Talk:Acupuncture

Restoring consensus wording re Ernst review

• Update: the somewhat-convoluted consensus wording [1] reflects the rather convoluted source material. But since Ernst '11 is a review of reviews that span 2000-2009, its findings are pretty outdated, and there's no good reason to keep it in the lede when we have recent, unambiguous stuff available. See below: Better sources for efficacy in lede; MEDDATE. --Middle 8 (contribs • COI) 09:56, 25 October 2014 (UTC)

original thread-starter follows:
Self-explanatory ES, and left a note on Doc James' page (section here) since I was reverting him. My edit [2] restores the latest consensus wording which was a bold edit by User:Vzaak [3] that accords with the source Ernst 2009. QuackGuru among others accepted this edit as we see in archived talk. That was a broad consensus; there were a lot of editors involved spanning more than one talk page, and those who didn't comment implicitly accepted Vzaak's edit per WP:SILENCE.

That said, I think that when it comes to efficacy we can do better than Ernst's 2009 review of reviews [4] whose dataset spans 2000-2009. But for safety that source remains fine. --Middle 8 (contribs • COI) 07:37, 13 October 2014 (UTC)

QuackGuru: You reverted my edits to the lede and body [5], saying "violation of consensus". WHAT???

As stated, my edit restored the broad consensus reached at archived talk supporting Vzaak's edit. In fact, as stated, you supported that consensus. (1) Please justify your edit in light of consensus, and show evidence for any supposedly more recent broad consensus. (Note that in e.g. this recent version, the wording in the body reflects Vzaak's consensus wording. Is there any discussion of what that later changed?) (2) Please explain why you changed your mind [6].

Also, above, you said: "Better sources were found and editors have moved on." (3) Which "better sources"?

Again, I'm being very specific. I sometimes have a hard time understanding your writing. So if you indicate which question you're replying to, it will help me with WP:DR a great deal. Thanks, Middle 8 (contribs • COI) 08:50, 13 October 2014 (UTC) revised 09:05, 13 October 2014 (UTC)

I do not see the justification for

"A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain..."

When this can be summarized as

"A systematic review of systematic reviews..."

Why exactly is "highlighted recent high-quality randomized controlled trials"? A proper systematic review for an intervention of course only includes high quality RCTs. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:27, 13 October 2014 (UTC)

(e/c) Because it was a review of reviews and the RCT was cited as an exception. The dataset was reviews of efficacy for pain, a majority of which were actually positive. But Ernst considered those results dubious, because of the low quality of many RCT's that the reviews looked at. (The reviews spanned 2000-2009, so the RCT's they looked at go back even further.) As part of his explanation of why he thought the positive reviews dubious, he pointed to some high-quality RCT's, including one from 2010, Suarez-Almazor, to which the phrase "real acupuncture was no more effective than sham" (on the last page of the review) refers. Then he went on to predict (correctly) that in the future, as RCT's got better, results would be likely to show small efficacy or none.

So we need to get both the spirit and the letter right while doing violence to neither. To do that we need to stick with the precise, consensus wording as long as we're citing Ernst 2009 in the lede for efficacy. And better, use more up-to-date reviews that actually find lack of efficacy.

Also see my comment on your talk page. And feel free, Doc James and all editors, to email me if you'd like a copy of the review. --Middle 8 (contribs • COI) 13:50, 13 October 2014 (UTC)

Addendum: So why not just cite more up-to-date reviews? The answer so far seems to be that QuackGuru is hot to see the phrase "real acupuncture is no better than sham" in the article (see here, where he proposes using a weak source for the claim, and here, where he wanted to use Moffet, another weak source that actually failed MEDRS, per Alexbrn [7], and was finally deleted by Doc James [8]). But that wording, "real acu is no more effective than sham", is of course synonymous with saying "acu isn't effective", which we already say for most conditions anyway. We should just (a) report the most recent results on efficacy and (b) explain to the reader what sham/placebo acu is: real acu at fake points, or fake acu at real points. I've tried this -- see above -- and QuackGuru escalated the drama and went to User:Kww, begging to let him take me to AN for "editing against consensus", which is pretty fucking ironic since my edits then and now actually uphold consensus, i.e. Vzaak's edit[9]. --Middle 8 (contribs • COI) 13:50, 13 October 2014 (UTC) edited 14:10, 13 October 2014 (UTC), Middle 8 (contribs • COI) 06:31, 27 October 2014 (UTC)

I likewise find Middle 8's proposed rewording greatly weakens the conclusion of the systematic review, and amounts to little more than whitewashing. Dominus Vobisdu (talk) 13:35, 13 October 2014 (UTC)

Have you read the review -- not just the abstract? I doubt it, or else you'd know that the phrase "real acupuncture was no more effective than sham" (on the final page) refers to the RCT by Suarez-Almazor (2009), with which Ernst was contrasting the dataset (which was reviews from 2000-2009 that found for efficacy, albeit with contradictions, hence Ernst's citation of newer, better stuff like Suarez-Almazor).

And please explain this edit summary -- where you revert my restoring Vzaak's consensus wording [10] and repeat QuackGuru's ES "violation of consensus". Oh really? Show us that contrary, more recent consensus? I doubt you can point to that either, since it doesn't exist.

Neither the source nor the edit history backs you up. I think -- and I think it's obvious -- that you're just trying to wing it, making broadly "anti-acupuncture" edits that you figure must be correct. Dude! Way to edit an encyclopedia! --Middle 8 (contribs • COI) 14:06, 13 October 2014 (UTC)

You could try a RfC Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:36, 25 October 2014 (UTC)

No need for an RfC when there is a consensus. Jayaguru-Shishya (talk) 18:13, 25 October 2014 (UTC)

What consensus? Can you prove that? The Banner talk 18:20, 25 October 2014 (UTC)

Middle 8 has tried again to edit against conneusus.[11] No consensus for the wording. I think editors need to quit trying to add unnecessary or misleading details to the lede.[12] QuackGuru (talk) 01:48, 26 October 2014 (UTC)

Restoration of verifiable material

I removed material that failed verification per source and replaced it with an earlier, verifiable piece of text[13]. I got reverted, however, by Dominus Vobisdu per "Fringe whitewashing". Taking that no explanation for such revert was given, @Dominus Vobisdu:, what was your reason for such a revert? Instead of editing collaboratively, your edit without any reason seems like a personal attack making accusations of "fringe" and "whitewashing", and such behavior cannot be tolerated at an encyclopedia. Jayaguru-Shishya (talk) 15:28, 13 October 2014 (UTC)

See my comments just above; same issue. Dominus Vobisdu is as wrong as can be on this, both on the history (both you, J-S, and I indeed restored consensus wording) and the source (per above). After the dust settles here, I will escalate the issue to a noticeboard unless D.V. changes course. --Middle 8 (contribs • COI) 15:37, 13 October 2014 (UTC)

(Personal attack removed) (Personal attack removed)

It's embarrassing, the way you guys are doubling down and not engaging on substance. Epitome of 2nd sentence of WP:NPA.

Re COI: I've seen no evidence J-S has one, and I've plainly declared mine. --Middle 8 (contribs • COI) 18:51, 13 October 2014 (UTC)

Personally, I see your being an acupuncturist as an asset because you can offer your expertise to edits. You're not editing an article on "Middle 8 the Acupuncturist". LesVegas (talk) 20:18, 13 October 2014 (UTC)

Thanks! A lot of editors don't really understand WP:COI. Sometimes subject-matter experts find that "no good deed goes unpunished" around here.  :-/ --Middle 8 (contribs • COI) 05:52, 14 October 2014 (UTC)

Put simply: The reason Ernst's review-of-reviews doesn't find unambiguously for lack of efficacy is because the dataset is old-ish reviews (spanning 2000-09) based upon still-older RCT's, which weren't designed very well. With newer and better RCT's we started seeing more and more convergence toward the null result (no efficacy vs. placebo). Ernst '09 predicts this... and cites one such RCT as an example of real being no better than sham. Hence consensus language [14]: A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain real acupuncture was no better than sham acupuncture. But we'd be better off using a newer, less ambiguous review, rather than a superseded one that requires clarification. --Middle 8 (contribs • COI) 08:36, 14 October 2014 (UTC)

OK, here is a full copy of Ernst '11 at researchgate.com. correction: it's Ernst '11 not Ernst '09 (thanks to User:ImperfectlyInformed, whose diff is also informative.) It's about two broad topics, efficacy and risks, and we're concerned with the former. Especially look at the Intro, Discussion and Conclusions. Which literature is Ernst talking about when he mentions real vs. sham, on p. 762? --Middle 8 (contribs • COI) 09:59, 14 October 2014 (UTC) <small.edited 09:43, 21 October 2014 (UTC): corrected name; it's Ernst '11

Thanks for the PDF, Middle 8, I'll try to have a look. When it comes to the achieved consensus, I think it withstands some random removals. After all, Wikipedia is not a democracy (WP:DEMOCRACY). Jayaguru-Shishya (talk) 14:56, 17 October 2014 (UTC)

You claimed the text failed verification and now you will "try to have a look"? https://en.wikipedia.org/wiki/Acupuncture#cite_note-Ernst_2011-8 Click on the Ernst 2011 source and you will see a little symbol of a PDF file. The PDF file has been in the article for quite some time. I read the source gain. Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture. That would be a misinterpretation of the source and the conclusion of an editor. It was the 2011 source that came to that conclusion. We do not need to say or mention it was referenced to the high-quality randomized controlled trials, anyhow. If we did something like that for every sentence this article would be ridiculously written. QuackGuru (talk) 06:02, 19 October 2014 (UTC)

It was the RCT Suarez-Almazor to which the text about real being no better than sham refers, and this should be obvious to editors who are applying scientific literacy in reading the source (and not being disingenuous). --Middle 8 (contribs • COI) 09:47, 21 October 2014 (UTC)

The part "highlighted recent high-quality randomized controlled trials which found" claims the RCTs came to that conclusion. That is a OR. I explained it was the 2011 source that made that conclusion.

It may be the RCT Suarez-Almazor is what the text refers to but that was not what was added to the article and it is unnecessary to explain where the text was sourced to. QuackGuru (talk) 10:03, 21 October 2014 (UTC)

Perhaps you meant it just the other way around, QuackGuru? The source still fails to verify the claim; it does, however, find that in reducing pain real acupuncture was no better than sham. In my earlier edit[15], I removed that piece of text that failed verification and replaced it with the previous verifiable one.

