Wikipedia talk:Identifying reliable sources (medicine)

MEDDATE

Here's an approximate idea of what I'm thinking about MEDDATE issues.

The ideal maximum age for a source depends upon the subject

Subject	Example	Maximum recommended age
Major topics in a major, actively researched area	first-line treatments for hypertension	Review articles published within approximately the last five years
Minor topics in a major area	treatment of hypertension in a person with kidney cancer	Approximately five years or the three most recent review articles, whichever is longer
Major topics in a minor area	treatment of cystic fibrosis	Approximately five years or at least three reviews, whichever is longer
Minor topics in a minor area	treatment of hypertension in a person with cystic fibrosis	The several most recent review articles, and any primary sources published since the penultimate review article
Very rare diseases	most genetic disorders	The several most recent peer-reviewed articles, regardless of absolute age

Does this seem approximately like what you all would expect to find if you were looking for sources? (On the fourth line, it may help to know that hypertension does not seem to be a common complication of cystic fibrosis.) WhatamIdoing (talk) 18:22, 6 October 2015 (UTC)

I like the idea of a table of different variants like this, but it's going to need some work. There are a couple of issues here:

 1. Ideal source are obviously always new up to date systematic reviews regardless of topic area

 2. Do we use number of reviews to determin which are major/minor topics and how do we know ehn a topic falls under any of these groups?

 3. How do we determine if reviews/articles have been published? You have WebOfScience and Scopus for this but very few editors have access. Pubmed doesn't really cut it.

 4. The wording "regardless of absolute age" is problematic because all you need to do is go back to a 1970s East German source and you can promote a wealth of alt-med diseases. I'd be more comfortable is we used something akin to Orphanet [1] to determine what rare diseases are - many old purported diseases are just that, and aren't considered real today.

 5. "any primary sources" is far to inclusive

 6. Best possible sources don't depend on subject but rather how much research has been performed - this means that even some very rare diseases have quite significant bodies of research.

CFCF 💌 📧 20:31, 6 October 2015 (UTC)

I agree that it needs work; that's why I posted it.  ;-)

1: Ideal sources are not always systematic reviews. The ideal sources for treatment efficacy are systematic reviews – assuming any exist – but systematic reviews are not the ideal source for 90% of article content.

2 and 3: I think that the number of reviews available might be one reasonable metric for major/minor (and all the things in between). We can base this on PubMed and treat it as a rebuttable presumption: if I find nothing in PubMed, but you've got access to Scopus and find more, then you can share your information with me. By the way, here are some quick numbers:

• "Hypertension" is mentioned in 12,730 (tagged) reviews on PubMed in the last five years, and is present in the title of 3,162.
• "Breast cancer" is mentioned in 6,447 and in the title of 3,741.
• "Pneumonia" is mentioned in 2,808 and in the title of 695.
• "Cystic fibrosis" (a heavily researched rare disease) is mentioned in 1,543 and in the title of 692.
• "Preeclampsia" is mentioned in 779 (plus more under the hyphenated spelling "pre-eclampsia") and in the title of 279.
• "Down syndrome" is mentioned in 469 and in the title of 160.
• "Kidney cancer" is mentioned in 225 (plus 174 non-duplicates for "renal cancer") and in the title of just 64 (plus 51 for "renal cancer").
• "Wilson disease" is mentioned in 62 and in the title of 17 (plus more for "Wilson's disease").
• "Oculodental digital dysplasia" (incredibly rare disease) is mentioned in zero.

(These are all quoted-phrase searches on PubMed, merely for illustration rather than ideal searches for these subjects.)

As a quick rule of thumb, then maybe this would work: If there are more than 100 hits among reviews published on the subject in the last year, then you should probably be using the "major" criteria for the bulk of your sources. If there are less than 100, then that might not be possible (because "hits" ≠ "reviews actually about the subject"). Or we could build it based on in-title searches: Use good reviews if you've got more than a couple dozen, but when you've only got 20 (or fewer) to choose from, the fact is that the available sources might not cover all of the material that ought to be in the article. For example, there is exactly one review that has both "cystic fibrosis" and "hypertension" in the title during the last five years, and if you need to source a sentence about non-pulmonary hypertension (perhaps to mention the need to control hypertension in advance of getting a lung transplant), then there are zero recent reviews available on that exact subject.

However, I think that most experienced editors are going to have an easy time deciding where a subject falls on the scale. If I have no trouble discovering sources, then it's a major topic. If my searches come up empty, then it's not. You should be using the best of what you've got, unless and until someone demonstrates that better ones; conversely, when better ones don't exist, then you should not be hassled by people who care about the date on the paper more than they care about the content of the article.

4. Bad sources are bad sources. Age is not the sole, or even main, determinant of whether a source is bad.

5. Bad sources are bad sources. Primary vs secondary status is not the sole, or even main, determinant of whether a source is bad.

6. Best possible sources do depend on the subject, because the subject determines how much research has been published. I believe that you meant to say that the best possible sources don't depend upon disease prevalence.  ;-) Also, it's necessary to write these rules to work for non-disease subjects, such as drugs and surgical techniques. WhatamIdoing (talk) 22:00, 6 October 2015 (UTC)

While I appreciate the thinking behind this proposal, I suspect that it will make things worse rather than better. As we all know, there is already a tendency – usually but not always editors who aren't familiar with how to read and use the published literature – to treat MEDRS as a series of yes/no checkboxes that must be met, rather than as a set of rules of thumb which a skilled editor might consider in evaluating a given source-assertion-context triple. (See also the related problem of editors who think that "reliability" is a magical inherent trait possessed by a source, without regard for how or where that source is being used. And editors who had WT:MED watchlisted earlier this year will be familiar with the individual who thought evaluate this article meant make a complete list of its citations older than 5 years and declare them not MEDRS-compliant, regardless of context.)

Creating a more-specific-looking set of criteria increases the tendency for slavish adherence to the letter of the rule rather than to the purpose of the rule. Saying that "most experienced editors are going to have an easy time deciding where a subject falls on the scale" misses the likely source of the problem— most experienced and competent editors already grasp the need for flexibility in applying MEDRS' guidelines. Where a question about a source arises under these new criteria, the discussion will be diverted from the central question of whether or not the source-assertion-context triple at hand is appropriate, and into bickering over whether a particular topic and area are major/major, major/minor, minor/major, or minor/minor. Once that binary categorization is achieved, there will be blind counting of number of reviews or blind adherence to the five-year criterion—which is the same problem we already encounter. And since the new criteria look more specific and 'scientific', then we're probably going to have more trouble dislodging individuals from their mistaken belief that these rules of thumb are etched in stone. TenOfAllTrades(talk) 11:49, 16 October 2015 (UTC)

Thanks for the thoughtful comment.

Part of the problem is structural: We want to tell people to do X if they're looking for new sources/creating new material, but X plus Y if they're evaluating whether an existing statement is okay. As in: If you're writing a new article, then use the best sources you can possibly lay your hands on. But if you're trying to figure out whether Source X verifies Statement 1, then "the best sources" aren't required. You need one that is good enough, but it only has to be barely good enough.

What do you think about killing any mention of five years at all? WhatamIdoing (talk) 21:29, 20 October 2015 (UTC)

I'm certainly open to the idea. The five-year rule of thumb (and its chronic misinterpretation as an iron-clad commandment) may be causing more problems than it solves, these days.

We generally prefer more recent sources, all other things being equal. But all other things are never exactly equal, and what qualifies as "more recent" varies a lot depending on the field, the content, and the context. I think we (Wikipedia editors) sometimes fall down when we over-prioritise recent publication dates over other measures of source quality and reliability. TenOfAllTrades(talk) 02:26, 21 October 2015 (UTC)

Actually, we don't necessarily prefer more recent sources, because of WP:RECENTISM. We do tend to prefer the most recent reviews, of course, because they can consider the impact of more recent primary sources. The "five-year rule of thumb" came into being when it was suggested that in many fields a review cycle (the time between consecutive major reviews) took roughly that amount of time. It's obvious that there is considerable variance in the time before a particular major review becomes superseded by an equally important successor, and unless editors take the time to find the most recent high-quality review, the rule of thumb becomes counter-productive. We really need to be saying something like "In many topics a review conducted more than five to ten years ago will have been superseded by more up-to-date ones, and editors should try to find those", rather than suggesting we reject a perfectly good source solely on the grounds of its age. --RexxS (talk) 15:21, 21 October 2015 (UTC)

As that's a very sensible and intelligible way of telling people what they really need to know, I have boldly replaced the sentence. I've also (separately) expanded it slightly, to reinforce the point that expert opinion doesn't necessarily change every five years. (Revert expected in three, two, one...) I suspect that the definition of chicken pox has been pretty stable for some decades now, so those sources aren't really "out of date" even if they're more than five or ten years old.  ;-) WhatamIdoing (talk) 06:59, 17 November 2015 (UTC)

As you can see at Wikipedia talk:Identifying reliable sources (medicine)/Archive 10#Standardizing the five-year rule, Bluerasberry was also worried about the application of the five-year standard; so it will be interesting to see what he thinks of these changes. Flyer22 Reborn (talk) 08:49, 17 November 2015 (UTC)

@Flyer22 Reborn and WhatamIdoing: Thanks for pinging me Flyer. WAID, I changed your edit to be only five years. I would prefer to not complicate the "5 year rule of thumb" to be a "5-10 year rule of thumb". I hope the idea is the same as what you intended, only simpler. Blue Rasberry (talk) 14:20, 17 November 2015 (UTC)

Hi Blueraspberry. I undid your change (I admit that when I did so, I hadn't realized that the "five to ten" wording was itself quite new) since I didn't want to encourage people to get fixated on five years. We already know that's a problem; in too many editors' minds "five-year rule of thumb" gets truncated to just "five-year rule". In edge cases and less-frequently-published-on topics I'd much prefer to see editors have the necessary conversation on the article talk page rather than shut down discussion with a blind MEDDATE says so. TenOfAllTrades(talk) 14:47, 17 November 2015 (UTC)

TenOfAllTrades I changed what you did to "five or so". Comment? I also do not want this used as a hard rule, but I feel it is very useful that we have some agreement about the rule of thumb being one certain number of years. Blue Rasberry (talk) 14:58, 17 November 2015 (UTC)

We often tell editors that the rule is really up to ten years or so, but it depends upon the subject (e.g., five years for hypertension, ten years for most rare diseases). But the structure of the statement is far more important to me than the numbers used in it. If we're happier with "five years or so" or "approximately five years", or whatever, then I won't object. WhatamIdoing (talk) 02:11, 18 November 2015 (UTC)

I agree to go with "five years or so." But I will note now that it's always irritated me how certain editors figured that the guideline meant that "older than five years" equates to "it's no longer good", even when we clarified WP:Recentism aspects in the guideline. Even the biomedical debating currently going on at this talk page shows that certain editors have interpreted WP:MEDRS too strictly. See this statement I made, which WhatamIdoing thanked me for via WP:Echo. The "two or three" years aspect was also a problem, which is why I'm glad that Blue Rasberry remedied that in the "Standardizing the five-year rule" discussion. Flyer22 Reborn (talk) 09:50, 18 November 2015 (UTC)

Questions about RFC closure - Country of origin

We do reject sources because they are from a specific country because there are sources that are poor sources and there are bias sources. According to the close the country of origin is a legit consideration where RS have identified it as an issue. There have been hard data (as contrasted to stereotypes) that have identified a systematic problem that is normally identified with an affiliated country of origin. Therefore, this edit seems to contradict the close. QuackGuru (talk) 17:00, 20 October 2015 (UTC)

The close that I wrote said no such thing. Besides, the suggestion that the edit that the close clearly and directly indicates is appropriate nonetheless contradicts the close by some extreme, odd interpretation is utterly nonsensical. Get the point. Discussion closed. --Elvey^(t•c) 03:34, 24 October 2015 (UTC)

User:Elvey, perhaps you would come back and clarify a few things for us. For example, you wrote "We cannot override WP:V or WP:RS." In what way would rejecting some sources, on some subjects, from countries with a strong reputation for the low quality their sources, constitute "overriding" WP:V or WP:RS? WhatamIdoing (talk) 21:35, 20 October 2015 (UTC)

Reread Albino's comment. To what end do you seek clarification? --Elvey^(t•c) 03:34, 24 October 2015 (UTC)

I am flummoxed as to why that single comment is singled out as of more weight than those of multiple other editors. This seems to me a very questionable closure. CFCF 💌 📧 12:02, 24 October 2015 (UTC)

I think that would likely be because Albino's comment stated that multiple editors were ignoring the fact that we are talking about high quality sources and some editors opposed low quality sources, which wasn't the purpose of the RfC. LesVegas (talk) 12:53, 24 October 2015 (UTC)

This is not true. The statement in the guideline is about high-quality types (emphasis in the original) of sources, not about high-quality sources. A meta-analysis is a high-quality type of source, but it can be a low-quality source (e.g., if it's outdated, poorly done, or irrelevant). WhatamIdoing (talk) 21:32, 28 October 2015 (UTC)

Yes, there are meta-analyses that are poor quality because of age, journal integrity, etc, but they are not poor quality simply on the basis of where they are published or the country of origin of its authors. That was the purpose of the RfC, and no, just as we cannot exclude sources because they receive industry funding, we also cannot exclude them because of country of publication. Not one single editor addressed why we don't reject industry funded sources on the basis of known bias, but we should ban sources based on speculative and unconfirmed publication bias due to country of origin. Not one editor. Note that Elvey mentioned as much in his close as well. There were multiple factors here really. LesVegas (talk) 19:23, 29 October 2015 (UTC)

It still completely fails to address the actual need for the addition. No discussion has been shown about not including high quality sources based on country of origin, this is a red herring and a useless bloating addition. CFCF 💌 📧 10:02, 26 October 2015 (UTC)

This discussion centres around attempts by SPA editors to crowbar low quality sources supporting various degrees of efficacy not shown in high quality sources of ALT-Med articles, particularly Acupuncture. Other attempts have been made, to WP:MEDRS for example. Characterising mainstream editors as racially prejudiced by SPA's has been happening for a while now, and is a particularly nasty tactic. -Roxy the dog™ (Resonate) 10:20, 26 October 2015 (UTC)

While I am surprised my comment was mentioned. I am not surprised with the close. My comment did point the problem with some of the responses. They were off topic. A problem that looks like its repeating down here. The RFC question specifically was about High quality sources. Low quality sources will be rejected regardless of what country they are from because they will not even pass WP:RS. AlbinoFerret 13:54, 26 October 2015 (UTC)

Are there examples of editors rejecting high quality sources because of racial prejudice? -Roxy the dog™ (Resonate) 14:30, 26 October 2015 (UTC)

A couple were mentioned during the RFC. I did point out I was unsure if it was widespread, but even if it isnt very widespread its a bad thing that should be stopped. It hurts the project in rejecting even a few high quality sources and makes the project look bad focusing in the ethnic angle. I think those editors who are concerned this will allow low quality sources in shouldt worry, low quality will always be excluded. Just point out the problems with the source that make it low quality and dont point out where they came from. Doing that give those pushing them a reason to argue. AlbinoFerret 14:46, 26 October 2015 (UTC)

I think this might work: "While country of origin per se is not a suitable reason to reject a source, it is appropriate to consider in cases where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries."

QuackGuru (talk) 20:31, 26 October 2015 (UTC)

While that may be what you want in the section, it does not say what the closer said. Here is the section:

"This addition should NOT be read as a PC ban on any mention of country of origin (or founding source, etc.) when necessary to refer to studies with hard data (as contrasted to stereotypes) that have identified a systematic problem that is normally identified with an affiliated country of origin, as mentioned by Richard Keatinge. Likewise, this addition should NOT be read as a changing the longstanding policy that sources from publications known to routinely publish and fail to retract material proven unreliable may be excluded."

What it appears Elvey is saying , and Elvey can correct me if I am wrong, is this close is not a ban on discussing problems with sources in a discussion of a source that talks about them. It doesnt appear to be a loophole to insert arguments about a source, based on a country, just because other crappy sources have come from there. What might be better to say is "It is better to look at the quality of a source, if the source is of low quality it should be excluded." AlbinoFerret 20:58, 26 October 2015 (UTC)

CORRECT on both counts. (The comma in the last sentence should be a semicolon or period.) --Elvey^(t•c) 02:27, 29 October 2015 (UTC)

Your proposal "It is better to look at the quality of a source, if the source is of low quality it should be excluded." is not about country of origin. QuackGuru (talk) 21:01, 26 October 2015 (UTC)

See the specific part of the close. See "when necessary to refer to studies with hard data (as contrasted to stereotypes) that have identified a systematic problem that is normally identified with an affiliated country of origin, as mentioned by Richard Keatinge." QuackGuru (talk) 21:02, 26 October 2015 (UTC)

Thats because the RFC has already said that country of origin is not a valid exclusion. I assumed that country of origin is added to the list of other things that should not be considered. The whole purpose of that section appears to be to tell people to look for high quality sources, then some things that should not be considered. I propose adding a sentence at the bottom to direct editors to, instead of looking at the country or funding, to look at the quality. AlbinoFerret 21:07, 26 October 2015 (UTC)

Yes, it says not to stop discussions about a topic that discusses low quality sources, not a loophole to allow discussions that we have already said should not take place like excluding a source based on ethnic origin. AlbinoFerret 21:09, 26 October 2015 (UTC)

You said "Thats because the RFC has already said that country of origin is not a valid exclusion." That what was written and that was what was added.

