal ganglia, cerebellum, limbic system and higher cognitive areas (e.g. prefrontal cortex). That's 16 of the studies. Different or contradictory results were found in the remaining 9 studies. Also see other quotes under section titled Descriptive findings of differences between verum and sham acupuncture. --Middle 8 (leave me alone • talk to me • COI?) 03:20, 14 August 2014 (UTC)

Article does not conform to scientific consensus

This article fails to conform to scientific consensus

Mayo Clinic

"The current scientific theories provide a basis for stating that acupuncture has an effect on the nervous system" [1]

Johns Hopkins School of Medicine

"The modern scientific explanation is that needling the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain." [2]

National Cancer Institute (USA)

"Acupuncture may work by causing physical responses in nerve cells, the pituitary gland, and parts of the brain" [4]

National Health Service (Britain)

"It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue." [5]

A Scientific Statement From the American Heart Association

"In the manual form of acupuncture, the mechanism of effect appears to be through sensory mechanoreceptor and nociceptor stimulation induced by connective tissues being wound around the needle and activated by mechanotransduction. In the case of electroacupuncture, the effects appear to additionally involve the stimulation of peripheral nerve fibers, including vagal afferents, that in turn activate central opioid (and other) receptors or anti-inflammatory reflex pathways. Reflex increases in sympathetic activity may also be reduced by electroacupuncture. The role of mechanoreceptor stimulation in the BP reductions in animal models is supported by the ability to attenuate this effect by gadolinium, which blocks stretch-activated channels. Both forms of acupuncture have similar central nervous system effects, although electroacupuncture tends to have a greater intensity of effect as determined by functional magnetic resonance imaging studies in humans." (PMID 23608661)

-A1candidate (talk) 02:32, 11 August 2014 (UTC)

These are really good MEDRS's that we've neglected but I don't see how they meet WP:RS/AC any more than some of the meta-analyses we quote. --Middle 8 (leave me alone • talk to me • COI?) 03:31, 14 August 2014 (UTC)

Excellent summary by A1! Given there is still doubt about exactly how acupuncture works, a true 'Mechanism of Acupuncture' section is probably still premature, but you have undoubtedly presented an outstanding case for rewriting the article to make it consistent with current scientific thinking and including a 'Possible Mechanism of action' section. Yet, we have been here before! I painstakingly set up a 'Possible Mechanism of Action' section for this article over a year ago - see: https://en.wikipedia.org/w/index.php?title=Acupuncture&oldid=561592493. It lasted about a week before its reversion. The subheadings for that section are still current and in-line with A1's summary, although some of the refs might need updating. I'd consider putting it back in again, but would this put me up for another bout of reversion and a caution? Tzores (talk) 21:47, 12 August 2014 (UTC)

It seems you have made your homework pretty well, A1candidate! I find it quite impressive all the sources you have listed above. With respect to the scientific consensus issue, what would you suggest? =P Jayaguru-Shishya (talk) 10:37, 13 August 2014 (UTC)

We already state, of scientists, that "They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." This (or some tweaked form of it) is enough - much more would be undue and a section on 'Possible Mechanism of Action' especially so, probably veering into OR territory. Alexbrn ^{talk|contribs|COI} 05:24, 13 August 2014 (UTC)

Huh? You'd omit MEDRS even if they don't fully accord with what you just wrote (re: no point specificity)? See PLOS One source supplied by A1Candidate above [22] and my diff giving e.g.'s of quotes from same [23]. --Middle 8 (leave me alone • talk to me • COI?) 03:28, 14 August 2014 (UTC)

First of all, Wikipedia is an encyclopedia, not a scientific research paper. Its articles are not supposed to "conform to scientific consensus", although they do report it. They are encyclopedic articles, and of a special nature, largely because of our NPOV policy, which requires coverage of all significant aspects of a topic, unlike normal encyclopedias.

Secondly, those nice snippets are basically saying "duh". Those are not surprising or unique results, and are about the same results as would be expected if you pinched someone or scratched them. Acupuncture does actually touch the body. It affects the body. It's not Therapeutic touch, where hands are waved over the body without actually touching it. These are real effects, but they are non-specific responses to external influences on bodily tissues. This proves nothing special about acupuncture, and says nothing about any specific and unique results from a specific poke in a specific acupoint. There is no consistent, specific, and reproducible reaction from acupuncture which applies to everyone.

There do seem to be some generalized reactions, sometimes of a somewhat positive nature (pain relief), but nothing one can count on, or that could not be obtained by any other method which triggered endorphin production, and certainly not better than, or as strongly or consistently or reproducibly as any of several standard analgesic drugs. That electroacupuncture seems to have a stronger effect is also unsurprising, and it's NOT acupuncture. It's electrotherapy.

So, what specific wordings are you proposing to make to the article? This is all speculation about possible mechanisms, but it really adds nothing we don't already know, so do you have something specific and unique to acupuncture which is a new addition to the article? -- Brangifer (talk) 06:28, 13 August 2014 (UTC)

You obviously failed to read the articles above. Scientific consensus isn't "speculation". It's something we summarize and conform to. -A1candidate (talk) 09:31, 13 August 2014 (UTC)

Brangifer, do you have anything aside from your own ponderings? Jayaguru-Shishya (talk) 10:37, 13 August 2014 (UTC)

A1, those aren't statements of "scientific consensus", they are simple statements of evidence, and that evidence is not special. Anyone, even the most ardent skeptic, will admit that they are true statements. So "...acupuncture has an effect on the nervous system". Duh! Of course it does. Has anyone denied that? No. So "... treatment can stimulate nerves under the skin and in muscle tissue." Duh! Of course it does. Has anyone denied that? No. I could go on with each one of the statements.

This amounts to a two year old finding a penny and presenting it to its mother and thinking that it has found something which no one else in the world knows about, and now it thinks it has taught its mother about the existence of money. The mother says "Oh, what a pretty penny!" If that same child does this every day, all the way up into its twenties, the mother replies "Duh. This is getting old."

So, we need to know what you're getting at, because you haven't brought anything new or enlightening to the table. How would you use these statements in the article? Don't we already acknowledge that the body does sense when it is poked? I don't think we deny that fact. The body is sensitive to anything which touches it. Duh! So what. We need more than what we already know and what we already acknowledge in the article. -- Brangifer (talk) 13:24, 13 August 2014 (UTC)

I love the smell of inappropriate use of sources in the morning. Here, we have promotions for acupuncturists at Mayo and Johns Hopkins being touted as representative of scientific consensus on acupuncture. The others are lay descriptions of acupuncture used to describe services that the scientific community still dismisses as being no more effective than a placebo. That certainly is a creative way to describe the sources, but hints at a strong desire to distort reality.—Kww(talk) 13:33, 13 August 2014 (UTC)

The article in Mayo Clinic Proceedings is classified in PubMed as a review article, not a promotion piece. -A1candidate (talk) 13:52, 13 August 2014 (UTC)

I can't find anywhere on that page where it's referred to as a "review article", but that's really beside the point. It is a RS, in the general sense of the word, but for what purpose in this connection? What you've quoted from it isn't really worth using, even if it was a "review article" which passed the criteria in MEDRS, so what are you proposing that we can do with it? -- Brangifer (talk) 00:36, 14 August 2014 (UTC)

The current scientific theories provide a basis for stating that acupuncture has an effect on the nervous system, but its effects cannot be explained with a single mechanism. -A1candidate (talk) 16:29, 14 August 2014 (UTC)

@A1candidate: you are seriously misrepresenting the NHS source. I only checked that one since I used it not so long ago and did not remember it conforming to your description. And so it does not. This gives me very little confidence that the rest of your edits may be taken at face value. Perhaps a specific proposal where we can all vet your use of sources would be better received? - 2/0 (cont.) 17:23, 14 August 2014 (UTC)

I quoted from NHS exactly as it is stated on their website. If it looks different from what you last saw, that's because the page was changed last month. They update their articles evey two years, so you need to check with the newest version.

If you want a specific proposal from me, see Talk:Acupuncture#Protected_edit_request_on_20_July_2014_2. There's still no consensus over there, so your input is very much welcome -A1candidate (talk) 18:00, 14 August 2014 (UTC)

Nobody said you messed up the copy/paste. Please read more carefully to avoid wasting the time of your fellow editors. You are misrepresenting the conclusions of that source; read it again to see how they treat the subject compared to your proposed use here. They do not conform. This is *never* appropriate. We must only and exactly provide a fair representation of the sources without cherry-picking or quoting out of context. - 2/0 (cont.) 18:38, 14 August 2014 (UTC)

And you are misrepresenting what I propose, which is that acupuncture stimulates the nervous system. That is exactly what the source says. -A1candidate (talk) 18:43, 14 August 2014 (UTC)

I think we all agree that inserting needles under the skin has an effect on the nervous system, at least based on discussion above. Please strike or modify your above aggressive comment in accordance with WP:CIVIL and WP:BATTLEGROUND. - 2/0 (cont.) 19:04, 14 August 2014 (UTC)

(e/c) 2/0, I may be missing something, but I don't see A1 giving any worse than he's getting from you on the aggression front; you both sound exasperated, and it may be just a misunderstanding. The NHS page [24], as of today, indeed includes verbatim the quote "It is based on scientific evidence....". Is there some other dispute about that source that I'm missing? What misrepresentation are you referring to specifically? Forgive some entirely possible denseness on my side (literally; my sinuses are all too dense at the moment, and it's radiating to what's left of my brain), but I'm not understanding what A1C is proposing to do with the NHS source beyond simply citing or paraphrasing that quote. --Middle 8 (leave me alone • talk to me • COI?) 19:25, 14 August 2014 (UTC)

oh -- you mean that A1Candidate is overstating the degree to which the NHS source represents scientific consensus? If so: yes, I think that several of these sources aren't as close to meeting WP:RS/AC as A1C is suggesting. But the NHS source is an excellent MEDRS, one of the best, and I think there's room for disagreement over how close it is to representing sci consensus. A1C, I hope you're reading this as well: The problem, which Brangifer has imo correctly identified [25], is that there is no unified sci consensus on most aspects of acu (other than its not being an established treatment). That's why there's such a broad range of views, and so much polarization; the extremes at each end (in real life and on WP) piss each other off. That there are good reasons to use it as a complementary therapy for pain and stress is a mainstream view; that that same view is unsupportable is also a mainstream view. (Note I said "good reasons", which is a superset of "good evidence". Patients really liking it is an example of what many consider a good reason.) So I think it would be better for A1C to portray his sources not as representative of sci consensus, but as MEDRS's (many of them excellent ones) that we need to weight adequately, and so far haven't been (perhaps because editorial consensus has thus far been overaggressive about depicting acu as wholly fringe). A1C, would you consider not reaching quite so far? You're losing some editors by doing so, editors who are reasonable enough to (gasp) accept that we can use good MEDRS's that don't wholly dismiss acu. The fact that many of the sources you're presenting haven't been given more (or any) weight shows how excessively editorial consensus had tended to swing past skepticism into outright, undue debunking. We need less hyperbole all around. It's not hyperbole to say that A1C has found no more and no less than a bunch of MEDRS's, not all but some about as good as they get, that deserve proper integration and weighting. --Middle 8 (leave me alone • talk to me • COI?) 20:14, 14 August 2014 (UTC)

Note. Stimulating nerves does not mean it is effective. QuackGuru (talk) 19:16, 14 August 2014 (UTC)

This is about the mechanism of action, not its effectiveness. -A1candidate (talk) 19:20, 14 August 2014 (UTC)

Exactly; it's a different aspect of point specificity (which I'm sure the text of the article will make clear). --Middle 8 (leave me alone • talk to me • COI?) 19:29, 14 August 2014 (UTC)

The text is under the heading "Theory" not mechanism of action. QuackGuru (talk) 19:34, 14 August 2014 (UTC)

It is referring to the theories about the mechanism of action -A1candidate (talk) 20:04, 14 August 2014 (UTC)

Is the fact that "acupuncture has an effect on the nervous system" some sort of great or new discovery? Has it EVER been denied? Is there any other possible "mechanism of action" when one touches or pokes the skin? (Hormones could also get involved, but that too is not specific.) I'm still not getting what this is about. It's still "duh", uninteresting, not unique, and not evidence for or against any claimed specific effects of acupuncture.

Please make a specific, precisely worded and sourced, proposal that isn't as foolish as the child with the penny, who is now twenty years old and is still presenting the same penny to its mother as if it has invented money. Please place your proposed edit here, in this thread. -- Brangifer (talk) 00:33, 15 August 2014 (UTC)

Just doing a search for "mechanism" in the current version turns up not even a "penny"-type comment. We have:

1. "TCM is pseudoscience with no valid mechanism" (in lede and body);
2. "The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles";
3. "[blah blah pseudoscience]... making many scholarly efforts to integrate evidence for efficacy and discussions of the mechanism impossible"; and
4. "[blah blah NIH]... even if research is still unable to explain its mechanism."

Similarly unhelpful stuff (with respect to mechanism) appears when one searches for the syllables "nerv" and "neur" (including examples of what is massive undue weight to serious adverse events). And the section Scientific view on TCM theory is almost absurdly weighted to sources from the skeptic movement, and at any rate only mentions endorphins. We can do better than that! Even if a penny is all there is to be found (and there does appear to be more, e.g. point-specific neurological responses), readers at least deserve to know that the damned thing is round, shiny (for awhile), coppery, and a little bigger than a dime. Let's.... de-escalate a little in terms of confrontational approach. What's obvious to editors is not always obvious to the reader. A1Candidate has found some terrific ones, and I'd rather encourage them to keep at it. A1C, how would you do this? There's probably some stuff in those sources on fascia, no? There's stuff from Napadow and Kaptchuk.... a whole lot of stuff has been neglected, which is what happens when too few editors are involved. A1C and Brangifer, you're both great assets here; don't alienate each other. --Middle 8 (leave me alone • talk to me • COI?) 05:41, 15 August 2014 (UTC)

Does the source say that "It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue."? If it does, what's the problem? In my opinion, we better stick to the sources instead of our own ponderings. Jayaguru-Shishya (talk) 18:09, 17 August 2014 (UTC)

Yes, fascia (connective tissue) is discussed in the consensus statement of the American Heart Association as follows:

In the manual form of acupuncture, the mechanism of effect appears to be through sensory mechanoreceptor and nociceptor stimulation induced by connective tissues being wound around the needle and activated by mechanotransduction.

PMID 23608661 -A1candidate (talk) 09:32, 15 August 2014 (UTC)

I added "The mechanism of action for acupuncture is still unclear.[170] Evidence suggests that acupuncture generates a sequence of events that modulate pain signals within the central nervous system.[170]" QuackGuru (talk) 17:55, 15 August 2014 (UTC)

You're doing it without consensus. The source is from 2008 and is way past WP:MEDDATE. We have many newer reviews to use -A1candidate (talk) 21:46, 15 August 2014 (UTC)

• Acupuncture Analgesia: I. The Scientific Basis (2008) in Anesthesia & Analgesia with an impact factor of 3.422

I added the source you proposed adding to the article. I added this source because it meets MEDRS and it was not ambiguous. QuackGuru (talk) 02:53, 16 August 2014 (UTC)

We should use the newest reviews, which are not ambiguous. -A1candidate (talk) 03:02, 16 August 2014 (UTC)

This was the specific source you wanted in the article and now you don't like what the source said? I added the source that was specifically about the mechanism of action for acupuncture, which was not vague or confusing. QuackGuru (talk) 03:20, 16 August 2014 (UTC)

I was proposing to use it to replace the editorials only. I am not entirely against your edit, but I think it needs to be formulated in a different way. "Modulate pain signals" is an ambigous phrase that requires explanation. -A1candidate (talk) 09:43, 16 August 2014 (UTC)

"They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." There is an explanation in the article. QuackGuru (talk) 16:49, 16 August 2014 (UTC)

Endorphins aren't pain signals. -A1candidate (talk) 17:34, 16 August 2014 (UTC)

The release of endorphins modulate pain signals. QuackGuru (talk) 02:22, 17 August 2014 (UTC)

That is what the article should say to reduce ambiguity -A1candidate (talk) 04:54, 17 August 2014 (UTC)

I added the context from the source according to the summary. QuackGuru (talk) 06:01, 17 August 2014 (UTC)

Arrhythmias

7 individual herbal therapies along with acupuncture and yoga have been studied and reported as having an antiarrhythmic effect:

• Review of Complementary and Alternative Medical Treatment of Arrhythmias (March 2014) in American Journal of Cardiology

Despite methodological shortcomings, these studies support acupuncture as an effective treatment for AF (atrial fibrillation), paroxysmal supraventricular tachycardia, inappropriate sinus tachycardia, and symptomatic premature ventricular contraction

-A1candidate (talk) 10:26, 15 August 2014 (UTC)

Good stuff -- hope you're being bold and adding at least some of these as you go, because good MEDRS's shouldn't be controversial -- as long as you're not removing others at the same time. If you also want to remove a MEDRS (for whatever reason), others might object to that part, so I'd do such an edit separately. (See situation below where an editor combined both good and bad edits into one big edit and it got reverted -- that was justified but could have been avoided.) --Middle 8 (leave me alone • talk to me • COI?) 07:50, 17 August 2014 (UTC)

Have these been added into the article? If not, I don't mind helping you guys out here. LesVegas (talk) 16:33, 30 August 2014 (UTC)

No specific explanation was given

No specific explanation was given to restore the poor evidence. The edit summary was "I see no consensus for deleting Mayo Clinic and AMA as sources (although the latter is pretty outdated)".[26] QuackGuru (talk) 07:29, 15 August 2014 (UTC)

Why don't you just say why you think the evidence is poor? You could have said so in your ES or in your post above. Anyway, I agree AMA is quite outdated, and I doubt anyone will mind removing it. But Mayo Clinic falls under Wikipedia:MEDRS#Other_sources as a good MEDRS. --Middle 8 (leave me alone • talk to me • COI?) 14:42, 15 August 2014 (UTC)

See Wikipedia:MEDRS#Other sources: "however, as much as possible Wikipedia articles should cite the more established literature directly."