Perhaps you could advise me which part exactly supports that conclusion? Jayaguru-Shishya (talk) 18:34, 20 October 2014 (UTC)

Your edit fails V and I already explained why. There is no justification for it. QuackGuru (talk) 18:48, 20 October 2014 (UTC)

@ QuackGuru No, it doesn't fail VER; we have consensus to that effect. You say there's no justification for the edit, and that was a good question Doc James asked -- but since you follow talk pages closely, I think you may have seen that I explained the situation already and he didn't respond. Indeed, nobody else who reverted my consenus-restoring edit [16] has responded to my explanations, so WP:SILENCE can be assumed. It's obvious we had a broad consensus in July that hasn't changed, and is substantively sound according to that consensus discussion. Time to move on. --Middle 8 (contribs • COI) 11:29, 22 October 2014 (UTC)

@ QuackGuru, continuing from your comments at 10:03, 21 October 2014: Glad to see you back; you went silent shortly after my replies to you above. I know we all want to keep WP:DR moving forward, so please respond to my questions 1, 2 and 3 there. Brief recap: after some discussion, I recently remembered that we actually had a broad consensus (including discussion at WT:MED, in which lots of editors participated) to use Vzaak's edit, which said "A systematic review of systematic reviews highlighted recent high-quality randomized controlled trials which found that for reducing pain real acupuncture was no better than sham acupuncture". And you supported that wording, enthusiastically, with a big "thumbs up" in your ES. It was great to see us all on the same page with what you called a "good compromise". Given your support (edit: at the time /edit) and the breadth of consensus, it seems to me we should just respect that consensus and move on, shouldn't we? I look forward to your responses. Again, since we sometimes have trouble communicating, please indicate specifically which questions you're replying to -- that will help me, and I suspect others here, a great deal. Thanks! --Middle 8 (contribs • COI) 10:24, 21 October 2014 (UTC) edited 13:37, 22 October 2014 (UTC), 03:17, 25 October 2014 (UTC)

I explained it was OR over and over again. The newer discussion showed editors support using the text for a conclusion.[17][18] QuackGuru (talk) 16:58, 21 October 2014 (UTC)

I agree with Middle 8 restoring the firm and sound wording of the text, it has been discussed already to a great extent. Since nobody is responding to the discussion, the established consensus can be assumed. Jayaguru-Shishya (talk) 20:17, 21 October 2014 (UTC)

I did respond to the discussion. Read my previous comment. No editor has been able to provide a rational argument to including the unnecessary wording. QuackGuru (talk) 20:27, 21 October 2014 (UTC)

@QuackGuru Yes, I saw your comment (starting with "I explained it was OR...."). The diffs you linked to were not explanations, but simply assertions that the consensus text (from Vzaak) was OR. No, it is not OR to quote a source correctly. Additionally, you cited two diffs from a September discussion at WT:MEDRS that opposed consensus wording; however, we both know that there were also editors favoring it (and with more detailed analysis based on the source's grammar) -- just read that discussion and see comments from Peter Coxhead (08:40, 3 September 2014 UTC) and 2/0 (15:12, 4 September 2014 UTC). More importantly, that discussion, having fewer participants and no consensus, does not supersede the July discussions (on this page and at WT:MED, cf. Vzaak's discussion-closing edit), which had more participants and did reach a consensus.

So with respect to the three questions I asked, you did offer an answer to (1), but you still haven't shown evidence for any supposedly more recent broad consensus than in July (for Vzaak's edit). You have not explained (2) at all, i.e. why you changed your mind -- not that you have too, but it is odd. Nor (3) have you explained your statement that "Better sources were found and editors have moved on" (3) Which "better sources" -- but we can let that one go since you're not pressing it. Still, that leaves (1), which is fundamental to consensus.

And most importantly, you are totally overlooking the context of Ernst's statement about real vs. sham. So I would ask some new questions: (4), are you suggesting that any statement X made in a review article, no matter what the context, can be cited as "the review found X"? If so, that's prima facie unsound; and if not, then (5) why do you think context doesn't matter in this case? Maybe English isn't your first language (and that's OK, obviously), but I assure you, grammatically, that the antecedent for Ernst's statement re real vs. sham is indeed Suarez-Alamazor. (6) Do you see that the dataset is reviews, and that they're old and based on poor quality RCT's? (7) In light of (6), do you see that Ernst is contrasting his dataset with Suarez-Almazor's RCT?

Additionally, we don't say that Ernst '11 found real to be no better than sham just because Ernst found that to be true in later papers. Which is why I've been saying we should cite later papers instead.... and I hope that that point makes it clear that I am not trying to "whitewash" anything; I just think content errors hurt the project.

And in light of our difficulty communicating in the past, I wish you would answer my queries specifically, e.g. "My answer to Middle 8's question 1 is (...); my answer to his question 2 is (...)? That would help me a lot, and it's not an unreasonable demand. So, work with me on this, OK? Thanks! --Middle 8 (contribs • COI) 11:21, 22 October 2014 (UTC) edited 13:34, 22 October 2014 (UTC), 22:28, 22 October 2014 (UTC)

But I did explain the problems with the current wording.[19] It is reasonable to ask you to follow WP:COIADVICE. You did declare you have a COI, right? QuackGuru (talk) 19:09, 23 October 2014 (UTC)

Your diff [20] simply says you changed your mind about how to read Ernst '11, which sort of answers my #2, but still leaves 4,5,6 and 7 unaddressed. I'm giving you every opportunity to move discussion forward. Re COI, etc., see long reply below [21] (or read the link in my signature, which anticipates your question). --Middle 8 (contribs • COI) 15:02, 24 October 2014 (UTC) edited 01:30, 25 October 2014 (UTC)

Continued controversial changes

• Revision as of 13:16, 8 July 2014 Middle 8 deleted sourced text but claimed the source doesn't support the general statement.

• Revision as of 05:45, 31 August 2014 Middle 8 replaced sourced text with original research in the lede. His edit was also a violation of lede because it did not summarise the body.

• Revision as of 07:58, 1 September 2014 Middle 8 reworded the text to alter the meaning of the sentence. The part "may be" was original research. See Talk:Acupuncture#Summarize.

• Revision as of 12:52, 7 September 2014. Middle 8 replaced sourced text with SYN and OR. For example, the part "that indicates a lack of effectiveness" was original research.

• Revision as of 06:33, 13 October 2014. Middle 8 restored disputed text again.

• Revision as of 09:14, 13 October 2014. Middle 8 restored disputed text again.

• Revision as of 15:52, 21 October 2014. Middle 8 restored disputed text again. According to his edit summary, he claims I agree with him.

Let's review: "These findings should be seen in the light of recent results from high-quality randomized controlled trials. Cherkin et al.[14] have shown that, for chronic low back pain, individualized acupuncture is not better in reducing symptoms than formula acupuncture or sham acupuncture with a toothpick that does not penetrate the skin." Reference number 14.[22]

"This view was further strengthened by a recent randomized controlled trial in patients with osteoarthritis examining the effects of acupuncturists’ communication style [128]." Reference number 128.[23]

The part "highlighted recent high-quality randomized controlled trials" refers to it should be seen in the light of recent results from high-quality randomized controlled trials. The source does not indicate it was the conclusion of the recent high-quality randomized controlled trials.[24] and this is not how to summarise sources. No other text (specially in the lede) needs to explain what sources a review may or might have referred to.

"Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham." This was an independent sentence that did not specifically refer to any randomized controlled trials. It is you opinion (educated guess) that you think the source refers to RCTs for that specific sentence. It is unencyclopedic writing to have this extreme level of detail, anyhow.

See WP:COI: "If the article you want to edit has few involved editors, consider asking someone at the talk page of a related Wikiproject for someone to make the change.

If another editor objects for any reason, then it's a controversial edit. Such edits should be discussed on the article's talk page."

Did Middle 8 violate WP:COIADVICE by knowingly making a controversial disputed edit? Middle 8, do you agree to follow WP:COIADVICE and revert your controversial edit and wait for consensus? QuackGuru (talk) 19:09, 23 October 2014 (UTC)

Hmm, many diffs loose from their context, and only accompanied by your personal commentaries. So have these issues been subjects of conversation before, and what are you suggesting exactly? Perhaps links to the original discussion would give a better picture than individual diffs alone? Especially when you are bringing up diffs from as early as last June, some clarification would be more than welcome! Cheers! Jayaguru-Shishya (talk) 13:17, 24 October 2014 (UTC)

@QuackGuru -- First, re my COI, it doesn't sound like you've read my declaration (see here or in my signature line) carefully. I have a COI (like any party with an interest in an outcome), but it doesn't make me ineligible to write a Cochrane review, for example. Nor does it reach Wikipedia's threshold, where COIADVICE kicks in. WP:COI has said, for years, that simply having a profession doesn't create a COI. Which makes sense: since I could write a Cochrane review on acupuncture, it would be pretty stupid for Wikipedia to restrict my editing simply on professional grounds. I know that some of the most ardent skeptic-warriors would very much like to see acupuncturists constrained by COIADVICE, but less partisan editors have observed, repeatedly, that doing so would be a kind of WP:GAME.

Second, re Ernst' 11, I don't know why you're re-litigating this. We reached a broad consensus in July, and it still applies, even though you changed your mind. And July's broad consensus got it right. Your analysis above misreads context. Here's the full paragraph from the top of p.762 of Ernst '11, color-coded for clarity. My clarifications are in [brackets]:

These findings [i.e. the findings of the older reviews Ernst examined, which were positive but contradictory; see Discussion on p.761] should be seen in the light of recent results from high-quality randomized controlled trials. Cherkin et al. [14] have shown that, for chronic low back pain, individualized acupuncture is not better in reducing symptoms than formula acupuncture or sham acupuncture with a toothpick that does not penetrate the skin. All 3 forms of acupuncture, however, were more effective than usual care. The authors consider, therefore, that the benefits of acupuncture ‘‘resulted from nonspecific effects such as therapist conviction, patient enthusiasm, or receiving a treatment believed to be helpful’’ [14]. This view was further strengthened by a recent randomized controlled trial in patients with osteoarthritis examining the effects of acupuncturists’ communication style [128]. [note: ref. 128 is Suarez-Almazor '09.] Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham. Moreover, a communication style generating high expectations in patients resulted in improved outcomes compared to a normal style, regardless of the type of acupuncture administered. In the primary studies included in the systematic reviews evaluated above, the risk of bias was often considerable. Adequately controlling for nonspecific effects in future is likely to demonstrate that acupuncture has no or few specific effects on pain [89].

Remember, this is a review of reviews spanning 2000-2009, and those reviews are based on RCT's that are even older. A LOT has changed since then, and that's why this paragraph exists: so that Ernst can contrast those reviews with newer, better RCT's. The text in brown pertains to Cherkin [14] and the text in purple pertains to Suarez-Almazor [128]. Your assertion to the contrary [25] is incorrect. We can't just pick a sentence from, e.g., the brown or purple text above and say "this was a finding of Ernst" -- that's absurd! Context matters. To find out what the findings of Ernst '11 are, look at the abstract, or the last two sentences of the paragraph above, where he is actually discussing his dataset.

The only way in which "real acupuncture was no better than sham" is a "finding" of Ernst '11 is in a very hazy "spirit of the law" sense, insofar as he predicts the trend of future research as methods improve. But our job is to get both the spirit and the letter right without screwing up either. To do that, all we have to do is use more recent sources that are less ambiguous than Ernst '11. That's a better use of your energy and mine.

Third, re your complaints about my edits: If I were you, I'd be careful about throwing around perfectly reasonable edits, because they may well boomerang back at you. You've already tried that multiple times at Kww's user talk, but he's been silent. You're attempting to imply that by making an edit more than once, I must be fighting consensus, but in fact I'm restoring July's consensus, which you've been edit-warring against: a classic boomerang situation. I'll respond below only to show how meritless your objections are, for the record.

• 1. Revision as of 13:16, 8 July 2014 Middle 8 deleted sourced text but claimed the source doesn't support the general statement.
  • And I was right (See also #3 below). This was resolved with a consensus-forming bold edit by Vzaak in July. (Discussion here & links therein, and sections preceding)

• 2. Revision as of 05:45, 31 August 2014 Middle 8 replaced sourced text with original research in the lede. His edit was also a violation of lede because it did not summarise the body.
  • Perfectly good edit -- very simple explanation of controls -- but you (QuackGuru) define OR as any sort of paraphrasing or summarizing of sources. See WP:CGTW, #5.

• 3. Revision as of 07:58, 1 September 2014 Middle 8 reworded the text to alter the meaning of the sentence. The part "may be" was original research. See Talk:Acupuncture#Summarize.
  • Similar to #1; Edit is fully consistent with ES, and ES is true. See Ernst '11, pp. 761, especially 1st paragraph under "4. Discussion."

• 4. Revision as of 12:52, 7 September 2014. Middle 8 replaced sourced text with SYN and OR. For example, the part "that indicates a lack of effectiveness" was original research.
  • Similar to #2. Any editor who knows the topic area and understands SYN/OR will recognize this as a good summary of study design. I can't help it if you keep reverting good edits.

• 5. Revision as of 06:33, 13 October 2014. Middle 8 restored disputed text again.
  • This was restoring consensus wording per #1.

• 6. Revision as of 09:14, 13 October 2014. Middle 8 restored disputed text again.
  • Same as #5.

• 7. Revision as of 15:52, 21 October 2014. Middle 8 restored disputed text again. According to his edit summary, he claims I agree with him.
  • Same as #5. And just as my ES says, you did support this in July: Your ES gave it a thumbs up.