"While country of origin per se is not a suitable reason to reject a source, it is appropriate to consider in cases where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries."[2] QuackGuru (talk) 21:11, 26 October 2015 (UTC)

My close is clear. It's not appropriate to --Elvey^(t•c) 02:27, 29 October 2015 (UTC)

You are adding a loophole that I dont believe the closer added. Lets wait for them to chime in as I have pinged the closer in a few posts ago. AlbinoFerret 21:14, 26 October 2015 (UTC)

Albino Ferret is right, in fact, it would violate the spirit of every single RfC done across wikipedia if we always added a reference tag and then just put whatever summary those opposed wanted. Adding in a summary of whatever you want to be read as a caveat is gaming an RfC outcome. Besides, the RfC wasn't about "should we say 'country of origin' and then have these caveats?" it was about the wording, "country of origin" specifically. And, to that, the answer was "yes," it needs to be added in. But since the consensus reading did mention other specifics and since some editors are persistent in wanting something else, I figured a link where readers could see the full consensus read/closing comments would be the best compromise. LesVegas (talk) 21:25, 26 October 2015 (UTC)

The outcome of the RfC is not constrained to be binary. It's intended to gauge consensus, and the closer found consensus to include 'country of origin', but with the caveat that it might be a legitimate consideration where "hard data" demonstrate a concern about biased literature. MastCell ^Talk 22:52, 26 October 2015 (UTC)

The point is that the addition is completely useless, and not supported by the RfC. QuackGuru – while I agree with the intent of your clarifications the fact is we are just introducing bloat. If any policy is to be taken seriously it needs to be succinct, and can't include hypothetical clauses that have never been proven to be needed. CFCF 💌 📧 22:48, 26 October 2015 (UTC) 

When the RfC is a question asking "should we add 'country of origin' to this list?", and the consensus reading says "Yes" removing it entirely is going against consensus. LesVegas (talk) 23:09, 26 October 2015 (UTC)

We're trying to get some clarification of some of the major issues with the close and a possible new clause, it isn't something we will do on a whim–we need to have a agree on what (if anything) to include. We should wait until clarification of what Elvey meant in the close summary. Currently the meaning of the text is very murky, and as such it may be challenged for not adequately summarizing the consensus. CFCF 💌 📧 23:15, 26 October 2015 (UTC)

(Late reply) Elvey, I'm trying to figure out what the relevance of your statement about "overriding WP:V and WP:RS" is. Imagine that you are trying to decide whether a source is reliable. Do you believe that considering the country of origin, e.g., to avoid citing the notoriously bad Soviet science, would somehow a constitute "overriding" WP:V? Could you point to any sentence in WP:V that would be violated or "overridden" by doing that?

Also, I have read Albino's comment, and you seem to have overlooked a critical difference between what the guideline says and what Albino wrote. The sentence in the guideline talks about high-quality types of sources (e.g., a meta-analysis is a high-quality type of source; a case study is a low-quality type of source). Albino talks about high-quality sources—a quality that takes far more into consideration than the type of the source. "High-quality types" and "high-quality sources" are not the same thing. It's possible to have a low-quality meta-analysis, and just like it's possible to have a top-quality case study. WhatamIdoing (talk) 21:32, 28 October 2015 (UTC)

I don't dispute that it's possible to have a low-quality meta-analysis. What's clear is there was consensus that "country of origin", per se, is not a valid method to identify a low-quality meta-analysis. --Elvey^(t•c) 02:27, 29 October 2015 (UTC)

What does "overriding WP:V and WP:RS" is? It seems to mean that MEDRS is wrong and that MEDRS overrides WP:V and WP:RS to exclude sources that meet WP:V and WP:RS. Therefore, country of origin such as from China are good even if they are poor quality and bias. QuackGuru (talk) 21:51, 28 October 2015 (UTC)

You didn't respond to my comment about your extreme, odd interpretation of what I said. I feel grossly misrepresented, and an apology would certainly have been welcome. "We cannot override WP:V or WP:RS" means just that. Surely none of you dispute that "We cannot override WP:V or WP:RS." There was consensus that "country of origin", per se, is not a valid reason to reject a source. I claim neither WP:V nor WP:RS contain any sentence consistent with allowing "country of origin", per se, as a valid reason to reject a source.

Again: You need to drop the stick. Insisting my close not clear by misrepresenting what I said with an extreme, odd interpretation is not going to fly, and you've just done that for the second time in this section, this time by claiming I've said MEDRS is wrong. STOP. It's disruptive and uncivil. I said no such thing. Not liking the close is not a valid reason to reopen it. I don't see any clarification request that hasn't been adequately addressed by AlbinoFerret or myself. Re-closing. --Elvey^(t•c) 02:27, 29 October 2015 (UTC)

No, you haven't answered my question. There are two basic ways to approach this. Either your comment about overriding WP:V and WP:RS is:

• pointless blather, with just as much relevance as you saying "Don't kick puppies" or "Be nice to your neighbors" in the middle of this (in which case, you should just remove it), or
• you actually meant to communicate something relevant, that editors need to know and understand (in which case, you need to explain what you meant, because everybody's confused).

The obvious assumption is that you meant what you said. What you said seems to be that (when relevant/appropriate/etc.) editors should not take notice of published academic research that says (for example) Soviet psychiatric research is a bunch of garbage (and garbage because it came out of a country that had difficulties with the concept of apolitical science), because you believe that doing so would be based on "country of origin" and that discarding sources on the grounds of country of origin somehow override WP:V and WP:RS.

Is that what you meant? WhatamIdoing (talk) 03:24, 29 October 2015 (UTC)

I'm not sure what Elvey meant, but I know some editors here have already exhausted this editor (a volunteer, as we all are) with complaints, so I'm willing to take a stab at it from my reading of Elvey's close. Documented issues with poor science conducted by a particular piece of research are a valid reason to exclude that individual piece of research because it doesn't meet the barometer of a high-quality source, per WP:V and WP:RS anyway. Excluding such research, however, because it is Russian or Soviet and they had scientific issues and therefore it all must be garbage science, is not an appropriate reason for rejecting it. In other words, what are the reasons that individual piece of research is invalid? And if it is documented invalid, it isn't high quality anyway. Funding sources have a well documented history of much worse; Elvey mentioned in their close that country of origin wasn't worse than funding, per consensus (since nobody seemed to tackle that question I raised.) LesVegas (talk) 19:38, 29 October 2015 (UTC)

This was the previous proposal: "While country of origin per se is not a suitable reason to reject a source, it is appropriate to consider in cases where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries."

It is known that there is publication bias from Chinese journals. We cannot claim "country of origin" is not a problem given the evidence. QuackGuru (talk) 20:24, 29 October 2015 (UTC)

That's a 2005 source, and it does illustrate publication bias in some fields. For those fields it notes, it may apply to Chinese sources published prior to 2005. LesVegas (talk) 23:00, 29 October 2015 (UTC)

LesVegas, your reply does not address my question at all. So far as I can tell, there is nothing in WP:V or WP:RS that requires us to accept sources that have characteristics which editors deem suspicious. However, it leads me to a question for you: Imagine that (it's 1985 and...) you are looking at a source produced by the well-documented mess that was Soviet psychiatry on the question of people with schizophrenia who claim to be political prisoners. Do you think that specific source could be excluded:

(a) because it was produced by the Soviet psychiatric system, which is an extraordinarily well-documented disaster (and therefore the odds are very high that it, too, is bad) or

(b) only if that individual source were called out, by name, in another reliable source, as an example of bad research?

Another way to put this: If a source was produced by a Soviet psychiatric institution, is it "tarred with the same brush" as the rest of the field, or "innocent until proven individually guilty" of politically manipulated science? WhatamIdoing (talk) 00:39, 30 October 2015 (UTC)

User:WhatamIdoing, you're right in that WP:V and WP:RS don't require us to use sources from countries with issues, but they also don't require us to exclude them on that basis. These policies simply tell us what a high quality source is and what it is not. The way I read the close is based on the content of the RfC expressed over and over again, which is we have our rubrics for determining what a reliable source is. That's the WP:V and RS part. So we use WP:V and WP:RS to determine if it is a high quality source. These rubrics do not allow us to exclude sources that meet WP:RS standards because of their country of origin, much as they don't allow us to reject sources because of industry funding issues. And the way I see it, the issues with the Soviet disaster likely produced journals that wouldn't meet MEDRS standards anyway, certainly being called out by reliable sources. If this occurred today, you would undoubtedly find a slew of journals being slammed by academia for problems. Having occurred so long ago, I'm sure there's some, but the point is moot because those journals are so old they wouldn't be reliable sources anyway per WP:MEDDATE. LesVegas (talk) 19:06, 30 October 2015 (UTC)

I think your going to have to clarify your thought process here - I can't tell how your different statements are related. And neither RS nor MEDRS are about finding high quality sources, they're about finding acceptable quality sources for Wikipedia, with MEDRS focusing on medicine. CFCF 💌 📧 19:23, 30 October 2015 (UTC)

MEDRS is WP:RS but specific to medical claims. We don't use low quality sources. What other statements do you not understand? LesVegas (talk) 19:38, 30 October 2015 (UTC)

Wikipedia most certainly does use low-quality sources—every hour of the day.

MEDRS in particular, but RS as well, has a structural problem with purpose. Is the purpose to show you the "minimum acceptable quality", so that you can find the line between barely good enough and not quite good enough, so you'll know when to tag or remove dubious contributions? Or is the purpose to show you how to find the best possible sources, so you'll be able to find great sources for writing new content?

MEDRS is largely written to show you how to find "best possible" sources. (As a result, we have a problem with people rejecting "good enough" contributions, because they aren't "best possible".) RS is split more evenly, but it still fails to tell editors when it's talking about "good enough" and when it's talking about "best possible", which causes unpleasant disputes, in which both sides believe themselves to be (and actually are) correct. We are not going to solve this problem this week. WhatamIdoing (talk) 03:38, 1 November 2015 (UTC)

Elvey the clarification that I asked you about is from an earlier discussion, that some want to add a loophole to the "country of origin" by stating it still can be considered with language like this as a note "it is appropriate to consider in cases where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries" saying that the last paragraph of your close says that. Is this what you wrote in that last paragraph of the close? AlbinoFerret 04:46, 29 October 2015 (UTC)

Editors are waiting for clarification. Editors do not agree with this change. See "The outcome of the RfC is not constrained to be binary. It's intended to gauge consensus, and the closer found consensus to include 'country of origin', but with the caveat that it might be a legitimate consideration where "hard data" demonstrate a concern about biased literature."[3] QuackGuru (talk) 19:32, 30 October 2015 (UTC)

Reread Albino's comment. To what end do you seek clarification, and of what? Clarification answers, AGAIN: "We cannot override WP:V or WP:RS" means just that. Surely none of you dispute that "We cannot override WP:V or WP:RS." There was consensus that "country of origin", per se, is not a valid reason to reject a source. I claim neither WP:V nor WP:RS contain any sentence consistent with allowing "country of origin", per se, as a valid reason to reject a source. No, I did not say that. There is no caveat in the close; just a clarification. --Elvey^(t•c) 02:37, 31 October 2015 (UTC)

Elvey, I seek clarification about exactly which sentence in WP:V or WP:RS would allegedly be "overridden" by rejecting a source on the grounds that it came from a particular country, where said country's academic publications were very widely accused of bias and politically motivated writing. The exact sentence, please, in the form of a direct quotation. Handwaving about "There isn't any rule that says you may exclude Soviet psychiatry sources if it superficially appears to meet all the other standards, and therefore you mayn't exclude Soviet psychiatry sources merely because the whole field is known to be crap." I want to know exactly which sentence this overrides.

NB that you cannot actually override rules that do not exist. If, as you say now, no such rule actually exists, then you should strike that sentence from your closing statement, because it is (at best) irrelevant. And if the main reason for your conslution is that dumping sources from disreputable countries actually would contradict this non-existent rule, then you should reverse the entire closing statement, because you were reasoning from false premises. (And in that case, I'd suggest letting someone else re-close it.) WhatamIdoing (talk) 03:31, 1 November 2015 (UTC)

Let me clarify: Even if you can show that reliable sources A thru D all say the whole field of X in country Y is known to be crap, then you still must not reject the the whole field of X in country Y on the basis that it's from country Y; rather you may (and should) reject the the whole field of X in country Y on the basis that reliable sources A thru D all say the whole field of X in country Y is known to be crap. The fact is, you do not seek clarification; rather you simply reject the clarification given. I claim neither WP:V nor WP:RS contain any sentence consistent with allowing "country of origin", per se, as a valid reason to reject a source. It's on you to find a sentence that allows "country of origin", per se, as a valid reason to reject a source. One cannot prove a negative. The two policies provide detailed guidance on what makes content verifiable via a reliable source. None of that guidance says anything to suggest that "country of origin", per se, is a valid reason to reject a source. Your straw man attack doesn't fly. Even if you can show that reliable sources A thru D all say the whole field of X in country Y is known to be crap, then you still must not reject the the whole field of X in country Y on the basis that it's from country Y; rather you may (and should) reject the the whole field of X in country Y on the basis that reliable sources A thru D all say the whole field of X in country Y is known to be crap. QuackGuru says "We do reject sources because they are from a specific country " per se. We must not do that. That is the consensus. --Elvey^(t•c) 22:58, 1 November 2015 (UTC)

Elvey, what's the practical difference between "We reject all sources from China about acupuncture because Chinese publications on acupuncture are unreliable" and "We reject all sources from China about acupuncture because Sources A through D say that Chinese publications on acupuncture are unreliable"? I'm seeing zero practical difference myself.

User:LesVegas, was it clear to you from Elvey's closing statement that sources about acupuncture from China would still end up being rejected, only with a slightly longer excuse? WhatamIdoing (talk) 02:46, 3 November 2015 (UTC)

User: WhatamIdoing I don't understand for the life of me what Elvey meant above, but I'm afraid your deciphering of Elf speak is just not the case at all. After all, Elvey stated that, "I was, rather, simply clarifying that mention of country of origin is not barred, even though it would now be explicit that decision making on the basis of country of origin, per se is not OK." That just means we can't bar or reject sources because of country of origin, much as we cannot reject them if they're industry funded, but that there is no PC ban on mentioning country of origin or anything else about or in sources, for that matter. LesVegas (talk) 17:24, 3 November 2015 (UTC)

Elvey has repeated that country of origin per se is not a reason to reject a source. I have finally figured out that Elvey is signalling that country of origin per quod is a valid reason to reject a source—i.e., because Soviet psychiatric sources are widely discredited. So you can't reject a source "because it's from the USSR" (country of origin per se); instead, you reject that source "because it's from the USSR and Soviet psychiatry has been widely discredited" (country or origin per quod). The end result is the same, but the excuse is wordier (and more accurate).

The application to Chinese acupuncture and the multiple denunciations of the publication bias and methodology issues should be obvious. WhatamIdoing (talk) 01:54, 6 November 2015 (UTC)

User:WhatamIdoing, I do agree that if methodology is specifically and widely criticized by the scientific community, and a piece of research uses that methodology, that's reason enough to reject. What should never happen (and this, I believe, is also what the close says) is for editors to assume all research originating from one country uses that very methodology. What is and should be allowed is for editors to say on talk, "hey, according to X source, a lot of environmental research from Sweden is flawed and needs to be examined to see if it adopts the same methods which have been widely discredited" and then reject those sources on that basis. But what we cannot do is reject all environmental research from Sweden because research from Sweden has been criticized for adopting a method that an individual piece of research from Sweden never used. That's what is meant by it, but if you disagree with what in saying and feel your interpretation is correct, I can always ask Elvey on his talk page if you want. LesVegas (talk) 13:43, 6 November 2015 (UTC)

So, you're back to saying that for a source to be discredited we need express mention of flaws in that source?CFCF 💌 📧 14:04, 6 November 2015 (UTC)

Yes, honestly I believe that's fair. Yet as the wording stands, it currently also prohibits editors from conducting a second peer review because of methods. While editors shouldn't be doing that because of their personal opinions on methodology, I think if the scientific community at large has criticized specific methods and a particular piece of research adopts those methods, we shouldn't be using that research. So under those specific grounds, I agree with you that we need further clarity for the RfC. So, I would be willing to compromise with you in this way: let's restore "country of origin" for now into MEDRS, per the previous RfC close, for now. As it stands, that is the way things are supposed to be. You and I can work together to re formulate this second RfC to make it clearer and contain genuine questions we both agree to disagree on, and that we hope to seek the community's opinion on because, even though we may disagree on exactly how to phrase it, I honestly do agree with you that we need some further clarification even with "country of origin" added into the sentence and I would like to see an RfC that brings clarity here to gain traction. Does that sound like a deal? LesVegas (talk) 15:50, 6 November 2015 (UTC)

I'm glad that we have agreed that some further clarification is necessary.

I don't think that we can restrict this solely to using a discredited methodology. The problem with Soviet psychiatry wasn't the reported "method": it was the political system that refused to publish research that disagreed with the party line. That's a problem that isn't reported in the methodology section of the paper itself. That's why so many sources said that nothing at all from Soviet psychiatry could be trusted, because it was impossible to know which results were tampered with or suppressed. WhatamIdoing (talk) 18:57, 6 November 2015 (UTC)

Greetings ladies and gentlemen! Sorry for chiming in so late. The Talk Page has grown rapidly during the past few days, and it's taken some time to keep track with the discussion. Anyway, it appears to me that there's been some rather heavy edit warring with respect to the former RfC close[4][5][6][7][8][9][10][11]. As far as I am concerned, the RfC close was quite clear on the fact that "country of origin" is no reason to omit any sources. Should there be well documented publication bias in a given country and field, then that sure serves as a red flag but never as reason to omit a source. Instead, where we pay attention to is the quality of the source: low-quality sources will always be discarded, no matter what's the country of origin. Likewise, high-quality sources shall be used, no matter how many low-quality sources there are published in the country of origin. Actually, this was paid attention to in the close as well; a lot of editors were arguing low-quality sources, and therefore I think the closer was correct in discounting those comments as off-topic.