We are citing high-quality Cochrane reviews and systematic reviews. There is no need to state the opinion of Mayo Clinic or other organisations. This is poor evidence. QuackGuru (talk) 16:20, 15 August 2014 (UTC)

Enough bad evidence meets MEDRS? Lots of marginal evidence would likely be construed as validation. Jim1138 (talk) 20:08, 15 August 2014 (UTC)

Just realized it's under Acupuncture#International_reception and being used as an RS there not a MEDRS. --Middle 8 (leave me alone • talk to me • COI?) 22:41, 15 August 2014 (UTC)

The Acupuncture#International reception section should be about the international reception. What is the point with keeping poor evidence in the wrong section. QuackGuru (talk) 03:00, 16 August 2014 (UTC)

It's not presented as evidence. Not any more than the commentaries by Quackwatch are -- and Mayo Clinic is certainly more mainstream than Quackwatch, I think, as RS go. --Middle 8 (leave me alone • talk to me • COI?) 07:26, 16 August 2014 (UTC)

Quackwatch is not being used in the International reception section. It is misplaced text in the International reception. It would not be acceptable to add to the effectiveness section because it is poor evidence. QuackGuru (talk) 15:42, 16 August 2014 (UTC)

Quackwatch (or SRAM, basically the same thing) was part of that section [27] when I wrote that comment. --Middle 8 (leave me alone • talk to me • COI?) 07:45, 17 August 2014 (UTC)

You claimed "Just realized it's under Acupuncture#International_reception and being used as an RS there not a MEDRS."

That is not accurate. It was being used as MEDRS is the wrong section. The text was a medical claim which falls under MEDRS. A lot of text was misplaced in that section. You have not made an argument to restore the poor evidence against MEDRS. QuackGuru (talk) 17:47, 23 August 2014 (UTC)

What's the problem with using it as an RS? Jayaguru-Shishya (talk) 18:09, 17 August 2014 (UTC)

I thought I previously explained it was presented as evidence in the wrong section. It was poor evidence and misplaced text in the International reception section. It would not be acceptable to add it the effectiveness section because we are using far better sources. No editor suggested that we must use the Mayo Clinic source in the effectiveness section. QuackGuru (talk) 16:21, 21 August 2014 (UTC)

Recent edits

User:QuackGuru just made a series of edits without consensus, which I reverted. You need to discuss each and every one of these editrs before adding them.

The Ice Man hypothesis is not supported by any scientific evidence. -A1candidate (talk) 22:04, 15 August 2014 (UTC)

I'm not entirely comfortable with A1C's bulk reversion, but OTOH I wasn't comfortable with QG's making a whole bunch of edits at once. Some of QG's edits are fine, but others obviously need consensus, and they shouldn't be done all at once. This fundamentally goes to to WP:CONSENSUS. QG, please do them one at a time so that anything viewed as controversial can be handled per WP:BRD. Or better, seek consensus first for major changes. --Middle 8 (leave me alone • talk to me • COI?) 22:52, 15 August 2014 (UTC) added last sentence 23:21, 15 August 2014 (UTC)

Hum deleting recent systematic reviews just because... Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:15, 15 August 2014 (UTC)

No, he needs to do the edits separately from one another. --Middle 8 (leave me alone • talk to me • COI?) 23:19, 15 August 2014 (UTC)

There is no compelling reason for the blanket revert to an older version and you have not given a reason to restore the poor evidence. See Talk:Acupuncture#No_specific_explanation_was_given. QuackGuru (talk) 19:09, 16 August 2014 (UTC)

I agree. Similar discussion have already taken place at Chiropractc (talk). A quote from the discussion: "... It is good practice to perform a series of smaller edits when content has been challenged... MrBill3 (talk) 12:48, 27 July 2014 (UTC)'" Jayaguru-Shishya (talk) 18:13, 17 August 2014 (UTC)

Yes, there is a good reason for a blanket revert, and I explained it above. And I will just once more: a combined good and bad edit is still a bad edit. --Middle 8 (leave me alone • talk to me • COI?) 07:40, 17 August 2014 (UTC)

What on earth? You're redoing a major part of this edit [28] while the discussion here was still under way, and when two editors have objected to your blanket edit? No consensus for Otzi, and this sentence -- "The poor quality evidence suggests that in regard to whether acupuncture in infertile men improves sperm motility, sperm concentration, and the pregnancy rate of couples is insufficient. -- is atrocious. You're edit warring. Don't do that. Wait for consensus. Don't make others clean up your messes please. --Middle 8 (leave me alone • talk to me • COI?) 08:30, 17 August 2014 (UTC)

Jerng et al.

Jerng et al. 2014 was recently removed without explanation. This looks like a decent source to integrate with the existing #Fertility and childbirth section. - 2/0 (cont.) 19:00, 16 August 2014 (UTC)

There should be a discussion over whether Asian Journal of Andrology, which is sponsored by the Chinese government, is considered a reliable source. -A1candidate (talk) 19:10, 16 August 2014 (UTC)

That is a good explanation. Thank you for supplying it when prompted. - 2/0 (cont.) 19:18, 16 August 2014 (UTC)

http://www.researchgate.net/journal/1745-7262_Asian_Journal_of_Andrology The impact factor is 2.14 and it is the only systematic review and meta-analysis covering poor semen quality in infertile males. QuackGuru (talk) 19:43, 16 August 2014 (UTC)

This is the current wording for Jerng et al.: A 2014 systematic review and meta-analysis found poor quality evidence for use of acupuncture in infertile men to improve sperm motility, sperm concentration, and the pregnancy rate; the evidence was rated as insufficient to draw any conclusion regarding efficacy.[86]

While the discussion here was under way, no rationale objection was made for reverting to an older version.

There is still no rationale explanation for reverting to an older version. Removing recent systematic reviews was inappropriate. Restoring the poor and misplaced evidence to the International reception section was also inappropriate. Cochrane reviews and systematic reviews are far better. QuackGuru (talk) 03:44, 21 August 2014 (UTC)

Allergies

Several studies regarding allergies were recently removed. Can we come to a consensus on this text instead of edit warring about it? - 2/0 (cont.) 19:01, 16 August 2014 (UTC)

The addition does not take into account the latest source , Acupuncture for allergic disease therapy – the current state of evidence (2014), in Expert Review of Clinical Immunology. -A1candidate (talk) 19:12, 16 August 2014 (UTC)

The Acupuncture for allergic disease therapy – the current state of evidence (2014) is a Perspective. I don't think it is a systematic review. QuackGuru (talk) 19:23, 16 August 2014 (UTC)

Expert Review of Clinical Immunology publishes review articles. The source says "This review summarizes current evidence for acupuncture treatment of allergies". The review article is written by allergy experts and is newer than the older sources. -A1candidate (talk) 19:37, 16 August 2014 (UTC)

At pubmed it does not say it is a review in the listing of the source. The text says "This review summarizes...[29] but it does not say it is a systematic review. At the of top of the source it says it is a Perspective. Not sure if it meets MEDRS. Thoughts? QuackGuru (talk) 20:01, 16 August 2014 (UTC)

The article was published in July 2014. The indexing procedure in PubMed is still in process. Previous perspective reviews in Expert Review of Clinical Immunology have been indexed by in PubMed as a review. See PMID 23971749 for example. If you have a newer systematic review, we could use it. If not, let's stick to the latest review that we have. -A1candidate (talk) 20:21, 16 August 2014 (UTC)

If it is reliable I would need a copy of the conclusion to make sure I add neutrally written text. QuackGuru (talk) 20:45, 16 August 2014 (UTC)

Time out for a moment. First, "Perspective" is not a genre. The source is a review, obviously, per A1C's multiple and patient clarifications. And a review can still be a MEDRS whether general or systematic; we can use them both, although the former does not supersede the latter.

Just because one doesn't like a source, it's not OK to make tendentious, nitpicky objections every step of the way -- like "it's not a review" when it obviously is. That may "work" -- in the sense that it slow-walks addition of sources one doesn't like, and frustrates those with whom one is disagreeing -- but it's a low-level form of disruption that decreases the quality of discussion. It is absolutely not how WP:DR works. (Or is it?) --Middle 8 (leave me alone • talk to me • COI?) 06:04, 17 August 2014 (UTC)

• QG, this is what the source concludes:

There are several randomized clinical trials supporting the use of acupuncture in allergic rhinitis as well as the symptom of itch. Experimental studies point to an effect of acupuncture in atopic eczema and asthma; however, large RCTs are lacking. Acupuncture for the treatment of other allergic diseases such as contact eczema, drug rashes or anaphylaxis cannot be recommended to date. Further research is needed to more clearly identify clinical effects above and beyond placebo and mechanisms of action.

The source provides a good overview of the mechanisms of action against allergy. -A1candidate (talk) 00:02, 18 August 2014 (UTC)

About "Further research is needed to more clearly identify clinical effects above and beyond placebo and mechanisms of action." What does this apply to? Allergic rhinitis and itch or atopic eczema and asthma or other allergic diseases? Tgeorgescu (talk) 00:39, 18 August 2014 (UTC)

Note. I added the source to the article. QuackGuru (talk) 04:09, 28 August 2014 (UTC)

Ice Man

The Ice Man's tattoo marks on his body which conform to acupuncture points, suggests to some experts that an acupuncture-like treatment was previously used in Europe 5 millennia ago.

The Ice Man thing is decently well sourced, but I think it has been pretty well rejected. I would like to remove it unless we have more than the current small slice of scientific speculation. - 2/0 (cont.) 19:06, 16 August 2014 (UTC)

The source says: "Bizarrely, the ‘Ice Man’, who lived in the Alps about 5000 years ago, displays tattoo marks on his body which correspond to acupuncture points. To some experts, this suggests that an acupuncture-like therapy was already used in Europe 5 millennia ago [15]."[30]

The source does not say it is merely speculation. To some experts, it suggests that a form of acupuncture was previously used in Europe 5 millennia ago. QuackGuru (talk) 19:09, 16 August 2014 (UTC)

Weak keep -- QG is right that while it's speculation, it is "expert speculation", plus it's even mentioned in a review. OTOH, Ernst mentions it mostly as an aside, and even adequately-sourced speculation is still speculation -- which means it's pretty weak in terms of WEIGHT. Interesting though. (Like much of speculation :-) --Middle 8 (leave me alone • talk to me • COI?) 06:46, 17 August 2014 (UTC)

There are recent sources in the news.[31][32] QuackGuru (talk) 07:01, 17 August 2014 (UTC)

It's fine with me, especially with the new evidence. (I think we can safely assume the media didn't botch this roll-out.) Speculative yes, but I don't think it's especially controversial, so no major reason not to have it. And it is interesting; fascia-nating actually (haha). But in the lede?? --Middle 8 (leave me alone • talk to me • COI?) 11:04, 17 August 2014 (UTC)

This discussion is regarding this edit. According to your previous comment, you supported to tentatively keep it in the lede. Now that I explained it is no longer controversial given the current evidence, you are now strongly questioning whether it should be in the lede. Can you see the tattoo marks correspond with acupoints? QuackGuru (talk) 20:23, 17 August 2014 (UTC)

2/0's thread-starter didn't say anything about the lede; sorry for any mixup. It's not WEIGHT-y enough for the lede, but the more recent research should be enough to keep it in the article. Yes, some of his tattoos are right on top of acupoints, and others are within a few mm [33] (diagram: [34]). And not just random acupoints, but major ones used for pain and tonification, like UB60 and Sp6. And being located under where clothing was worn, they're unlikely to be decorative. Quite intriguing; maybe the underlying connection is related to trigger points. Who knows.... Hey, can we use this as cross-cultural evidence for point specificity? ;-) --Middle 8 (POV-pushing • COI) 17:01, 18 August 2014 (UTC)

If there is more detailed research in the future things could change again. Can we use this as cross-cultural evidence for point specificity? Not sure when no specific proposal was made. QuackGuru (talk) 17:05, 18 August 2014 (UTC)

My last sentence in jest. Hence ;-) --Middle 8 (POV-pushing • COI) 07:57, 19 August 2014 (UTC)

I get it now. All this time you were arguing ad nauseam and reverting me to encourage me to continue to improve the article.

Reverse physiology works? QuackGuru (talk) 18:39, 24 August 2014 (UTC)

My joke (about "cross-cultural evidence for point specificity) was about acupuncture and evidence, not about you. OTOH, it's very hard to see your immediately preceding comments as anything other than baiting. Wikipedia isn't a battleground, and when I make an edit, I'm not thinking about you. I could care less about reverse psychology or any other game. Please stop acting as if editors' content disagreements are personal. --Middle 8 (POV-pushing • COI) 07:28, 26 August 2014 (UTC)

1997 NIH statement

The 1997 NIH panel statement is really old and a bit unusual. We should not use it to represent anything modern, though perhaps it can be retained for some historical significance. Thoughts on removing the reference? - 2/0 (cont.) 19:13, 16 August 2014 (UTC)

Agree that it should be removed. There is an explicit warning against using it: "They were current when produced, but are no longer maintained and may now be outdated." -A1candidate (talk) 19:18, 16 August 2014 (UTC)

We are using the 2005 Quackwatch as a source now. See Acupuncture#Ethics. I recently fixed the text. QuackGuru (talk) 19:21, 16 August 2014 (UTC)

The statement was only being used to support some pretty basic and unlikely to be challenged information, so I boldly removed the reference. - 2/0 (cont.) 19:26, 16 August 2014 (UTC)

I requested a source for the non-controversial claims. QuackGuru (talk) 20:08, 16 August 2014 (UTC)

Why did you do that? We don't use sources for non-controversial claims. Such a request can be seen as disruptive, so why do it? You're not making sense. -- Brangifer (talk) 00:50, 17 August 2014 (UTC)

I am not making a request that we must use a source. I was stating when someone finds a source it can be added to the article. QuackGuru (talk) 00:58, 17 August 2014 (UTC)

Ooookaaay...? Then we can remove that CN, since it's not necessary. We don't clutter articles, especially the leads, with unnecessary things. If it's really necessary, the body will contain references. -- Brangifer (talk) 01:01, 17 August 2014 (UTC)

Indonesia

Recent edit from 222.244.210.15:

All traditional medicines, including TCM, are regulated on Indonesian Minister of Health Regulation in 2013 about Traditional Medicine. Traditional Medicine License (Surat Izin Pengobatan Tradisional -SIPT) will be granted to the practitioners whose methods are scientifically recognized as safe and bring the benefit for health. The TCM clinics are registered but there is no explicit regulation for it. The only TCM method which is accepted by medical logic and is empirically proofed is acupuncture. The acupuncturists can get SIPT and participate on health care facilities.

I think there should be something usable here, but not in the current form. Removed here for discussion. - 2/0 (cont.) 13:14, 18 August 2014 (UTC)

No serious dispute

Rather than wait for this discussion to crop up again I will start it again and take the initiative.

TCM is largely pseudoscience, with no valid mechanism of action for the majority of its treatments.[27]

This is no serious dispute. See WP:ASSERT. We don't need to have another discussion every six months. When there is a new source that says TCM is science and there is a mechanism of action for the majority of its treatments we can also include that source with in-text attribution for both sentences. QuackGuru (talk) 01:28, 21 August 2014 (UTC)

Sorry, I'm relatively new to editing and formatting in the Wikipedian community, I've made some tentative edits on an account which I can't remember how to access. However I've also been watching the edit histories daily and talk pages of many subjects in order to learn WP policy and how it's applied in various environments. /End of preface.

Several things about this confuse me. For instance, are you saying that via WP:ASSERT we should present the statement you are addressing as factual rather than opinion? This confuses me, first of all, based on the lack of tangible information in the editorial article itself. But I don't know if that's something we deal with here. More prominently it concerns me because isn't the definition of an editorial article that it is an opinion piece by the editor? Doesn't WP:ASSERT caution specifically against presenting opinion as fact, even if it is a notable opinion?

Secondly, why is this an important addition to a section entitled "theory"? Would it not be more appropriate in the lead? The TCM article itself acknowledges that the source is editorial opinion, although at some point the "editorial" attribution was moved from the lead to the body of the text (in my opinion, a strange move, but maybe there is a policy for that).

It reads:

"Successful results have however been scarce: an editorial in Nature said that while this is simply because TCM is largely pseudoscience without a rational mechanism of action for the majority of its treatments, advocates have argued that it is because research had missed some key features of TCM, such as the subtle interrelationships between ingredients." Once again, sorry for any confusion on my part.OnceTheFish (talk) 18:06, 21 August 2014 (UTC) Sock comments stricken. QuackGuru (talk) 03:50, 23 August 2014 (UTC)

As QuackGuru said, the contrary viewpoint is virtually nonexistent in the medical literature that matters, so we cannot seriously pretend that TCM would be considered scientific by any medical researcher worth his salt, therefore "TCM is pseudoscientific" wins by default. Tgeorgescu (talk) 00:33, 22 August 2014 (UTC)

Funny things are happening again. OnceTheFish is way too familiar with this content dispute. The last time someone was pretending to be a newbie we knew it was a sock account. QuackGuru (talk) 06:11, 22 August 2014 (UTC)

These types of responses are the type which kept me out of this editing game for so long, especially in these topics. I have been bemusedly watching these pages for several months now. It has been an engaging lesson in the stark realities of the wiki project. As to the wonderful welcoming accusation, I would be willing to verify my identity to an admin, or have a longtime contributor who encouraged me to register an account vouch for me to an admin or official representative.

My question, are you arguing that via WP:ASSERT we should present an editorial opinion as fact? This seems utterly contrary to the purpose of this policy. If it is not, could you explain to me where I have read it wrong? Whether or not the other literature says X or Y (which if it does, why are we not using that rather than an editorial opinion?), strictly speaking WP:ASSERT which was the policy cited by QuackGuru seems to say contrary. On top of which, there is a precedence in the TCM wiki proper to identify the attribution of the editorial opinion, which I would guess is how WP:CON develops, although I may be wrong about that as well.