All in all, it's time for you to stop fighting a broad consensus that was factually correct, and to stop accusing others of violating consensus when you're actually the one doing that. That kind of conduct is very likely to boomerang.

A better idea: let's use more recent sources. Ernst '11, as I said, relies on reviews from 2000-2009, which are based on RCT's probably going back to the early 1990's. The Streitberger needle didn't even come along until ca. 1998! Ernst '11 is full of outdated information, which is why he made a prediction in the last sentence of the excerpt above. Better, less ambiguous sources now exist. --14:51, 24 October 2014 (UTC) copy-edit and format, 15:16, 24 October 2014 (UTC), minor edits 18:52, 24 October 2014 (UTC)

See below at section Better sources for efficacy in lede; MEDDATE re suggestions on improving sourcing and getting around tedious wording disputes associated with older sources. --Middle 8 (contribs • COI) 09:23, 25 October 2014 (UTC)

There is broad consensus for the concise wording

User:Dominus Vobisdu,[26] User:McSly,[27] User:Jim1138,[28] User:Roxy the dog,[29] User:Doc James,[30] User:Bobrayner,[31] prefer the accurate wording. There is no need to add the complicated or inaccurate details to the lede. User:RexxS articulated that "This is completely against our policy of respecting secondary sources; none of us can know how many sources, primary and secondary, he has examined to reach his conclusion."[32] User:RexxS also explained that adding the amateur detective work of Wikipedia editors is precisely what we don't do in MEDRS.[33] User:Yobol stated that "Ernst spends an entire paragraph (the largest paragraph in the discussion section, as a matter of fact) to basically endorse two high quality primary studies finding "real" wasn't different than "sham". My interpretation: It would be incorrect to say that discussion about sham acupuncture was the only or primary conclusion of the paper; however, does seem to be a conclusion Ernst is making and therefore citable as a source for that conclusion."[34] The text is sourced and the 2011 review is MEDRS complaint. QuackGuru (talk) 19:40, 26 October 2014 (UTC)

QuackGuru, we both know that the real/sham wording is about a particular RCT and not an overall "finding" of Ernst '11. Your wording isn't factually true, but it is truthy.

• I agree with Yobol's observation in a sense, but only in a "spirit of the law" way, and it's a stretch.
• You're citing only editors who agree with you. Discussions on this have ranged from inconclusive to opposing your preferred wording. Neglecting that is dishonest.
• Dislking the more complex wording isn't the same as endorsing the simpler wording. There's a third choice of dropping the real/sham wording altogether. It's not in the abstract, and it's not an accurate description of Ernst's findings.
• I know as well as anyone that the trend in acu research has been toward the null (where real and sham are equivalent), or clinically insignificant differences between real and sham. But "real is no better than sham" is not a "finding" of this paper. If Wikipedia wants to play it truthy and sloppy, that's the way it is. I think we can do better than that, and get the letter and spirit of the law right without screwing up either.

--Middle 8 (contribs • COI) 04:56, 27 October 2014 (UTC) editedMiddle 8 (contribs • COI) 05:19, 27 October 2014 (UTC)

• Doc James, e.g., wrote "I am of the opinion that one can just summarize the conclusions of the review which is "in conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain." [35]". [36] --Middle 8 (contribs • COI) 05:01, 27 October 2014 (UTC)
• 2/0 wrote: "Middle 8's reading of the source in context agrees with mine that the sentence "Real and sham acupuncture were both more effective in reducing pain than no acupuncture at all, but real acupuncture was no better than sham" is a report of the conclusion reached by Suarez-Almazor 2010. Ernst 2011 is pretty harsh on the quality of available evidence and should by no means be cited as supportive of the practice, but this particular statement is providing context for the results being reported: it is not a result itself of the present work." [37] --Middle 8 (contribs • COI) 05:05, 27 October 2014 (UTC)

We are already including a conclusion and the conclusion in the lede.[38]

Complicated wording is sloppy wording. Verification for the concise text was previously provided and your proposals are tantamount to original research.

I provided evidence there are several editors who disagree with you.[39][40][41][42][43] [44] That is your choice if you ignore consensus. You should not delete it from the lede because you don't like the concise wording for the lede. The text should be concise and not be complicated, especially in the lede for the general reader. QuackGuru (talk) 05:18, 27 October 2014 (UTC)

No, I was not being disingenuous here.[45] Read comments from other editors who disagree with your personal interperation.[46][47][48] Your changing your comment after I replied. It would be easier to follow if you striked your comment. QuackGuru (talk) 05:43, 27 October 2014 (UTC)

(e/c) You're citing editors who were then reverted and didn't object to talk page discussion, cf. WP:SILENCE, and that's not very honest. We had broad consensus in July (discussion here) that the more complex wording is the proper way to parse the source (as long as you insist on keeping the real/sham wording), and you supported that. It's not clear why you changed your mind. You wrote: "Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture." [49] WHAT? How do you figure that? --Middle 8 (contribs • COI) 05:48, 27 October 2014 (UTC)

It would be most concise to just cite the abstract as Doc James suggests and bypass the disputed wording. --Middle 8 (contribs • COI) 05:57, 27 October 2014 (UTC)

Do you think any other editor is or was being disingenuous too?[50] I citing editors who reverted the complex wording and they don't have to argue on talk page discussion. See WP:EDITCONSENSUS. I just did explain the concise wording with including sham vs real acupuncture is better and I did explain it was a conclusion from the review. You can read my recent comments again if you still don't understand my arguments. Now that the text is not too wordy for the general reader you don't like it? There is a general consneus for COI editors to follow WP:COIADVICE and there are ways for dealing with WP:SPA. See Wikipedia:Conflict of interest#Dealing with single-purpose accounts. Do you think your edits are Wikipedia:Conflict of interest#Non-controversial edits? QuackGuru (talk) 06:16, 27 October 2014 (UTC)

Yes, you are being far more than disingenuous, fellow editor; you are outright lying in order to get your way. See below. --Middle 8 (contribs • COI) 07:41, 27 October 2014 (UTC)

Taking into account that a broad consensus indeed was achieved, reverting against the consensus just because "I don't like it" is not an excuse. On the opposite, WP:TALKDONTREVERT makes it very clear that it is an obligation of every editor to discuss the issues at Talk Page. What matters is "the quality of arguments"; the editors you mentioned QuackGuru, they didn't even participated the discussion.

In determining consensus, consider the quality of the arguments, the history of how they came about, the objections of those who disagree, and existing policies and guidelines. The quality of an argument is more important than whether it represents a minority or a majority view. The arguments "I just don't like it" and "I just like it" usually carry no weight whatsoever. [...] This obligation applies to all editors: consensus can be assumed if editors stop responding to talk page discussions, and editors who ignore talk page discussions yet continue to edit in or revert disputed material may be guilty of disruptive editing and incur sanctions. (WP:TALKDONTREVERT)

Jayaguru-Shishya (talk) 18:42, 27 October 2014 (UTC)

So, are you going to continue to ignore WP:COIADVICE or are you only going to make Wikipedia:Conflict of interest#Non-controversial edits? QuackGuru (talk) 08:15, 27 October 2014 (UTC)

Classic IDHT: I've twice replied on this [51][52], and anyone can read my COI declaration (in my signature), which you undoubtedly have.

Additionally, I noticed that you placed the COI template Template:Connected contributor on top of this page on 13 October 2014. (In good faith I have filled it in further [53].) But putting it there was gratuitous, since that template states:

The default wording assumes that the editor has not formally declared an interest; the guidance at Wikipedia:Conflict of interest is that users are "strongly encouraged—but not actually required—to declare their interests", so there is no need to formally require a contributor to declare themselves - the template itself provides links to relevant guidance to allow the user to make an informed choice regarding declaration.

I've obviously made an informed choice already since I already have a COI declaration (see history). And your question about COI was the third time you've asked me. Your repeated "questioning" (as if you didn't know the answer) is disingenuous. --Middle 8 (contribs • COI) 14:56, 27 October 2014 (UTC)

WP:LIE: Just don't.

It's one thing to complain about reasonable enough edits, and another to push truthy mainspace edits, but I draw the line at outright dishonesty, which is what we are now seeing from User:QuackGuru. He stated: "Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture." [54] He's referring to RCT's cited by Ernst '11 at the top of p.762: namely Cherkin's famous "toothpick" study [55] and Suarez-Almazor's study on knee osteoarthritis that also looked at bedside manner [56]. Both of these studies very clearly found for no efficacy. QuackGuru's full quote:

"I read the source again. Actually the high-quality randomized controlled trials did not find that for reducing pain real acupuncture was no better than sham acupuncture. That would be a misinterpretation of the source and the conclusion of an editor. It was the 2011 source that came to that conclusion." [57]

Only the woo-iest of woo-pushers would argue that Cherkin's "toothpick" study found other than a null result. There is no way someone can possibly both be medically literate and truthfully make that statement, and we know QuackGuru is medically literate. Nor is there any way one can approach matters here with the usual trenchancy and then go all wobbly and plead that we're seeing good-faith error. This is simply "end justifying the means" stuff and is inappropriate. He's saying this only to push the view that Ernst's comments about real/sham are an "overall finding" as opposed to a comment on a particular RCT. He could have just been honest and said, as Yobol did [58], that it's reasonably construable as "a" finding. I get that. But in order to get his way, QuackGuru was willing to say whatever it takes, even a bald untruth.

Rather than working from sources, QuackGuru has fixated on the phrase "real acupuncture is no better than sham" and tried to find any source possible to get it in. See here, where he proposes using a weak source for the claim, and and here, where he wanted to use a review by Moffet, another weak source. Moffet is from a "fringe journal" and actually failed MEDRS, as Alexbrn noted, which Doc James finally deleted). QuackGuru is usually the first to object to such MEDRS-compliant sources. But not when it suits his agenda, in this case.

As far as the current dispute goes, I'm not going to spend much more energy debating QuackGuru's prefered "simple-yet-inaccurate" wording, unless others want to file an RfC/A. [59] I know very well that it looks tendentious and POV-pushy for me, as an acupuncturist, to argue against anything critical of acupuncture -- after all, even if it's technically inaccurate, it's consistent with Ernst's prediction that "Adequately controlling for nonspecific effects in future is likely to demonstrate that acupuncture has no or few specific effects on pain". (And of course we could just cite that, but that's not good enough for the page's owner.[60][61])

So be aware of what is happening. We have a dubious mainspace portrayal of an Ernst review and a completely ridiculous talkspace assertion about good RCT's [62] for the sole purpose of supporting that mainspace edit. When a "skeptic" editor resorts to outright deception on order to push wording that is as critical as possible of an alt-med, is that good for the project? Maybe as long as we get the right answer. But we also saw this same editor wanting to use a non-MEDRS-compliant sources to get his desired wording. So no, we're not necessarily getting the right answers at all.

And yes I know this is a stupid dispute, and am going to take a break. --Middle 8 (contribs • COI) 07:41, 27 October 2014 (UTC)

It was you who continued this dispute when you deleted the text back in July and now that the text is not complex you want it gone from the lede. The 2011 source mentioned the randomized controlled trials but the review itself came to their own specific conclusion. QuackGuru (talk) 08:15, 27 October 2014 (UTC)

Middle 8, I agree with you wholeheartedly so I wouldn't mind filing the RfC/A for this, and frankly, for other issues as well (like repeated removal of justified POV tags). I'm not an acupuncturist so I don't have the supposed COI you do, but I am still fairly new and haven't ever done this before. Would someone be willing to help assist me in this? LesVegas (talk) 17:42, 5 November 2014 (UTC)

The policy and guidelines for placing your favourite POV tags are clear, which is the reason they get removed when you place them. -Roxy the dog™ (resonate) 18:59, 5 November 2014 (UTC)

LesVegas, have you seen Talk:Acupuncture#Outstanding issues already? As the name says, there's an extensive summary of the outstanding issues in the article. Cheers! Jayaguru-Shishya (talk) 20:14, 5 November 2014 (UTC)

Yes, I sure have but never considered it to construct an RfC. Excellent idea! Thanks! LesVegas (talk) 06:22, 11 November 2014 (UTC)

Low impact factor journal

The impact factor is O.59[63] according to ResearchGate.