If the same editors who opposed the proposal at the RfC, still keep opposing it after the close, it doesn't mean that the RfC is disputed and therefore the changes cannot be implemented. Meanwhile, I agree that the consensus per the last RfC should be incorporated until we get more clarity on the issue and the possible wording. Cheers! Jayaguru-Shishya (talk) 16:22, 8 November 2015 (UTC)

User: WhatamIdoing, you raise a good point about the Soviets and methods and this makes me think about even further angles for how we can clarify this. What seems apparent to me is that the Soviet research we wouldn't be using anyway, not because of the country (and time period) it originated from, but because it shouldn't be considered "high quality"and the sentence we are talking about is on high quality sources anyway. So that's how we disqualify it. Now, I'm not exactly sure MEDRS currently has clauses on how to determine if sources like that aren't high quality or not, so I think that's how we can fix it to where everyone's happy. Bogus Coca Cola funded research showing cokes don't cause obesity should also clearly not be allowed on MEDRS (and, yeah it was a primary study, but clearly could become part of a secondary source) and, as it's written, I don't see any reason it would be rejected. So, in my opinion, the issue will easily be resolved if we better address what precisely precludes a source from being a high quality one. I now think that's how we go about clearing up the RfC, not necessarily with another sentence and certainly not with altering the closed one. LesVegas (talk) 18:43, 10 November 2015 (UTC)

• The paragraph isn't about "high-quality sources". I believe I've mentioned this three or four times already, and I'm hoping that you will pay attention to this detail this time, even if it seems unimportant to you. The paragraph is about "high-quality types of studies". As in: Do not reject a meta-analysis (a high-quality type of evidence) in favor of a randomized controlled study (a low-quality type of evidence) because of your personal objections. This paragraph is not "about high-quality sources". It's about people trying to dump good evidence types (some of which are actually low-quality sources) in favor poor evidence (some of which are actually high-quality sources).
• How do you know that Soviet psychiatry is a low-quality source? You know it's a low-quality source because of its country of origin. You would, in fact, be rejecting it due to its country of origin (combined with the fact that said research on that subject, emanating from that country, has been specifically, by country name, declared to be garbage by experts.
• Perhaps, though, we don't actually need a clarification, so much as we need to agree that (a) this section is about editors' personal objections to sources, and (b) once you have a source that says all Soviet psychiatry sources—or all Chinese acupuncture sources—are biased, then it's no longer a "personal objection", and therefore it's perfectly fine to chuck Soviet sources about psychiatry out the window. WhatamIdoing (talk) 01:48, 11 November 2015 (UTC)

User:WhatamIdoing, the way in which we know a Soviet psychiatry source would be low quality is that the journals, methods used, etc, would be discredited in reliable sources. To be specific, The Russian Federation admitted that Soviet Psychiatry was used for political purposes. Yes, that is a pretty large umbrella. Were they talking about the practice of declaring political dissidents to have mental illness in order to imprison them? Yes, they were. Were they talking about every single piece of psychiatric research published during the entire Soviet era? Of course not. G.E. Sukhareva was an influential Soviet psychiatrist who worked in the Soviet era. Are his works and findings discredited? Andrey Yevgenyevich Lichko is another. Is all his research discredited? See, the problem with stereotyping sources and politicizing them in order to reject them is that not everything fits so neatly in those confines. Btw, I understand what MEDRS states as high quality here, and it always appeared to me you are the one who thinks it needs to be more stringent, whether you realize it or not. I was politely extending an olive branch to you for something it appears you want, and that's exactly why I'm saying perhaps we need to redefine, in that paragraph and elsewhere, what a high-quality is, so that the sentence "do not reject a high quality type of study due to, w, x, y and z" might mean something we can all agree on, even if it would mean changing "study" to "source". That's what I mean by clarification. And yes, we do, perhaps, need clarification because not all Soviet psychiatry sources are biased, not all Chinese sources on acupuncture are biased (bias is only listed in reliable sources as one of several possibilities during a particular period of time, a fact I have also repeated numerous times). I seriously don't know how you can possibly want to reject all Chinese studies on acupuncture, yet are ok with wording that gives carte-blanche usage for industry funded Coca-Cola or Big-Tobacco research. WhatamIdoing, you have always struck me as a very reasonable and highly intelligent editor, unlike many here. I would love to work with you on a reasonable compromise and fix this so that MEDRS actually works in principle moving forward. I'm sorry I had to point out the flaw and force a fix, but it was something I felt needed doing, and now it seems that with so many editors so emotional about the close we probably need some additional wording redefining "high quality" which we can all agree on. LesVegas (talk) 15:10, 11 November 2015 (UTC)

You are reasoning from false premises. The reason that we know Soviet psychiatry sources are unreliable is not because some of the methods or non-Soviet journals are discredited (not all Soviet psychiatry was published in Soviet-controlled journals). The reason that we know Soviet psychiatry sources are unreliable is because they were published under a political system (the political system in their "country of origin") that suppressed and manipulated the sources. It is (presumably) true that only some of the Soviet sources were directly tampered with; it is definitely true that some of the problem is due to refusing to publish research that had the "wrong" answer (a problem that is neither with the methods nor the journals). But we don't know which sources were tampered with, or how much suppression was involved, therefore all Soviet sources are unreliable for statements of psychiatric fact.

Or, to put it another way: When a researcher is exposed for serious, intentional fraud, reputable scientists stop citing all his publications, not just the one for which fraud has been proven. Why? Because you no longer know how much you can rely upon anything that the liar wrote. Maybe the researcher only told lies once, but maybe he told lies through his whole career. And you don't know, so you can't rely upon any of it.

In an exactly analogous manner, when a whole political system is exposed for serious, intentional fraud, intelligent people stop citing all the publications from that political system, not just the individual ones for which proof of fraud has already been published.

(I agree that a simpler summary of "high quality" is needed, but it's irrelevant to this paragraph. This paragraph is about preferring better evidence over weaker evidence, even if there's something about the better evidence that an editor personally objects to. And of all people on Earth, I should know the actual intent, because I wrote this paragraph. NB that the edit was made in 2010, but based upon multiple conversations throughout most of 2009.) WhatamIdoing (talk) 16:46, 11 November 2015 (UTC)

So what is wrong with saying that country of origin, basically a possible racial motive and very disturbing if it happens, is not an exclusion criteria in that context for high quality (add whatever word you want here sources, type, etc)? AlbinoFerret 16:53, 11 November 2015 (UTC)

Yes, I second Albino Ferret's question. What is wrong with saying this? And I really hope you're not saying the works of Ivan Pavlov, Vladimir Bekhterev or Pyotr Gannushkin, who are highly regarded and highly influential psychiatrists who did happen to work in the Soviet era, are unreliable. You're not actually saying their research during this era is unreliable are you? Do you see why this can't fit so easily into a tiny, neat box where everything should unilaterally be banned as unreliable, but instead needs some nuance? LesVegas (talk) 17:17, 11 November 2015 (UTC)

Once again

Let's try this again, from the top:

• The statement is not about high-quality sources. It is about high-quality types of sources, e.g., meta-analyses, including low-quality, poorly conducted meta-analyses. So what's wrong with high-quality sources? Nothing, except that the sentence isn't talking about high-quality sources. It's talking about high-quality, mid-quality and low-quality sources that happen to rank higher on those pyramids of evidence quality.
  • You should exclude low-quality sources that use a high-quality type of study design.
  • You should include high-quality sources that use a high-quality type of study design.
  • Using a high-quality type of study is not the sole determinant of whether something is a high-quality source. Meta-analysis = high-quality type. Meta-analysis ≠ high-quality source.
• If we exclude "country of origin" from the list of "personal objections" that editors must ignore, then both Chinese acupuncture and Soviet psychiatry are excluded. Why? Because once you've got a list of academic sources saying that these entire output of these two countries on these particular subjects, is tainted by political bias, then the editors are no longer rejecting them because of "personal objections". They're rejecting them because of objections that are verifiably held by actual subject-matter experts.
• If we don't exclude "country of origin" from the list of "personal objections" that editors must ignore, then Chinese acupuncture and Soviet psychiatry are still excluded. Why? Because once you've got a list of academic sources saying that these entire output of these two countries on these particular subjects, is tainted by political bias, then editors should avoid those sources. They should find sources from an academic and political system that isn't widely condemned for political bias.

So basically I'm concluding that this is an irrelevant addition. You want this change so that you can say "Look, we get to use Chinese acupuncture sources!" And the response will be, "That sentence is only about personal objections to Chinese acupuncture sources. I have no personal objections. I only object because these three peer-reviewed academic sources say that all Chinese acupuncture sources are suspect. I have purely impersonal objections. Therefore, we still won't use them." WhatamIdoing (talk) 06:20, 17 November 2015 (UTC)

User:WhatamIdoing I understand your point and you don't have to keep repeating yourself, that's a lot of effort you're having to needlessly expend, so I just want to make it clear that I understand your point. I'm not sure, however you understand mine, so let me repeat two simple questions: if academic sources have identified Soviet psychiatric research as unreliable, should we remove or reject research from Ivan Pavlov, Vladimir Bekhterev or Pyotr Gannushkin, well-regarded and influential in the psychiatric field, each of whom did happen to work in the Soviet era as well? And why do you support allowing industry funded research in certain fields when much worse bias has been shown there than those studies on Chinese acupuncture research you complain about? You do know that this was mentioned in Elvey's close, right? Ok, that's three questions, but you get the point. LesVegas (talk) 15:23, 17 November 2015 (UTC)

We can use Chinese or Soviet sources if they are of high-quality, but low-quality sources we shall discard without doubt. It's all a question of source quality, and this must be assessed on a case-by-case basis. The country of origin has no role in this, and the close of the last RfC also conforms this.

Should there be a study suggesting the possibility of publication bias, it sure serves a red flag and calls for extra attention with respect to the sources, but the source quality is what mattes in the end; not the country of the origin. The purpose of the statistical tests carried out to study possible publication bias is not to discard all the studies of the country in question (i.e. do not extrapolate the results outside the sample), and this misunderstanding on the nature of statistics appears to be behind some users suggestion to discard all sources from the countries in question.

They say that there are "three kinds of lies: lies, damned lies, and statistics". This is hardly true, though. Usually the problem is misunderstanding of statistics. Jayaguru-Shishya (talk) 19:56, 17 November 2015 (UTC)

Yes, LesVegas, the fact that those prominent scientists worked under the Soviet system is definitely a red flag. If the case of Pavlov (most of whose career was pre-Soviet anyway), his work was famously not manipulated, so we can counter sources that condemn Soviet psychiatry as a whole with sources that accept his specifically. But "Pavlov's work seems to have been okay" doesn't mean that you can use any other Soviet psych sources. (Also, Pavlov technically did physiology, not psychiatry; in fact, Pavlov died the year after the first-ever board-certified psychiatrists were approved in the U.S.) I don't know anything about the other two, but I note that they both died even earlier than Pavlov.

Jayaguru, if the source indicates publication bias based on country of origin, then the country of origin is indeed a red flag against the source. Like every other consideration, it is not necessarily a sufficient consideration, but if the source is published in a system with demonstrated bias, then that is a verifiable indication that the source may not be high-quality after all. WhatamIdoing (talk) 02:26, 18 November 2015 (UTC)

User: WhatamIdoing Thank you for your response to one of my questions and I appreciate your consistency with your answer. Regarding Pavlov, you are correct, much of his famous published works for which he won the Nobel Prize, occurred before the Soviet Union was formed. However, he did continue to publish up until 1924, two years into the formation of the USSR, and then he worked in the clinical field after that. Would those publications be allowed? The other two get a bit more complicated, as some of their publications were actually seminal works and published after the Soviet Union was formed. Bekhterev was credited for founding objective psychology before Watson, for discovering the role of the hippocampus in memory, for discovering ankylosing spondylitis (which, yeah, is more physiology than psychology related, I was just illustrating he's a big deal) and he just so happened to publish a posthumous work in 1927, nearly 5 years into the formation of the USSR. Gannushkin published important research in the late 20's and also a posthumous work in the early 30's on personality disorders and that research is credited as a War and Peace of personality disorders, the most complete exhaustive description of them. These are all influential works and, despite being psychology works published in the Soviet Union, they are well received and I see no academic objections to them, not even close. Therefore, wouldn't the best way for us to deal with these is to say they're allowed, but if editors find reliable sources that have serious objections to them, thereby making them not "high quality sources", they're disallowed? (which would mean a rewrite of the paragraph from type to source). I also note that you didn't answer my question about why funding sources are not a reason for rejecting a source, despite much stronger evidence in certain fields that this is clearly the case than we have for Chinese studies on acupuncture, yet you seem fine with disallowing those. I'm seriously not trying to pummel you or make you look like a hypocrite and I hope you don't think that's the case. My intention is just to suggest that perhaps you have overlooked a blind spot with regard to our wording, and that perhaps it should be something that is consistent. And also to point out that this was noted by Elvey in his close and any proposed implementation of wording should take this into consideration, and I'm not sure your proposal did. I can ask you down there, though, if you'd rather. LesVegas (talk) 13:56, 18 November 2015 (UTC)

If, e.g., Gannushkin's work is respected, then we ought to be able to find sources that balance the overall reputation ("All Soviet psychiatry is untrustworthy garbage") with sources that specifically praise his ("Soviet psychiatry is generally untrustworthy, but Gannushkin's work on personality disorders is actually good").

I've seen no similar claims for the Chinese source you want to include.

I don't believe that our guidance about funding sources has any bearing on this question. WhatamIdoing (talk) 23:23, 21 November 2015 (UTC)

Phrasing

We're having significant issues implementing the result of the RfC, in part because it was ill-formed, and in part because it had a very unclear close. I think the situation demands more discussion in order to sort out the proper phrasing. Before staring a new RfC or anything similar I think we should tally our suggestions:

This is the last suggestion:

Editors should not perform detailed academic peer review. Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, country of origin or conclusions.

References

I think the major issue with this is bloat – we're basically wasting time explaining the obvious here. Is it needed at all, and why not forgo it entirely? Since country of origin pew say has never been proposed to be a reason to exclude sources, why should we waste valuable space when it's going to need such a lengthy explanation that the clause really it doesn't mean anything at all? CFCF 💌 📧 01:38, 31 October 2015 (UTC)

The wording is ambiguous. It does not improve or clarify anything. QuackGuru (talk) 01:42, 31 October 2015 (UTC)

All this talk about country of origin is misguided because it does not matter what this guideline says—if there is a reason to consider country of origin when assessing the reliabity of a particular source for verification of particular text, the country will be considered. A guideline cannot prohibit common sense. Naturally anyone saying "that source has to be rejected because it came from China" can be ignored, but there may well be reason to be cautious about some types of research which a guideline cannot rule out. Johnuniq (talk) 02:36, 31 October 2015 (UTC)

I support the proposal above. For now, I have added in "country of origin" to the article since that much was clear from the consensus read. The remainder, in my opinion, should link to the full wording of the close since a summarized version will never be agreed upon. The above version, in linking to full wording, does just that. I also like the footnote for conclusions as well, and think it serves a valuable purpose here. LesVegas (talk) 16:15, 31 October 2015 (UTC)

Archival

This is insane. I asked what clarification question was given no answer, but got no reply. Archiving. --Elvey^(t•c) 02:37, 31 October 2015 (UTC)

Elvey - your archiving of this discussion was a major side-step and not in line with Wikipedia's consensus-building. If we are unable to discuss this properly as to elucidate what wording is most appropriate - the only alternative will be to throw out the consensus-reading and start anew. For starters we had a 4 Support v 11 Oppose close in favor of the minority position - this seems completely bizarre when you look at it. Either we start a new RfC or we send it to the appropriate venue for a close dispute. CFCF 💌 📧 11:07, 31 October 2015 (UTC)

Consensus reads are not simple vote tallies. The majority of those opposed were talking about low quality sources which are not allowed per WP:V or WP:RS anyway, hence the reading. LesVegas (talk) 16:08, 31 October 2015 (UTC)

This was a flawed close. There is no consensus - by any definition of the term - in favour of the "yes" position, yet Elyey finds consensus. Elvey says we can't overturn WP:V and WP:RS. Excluding acupuncture studies published in China would be following those policies. We're expected to use the best sources and there is a cloud over those studies. Relying on them would be doing a serious disservice to our readers. (As I said above, we need to reconsider the weight we give to industry-funded psychopharmacology studies, too, but that's probably for another discussion - but maybe not. Maybe now is the right time for that, since both controversies hinge on publication bias/cherry picking/salami slicing.)

I see Elvey has tried to close this discussion. That's inappropriate.

Is it appropriate for Elvey to be making non-admin closures while they are under editing sanctions? I'm not sure of the details, but Elvey mentioned them on Jimmy's talk page. [12] --Anthonyhcole (talk · contribs · email) 02:38, 1 November 2015 (UTC)

I don't think there's a rule about NACs while under sanctions, but I'd consider it a bad idea myself due to the necessary level of community trust. In this case there are actually connections with the RfC - Elvey's topic ban followed some highly acrimonious interactions with User:Jytdog (one of the editors !voting Oppose), and the t-ban was supported by several other editors who also !voted Oppose here. I read the close as likely being an attempted supervote, especially after their subsequent actions - joining the edit warring over the RfC result, telling editors questioning the close to "drop the stick" and other less complimentary things, and ultimately trying to archive this discussion. But either way, the close unfortunately perpetuated the dispute rather than resolving it. Sunrise (talk) 12:03, 1 November 2015 (UTC)

Yes. The close was incompetent and nonsensical. Given the closer's history, that may be the best gloss on it. Alexbrn (talk) 14:31, 1 November 2015 (UTC)

Elvey removed the above comments on the basis they were personal attacks. These are not personal attacks, but focus on the fault of the close. Elvey , your actions are very possibly a violation of your COI-topic ban. The discussion regarding Chinese sources covered conflict of interest on the part of the researchers, you should not be involving yourself in discussions surrounding COI at all. CFCF 💌 📧 23:28, 1 November 2015 (UTC)

RfC Appropriate version for the new clause

Possible phrasings required to support the inclusion of a clause surrounding country of origin are multiple and we have so far no consensus on what to use. For this reason I have listed the following versions as possible:

(Note: other wording is also possible, feel free to add o the end of this list)

1. Clarification
   Do not reject a high-quality study-type because of objections to: inclusion criteria, references, funding sources, country of origin or conclusions except when they explicitly impact the quality of the source.
2. Omission of the addition
   Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, or conclusions.
3. Link to extended discussion
   Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, country of origin or conclusions.
4. Alternate clarification
   Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, country of origin, or conclusions. However, you should consider these factors if reliable sources have specifically linked them to systematic problems in the medical literature.
5. Another alternate clarification
   Where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries it may impact the quality of the source. (Without including <ref></ref> tags.)