I am not speaking to anything else other than the specific instance of policy which QuackGuru has cited. Thanks.OnceTheFish (talk) 15:36, 22 August 2014 (UTC) Sock comments stricken. QuackGuru (talk) 03:50, 23 August 2014 (UTC)

Again, in reliable sources there isn't a debate whether TCM would be pseudoscience. There is no controversy about this, all such sources concur that it advances pseudoscientific mechanisms for explaining its treatments. If would not be that editorial, fine, there are other reliable sources which make the very same point. Whether each of those treatments is effective or not is another matter, e.g. there might be some herbs which have a real therapeutic effect. But a few herbs which are proven to have such effects do not mean that TCM would not be pseudoscientific, they would just be its lucky guesses. Until Tao, Yin and Yang would be observed in laboratory, it will remain pseudoscience even if it got a couple of treatments right. Oops, I forgot that Tao defined is no Tao at all, so its claims are principally unfalsifiable, relying upon mystical energies which are undefinable and some of its advocates say these have no relation to the present-day meaning of "energy", either. So, I would like that you propose bona fide changes to the article instead of insisting upon advocacy for pseudoscience. User:Jytdog acknowledges there are mainstream uses for acupuncture because it is a convenient way of fooling patients into feeling better, even if it is placebo produced by pseudoscientific practice. Tgeorgescu (talk) 23:23, 22 August 2014 (UTC)

TCM predates science. How would you expect it to explain how a treatment works? Because they say "qi", that means there can't be any rational mechanism? I find that argument unimaginative and unpersuasive. Ancient astronomer/astrologers thought that gods and demons battled in the sky; does that mean that their predicting eclipses was just lucky guessing? --Middle 8 (POV-pushing • COI) 08:57, 26 August 2014 (UTC)

Tgeorgescu please strike your comment. You characterize me bizarrely and are trying to use me as a tool in a debate I am not involved in. I object to that. I also think you do not understand what I represent here. So please just strike your remark. Jytdog (talk) 23:39, 22 August 2014 (UTC)

Ok, I have stricken my comments, but perhaps you should better explain your point. Tgeorgescu (talk) 23:46, 22 August 2014 (UTC)

Tgeorgescu, there seems to be a considerable hostility in the tone of your writing. If I have somehow offended you or broken etiquette, please let me know what in particular I can correct so that we can discuss in a productive manner. Let me clarify my perspective. 1. QuackGuru cited a particular reference, and then a particular policy WP:ASSERT. 2. I asked for clarification of how he would like to implementWP:ASSERT with regards to that reference. 3. The reasoning behind my request is as follows, a)WP:ASSERT states "A simple formulation is to assert facts, including facts about opinions, but don't assert opinions themselves." b) an editorial is, by definition, an opinion. If you search Editorial in wikipedia the following appears: "An editorial, leading article (UK) or leader (UK), is an opinion piece written by the senior editorial staff or publisher of a newspaper, magazine, or any other written document. Editorials may be supposed to reflect the opinion of the periodical." c)Given that the policy QuackGuru cited explicitly dictates that opinions should be written in a separate voice from a point of fact, and an editorial reference is by definition an opinion piece, it follows that the citation of the policy next to the reference is at the very least quite confusing for me. Whether we keep the reference with proper attribution, find another of these non-opinion references you allude to, re-write the WP:ASSERT policy, or correct the definition of "Editorial", I don't know, so I ask you guys. My proposal is to continue WP:CON as we see it in the TCM (traditional Chinese medicine) and Chinese Herbology pages by adding the proper attribution. For example "An editorial in Nature stated that TCM is largely pseudoscience, with no valid mechanism of action for the majority of its treatments." as seen in the lead of Chinese herbology. Furthermore I propose that the attribution of this editorial is moved from the body of the TCM page into the lead, however I don't know if this is the correct page for that. (talk) 01:30, 23 August 2014 (UTC) Sock comments stricken. QuackGuru (talk) 03:50, 23 August 2014 (UTC)

The problem with your position is that there is no reliable source contradicting the position that Traditional Chinese Medicine is pseudoscience. —Kww(talk) 02:32, 23 August 2014 (UTC)

The sock account was blocked. QuackGuru (talk) 03:38, 23 August 2014 (UTC)

well i guess that is done. Tgeorgescu thanks for striking your comment. I am happy to explain whatever you like, but this is not the place for it. If you want to clarify your question (which I don't understand) I would be happy to do it on my talk page. thanks again. Jytdog (talk) 05:48, 23 August 2014 (UTC)

I (user:Ontarioboy) have known (user:OnceThe Fish) for all of his young life as our families have shared weekly dinners for the past twenty years. During dinner conversations I occasionally allude to my own wide-ranging edits on Wikipedia and have encouraged my young friend to become active there, which he finally did last month. His first contribution, to the talk:acupuncture page, landed him in the midst of an ongoing quackery controversy and his rather detailed comment was deemed prima facie evidence of sockpuppetry. This is not so. Apart from a small anonymous edit or two back in 2008, he is a first-time novice Wikipedian. David G Anderson (talk) 03:26, 1 September 2014 (UTC)

Where was this edits back in 2008? QuackGuru (talk) 03:32, 1 September 2014 (UTC)

My young friend says that it was at his local college in a modern media class when the instructor had every student go on Wikipedia and make a minor edit or two so as to acquire familiarity with the edit process. His contribution was "inconsequential and forgettable" and occurred prior his current interest in TCM, acupuncture and such. David G Anderson (talk) 21:35, 2 September 2014 (UTC)

Serious dispute

We simply don't have RS showing sci consensus that acu is pseudoscience, and we do have RS and other indicia that there is significant disagreement. The large majority of RS discussing acupuncture and TCM are silent on pseudoscience, and nearly all MEDRS are, and there's no reason to believe that silence necessarily indicates agreement or disagreement. But, using common sense, it's highly unlikely that those who use acupuncture in mainstream settings, like academic centers, believe it's pseudoscience.

And yes, there's debate over the pseudoscience label; see the invited "pro" editorials in Analg. Anesth (pro; con); the "pro" article rejects labels like "pseudoscience" and "quackery". The "con" article is still cited in the article, although I think we have consensus not to use either as MEDRS. But they are RS and mainstream. Additionally, there are RS that demarcate acu neither as science nor pseudoscience, but in a grey area between the two; see archived talk. An example is Michael Shermer's recent book chapter: [35].

So, we have RS showing that acupuncture shouldn't be categorized as pseudoscience on WP. Rather, cf. WP:FRINGE/PS, it falls under "questionable science": "Hypotheses [or practices -- ed.] which have a substantial following but which critics describe as pseudoscience". But more than that, we see it being used in some mainstream settings, while others denounce such use as "quackademic medicine". Sounds like "a reasonable amount of academic debate" to me (WP:FRINGE/PS). And we have nothing close to a source meeting WP:RS/AC, which again isn't surprising given acu's broad sphere of usage. So why should we use category:pseudoscience, or otherwise say in WP's voice that acu is pseudoscience? --Middle 8 (POV-pushing • COI) 08:50, 26 August 2014 (UTC)

I agree. So I could recall, that this has been already discussed earlier. That's why at traditional Chinese medicine on a dispute about using Wikipedia's voice I reverted the removal of the very editorials expressing these views[36]. According to Kww[37], however, "yes, it has, with the decision being that a bald description as "pseudoscience" in WP's voice is appropriate".

Whereas reliable sources are bringing forth a significant disagreement over the subject, I think we should definitely include 1) the source behind each claim, and 2) the sources with differing views. Jayaguru-Shishya (talk) 10:52, 26 August 2014 (UTC)

Safe?

With acupuncture "there is a risk of accidental puncture of nerves, which could lead to brain damage or strokes. Kidney damage can result from deep needling in the lower back, and unsterilised needles can transfer HIV and hepatitis." QuackGuru (talk) 17:28, 23 August 2014 (UTC)

Since when is The Daily Telegraph an MEDRS-compliant source? -A1candidate (talk) 01:16, 25 August 2014 (UTC)

Yeah, I'd like to hear that as well. Jayaguru-Shishya (talk) 12:10, 25 August 2014 (UTC)

Yes popular press should not be used for medical content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:35, 25 August 2014 (UTC)

If an editor (who should know better) were to suggest using popular press as MEDRS for "pro-acupuncture" statements, an admin would use that to support sanctioning that editor under AE. Strange the converse doesn't seem to be true.... --Middle 8 (POV-pushing • COI) 08:47, 26 August 2014 (UTC)

You were using a primary source is engage in a "pro-acupuncture" statement. Do you think an admin would use that to support sanctioning you under AE? QuackGuru (talk) 20:23, 26 August 2014 (UTC)

Ummm.... that diff shows me using a peer-rev RS for a non-medical claim. That's not quite the same as your proposal above to use a newspaper as a MEDRS. (BTW, why is the link to your talk page in red? Redlinks imply that no such page exists; it's confusing.) --Middle 8 (POV-pushing • COI) 04:07, 27 August 2014 (UTC)

You added a primary source that violated WP:SECONDARY and WEIGHT. I did not make a proposal to use the source above. See WP:AGF. I was using the talk page to document what was missing from the article and added this. QuackGuru (talk) 04:14, 27 August 2014 (UTC)

If that was why you mentioned the news article, then you should have said so; three editors misunderstood you. In light of your clarification, I'm striking my comments about sourcing. With respect to the point you're trying to make, your quote was selective. The bit you quoted is preceded by "While most acupuncture causes little harm," is consistent with how the literature weights AE's. Omitting important context like that is not a great way to get others to AGF. More re which, please see your talk page. --Middle 8 (POV-pushing • COI) 07:18, 27 August 2014 (UTC)

I wasn't trying to make a point. I was making a note. We are not using that source. QuackGuru (talk) 07:28, 27 August 2014 (UTC)

Why did you post it at all then? Was it to show that the article needs to spend more time on infection and other adverse events?

Here's the full quote -- which is a pretty accurate depiction of our MEDRS's -- with the part you omitted in bold red:

"While most acupuncture causes little harm, there is a risk of accidental puncture of nerves, which could lead to brain damage or strokes. Kidney damage can result from deep needling in the lower back, and unsterilised needles can transfer HIV and hepatitis."

The bold red part -- which you omitted -- shows why it's an UNDUE problem to devote excessive coverage to infection and other serious adverse events. Why did you omit it? --Middle 8 (POV-pushing • COI) 10:21, 28 August 2014 (UTC)

On the contrary, I added "Acupuncture is generally safe when administered using clean technique and sterile single use needles.[3][16]" See diff. I previously explained, I left a note on the talk page. QuackGuru (talk) 19:08, 31 August 2014 (UTC)

I'm not talking about article space edits -- and that was a good article edit, although you didn't make it until you got called out here. Taking material out of context anywhere, including article talk, can create a biased impression. Here, you omitted the one part of the quote that gives the rest of the quote proper weight. Why? See WP:OPPONENT. --Middle 8 (POV-pushing • COI) 04:54, 2 September 2014 (UTC)

Re recent edits listing specific infections, please see Talk:Acupuncture#Infection below.

Discussion had already begun below, and the above discussion about the newspaper is extraneous, except for the UNDUE issue. --Middle 8 (POV-pushing • COI) 10:21, 28 August 2014 (UTC)

Quackwatch is a reliable source

Quackwatch stated that:

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"". Retrieved 31 December 2013.

Rather than wait for this discussion to crop up again I will start it again and take the initiative. The source is reliable per many previous discussions. QuackGuru (talk) 16:16, 25 August 2014 (UTC)

Then why start the discussion again? It's a pretty settled matter that QW is reliable for these subjects, but always on a case by case basis. If in doubt, then attribute it to the author, whether it's Barrett or someone else. -- Brangifer (talk) 03:51, 26 August 2014 (UTC)

I don't like using QW. It's really just a personal self published blog. It would be better to use the medical references that it relies upon rather than QW directly. All sources should follow WP:MEDRS. It's hypocritical to use one personal website and then deny others. --Harizotoh9 (talk) 08:06, 26 August 2014 (UTC)

I think it's a good initiative to start the discussion again, but definitely it needs a broader audience than just the editors of Acupuncture. Well, I have to agree with Harizotoh9 here. QuackWatch is a self-published blog that has undergone no academic peer-review process, i.e. the ones hosting that site can publish whatever they want on that site. And we are not interested in one's opinions. Entertaining? Perhaps. Scientific? Perhaps not.

And when it comes to blogs in general, even if we had a eminent Economist like Paul Krugman publishing his blog at The New York Times, we still can't take what he says there as scientific claims (which is really apparent if you read his blog).

If QuackWatch really is a reliable source, sure it would be largely cited in scientific papers. Is it? Jayaguru-Shishya (talk) 10:53, 26 August 2014 (UTC)

As I understand it, under WP:PARITY, Quackwatch can be useful for highly fringe topics that scientists haven't commented on. Acupuncture is not such a topic, and better sources than Quackwatch are usually available. I agree with using it on a case-by-case basis, as Brangifer says. And I'd add: sparingly. BTW, as far as getting Quackwatch declared a non-RS goes, see WP:SNOWBALL. It's been discussed many times, and sometimes with editors who don't usually edit alt-med type stuff, and the result has generally been about as I've outlined it. --Middle 8 (POV-pushing • COI) 12:14, 26 August 2014 (UTC)

Since there are significant areas of acupuncture which have not been discussed in the scientific literature (e.g. anything having to do with a scientific plausibility of qi) quackwatch can be used to explain those points. The quote that QG points out is pretty much in that category. jps (talk) 19:56, 26 August 2014 (UTC)

No, it has been reviewed in scientific literature. And we should cite that instead, as discussed many times before. -A1candidate (talk) 20:05, 26 August 2014 (UTC)

Which scientific literature is that? Has there been a "Qi review" that I missed? jps (talk) 20:16, 26 August 2014 (UTC)

PMID 21870056 -A1candidate (talk) 20:25, 26 August 2014 (UTC)

The source says "we speculate that the mechanism"... According to you we should not include speculation in this article. QuackGuru (talk) 20:41, 26 August 2014 (UTC)

The speculation is about "a separate channel of cellular communications". This is different from their conclusion that "the ancient model appears to have withstood the test of time ". -A1candidate (talk) 20:48, 26 August 2014 (UTC)

You misrepresented the source. It goes on to say "...surprisingly well confirming the popular axiom that the old wine is better than the new." That is ambiguous. QuackGuru (talk) 02:10, 27 August 2014 (UTC)

Explain how that terribly written and poorly researched article passes WP:MEDRS. jps (talk) 01:06, 27 August 2014 (UTC)

Last I checked, medical review articles in peer-reviewed journals (impact factor 3.07 in this case) were MEDRS's. Acupuncture is a good example of a topic area where we have plenty of MEDRS's and thus don't need to use Quackwatch for such purposes. --Middle 8 (POV-pushing • COI) 01:20, 27 August 2014 (UTC) revised 01:41, 27 August 2014 (UTC)

So why is it not cited outside of credulous acupuncturist circlejerks? jps (talk) 02:04, 27 August 2014 (UTC)

It is cited by internists and gynaecologists in this Cochrane review. Can you show me a review paper that cites QW? -A1candidate (talk) 02:12, 27 August 2014 (UTC)

That Chochrane review was written by acupuncturists, so try again. Yes, there are reviews that cite QW, some of which are cited in our article on Quackwatch. jps (talk) 17:45, 29 August 2014 (UTC)

Cochrane review is a Cochrane review. I am afraid we are not interested in your personal opinions about it.

Written by whom? An economist writing about economics is more than preferable, a physicist writing about physics is more than preferable, a physician writing about medicine is more than preferable... I wonder where you managed to break the pattern? ^^

Can you give me few reliable high-quality acedemic sources where QuackWatch is beng cited? Thanks! Jayaguru-Shishya (talk) 19:01, 29 August 2014 (UTC)

Acupuncturists are generally believers in pseudoscience and so cannot be trusted to comment on the pseudoscientific nature of their practice. Their abilities to publish review articles may or may not be relevant to this point (actually, review articles rarely address the subject of pseudoscience). The fact that acupuncture is closely associated with pseudoscientific tosh is not something to be shied away from, and we have plenty of reliable sources to that effect in spite of the acupuncture true believers such as yourself, Middle 8, and A1candidate trying to get it removed because it offends your delicate sensibilities and true beliefs. jps (talk) 20:34, 29 August 2014 (UTC)

@ QTxVi4bEMRbrNqOorWBV aka jps: If you are asserting that I and other editors are trying to suppress V RS material, that is a personal attack unless you can provide clear and convincing diffs (which I don't think you can, or else you would have filed at ANI etc. by now). I strongly object to the assertion that I am here to do anything other than to improve Wikipedia. Please provide diffs or strike or clarify your assertion. --Middle 8 (POV-pushing • COI) 05:09, 2 September 2014 (UTC)

I am sorry to disappoint you, but I am not an "acupuncture true believer", neither a mere "acupuncture believer". I hope you can get over such assumptions when editing at Wikipedia. Anyway, do you have any facts and sources aside your own personal opinions? I am afraid we are not interested in your own ponderings. As I said, a Cochrane review is a Cochrane review. Should you have a source discrediting that, please do let us know.