I'd rather delete the fringe journal because we have better sources such as a 2013 Cochrane review in the same section. We should review each journal on a case by case basis. Sometimes fringe journals can fill in the blankets for mundane claims but I think it is unnecessary to include this one. Thoughts? QuackGuru (talk) 18:33, 29 October 2014 (UTC)

QuackGuru, first, I want to commend you for not making a POV edit here. Thank you, thank you, thank you. I know you really don't like or believe in acupuncture so it is refreshing to see you propose deletion of an anti-acupuncture review for the sake of the article's quality, and again, I'm happy to see this behavior. But back to your question. Overall, it seems to me there is a great deal of information that is left out of the article. We need more studies, from everywhere, not less. I think this article needs to be expanded a great deal to include more studies from everywhere and on every topic. There is a rich amount of data we still need to mine. Then I think once we have a robust amount of data on the article, at that point, we trim. For now, impact factor should be a factor in placement, absolutely, but we shouldn't delete anything reliably sourced. Is the journal peer reviewed? LesVegas (talk) 17:32, 5 November 2014 (UTC)

This article should focus on acupuncture and the suggestion to include "more studies" would not meet the higher bar of WP:MEDRS. Recent reviews are most appropriate.

If we allow this low-quality source to stay we would allow over a hundred other low-quality sources to flood the article. There is already "a robust amount of data" in this article. QuackGuru (talk) 19:38, 5 November 2014 (UTC)

QuackGuru, since you're really intent on removing this, fine, that's ok with me. We do have that Cochrane info so I won't fight you on this. But as a general rule, MEDRS doesn't say anything about impact factor. We have to make sure the sources aren't primary, are from peer reviewed journals, are recent (unless there's nothing newer on the subject) but impact factor has no bearing on a source being used or not. Yes, we don't want such sources in the lede, perhaps, and not more prominent than high impact factor sources. But reliable sources should always be allowed! and it's problematic if they're ever removed for any reason. LesVegas (talk) 06:11, 11 November 2014 (UTC)

For the record, I believe that QG is the last person that needs a condescending lecture like that !! -Roxy the dog™ (resonate) 06:16, 11 November 2014 (UTC)

Actually, QG has continually removed many reliable sources I and others have added. I will lecture him, and if the behavior continues, I will report him. LesVegas (talk) 06:27, 11 November 2014 (UTC)

Haha, good luck with that, but watch out for the boomerang catching you on the back of the neck. -Roxy the dog™ (resonate) 19:36, 11 November 2014 (UTC)

This has already been discussed earlier. As Roxy the dog™ said herself: "I don't believe there is a hard and fast rule on impact factor". User Brangifer supported this interpretation: "Correct. There isn't any. There can be many situations where it's not a factor, but in some it might be a decisive one.". I am more than happy to restore sources that have been removed solely on the basis of impact factor when no better reason exists. Please bring to my attention if such cases do exist. Jayaguru-Shishya (talk) 20:04, 11 November 2014 (UTC)

Note. MEDRS asks for independent sources. See Wikipedia:Identifying reliable sources (medicine)#Use independent sources. QuackGuru (talk) 20:37, 11 November 2014 (UTC)

Plos One

I thought there was consensus that Plos One is not per se a reliable source, is never a WP:MEDRS, and should only be used if all the authors are experts in appropriate fields. I could be wrong, though. — Arthur Rubin (talk) 20:20, 8 November 2014 (UTC)

Unlike the reference in the section above, I don't think it has negative reliability, just little positive reliability. — Arthur Rubin (talk) 20:22, 8 November 2014 (UTC)

I don't remember any specific discussion whether Plos One is reliable. This source (PMID 24349293) was recently added. QuackGuru (talk) 20:30, 8 November 2014 (UTC)

Think the OP would be better off asking this on the Talk:PLOS ONE. I can't recall any mention on WP or anywhere else, that questions PLOS's reliability. The section about is titled low Low Impact factor but this has nothing to do with WP:MEDRS. PLOS is peer reviewed. However, it does publish a great amount stuff (compared to other journals) that is very little studied. So it is expected that it will have a low impact factor when compared to journals that cherry pick the flavor of the month academic papers. So one must not judge by that metric - alone.--Aspro (talk) 18:45, 9 November 2014 (UTC)

Whether PLOS ONE is a reliable source is completely irrelevant to the article PLOS ONE, so there should be no discussion at Talk:PLOS ONE. WP:RSN may be the appropriate board for discussion, unless there is a specific board for WP:MEDRS questions. In addition, absent evidence to the contrary, the "peer review" in WP:MEDRS should be "traditional" (pre-publication, and probably anonymous) peer review, not the post-publication peer review described for this journal. — Arthur Rubin (talk) 10:38, 11 November 2014 (UTC)

There is no specific discussion of PLOS ONE at WP:RSN; there is a clear consensus that at least two publishers of open-access journals do not have adequate review to be considered reliable, but that is specific to those publishers. PLOS ONE has a different "peer review" model, and, if WP:MEDRS is changed to include non-traditional peer review, it might qualify. — Arthur Rubin (talk) 10:46, 11 November 2014 (UTC)

PLoS Medicine is specifically listed as a "high-quality journal" in WP:MEDRS (although, oddly enough, not specifically stated to be "reliable"); if that represents consensus, I'm tempted to withdraw this comment, until consensus can be confirmed at WT:MEDRS. — Arthur Rubin (talk) 10:52, 11 November 2014 (UTC)

The point about first questioning this at Talk:PLOS ONE is that along the same lines as "given enough eyeballs, all bugs are shallow". It is the first logical step before escalating. Second: PLOS (as far as I can see) does employ "traditional peer review". So, therefore, et cetera, et cetera, WP:MEDRS does not need updating. The difference to other journals perhaps, is that PLOS rely on post publication discussions to decide the importance, rather than leaving it to the foibles of their own editorial team. Did you base your question on the ramblings of a malfarius yellow journalist critic or internet blogger? Guard against letting the tail wag the dog.--Aspro (talk) 14:08, 12 November 2014 (UTC)

Plos One favors quantity (and free access) over quality. It is how itself defines its business model. That should be a red flag. Tgeorgescu (talk) 11:05, 11 November 2014 (UTC)

Your quote:Plos One favors quantity (and free access) over quality. By what evidence do you suggest this? This is like a logical fallacy. A supermarket may have thousands on lines on their shelves but does this mean quantity of their fair are of a lesser quality from the corner shop that 'specializes' on just a few basic items? So much for you red flag!--Aspro (talk) 14:11, 12 November 2014 (UTC)

From the horse's mouth: http://blogs.plos.org/everyone/2012/12/13/plos-one-launches-a-new-peer-review-form/ Tgeorgescu (talk) 00:16, 13 November 2014 (UTC)

I'm curious, if Plos One is unreliable as some suggest, what about Plos Medicine? Same open access, same registration fees, peer review, etc. Is Plos anything unreliable? LesVegas (talk) 00:35, 14 November 2014 (UTC)

I don't know about that, but Plos One stated that its own peer review process is shallow. Tgeorgescu (talk) 02:21, 14 November 2014 (UTC)

I read your link and didn't see Plos One directly state what you claimed, but rather describe the fact that their review process doesn't include the step where literature that does not make a significant advance is editorially rejected. To me, this doesn't create shallow content, and in fact, is a solid check on the centralization of scientific research. Excellent research comes out of this publication. In fact, several nobel laureates have research published in it. But listen, I get it. I understand the need for quality publications in the article here. If I had it my way, we would get rid of any research that does not meet STRICTA/CONSORT reporting standards. But MEDRS says nothing about reporting quality, so I can't justifiably hold that rubric to this article. Likewise, Plos One meets all the requirements Medrs suggests. It's peer reviewed and while their process is different than some other journals, they do have a process. I don't see any reason this journal should be excluded. And earlier, you said there was consensus about it. But clearly, since I'm protesting along with a few others, there isn't consensus. LesVegas (talk) 20:04, 14 November 2014 (UTC)

It's highly respected in many fields and has a solid impact factor of around 3.1, which I think would easily put it in the top 25% of journals. TimidGuy (talk) 11:51, 11 November 2014 (UTC)

Note. MEDRS requires using independent sources. Cheong KB, Zhang JP, Huang Y, and Zhang ZJ are alternative medicine advocates (PMID 24349293). See Wikipedia:Identifying reliable sources (medicine)#Use independent sources. QuackGuru (talk) 20:41, 11 November 2014 (UTC)

They may be advocates, I don't know for certain, you would probably be more of an expert there than I would. But if independence is of strict concern, then you would have to remove anything by Ernst since he's an avowed opponent of alternative medicine. When it comes to something like acupuncture, there's always going to be parties that aren't completely neutral or may have stated their opinion at one time or another. My philosophy is pretty libertarian and I'd like the article to encompass everything, not in favor of one side or the other, and have as much rich data as possible. Placement and weight can be debated, but inclusion/exclusion not so much, at least not if we are to follow policies here. LesVegas (talk) 01:14, 12 November 2014 (UTC)

"Many medical claims lack reliable research about the efficacy and safety of proposed treatments or about the legitimacy of statements made by proponents." Statements made by proponents are not independent. See Wikipedia:Identifying reliable sources (medicine)#Use independent sources. QuackGuru (talk) 02:10, 12 November 2014 (UTC)

Sure, we could argue about that forever. Fact is researchers always have opinions, deep down, whether they admit to these or not. What matters is, are they following the scientific method? Are the sources reputable, peer-reviewed, secondary, etc? Yes, yes, and yes. But at the end of the day, we have to remember MEDRS is not the law of the land but is just a guideline. NPOV is law of the land, and here is what it has to say:

"Neutral point of view should be achieved by balancing the bias in sources based on the weight of the opinion in reliable sources and not by excluding sources that do not conform to the writer's point of view." LesVegas (talk) 00:14, 14 November 2014 (UTC)

I don't completely agree with anyone else here.
Discussion of whether PLOS ONE is reliable should not be at Talk:PLOS ONE, per WP:TPG. Discussion or whether PLOS ONE is really peer-reviewed might be there, but it would not necessarily relate to our use of "peer-reviewed".
I agree that, even in WP:MEDRS, we may use clearly biased articles if published in (traditional) peer-reviewed journals, as the review is supposed to remove bias affecting the meaning of the article. However, PLOS ONE is not "peer-reviewed" in the that sense, for two reasons: the the "peers" are self-selected, and the reviewers are not supposed to judge whether the result is "interesting", which is how extreme bias is removed in traditional review. The review occurring after publication is irrelevant.
On the other hand, QG is wrong as to the meaning of "independent". If the journal were peer-reviewed, then the articles would be considered "independent" even if written by proponents, because the editors or reviewers would be independent. On the other hand, if not, then QG would be correct in regard WP:MEDRS guidelines. (I thought that WP:SPS had restrictions on using experts' self-published comments on their own work. Apparently, I was mistaken.) — Arthur Rubin (talk) 03:49, 17 November 2014 (UTC)

Arthur, thank you for your interesting points. I do agree that self-selection of peers might be problematic, but since I'm not an expert on scientific journals (and probably most of us here are not) I do think this topic would probably be better discussed somewhere else. I also agree with you that Plos:One talk is not the place to do this, though. But since Plos One articles are cited widely across Wikipedia, perhaps a policy or guideline talk page would be better? MEDRS talk maybe? It would be nice if MEDRS was more specific about peer-review. As it stands, there is no truly clear criteria for what is acceptable peer review and what is not. If you take this up there, please let me know, as I would love to be part of that discussion. I have particularly strong opinions on editors squashing research because the results aren't "interesting," and would love to be part of any discussion that brings this up specifically. LesVegas (talk) 17:39, 17 November 2014 (UTC)