References

• Support 1 or 2 - Oppose 3 Adding the link will result in noone reading the content and the entire sentence losing its meaning with new time-consuming debates blossoming. My reading, and I think the only sensible one is that the RfC overwhelmingly supported not including the statement on the basis that is was a hypothetical situation that had never occurred. CFCF 💌 📧 11:21, 1 November 2015 (UTC)

Also considering the difficulty of understanding the close as it is we can count on that the addition of a link will only confuse future readers. CFCF 💌 📧 12:58, 1 November 2015 (UTC)

• Comment This seeks, in less than a month, to undo a RFC by removing the consensus of the last RFC. AlbinoFerret 13:42, 1 November 2015 (UTC)
  • No, it does not. There are multiple alternatives and including the majority supported position expressed in the previous RfC is only proportionate. CFCF 💌 📧 14:01, 1 November 2015 (UTC) 
  • If I'd been asked, I would have recommended waiting a few weeks, so that this page isn't quite so busy with other discussions. But there is no actual rule against starting a second RFC the day after the first expires, or even before then.
    Actually, if I'd remembered that the proximate cause of Elvey's topic ban was a dispute with multiple participants (Jytdog, Doc James, and Alexbrn were all mentioned in the original AN complaint, and all opposed this change) and involved articles about drugs and medical devices, then I might have suggested following the directions at Wikipedia:Closing discussions#Challenging other closures to have the original close formally overturned and the discussion re-closed by someone else (ideally, an admin. NACs are discouraged from taking on contentious closes like this one). It rarely looks good when you close an RFC about a guideline in favor of a position held by only ~30% of participants; when you are also closing it against multiple people who were involved in getting you topic-banned, then it's even worse. The "smell test" matters for closers. WhatamIdoing (talk) 15:45, 1 November 2015 (UTC)

Yes the smell test may matter. But part of a closers job is to discount off topic comments. It is reasonable to discount comments about low quality sorces in a discussion that from the start was about high quality sources. AlbinoFerret 17:02, 5 November 2015 (UTC)

Since the sentence in question is about sources of all quality levels that use high-quality types of study designs, I disagree that complaints about low-quality meta-analyses are "off topic". If the NAC didn't understand the difference between "top of the pyramid vs bottom of the pyramid, as determined solely by the pyramids and ignoring the entire rest of this page and all sourcing policies" and "high-quality source, as defined not only by those evidence-oriented pyramids but also after taking into account all the other factors on all the sourcing policies and guidelines", then the NAC certainly had no business rendering a decision here. WhatamIdoing (talk) 06:25, 17 November 2015 (UTC)

I am curious, this RfC is titled "appropriate version for the new clause" but I am at a loss as to how any option but number 3 is actually a version of the new clause. Options like number 2 actually appear to be merely upset editors gaming against the previous close. Can anyone tell me where I'm wrong? LesVegas (talk) 14:12, 2 December 2015 (UTC)

• Support 3 only, and comment This RfC isn't valid and goes against proper procedure. It was generated by an editor who disrespects both consensus and policy and has started an illegitimate RfC to justify edit warring and disruption. Many options here don't actually address how to implement the wording from the previous close. Option 3 is the only one that addresses what the previous close said. Option 1, while it does put "country of origin" on equal footing as "funding sources" (which the previous close addressed), the wording "except where it explicitly impacts the quality of the source" was never once addressed in the RfC close. I wouldn't be opposed to it in principle, but it is frankly necessary to do an entire RfC on that alone to address how it could be gamed, and that's not the scope of this RfC. Option 4 is a similar issue. All other options (2, and 5) aren't valid whatsoever because they don't address implementation of the wording "country of origin" from the previous RfC close, but rather get rid of it entirely. LesVegas (talk) 17:42, 1 November 2015 (UTC)

We've been through multiple iterations trying to apply the result of the close, none of which has been stable or consensus-driven. An RfC could settle this matter, and this one also includes the ability to add other potential wordings. The only reason you would dislike this RfC is if you feared that it would undue the previous close reading, which really shouldn't be a problem if you have real consensus. The other venue available is of course a close review, and seeing as there is little visibility for this RfC that may be more appropriate. CFCF 💌 📧 18:25, 1 November 2015 (UTC)

No, you've been through multiple iterations. The previous RfC settled it on wording suggested in that RfC. I advised you that if you had a problem with it you could formally challenge it. Edit warring and starting another RfC isn't the way to go about this, and looks especially bad for you since there's an open ANI case over this very behavior. LesVegas (talk) 23:53, 1 November 2015 (UTC)

In all the examples that you gave in support of the previous RfC, concern about the country of origin was clearly justified. Hence you have not established why the change of language was necessary in the first place. Furthermore the close of the previous RfC was questionable as it used a circular argument for its justification. In a nutshell, it stated that the RfC only applied to high quality sources, but country of origin can be a legitimate consideration in determining whether the source is high quality. Finally the closure did not specify the exact language that should be implemented. This RfC simply tries to establish what language should be used. Boghog (talk) 06:30, 2 November 2015 (UTC)

• Support 1 and Oppose 3 As pointed out during the previous RfC, there are well documented cases of culture specific bias in biomedical publications and taking into account the source's country of origin in these cases is clearly justified. The problem with the current language is that it can be misused to argue that these biases should not be taken into account. The clarification wording removes the potential for abuse. Boghog (talk) 19:58, 1 November 2015 (UTC)

• Comment - One thing that seems to be missing in all the options presented so far is the issue context. Reliability often depends on context... when we examine a source, we always need to examine the exact wording of the information being supported by that source. Is the source being used to verify a fact? Is it being used to verify an opinion? A source that is unreliable in one context might be quite reliable in another context. If we apply this to the issue of "country of origin", it will mean that sources from a particular country may well be unreliable in one context (for example, when stating something as a blunt medical fact)... and yet quite reliable in another context (such as explaining a cultural opinion on something medically related). Blueboar (talk) 12:53, 2 November 2015 (UTC)
  • I'm sure you won't be surprised to hear that the whole sentence is being taken out of context. ;-)  This is in a section on assessing evidence quality (e.g., a meta-analysis of multiple randomized controlled trials is better evidence than one randomized controlled trial; one randomized controlled trial is better evidence than a case study). A few years ago, we had a problem with some editors "assessing evidence quality" by personally scrutinizing the methods, and then rejecting any source that included things they disapproved of. So we would end up with editors refusing to use (or to permit others to use) apparently excellent meta-analyses, and demanding that primary sources be preferred to secondary sources, because they "assessed the evidence quality" and decided that the meta-analysis was "low-quality evidence" and that the primary source was "high-quality evidence", because the meta-analysis used studies with the wrong inclusion criteria, or because the primary source was funded by an activist group instead of an industry group, or whatever their hobby horse was. So it's not actually meant to discuss article content at all; it's meant to help you screen sources so that you can write a better (i.e., more representative of biomedical reality) article. It's really about helping you find what's WP:DUE instead of what's WP:V. WhatamIdoing (talk) 03:23, 3 November 2015 (UTC)
  • The context of the original RFC is quite clear: LesVegas wants to include questionable sources that misrepresent the effectiveness of acupuncture, and wishes to rewrite policies and guidelines to help him justify doing so.—Kww(talk) 17:16, 3 November 2015 (UTC)
• Support 5: Where reliable sources have identified systematic problems in the medical literature associated with specific regions or countries it may impact the quality of the source is positive guidance that addresses the issue at hand.—Kww(talk) 17:16, 3 November 2015 (UTC)
• Support 5: per Kww. This is the clearest version if we really need further clarification. However, I note that none of the possibilities exclude us from using well-referenced concerns about systematic pseudoscience in defined areas, so they all strike me as acceptable. Version 4 is fine too. As nobody is seriously proposing that personal objections are an acceptable basis for an encyclopedia (LesVegas's interlocutor notwithstanding) the mention of "personal objections" in 2 and 3 strikes me as not required. Richard Keatinge (talk) 13:10, 12 November 2015 (UTC)
• Support 1 or 5. Oppose 3. It is clear that this particular change to this guideline was started to win an underlying content dispute. I agree that in general these criteria as personal opinions are dubious as reasons to apply, but when independent sources identify them as problematic, we need to follow those source as well. Yobol (talk) 01:35, 13 November 2015 (UTC)

I noted that you, along with CFCF, opposed the previous RfC. Option 5 goes entirely against it, and this RfC is actually about how to word the inclusion of "country of origin" from the previous close, not undermine it, as many options, including option 5, do. LesVegas (talk) 16:44, 2 December 2015 (UTC)

Your point being? CFCF 💌 📧 23:26, 2 December 2015 (UTC)

• In my humble opinion 5 shouldn't even be an option here. This request for comment is about implementing certain wording, not about getting rid of it. 166.170.47.193 (talk) 15:07, 15 November 2015 (UTC)
• Start from scratch, using the information we gained in this dispute about how some editors misunderstand this. I think that we need to re-write the entire sentence, because it's clear that the current language is too subtle. A couple of editors keep confusing "high-quality type" and "high-quality source". So how about we scrap the (demonstrably) confusing "high-quality type" language and say something like this?
  "Assessing evidence quality" means editors should determine quality of the type of study, and where that type falls on these evidence pyramid charts. Editors should not perform detailed academic peer review. Do not reject a source that is high on the evidence pyramid in favor of one that is lower on the evidence pyramid because of personal objections to: inclusion criteria, references, funding sources, or conclusions. This factor must be considered alongside other criteria when evaluating a source. It is possible for a source to rank high on the evidence pyramid and still be a low-quality source over all, e.g., because it is outdated or published by a disreputable source.
  I've underlined the bits that are new. I grant that it's not going to win any awards for brilliant prose, but I'm not planning to submit it for FA. The paragraph is about two inches below the two large, rainbow-colored pyramid diagrams about evidence. Can anyone read what I've written here and see ways for it to be misunderstood or misinterpreted? WhatamIdoing (talk) 06:50, 17 November 2015 (UTC)

Good suggestion WhatamIdoing. Its main problem is that it won't help anyone win their content dispute. Richard Keatinge (talk) 22:06, 17 November 2015 (UTC)

I support changing high quality type to high quality source, especially because this gives a stronger barrier to entry of all of our sources. However, I do not support omitting "country of origin" for two reasons: 1) it goes against the previous close, 2) it allows "funding sources" (which in some fields have shown major issues with bias) but disallows country of origin for same, albeit lesser, reasons. Why would we allow funding sources into our statement but not country of origin? LesVegas (talk) 14:05, 18 November 2015 (UTC)

Since the whole section is about types of studies, then why would we change it to talk about individual studies? A source can be the very best type of study and still be unreliable due to factors unrelated to evidence quality. WhatamIdoing (talk) 23:27, 21 November 2015 (UTC)

• Support 5. Reject all other proposals. Bias sources may be rejected where they is a known problem. WhatamIdoing, your proposal is too confusing for me. QuackGuru (talk) 05:22, 19 November 2015 (UTC)
  • It would be very helpful to me to know which of the proposed changes is most confusing to you. WhatamIdoing (talk) 23:27, 21 November 2015 (UTC)
    • Number 4 is most confusing (ambiguous). Your proposal is too complicated. QuackGuru (talk) 00:48, 22 November 2015 (UTC)
• Support 3 and second 1. Country of origin should not be a factor in disqualifying high quality sources. AlbinoFerret 14:16, 4 December 2015 (UTC)
• Support 3 only The other options are really invalid options since the content of these was not addressed during the previous RfC close, plus this RfC is about how exactly to word the previous close's decision (something the previous RfC also tackled, but certain tendentious editors are ignoring that fact.) When the previous RfC is a simple question asking, should we change MEDRS from:

Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions.

to

Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, country of origin, or conclusions.

The answer to that simple question was Yes, so this RfC about what version to implement wasn't needed. But CFCF, who objected to the original RfC, decided to game the system and create an RfC that seeks to overturn the previous close, while cloaking this RfC as "which version of the new clause" do we use? This RfC is nothing more than an elaborate WP:GAME by an editor who objected without basis, was refuted, attempted to edit war his version into place, and hopes to have a version that circumvents due process.

Options 2 and 5 are particularly awful since they don't even contain the words "country of origin" whatsoever, something the prior close was adamant was necessary. I will also note that the OP, CFCF, stated this was a hypothetical situation that had never occurred., yet he continues to ignore the fact that, yes, it had occurred multiple times1 [2 3, all of which were outlined in the previous RfC, and whose close he edit warred and disruptively disputed, or else we wouldn't even be talking about this right now. LesVegas (talk) 04:43, 9 December 2015 (UTC)

What does MEDRS cover?

{{rfc|med|sci|policy|rfcid=7B701F6}}

In the lead should we use "biomedical and health information" or "biomedical information"?

Biomedical and health

• Support MEDRS's goal is that "information is accurate and reflects current knowledge". Biomedical covers health, and this clarifies for the reader. CFCF 💌 📧 22:42, 2 November 2015 (UTC)
• Support Health content is a subsection of biomedical content. Using biomedical and health simply simplifies and clarifies our text without changing its meaning. Doc James (talk · contribs · email) 22:48, 2 November 2015 (UTC)
• support biomedical content includes health content, without question--Ozzie10aaaa (talk) 22:53, 2 November 2015 (UTC)
• Support. The way I see it, Wikipedia sets particularly high standards for content that can affect the well-being of our readers. We do not want poorly sourced content that might lead a reader into being harmed. Content that bears on our readers' health clearly falls within the proper area of this concern. Obviously, this encompasses biomedical topics, but I do not want editors to try to use a loophole to argue that some sort of fringe "health" subject gets to be held to a lower standard. --Tryptofish (talk) 23:10, 2 November 2015 (UTC)
• Oppose "Biomedical" is reasonably defined through the link, while "health" is undefined and open to the broadest of interpretations - practically anything can be viewed as health-related. This is unsuitably imprecise for official guidance, let alone for a summary of same. --Tsavage (talk) 23:13, 2 November 2015 (UTC)
• OpposeConditional support If the addition is linked as biomedical and health to avoid ambiguity and gaming. Health is an over broad term and is subject to ambiguity and gaming. I am also concerned with the removal of the phrase "treatment information" in the edit that has been being cited in this discussion [13]. That term seems to clearly constrain the areas this guideline was intended to deal with removing it seems to greatly expand the scope from 'biomedical... treatment information' to 'biomedical and health... information. Which seems far outside the intended scope. Jbh^Talk 23:28, 2 November 2015 (UTC) Modified !vote Jbh^Talk 23:50, 2 November 2015 (UTC) Struck concern about removal of "treatment efficacy". It was pointed out this is another issue under discussion and not related to this change. Jbh^Talk 13:28, 3 November 2015 (UTC)
• Oppose As said above, this is over broad and allows it to be applied to areas it should not. This would allow application to almost any human activity. This addition would not be clear and concise, both requirements of WP:GUIDELINE. I will also point out that those that say its a long standing version or meaning are incorrect. This diff [14] shows "and health was not part of the page from 2011 until CFCF added it in 2015.[15] AlbinoFerret 23:33, 2 November 2015 (UTC)
• Support Agree with CFCF. Cloudjpk (talk) 23:52, 2 November 2015 (UTC)
• Support agree with nominator. We have always understood MEDRS to apply to health-related information. "Biomedical and health" makes this easier to understand for lay readers. --Tom (LT) (talk) 01:32, 3 November 2015 (UTC)
• Support this is the intent. Zad68 03:20, 3 November 2015 (UTC)
• Oppose as over-broad; see WhatamIdoing's excellent analysis in the discussion section. -- Notecardforfree (talk) 03:34, 3 November 2015 (UTC)
• Support per DocJames, Tryptofish & others. BMK (talk) 06:59, 3 November 2015 (UTC)
• Oppose. This attempted expansion of MEDRS has already been used to suppress citations to the National Advisory Council on Violence Against Women and the American Psychiatric Association's DSM-5[16], the Los Angeles Times[17], and the scientific journal Psychological Reports (because the paper was published in 2004 -- before the MEDRS 5-year limit)[18]. And that's just one editor on one page. --Guy Macon (talk) 07:26, 3 November 2015 (UTC)
• Oppose "health" is not clearly defined, and those proposing this idea seem to be pushing a non-neutral point of view. Graeme Bartlett (talk) 12:13, 3 November 2015 (UTC)
• Support health is medicine. needs to be broad to avoid lawyering around the edges. Cas Liber (talk · contribs) 12:55, 3 November 2015 (UTC)
• Oppose because "health" is too broad and too ambiguous and MEDRS was not intended to be that broad. See discussion. Minor4th 18:58, 3 November 2015 (UTC)
• Oppose - as in the discussion below "health" encompasses a range of topics covered poorly or not at all by peer reviewed medical literature. Health is neither synonymous with nor a subset of 'biomedical topics', though there is certainly overlap. Dialectric (talk) 19:56, 3 November 2015 (UTC)
• Support. There is a huge overlap between (bio)medical/health and this wording covers all. JFW | T@lk 20:32, 3 November 2015 (UTC)
• Support Obvious. Those opposing this seem to be anti-GMO WP:ACTIVISTs. jps (talk)
• Oppose expansion of MEDRS beyond "biomedical". petrarchan47คุก 04:07, 4 November 2015 (UTC)
• Oppose if health is automagically biomedical, then there is no need for this wording. If on the other hand there are aspects of health that isn't biomedical, and which is treated better within other sciences, as several editors have pointed out, then this wording is too encompassing. There are moral and philosophical aspects of health that is/are better treated within sociology, philosophy etc. The need for airbags is a health issue, but the implications and discussions of this aspect encompasses several other sciences, and thus shouldn't be limited to medrs sourcing, but instead rely on WP:RS and the best available sources in general. --Kim D. Petersen 09:14, 4 November 2015 (UTC)
• Oppose I am not sure that I know the difference between health information, biomedical information, and medical information. I prefer using either "medical" or "health" which are simple words then clarifying the limits elsewhere. Blue Rasberry (talk) 17:52, 4 November 2015 (UTC)

Support My preferred choice is not listed, which would be to say "health" only. Still, of the options presented, this is the one I support. This conversation is hardly about the term "biomedical" at all anyway, and this is about whether to use the term "health". Yes, use "health". "Biomedical" is the term I oppose, but that is not even being discussed here. Blue Rasberry (talk) 20:06, 6 November 2015 (UTC)

• Oppose of course "health" sounds good but, supporters, think about it, dont gloss over this, face it: it is not clearly defined. WhatamIdoing's examples above of driving the car w/wo seatbelt illustrates the point exactly: biomed is narrower, health could be the universe and back.--Wuerzele (talk) 04:47, 5 November 2015 (UTC)
• Support per DocJames, Tryptofish & others. RDBrown (talk) 05:45, 5 November 2015 (UTC)
• Support. We should use only the very best sources where human health is concermed. --Anthonyhcole (talk · contribs · email) 05:54, 5 November 2015 (UTC)
• Support Biomedical includes claims of effects on health, and clarifying that health claims must be supported by reliable medical sources will help prevent edit warring over fringe health issues. Adrian^[232] (talk) 19:59, 6 November 2015 (UTC)
• Oppose As many other editors have wisely stated, the terms "health" and "health-related" are far too broad to be confined to MEDRS. Inclusion of such ambiguous terminology may be Wikipedia:Opening up a can of worms, IMHO. Keep things simple......Charlotte135 (talk) 22:59, 6 November 2015 (UTC)
• Oppose. For five reasons: 1) Biomedical is more clear term whereas "health" is too ambiguous 2) adding "health" would be open to WP:GAME, 3) WP:MEDRS does not need expansion, 4) the attempted expansion actually has already been used to suppress citations in some articles, and and last but not least, 5) MEDRS could be applied to pretty much everything, like editor RexxS already stated that MEDRS should actually apply to articles such as "bicycles"[19]. Also, I think Kim D. Petersen made a good point above. Jayaguru-Shishya (talk) 16:52, 8 November 2015 (UTC)
• Oppose "Biomedical and Health" greatly and dangerously expands MEDRS's application and actually leads to less clarity. MEDRS should not be applied to organic food, for instance, but it should be applied if we make a biomedical claim about organic food. Sources that talk about facts regarding pesticides, like chemical composition, are already well covered by RS and if we allowed editors to reject these because they don't pass MEDRS's barometer, we're opening up an enormous can of worms, which incidentally should also not have MEDRS policing claims about them, unless we talk about the nutritional benefit of eating canned worms, a biomedical claim, and then MEDRS applies. LesVegas (talk) 19:08, 10 November 2015 (UTC)
• Support. The lay reader does not know what the term "Biomedical" means. "Biomedical and Health" clarifies the meaning. QuackGuru (talk) 19:15, 10 November 2015 (UTC)
• Support in theory, with narrowing. Just "health" by itself is too vague, and would arguably subject things like Chinese medicine and ayurvedic medicine to MEDRS, which seems dubious. But the vast majority of disputes I've seen about MEDRS are attempts to "corral" WP:FRINGE and "lifestyle" (e.g. electronic cigarettes articles, even when they contain actual biomedical information (as at electronic cigarette aerosol), as being outside the scope of MEDRS, on the faulty basis that they somehow not "really" bio-medical but just vaguely "health" related. This is basically nonsense and WP:WIKILAWYERing at its worst, for PoV-pushing purposes.  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  13:45, 12 November 2015 (UTC)