Ps. Those high-quality academic sources where QuackWatch is being cited would be more than welcome. Cheers! Jayaguru-Shishya (talk) 20:57, 29 August 2014 (UTC)

We can all see your contributions and know what your general approach has been. If you are not a true believer, you are an apologist for true belief. That makes it very difficult to collaborate with you because you either don't have a head for reality or you are pretending to not care about such. "A Cochrane review is a Cochrane review" is a content-less comment meant to shut-down discussion and I've already pointed you in the direction of the sources that cite QW. Go back to your WP:ADVOCACY. I won't stop you. Cheers! jps (talk) 21:02, 29 August 2014 (UTC)

Do you have some specific edits you'd like to discuss, or are you attacking me as an editor? "....don't have a head for reality...." and [[WP:ADVOCACY]], ouch? Anyway, I hope you could stick to the topic. If there are any other concerns, please do start a new thread or find an appropriate forum to discuss those. Cheers! Jayaguru-Shishya (talk) 21:13, 29 August 2014 (UTC)

Ps. As I said: "Should you have a source discrediting that [Cochrane review], please do let us know.. Aside from that, no high-quality academic sources where QuackWatch would have been cited has been provided. Jayaguru-Shishya (talk) 21:23, 29 August 2014 (UTC)

• Internists and gynaecologists are not acupuncturists. PMID 21870056 isn't the only review that validates the science of acupuncture and disagrees with QW. See PMID 24079683 -A1candidate (talk) 22:27, 29 August 2014 (UTC)

It seems that there is far more heat than light in this thread. Can we all calm down and just drop the sniping? How about just hatting this thread since it's dead in the water? Start a new one which doesn't mention QW. -- Brangifer (talk) 22:37, 29 August 2014 (UTC)

How about removing non-scientific sources like QW? -A1candidate (talk) 23:06, 29 August 2014 (UTC)

How about removing POV-pushing editors like yourself? jps (talk) 00:01, 30 August 2014 (UTC)

Think this discussion would be better off on say Wikipedia:Reference_desk/Science. Quackwatch should -in the spirit of Wikipedia- be banned as a source (on WP) because of its clear biased agenda. It misleads nouveau editors. It leads them to confuse fact with fiction. --Aspro (talk) 23:28, 29 August 2014 (UTC)

Nonsense. The only people who argue this way are true believers in alternative medicine. I take that kind of opinion pushing to be prima facie evidence of a lack of WP:COMPETENCE, but it is nice because it serves to illustrate who we should be monitoring. I see that you are an anti-vaccine advocate. I'll be sure to revert your blinkered edits as they come through. jps (talk) 00:03, 30 August 2014 (UTC)

Please revert your edit. I happily had a anti-tetanus jab because I did not want to sufferer the (small) risk of getting lockjaw, after getting a hole in my arm. It was a very small risk, as it didn't happen in a situation where where one was likely to contract that bacteria. (I had a fight with my flat-mate on the balcony -so no soil involved) Yet here, in the UK I could have a jab for free – so I had one! Don't be so pontifical. I makes you look ignorant. Next time 'think' before putting fingers to keyboard. OK? --Aspro (talk) 02:39, 30 August 2014 (UTC)

No Aspro, it is your snarky, talk page-violating comments, here and elsewhere, which should be tamed or removed. Stop the attacks.

Those who dispute and criticize Quackwatch are consistently non-mainstream/fringe sources, and individuals who are known quacks, scammers, felons, frauds, and/or individuals who are ignorant of science and medicine, and/or ignorant of all sides of the underlying issues. No mainstream sources offer any serious criticisms, only minor quibbles. Quackwatch is consistently recognized and recommended as a mainstream, very accurate, source. One may not agree with the approach, but the POV is always consistent with the mainstream. Its huge expert base ensures that.

That's why all of the attempts to muzzle, delete, or otherwise limit the appropriate use of Quackwatch (on a case by case basis) have always failed. In fact, such attempts have only solidified its value and importance here. Your attacks create a Streisand effect / Pyrrhic victory / backlash against those who are attacking the largest database of anti-quackery resources on the internet. It is the miner's canary which defends science and medicine from attacks by quacks and frauds. When you attack it, you are revealing your unfitness to edit these subjects. -- Brangifer (talk) 05:58, 30 August 2014 (UTC)

BullRangifer, do you have anything to support what you say or are you again just telling your own opinions? As I have said numerous times, I am afraid we are not interested in your own opinions here. I hope I don't have to tell you that again.

Let's keep it simple: QuackWatch is a self-published site that has not gone under any sort of peer-review process. The moment it turns into a peer-reviewed one, please let us know. Meanwhile, I'd advise to replace any claim made by QuackWatch with a reliable medical source, providing one exists though.

QTxVi4bEMRbrNqOorWBV and BullRanfiger, constantly calling editors who happen to disagree with your own opinions as "advocates" or "POV-pushers" is not constructive editing. Should editing this article cause too much distress, I'd advise to keep a break. If you don't have anything meaningful to say about the content and sources instead of making continuous remarks about the other editors, better not say it at all. Cheers! Jayaguru-Shishya (talk) 06:47, 30 August 2014 (UTC)

Ps. The discussion about QuackWatch may need a bigger forum than mere Acupuncture talk page. Jayaguru-Shishya (talk) 06:54, 30 August 2014 (UTC)

It has had a much larger forum many times, including ArbCom, and it's passed with flying colors every time. Those aren't just my opinions, but the opinions of RS and numerous experienced editors, admins, and ArbCom members. Read the sources at the QW article, and look at the top of its talk page, which lists just a few of the times it's been up for discussion. The guidelines for using QW are pretty straightforward, and they don't include being "banned as a source (on WP)". As for any "clear biased agenda", that agenda is exactly the same agenda which is behind mainstream science and medicine, and Wikipedia is a mainstream encyclopedia. It favors truly RS, not fringe ones. You won't find QW disagreeing with mainstream consensus. QW actually does NOT "misleads nouveau editors", simply because it teaches them how not to "confuse fact with fiction." It teaches them the difference and exposes pseudoscientific fiction. (The one who wrote those disparaging remarks in quotes has really exposed themselves, and has now gotten many eyes watching their every move. I doubt they will last very long here.)

Your IDHT attitude (which has also drawn attention to you) is causing you to continually repeat your misunderstandings, which have been explained to you many times, but instead of learning, you just repeat them. QW is not a blog, or a scientific journal, but a source of information and expert opinion from scientists, physicians, and scientific skeptics, just like the NYTimes is a source of information for many things. Neither of them use peer review in the normal sense, although QW has a board of expert advisers. No website uses "peer review". Only scientific journals do that. That is not required of every type of RS we use here. You're barking up a straw man tree, so please stop repeating your misunderstandings and misdirections.

Peer review of a website? Really? Have you ever heard of it? No. It is edited by Barrett, a prize winning expert on his topics, with a large team of other experts who advise him, and who also write many of the articles. We use some of them as sources, but only on a case by case basis, and sometimes because WP:PARITY justifies using them. Some are appropriate, and we may use them, and others are not, so we don't use them.

It is often one of the few sources which take on unscientific and pseudoscientific matters, simply because peer reviewed journals don't deal with them. They don't debunk lies. They just ignore them and do their thing, so sometimes there is nothing in the peer reviewed material we can use, so we use QW, SBM, and other skeptical RS. Scientific skeptics, unlike laboratory scientists, deal with the gray border zones between mainstream and fringe, and expose what's going on there. They are like correspondents reporting from the trenches in a war zone. Their opinions are a valuable part of the "sum total of human knowledge" which Wikipedia seeks to document. They are RS for doing that. When in doubt, we quote and attribute the opinions to the author, Barrett, or QW. Although his name is on many of the articles, they have often been a team effort, but he gets the credit.

It is not a MEDRS source, but is sometimes quoted when it echoes the same opinions as MEDRS. At other times, when a source doesn't have to be MEDRS, it is used like any other source of opinion. Again, it is always used on a case by case basis. Only if it is found to be clearly wrong, in matters that are not opinion, is it not used (for example a typo or misprint), and it's pretty rare that it's totally wrong, but it's possible an article hasn't been updated. Then we wouldn't use it until it was updated.

Of course believers in alternative medicine think it's always wrong, which just goes to show on which side of the mainstream/fringe, right/wrong, truth/error divide they stand, and they are obviously not standing on the side of what RS say. That puts them at odds with our sourcing policies and with QW. The ones holding the smoking gun aimed at the miner's canary (QW), are holding the evidence of their incompetence in their hands. Don't blame me for pointing it out. They are digging their own grave when they criticize QW. -- Brangifer (talk) 08:38, 30 August 2014 (UTC)

This comment from Brangifer is very good and might become part of a FAQ-like essay relating to sites like Quackwatch. A couple of observations: First, Jayaguru-Shishya, you should heed (or should have heeded) my comment above about WP:SNOWBALL; Quackwatch is frequently used as an RS here (depending on the claim, which is true for any source). But Jaya appears to be kind of new around here so please, let's not bite him too hard. Second, QTxVi4bEMRbrNqOorWBV aka JPS's general "more heat than light" approach and denigration of PMID 21870056 and the Cochrane review that cites it are good examples of POV-pushing from the skeptic side. Just because you don't like some sources doesn't make them not MEDRS. A range of views exists in (and near and at the fringes of) the mainstream, and naturally sources are going to reflect that. Similarly, just calling Harvard and Yale Med Schools, et. al., "quackademic" doesn't make them any less mainstream; it doesn't win or end the debate, it simply highlights the fact that debate exists. To the degree that acupuncture is accepted in mainstream academic settings, we need to treat it as having mainstream as well as fringe aspects. Because we follow the mainstream. --Middle 8 (POV-pushing • COI) 12:24, 30 August 2014 (UTC)

• Brangifer's comment is false and incorrect because scientific journals do deal with disproven therapies, especially popular ones such as PMID 15061600 and PMID 21322466. With regards to QW's comment that TCM theories are so nebulous that no amount of scientific study will enable TCM to offer rational care, it is clearly an opinion statement. -A1candidate (talk) 01:11, 31 August 2014 (UTC)

Yes, that quote is very much opinion and stating it in WP's voice violates WP:CRYSTAL, which says: "Predictions, speculation, forecasts and theories stated by reliable, expert sources or recognized entities in a field may be included, though editors should be aware of creating undue bias to any specific point-of-view." Stating it in WP's voice also violates WP:ASSERT, because we don't have RS evidence that this opinion is held by the sci community. It's a view of scientific skeptics, and significant, and could be cited as long as it's not an UNDUE problem, but not to the exclusion of other views. (I think Brangifer might agree with that, but of course he speaks for himself.) --Middle 8 (POV-pushing • COI) 04:46, 2 September 2014 (UTC)

Of course acupuncturists would be in favor of using low-quality sources that proffer poor methodology in exchange for claims that qi exists. Mention in a Cochrane review does not confer reliability on nonsense. That's not how it works. The fact is that there is no mechanism ever proposed for qi -- and claimed correlations which are not done with rigor but rather with anecdotal pareidolia of a match between a central nervous system and the absurd number of meridians proposed in acupuncture texts is no more reasonable a conclusion than someone who goes on about ley lines and tectonic faults.. That needs to be made clear in the article. jps (talk) 13:04, 2 September 2014 (UTC)

@jps - Your response is threaded after mine, but if you're responding to me I have no idea which "low quality sources" you're talking about, nor do I assert qi exists. What I do think is that translation is possible in some cases. [38] Perhaps not for acu, but for herbs, why not? A TCM pattern like "damp heat" can be translated roughly as purulence, especially when herbs used to treat it (e.g huang lien) contain antibiotic compounds like berberine. That's not pareidolia. (Great word btw.) --Middle 8 (POV-pushing • COI) 15:21, 2 September 2014 (UTC)

You are on a roller coaster, here. PMID 21870056 nearly asserts that qi exists in the way I describe. Treating it as the end of the discussion about qi (or even a perspective which is debated) is problematic. jps (talk) 17:02, 2 September 2014 (UTC)

Reliable source? - "From Alien Abductions to Zone Therapy"

What about this one: "From Alien Abductions to Zone Therapy", are we using books on extraterrestrials (!) now too? Jayaguru-Shishya (talk) 12:10, 25 August 2014 (UTC)

It is not a scientific source and we should not use it. -A1candidate (talk) 20:27, 26 August 2014 (UTC)

We are not using a book on extraterrestrials in general. QuackGuru (talk) 20:45, 26 August 2014 (UTC)

Copied from User talk:Jayaguru-Shishya#Encyclopedia of Pseudoscience is a reliable source

• William F. Williams, ed. (2000). Acupuncture. Facts on File. pp. 3–4. ISBN 978-1579582074. {{cite encyclopedia}}: |work= ignored (help) This is not a random book. It is an encyclopedia.QuackGuru (talk) 16:10, 25 August 2014 (UTC)

I haven't yet found where to access that book. The name, however, implies that it has something to do with extraterrestrials, is that right? If so, are we using an encyclopedia on extraterrestrials to support claims on medical efficiency? Jayaguru-Shishya (talk) 09:35, 26 August 2014 (UTC)

The Encyclopedia of Pseudoscience is not a book about extraterrestrials in general. The encyclopedia covers pseudoscience from Alien abductions to zone therapy. The name does not imply it is a book on extraterrestrials in general. It covers a wide range of pseudoscience topics. Please don't get involved in an edit war or claim the source is not reliable. Did you read the Encyclopedia of Pseudoscience page? QuackGuru (talk) 19:40, 26 August 2014 (UTC)

Have I made even one single revert concerning your addition of this book? Jayaguru-Shishya (talk) 20:10, 26 August 2014 (UTC)

You have made a comment on the talk page which concerns me. Do you agree your comment on the talk page was misleading or you made a mistake? QuackGuru (talk) 20:16, 26 August 2014 (UTC)

This was copied from his talk page. QuackGuru (talk) 20:34, 26 August 2014 (UTC)

The discussion belongs here, not on his talk page. -A1candidate (talk) 20:38, 26 August 2014 (UTC)

He is misrepresenting the book. Do you concur? QuackGuru (talk) 20:45, 26 August 2014 (UTC)

I would agree that the book is certainly much more about than aliens and UFOs, but according to our article on Encyclopedia of Pseudoscience, many of its contributors hail from dubious institutions such as "Center for UFO Studies" and "Department of Religious Studies". The publisher does not sound very reputable either -A1candidate (talk) 20:58, 26 August 2014 (UTC)

You claim the book is much more about aliens and UFOs. No, I previously explained the encyclopedia covers many pseudosciences.

Do you think the encyclopedia is widely used on Wikipedia? QuackGuru (talk) 21:06, 26 August 2014 (UTC)

The publisher is in general a decent publisher and good enough to not disqualify one of its books on the basis of the publisher alone. But there do seem to be some perhaps reasonable grounds to question some of the content as per reviews in the article. It would help a lot if it was more clearly indicated what specific material from the book is being used as well as the name and reputation of the author of the specific article in question.John Carter (talk) 21:29, 26 August 2014 (UTC)

Copied from User talk:Jayaguru-Shishya#Encyclopedia of Pseudoscience is a reliable source

You changing your previous comment and questioning weather the book is reliable. You claimed "What about this one: "From Alien Abductions to Zone Therapy", are we using books on extraterrestrials (!) now too?."

I told you the book is not on extraterrestrials in general. See WP:IDHT. QuackGuru (talk) 20:29, 26 August 2014 (UTC)

You are not giving a valid reason for deleting sourced text. For example, you have not shown how the encyclopedia is unreliable. QuackGuru (talk) 21:10, 26 August 2014 (UTC)

I meant to say that the book is much more than aliens and UFOs. Being cited on Wikipedia has no relevance to its reliability and I don't think it qualifies as an actual medical textbook. -A1candidate (talk) 21:49, 26 August 2014 (UTC)

No need to include any extraterrestrial / UFO authors for medical claims, that's it! Please do find a better source. So simple, problem solved! Jayaguru-Shishya (talk) 21:44, 26 August 2014 (UTC)

The above comment seems to be taking the editors own assumptions as conclusions and such behavior is not considered acceptable here. In short the only problem in this topic is the problem of the editor who apparently is making completely unwarranted assumptions about the content of a book based apparently simply upon a misreading of the title. The real list of articles contained in the book beyond the names of the first and last alphabetical entries can be found at Wikipedia:WikiProject Skepticism/Encyclopedic articles#Encyclopedia of Pseudoscience. I might go further and say that it strikes me as being potentially problematic behavior to attempt to dismiss such a source on the extremely dubious rationale apparently being used here.John Carter (talk) 21:55, 26 August 2014 (UTC)

"Alien abductions", "extraterrestrial intelligence", "communication with extraterrestrial intelligence" ... are you pretty sure this is a medical textbook? So should we be using this as a medical source? Jayaguru-Shishya (talk) 22:10, 26 August 2014 (UTC)

I never said it was a medical textbook and I very strongly suggest that editors here refrain from any further disruptive editing of that type. I had asked a question regarding what content the source is being used to support in the article. It is in fact generally common practice to indicate that at the beginning of a thread to make discussion easier and I am rather surprised that the OP had not indicated that earlier in the thread. I find the questions asked above to be counterproductive because they seem to be making implicit assumptions about matters which have never been so far as I can see specifically introduced into discussion. Unfortunately such conduct can be seen as problematic. I would very much welcome seeing more clearly useful comments perhaps along the lines of directly responding to the questions I had asked earlier.John Carter (talk) 22:23, 26 August 2014 (UTC)

Jayaguru-Shishya, please stop the endlessly repetitive IDHT disruptive comments! When it comes to determining whether a source is a RS, it all depends on how it's used. No single source (even the New York Times) is considered reliable in every situation, and there is practically no single source that isn't considered a RS for some very limited purpose (such as the nonsensical insane Twitter speculations of a weirdo, used in an article about that weirdo, for the purpose of documenting their POV).