I don't know if that's the basis. I've rarely seen papers which are so biased as to be misleading actually published, and I assume that the reason a reviewer would state for rejection is that the authors' statements of their own views is not "interesting", as the claim that they are "inaccurate" would be false. I know that, in the few instances that I was selected as a peer-reviewer, I would have rejected such a paper, even if it was not in the publication guidelines. Other more current peer-reviewers would have to comment as to the reason the reviewer would give, but "so biased as to be misleading" is not commented on by any of the published Plos One reviewing guidelines. Probably WP:RSN would be the appropriate place for initial discussion, as there doesn't seem to be a WP:MEDRSN; although WT:MEDRS might also be appropriate for the general question of the definition of "peer-review" for the purpose of WP:MEDRS. My wife's injury last Saturday is more severe than I had previously thought, so I may not have time to bring this up. — Arthur Rubin (talk) 23:27, 18 November 2014 (UTC)

As someone who has a passing familiarity with PLOS - PLOS One is peer-reviewed only for "technical" issues, so they ensure that e.g. the reported results support the conclusion, but they do not evaluate e.g. whether the conclusions are scientifically important. (The post-publication discussion isn't a peer review.) It has some good papers, especially because a few well-known scientists publish exclusively in PLOS One based on principle, but overall article quality can vary a lot. The other PLOS journals, like PLOS Medicine, employ traditional peer review. Sunrise (talk) 06:56, 20 November 2014 (UTC)

Old reference

Hello all! I added a review article from 2011 which compared acupuncture meridians and fascial networks. I rearranged the citation below it for now, which is Ernst 2008. However, it says, "no research has established any consistent anatomical structure or function for either acupuncture points or meridians" which is outdated now, particularly since a 2011 review did just that. But before deleting the old 2008 information, I figured I would bring it to the talk page first. Any objections? LesVegas (talk) 18:07, 11 December 2014 (UTC)

Yes. 2008 is not old compared to 2011. QuackGuru (talk) 18:17, 11 December 2014 (UTC)

4 years is awhile in any emerging science, but yes, I understand that in comparison it's not too bad. However, 2008 is beyond the parameters of the 5 year window which MEDRS recommends, and we have agreed that citations which get outdated based on newer research ought to be removed. That 2008 citation is now nearly 7 years old, which doesn't make it un-usable on that count alone, but since it is clearly in conflict with the more recent research I can't see that it passes the reliability test any longer. MEDRS seems pretty clear that we should remove citations like this. Is there anything else I am missing?LesVegas (talk) 18:57, 11 December 2014 (UTC)

Your using a poor source to argue against a more reliable source. The refs are 3 years apart. QuackGuru (talk) 19:26, 11 December 2014 (UTC)

The journal has a decent impact factor, it's respected in its field, peer-reviewed and the 2008 citation isn't a journal at al, but a book making a dated claim instead. I don't see where you can possibly argue that one source is poor and the other is reliable. According to MEDRS, part of reliability is whether something is dated or not. A book, making a bold claim that is now inconsistent with more modern research, is not reliable any longer. At one time, perhaps, but not in December 2014. LesVegas (talk) 19:41, 11 December 2014 (UTC)

Remember, you wanted the fringe journal in the article. What you wrote was inconsistent with the source. Now the text says "They found that the anatomical basis for the notion of acupuncture points and meridians in TCM has not been determined.[223]" QuackGuru (talk) 19:47, 11 December 2014 (UTC)

An impact factor of 2.175 is significant. It is higher than many anatomy and physiology journals. -A1candidate (talk) 20:06, 11 December 2014 (UTC)

The source does not contradict the 2008 source. The text was misleading. I went ahead and fixed it. QuackGuru (talk) 20:14, 11 December 2014 (UTC)

"In this paper, a convergence of evidence from various fields related to fascial anatomy and physiology were reviewed and considered with respect to the possibility that the fascia might be the physical substrate referred to as the meridian system in TCM." I fixed the orginal research. I also fix the misleading text by adding a quote instead: They found that "the basis of the nature and material of acupuncture points and meridians has not been resolved."[64] QuackGuru (talk) 20:14, 11 December 2014 (UTC)

Which the text does not 'conclude. The first line quotes that "it has not been resolved" clearly referencing all the old data, such as the very 2008 source we are talking about. Then they go on to show correlations between meridians and fascia. If Galileo says "The debate about a geocentric universe hasn't been resolved," and then goes on to show his strong argument that Earth revolves around the sun, you can't then say "But Galileo found that the basis for a heliocentric universe hasn't been resolved," as though this were his conclusion. You are clearly taking this out of context. LesVegas (talk) 20:21, 11 December 2014 (UTC)

I quoted the source correctly. I did not quote the first line from the abstract. QuackGuru (talk) 20:26, 11 December 2014 (UTC)

No, that is essentially what the first line of the abstract says. Do you think you're quoting from somewhere else, or are you just not hearing me? LesVegas (talk) 20:33, 11 December 2014 (UTC)

Further, exactly how is the statement, "They found that the human fascial system could be the anatomical basis of acupuncture points and meridians in TCM" original research, when the friggin title of the article is "Review of Evidence Suggesting That the Fascia Network Could Be the Anatomical Basis for Acupoints and Meridians in the Human Body" and the conclusion finds just that, that there is a correlation and fascia may very well be the material basis? LesVegas (talk) 20:38, 11 December 2014 (UTC)

You could not verify the text but I did. See "..., the basis of the nature and material of acupuncture points and meridians has not been resolved."[65] This is not from the abstract. The source said it "...considered with respect to the possibility that the fascia might be the physical substrate referred to as the meridian system in TCM."[66] QuackGuru (talk) 20:46, 11 December 2014 (UTC)

QuackGuru, it is the first line from the abstract! It is again quoted in the introduction in this context, "Although scientific interest in the validity of meridians and acupoints has been growing in the last decade, the basis of the nature and material of acupuncture points and meridians has not been resolved." Please note it is in the abstract and introduction and note the context with which it is used. My point is that you are quoting it as a conclusion.Are you still not hearing me? The title of the article is "Review of Evidence Suggesting That the Fascia Network Could Be the Anatomical Basis for Acupoints and Meridians in the Human Body." The article then quotes, "The VCH and living body imaging studies together indicate that the anatomy of the fascial network in the human body is consistent with the traditional view of the meridian network pattern." LesVegas (talk) 21:07, 11 December 2014 (UTC)

https://www.ncbi.nlm.nih.gov/pubmed/21584283 The abstract does not have that quote. That quote is from the full text and they stated it is not resolved. As for the other text, your quoting part of the context. Read what they wrote at the beginning of the same paragraph what they said under 3. Discussion: "...considered with respect to the possibility..."[67] QuackGuru (talk) 21:17, 11 December 2014 (UTC)

Here is the abstract, in full:

Abstract

The anatomical basis for the concept of meridians in traditional Chinese medicine (TCM) has not been resolved. This paper reviews the evidence supporting a relationship between acupuncture points/meridians and fascia. The reviewed evidence supports the view that the human body's fascia network may be the physical substrate represented by the meridians of TCM. Specifically, this hypothesis is supported by anatomical observations of body scan data demonstrating that the fascia network resembles the theoretical meridian system in salient ways, as well as physiological, histological, and clinical observations. This view represents a theoretical basis and means for applying modern biomedical research to examining TCM principles and therapies, and it favors a holistic approach to diagnosis and treatment.

LesVegas (talk) 21:25, 11 December 2014 (UTC)

The other text, in full is here:

In this paper, a convergence of evidence from various fields related to fascial anatomy and physiology were reviewed and considered with respect to the possibility that the fascia might be the physical substrate referred to as the meridian system in TCM. The anatomy of the fascial network in the human body, as demonstrated through VCH and living body imaging studies, is consistent with the traditional view of the meridian network pattern, and the efficacy of acupuncture has been shown to rely on interactions with the fascia. Additionally, it appears that the fasciae mediate an active mechanical transference role as they provide dynamic connections between and among the muscles and bones. Moreover, the phenomenon of neurogenic inflammation triggered by stimulation of nociceptive receptors in fascial tissues is consistent with the notion that disruption of fascial physiology can have notable consequences on human health. Indeed, it is our view that neurogenic inflammation in fasciae may constitute a form of disruption of meridian energy flow in TCM.

What is out-of-context here? Please show me. LesVegas (talk) 21:29, 11 December 2014 (UTC)

Wow, let us everyone cool down guys. There is no original research, and we can replace the outdated 2008 source with a more recent 2011 one. I just restored a more stable version of the article[68], but I couldn't help wondering if we needed to go even further back to a better version? After all, many of the recent edits are rather questionable, and don't really justify altering the improvements made earlier. Cheers! Jayaguru-Shishya (talk) 21:55, 11 December 2014 (UTC)

LesVegas was kind enough to alert me on my talk page that I had removed the Bai, et al content. I wasn't aware this had been discussed in this thread, so I'll explain why I removed it. Here is what I removed:

• Despite scientific debate in the validity of meridians and acupoints has been increasing, the premise for the idea of acupuncture points and meridians in TCM has not been determined. A 2011 review, representing a theoretical basis, noted that the human fascial network is consistent with the ancient view of the meridian network pattern, and may be the anatomical basis for acupoints and meridians within the human body. Further, it noted that the efficacy of acupuncture has been observed to depend on interactions with the fascia. It noted that reconstructions of the fascial connective tissues in the body show line-like structures, similar to those of acupoints and meridians/collaterals.Additionally, these fascial strings form a network of lines that are close to the virtual meridians in anatomical location.

My edit summary should be self-explanatory: "rmv content from one source which is not a true "review" of the literature. It's one primary source and speculation, and it violates MEDRS rather grossly.".

What likely fooled people is that the title uses the word "review", but it's not a literature review at all. It's a primary source opinion piece, filled with speculation and "if"-type qualifiers. It's also a lot of content using just one source, a source which doesn't begin to meet our MEDRS standards. If anyone still questions the wisdom of my removal, let's discuss it here, and please ping me. Thanks. -- Brangifer (talk) 04:04, 18 December 2014 (UTC)

Hi BullRangifer, thanks very much for your thoughtful comments. I noticed the speculation and if type qualifiers as well, and when I originally posted it, like this it was consistent with the "discussion" section at the end of the piece. While they did state that the human fascial network "is consistent" with the ancient view of the meridian system, they certainly do use a lot of "may's" and "could be's". But in my original edit, I wanted it to be very consistent with the spirit of the source. That edit took on several incarnations which I did not approve of and made it known. I'm not sure if those indicators were still present, and probably were not, by the time you altered it, so your revert was probably well justified on those grounds (I dunno, I'll have to go back and check.) Now, one area where I'm afraid that I must disagree is that it is a primary source. In the section on "characteristics of secondary sources" it meets these as it's built from several primary sources, it provides commentary, analysis, interpretation, etc on them, etc. While it's not a systematic review, it is a review, and certainly not primary. MEDRS would classify it as a narrative review, or a literature review, opposed to the systematic reviews we usually see used. But MEDRS does allow for these types of reviews to be used. Actually, MEDRS does even allow for primary studies to be used, but only until secondary sources come about later, if I'm reading it correctly. Anyway, if I'm incorrect in any of this, by all means let me know. LesVegas (talk) 00:30, 19 December 2014 (UTC)

TCM is largely pseudoscience according to the source presented

Getting back to the NPOV version. Misleading text was restored. This edit replaced sourced text with OR. QuackGuru (talk) 22:11, 11 December 2014 (UTC)

It was summarized, but now I quoted it nearly verbatim because you continue to object and call any degree of summarization OR. LesVegas (talk) 23:58, 11 December 2014 (UTC)

The text you added was about the imaging. It was not the evidence. QuackGuru (talk) 00:46, 13 December 2014 (UTC)

This is getting out of hand at this point. QuackGuru (talk) 23:49, 11 December 2014 (UTC)