 SMcCandlish, the Ayurveda article has been subject to WP:MEDRS; there has been a lot of dubious editing and edit warring at that article. In fact, the article is currently locked down when it comes to new and/or unregistered editors. Flyer22 Reborn (talk) 14:27, 12 November 2015 (UTC)

I don't mean to second-guess consensus on that; I was not part of those discussions. My point is that the very presence of the word "health[y]" on a page should not magically trigger MEDRS. Actual heath claims that can be subject to scientific examination should need to be at issue in order for MEDRS to apply, but if they are present, then MEDRS definitely should apply. "This helps balance your chi and chakras for a healthier life" is not a claim that can be subject to such testing. "Heals tumors and promotes tooth enamel restoration" is. There'll be a lot of grey area between these, and I think we should err on the side of MEDRS out of basic ethical responsibility to the public. We all know full well that many people are apt to believe uncritically, through sheer hope, any claim made about possible health benefits of something, no matter how dubious it is.  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  15:47, 12 November 2015 (UTC)

• support -- TRPoD aka The Red Pen of Doom 19:07, 18 November 2015 (UTC)
• Support. To me this describes the sense of this clause more clearly, in a way that should head off wikilawyering on topics that should be covered by MEDRS but where tendentious editors wish to evade its coverage. —David Eppstein (talk) 23:32, 21 November 2015 (UTC)
• Support: Rewriting the scope to include health will make explicit this guideline's appropriateness for articles on health topics. In my opinion, the potential for the ambiguity of the term "health" to be misused is less than the potential harm that can be caused by people not believing high quality medical sources are needed for articles concerning human health. Songleaves (talk) 04:57, 22 November 2015 (UTC)
• Oppose: Oppose. The purpose of MEDRS, which includes the three letters MED for Medicine or Medical, is to make sure that readers who mistakenly rely on Wikipedia for medical advice are not mislead, and Wikipedia is not subject to a medical malpractice lawsuit. That was made clear since the initial version of 10 November 2006 here and has stood firm since then. I have witnessed how this standard is being misapplied and needlessly expanded by those with a particular narrow agenda to CENSOR good content and sources regarding political, philosophical, legal, administrative, cultural or controversial material, by eliminating sources that formerly had been acceptable for coverage and restricting only to high quality sources related to medicine. That is unacceptable for an encyclopedia. Wikipedia is not a medical journal and should not have an increasing scope of articles subjected to such a standard. --David Tornheim (talk) 21:45, 26 December 2015 (UTC)
• Support. Most of my concern if health was not included is gaming. I've seen editors try to argue a topic is not health related (e.g., e-cigs, GMOs, etc.) when the very spirit of this guideline has always been health. Including the term health would prevent that kind of wikilawyering. If the "worst-case" scenario happens described by opposers that some topics get placed under MEDRS that are more tangential, then we're just going to have a push for more reliable sources. There's not really a downside to including the health term at all. Kingofaces43 (talk) 19:17, 28 December 2015 (UTC)
• Oppose: I fail to see how the inclusion of a completely redundant term in this proposal could add anything useful. The additional wording ("health") has an extraordinarily large scope, covering a range of related topics that are not subject to MEDRS such as public health policies and public healthcare funding. It is likely to cause unnecessary confusion to the reader and so I strongly oppose the use of such a vague and overly broad description. -RoseL2P (talk) 13:49, 29 December 2015 (UTC)
• Support the whole point of MEDRS is to keep sourcing standards high for WP content about health; the internet is full of poor quality content about health and MEDRS helps us keep that crap out of the encyclopedia. Jytdog (talk) 17:55, 29 December 2015 (UTC)
• Support Support per Doc James, Tryptofish, Jytdog, etc. Alexbrn (talk) 19:25, 29 December 2015 (UTC)
• Oppose I see the reasons for wanting to include "health" here as being dishonorable and dishonest, an attempt to sort of "game the system" to be able to require higher level sourcing for some claims about sociology related to things like violence, as i've seen from some past discussions on this topic, and therefore i say leave it as "biomedical" alone because we want actual physical health-related content to be included but not necessarily sociological dynamics that may surround health but not be central to the intent of MEDRS. SageRad (talk) 20:13, 29 December 2015 (UTC)
• Oppose - much too broad. Perhaps if it was better defined to a specific area, it would garner more support but "health" is too far reaching. For example, a healthy diet is good for you - uhm, we don't need to cite MEDRS. Atsme^📞📧 21:54, 29 December 2015 (UTC)
• Oppose - too broad. TimidGuy (talk) 11:43, 30 December 2015 (UTC)
• Support – I am somewhat conflicted on this RFC because I see both sides abuse the scope of MEDRS. However I think the more problematic abuse arrises from applying a too narrow definition. For example, alternative medicine is often considered outside the scope of biomedicine but within the scope of health and medicine. Despite the medical disclaimer, readers do sometimes consult Wikipedia in making health decisions and therefore it is prudent that any health related content be held to a higher sourcing standard. Hence I think it is reasonable to add health in defining the scope of MEDRS to remove any doubt that health related subjects such as alternative medicine are covered. Boghog (talk) 13:54, 30 December 2015 (UTC)
• Support; this all seems like wiki-lawyering to exclude health. --Jules (Mrjulesd) 02:18, 31 December 2015 (UTC)
• Support as clarification of what the longstanding of what MEDRS has typically covered. Yobol (talk) 02:39, 31 December 2015 (UTC)

Biomedical

• Support. Note that this wording has been in the the guideline for at least the last five years. Expanding this to include health will allow editors with a POV to push to reject high-quality sources that they disagree with. For example, car crashes and motorcycle have a huge impact on health and information about how often they occur is generally considered to be public health information. The US government department of transportation publishes statistics on how many crashes and injuries cars and motorcycles have per mile traveled. If we expand this guideline to apply to health, a motorcycle fan could use it to suppress the statistics about motorcycle crashes because they were not published in a peer-reviewed rigorous scientific journal in the last five years. WP:MEDRS is not broken, and it doesn't need to be fixed. --Guy Macon (talk) 23:03, 2 November 2015 (UTC)
• Oppose We want to have a simpler wording and adding health simplifies it. Doc James (talk · contribs · email) 23:15, 2 November 2015 (UTC)
• Support Biomedical is clear. Adding health is open to gaming and/or disruptive POINT making. Jbh^Talk 23:22, 2 November 2015 (UTC)
• Oppose. Well, if we really need to have opposes... I'll say this: I think that a good case can be made for "health" by itself, and omitting "biomedical" (not that I'm actually proposing that, which I am not). "Health" defines the subject matter where we do not want poorly-sourced information to cause harm to our readers. If a reader is misled about something biomedical, that might not be any more harmful than if it were something about physics or math (assuming that it is basic biomedical science, and not implying that misinforming readers about any matter of fact is a good thing). Just as we have a serious responsibility not to mess up biographies of living persons, we have a serious responsibility not to mislead readers on matters of their health. --Tryptofish (talk) 23:26, 2 November 2015 (UTC)
• Oppose I agree with Tryptofish, but to expand: Wikipedia doesn't only cater to private individuals. Writers of health policy, lawmakers, public health professionals and the like also use us as a source of information, and we owe it to Wikipedia to make sure our information is the best we can get. MEDRS aims to make sure just that, because it is far to easy to cherry-pick poor sources when it comes to health.CFCF 💌 📧 23:31, 2 November 2015 (UTC)
• Support A more refined option and less open to being applied to just about anything related to human activity. This follows the clear and concise requirements of WP:GUIDELINE. AlbinoFerret 23:34, 2 November 2015 (UTC)
• oppose --Ozzie10aaaa (talk) 23:37, 2 November 2015 (UTC)
• Oppose Agree with Doc James and CFCF Cloudjpk (talk) 23:54, 2 November 2015 (UTC)
• Support WP:IRS and WP:SCIRS are sufficient guidelines to prefer high quality sources to low quality sources. The purpose of having MEDRS in addition is to guard against dangerously misleading information that could influence readers' personal health decisions. Going beyond that is WP:CREEP. Rhoark (talk) 01:05, 3 November 2015 (UTC)
• Support: I agree with many people above. Biomedical is clear, and adding health is unnecessary and indeed more confusing, in contrast to people stating that this makes the guideline clearer. See for instance this article, which I gave above in response to an explicit challenge by CFCF, in the journal Conflict and Health. Is anyone really contending that the intent of WP:MEDRS was to cover this sort of stuff? Secondly, the sentence is ambiguous, "biomedical and health" can be interpreted as both "biomedical" AND "health" (logical and), or as "either biomedical or health" (logical or) - it is clear that many people are actually reading the sentence like the latter. Why people want to use a misleading and ambiguous formulation is beyond me. Btw, I do not see why there are two sections, it is really confusing. Clearly, there are two options, and people who support both cancel out. Kingsindian ♝♚ 03:35, 3 November 2015 (UTC)
• Oppose - Simpler. BMK (talk) 06:41, 3 November 2015 (UTC)
• Support keeping it the way it is now will cause less disruptive editing to Wikipedia. Graeme Bartlett (talk) 12:15, 3 November 2015 (UTC)
• Oppose - avoid wikilawyering at edges. Cas Liber (talk · contribs) 12:56, 3 November 2015 (UTC)
• Support per the observations that "Expanding this to include health will allow editors with a POV to push to reject high-quality sources that they disagree with" and "Adding health is open to gaming and/or disruptive POINT making." I have no doubt at all that this change would result in refusing information that is included in some of the articles that I work on, information that is important to the articles and informs our readers. Gandydancer (talk) 14:41, 3 November 2015 (UTC)
• Support as per several others above. Biomedical is clear to me. SageRad (talk) 14:50, 3 November 2015 (UTC)
• Support for reasons I stated in the discussion. "Health" is too broad and subject to misuse and confusion. Minor4th 18:57, 3 November 2015 (UTC)
• Oppose. "Biomedical" alone implies only the investigational aspects of medicine, and does not appear to include clinical healthcare, health promotion, and the social aspects of medicine. I would not associate the word "biomedical" with clinical practice, but more with its laboratory aspects. JFW | T@lk 20:37, 3 November 2015 (UTC)
• Oppose. Above is beter. Supporters appear to be mainly anti-GMO WP:ACTIVISTs. jps (talk) 02:50, 4 November 2015 (UTC)
• Support "Biomedical" works perfectly; MEDRS does not need expansion. petrarchan47คุก 04:02, 4 November 2015 (UTC)
• Support biomedical works, albeit not without caveats - but these can be sorted out within the context of individual articles and topics. --Kim D. Petersen 09:15, 4 November 2015 (UTC)
• Oppose "Biomedical" is not a clear term and I would prefer to avoid it. Blue Rasberry (talk) 17:52, 4 November 2015 (UTC)
• Support even though i too would prefer a simpler term -as User:Doc James said- and dislike the insider "biomedical" which i agree may not be clear per User:Bluerasberry, and pointed out by User:Jfdwolff, but then lets define it more precisely. Adding health to biomedical does neither make anything clearer, nor simpler. Agree with Gandydancer's and User:Jbhunley's observations of gaming and pointiness, Minor4th, Guy Macon and AlbinoFerret's concern that MEDRS may be applied to just about anything related to human activity, Rhoark's creep argument, Petrarchan47 that MEDRS does not need expansion, Graeme Bartlett that its less disruptive, and Kingsindian's remark about the odd duplication of vote making things more diffuse than needed...--Wuerzele (talk) 03:20, 5 November 2015 (UTC)
• Oppose. Leaving out other aspects of human health is irresponsible. Close this loophole. --Anthonyhcole (talk · contribs · email) 05:59, 5 November 2015 (UTC)
• Oppose. Language isn't clear enough. Leaving out claims on health effects could be confusing to newcomers or others not familiar with MEDRS. Adrian^[232] (talk) 20:07, 6 November 2015 (UTC)
• Support - making the topic area more precise and medical information is specifically what is provided in the medical journals this directs one to. It seems a reasonable objection that health is too broad and it also seems pointless to direct folks to JAMA for material that isn't there. Markbassett (talk) 22:05, 6 November 2015 (UTC)
• Support. Biomedical is quite specifically defined with clear parameters and appears to have been in the the MEDRS guideline for at least the last 5 years. Why change it now? Including such a broad and ambiguous word as "health" makes no sense but has the potential to create much unnecessary confusion.Charlotte135 (talk) 11:02, 7 November 2015 (UTC)
• Support. Those aspects of health that are covered by "biomedical" are included; any other aspects aren't. Maproom (talk) 08:43, 8 November 2015 (UTC)
• Support. For five reasons: 1) Biomedical is more clear term whereas "health" is too ambiguous 2) adding "health" would be open to WP:GAME, 3) WP:MEDRS does not need expansion, 4) the attempted expansion actually has already been used to suppress citations in some articles, and and last but not least, 5) MEDRS could be applied to pretty much everything, like editor RexxS already stated that MEDRS should actually apply to articles such as "bicycles"[20] Jayaguru-Shishya (talk) 16:50, 8 November 2015 (UTC)
• Support Health is far too broad a term, could easily be misapplied, and would create edit wars and WP:GAMEs galore. I have already seen editors try applying MEDRS to even things like organic food (for non-biomedical claims) and they should always get shot down. WP:RS works fantastically for non-biomedical claims, including health-related ones and MEDRS for biomedical claims. Doc James wrote that "'health' simplifies the wording": no, it doesn't. It confuses it greatly, and extends MEDRS to policing claims from everything from apples to zoos. Biomedical claims about apples, yes, MEDRS already covers these well. Children getting ill from petting animals at zoos? Yes, that could possibly be a biomedical claim also covered by MEDRS. But, just like zoo animals, MEDRS also needs to be caged and editors shouldn't be able to release it to run amok. LesVegas (talk) 19:01, 10 November 2015 (UTC)
• Oppose. The wording "Biomedical" is too ambiguous and confusing. QuackGuru (talk) 19:15, 10 November 2015 (UTC)
• Support as less vague and less all-encompassing than "health". Also, I support me finally having a couple of weeks to write a first draft of WP:MEDDUE, so that people will quit abusing MEDRS as a way to get WP:DUE weight into articles, and in the meantime, I support adding a clear, unambiguous section to MEDRS that states that many subjects are multidisciplinary (e.g., rates of seat belt use, crime, and poverty) and that the community does not support a "medicine über alles" approach to multidisciplinary subjects. WhatamIdoing (talk) 06:32, 17 November 2015 (UTC)
• oppose per Tryptofish. -- TRPoD aka The Red Pen of Doom 19:09, 18 November 2015 (UTC)
• Support Covers the intended scope of MEDRS, and is quite clearly defined as a term, whereas health is so broad, it would require its own MEDRS-specific definition to be meaningful. Combining "biomedical and health" further confuses the situation, considering that the general argument for health is that it is essentially synonymous and does not expand the scope - how can we have an "and" if they are the same thing? "Biomedical" is the reasonably clear and straightforward choice. --Tsavage (talk) 21:33, 26 December 2015 (UTC)
• Oppose. The spirit of this guideline has always been related to health claims in general. Including only biomedical is ambiguous and opens up the guideline for more gaming than biomedical and health would. Kingofaces43 (talk) 19:19, 28 December 2015 (UTC)
• Support: I fail to see how the inclusion of a completely redundant term in the first of the two proposals could add anything useful. Besides, the proposed additional wording ("health") has an extraordinarily large scope, covering a range of related topics that are not subject to MEDRS such as public health policies and public healthcare funding. It is also likely to cause unnecessary confusion to the reader and so I am inclined to support the second proposal especially for its brevity -RoseL2P (talk) 13:49, 29 December 2015 (UTC)
• Oppose the whole point of MEDRS is to keep sourcing standards high for WP content about health; the internet is full of poor quality content about health and MEDRS helps us keep that crap out of the encyclopedia. Jytdog (talk) 17:55, 29 December 2015 (UTC)
• Support - per Guy Macon. Atsme^📞📧 21:53, 29 December 2015 (UTC)
• Oppose per my comments in the previous section directly above. Boghog (talk) 22:56, 30 December 2015 (UTC)
• Oppose; this all seems like wiki-lawyering to exclude health. --Jules (Mrjulesd) 02:19, 31 December 2015 (UTC)
• Oppose; as a change against longstanding consensus on what MEDRS covers. Yobol (talk) 02:39, 31 December 2015 (UTC)

Discussion

For the longest time MEDRS has governed which sources we use on health related topics. The recent discussion called into question this by trying to redefine "biomedical" to not include matters of public health or epidemiology. This is becoming a gradually larger problem and something that needs to be addressed. Being exposed to the term continuously I take it for granted that biomedical includes basically anything that is associated with medicine, including epidemiology and health. If we do not adhere to this definition we are excluding psychiatry (as a science not based upon the application of biological models) as well as epidemiology, which would allow for claims such as:
Banana's help prevent cancer
     or
Working your abs at the end of your workout is best for burning abdominal fat

References

(Proper sources by WP:RS standards).