If you will check the two places where the Encyclopedia of Pseudoscience is being used in this article, it is used appropriately for the use intended in that context. Context is everything when determining whether a source is being used appropriately. If so, then it is a RS for that purpose. SMH...! (I really get tired of explaining this basic stuff when competence is lacking.) Can we hat this yet?! -- Brangifer (talk) 22:57, 26 August 2014 (UTC)

Its contributors are mostly from the humanities department. The book is not from a notable academic publisher and it is more than a decade old. Please read WP:MEDRS carefully. -A1candidate (talk) 23:40, 26 August 2014 (UTC)

MEDRS does not apply to the way this source is being used. This is documenting the POV of those who consider the subject worthy of being included in an encyclopedia about pseudoscience. MEDRS citations rarely deal with pseudoscience. They generally ignore it. -- Brangifer (talk) 00:03, 27 August 2014 (UTC)

All health content here is subject to WP:MEDRS. If you wish to edit Wikipedia, please respect our policies and guidelines. -A1candidate (talk) 00:24, 27 August 2014 (UTC)

Like I already said if you disagree and wish to resolve this matter the appropriate forum would be RSN. Also I believe you may be making a mistake of overgeneralization. Not all content in all articles relating to medicine broadly construed must necessarily always adhere to MEDRS and this particularly includes content relating to public perceptions and history and other material not of an explicitly medical nature.John Carter (talk) 00:33, 27 August 2014 (UTC)

The source is not being used for biomedical information it being used for how acupuncture is described/viewed. Please read the guidelines you cite. While your at it read the core policy NPOV which requires we present the significant published views on the subject. Might I also suggest reading Tendentious editing. As above the appropriate forum is RSN, be sure to specify what content is supported by the source and why you don't think it is a reliable source for that content. - - MrBill3 (talk) 00:39, 27 August 2014 (UTC)

The content backed up by the source is not just of a medical nature, it is also a direct health claim so WP:MEDRS applies. -A1candidate (talk) 00:42, 27 August 2014 (UTC)

A1candidate, there is another solution. Try to suggest altered wording which justifies using the source. You obviously believe the source is misused. How about suggesting tweaks of the wording? Maybe we can find a solution that way. Okay? -- Brangifer (talk) 00:51, 27 August 2014 (UTC)

Read the content some contemporary practitioners...have abandoned the concepts of qi and meridians as pseudoscientific." not a health claim but a description of the views and practices of some contemporary practitioners, and "Some modern practitioners...They, along with acupuncture researchers, explain the analgesic effects of acupuncture as caused by the release of endorphins, and recognize the lack of evidence that it can affect the course of any disease." again neither biomedical information presented as fact nor a health claim but the explanations and realizations of an identified specific group. The source is RS for what some practitioners think or say. Note also all of the information associated with this content that is of a biomedical nature is very well spelled out and supported with MEDRS quality sources when it is presented in terms of health claims and biomedical information. Your IDHT is becoming quite tendentious RSN has been suggested. This article is under discretionary sanctions. Consider this a notification of the PAG in relation to Tendentious editing and Discretionary sanctions A1candidate. Please consider this in your further editing. - - MrBill3 (talk) 01:03, 27 August 2014 (UTC)

I was referring to this content, not the one you quoted. -A1candidate (talk) 01:19, 27 August 2014 (UTC)

We can compromise and tweak the text. QuackGuru (talk) 05:19, 27 August 2014 (UTC)

Thank you for the clarification. It really helps when objecting to a source to specify what content is being challenged. The content I quoted is all that is currently in the article supported by this source.

I agree with A1candidate that the content in the diff provided above is difficult to justify supporting with Williams 2013. I agree a more MEDRS compliant source is appropriate for "There is no evidence that inserting needles can affect the course of any disease." I apologize for my contentiousness, it was due to a misunderstanding. - - MrBill3 (talk) 01:32, 27 August 2014 (UTC)

This comment was very helpful. I can tweak the text to a specific group. QuackGuru (talk) 05:17, 27 August 2014 (UTC)

The phrase in the article: 'lack of evidence that it can affect the course of any disease' is not consistent with a published Cochrane review. Tension-type headache are considered to be diseases by the current version of the WHO's ICD-10 (disease number G44.2). The 2009 Cochrane review of acupuncture for tension headache (www.ncbi.nlm.nih.gov/pubmed/19160338) states "acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches". The WP article actually refers to tension headaches in the Headaches and migraines section but incorrectly cites a Cochrane review on migraine and contradicts itself. With consensus, the latter incorrect citation should reasonably be corrected to cite the correct article and the contradictory statement should be removed. Is the Cochrane review on tension headache sufficient to withdraw the statement on lack of evidence that acupuncture can affect the course of any disease? Tzores (talk) 05:52, 27 August 2014 (UTC)

The Cochrane review does not clearly state benefit. "could be a valuable non-pharmacological tool" With respect to affected long term disease outcomes it states "Long-term effects (beyond 3 months) were not investigated" Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:46, 27 August 2014 (UTC)

The source we are working with [39]

It states "Orthodox researchers posit that the practice generates endorphines, chemicals imilar to narcotics, but they add that, although pain is reduced, there is no evidence that the application of needles can influence the course of any organic disease."

The source is from 2013. The publisher is "Routledge" which is well respect in the humanities.[40] Acupuncture being on the fringe of science is covered by the humanities and thus this source is not unreasonable.

The next question is how should we summarize it. Maybe "Western medicine, while accepting it may affect pain through increasing the bodies release of endorphins, does not consider acupuncture to alter the long term course of diseases" Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:54, 27 August 2014 (UTC)

The text you're proposing is an excellent example of WP:OR. All medical articles must rely on scientific sources. -A1candidate (talk) 07:43, 27 August 2014 (UTC)

Should not be too difficult to support this by other sources aswell I imagine. In fact we have "The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits" which is basically the same thing. [41] Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:06, 27 August 2014 (UTC)

Yes, this review is much better than the non-scientific source. I have no objections to using it for now, although I note that it is slightly past WP:MEDDATE so we should continue to look for more recent reviews. -A1candidate (talk) 07:43, 27 August 2014 (UTC)

My post below was almost e/c'd with A1C's post, and agree -- prefer the solid MEDRS. --Middle 8 (POV-pushing • COI) 07:57, 27 August 2014 (UTC)

A1candidate, if you agree then what was the reason you tried to delete the text from the lede along with other reviews? QuackGuru (talk) 08:47, 27 August 2014 (UTC)

It's not an unreasonable claim, and we should be able to work it in somehow. But acu isn't so fringe that we lack full-blown MEDRS's on it -- quite the contrary; it's been massively researched -- and I think we should use those whenever possible.

And I'm not so sure that the amelioration of pain and stress doesn't affect the long term course of chronic diseases -- it's just a very very non-specific effect. Isn't that why it's used as a complementary therapy in academic medical centers like Harvard [42] and U-Maryland [43] etc etc? Or is that just to make patients feel better... or is that the same thing? (Seriously, just because critics call such use "quackademic" doesn't change the fact that these settings are about as mainstream as it gets. We need to reflect that. Why is it used so widely? The answer isn't irreconcilable with systematic reviews.) --Middle 8 (POV-pushing • COI) 07:44, 27 August 2014 (UTC)

Yes agree we can just stick with the better source that says more or less the same thing. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:55, 27 August 2014 (UTC)

MEDRS and WEIGHT issues in recent edits

This edit uses a non-MEDRS for a MEDRS claim (and goes even further by speaking in WP's voice), and this one worsens the already excessive undue weight given to serious adverse events. (Contra this ES, those two errors don't cancel each other out; and whatever else one can say about Williams' Encyclopedia of Pseudoscience, it's not a MEDRS.) Following WP:BRD, I reverted both [44][45]. Now's the time for the editor, QuackGuru, to make a case for these edits; now is not the time to edit war [46][47]. --Middle 8 (POV-pushing • COI) 00:54, 27 August 2014 (UTC) added more 01:08, 27 August 2014 (UTC)

Why on earth is QG going to FTN before even trying WP:DR here? [48][49] That could be construed as a canvassing attempt. --Middle 8 (POV-pushing • COI) 02:32, 27 August 2014 (UTC)

Acupuncture is also within the domain of the humanities and thus a humanities textbook may be appropriate for certain statement. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:56, 27 August 2014 (UTC)

Certain statements, sure, but a MEDRS statement? I could see that if we didn't have much in the way of MEDRS's, but that's not the case here. If at all possible we should stick with MEDRS. --Middle 8 (POV-pushing • COI) 07:23, 27 August 2014 (UTC)

When making claims on medical efficiency, we follow MEDRS. The source under discussion is not MEDRS compliant. Jayaguru-Shishya (talk) 08:34, 27 August 2014 (UTC)

The source has been in the article for a while now. I don't see consensus to delete the 2013 source. QuackGuru (talk) 08:40, 27 August 2014 (UTC)

If anyone still thinks it is canvassing to use the WP:NOTICEBOARD I encourage you to MFD the noticeboard or expect you to strike your comments. There was a previous thread I started for Talk:Acupuncture#Safe.3F. There was some information missing from the safety section. I read the existing sources in the article and updated it accordingly. Things are very quiet again and the article is stable. If past behaviour is any indicator of future behaviuor a certain editor will soon return and delete sourced again as he did in the past. Does he make counterproductive edits?

I was removing text that was not MEDRS compliant but he restored it.

In 1997, the American Medical Association Council on Scientific Affairs stated that, "There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well- designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies." So what was the motivation to restore this? How is using a source that does not mention acupuncture improve the article? Read the edit summary. He thought one of the sources was dated. So why restore it? QuackGuru (talk) 15:46, 27 August 2014 (UTC)

Infection

This is a break in the "MEDRS and WEIGHT issues in recent edits" section to focus on the edit about infection.

Regarding this edit and then a repeat of the same edit: (moved from above)

Infections included mycobacterium, staphylococcus, septic arthritis, necrotizing fasciitis, pneumoretroperitoneum, facial erysipelas, HIV, Listeria monocytogenes-caused arthritis, and infections via Enterococcus faecalis, and Pseudomonas. This text was deleted but the source says infections was a major complication.
— User:QuackGuru 08:02, 27 August 2014

QuackGuru's comment above doesn't address the UNDUE problem I mentioned above and at FTN. (Let's not fork anymore please.) I will repeat:

We don't need to list every opportunistic pathogen. Serious adverse events, which include infection, are rare, per multiple sources.

The "Safety" section is already unduly weighted toward irrelevant details of very rare events. (This is the case largely because of one editors' insistence that every detail of every adverse event, no matter how rare, be covered. If we did this with ibuprofen, that article would be easily a dozen times as long as it is now.). --Middle 8 (POV-pushing • COI) 10:23, 28 August 2014 (UTC)

Removed extraneous list of pathogens: [50] --Middle 8 (POV-pushing • COI) 10:34, 28 August 2014 (UTC)

Adverse events that are very unlikely at each session become very important when applied across the whole population. The FDA withdraws drugs during post-marketing monitoring for events that were too rare to show up in large clinical trials, after all. We need to list infection as a possible complication, as it is any time the skin barrier is broken. So far as I can tell, those pathogens are not associated with acupuncture per se so much as they just happened to be lingering around to be introduced. I am fine just noting that infections can occur without listing out every pathogen that has been observed. - 2/0 (cont.) 15:32, 28 August 2014 (UTC)

Agree entirely, and in particular I agree with your first two sentences. More on undue weight in that section later... --Middle 8 (POV-pushing • COI) 11:41, 30 August 2014 (UTC)

Academic centers

As mentioned above, acupuncture is used at a number of academic centers. This certainly belongs in the article; for starters, I've added its own subsection under Acupuncture#International_reception [51]. It's used at a great many such places, and at some point we might have so many that it may be a good idea to create a list.

I know acupuncture is a fringe topic, and I would like to apologize in advance for pushing mainstream POV into it. :-) --Middle 8 (POV-pushing • COI) 14:44, 28 August 2014 (UTC)

This is a good edit. I tweaked the text to indicate that the list presented is not exhaustive. We of course need to be careful not to imply that just because these centers use the practice that they know how it works (or even where it is effective), but we do need the information that it is used at hospitals as well as at stand alone clinics. A third or maybe even a fourth example citing non-US use would be good to help reflect a worldwide view. Maybe one from China and one from Germany or somewhere like that? - 2/0 (cont.) 15:25, 28 August 2014 (UTC)

Thanks; yes, good idea re worldwide view. We can also talk about acu's role in medical education worldwide; in China, IIRC, TCM is taught as anywhere from (very roughly) 5% to 50% of the curriculum. --Middle 8 (POV-pushing • COI) 12:00, 30 August 2014 (UTC)

I agree, that's valuable piece of information. The sources are perfectly reliable to illustrate the use of acupuncture at academic centers. I'll try to see if I can find anything about the situation in Finland (HYKS, KYKS, OYKS, TYKS and TAYS). Jayaguru-Shishya (talk) 11:57, 1 September 2014 (UTC)

Acupuncture is among popular CAM treatments in all five Nordic countries but it is used less in Finland.[232]

Since acupuncture is deregulated in Finland many people without education in healthcare are able to give acupuncture treatment.[246]

I have included specific information about Finland. QuackGuru (talk) 20:05, 5 September 2014 (UTC)

Primary sources/poor sources and original research

http://www.brighamandwomens.org/Departments_and_Services/medicine/Services/oshercenter/acupuncture.aspx

This source is a link to a hospital website. It is unreliable.

http://medicine.yale.edu/psychiatry/psychology/predoc/sites/cmhc/substanceabuse.aspx

This source is a link to a School of Medicine website. Where does this link mention acupuncture? Auricular acupuncture and acupuncture are different. The sentence is poorly sourced and partly fails verification. See WP:CIR. QuackGuru (talk) 02:02, 30 August 2014 (UTC)

IMO, the above criticisms from QuackGuru lack merit and the bit about competence (CIR) is gratuitous. Anyone else think QG is making any valid points here? --Middle 8 (POV-pushing • COI) 12:00, 30 August 2014 (UTC)

You are not addressing that you are adding primary sources and text that failed verification. I previously explained, Auricular acupuncture (ear acupuncture) is not acupuncture. You ignored it was original research. See WP:IDHT. Adding even more primary sources or poor sources is not appropriate. You have not shown how the sources are reliable in accordance with WP:SECONDARY. QuackGuru (talk) 17:41, 30 August 2014 (UTC)

QG is correct that even Wikipedia has a separate article on Auriculotherapy. jps (talk) 17:58, 30 August 2014 (UTC)

QG is incorrect. Ear acupuncture is a common form of acupuncture. See the meta-analysis below. -A1candidate (talk) 18:37, 30 August 2014 (UTC)

Did you read the entry for Auriculotherapy? Do you understand this is a primary source that says Auricular Acupuncture? User:John Carter warned you about nonproductive editing on the article talk page.

"This systematic review evaluated the effects of ear acupuncture, ear acupressure and auriculotherapy for cigarette smoking cessation (SC) at end-of-treatment (EoT), three, six and 12 months follow-up."[52]

According to the source ear acupuncture, ear acupressure and auriculotherapy are a bit different or is the source ambiguous? Middle 8's comment does not make sense given the evidence. QuackGuru (talk) 03:50, 31 August 2014 (UTC)

I did discuss the problems with this edit on Jayaguru-Shishya's talk page. Jayaguru-Shishya largely ignored my concerns or did not understand. "He wrote If you have a specific edit you'd like to discuss, please let me know. So far, you have said that "there is original research in the article using a primary source", and you are giving me a diff where QTxVi4bEMRbrNqOorWBV says at the Talk Page that "even Wikipedia has a separate article on Auriculotherapy". I am sorry, I don't really see the connection here?[53] I did let him know the issues. See WP:CIR. I left a message on his talk page. QuackGuru (talk) 19:16, 5 September 2014 (UTC)

The source does not verify the claim "several".[54] This confirms the source does not say "several". QuackGuru (talk) 19:33, 5 September 2014 (UTC)

So if Wikipedia has a separate article on Auriculotherapy, how is it connected to original research? :D I alrady provided you a source[55] (which seriously nobody needs). As Middle 8 well put it: "just as auricular acu is a kind of acu, and chocolate milk is a kind of milk". Just common sense.

QuackGuru, do you know what "paraphrasing" means? I think user NuclearWarfare has already noticed you about "getting caught over specific wording"[56], right? If you have problems with paraphrasing yourself, please leave it to other editors, that's what I'd like to suggest. Cheers and happy weekend! Jayaguru-Shishya (talk) 20:27, 5 September 2014 (UTC)

Indeed, indeed... "Being of a number more than two or three but not many" (http://www.thefreedictionary.com/several) Jayaguru-Shishya (talk) 20:44, 5 September 2014 (UTC)

I fixed the issues by using another source that verified the claim rather than use a source that was ambiguous. As a bonus, I expanded the sentence and included Duke. QuackGuru (talk) 20:41, 5 September 2014 (UTC)

Ear acupuncture is a form of acupuncture

Drug and Alcohol Dependence (journal) with impact factor of 3.278 caries more weight than QuackGuru's incorrect claims:

• Di, Yuan Ming; May, Brian H.; Zhang, Anthony Lin; Zhou, Iris Wenyu; Worsnop, Christopher; Xue, Charlie C.L. "A meta-analysis of ear-acupuncture, ear-acupressure and auriculotherapy for cigarette smoking cessation". Drug and Alcohol Dependence (journal). 142: 14–23. doi:10.1016/j.drugalcdep.2014.07.002.

Ear acupuncture is a common form of acupuncture. EAP showed superiority over non-specific/inactive controls.

-A1candidate (talk) 18:32, 30 August 2014 (UTC)

Yeah, the argument that ear acupuncture isn't acupuncture is tendentious. --Middle 8 (POV-pushing • COI) 02:54, 31 August 2014 (UTC)

It is, of course, a particularly ludicrous form of acupuncture apparently based on the ridiculous idea that the ear is a homunculus, but that's by the by. Guy (Help!) 23:19, 31 August 2014 (UTC)

Yes, I certainly don't know of any biomedical evidence for a homunculus on the ear.....creative idea though, and novelty probably helps (along with ritual, noxious stimulus, TLC, community setting for drug detox....) --Middle 8 (POV-pushing • COI) 15:53, 2 September 2014 (UTC)

Ear acupuncture is a form of acupuncture.[57] Nobody seriously would have needed a source for that though, right? I've heard that some have started to look for clues from the actual name itself ^^ Jayaguru-Shishya (talk) 11:57, 1 September 2014 (UTC)

Please show a source to support your claims. -A1candidate (talk) 00:00, 1 September 2014 (UTC)

Here is a ref for you to read. QuackGuru (talk) 03:19, 1 September 2014 (UTC)

Summarize

The lead is supposed to be a simple summary.