What has gotten out of hand is outrageously ridiculous POV edits like this everywhere in the article. We don't engage in disputes using Wikipedia's voice. It violates at least three policies in NPOV, and I quoted all of these in the edit summary. Nowhere in the article should statements like this exist, least not in the lede. LesVegas (talk) 23:58, 11 December 2014 (UTC)

Lets get back on track to the last NPOV version here where the text was neutrally written and used a quote form the source. QuackGuru (talk) 00:07, 12 December 2014 (UTC)

Oppose - This is about acupuncture itself, not about TCM. -A1candidate (talk) 00:09, 12 December 2014 (UTC)

On the contrary. Are you saying support when you can't provide a rationale explanation? For example, the sentence is about TCM not acupuncture. QuackGuru (talk) 00:13, 12 December 2014 (UTC)

There is nothing irrational about making sure that acupuncture, not TCM, is discussed in the lede of acupuncture. -A1candidate (talk) 00:15, 12 December 2014 (UTC)

Let me remind you that acupuncture is often accompanied by using TCM. According to your edit summary you thought the sentence was about acupuncture. QuackGuru (talk) 00:22, 12 December 2014 (UTC)

That will only merit a discussion in the lede if acupuncture had no valid mechanism of action, but it does have. -A1candidate (talk) 00:26, 12 December 2014 (UTC)

The sentence was about TCM not acupuncture. QuackGuru (talk) 00:31, 12 December 2014 (UTC)

Acupuncture has a valid mechanism of action. It's misleading to imply otherwise. -A1candidate (talk) 00:35, 12 December 2014 (UTC)

Do you understand the sentence you deleted is specifically about TCM? QuackGuru (talk) 00:38, 12 December 2014 (UTC)

Yes, it's a misleading statement and it doesn't belong there. -A1candidate (talk) 00:40, 12 December 2014 (UTC)

It is misleading, it is written in Wikipedia's voice, and is not attributed to the author. Further, it is misleading since it takes sides. Wikipedia doesn't engage in disputes, it describes them only. The statement that TCM is pseudoscience is disputed in many places. That one statement violates multiple aspects of NPOV. Just as a refresher, here's just one of the violations from the NPOV policy page:

1) Avoid stating seriously contested assertions as facts. If different reliable sources make conflicting assertions about a matter, treat these assertions as opinions rather than facts, and do not present them as direct statements.

2) An article should not give undue weight to any aspects of the subject but should strive to treat each aspect with a weight appropriate to the weight of that aspect in the body of reliable sources on the subject.

3) Wikipedia describes disputes. Wikipedia does not engage in disputes. A neutral characterization of disputes requires presenting viewpoints with a consistently impartial tone; otherwise articles end up as partisan commentaries even while presenting all relevant points of view. Even where a topic is presented in terms of facts rather than opinions, inappropriate tone can be introduced through the way in which facts are selected, presented, or organized. Neutral articles are written with a tone that provides an unbiased, accurate, and proportionate representation of all positions included in the article.

4) The tone of Wikipedia articles should be impartial, neither endorsing nor rejecting a particular point of view. Try not to quote directly from participants engaged in a heated dispute; instead, summarize and present the arguments in an impartial tone.

5) Biased statements of opinion can be presented only with attribution. For instance, "John Doe is the best baseball player" expresses an opinion and cannot be asserted in Wikipedia as if it were a fact.

And further, as A1Candidate said, it's irrelevant because it deals with TCM and this page is acupuncture. While the two are related, broader topics shouldn't be in the lede, least not when they violate multiple NPOV policies. LesVegas (talk) 01:18, 12 December 2014 (UTC)

The article is about acupuncture, not traditional Chinese medicine. Insertions about TCM should be placed to traditional Chinese medicine, and insertions about acupuncture should be kept here at acupuncture. Jayaguru-Shishya (talk) 19:55, 12 December 2014 (UTC)

Acupuncture is often used with TCM. It is largely and no serious dispute exists. QuackGuru (talk) 00:46, 13 December 2014 (UTC)

Copyvio?[69][70] QuackGuru (talk) 00:46, 13 December 2014 (UTC)

Quackguru, first of all, it is not pertinent to talk about TCM in an acupuncture lede. It is too broad of a subject. Even still, that statement does not belong in the TCM article. It violates all 5 of the aspects of NPOV I mentioned above. It is a clear violation of NPOV. We do not state seriously contested assertions as facts in Wikipedia's voice, period. We do not take one side on an issue. To say TCM is pseudoscience just because some POV editor here dug up a citation saying those words, is wrong on many counts. BLP issues aside, we cannot say "Bill Cosby is the most prolific rapist of all time" citing Howard Stern's radio broadcast, using Wikipedia's voice. We cannot say "Bill Clinton is a criminal" and cite Rush Limbaugh. There's many, many problems with that.

As for this copyvio accusation, let me remind you you accused me of taking something out-of-context. You also said you weren't quoting directly from the abstract. So that's when I posted the context and posted the abstract, to show everyone else the truth. Now you want to accuse me of a copyvio?? Why do you always insist on turning everything into a battleground? LesVegas (talk) 04:11, 13 December 2014 (UTC)

So this statment belongs to traditional Chinese medicine, not acupuncture. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

No, LesVegas, TCM is obvious pseudoscience. The violation of policy would be to portray TCM as having any merit.—Kww(talk) 04:36, 13 December 2014 (UTC)

Some forms of TCM have a valid mechanism, such as acupuncture. -A1candidate (talk) 08:48, 13 December 2014 (UTC)

This question have popped up every now and then. I agree with Kww to the extent that we should have extreme caution with any claims of medical efficiency of TCM. However, TCM predates what we call as "science" by thousands of years, so personally I find it pretty hard to see how it could possibly be "pseudoscience". Anyway, this is getting a bit off-topic now since this is Talk:Acupuncture, not Talk:TCM. Cheers. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

Really? And what would that be? Yes, the body can sense and react to getting poked by a needle. There is nothing unusual about that. It's the speculative connection between a needle and nonexistent acupoints and meridians, and then claims of healing, that's where the problem lies. For it to then be useful, one needs consistency, predictability, reliability, reproducibility, and objectively verifiable results which are clear to everyone, including nonbelievers. Acupuncture fails miserably on all counts. -- Brangifer (talk) 08:56, 13 December 2014 (UTC)

It's not speculative. Read the article carefully. -A1candidate (talk) 09:06, 13 December 2014 (UTC)

You are confusing two things, A1candidate. Do some of the things that TCM advocates work? Certainly. Does TCM provide any sound explanation for this? No, because TCM is a pseudoscience based on false principles. Not all conclusions derived from false principles are necessarily false: even a stopped clock is right twice a day.—Kww(talk) 15:46, 13 December 2014 (UTC)

You've acknowledged that some forms of TCM (such as acupuncture) works. We should provide the scientific explanation instead of debunking TCM. -A1candidate (talk) 16:18, 13 December 2014 (UTC)

That would appear to be an intentional misreading, so I will say it in a less polite form, A1candidate: each and every explanation provided by TCM is false. It is pseudoscientific to its core, and any effort to portray it as having merit goes against the policies set down by the pseudoscience arbitration decisions. Do not continue to attempt to portray TCM as having validity: it has none. That's a completely different thing from saying that each and every item used in TCM is harmful or fruitless: if someone believed that penicillin works by scaring demons away, he's completely wrong, but that doesn't keep the penicillin from working.—Kww(talk) 16:26, 13 December 2014 (UTC)

TCM may or may not have validity, but acupuncture certainly has. -A1candidate (talk) 16:30, 13 December 2014 (UTC)

I am not sure if I understood this correctly, but whenever we are dealing with claims on medical efficiency, we strictly follow MEDRS. So if there is a reliable MEDRS compliant source that has to offer some positive results, then we can use it. We can't, however, categorially exclude any such sources. And this works in both directions. Probably most of the MEDRS compliant sources report that TCM isn't effective, so if we just follow MEDRS, it will represent the reality as it is.

"...if someone believed that penicillin works by scaring demons away, he's completely wrong, but that doesn't keep the penicillin from working." Heh, well put... but it doesn't prevent us from reporting that penicillin per se does posses beneficial medical properties. If there is a peculiar tradition that indeed believes that penicillin scares demons away, we can report that as the very belief of that tradition, but we have to strictly separate that from the facts concerning the medical efficiency. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

I'll grant that it has enough appearance of validity that people study it, but that doesn't mean that your any of your comments related to the TCM discussion have much merit. The sentence you insist on removing is about the TCM foundation of acupuncture. Acupuncture has its foundation in TCM: that's indisputable. Even if it happens to work in some limited fashion for some limited set of cases, there's no scientific consensus that it does, and no scientific consensus as to what the mechanism would be. You keep arguing "endorphins", but that's a hypothetical explanation supported by an extremely small group of studies.—Kww(talk) 16:44, 13 December 2014 (UTC)

Claiming that TCM is pseudoscience, therefore acupuncture is also pseudoscience because it is based on TCM, is a violation of WP:ORIGINALSYN. Please read WP:OR carefully. -A1candidate (talk) 16:55, 13 December 2014 (UTC)

If the article would say that "Acupuncture has its roots in traditional chinese medicine", going on about TCM would be reasonable. At the moment, the article just suddenly jumps into TCM, even the article indeed is about acupuncutre. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

If the article would say that "Acupuncture has its roots in traditional Chinese medicine", going on about TCM would be reasonable. At the moment, the article just suddenly jumps into TCM, even the article is indeed about acupuncture. The question about "being a pseudoscience", though, is highly controversial for obvious reasons. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

Oh, I have, A1candidate. I'm not in violation in any way, nor is accurately pointing out acupuncture's foundation a violation. You, on the other hand, are apparently attempting to disrupt this article in an effort to promote acupuncture.—Kww(talk) 17:15, 13 December 2014 (UTC)

The source is about TCM, not acupuncture. -A1candidate (talk) 17:17, 13 December 2014 (UTC)

And the sentence you are continuously deleting discusses TCM. If your contention is that we cannot mention the origins of acupuncture in an article about acupuncture, that's clearly a non-starter of an argument.—Kww(talk) 17:32, 13 December 2014 (UTC)

It may be okay to discuss related issues in the main body, but not in the lede. -A1candidate (talk) 17:38, 13 December 2014 (UTC)

A1candidate has got it right here: the source doesn't even discuss acupuncture. It might indeed be that acupuncture has its roots in TCM, and I find it perfectly reasonable to mention that in the article. The article is about acupuncture though, so I find it a bit absurd that we insert claims about TCM using sources about TCM. It's like adding to chemistry out of the blue that "Alchemy is pseudoscience". Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

That certainly appears to be an arbitrary fiat without a foundation in policy or logic.—Kww(talk) 17:49, 13 December 2014 (UTC)

Wikipedia is an encyclopedia, not a place to debunk pseudoscience. We consider the needs of the reader first and foremost. -A1candidate (talk) 17:54, 13 December 2014 (UTC)

That's certainly true. Why wouldn't the reader of an article on acupuncture need to know about its foundations?—Kww(talk) 18:34, 13 December 2014 (UTC)

Because we place more emphasis on actual scientific mechanisms and less on mythological interpretations. To quote AndyTheGrump at the Aryuveda article: "The (pseudoscience) label cannot be misapplied retroactively. It is impossible to be practice pseudoscience in a pre-scientific era, and accordingly one cannot describe an entire subject spanning well over two thousand years as such. Pseudoscience can only exist once there is a real science for it to imitate.". -A1candidate (talk) 18:40, 13 December 2014 (UTC)

Treating people with Ayurveda in the 21st century is pseudoscience, because there is science-based medicine, which has removed the need for such bogus, superstitious treatments. Besides, there are purported scientific mechanisms for acupuncture, there is no scientific consensus that acupuncture would be based upon some scientific mechanism, nor which scientific mechanism would that be. Tgeorgescu (talk) 22:23, 13 December 2014 (UTC)

If it doesn't imitate science, it won't matter which century you're referring to. -A1candidate (talk) 23:54, 13 December 2014 (UTC)