One should also note that MEDRS has never aimed only to cover treatment, and that is actually absurd as I hope my above comments show. CFCF 💌 📧 23:15, 2 November 2015 (UTC)

Adding more language is not likely to stem a rising tide, if that's indeed the situation, it will just increase the number of additional disputes made possible by new words to play with. Going straight to the examples, "medical claims" would seem to work better - is there a reason why it is not used more prominently in MEDRS? It addresses both bananas and abs, while not offering as obvious a scope-broadening potential as "health," "health-related," "health claims." --Tsavage (talk) 23:35, 2 November 2015 (UTC)

Medical claims and health claims are synonymous. Thus MEDRS already covers this scope. This is just clarifying it. Doc James (talk · contribs · email) 23:37, 2 November 2015 (UTC)

(edit conflict) I would opt instead to use health claims, but I see where you are coming from. CFCF 💌 📧 23:39, 2 November 2015 (UTC)

I would have no objection to the wording proposed if its intention/meaning were constrained by linking it biomedical and health vice biomedical and health. Jbh^Talk 23:43, 2 November 2015 (UTC)

(edit conflict) I have no opposition to, in fact strong support for, MEDRS applying to epidemiology and psychiatry. Where my concern is is how for the unmodified term 'health' can be stretched. To use an example we are both familiar with under the proposed wording MEDRS would apply to the illustration and representation of 'health' issues ie to pictures used to represent mental disorders. Based on your arguments in that case you would resist MEDRS requirements there. It is the potential for ambiguity in situations like that and other knock on issues which give me pause. Jbh^Talk 23:38, 2 November 2015 (UTC)

Re:CFCF, let us clarify that MEDRS has been in place since mid-2008 rather than time immemorial, and that it has never been accepted as policy. As such, it suggests, rather than governs, which sourcing should be used.Dialectric (talk) 23:41, 2 November 2015 (UTC)

Comment: As I've pointed out more than once now, "health" and/or "medical" was in place of "biomedical" at various parts of the guideline. The guideline had been stable in that respect. This was changed in August, as seen with this and this edit. So I don't view re-adding "health" as some big change; "health" and "biomedical" is how it was. And reverting the guideline to the WP:STATUSQUO version while editors debate if "health" should have been removed is more appropriate. Flyer22 Reborn (talk) 23:42, 2 November 2015 (UTC)

This RfC isn't about those other sections it is about changing the lead. It is an established fact that the lead has been stable at "biomedical" for many years. You are free to edit6 those other sections to your liking and follow the normal consensus policy if anyone disagrees. --Guy Macon (talk) 09:14, 3 November 2015 (UTC)

Having it in the lead is probably the best way to ensure proper visibility. The point is that readers will not go through the entire guideline, and if we can point to the lede instead of wasting time pointing to sections and subsections it will be beneficial for everyone. The scope isn't changing, only how clear it is. CFCF 💌 📧 09:19, 3 November 2015 (UTC)

Guy Macon, that you keep missing the fact that those two diff-links show changes to the lead, and that "health" had been in the guideline for years, makes me think you are purposely acting blind. Flyer22 Reborn (talk) 10:09, 3 November 2015 (UTC)

Discussion question

• I have a question, and it's not simply a rhetorical one, for the editors who oppose "health". Can you tell me an example of a topic that would be described as "health", where it would be OK with you if information were sourced in such a way as to risk misleading our readers? --Tryptofish (talk) 23:49, 2 November 2015 (UTC)

The problem, as I see it, is there is no way of determining what is a health claim. How are things handled when, for instance, someone claims cell phone tower or power line siting is a health issue? It is possible to say there are no health effects fro cell tower radiation but it is harder to say there is no 'health effect' from these things because you can argue that they cause fear and anxiety which has a determent to health therefore a 'heath effect'. It is that kind of absurdity, second order knock on claims, I am worried about. Jbh^Talk 00:00, 3 November 2015 (UTC)

Thanks, that's helpful. The way I see it, there is no need for MEDRS to apply automatically to pages about power lines (obviously). But, as soon as an editor wants to add content about whether or not there are health effects associated with power lines, then that content should, as a guideline, be sourced according to MEDRS. That's because we don't want a statement about those putative health effects to be sourced to some-nutcase-blog-about-fringe-theories, in case it might mislead a reader into not getting the health care that the reader needs. It might seem absurd at first to say what I just said about a topic like power lines, that is far-removed from medical topics, but I would argue that it is not at all absurd when one looks at it from the perspective that our readers, from the general public, look to us for information that they can trust, and that information can affect choices that they make about their own health. --Tryptofish (talk) 00:10, 3 November 2015 (UTC)

Tryptofish, I share the concern about not being able to find the boundaries. People have really widely different understandings of "health".

But I want to add that your question is really odd. When is it ever "OK with you if information were sourced in such a way as to risk misleading our readers", anywhere on Wikipedia, in any subject? We don't accept misleading material on articles about television shows, horse racing, algebra, insects, or anything else. Why would we accept that for non-biomedical health-related information?

This guideline describes a set of ideal sources for <whatever the scope is>, and it strongly encourages editors to use those. That's great. You know I'm a fan of MEDRS, and have been from the beginning. But there needs to be a match between "the ideal sources" and "the stuff being supported by the sources". We have basically declared that the ideal source for <whatever the scope is> is a review article published in a reputable medical (NB: not nursing! not physics! not chemistry! not history! not statistics! not economics! not gender studies! not sociology! not law! not education! only medical!) journal during the last five years, or (if you really have to) a medical school textbook.

Problem: There are "health" things that are actually not ideally sourced to medical journals and medical school textbooks. These examples come from all sorts of domains, but let me give you some very everyday examples:

• Patients respond differently to providers based on the providers' race and gender. A woman may prefer giving birth unassisted to allowing a male midwife to help her. This is a big "health" issue, but telling a man that he's not allowed to look under her dress is not a "biomedical" issue. According to MEDRS, you should not cite a gender studies or religious studies article about this. The "ideal" source—and therefore the only acceptable POV—is the one that the medical providers themselves publish about their encounters with patients, in a medical journal.
• Providers treat blue-collar patients differently than white-collar ones. This is a big "health" issue, but it's not "biomedical". Providers give less pain medication to blue collar workers because of their bias, not because of their biology. According to MEDRS, you shouldn't cite a sociology book for information about this sociological phenomenon. According to MEDRS, the "ideal" is for you to only include information that you can cite to a reputable medical journal. Criticism of medicine by non-medical sources must be rejected.
• Patients have a different POV than providers. Patients care about prognosis and everyday life more than providers. But don't let Wikipedia include how cancer patients are affected emotionally by pink ribbon culture unless it's been published in a medical journal! MEDRS's "ideal" source for the health-related information about how alienated some patients feel when 60-year-old breast cancer patients are given children's toys—or how alienated other cancer patients feel when breast cancer patients get special treats just because it's Breast Cancer Awareness Month—is still a medical journal, not a book written by patients or researched by sociologists.
• Trans people often do not consider themselves to have a medical condition at all (especially if they are not seeking specific treatments). When they do, it's often therapy for distress over the way that society treats them, e.g., by misgendering them on their official documents. But according to MEDRS, the "ideal" source is to ignore almost every source written by trans people, in favor of only sources published by medical journals. The only POV you can find in "ideal sources" is the one that says it's a psychiatric condition with as-yet unknown differences in neurology and that needs to be treated (very expensively) by a bunch of doctors. The one in which a trans person says that society just frankly shouldn't care that much about shoving people into boxes labeled "boy" or "girl" isn't one that you'll find much in medical journals. But the "ideal" source about how to report gender on drivers' licenses and passports is still a medical journal, if MEDRS applies there.
• The WHO defines "health" as requiring "a complete state of physical, mental and social well-being". If you are unemployed and worried about whether you will be able to pay your bills this month, or if your neighbors dislike you, or if you are racially disadvantaged, or if a loved one died recently, then the WHO says you are not healthy. But does anyone really think that "a review article from a medical journal" is the "ideal" source for articles on unemployment, rudeness, discrimination, or normal grief?

I could go on, but you've probably read the examples given elsewhere on this page, too, so I'll stop. The problem, then, is this: We're recommending an "ideal" source. This is good. Sources are only "ideal" is they're appropriate to the content. Therefore, the scope of MEDRS must be whatever the "ideal source" is actually "ideal" for. MEDRS's "ideal source" is truly ideal for biomedical information. The recommended ideal source type is not so ideal for socio-medical information, especially if you're trying to include non-medical POVs, and it's lousy for non-medical information (e.g., annual sales figures—which MEDRS itself says to use plain RS for, rather than MEDRS' "ideal").

If you want to think this through, then you might look at the section #For each, above. Then think about the sections and the content we might want to include across the wide variety of health-focused articles. Is there anything that (a) you would probably include in an FA-class article about a medical condition, a treatment, or medicine as a profession, but (b) the best sources for that content is not solely review articles from a medical journal or textbooks used in medical schools?

If your "ideal" source is anything else, then that type of information is probably outside the scope of MEDRS. WhatamIdoing (talk) 06:21, 3 November 2015 (UTC)

First, I have to express amazement at the amount of TL;DR on this talk page in the short period of time since I was last logged in. I normally don't watchlist this page, and I'll probably take it off my watchlist again pretty soon. Wow! OK, that said, now I want to reply to WhatamIdoing's very thoughtful comment. What you pointed out to me, as well as what I think I see in the talk section immediately below this one, is making me suspect that editors (including me) are sort of talking past one another, because we sincerely misunderstand each other, with some editors assuming things that other editors do not assume, and that that is getting in the way of consensus. I realize that I have been assuming something that I should not assume, that it is self-evident (which it isn't) when something on a page such as power lines (that is, a page topic that is not obviously health-related) is or is not related to how readers might make decisions about their own health. I'll take each of your examples, to try to explain that:

1. About gender and birth issues: You are right that the topic of how women might feel about the birth process with respect to gender and autonomy is something that is, simultaneously, related to health and also something where there is, very properly, gender studies sourcing that should also be cited. It comes down to what the source is cited for. If a gender studies or religious source says things like: there are societal arguments for doing childbirth in certain ways and not in others, or there is evidence that certain childbirth practices result in women not getting the health care that they need, etc., then I'm fine with using those sources for that. But if a gender studies or religious source says that children or mothers are healthier or less healthy after certain childbirth procedures, then no, I want a MEDRS source for that.
2. Economic discrimination in health care is another encyclopedic topic where non-MEDRS sources are valid to cite. It is valid to cite them for evidence of such discrimination, and criticism of such discrimination. But it is necessary to cite MEDRS sources if you want to talk about what dose of an analgesic is suitable for a given amount of pain.
3. How cancer patients feel about how they are treated is health-related, but there is encyclopedic content about each of the issues that you described that can properly be discussed in terms of non-MEDRS sources. You don't need a MEDRS source to cite how a patients' group is protesting treating older patients like they are children. But you do need a MEDRS source to cite which health care treatments are or are not effective against breast cancer.
4. How transgender people feel about how they are treated by the medical establishment should be sourced to sources that reliably reflect how those people feel. How the medical establishment currently defines and describes transgender should be sourced to MEDRS sources.
5. One of your WHO examples is when a loved one has died recently, so, in the interest of brevity, I'll use that as an example. Stuff like a person losing their employment because the employer does not provide adequate paid leave following such a loss (or after having a child, for that matter) should be cited to non-MEDRS sources. But the clinical diagnosis and treatment of what that person is going through belongs with MEDRS.

What I'm trying to illustrate there is that it matters what specific kind of content is being sourced. Simply because a topic is related to health (as the WHO example illustrates very well) does not mean that MEDRS applies to anything and everything within that topic. On the other hand, when the content pertains to what kind of health care will be good or bad for the person then MEDRS sources are, as a guideline, the preferred sources. We need to come up with wording that communicates this distinction better than the wording that we use now. There should be some sort of shorthand test, along the lines of "does it have the potential to influence how our readers make choices about their own health?"

Please note that this distinction is not about "health" versus "biomedical". It won't go away if we just say "biomedical" and leave out "health". And I recognize that there always have been, and probably always will be, times when the mainstream medical establishment lags what is really right, but Wikipedia cannot go beyond what the preponderance of reliable sources tell us. I can see how some editors would be concerned about, for example, reliable sources from trans people about how they feel being set aside in favor of MEDRS sources. That is a misuse of MEDRS. But I have to say, what I see around the Wiki is mostly the other side of that problem. The overwhelming amount of the time, it isn't some big bad cabal from WP:MED being mean to nice editors. It's POV-pushers who want to use non-MEDRS sources to say that [cannabis, e-cigarettes, homeopathy] is great for you, or that [GMO foods, conventional psychiatry] is the work of the devil, and they have a great website source to back it up, and are pissed as hell at those mean medical editors who insist on MEDRS. --Tryptofish (talk) 18:45, 3 November 2015 (UTC)

I think we agree entirely. The problem isn't what to call it; the problem is where to draw the line. You and I seem to draw it in the same place, but I believe that not everyone agrees with us. Once we have a good shared understanding of where the line is, then we can sort out what words to use for it. IMO "biomedical" is less wrong than "health", but it is not exactly right, either. WhatamIdoing (talk) 02:21, 6 November 2015 (UTC)

MEDRS allows for a number of sources that aren't included in the first "ideal" definition. The fact is that if you're going to make health claims it is very easy to cherry-pick sources and WP:RS fall extremely short. If we were to use the standard professional definition of biomedical like you do, there would be no problem. But as you can clearly see in this discussion editors aren't. All of those examples are notable, but they really won't fall under the definition "biomedical and health information" which is about health claims. Also any high quality socio-medical doesn't need to be from a medical journal as you should be aware, but it should be a high quality review. CFCF 💌 📧 06:43, 3 November 2015 (UTC)

• MEDRS defines the ideal, and that ideal helps us understand the scope of the guideline.
• It's very easy to cherry-pick sources for almost all subjects. History is no different from health in that regard.
• I'm willing to write the standard professional definition of "biomedical" directly into the guideline, if that would address your concerns adequately. I would strongly prefer that to writing "MEDRS applies to all health information".
• "High-quality source" is not synonymous with "high-quality review". Some academic fields actually prefer a publication format called a "book".  ;-)  WhatamIdoing (talk) 07:27, 3 November 2015 (UTC)

History is very different from health. Per a comment by RexxS:

The only reason why we need MEDRS to spell out those principles is that there is too much money involved in pushing poor quality medical products and procedures and too many SPAs trying to gain recognition for their own pet area in the largest encyclopedia ever created. Without the bulwark provided by insisting on only the highest possible quality of sources, our encyclopedia would be swamped by snake-oil salespersons and big pharma. The first thing that any SPA wants is to stop MEDRS from applying to their edits. We should not be trying to make life easier for them.

Book or review doesn't matter really, as long as the book is written as a review of the literature. Books are published extensively in medicine as well, but a dissertation doesn't hold more weight than a primary source, because that's what it is.CFCF 💌 📧 07:34, 3 November 2015 (UTC)

History doesn't have a bunch of POV pushers trying to gain recognition for their pet thing? Maybe you should spend a month at the articles related to the Palestinian–Israeli conflict.

Your focus on "as long as the book is written as a review of the literature" is still showing your bias towards your own field's preferences. Literature reviews don't have the same status in non-STEM fields. Some fields actually expect their members to already know what was previously published; lit reviews are what you create for students and other newbies, rather than the pinnacle of reliability. A high-quality history source is a source that is considered high-quality by historians, not by scientists. WhatamIdoing (talk) 07:55, 3 November 2015 (UTC)

No, not in the same way. There are far from the same monetary interests that produce shoddy primary sources, and not the same amount of paid advocates. The Palestinian–Israeli conflict is a modern conflict and is also under extended protection I may remind you, most of the dispute isn't exactly summed up as history.

And you completely misunderstand the point about being written as a review of the literature. History is not rebuilt every time it is written, but books depend on other books and constantly back-reference. While different standards exist, a book with only original research is not going to carry any weight. CFCF 💌 📧 08:09, 3 November 2015 (UTC)

Discussion break 01

• Comment- This RfC and the others above are not going to solve the underlying problem of the guideline being misused by some editors trying to exclude content they disagree with by an overly broad application of MEDRS and other editors trying to include inadequately sourced content that really should be sourced with the higher MEDRS standard. Those are issues of POV and non-neutrality. For reasonable editors, who are actually neutral on the content of articles they are editing, this is not going to be a problem. There are many topics that include medical, sociological, legal and cultural implications - and there's no reason we shouldn't be able to use the best quality sources from any or all of those disciplines where they apply. As I have seen above from CFCF primarily, the argument is being made that if a topic has any potential implication on human health, then the sourcing must meet the higher MEDRS standards - so, "health" information would include information about power lines, bicycles, plumbing and war and must be sourced to MEDRS because they all have an impact on human health. I do not believe that MEDRS was ever meant to be that broad. Minor4th 02:52, 3 November 2015 (UTC)

I concur with Minor4th's excellent analysis. -- Notecardforfree (talk) 03:35, 3 November 2015 (UTC)

Yes if you wish to claim that power lines cause cancer you need a good source. This keeps us from turning into a promoter of conspiracy theories. Doc James (talk · contribs · email) 03:18, 4 November 2015 (UTC)

That's obvious, and no one is disputing that. We need good sources for everything - we're talking about the bounds of MEDRS though, and it's much more restrictive than our general sourcing policy. But let's turn back to the topic of Domestic violence -- I think we can all agree that we would need MEDRS sources for medical content about PTSD caused by repeated exposure to DV. But can we also agree that the success rates of court-mandated participation in batterer's intervention programs might be properly sourced with a peer reviewed law journal or academic journal in sociology? There are some here who would argue that only medical review articles can be used as sources for such information, and in that manner MEDRS is being selectively cited to exclude content that is reliably sourced to something other than a medical review article less than 5 years old. Minor4th 03:47, 4 November 2015 (UTC)

Noone here is arguing that you need a medical soruce for "success rates of court-mandated participation in batterer's intervention programs". MEDRS is needed when you're making health claims, such as that women's health is more impacted by DV because that is a claim made in epidemiology. Epidemiology doesn't cover legal claims. CFCF 💌 📧 22:51, 4 November 2015 (UTC)

Are you sure about that, CFCF? What if the batterer's intervention program uses cognitive behavioral therapy? Wouldn't CBT be "health" and "clinical psychology", and even "medicine"? WhatamIdoing (talk) 02:30, 6 November 2015 (UTC)

That comment is not succinct, and misses to point out that what brought this discussion to the fray were attempts to use old out-of-date articles for epidemiology in Domestic violence against men. Adhering to a higher standard for evidence will never result in any biased point of view, except the majority-accepted evidence-based point of view. This is Wikipedia's express goal!
It is far too simple to cherry-pick poor low quality sources to use them to promote fringe ideas. CFCF 💌 📧 06:34, 3 November 2015 (UTC)

Regrettably, "majority-accepted" and "evidence-based" are not always the same POV in medicine. Anyone who's been told not to drink even so much as a small cup of water for 8 or more hours before surgery has been treated with the "majority-accepted" but "evidence-ignored" POV. There are more examples of this—and that's assuming that the medical POV is the appropriate POV in the first place, which is disputable for some subjects.