" A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which" can be summarized as "A systematic review"

Because a "systematic review of systematic reviews highlighted recent high-quality randomized controlled trials" is a type of systematic review. We can get into the specifics in the body of the article. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:19, 31 August 2014 (UTC)

Agree it was too much detail for the lede. QuackGuru (talk) 04:34, 31 August 2014 (UTC)

Only problem is that it's now inaccurate. Here's the deal -- Doc, hope you're reading:

1. Efficacy is defined as real acu being better than sham -- that's the thing readers need to know, that we aren't telling them.
2. Ernst '11 found that a majority of the reviews he looked at were positive for pain, but then caveated that finding -- by pointing to findings from more recent and better trials. Agreed that that level of detail belongs in the body, not the lede.
3. Some trials for pain show sham = real, and meta-analyses vary in their conclusions. We already say that in the lede when we talk about efficacy.

So what we need to in the lede is simple -- drop the statement in question and replace it with a statement along the lines of #1. --Middle 8 (POV-pushing • COI) 05:31, 31 August 2014 (UTC)

So what are you proposing? Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:39, 31 August 2014 (UTC)

How about this? (good timing of your comment :-) --Middle 8 (POV-pushing • COI) 05:47, 31 August 2014 (UTC)

The proposal is now ambiguous and deleted sourced text that summerised the body. Now the text does not summarise the body. Middle 8 has had a problem with deleting sourced text. User:Jmh649, maybe we should also shorten the body. It says "The review also highlighted recent high-quality randomized controlled trials which found that for reducing pain, real acupuncture was no better than sham acupuncture.[6]" It is a bit too wordy. See Acupuncture#Pain. QuackGuru (talk) 06:03, 31 August 2014 (UTC)

You need to use references per WP:V and WP:MEDRS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:03, 31 August 2014 (UTC)

We don't source every statement in the lede... and naive readers aren't going to know what sham acu is. (I do hope for the sake of the article that you understand it's a true statement... it's acu study design 101.) --Middle 8 (POV-pushing • COI) 08:25, 31 August 2014 (UTC)

I previously explained the text you added to the lede did not summarise the body. QuackGuru (talk) 08:29, 31 August 2014 (UTC)

You claim readers won't know what sham is. See https://en.wikipedia.org/wiki/Acupuncture#cite_note-Madsen2009-11 QuackGuru (talk) 10:13, 31 August 2014 (UTC)

An accurate claim at the time [58], seeing you added that note subsequently [59] -- which is a good addition, though I think the reader would be better served if it were in the lede and not a note. --Middle 8 (POV-pushing • COI) 07:41, 1 September 2014 (UTC)

We should also tell the reader that another form of sham acu is the use of real needled at non-acupoint locations. --Middle 8 (POV-pushing • COI) 07:52, 1 September 2014 (UTC)

Anyway just noticed that we said the same thing already in the paragraph using that ref? So deleted it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:07, 31 August 2014 (UTC)

The statement is different from the other text. It is comparing sham versus real acupuncture. QuackGuru (talk) 06:20, 31 August 2014 (UTC)

This "while a systematic review of systematic reviews found little evidence that acupuncture is an effective treatment for reducing pain"

Is more or less the same as "A systematic review found that for reducing pain real acupuncture was no better than sham acupuncture."

When one says that there is little evidence for something one needs a comparator and that comparator is sham acupuncture. IMO we do not need to say both in the lead. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:10, 31 August 2014 (UTC)

I will compromise and merge the other statement so there will only be one sentence. QuackGuru (talk) 07:33, 31 August 2014 (UTC)

The wording is simplified and adjusted. QuackGuru (talk) 08:12, 31 August 2014 (UTC)

It is incorrect. Newer meta-analysis concludes that significant, but modest differences exist between sham and verum. -A1candidate (talk) 15:28, 31 August 2014 (UTC)

"Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said the study "impressively and clearly" showed that the effects of acupuncture were mostly due to placebo. "The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies."

Jha, Alok (10 September 2012). "Acupuncture useful, but overall of little benefit, study shows". The Guardian. {{cite news}}: Italic or bold markup not allowed in: |newspaper= (help)

"What really matters is that Vickers et al showed that the difference is far too small to be of the slightest clinical interest."

Colquhoun, David (17 September 2012). "Re: Risks of acupuncture range from stray needles to pneumothorax, finds study". BMJ.

A systematic review of systematic reviews is a higher quality authoritative source. The author of this source is Edzard Ernst. He invalided the Vickers study.

That Vickers study shows no meaningful difference according to which experts on the subject? See above. QuackGuru (talk) 17:32, 31 August 2014 (UTC)

Ernst's review couldn't have "invalided" Vickers because the latter hadn't even been written yet. --Middle 8 (POV-pushing • COI) 06:19, 1 September 2014 (UTC)

The source says "We found acupuncture to be superior to both no-acupuncture control and sham acupuncture for the treatment of chronic pain," wrote Vickers in the September 10 edition of the Archives of Internal Medicine."[60] Ernst was reviewing Vickers. QuackGuru (talk) 06:27, 1 September 2014 (UTC)

Newspapers and news reports of BMJ aren't MEDRS compliant. An older review (2011) cannot be used to disqualify a newer meta-analysis (2012). -A1candidate (talk) 17:54, 31 August 2014 (UTC)

You disagree that a systematic review of systematic reviews is a higher quality source?

This is a newer 2013 meta-analysis written in part by Vickers: "When comparing acupuncture to sham controls, there was little evidence that the effects of acupuncture on pain were modified by any of the acupuncture characteristics evaluated, including style of acupuncture, the number or placement of needles, the number, frequency or duration of sessions, patient-practitioner interactions and the experience of the acupuncturist..."

MacPherson, Hugh; Maschino, Alexandra C; Lewith, George; Foster, Nadine E; Witt, Claudia; Vickers, Andrew J; Acupuncture Trialists' Collaboration (2013). Eldabe, Sam (ed.). "Characteristics of Acupuncture Treatment Associated with Outcome: An Individual Patient Meta-Analysis of 17,922 Patients with Chronic Pain in Randomised Controlled Trials". PLoS ONE. 8 (10): e77438. doi:10.1371/journal.pone.0077438. PMC 3795671. PMID 24146995.{{cite journal}}: CS1 maint: unflagged free DOI (link)

According to your previous argument a 2012 is the newer meta-analysis. That is incorrect. See (PMID 24146995). QuackGuru (talk) 18:09, 31 August 2014 (UTC)

You conveniently ignored the fact that "Increased number of needles and more sessions appear to be associated with better outcomes when comparing acupuncture to non-acupuncture controls. This suggests that the dose of acupuncture is important", as they concluded in the 2013 meta-analysis. -A1candidate (talk) 18:34, 31 August 2014 (UTC)

This detail is in the body. See Acupuncture#Scientific view on TCM theory. The lede should be kept a summary. That would be too much detail for the lede and we are using a better source (a systematic review of systematic reviews) for the main point. QuackGuru (talk) 18:47, 31 August 2014 (UTC)

A newer meta-analysis of 18,000 patients carries more weight than older systematic review of reviews. -A1candidate (talk) 19:21, 31 August 2014 (UTC)

Or at least it would if there was a remotely plausible mechanism of action, and solid evidence for the existence of qi and meridians, and evidence that the location of needling makes any difference. But there isn't.

You have made it rather plain that you are a True Believer, and the review you promote was also written by True Believers. Oddly, when anyone who is not a True Believer conducts the test, the effect seems to vanish. I wonder why that is? Guy (Help!) 23:17, 31 August 2014 (UTC)

Yes, I'm a True Believer in science, if that's what you're trying to say. -A1candidate (talk) 23:58, 31 August 2014 (UTC)

Guy, even if it is written by true believers (and I'm not sure that's wholly true), it still passed peer review, and is still part of the literature that we seek to represent. The "effect" in this case -- the statistical significance of their findings -- is not belief-dependent. Nobody has suggested that if a non-true believer re-crunched the numbers, their findings would change; only the interpretation of those findings is contested. AFAIK, it's the only meta-analysis of individual patient data in acu research, which is the gold standard of meta-analysis.[61], so it does weigh considerably. And in order for acu to have a small specific effect, prescientific Chinese ideas don't have to be true; how else would you expect them to have explained acu in their time? With reference to fascia and endorphins? ;-) --Middle 8 (POV-pushing • COI) 06:16, 1 September 2014 (UTC)

All this speculation about "true believers" is totally useless. If there is such a bias, it sure have been studied and one could find a source for it. If it's not, then we don't speculate on that either.

I do agree with Middle 8 about the weight of that meta-analysis though. Jayaguru-Shishya (talk) 11:57, 1 September 2014 (UTC)

(e/c) A1Candidate almost always brings really good MEDRS's to the discussion, but shoots themselves in the foot by overstating their weight relative to other sources. But they still weigh. Multiple editors have commented that there is POV-pushing from both sides, but while the pro-acu side inevitably gets called out, the anti-acu side (no matter how extreme) gets a free pass. --Middle 8 (POV-pushing • COI) 06:47, 1 September 2014 (UTC)

The main point of (PMID 24146995) is redundant. The lede says more or less the same thing that there is little difference between sham and acupuncture. QuackGuru (talk) 06:33, 1 September 2014 (UTC)

It depends on which trial or review one is talking about. Efficacy (to whatever degree it may exist) is defined as the (statistically significant) difference between sham and real -- period. Whatever generalization we make about sham should be nothing more or less than what we say about efficacy. And efficacy is handled reasonably well in the lede. Let's not act as if sham is some new thing to be hashed out and weighted. 2/0, A1Candidate, Brangifer, Jaya-S, Doc James and Guy will know what I'm saying, even if you, QG, claim not to. --Middle 8 (POV-pushing • COI) 11:56, 2 September 2014 (UTC)

Utter rubbish. Efficacy is the extent to which a treatment has a positive effect. Period. You're confusing the fact that 'sham acu' (a placebo) is effective, as is 'real acu' for exactly the same reason. What you're not prepared to accept is that any attempt to explain a mechanism for differential action between sham and real will inevitably be laughed at as unscientific mumbo-jumbo. --RexxS (talk) 16:45, 2 September 2014 (UTC)

Hi RexxS. Of course sham acu is effective! When I say "Efficacy is the extent...." I mean "efficacy beyond placebo", which is what researchers are interested in. Ask 2/0 or Brangifer if you don't believe me. And tone down your rhetoric please. --Middle 8 (POV-pushing • COI) 17:08, 2 September 2014 (UTC)

Fixed wording to reflect source [62] -- ES self-explanatory, and I'm that any science-literate editors willing to look at the source will see that it's accurate. But this being Wikipedia, who can say if that will happen? --Middle 8 (POV-pushing • COI) 08:01, 1 September 2014 (UTC)

A systematic review of systematic reviews found real acupuncture was no better than sham acupuncture and concluded that their is little evidence that acupuncture is an effective treatment for reducing pain.

A systematic review of systematic reviews of acupuncture for pain concluded that there is little evidence that acupuncture is an effective treatment, i.e. that real acupuncture may be no better than sham acupuncture.

You added original research. You recently tried to add OR to the lede and now you are doing it again.

The source does not say it "may be" be no better. The other part was also misleading and ambiguous. The source says "In conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain." Please stop adding original research to the lede. QuackGuru (talk) 17:01, 1 September 2014 (UTC)

Neither of those diffs is OR; please see your talk page. --Middle 8 (POV-pushing • COI) 08:41, 2 September 2014 (UTC)

Thanks for accurately quoting his conclusion (see PMID 21440191). Why not cite that? I don't see any mention of sham in the conclusion or the abstract. --Middle 8 (POV-pushing • COI) 04:33, 2 September 2014 (UTC)

Sham acu is a worthy topic but this paper doesn't support what you seem to want to say. You've been pushing this sentence for months and arguing that Moffet, then Ernst support it, but they don't. --Middle 8 (POV-pushing • COI) 04:36, 2 September 2014 (UTC)

The part you added "may be" no better I could not verify.[63] The current text is accurately summarised. You claimed RexxS's ad hominem & general drama is a confession of weakness. You had a discussion on User:RexxS's talk page too. See User_talk:RexxS/Archive_25#Ernst_re_pain..._and_talk.... We already had a discussion about this. See Wikipedia_talk:WikiProject_Medicine/Archive_51#Acupuncture_again. QuackGuru (talk) 14:33, 2 September 2014 (UTC)

Again why use wording that's not in the abstract or conclusion, and not supported by the text? Especially when you demand that others meet that standard? [64] (Nothing against RexxS, but he was wrong in that case, and Imperfectly Informed was correct. There aren't two correct answers. We could go to RSN if editors here don't figure it out.) --Middle 8 (POV-pushing • COI) 16:19, 2 September 2014 (UTC)

No, I was not wrong. No matter how many times you try to deny it, you can't invalidate the conclusions of a reliable secondary source that you dislike by making your own amateur analysis to try to discredit it. Ernst is never in any doubt that real acu is no better than sham acu and we all know that any differences are so small as to be insignificant both statistically and clinically. That's the correct answer and that's what should be reflected in the lead if we should need that much detail (which we don't). --RexxS (talk) 16:45, 2 September 2014 (UTC)

Sure you were wrong; you made several mistakes interpreting the paper in the original discussion, and this is another. See User:Middle_8/Ernst-11. And of course sham acu is sometimes better than real acu: the majority of the 57 reviews he studied were positive for acupuncture, if you recall. (Positive meaning "showing efficacy", i.e. "efficacy beyond placebo", i.e. "real acu being superior to sham to a statistically significant degree.) Read the lede; of course there's still some debate over efficacy, mainly for pain and nausea, although that may be due to artifact. --Middle 8 (POV-pushing • COI) 17:14, 2 September 2014 (UTC)

The source does not specifically state "sham acu is sometimes better than real acu". QuackGuru (talk) 17:18, 2 September 2014 (UTC)

Not in those exact words, no. But that's what it found. I cover all that and more at User:Middle_8/Ernst-11, which I hope you and others find helpful. -Middle 8 (POV-pushing • COI) 19:24, 2 September 2014 (UTC)

You want to replace verified text in accordance with V with your own SYN/OR interpretation? QuackGuru (talk) 19:34, 2 September 2014 (UTC)

I would like to restore the comment that was deleted. QuackGuru (talk) 16:48, 2 September 2014 (UTC)

To QuackGuru (and all editors here): Most humble apologies for my overwrite of your edit, QG! https://en.wikipedia.org/w/index.php?title=Talk:Acupuncture&diff=prev&oldid=623878169] I would never, ever do such a thing intentionally. In this instance, the buttons on my trackball are a bit sticky, so I must have accidentally selected your comment, not realized I'd done so, and then deleted it as soon as I started typing. To make matters worse, Doc James asked me what was the deal with that edit, and I simply explained the text I added, being sufficiently out of it that I didn't see from the diff that I'd actually overwritten QG's comment. Have been editing a lot today, obviously need a break. Apologies to all for the distraction and any misunderstandings caused. --Middle 8 (POV-pushing • COI) 12:53, 3 September 2014 (UTC)

According to this comment on 19:10, 2 September 2014 you got upset about my comment. That was your initial reaction after I restored my comment on 16:50, 2 September 2014 you deleted early on 16:19, 2 September 2014. You added OR research to the lede twice recently.[65][66] Is this a pattern? QuackGuru (talk) 17:16, 3 September 2014 (UTC)

No, QG, as I said I had absolutely no idea what I'd done until Jytdog clued me into what Doc James meant by posting on my page asking, rightly, what was the deal. I'm sorry you choose to take my apology in bad faith. I didn't agree with your post (hence that first diff you cite [67]) but I sure as heck didn't delete it on purpose!

I'm very disappointed that in response to my apology you'd reply with a post like this, implying ulterior motive, and repeating an inaccurate allegation that I added "OR to the lede". It takes some gall for you to do that, frankly, because I posted on your user talk speifically refuting that exact same assertion. Here is the diff; short version: Please stop calling it OR every time an editor merely uses wording that is not your exact preferred wording, or is not verbatim from a source. There's this thing called "paraphrasing".