Wasn't this discussed just recently at Talk:Ayurveda? Correct me if I'm wrong, but wasn't the outcome that Ayurveda is not pseudoscience (for the very obvious reason that it pre-dates what we call "science"). Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

Pretending to effectively treat people is a medical claim, and in the 21st century medicine is a science, so all medical treatments based upon ancient superstition are pseudoscience, unless they are scientifically shown to be effective. Tgeorgescu (talk) 00:43, 14 December 2014 (UTC)

In the 21st century Ayurveda is bereaving people of evidence-based treatment, so it is an alternative which is opposed to science. When there was no such thing as modern science, obviously there was no such thing as "alternative opposed to modern science". Tgeorgescu (talk) 00:49, 14 December 2014 (UTC)

The term "pseudoscience" has a definition of its own, and I don't think this is one of them. I understand where you are getting at Tgeorgescu, but we shouldn't use the term "pseudoscience" loosely. We are discussing the medical efficiency of Acupuncture / TCM largely in the articles, and the reality makes justice here; both acupuncture and TCM have at most cases provided to be ineffective, and that't what we report in both articles. If there are, however, MEDRS compliant studies that suggest positive results on the efficiency, sure we can report them. If you are afraid that the article will get biased in favour of acupuncture / TCM, you can rest easy: the very reality and MEDRS ensure us that no such bias will be born. Should there be an unreliable source in the article(s)? Remove it. For these two reasons the article will be just fine. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

If there were a consensus that acupuncture was effective, that would be one thing. There's consensus that there's enough reason to investigate effectiveness, but no consensus that it is effective or via what mechanism that it would be effective if it is.—Kww(talk) 00:59, 14 December 2014 (UTC)

There is consensus that it is effective for some conditions (albeit a very limited number) and there is consensus that it involves stimulating the nerves and the release of neurotransmitters. -A1candidate (talk) 09:38, 14 December 2014 (UTC)

More like there are some studies that showed some signs of effectiveness. There's not a general consensus that it is effective.—Kww(talk) 15:24, 14 December 2014 (UTC)

It is effective for some conditions -A1candidate (talk) 15:42, 14 December 2014 (UTC)

A meta-review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias says it all: there's no consensus that it is completely ineffective, but no consensus that it is effective, either.—Kww(talk) 15:46, 14 December 2014 (UTC)

That review is from January 2009. We need to use reviews published within the last five years. -A1candidate (talk) 16:41, 14 December 2014 (UTC)

You have a source that speaks to some massive sea-change in terms of studies? The situation remains much the same: glimmers of hope, signs of effectiveness, but no consensus that it actually is effective or how it would be effective.—Kww(talk) 17:13, 14 December 2014 (UTC)

The old review you cited included 13 trials with 3025 patients, while a newer review includes 29 trials with 17922 patients and concludes that "Acupuncture is effective for the treatment of chronic pain". --A1candidate (talk) 17:57, 14 December 2014 (UTC)

We can follow MEDRS. It'll be just fine. Jayaguru-Shishya (talk) 21:17, 14 December 2014 (UTC)

One study does not create a general consensus. I'll stand by my assessement of these sources: there are studies that indicate effectiveness, there's a consensus among the medical community that there's enough evidence of effectiveness to warrant further study, but there is not, at this point, a general consensus as to it being effective, how it would be effective, or what it would be effective for.—Kww(talk) 13:45, 15 December 2014 (UTC)

A sytematic review is not just "one study" but takes into account many dozens. The consensus is that is is effective for treating chronic pain. You can verify that in most medical textbooks and reference works. -A1candidate (talk) 14:09, 15 December 2014 (UTC)

I know precisely what a systematic review is. It doesn't create a general consensus.—Kww(talk) 14:33, 15 December 2014 (UTC)

The consensus is in medical textbooks -A1candidate (talk) 15:07, 15 December 2014 (UTC)

Kww, what I see are essentially two major issues with this sentence being in the lede.

Issue #1 As A1Candidate says, this article is not about TCM, it is about acupuncture. Some people mistakenly believe the two are somewhat interchangeable, that acupuncture is always part of TCM, but it's not. Acupuncture predates TCM, which is a style based on several different classical lines of thought, mixed in with some Western medicine concepts. In fact, there are dozens of different acupuncture styles: there's family lineage-based styles like Worsley 5 Element style, or Tung style, there's classical styles that were orally transmitted 5,000 years ago and were recorded 2,000ish yrs ago, during the Warring States period. They do not resemble TCM style acupuncture whatsoever. As a matter of fact, in classical-style, the tools used are the "9 needles" one being strikingly similar to a scalpel and was used to drain accesses almost exactly the way they are done now in the West. There's Japanese styles of acupuncture and Korean styles, and they are widely practiced, very popular and do not share any relationship to TCM in philosophy, diagnosis, or method of treatment. So do you see why it is really, really wrong to criticize TCM in the lede on acupuncture? It would be like criticizing Protestantism in the lede on Christianity. Yes, there are plenty of reliable sources that criticize Protestantism, but quoting these sources wouldn't stick for a second on a page like Christianity (unless it was overrun with very zealous Catholics:)

Issue #2 Wikipedia forbids us to state seriously contested assertions as facts. When different reliable sources make conflicting assertions about a matter, we are supposed to treat these assertions as opinions rather than facts, and we are never to present them as direct statements, such as "TCM is largely pseudoscience with no valid mechanism of action for many of its treatments." Just because a source says it, doesn't mean we can use it. NPOV forbids it in this context. Listen, for the record, I do not believe TCM is pseudoscience. I'm not a practitioner, but something of a lay-scholar on Classical Chinese Medicine, with a formal education in Chinese language and cultural history. I receive acupuncture treatments constantly, and have tried many different styles. TCM was the first style I tried, while I was living in China. While, today, I don't have great affection or even much respect for "TCM", I definitely don't believe it's pseudoscience, and there's plenty of sources, in part of whole, that say otherwise. But it's not what I think that matters here. It's Wikipedia's policy. I know of reliable sources that essentially say, "TCM is superior, in many regards, to western medicine and successfully treated many diseases before Western medicine even discovered them". Would I even think about putting a quote like that into the article? After all, the source says it. But it's against policy to use it like that. You're using Wikipedia's voice to say this. You can't do that. Neutral point of view policy is very, very clear on this. LesVegas (talk) 22:53, 14 December 2014 (UTC)

Issue 1 at least is debatable. However, issue 2 is laughable: there's no serious contest to TCM being pseudoscience. As explained multiple times in this discussion, that doesn't mean that every treatment derived from TCM is ineffective, simply that the explanation provided by TCM has no foundation in reality.—Kww(talk) 13:45, 15 December 2014 (UTC)

I explained it in my edit summary the problems with the previous text. This text was about the imaging and was not the summarised evidence. I tagged some MEDRS violations. QuackGuru (talk) 05:23, 14 December 2014 (UTC)

I'm sorry I just now noticed this comment. This whole section is somewhat disorganized, it's difficult to wade through the muck and see responses. I'm glad you see that issue #1 is debatable. To me, issue #2 is still very debatable, especially since this citation is from an article in Nature, representing the opinion of one author and not a large scientific consensus. If there was a large body of scientists who agreed TCM=pseudoscience, then we could quote this consortium in the current manner. But there isn't such a body, that I'm aware of, plus there actually are citations from Chinese government's national medical institutes, which are on par with the NIH or CDC, which always talk very positive about the scientific validity of TCM, and those views are not being expressed in this rather broad statement that's written in Wikipedia's voice. Anyway, since we have at least some common ground here, here's what I propose: I want to make sections on various styles of acupuncture (Japanese, Classical, Family-Lineage based, TCM, etc.) and within the TCM section we can have this comment, but only attributed to its source, Nature, not in Wikipedia's voice. Then, we can add an notable MEDRS-compliant opposing views stating that TCM has scientific validity for balance. I've always wanted to expand the article to include various styles of acupuncture anyway so this accomplishes several tasks. What do you think? LesVegas (talk) 00:49, 19 December 2014 (UTC)

I think you already know that discretionary sanctions apply to the apology of pseudoscience. Don't parse words in order to deny obvious facts. TCM is and will remain pseudoscience, since it appeals to mystical "energies" (in physics there are no energy fields, there are just force fields, which are abstractions). Tgeorgescu (talk) 13:36, 19 December 2014 (UTC)

I think that your goal is to make TCM sound as if it has validity. There's no aspect of TCM that isn't pseudoscience. The Nature review does reflect scientific consensus.—Kww(talk) 13:56, 19 December 2014 (UTC)

There are some aspects of TCM that have some scientific basis such as acupuncture and some forms of herbal medicines. -A1candidate (talk) 14:07, 19 December 2014 (UTC)

Making a quick catch-up with the recent discussion:

1. Appeals to mystical "energies"? Maybe. Pre-dates science? Definitely. With due all respect, Tgeorgescu, I don't quite follow your logic here.
2. Kww, instead of good-for-nothing speculation, I'd like to suggest that all the editors follow MEDRS, so we will avoid the problems. If the reality is that TCM is inefficient, then naturally our MEDRS compliant sources will express that.
3. Reporting the Nature source, we can phrase it as: "According to an editorial in Nature'..." or something like that. It should solve the problem.

Dear fellow editors, I'd like to remind you all that this is Talk:Acupuncture. The right venue to discuss TCM related issues would be at Talk:traditional Chinese medicine. Cheers! Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

Even a broken clock is right twice a day. Tgeorgescu (talk) 14:30, 19 December 2014 (UTC)

TCM is not a household appliance. -A1candidate (talk) 14:34, 19 December 2014 (UTC)

Of course not, it is pseudoscience. -Roxy the dog™ (resonate) 14:42, 19 December 2014 (UTC)

Show me a good review article that makes that conclusion. -A1candidate (talk) 14:45, 19 December 2014 (UTC)

We are going in cycles here, aren't were? Repeating the same comment multiple times doesn't make it any better. Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

I'll ask in good faith, A1candidate: do you have an ESL difficulty that made it difficult for you to understand Tgeorgescu's meaning?—Kww(talk) 14:52, 19 December 2014 (UTC)

No, but I do have low tolerance for people who debate with unsuitable metaphors. -A1candidate (talk) 15:04, 19 December 2014 (UTC)

A1candidate, it's a perfectly suitable metaphor. No one is claiming that TCM is intentionally wrong, or that the people that developed it did so with the intention of creating dangerous and ineffective treatments. As a result, they may have some practices that have some degree of validity. That doesn't mean the theoretical underpinnings have any validity at all.—Kww(talk) 16:09, 19 December 2014 (UTC)

The claim that "all aspects of TCM are pseudoscientific" is not supported by scientific literature. If you disagree, do show me a good review article that says something along that line. -A1candidate (talk) 16:56, 19 December 2014 (UTC)

The burden is on you: show a source for any effective treatment that indicates the theoretical underpinning of TCM provided a valid scientific explanation of the effect. Not a source that says "this particular herb may be effective", but a source that says "this particular herb may be effective, and the TCM theory of five phases/chi/meridians/qi provides an accurate explanation of why it is effective". You won't be able to find anything, because the theoretical foundation of TCM is pseudoscience.—Kww(talk) 19:26, 19 December 2014 (UTC)

Actually, the scientific validation of TCM concepts and therapies is done by government and mainstream health agencies in China, Singapore, Taiwan, Japan, etc. In fact, worldwide, there's much more agreement that TCM isn't pseudoscience than the opposite. I'm afraid that in this matter, as A1Candidate said, you need to show a source strong enough to back up the claim that TCM is definitively pseudoscience. The citation does not support the claim. Essentially, editors here are invoking WP:BLUE, but wrongly. "It's obviously pseudoscience, we don't have to support it with any more than an opinion piece in a magazine." If the claim was so easy to support, there would be no shortage of high quality sources and you wouldn't have to use a magazine article. As it stands, it's OR and doesn't pass the verifiability test. LesVegas (talk) 19:34, 19 December 2014 (UTC)