Also, while it's true that the relatively famous Archer source is 15 years old, there are more recent ones that say the same thing. They really have a DUE problem at that article, not an evidence problem. WhatamIdoing (talk) 07:11, 3 November 2015 (UTC)

When there is a well represented second opinion in the literature we of course present it with due weight. Then again if the only sources promoting that drinking water is okay are newspapers then it shouldn't be on Wikipedia. If on the other hand the American Surgical Association writes a paper about it then we need to constrast this with the guidelines. This is actually a strength of MEDRS, and it isn't a problem. CFCF 💌 📧 07:24, 3 November 2015 (UTC)

CFCF, some perspectives have been marginalized within the academy and are not necessarily represented in mainstream literature (see, e.g., the example about trans people above). This exclusion contributes to the perpetuation of Confirmation biases; this is why we should not continue to marginalize these perspectives through our citation standards at Wikipedia. -- Notecardforfree (talk) 07:34, 3 November 2015 (UTC)

Notecardforfree - Wikipedia isn't here to WP:Rightgreatwrongs, and the point is to represent the mainstream literature. There are issues with science, but we aren't here to correct them, if that is your cause may I suggest writing a review article for a peer-reviewed paper? CFCF 💌 📧 07:46, 3 November 2015 (UTC)

Not exactly. The point is to represent the mainstream POV as being the mainstream POV and significant minority POVs as being minority POVs. This is WP:YESPOV. We don't have a WP:MAINSTREAMONLYPOV or WP:SCIENCEONLYPOV policy. WhatamIdoing (talk) 07:58, 3 November 2015 (UTC)

Yes, actually because the mainstream literature includes any significant minority positions, and MEDRS goes so far as to explain:

Although significant-minority views are welcome in Wikipedia, such views must be presented in the context of their acceptance by experts in the field. Additionally, the views of tiny minorities need not be reported.

If something is so unaccepted that it isn't present in the mainstream literature even as an opposing view it should probably not be included. This is expanded upon elsewhere in MEDRS. CFCF 💌 📧 08:04, 3 November 2015 (UTC)

CFCF, the quotation selected above highlights one key equivocation in your larger argument. You can be an "expert", even if you don't publish review articles. In fact, there are many expert perspectives outside the universe of review articles. -- Notecardforfree (talk) 08:20, 3 November 2015 (UTC)

Very true. You can also be an "expert" and never publish in a medical journal. WhatamIdoing (talk) 08:22, 3 November 2015 (UTC)

Absolutely, and I have never expressed anything else. I don't really see the point here?

WP:RS clearly states:

Wikipedia articles should be based on reliable, published sources, making sure that all majority and significant minority views that have appeared in those sources are covered (see Wikipedia:Neutral point of view). If no reliable sources can be found on a topic, Wikipedia should not have an article on it.

Reliable sourcse for medical or health claims are different, but the same idea applies here. Newspapers don't cut it, and a vast multitude of other sources don't. For example see the comments I made above about bananas fighting cancer. CFCF 💌 📧 08:29, 3 November 2015 (UTC)

References

• In the above comments, WhatamIdoing hit the nail on the head. I encourage everyone to read the comment, even if it it a bit longer than most. --Guy Macon (talk) 06:38, 3 November 2015 (UTC)

I second that suggestion. WhatamIdoing is on-point here. -- Notecardforfree (talk) 06:47, 3 November 2015 (UTC)

Third. And I note that after some refactoring WhatamIdoing's comments are now in a different section - I believe it's the section immediately above this one. Minor4th 19:03, 3 November 2015 (UTC)

No, because MEDRS hasn't applied to that from the start. MEDRS has always included health information, but doesn't require those things off sources anyway. In fact it's a miss understood comment. CFCF 💌 📧 06:52, 3 November 2015 (UTC)

CFCF, Is it possible a broadly defined MEDRS can be misapplied and used to block sources? AlbinoFerret 07:08, 3 November 2015 (UTC)

No, it can't. MEDRS allows for a large number of different sources, with the exception of primary research literature and newspapers etc. CFCF 💌 📧 07:29, 3 November 2015 (UTC)

MEDRS has already been used to in an attempt to suppress citations to the National Advisory Council on Violence Against Women and the American Psychiatric Association's DSM-5[21], the Los Angeles Times[22], and the scientific journal Psychological Reports (because the paper was published in 2004 -- before the MEDRS 5-year limit)[23]. And that's just one editor on one page. I could give you dozens of other examples. --Guy Macon (talk) 07:37, 3 November 2015 (UTC)

That isn't called suppressing citations, that is called sticking to high quality sources. Of course we aren't going to use the LA-times for the article on Domestic violence, and as for the others, when there are more up-to-date and higher quality sources of course we use them. This is the express purpose of MEDRS!CFCF 💌 📧 08:14, 3 November 2015 (UTC)

Guy Macon, you have a misunderstanding of the guideline; you are applying the five-year standard as though it is gospel. Like I stated in this WP:ANI thread, MEDRS is not hindering these types of articles. "For example, WP:MEDDATE states, 'These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or where few reviews are published.' It is also clear that newer is not necessarily better. If the older source is better, then we go with that, as medical editors commonly do at the Circumcision article." Flyer22 Reborn (talk) 10:20, 3 November 2015 (UTC)

I agree that MEDRS isn't intended to cover that kind of health information. But it's still health information, and if we now say "Oh, by the way, MEDRS applies to all health information, not just the biomedical subset of health information", then we actually would be saying that MEDRS applies to "that kind" of health information. If we don't intend for MEDRS to define the ideal source for 100% of non-biomedical health information, then we really shouldn't say that MEDRS applies to (non-biomedical) health information. WhatamIdoing (talk) 07:13, 3 November 2015 (UTC)

But MEDRS applies to health claims, and pretty much all of the above examples if they have health implications to a patient, individual or community. WhatamIdoing don't let perfect be the enemy of good, and I am very supportive of more accurate language about what ideal sources are for a number of different topics, but this can be done once the major issue cools down. We want high quality sources for all of your examples, and no they aren't going to be meta-analysis, but neither should they be RS-newspaper articles. CFCF 💌 📧 07:19, 3 November 2015 (UTC)

Can you point to any harm to Wikipedia that has come in the five years that the lead paragraph of the article didn't have the change you are proposing? It seems to me that the person proposing a major change to a major Wikipedia guideline needs to demonstrate the the change is needed. --Guy Macon (talk) 07:32, 3 November 2015 (UTC)

No, but as Flyer22 Reborn accurately points out in an above comment what you're saying isn't true. First of all the lede has included a different definition of just "medical", as well as up until August of this year the entire guideline had health and medicine in it at several points. This was all removed in one go by one editor without talk-page interaction. This is seriously problematic, and for example having MEDRS not apply to epidemiology in Domestic violence is harm, quite significantly so. CFCF 💌 📧 07:37, 3 November 2015 (UTC)

Now you are just making things up. Flyer22 Reborn listed no changes to the lead. Here is what has been in the lead for years:

• Version from 1 October 2015: "any biomedical information in articles"[24]
• Version from 2 September 2015 (as edited by CFCF!): "any biomedical information in articles"[25]
• Version from 7 July 2015: "the biomedical information in all types of articles"[26]
• Version from 13 January 2015: "the biomedical information in all types of articles"[27]
• Version from 4 January 2014: "the biomedical information in all types of articles"[28]
• Version from 26 January 2013: "the biomedical information in all types of articles"[29]
• Version from 24 January 2012: "the biomedical information in articles"[30]
• Version from 1 January 2011: "the biomedical information in articles"[31]

Changes to other parts of the guideline do not equal a consensus to change the lead. Do your homework, list when those other changes were made, and the community will consider them. This RfC is about the lead paragraph. --Guy Macon (talk) 07:55, 3 November 2015 (UTC)

What is as edited by CFCF! supposed to mean, that I missed the change in July because it seemed self-evident that biomedical included health? We aren't talking about the exact wording of the lede, but that MEDRS has had health within its scope for the longest time.CFCF 💌 📧 07:59, 3 November 2015 (UTC)

I suspect that you "missed the change in July" because it happened in August.  ;-) You may recall reading recently the reason I posted for the change: Editors were quite reasonably (mis)understanding MEDRS as covering "any content that relates to (or could reasonably be perceived as relating to) human health", which is IMO far too broad. We didn't write the guideline to cover that broad a territory.  WhatamIdoing (talk) 08:28, 3 November 2015 (UTC)

Guy Macon, if I listed no changes made to the lead, then what do you call this and this edit? Those are changes to the lead. "Health" was there in the guideline for years, no matter how you much deny it or ignore it. Flyer22 Reborn (talk) 09:58, 3 November 2015 (UTC)

Exactly, it is a very new addition that health is so underrepresented in the guideline. There are numerous diffs of editors removing health, and I think the reason it all went so under the radar was because "biomedical" was interpreted as including the vast majority of health topics. CFCF 💌 📧 10:26, 3 November 2015 (UTC)

---

In both of the edits you just linked to. the lead paragraph (which, I will remind you, is the paragraph that CFCF changed in the middle of the discussion, the paragraph CFCF edit warred over and was reported to ANI twice over, and the paragraph that this RfC is about changing) were exactly identical before and after your edit.

In the first case the lead paragraph was...

"Wikipedia's articles are not intended to provide medical advice, but are important and widely used as a source of health information.[1] Therefore, it is vital that any biomedical information in articles be based on reliable, third-party, published secondary sources and accurately reflect current knowledge"

...before and after your edit, and in the second case the lead paragraph was...

"Wikipedia's articles, while not intended to provide medical advice, are nonetheless an important and widely used source of health information.[1] Therefore, it is vital that the biomedical information in all types of articles be based on reliable, third-party, published secondary sources and accurately reflect current medical knowledge."

...before and after your edit. The lead paragraph (the specific paragraph we are talking about changing) has been essentially the same for five years. You and CFCF are proposing a major change to the lead paragraph. That is an easily-verified fact. --Guy Macon (talk) 19:32, 3 November 2015 (UTC)

But not as easy as it is to falsify - it just isn't true. It was changed to the present version in August this year [32]. It is not at all as stable as you suggest. CFCF 💌 📧 22:09, 3 November 2015 (UTC)

Guy Macon, so now you are only focusing on the first lead paragraph, not the other parts of the lead that were changed in August? As for what you stated in this edit summary, I have not been advocating to add "health" to the lead; I haven't even yet voted on whether or not "health" should be re-added; this is because I do have concerns that it might be used too broadly. "Health" is still in the lead paragraph, though. By the way, since this guideline is not an article in the strict sense, I don't like calling its introduction a lead. Flyer22 Reborn (talk) 02:23, 4 November 2015 (UTC)

Guy Macon you have not explained which article you are referring to. It seems fully accurate that we don't cite the LA-times when it comes to Domestic violence, and over 10 year old sources in a topic with significant research should be replaced! That isn't an expansion of the scope, and is fully according to the intention of MEDRS! CFCF 💌 📧 07:39, 3 November 2015 (UTC)

(edit conflict) Why shouldn't we use a newspaper or magazine article to support claims about trans people wanting to change laws about how their genders are reported on official documents? Does that kind of information really need the endorsement of an official academic journal?

Also, sometimes a news source provides a clean summary of a complex health-related subject, like this one on the non-biological, non-evidence-based, conventional medical practice of denying food and water to patients who are scheduled for surgery the next morning. It's accurate, understandable, concise, and accessible. Why not use it (appropriately), e.g., to say that "NPO after midnight" became popular in the 1960s but never had an evidence behind it? WhatamIdoing (talk) 07:45, 3 November 2015 (UTC)

Please, that is never what I said, and not the implication of covering health. These types of statements were never subject to MEDRS when it previously included health and medicine throughout. For the example on surgery we shouldn't use it because the New York times is not a credible source for this type of information, as any health professional will tell you. Sure, that source can be used to give the background history that it was promoted during the 1960's, but you are going to need a better source to claim there was no evidence. And actually there was quite a bit of evidence, albeit flawed, but it isn't a baseless claim like the NY-times makes it out to be. You can actually see that if you go to the review they link, which is the one we should use for any such claims. CFCF 💌 📧 07:55, 3 November 2015 (UTC)

It might interest you to know that over the last few years, the guideline has slowly shifted from using the word health about 25 times to using the word health, well, about 25 times. The main change has been an increase in the use of the word bio-, from about 20 to about 25. Medical dwarfs them both, with about 60 and 80 uses over the same time period (the guideline has gotten longer, which accounts for most of the increases). WhatamIdoing (talk) 08:19, 3 November 2015 (UTC)

What matters isn't only how many times it's mentioned, but where also matters. The guideline was previously very clear throughout (albeit did use the word biomedical in the lede) that health effects was what mattered, not purely "bio"-medical topics. CFCF 💌 📧 08:23, 3 November 2015 (UTC)

"Health effects" is not a synonym for "health information". You are proposing that "health information", not "health effects", be added to the lead. WhatamIdoing (talk) 08:42, 3 November 2015 (UTC)

WhatamIdoing - I don't make that clear distinction, and I'm under the impression several others here consider them synonymous. But to be clear, would you be more supportive of health effects or health claims instead of what is currently proposed? CFCF 💌 📧 09:10, 3 November 2015 (UTC)

Yes.

I can elaborate on the difference between an effect and a fact (or "information"), but I think you'll figure it out if you think about it. WhatamIdoing (talk) 02:35, 6 November 2015 (UTC)

Discussion break 02

• Keeping in mind that MEDRS applies to sources, not articles, could someone explain how Tawny Kitaen beating on Chuck Finley as documented at http://web.csulb.edu/~mfiebert/latimes.htm and http://www.cbc.ca/sports/baseball/wife-accepts-chuck-finley-plea-bargain-1.330984 is allowed on our Tawny Kitaen page but is (supposedly) forbidden by MEDRS on our domestic violence page, as CFCF claims?[33] (I am not interested in whether it would be a good addition to that article, just whether MEDRS forbids its inclusion unless a recent peer-reviewed medical journal starts covering celebrity divorces.) --Guy Macon (talk) 08:57, 3 November 2015 (UTC)

This is not the best photograph to show what a helicopter is nor what the Sydney Opera House looks like.

Without looking into the situation WP:OTHERSTUFFEXISTS. If it is as you make it out to be, no of course it shouldn't be allowed. Wikipedia unfortunately suffers because we don't have infinite time to patrol every page, if you see misuse of sources for medical claims on that page, go ahead and rectify it. CFCF 💌 📧 09:07, 3 November 2015 (UTC)

P.S. MEDRS allows for sources other than peer-reviewed medical journals, this has been mentioned repeatedly. I'm not seeing any real health claims here. Also getting rid of those celebrities from the article on Domestic violence probably has nothing to do with MEDRS, but is an issue of WP:DUE WEIGHT. CFCF 💌 📧 09:13, 3 November 2015 (UTC)

So are you retracting your claim that the LA Times cannot be used as a source for domestic violence because MEDRS forbids it?[34] (Again, I don't care about any other reasons for excluding it). Or are you saying that because of MEDRS the LA Times cannot be used as a source for Tawny Kitaen committing domestic violence against Chuck Finley on the Tawny Kitaen page as well as on the domestic violence page? --Guy Macon (talk) 09:26, 3 November 2015 (UTC)

As I said, I haven't looked into the situation. My claim is that the LA-times is not a decent source for health information. You seem to be mistaken that it is MEDRS that was invoked to get rid of this, it just isn't due weight for an encyclopedic article on domestic violence.CFCF 💌 📧 09:29, 3 November 2015 (UTC)

I guess the "deleted la times citation per wp:medrs" in the edit comment[35] fooled me into thinking that that particular editor deleted the LA Times citation per WP:MEDRS. --Guy Macon (talk) 10:00, 3 November 2015 (UTC)

That diff is a health claim, and not a specific claim about those celebrities, and as such MEDRS applies there. Furthermore the editor is claiming a case of WP:Verifiability-violation, where the source doesn't support the statement. To me it seems pretty odd that we would use an article about a celebrity couple and their problems to support "broad consensus", especially as it is a 13-year old snippet? CFCF 💌 📧 10:10, 3 November 2015 (UTC)

That's the problem, all right. You think that "there is broad consensus that women are more often subjected to severe forms of abuse and are more likely to be injured by an abusive partner" is a health claim subject to WP:MEDRS while pretty much everyone else thinks that it is a sociological claim subject to WP:RS. The question is whether you are going to be allowed to modify the lead paragraph of MEDRS so that it agrees with you. --Guy Macon (talk) 20:53, 3 November 2015 (UTC)

The above RfC has made it extremely clear that epidemiology is covered under medrs, and its actually ridiculous that you are pushing for a 13 year old unrelated snippet article for an article which covers public health.CFCF 💌 📧 07:50, 4 November 2015 (UTC)

Guy Macon - MEDRS doesn't apply to sources in that sense, but to sources of specific statements. What is a horrible source for one statement may be a fully adequate source for another. I think the example from Wikipedia:Manual of Style/Images is a damn good analogy:
To clarify, when I first glanced over the diff you linked I thought it mentioned the celebrity pair in the article on domestic violence (WP:UNDUE), I now see that it was actually used to support a medical/health claim, and the user who deleted it is fully correct in citing MEDRS. CFCF 💌 📧 10:41, 3 November 2015 (UTC)

Guy Macon I also see you saying the changes have "already" been used to remove proper sources, but your diffs are from 2014! You're not making a very strong case here. CFCF 💌 📧 10:47, 3 November 2015 (UTC)

Please list the exact attributes of what kind of example you are willing to accept without resorting to WP:IDHT, and I will list multiple examples that meet your specific conditions for what you are willing to accept. --Guy Macon (talk) 20:53, 3 November 2015 (UTC)

Who put the breaks in the page? They break up the discussion in odd places. AlbinoFerret 09:50, 3 November 2015 (UTC)

I don't know, but I tried removing them and WhatamIdoing restored them because they decrease the amount of edit-conflicts. CFCF 💌 📧 10:10, 3 November 2015 (UTC)

I added some, but not all of them. Breaking up discussions in odd places has the unintentional side effect of not emphasizing certain points. My usual practice is to split a long discussion approximately in the middle, usually just above someone {{outdent}}ing. WhatamIdoing (talk) 02:41, 6 November 2015 (UTC)

• @CFCF: Throughout this discussion I notice you are saying other editors comments are "misunderstandings" or what is "health" or how it would be applied etc. What you seem to be missing is if the editors discussing the issue here can misunderstand what your change means then the body of Wikipedia editors as a group are even more likely to "misunderstand" the new wording. Your response to counter-arguments are in fact showing the weakness of this proposal. You should consider addressing the matters raised rather than dismissing them. Jbh^Talk 13:53, 3 November 2015 (UTC)

Addressing which matters exactly? Several of the arguments against the proposal are reductio in absurdum where editors are trying to defuse the argument by taking it to its extreme. MEDRS is intended to help with health and medical claims, and I have responded to any such claims with the fact that it applies. If you're touching upon the example just above here I think I made it very clear (despite the best efforts of certain parties to misrepresent, not misunderstand, the situation). CFCF 💌 📧 14:28, 3 November 2015 (UTC)

Please WP:AGF. Your accusing other editors of things like deliberately misrepresenting the situation are becoming disruptive, and they do not strengthen your argument. Quite the opposite, actually. --Guy Macon (talk) 20:53, 3 November 2015 (UTC)

This entire discussion is a result of pushing poor sources on Domestic violence against men. It is not assuming bad faith when there is clear evidence of bad faith. Editors came here with the express wish to decrease the scope and power of MEDRS in order to promote old, fringe, or otherwise poor sources on controversial topics. Our policies, including WP:AGF are WP:not a suicide pact. CFCF 💌 📧 21:43, 3 November 2015 (UTC)

That is not the issue or the article that brought this discussion here. What brought this here was the 2000 Archer review - that would meet MEDRS in any event when used in context. We have now moved on to a discussion about how broadly MEDRS can be interpreted to exclude otherwise reliable sources for content related to "health information" (since you have edit-warred that ambiguity into the actual policy. Minor4th 22:58, 3 November 2015 (UTC)

Yes, that is the exact issue. That review is old and does not meet MEDRS when used in a field that has seen several more recent and more inclusive reviews. MEDRS makes sure that what we include is the best and most up-to-date sources, and the reason this source is excluded is beceause it isn't considered reliable. This is in accordance with the first few sentences in WP:RS:

Wikipedia articles should be based on reliable, published sources, making sure that all majority and significant minority views that have appeared in those sources are covered (see Wikipedia:Neutral point of view). If no reliable sources can be found on a topic, Wikipedia should not have an article on it.