I'm also disappointed that after I posted to Doc's user talk explaining my mistake, and he replied saying he was glad it was just a mistake, that you would then post there seeking to depict my mistake as intentional.[68] Why are you doing this? I'll repeat: what can we do to end this apparent bad blood between us? I posted a sincere olive branch to you last week [69], but you deleted it without comment [70]. --Middle 8 (POV-pushing • COI)

I went ahead and restored it. QuackGuru (talk) 16:51, 2 September 2014 (UTC)

QG, since you're insisting on rehashing past heat rather than light, I'll say this for the record: Now go back and read RexxS's hyperbole. My comments are WP:SPADE and comparatively quite tame. But why focus on old drama? Why not comment on the substance at hand? I've given ample food fr thought at User:Middle_8/Ernst-11. --Middle 8 (POV-pushing • COI) 19:10, 2 September 2014 (UTC)

Jha, Alok (10 September 2012). "Acupuncture useful, but overall of little benefit, study shows". The Guardian. Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said the study "impressively and clearly" showed that the effects of acupuncture were mostly due to placebo. "The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies. Several investigations have shown that the verbal or non-verbal communication between the patient and the therapist is more important than the actual needling. If such factors would be accounted for, the effect of acupuncture on chronic pain might disappear completely." {{cite news}}: Italic or bold markup not allowed in: |newspaper= (help) Here is another source where Ernst makes a similar point. This is the same author who wrote the 2011 source. See (PMID 21440191). QuackGuru (talk) 19:53, 2 September 2014 (UTC)

The Guardian doesn't meet MEDRS for claims on medical efficiency, so we are not using it. Jayaguru-Shishya (talk) 20:19, 2 September 2014 (UTC)

Do you disagree that this is the same author who made a similar point? QuackGuru (talk) 20:35, 2 September 2014 (UTC)

(e/c)::@Jayaguru-Shishya - Well, the interpretation that has prevailed (and with which I've agreed) is that the source is Ernst himself (and the Guardian is considered reliable for reproducing his words), and per WP:SOURCES (I think), someone like Ernst can be an RS when self-publishing because he's an expert who has published under peer-review, as long as they're talking about their field of expertise (in which they've published). That said I am reconsidering whether such a quote is acceptable as a MEDRS (as opposed to RS) and leaning toward not. If Ernst really wants to refute that paper there's a way to do it: publish something. Colquhoun did, and we can cite that, and it says much the same thing, so deleting Ernst shouldn't be a big deal IMO. We should probably draw the line at MEDRS, and not allow Ernst, because otherwise we get an UNDUE problem whereby an expert's opinion is given the same weight as a carefully crafted MEDRS. In fact, the gold standard of MEDRS's: meta-analysis of individual patient data. Yes, I know the criticisms of Vickers are that the differences he find between sham and verum, though statistically significant, aren't clinically significant and may be artifactual (unblinding). Still it weighs, and significantly. After all, criticisms can be made of other MEDR's, such as their non-adherence to STRICTA, and we don't deprecate them nearly as much as Vickers has been deprecated. (Matter of fact, QG, some time back, fought the inclusion of nothing more than the four types of pain Vickers looked at. Vickers, a gold-standard source, the biggest and most exacting meta-analysis ever (AFAIK) for acu. Yet more double-standard. (whew -- need a timeout) --Middle 8 (POV-pushing • COI) 20:37, 2 September 2014 (UTC)

What Ernst said in the past and present has not changed. There is no debate over what Ernst said then. QuackGuru (talk) 20:44, 2 September 2014 (UTC)

Which is irrelevant to whether his comment is a MEDRS. (RS, yes, it is, but he is making a MEDRS claim in that quote.) Now, if he criticize Vickers in a more recent review -- which I may have missed -- then that supersedes the Guardian source. --Middle 8 (POV-pushing • COI) 21:01, 2 September 2014 (UTC)

Exactly, exactly.... Jayaguru-Shishya (talk) 21:05, 2 September 2014 (UTC)

Arbitrary break for more input

I've outlined the issue regarding Ernst '11 (PMID 21440191), and have filed at WT:MEDRS. (I don't remember if we discussed this there or elsewhere before but that does seem the best venue.) --Middle 8 (POV-pushing • COI) 17:49, 2 September 2014 (UTC)

See WT:MEDRS#Acupuncture_source. Have also explained the issue clearly at User:Middle_8/Ernst-11, and remember, you can email me (or any editor with access) for a copy. Let's go for more light and less heat, fellow editors! -Middle 8 (POV-pushing • COI) 18:01, 2 September 2014 (UTC)

Is Middle 8 canvassing editors on there talk page long after the discussion was over? Not sure why you are bringing it up again.

Do you remember you had a discussion on User:RexxS's talk page. See User_talk:RexxS/Archive_25#Ernst_re_pain..._and_talk.... We did have a long discussion on this talk page and at Wikipedia_talk:WikiProject_Medicine/Archive_51#Acupuncture_again. QuackGuru (talk) 17:59, 2 September 2014 (UTC)

If I understand the point being made, it is pretty straightforward. Many trials exist of acupuncture vs. sham or placebo, but proper blinding to the the controls is difficult if not impossible due tot he nature of acupuncture (e.g. the tendency to leave bruising for up to a fortnight afterwards, a dead giveaway). There's also the problem that negative results are virtually never published in the acupuncture / TCM journals, and most are published in China where there is a well documented systemic bias. You want to assert the primacy of the larger trials, despite the lack of any proven mechanism of effect. Ernst makes the point, quite forcefully, in numerous venues including this paper, that the positive results are weak and not getting any stronger, whereas increasingly sophisticated controls show ever more strongly that needling is ineffective (and this is additive to the finding that the location of needling is irrelevant, as expected form the absence of any empirical basis for the locations traditionally used, and lack of unanimity between traditions).

However, I find reading any argument by pro-quackery editors frustrating and I become impatient, so if someone could distil the actual question into a short sentence, I will email it to the source and ask (this is legitimate when it's a matter of clarifying our interpretation, rather than original research). Guy (Help!) 19:39, 2 September 2014 (UTC)

@ JzG: Here's a better, simpler summation than the below: should we cite Ernst's statement "real acupuncture was no better than sham" as being the conclusion of his review per se, or not. The statement appears in the first paragraph on p. 762 of PMID 21440191.

In context, it is apparent that his statement refers to some recent, high-quality trials that showed null results. Contrary to QG's reading, it does not refer to the reviews he looked at, and is not a general conclusion of his review. The majority of those reviews were actually positive for acu, but with numerous contradictions and caveats. That's why he said those result should be seen in light of recent, better trials. The highlighted text at User:Middle_8/Ernst-11 illustrates this context, and the unlikelihood of QG's reading. --Middle 8 (POV-pushing • COI) 05:09, 3 September 2014 (UTC)

And the answer is: yes, undoubtedly. That is his settled view, and you can read his blog yourself for plenty more to that effect. You are playing semantic games, when to an outsider it is very obvious what he means, and it is not in the least bit flattering or supportive of acupuncture. Guy (Help!) 21:55, 3 September 2014 (UTC)

@ JzG (talk · contribs)/Guy - We can get both the letter and spirit of the law right without doing violence to either. That's the hallmark of a good encyclopedia. Did Ernst reply to you? I'd like to see exactly what you asked and what he replied. Thanks, --Middle 8 (POV-pushing • COI) 05:00, 4 September 2014 (UTC) edited for wl 05:07, 4 September 2014 (UTC)

earlier, longer reply to Guy

@ JzG: (I hope you're not counting me as pro-quackery.) tl;dr: The question is simply one of context: what does the statement "real acupuncture was no better than sham" (the bolded sentence in the excerpt at User:Middle_8/Ernst-11) refer to: (a) the high-quality trials Ernst points to (whose negative results Ernst correctly predicted set the pattern for future high-quality trials) -- that's the right answer -- or (b) the findings of the 57-odd reviews that he reviews. (end tl;dr) QuackGuru wants to cite all or part of that sentence as referring to (b), and by extension, all of the acu literature. But the literature, as we know, still has some reviews finding efficacy (however artifactual) for pain and nausea -- that's why there's so much controversy in the blogosphere, right? If it were slam-dunk like homeopathy is, Steve Novella wouldn't be skewering the extant reviews finding for efficacy. This isn't about how I or anyone might want it to be, it's what is the meaning of Ernst '11 and what is the current state of the literature, which is what we're obliged to depict. I mean, come on, per WP:ENC we don't play fast and loose with the meaning of Ernst's paper, even if that sentence is "the spirit of where Ernst thinks things are headed" (which is the source of much of the confusion). --Middle 8 (POV-pushing • COI) abridged 20:14, 2 September 2014 (UTC)

Hypertension

• Wang, Jie; Xiong, Xingjiang; Liu, Wei. "Acupuncture for essential hypertension". International Journal of Cardiology. 169 (5): 317–326. doi:10.1016/j.ijcard.2013.09.001.

Systematic review conducted according to the Cochrane standards showed that acupuncture significantly reduced systolic and diastolic blood pressure, although further confirmation of is required.

-A1candidate (talk) 00:08, 1 September 2014 (UTC)

You are once again misrepresenting a source. This is a pattern with you.

The source looks good, though, so I have added a section. - 2/0 (cont.) 01:19, 1 September 2014 (UTC)

That's what the source says, further confirmation of results is required. -A1candidate (talk) 01:41, 1 September 2014 (UTC)

The source says "a definite conclusion on efficacy and adverse events associated with acupuncture cannot be drawn from this review." It belongs in the other conditions section. QuackGuru (talk) 03:06, 1 September 2014 (UTC)

• Wang, Jie; Xiong, Xingjiang; Liu, Wei (2013). "Acupuncture for essential hypertension". International Journal of Cardiology. 169 (5): 317–326. doi:10.1016/j.ijcard.2013.09.001. ISSN 0167-5273. PMID 24060112. I added it to the correct section. Please include the pmid when formatting a ref. QuackGuru (talk) 03:16, 1 September 2014 (UTC)

It is not hypertension. It was essential hypertension. QuackGuru (talk) 06:03, 1 September 2014 (UTC)

Which is a kind of hypertension (just as auricular acu is a kind of acu, and chocolate milk is a kind of milk). --Middle 8 (POV-pushing • COI) 06:13, 2 September 2014 (UTC)

Rearrange

Section under "effectiveness" should be rearranged in a logical manner, either alphabetically or by physiologcally. The current arrangement appears random and unsystematic. -A1candidate (talk) 01:52, 1 September 2014 (UTC)

I think User:Jmh649 is best at arranging sections and articles. QuackGuru (talk) 03:25, 1 September 2014 (UTC)

IMO the one with the best evidence should go first. This means that pain should go first. No strong feeling about the ordering of the rest. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:37, 3 September 2014 (UTC)

Time out: Academic centers, again, and a request

A section that four editors thought was adequately-sourced [71][72][73][74] has disappeared without explanation in a complex partial revert by QuackGuru [75]. (Previous discussion above.)

Controversial changes are part of the process, but don't bury them; do them individually. An editor watching the page wouldn't even know there was a wholesale deletion. The ES gave no clue -- "update (replace poorly sourced text with text from an independent source)" -- and so many other changes are made that the character count actually increases.

This isn't the first instance of a complex edit that combines good edits with controversial or poor ones. There's this, discussed above. Two editors asked QG not to do that again, but he re-did a large part of it anyway [76]. Such edits are hard to follow, hard to discuss individually (or revert, should BRD apply), and they need to stop.

For the sake of collaboration, is it asking too much for editors to discuss changes, and not make complex edits that mix together decent changes with dicey ones? And to make one major edit at a time and use accurate ES's? --Middle 8 (POV-pushing • COI) 10:01, 1 September 2014 (UTC)

Addressing QG's objections:

• Re objections above: As this ES pointed out, websites of academic centers and their affiliates are reliable for saying which procedures they offer.
• Re QG's ES: "No need for a separate section. This is US centric." -- spurious; subsection header is "Academic centers" which isn't US-centric, and we can fill in with content from other countries too, per 2/0 above.

(I tire of QG's spurious objections; see also e.g. Talk:Acupuncture#Allergies where he attempts to argue a review article isn't a review article.) --Middle 8 (POV-pushing • COI) 10:16, 1 September 2014 (UTC)

You added largely duplication and I found better sourcing. You don't need to use a bunch of primary sources. "Acupuncture is used at many places in the US, including Harvard, Stanford, and Yale." The article already stated this. The text each country can go into each specific section for each country in the International reception. You need to stop adding primary sources when better sources were found. QuackGuru (talk) 17:12, 1 September 2014 (UTC)

As pointed out at Talk:Acupuncture#Academic centers, the sources are perfectly reliable to illustrate the use of acupuncture at academic centers. I restored[77] the original edits concerning this area. Please try to seek for consensus before making controversial edits. Jayaguru-Shishya (talk) 18:18, 1 September 2014 (UTC)

Thanks, agree, and I improved on your edit per ES [78] --Middle 8 (POV-pushing • COI) 18:44, 1 September 2014 (UTC)

Jaya-S is right: Calling the sites of universities or their affiliates "Primary sources" is in this case a spurious objection; the sites are reliable for services they provide. And I'm not convinced "Academic centers" shouldn't have its own section, and QG hasn't explained why, other than "US-centric bias". Why should reception only be organized by country, as opposed to group (e.g. doctors, different organizations)? --Middle 8 (POV-pushing • COI) 18:46, 1 September 2014 (UTC)

We have more sections than needed. Why a section for just one sentence when that can be dealt with in the section above. Have adjusted. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:43, 1 September 2014 (UTC)

Request re: collaboration

QuackGuru: Will you PLEASE STOP MAKING MULTIPLE MAJOR EDITS AT ONCE? And discuss them on talk, and use clear ES's? Without a clear diff, discussion and/or ES, it's virtually impossible to tell what you're doing! --Middle 8 (POV-pushing • COI) 18:49, 1 September 2014 (UTC) moved 04:06, 2 September 2014 (UTC)

This is normal for QuackGuru, and I think the time has come to request escalation. Large-scale rapid fire editing, WP:OWNership and a dismissive response to dissent are a long-standing problem with this editor. Guy (Help!) 09:08, 2 September 2014 (UTC)

Yes, it is normal behavior for him/her and IMO it has been allowed to go on for far too long. Normal differences in POV are good for an article, but this sort of behavior has resulted in a seriously flawed article. Gandydancer (talk) 12:04, 2 September 2014 (UTC)

On the contrary, a lot of QG's edits are valuable in redressing the POV-pushing by SPAs in articles like this. Many of those would love to see QG removed from these articles because he's not prepared to sit back and see them owned by the SPAs and practitioners who have a vested interest in seeing Wikipedia give a positive spin to their subject. If you have a problem with a particular edit, then take it to talk. Remember that this page is for discussing improvements to the article, so if you think QG has violated policy, name that policy, find the diffs, and take it to dispute resolution. Time to put up or shut, not smear other editors with unspecific grumbles. --RexxS (talk) 16:56, 2 September 2014 (UTC)

I'd be happy to see QuackGuru get some mentoring, say from Doc James or Kww, but dunno if they'd want to take it on. And I don't think my request to do edits one at a time is POV-pushing. "Unspecified grumbles?" See diffs above: Talk:Acupuncture#Time_out:_Academic_centers.2C_again.2C_and_a_request. BTW, RexxS, your civility, coolness and lack of NPA continue to underwhelm.--Middle 8 (POV-pushing • COI) 19:00, 2 September 2014 (UTC)

I do not think anything short of a binding restriction to a maximum mumber of edits per article per day will work. Guy (Help!) 19:42, 2 September 2014 (UTC)

I agree. Mass edits without a chance for discussion creates problems. It's not collaborative editing, and QG does this far too often. Your idea might work. Set some limit. -- Brangifer (talk) 04:39, 3 September 2014 (UTC)

Mentoring or something to help improve talk page usage would also help. A lot. Want to paraphrase a source (generally a desirable thing per COPYVIO)? Prepare for round after round of "I could not verify the text" and "OR was added to the article". --Middle 8 (POV-pushing • COI) 20:43, 3 September 2014 (UTC)

What is this really about?

What is this really about?! We are probably all various types of healers, and probably all want to see people's pain and dysfunction relieved...Let's have a section called "Acupuncturists' Experiences" where those experienced in this form of therapy can share case studies. And another section can be there called "Not Everyone Agrees", where people who are threatened by this modality can voice their negativity.Merriels (talk) 03:15, 3 September 2014 (UTC)

That would be great for a blog or private website, but not here. We are creating an article in an encyclopedia, and all discussion should be directed towards that end. This is not a forum. Read WP:TALK. -- Brangifer (talk) 04:41, 3 September 2014 (UTC)

Not superior to sham for low back pain symptoms

"Acupuncture is considered to be a form of alternative or complementary medicine, and as noted above, it has not been established to be superior to sham acupuncture for the relief of symptoms of low back pain."[79] QuackGuru (talk) 06:26, 4 September 2014 (UTC)

A good source, which weighs, along with our other MEDRS's on low back pain -- which are not unanimously negative. Some are more recent too I believe.

Remember, if MEDRS's were unanimously negative on efficacy this wouldn't be nearly as controversial a topic. But right now we have good MEDRS's finding for efficacy for pain (probably acu's most significant indication), and a lot of the dissent is in sources that aren't MEDRS or even clear-cut RS. That's a picture of a field with significant remaining controversy. I trust that is a common-sense observation.... --Middle 8 (POV-pushing • COI) 07:00, 4 September 2014 (UTC)

This source is also good MEDRS. I don't get the objection. This is specifically for low back pain not pain in general. QuackGuru (talk) 07:14, 4 September 2014 (UTC)

It's not an objection. My second para is a general comment; my opinion on the source is in the first para. Yes, it's fine, again keeping in mind whatever other MEDRS's we have for low back pain. But remember that we treat low back pain as a subset of back pain: distinct in a sense but not wholly distinct. --Middle 8 (POV-pushing • COI) 08:45, 4 September 2014 (UTC)

Tags

Hello everyone! I've added a NPOV tag to your article because I see on the talk page that its content is and has obviously been under dispute for a very long time. Just to remind everyone, per Wikipedia policy, please do not remove the tag until the disputes have been resolved and there is consensus to do so. Also, I came here from the Countering Systemic Bias project page, and am also considering adding in a systemic bias tag but wanted to ask everyone's thoughts first. My hope for that tag is to attract other editors to the page that come from other cultural and linguistic backgrounds who can add something positive to your work here. I lived in Asia for several years and can read Mandarin and see much information I can add here. I would just go ahead and add it, but don't want to shame the article by over-tagging it. This can also be a talk page section where we can work to positively resolve the neutrality issues, and any input is welcomed. Thank you! LesVegas (talk) 20:04, 4 September 2014 (UTC)

For a new, unexperienced editor such bold moves are ill advised. Tgeorgescu (talk) 20:18, 4 September 2014 (UTC)

The root cause of the problem is the false equivalence given to the views of anti-fluoridationists and the scientific community. The scientific consensus, by definition, incorporates all significant valid viewpoints. It develops over time in response to new data. In maters of science, the scientific consensus view is inherently the neutral point of view for Wikipedia purposes. To "balance" that with anti- views is to compromise fundamental policy.