I am quite disappointed to see that the same arguments keep popping up over and over again. I can hardly see how the theoretical fondation of TCM could be pseudoscientific as TCM pre-dates what we call as "science". However, this article is till about acupuncture, and issues regarding traditional Chinese medicine should be discussed at talk:traditional Chinese medicine. Time to move on ladies and gentlemen? Cheers! Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

As I have suggested, it is more a problem of physics than of medicine: there is no such thing as an energy field. Tgeorgescu (talk) 20:16, 19 December 2014 (UTC)

If you need a source: http://www.csicop.org/si/show/acupuncture_magic_and_make-believe Tgeorgescu (talk) 20:21, 19 December 2014 (UTC)

That's not a scientific source. The magazine is not indexed in scientific databases and it has no impact factor. It's not even owned by a reputable academic publisher -A1candidate (talk) 20:28, 19 December 2014 (UTC)

• Kww, see PMID 24122014 for herbs and PMID 21870056 for acupuncture. -A1candidate (talk) 20:18, 19 December 2014 (UTC)

Unfortunately, I don't see that this source could be used. Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

Tgeorgescu, I understand your point, but that still doesn't substantiate the claim with the source. There's policies being violated here. The only substantiation for the sentence in question is the preconceived notions of a few editors here, and that's no substantiation at all. We have to rely on sources. But, listen, since you've made this an academic debate, on physics, I wouldn't mind adding a brief lesson in Chinese language here and how it relates to your point. The Chinese character for Qi is steam arising from rice. That's the "energy" which "Qi" means. That's the exact same "energy" we use in physics. The whole energy nonsense in TCM is really overblown by a bunch of hippies and European vitalists who are responsible for the misconception. It has no true academic basis in the Chinese language. LesVegas (talk) 20:48, 19 December 2014 (UTC)

Energy is measured in Joules, so how many Joules of Qi does one have? The CSICOP article on acupuncture has been reprinted somewhat differently in Shermer's Encyclopedia of Pseudoscience. And what better sources are there telling us what amounts to pseudoscience? As pointed at User:Jytdog/Why MEDRS?, biology or medical articles don't usually handle pseudoscience or make claims that a treatment would be pseudoscientific. So the only people busy with identifying pseudoscience are debunkers like Shermer. Tgeorgescu (talk) 21:33, 19 December 2014 (UTC)

Debunker websites are not MEDRS compliant sources. -A1candidate (talk) 22:29, 19 December 2014 (UTC)

See WP:REDFLAG. Obviously a society that systematically does what they can to ward of badness will find some remedies that at least help to make people feel better, however the claims about energy and what-have-you are pseudoscience because they are claims about how stuff works that are not supported by sources that are reliable for scientific matters. Per REDFLAG, strong sources are not needed to debunk unreliable claims. Johnuniq (talk) 23:02, 19 December 2014 (UTC)

Agree. Tgeorgescu, I have one simple advice for you: should you make a claim on medical efficiency, please lean to MEDRS compliant source. It will save you a lot of trouble. Cheers! Jayaguru-Shishya (talk) 20:20, 20 December 2014 (UTC)

Tgeorgescu, precisely how much dopamine is secreted in the state of joy? Same language, you're just talking emphasis on quantitative versus qualitative. And listen, Shermer has his opinions as does that author for Nature. Does Shermer represent worldwide scientific consensus? There's standards on Wikipedia, especially when over one half of the world says it's science. REDFLAG certainly doesn't apply if insurance companies reimburse for acupuncture, (and not for gemstone healing or chakra balancing) and it receives favorable mentioning by the NIH and NHS. Not when the scientific validation of TCM concepts and protocols are done in mainstream academia and policy-making health organizations all over Asia. When all you can do is find a couple of little non MEDRS compliant references that think it's pseudoscience, you're on shaky ground. But listen, I'm sure some editors will never be convinced. I suppose we'll have to file an RfC to sort the matter out. LesVegas (talk) 23:19, 19 December 2014 (UTC)

The existence of dopamine convinced organized skeptics. The existence of Qi didn't. There is a way of identifying dopamine, a way of knowing what it is made of, its molecular mass is known, there aren't such things for Qi. Tgeorgescu (talk) 02:56, 20 December 2014 (UTC)

Wikipedia's purpose is to summarize scientific literature. It's not for pushing the POV of "organized skeptics" and other dubious groups. -A1candidate (talk) 09:51, 20 December 2014 (UTC)

Organized skeptics = the scientific community. That's what CUDOS means. Tgeorgescu (talk) 00:20, 21 December 2014 (UTC)

This dubious "scientific community" has yet to publish any scientific articles to support your WP:FRINGE claims. -A1candidate (talk) 02:18, 21 December 2014 (UTC)

Hilarious! Organized skepticism=one of the five norms of doing science, per Robert K. Merton. There is nothing fringe about dopamine being identifiable and measurable, the WP:FRINGE/PS stuff is the claim that Qi would be real, identifiable and measurable (in Joules?). Tgeorgescu (talk) 16:04, 21 December 2014 (UTC)

The fringe claim is that all aspects of TCM are based on pseudoscience. Merton is not a scientist but a sociologist, a profession which I generally have very low opinion of. -A1candidate (talk) 16:19, 21 December 2014 (UTC)

Tgeorgescu I'll ask you one last time in good faith: Please show me a scientific source, prefably an MEDRS compliant review, that explicitly states that all aspects of TCM are pseudoscientific. Thanks -A1candidate (talk) 16:23, 21 December 2014 (UTC)

Weight violation

I deleted the WP:MEDRS violations. They are not reviews. I also fixed the wording for the 2011 review and added safety information from a review. I also fixed the formatting for refs in the other conditions section. QuackGuru (talk) 08:46, 14 December 2014 (UTC)

I previously explained the text that was recently added was about the images. The misleading text was asserted in Wikipedia's voice and was not the conclusion the source made. I also explained the problem with the wording for another sentence. I explained this in my edit summary the wording for the 2011 review but no specific objection was made by other editors. The MEDRS violations were restored along with other non-neutral text. The formatting for the sources in the other conditions sections were fixed but it was reverted without explanation and sourced text to a review in the safety section was also deleted without explanation. This shows an editor blindly reverted because the editor deleted information from the safety section. QuackGuru (talk) 05:22, 15 December 2014 (UTC)

The contents I careless deleted during I revert the deletion from you had been re-added. Now the problem got solution. Miracle dream (talk)

There are still other problems with your edits such the MEDRS violations. I went ahead and restored the other sentence you deleted to the correct section and fixed the refs again. QuackGuru (talk) 20:41, 15 December 2014 (UTC)

"A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity."[29][71] This was a cut and past. See Acupuncture#Headaches and migraines.

"A 2014 Australian clinical study involving 282 men and women showed that needle and laser acupuncture were modestly better at relieving knee pain from osteoarthritis than no treatment, but not better than simulated (sham) laser acupuncture."[30][72] This was a cut and past. See Acupuncture#Extremity conditions.

"According to NCCAM, results of a systematic review that combined data from 11 clinical trials with more than 1,200 participants suggested that acupuncture (and acupuncture point stimulation) may help with certain symptoms associated with cancer treatments.[85]"[73] This was a cut and past. See Acupuncture#Cancer-related conditions.

There is no need to use a poor source when we are citing systematic reviews and Cochrane reviews. This is a WP:weight violation (and possible MEDRS violation) IMO. Rather than cite NCCM we should cite the systematic review itself and high-quality reliable sources. See WP:SAYWHEREYOUREADIT. QuackGuru (talk) 23:00, 15 December 2014 (UTC)

In the context of an article already bloated with weak positive studies, seemingly included in order to cast doubt on the consensus view that the weak positive results are fully consistent with the null hypothesis, I agree that Cochrane review is all we should need here. Guy (Help!) 09:52, 17 December 2014 (UTC)

Previously, I don't know much about the rule for MEDRS. Hence, I don't know what is the difference between the reliable source required in this article and in others. For other articles, it must be an undoubtedly reliable source which is from official organization from U.S. government. However, I don't know the rule in this article. Hence, I wait others comments.

Now user User:BullRangifer opened a discussion in Wikipedia talk:WikiProject Medicine#NCCAM as a MEDRS?.I knew User:BullRangifer thought NCCAM was unbelievable. User:QuackGuru, you also joined in that discussion [74], I don't know why you opened a new discussion. From I read by now,it seems it hard to say source from NCCAM is MEDRS violation. The comment made me believe this is someone wrote like this"[MEDRS] says: "Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include....U.S. National Institutes of Health"

Based on this comment, I read the [MEDRS]. It clearly said "include the U.S. National Academies (including the Institute of Medicine and the National Academy of Sciences), the British National Health Service, the U.S. National Institutes of Health" It means the rule of MEDRS thought the source from U.S. National Institutes of Health is MEDRS compliant. As we know, NCCAM is a part of U.S. National Institutes of Health. It made me very confused every source from NIS is MEDRS compliant why NCCAM is MEDRS violation. Then for the ongoing debate in Wikipedia talk:WikiProject Medicine#NCCAM as a MEDRS?. It seems someone really agreed that NCCAM is MEDRS compliant, such as User WhatamIdoing. By now, the discussion is ongoing. It means consensus hasn't been reached.

For the contents I cited, I use the comments from User WhatamIdoing

• • In the instant case, the statement says, "A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity."
  • The source cited was What the Science Says About the Effectiveness of Acupuncture-For Heaache from National Center for Complementary and Alternative Medicine.
  • The relevant contents of the NCCAM website are, "A 2012 analysis of data on individual participants in acupuncture studies looked at migraine and tension headaches. The analysis showed that actual acupuncture was more effective than either no acupuncture or simulated acupuncture in reducing headache frequency or severity"—word-for-word what the NCCAM webpage says. (There's no copyvio here, because there's no copyright in US government works.)
  • Is this webpage reliable for these contents (i.e., for describing the contents of some other source)? Yes.
  • Would the underlying "analysis of data in...[multiple] acupuncture studies" be exactly the sort of meta-analysis that MEDRS promotes? Yes. Or, at least, it is presumably the sort of source that MEDRS holds in highest esteem, although it's possible that there would be some serious failing (e.g., not ever having been published).
  • In particular, it would be really silly to say that it's excellent for a Wikipedia editor to read that meta-analysis and write his own description of it, but that it's impossibly bad to have actual professionals read that study and write a description of it. Amateurs are not always better than professionals, especially when it comes to evaluating something technical. Also, if your information comes from NCCAM, then WP:SAYWHEREYOUGOTIT applies, and you aren't permitted to cite the original meta-analysis (unless and until you obtain the paper and read it).

I don't know whether it's Ok to use other Users' comment. If it is some rule violation, please notice me and I will delete these comments from User WhatamIdoing. However her comments is some kind of what I agree with.

I made a conclusion here. The rule at least what I read in [MEDRS] clearly said source from U.S. National Institutes of Health is MEDRS compliant. Then NCCAM is part of U.S. National Institutes of Health. It should be compliant based on this rule. Then there is an ongoing discussion in Wikipedia talk:WikiProject Medicine#NCCAM as a MEDRS?. The consensus hasn't been reached. Hence,you cannot get the violation from this discussion. I think users can join the discussion in that page instead of this one. Then some reason why NCCAM is MEDRS violation like "NCCAM is populated and operated mostly by pro-AM people" " Even Cochrane reviews are becoming dubious sources, so even with reviews we must be wary" "Our MEDRS guideline is much better than the standards of NCCAM and most peer reviewed medical journals. We should be proud of that and not lower our standards." from User:BullRangifer made me feel like a wiki academic research result by wiki Users which I thought it's totally an original research. 17 December 2014‎ Miracle dream

NCCAM was set up by believers in woo, is designed to produce evidence supportive of woo, and has a history of publishing credulous articles about woo. That said, for the expenditure of something like one and a half billion dollars, it has yet to validate a single alternative treatment. And its latest rebranding suggests it's not even going to try any more. Guy (Help!) 23:21, 20 December 2014 (UTC)