— Guy, [80]

Quoted by Tgeorgescu (talk) 20:22, 4 September 2014 (UTC)

Hi Tgeorgescu! What moves are you referring to? Certainly not the neutral POV tag, as from this talk page alone, we see many editors with many disputes over the neutrality of the article. The tag I added seems highly appropriate and I'm frankly baffled why I'm the first person to add it. Of course, your input is very welcome and I'm glad to have you participating in this discussion! Regarding your quote, I'm not trying to balance the scientific view with unscientific viewpoints, nor do I think any editors here are trying to do so. For example, if you look at this talk page above at A1Candidate's proposed additions, he has numerous high quality scientific sources he wants to add in to give a more well-rounded viewpoint here, and perhaps this section on the talk page can be used as a medium to discuss how best to add these in. And I do want to be bold, as that's Wikipedia's motto, but not overly bold which is why I haven't added the systemic bias tag yet. What are your thoughts on that? If you'd like to read our discussion, you certainly can at this link here LesVegas (talk) 20:40, 4 September 2014 (UTC)

re "and perhaps this section on the talk page can be used as a medium to discuss how best to add these in" -- agree 100%! --Middle 8 (contribs • COI)

@Tgeorgescu: Adding a tag is not a bold move. A good-faith invitation for more eyes on the article is always to be welcomed. Your comment is somewhat WP:BITE-y imho ... not an outright bite, but a bit of a snap. :-) Completely agree that we need to make sure that the reasons for the tag are clear and fairly precise. --Middle 8 (contribs • COI) 00:20, 5 September 2014 (UTC)

Disputed content doesn't necessarily mean there is a POV dispute. Note that in placing a tag you should follow the instructions at Template:POV, which includes "pointing to specific issues that are actionable within the content policies." In other words: what POV is being under- or over-represented, and why? It seems to me from the talk discussion above that the article's representation of efficacy is fairly neutral, though of course I could be mistaken. I've removed the tag for now pending discussion of this. Sunrise (talk) 21:06, 4 September 2014 (UTC)

Thanks for pointing out that I've only been vague thus far as to what the disputes are. So far, we have he lack of inclusion of:

• 1)A1candiate's information he pulled up on acupuncture and placebo
• 2) Nocebo
• 3) Allergies
• 4) Mechanism of acupuncture (which directly contradicts the lede, thus the neutrality dispute)
• 5) acupuncture and the brain data (again giving a mechanism of action)
• 6) inclusion of arrhythmia information
• 7) the validity of Quackwatch as a source. I see the large blockquotes content is specifically disputed.
• 8) Middle 8 has unresolved issues with acupuncture and safety as it's stated in the article
• 9) a dispute about an encyclopedia on aliens and related subjects ought to be used as a source
• 10) Weight issues
• 11) For me, systemic bias issues. I see additional weight issues by putting sources using non-STRICTA, and NIMH-adopted reporting standards ion equal footing with studies/review articles that do.

And going back into this talk page's archives I see:

• 1) unresolved conflicts regarding "Strong Bias Toward Sceptic Researchers"
• 2) lack of inclusion of well-sourced information regarding Myofascial Meridians. By the way, the person proposing this contacted me about the merger of that article and this one. He's been banned so while I don't think merging them is likely, I do think the idea behind that unresolved dispute should be honored and some of the contents of that article be added into this main one.
• 3) lack of inclusion of many sources showing positive results for acupuncture (many times, and these are unresolved conflicts from the best I can tell)
• 4) a source in Nature which has been disputed many times and appears to be unresolved
• 5) Weight issues in the lede, such as cost effectiveness which appear unresolved
• 6) unresolved conflicts, from what I can tell, regarding inclusion and placement of information on adverse events in the article
• 7) lack of inclusion on a dopamine-modulated mechanism of action for acupuncture
• 8) lack of encompassing international studies (which is another instance of systemic bias)
• 9) Unresolved conflicts on the dispute of cherry-picked sources in the pain section, from what I can tell
• 10) unresolved conflicts on removal of information from Nancy Snyderman
• 11) and this list goes on and on. I'll add to it as we proceed and invite anyone else to do so as well!

Anyway, now that we have an active list, I see no reason why the POV tag shouldn't be added back. Let's get to work so we can get rid of this tag! LesVegas (talk) 22:12, 4 September 2014 (UTC)

Thanks for the list, but it's still unclear what you think the POV disputes are. Discussions about the inclusion of specific content or the reliability of specific sources, or just commenting that a particular issue is not resolved, do not mean that we have an NPOV issue. Many disputes on Wikipedia remain unresolved when discussion stops, and that isn't unusual. A few of the entries seem like they relate to the NPOV policy, but they still don't specify what actionable issues you're identifying, except perhaps #11 in the first list. As I asked in my previous comment, what POV or POVs do you think are currently over- or under-represented in the article? Sunrise (talk) 23:21, 4 September 2014 (UTC)

Keep in mind that, per WP:NPOV, the article is supposed to reflect the weighted sum of WP:MEDRS-compliant sources without inserting a false balance. The banned editor to whom you are referring was not banned for no reason - if you rely on their summary you will get a skewed view. I would like to second Sunrise's request for specificity in your objections. If you make your case reasonably I am certain we can work something out. - 2/0 (cont.) 23:37, 4 September 2014 (UTC)

Agree. His list is a really good start (more than a start), and certainly adequate to justify the tag (I've seen edit wars over tags in the past and am glad we haven't "gone there". There are no deadlines on WP, and as long as we're making reasonable progress (or are stalemated but actively recruiting new editorial eyes), the tag is fine. --Middle 8 (contribs • COI) 00:33, 5 September 2014 (UTC)

Thanks guys for your participation! Sunrise, your original response prompted me to go back into the archives here and I've found many more objections to neutrality on this article. I knew it was odd nobody added a POV tag before, indeed it was odd because this tag has been added before, many times. Not once do any of the issues appear to be resolved before the tag is removed, per policy. So I'm not breaking new ground by arguing for this tag, as much as I'd love to pat myself on the head. Regarding which POV is underrepresented, I think it's safe to say the sceptic POV is over-represented (as another editor said in "Strong Bias Towards Sceptic Researchers) and all other viewpoints are under-represented. This includes, but is not limited to, alternative medicine proponents, governmental bodies (such as the NHS, Federal Joint Committee, the CMBV, and many more)' acupuncture professionals (there is a notable lack of information regarding various acupuncture styles, such as Tung, classical, Japanese styles, Korean, only TCM which is the sole subject of both praise and attack in the article,( although there is a separate tag for this particular example)), whatever POV Middle 8, A1candidate, Herbxue, Jayaguru-Shishu, Bob MeeowCat and many others represent (as they seem to have continuous unresolved problems with some dominant POV's in this article), as well as systemic bias for multiple reasons I won't go into here, but if interested, anyone is welcome to go into here Again, the systemic bias issue is somewhat different, which is why I was proposing the addition of a systemic bias tag as well. I'd love to hear any opinions on that as well! I may be wrong here, and if I am, I totally don't mind putting a POV-check tag on the article instead and invite others to come here and check things out on the NPOV noticeboard. Nothing hurts from having more peeps give us their opinion. Anyway, I hope I answered your questions well! I'm always glad for input! Peace! LesVegas (talk) 01:02, 5 September 2014 (UTC)

About the skeptical bias, science is organized skepticism. So remove skepticism and there is no science left. Tgeorgescu (talk) 01:07, 5 September 2014 (UTC)

Hey there Tgeorgescu! Glad to see you again bro. I apologize for confusion about skepticism. I was largely using another user's objection which I found in the archives of this here talk page, entitled "Strong Bias Toward Sceptic Researchers". I totally agree with you, skepticism is a scientific pillar. What I think that editor really meant is there is a strong bias toward cynical researchers and the cynical point of view. In the archives, I noticed that there was a dispute between the researchers Vickers and Ernst, where conclusions of one of these gents's work (I don't remember which one) was criticized as nothing more than a platform to make ad homiem attacks. If true, that would be cynicism, and the article would have undue weight if that viewpoint were given a larger platform than it deserved. Anyway, sorry for the confusion, I'm not at all suggesting we get rid of sources rooted in valid scientific inquiry. Peace! LesVegas (talk) 01:31, 5 September 2014 (UTC)

Hi LesVegas! I knew what you meant by "skeptical bias", and semantics aside, I don't think the term is all that unclear. Of course one cannot be too scientific or too skeptical when it comes to the rational study of objective phenomena. However, one can take a given conclusion too far in a certain direction, or give too much weight to one segment of the mainstream. When the trend apparent in the acu literature suggesting the null result is overgeneralized (or perhaps prematurely extended) to all the literature, and we start saying without qualification (or with insufficient qualification, relative to extant MEDRS's) that acupuncture is a placebo, that's an example of skeptical bias. When the consensus of scientific skeptics is taken as being identical to the mainstream consensus despite ther being no unified mainstream consensus -- particularly on the question of whether there is a place for acu in medicine -- that too is an example of skeptical bias. Welcome! I like your approach on this page. --Middle 8 (contribs • COI) 07:22, 5 September 2014 (UTC)

I think LesVeges' list gives justification enough to keep the tag. We've still got quite a lot to improve with this article! Cheers! Jayaguru-Shishya (talk) 14:46, 5 September 2014 (UTC)

OK, now that there seems to be some agreement about the use of this tag, I propose we start by resolving issue número uno on the list, A1candidate's proposal to rectify this info on acupuncture and placebo, specifically, this:

• Acupuncture, psyche and the placebo response (2010) in Autonomic Neuroscience: Basic and Clinical with an impact factor of 1.846

• Acupuncture for Chronic Pain: Is Acupuncture More than an Effective Placebo? A Systematic Review of Pooled Data from Meta-analyses (2010) in Pain Practice with an impact factor of 2.183

"The first review found some evidence that "biological differences" exist between a placebo response and sham acupuncture. The second review concluded that "acupuncture is more than a placebo". Are there any recent reviews that suggest otherwise? " as quoted by master editor A1candidate, Wikipedia, 2014 LesVegas (talk) 01:38, 5 September 2014 (UTC)

Note that A1candidate has a reputation for misrepresenting sources. We cannot use anything they propose without thoroughly checking it first. That said, your idea to add more about the several different styles and traditions of acupuncture is an excellent one. I could see adding such material under #Clinical practice, or maybe #Theory or #History, depending on how we present it. Does that sound like something worth working at? - 2/0 (cont.) 12:21, 5 September 2014 (UTC)

@LesVegas: Did you bother to read the section Pain? It answers your "issue número uno" - Yes there are newer reviews that suggest otherwise and they are cited in that section. It's worth noting as well that Hopton & MacPherson (2010), the second source you want included is already used in that section to cite "A 2010 systematic review suggested that acupuncture is more than a placebo for commonly occurring chronic pain conditions, but the authors acknowledged that it is still unknown if the overall benefit is clinically meaningful or cost-effective." Now have you got any specific wording that you want introduced into the article or shall I just remove the tag until you've done your homework and have got something useful to add? --RexxS (talk) 18:16, 5 September 2014 (UTC)

The tag was removed multiple times

• 1) The information on acupuncture and placebo was resolved. If a source was not added to the article yet that does not mean we need a tag for that.
• 2) Nocebo Which specific source? A tag is not needed to add one or two sources. What is needed it to let editors know which source may be applicable for inclusion.
• 3) All the sources for allergies were added to the article.
• 4) Mechanism of acupuncture was added to the article which does not contradict the lede.
• 5) Acupuncture and the brain data was resolved. They don't show the effectiveness of acupuncture.
• 6) Inclusion of arrhythmia information. What source is specifically about acupuncture?
• 7) The validity of Quackwatch as a source was resolved.
• 8) The issues with acupuncture and safety as it's stated in the article was resolved. If it is too long we can start a new article titled Safety of acupuncture.
• 9) A dispute about the Encyclopedia of Pseudoscience: From Alien Abductions to Zone Therapy was resolved.
• 10) I don't see any unresolved weight issues.
• 11) The Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) (and the National Institute of Mental Health (NIMH)-adapted standards ion equal footing with studies/review) is covered by WP:MEDRS, and WP:WEIGHT and WP:FRINGE on Wikipedia. There is not a strong Bias Toward Sceptic Researchers. See Talk:Acupuncture/Archive_13#Strong_Bias_towards_Skeptic_Researchers.
• 12) The information regarding Myofascial Meridians using primary and fringe sources were inappropriate to use.
• 13) There is no lack of inclusion of many sources showing positive results for acupuncture? What sources?
• 14) The source in Nature was resolved.
• 15) The issues in the lede was resolved.
• 16) The text about adverse events are in the proper place in the article
• 17) There is no lack of inclusion on a dopamine-modulated mechanism of action for acupuncture The following sentence is in the article. Evidence suggests that acupuncture generates a sequence of events that include the release of endogenous opioid-like substances that modulate pain signals within the central nervous system.
• 18) There is no lack of encompassing international studies. For example, the Chinese journals were unreliable.
• 19) The issues with sources in the pain section was resolved. For example, the following source is already in pain. Hopton A, MacPherson H (2010). "Acupuncture for chronic pain: is acupuncture more than an effective placebo? A systematic review of pooled data from meta-analyses". Pain Practice. 10 (2): 94–102. doi:10.1111/j.1533-2500.2009.00337.x. PMID 20070551.
• 20) The removal of information from Nancy Snyderman was resolved. It was resolved when the unreliable source was removed. See Talk:Acupuncture/Archive_11#Dr._Nancy_Snyderman_information_repeatedly_removed.
• From what I can discern, the dispute is mainly with editors who did not like what the reliable sources said. There is no consensus for a tag that was added and removed multiple times.

• Koog, Yun Hyung; Lee, Jin Su; Wi, Hyungsun (2014). "Clinically meaningful nocebo effect occurs in acupuncture treatment: a systematic review". Journal of Clinical Epidemiology. 67 (8): 858–869. doi:10.1016/j.jclinepi.2014.02.021. ISSN 0895-4356. PMID 24780405.
• Enck, Paul; Klosterhalfen, Sibylle; Zipfel, Stephan (2010). "Acupuncture, psyche and the placebo response". Autonomic Neuroscience. 157 (1–2): 68–73. doi:10.1016/j.autneu.2010.03.005. ISSN 1566-0702. PMID 20359961.
• Langhorst, J.; Klose, P.; Musial, F.; Irnich, D.; Hauser, W. (2010). "Efficacy of acupuncture in fibromyalgia syndrome--a systematic review with a meta-analysis of controlled clinical trials". Rheumatology. 49 (4): 778–788. doi:10.1093/rheumatology/kep439. ISSN 1462-0324. PMID 20100789.
• La Touche, Roy; Goddard, Greg; De-la-Hoz, José Luis; Wang, Kelun; Paris-Alemany, Alba; Angulo-Díaz-Parreño, Santiago; Mesa, Juan; Hernández, Mar (2010). "Acupuncture in the Treatment of Pain in Temporomandibular Disorders: A Systematic Review and Meta-analysis of Randomized Controlled Trials". The Clinical Journal of Pain. 26 (6): 541–550. doi:10.1097/AJP.0b013e3181e2697e. ISSN 0749-8047. PMID 20551730.
• Kim, Tae-Hun; Choi, Tae Yong; Lee, Myeong Soo; Ernst, Edzard (2011). "Acupuncture treatment for cardiac arrhythmias: A systematic review of randomized controlled trials". International Journal of Cardiology. 149 (2): 263–265. doi:10.1016/j.ijcard.2011.02.049. ISSN 0167-5273. PMID 21421272. I added lots of good sources to the article. QuackGuru (talk) 20:14, 5 September 2014 (UTC)

Hi Quackguru! Thank you for contributing here, the more the merrier! I appreciate the amount of work you put into your post, and think you can be a valuable asset towards resolution here because I see you frequently put a tremendous amount of effort into making your points, and it appears you have a good deal of knowledge about the history of the disputes on this topic. I also see that you reference your points quite well on this talk page, and that's a big plus to any discussion. Clearly you have a passion for this subject and you put in a great deal of work towards your efforts. I see, for instance, on #17 that you provided an excellent reference to support your point. I didn't see what appeared to be a complete resolution on the talk pages, but then again I'm human and I may have overlooked something on that one issue. Would you be so kind as to provide sourcing for when/where exactly some of these other issues were resolved? No hurry, I don't want to overburden you, it will take time to resolve the issues where there is still clear disagreement. That way, we can all debate whether we feel like there has been a valid resolution, point by point, or not. If 3-4 feel like issue #10 is resolved and 3-4 feel like it's unresolved, well then the tag would still be justified, right? But if we all feel it's a non-issue, then we could go ahead and scratch it off the list and spend our time on other issues on the list. That's where I think you can be a tremendous asset to everyone here.

Regarding consensus for the tag, I very sorry but I must disagree with you as there are several other editors who support this tag. If all the issues had been resolved, these editors wouldn't support the tag. And in my opinion, we also wouldn't have had a history of this tag. But you did state that the POV tag was removed multiple times already( per consensus and not just some random single editor) and I will look into the edit history deeper to see who removed it, why it was removed, and what everyone's justification was for de-tagging the page and report these findings back here because I think they can be a great help in this current effort. And please feel more than free to disagree with anything I'm saying here. If you feel the inclusion of this tag to still be unjustified, you will have my full support to go onto the neutral point of view noticeboards and ask for an outside/third-party opinion. Again, I appreciate your response and look forward to working with you! LesVegas (talk) 23:22, 5 September 2014 (UTC)

Failed verification?

Wiki-aricle:

"Acupuncture is used at several academic medical centers,[81]"

QuackGuru [82]:

" Failed verification. How does the source verify the claim Acupuncture is used at "several" academic medical centers? Encyclopedic content must be verifiable."

The given reference [83]:

"As it turns out, Johns Hopkins is coming late to the party. Acupuncture is already a fait accompli at many peer institutions—Mayo Clinic, Duke, Stanford, UCLA and at least a dozen others included. Most of these medical centers"

So, verified. Joshua Jonathan -Let's talk! 19:25, 5 September 2014 (UTC)

The sources does not state it is only used at "several" academic medical centers. The source goes much beyond that. Acupuncture is used at many academic medical centers,... QuackGuru (talk) 19:57, 5 September 2014 (UTC)