Domestic violence is a field which has moved massively the past 15 years, and using a very old review will skew the article considerably. This isn't a freak occurance either, editors push for old sources that are more conductive to their point of view all the time, finding something in a field that was published 15-30 years ago and claiming that it is the only authorative voice on the subject.

As for edit-warring there is actually no ambiguity, just misinterpretation of what biomedical means in a professional context. The edits were strongly supported, as you can see from the vote, and were also a restoration closer to the pre-August version where health was specifically mentioned in the lede. This has been linked multiple times arleady, but not once has this been responded to. This discussion is going in circles, and only one side is actually meeting arguements, the other is simply repeating them. CFCF 💌 📧 15:18, 4 November 2015 (UTC)

And the issues related to the Archer study have long been resolved, since the same information was found to be published in more current sources. The problem was - MEDRS was being used to exclude studies that found any kind of gender symmetry based on MEDRS, while older and more out-of-date and primary sources had been used throughout the article for studies that found no gender symmetry or that didn't discuss the issue at all. When MEDRS is being applies inconsistently like that, it has the appearance that MEDRS is being used to promote a certain POV and to exclude other POVs. And besides, MEDRS doesn't say that content has to be excluded if it is not ideally sourced - it is a guideline about how to improve medical content.

Given the breadth of this discussion and the differing opinions, I think it's clear that the addition of "health" is not a clear improvement or a simple clarification of what has always been understood. Minor4th 22:06, 5 November 2015 (UTC)

Minor4th, WP:MEDRS is not why I rejected the Archer text. I've been clear about that on this talk page. And the #Newer sources? section above is clear that there are quality sources that do not agree that "women [are] slightly more likely than men to use one or more act of physical aggression and to use such acts more frequently"; what secondary sources, reviews or otherwise, exactly support Archer on that claim? Archer's study includes content that is supported by secondary sources, but it's not like most of his domestic violence studies and claims are supported without debate. Flyer22 Reborn (talk) 22:41, 5 November 2015 (UTC)

Furthermore, there is broad agreement among scholars that males engage in physical aggression far more than females do, and that this is the case across the animal kingdom. Of course...there are other types of aggression. Flyer22 Reborn (talk) 22:49, 5 November 2015 (UTC)

I think we're getting a bit off topic for this discussion but maybe it's helpful to use a real example. As you know, there are quality sources that say men and women commit roughly equal levels of physical abuse (just tallying number of incidents); there are quality sources that discuss domestic violence as a women's issue and don't even address domestic violence against men; there are quality sources that say that men commit domestic violence much more than women do; and all of the studies that discuss the issue as far as I'm aware say that women are much more impacted by domestic violence than men for a variety of reasons (more severe injury, levels of fear, economic reasons, etc), irrespective of whether the number of incidents by men and women are roughly equal or not. Sorry to do this but I have to run to a meeting so I will have to finish this comment when I return. Minor4th 23:25, 5 November 2015 (UTC)

Editor Whatamidoing looked for newer sources to Archer's 2000 review and found that PMID 18624096 and PMID 18936281 were the only 2 reviews that cover the same basic territory as the 2000 Archer source. They're both from 2008. They both agree largely with findings from Archer's review. They all comply with MEDRS. I think that Whatamidoing summed things up particularly succinctly by stating "It is possible that the Archer source is getting used so widely because there really isn't anything better." Minor4th is correct also in their logical and coherent summation above.Charlotte135 (talk) 23:56, 5 November 2015 (UTC)

Note: Given the different interpretations, and/or selective quoting, of what was stated or shown in some sections on this talk page with regard to the current biomedical/health/WP:MEDRS dispute, I advise editors to read such sections instead of going solely on what one editor states about them, whether it's all of what WhatamIdoing stated in the Newer sources? section above or something else. Flyer22 Reborn (talk) 02:38, 7 November 2015 (UTC)

Responses to votes

Because we have a discussion section it seems advisable to keep responses out of the vote section. I have moved the following: CFCF 💌 📧 10:15, 3 November 2015 (UTC)

• Response to Doc James' vote: No, you've got it backwards. Socio-medical information is health information, too, but it's not biomedical information. There's nothing "biomedical" about a woman refusing consent for an intimate exam by a male provider, but there's a lot of "health" in that decision. "Biomedical" is smaller than "health". WhatamIdoing (talk) 05:21, 3 November 2015 (UTC)
• Response to Ozzie10aaaa's vote: Perhaps you should rethink that "without question", seeing as how you have managed to reverse what is contained within what. Health content is far larger than and includes biomedical content, not the other way around. --Guy Macon (talk) 09:03, 3 November 2015 (UTC)
• Response to Casliber's vote: I am puzzled by your comment. You say "health is medicine". Are you saying that they are synonymous? Or that heath is a subset of medicine? Is exercising medicine? Or that medicine is a subset of health, in which case, why isn't just putting medicine enough to avoid wikilawyering? Wikilawyering can work both ways - arguing that a narrow category doesn't apply, or arguing that a broad category applies. Since WP:MEDRS is a guideline which restricts sources (in principle), the latter event is more pernicious - arguing that a source doesn't fulfill WP:MEDRS simply excludes it from discussion. The former can still be handled with WP:DUE, WP:NPOV etc. Kingsindian ♝♚ 14:04, 3 November 2015 (UTC)
• Response to Tsavage's vote: Biomedical currently redirects to Medical research, wouldn't Biomedicine or even better, Medicine make more sense? Surely the intention is that MEDRS should apply not only to biomedical research, but the application of that research to clinical practice. Also isn't health reasonably well defined? The ICF and ICD definitions of health are very precise. Boghog (talk) 17:32, 29 December 2015 (UTC)

Please stop refactoring comments. Minor4th 22:32, 3 November 2015 (UTC)

• Use good grammar, please, and employ the subjunctive mood. It should read "any biomedical information be based...accurately reflect..." or be changed as necessary for the replacement wording. 76.181.192.61 (talk) 04:10, 4 November 2015 (UTC)

Additional proposal

Comment: I believe that there is an excluded middle which would potentially be covered by "medical information", as opposed to "biomedical information". If there are no objections, I will add this as a third option. - Ryk72 ^'c.s.n.s.' 02:13, 3 November 2015 (UTC)

Your comment was lost, I have moved it here to increase the likelyhood of being seen. I think introducing a third option is only likely to muddy the waters without really improving the discussion. It may be better to wait and see how the RfC pans out before we do this. If we have an unclear result we can opt to add this question. CFCF 💌 📧 10:22, 3 November 2015 (UTC)

Ryk72, I believe that you're correct: "medical" includes socio-medical issues, like people refusing providers for reasons of race, sex, etc. It is also open to some (but not as much) of the vagueness and expansiveness that plagues "health information". We have a significant problem with different people having different conceptions of what's "medical".

But I don't think that adding any more options is going to be useful. WhatamIdoing (talk) 02:47, 6 November 2015 (UTC)

Hi WhatamIdoing, Firstly thanks for taking the time to respond & provide your thoughts. The example provided is illustrative; as I would not have included this in my understanding of "medical", but appreciate that other editors may (and do). I would have included it in my understanding of "health", and would also suggest that it is not the type of information that should be covered by WP:MEDRS. - Ryk72 ^'c.s.n.s.' 03:10, 6 November 2015 (UTC)

Logical inconsistency in this RfC discussion

1. A good deal of the argument for including the word "health" maintains that it is has been in the guideline all along, is synonymous with "medical," is already included in "biomedical," and so forth - in short, that it is only a routine clarifying update that doesn't substantially change anything or add anything that wasn't already there.

2. At the same time, the reason for including "health" in the summary is argued as a way to address a perceived growing problem where editors are abusing the current term by arguing against its scope - therefore, it would seem "health" is expected to have a significant, substantial effect on how MEDRS is argued, by increasing, at the least, the perception of, its scope.

3. A good deal of the argument against adding "health" to the summary is that it will change how MEDRS is argued, and will, in fact and/or in perception, broaden its scope.

It seems that 1 and 2 are inconsistent with each other - what is proposed as a small, routine wording update cannot reasonably be expected to have a wide effect. Meanwhile, 2 and 3 seem entirely consistent, in saying that "health" is expected to have a significant, wide effect on how MEDRS is argued.

Given that common sense tells us that "health" is likely to be interpreted in an extremely broad way - for example, ask random people in the the street (potential Wikipedia editors, all), "How does 'health' relate to all the things in your day-to-day routine?" - and that using it is likely to have a significant effect on how the guideline is interpreted, we should be looking for more precise wording than "health," wording that is less likely to provide fuel for wikilawyering, and less likely to increase general confusion over the scope of MEDRS. --Tsavage (talk) 13:51, 3 November 2015 (UTC)

Complains that MEDRS is too vague and confusing are nothing new. You're right, broadening its scope to all things "health"-related would only exacerbate this (unaddressed) problem. petrarchan47คุก 04:14, 4 November 2015 (UTC)

But this is where you are completely wrong, it's about clarifying scope, not expanding it. This avoids long-winded discussion of whether MEDRS should apply to lots of health topics it clearly does apply to, for example health effects of GMO-products! CFCF 💌 📧 15:06, 4 November 2015 (UTC)

Agree with Tsavage and Petrarchan47 completely. the issue is that the wikiproject medicine has instrumentalized MEDRS to thwart article expansion arguing illegitimate addition of sources, particularly in areas that are orphan subjects, or not traditional medicine, including toxicology and environmental health, which most docs know little about, and which are more at home in public health.

I am an academic mainstream physician with a masters in epi. I know for sure, that many in the project arent physicians, but PhD's, these may be good at microbiology or virology, but dont know about the med business, patient care. some are MD's and most of them have little if any clue about environmental health and know public health in passing. some are med students acting as professors. many are arrogantly dismissive of scope and results, intolerant of the need to be flexible, to adequately inform. MEDRS is the mantra of wikiproject medicine. the primary source whip is cracked at those who dare to think outside the wikiproject medicine clique's box or question the boss. in this authoritarian manner articles are straightjacketed made worse than they need to be. worst is the double standard of allowing primary sources when it fits the project's POV.

I'd draw the line where it was: Medicine in the narrowest, traditional term. Not biotechnology, not health, not public health. yes, reviews are often better. But reviews in some topics may not be written up for years, for example, so exceptions of GOOD sources from peer reviewed journals should be allowed. I am against MEDRS to grow like kudzu covering all of wikipedia, because in my experience it has been used negatively.--Wuerzele (talk) 21:42, 4 November 2015 (UTC)

Wuerzele - The issues you outline are with MEDRS, and several of them are legitimate. The problem is that MEDRS is the best we've got, and I am the first to admit it isn't perfect, and could do with a bunch of improvement, but the one thing it doesn't need is a weakening of scope. MEDRS expressly allowed for other sources than the "ideal" when it comes to situations where review don't exist, and we are all here open to expanding the guideline with more express examples of when this happens. The problem we had here was editors who added questionable content to Domestic violence against men and then came here trying to promote the use of poor sources on anything they deemed not to be specifically "biomedical", which by their definition did not include epidemiology. I see it as a far larger problem than "students acting as professors" that advocates for a cause push their cause by using poor sources. What we count here isn't the title, but the weight of the argument, especially well sourced arguments. The benefit a professor will have on Wikipedia isn't his/her title, but the mere fact that he/she will know so much more and will have a much easier time expressing this in text. CFCF 💌 📧 22:45, 4 November 2015 (UTC)

Why did a simple argument over sources regarding domestic violence against men become a multi-RfC event? petrarchan47คุก 22:56, 4 November 2015 (UTC)

It didn't. That's a straw man. The underlying issues in the DV articles have long since been resolved, but CFCF has refused to acknowledge that and keeps bringing it up as if it's an ongoing controversy. The community and this RfC have quite clearly moved on to clarifying the scope of MEDRS in its community-wide application. Minor4th 23:04, 4 November 2015 (UTC)

Because the guideline was attacked for using the term biomedical when it prior to August had used both "medical" and "health-related" in its place. Biomedical while very clear for many was being defined in such a way that it did not include epidemiology. This discussion has brought with it a fair share of advocates who would have nothing rather than a complete break-down of MEDRS. CFCF 💌 📧 23:00, 4 November 2015 (UTC)

That is not true. The lead paragraph (the one you changed. the one you edit warred over and the one you posted this RfC about) did not have "medical" or "health-related" in the place of "biomedical" prior to August. Please stop saying that it did. Repeating the same easily-checked falsehood over and over isn't fooling anyone. --Guy Macon (talk) 23:42, 4 November 2015 (UTC)

"...fair share of advocates who would have nothing rather than a complete break-down of MEDRS" - CFCF, would you show me an example of exactly what you are referring to in this statement? petrarchan47คุก 08:10, 5 November 2015 (UTC)

• Personally I would love to see what solution the community could come up with if the top 3 or so commenters on this issue would take a step back rather than flooding these threads with the same stuff over and over and over again. It is far from necessary for only a couple of people from each side to reply to almost every comment from the other side. It cuts off opportunities for new perspectives and created a TL;DR thread which will resolve nothing because few people want to plow through all of the text. I guarantee that everyone is well aware of the primary 'participants' views on this issue - the purpose of an RfC is to get other editors' opinions. Just say'n. Jbh^Talk 00:01, 5 November 2015 (UTC)

• 1 and 2 are not logically inconsistent when analyzed correctly. 1 is a minor clarification of the always intended, and actually applicable scope. The effect predicted in 2 is on misperceptive expectations that MEDRS's scope was intended to be ridiculously narrow and WP:GAMEable. As an analogy, in most Western legal systems, it's unlawful to make threats of bodily harm. Not all of these laws state outright that they apply to oral as well as written threats, and many people are not aware that they apply to oral threats, or such threats would not happen very often. If it were proposed that a particular statute were clarified so as to leave no doubt that it also covered orally made threats, this would in fact be a minor clarifying change, no matter how many people flipped out and thought that it was a new, censorious legal land-grab intended to criminalize previously legal (in their mistaken view) behavior. That said, while I agree with the general thrust of this proposal, the unqualified word "health" by itself may be too vague and overbroad; we do not want MEDRS to pertain to traditional medicine systems, though perhaps claims about their efficacy should be.  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  13:55, 12 November 2015 (UTC)

SMcCandlish ☺ I agree with your analysis, insofar as the term "health" might be clearly included in "biomedical" or other existing guideline material, in the way that "oral threats" may be included in "threats of bodily harm" (and so adding "health" is simply doing some housekeeping on routine wording). However, the inconsistency I see is in the arguments that suggest that adding "health" changes nothing, because it was already there (1), while other arguments suggest that adding health will have a significant effect (2, 3). If a "minor clarification" has major effects, then, from a practical standpoint, it is (also) a major clarification. The inconsistency only vanishes if you narrowly define "minor" to refer to the semantics of a definition, to the exclusion of actual effect. In the legal example, trial outcomes would presumably be unaffected by the change, so in a statutory sense it would be a minor alteration, but if making "oral threats" explicit resulted in a slew of newly founded charges, there, too, it would not be minor in effect. In any case, in Wikipedia, we in theory rely on reasonable interpretation, case by case, and on the implied as much as the explicitly stated, and particularly in that context, "health" seems entirely too broad and vague for this purpose. --Tsavage (talk) 00:22, 18 November 2015 (UTC)

To expand on the above, attempting to make changes based upon "health" being in the first paragraph has already happened, even though "health" was never in the first paragraph. This entire conversation started when an editor attempted to use MEDRS to remove a reliable source (Scientific American) and its associated claim concerning the rates of male on female vs. female on male domestic violence. The editor argued that domestic violence is a public health issue and thus MEDRS applies, When told that MEDRS applies to biomedical claims, not public health claims, he started a campaign to change MEDRS so that it supports his source removal. So adding "health" is clearly not a minor clarification but rather a major change that would apply WP:MEDRS to thousands of articles that are now under WP:RS. Also, "health" can never be included in "biomedical", because "biomedical" is already included in "heath". "Health" is a much larger topic that includes "biomedical" as a sunset. --Guy Macon (talk) 01:03, 18 November 2015 (UTC)

As it is currently worded, the Nutshell summary should properly be: "Ideal sources for biomedical and health material ..." because we can't have supplementary guidelines, intended to focus and clarify core policies for specific subject areas, defining themselves in terms so broad, we can't provide a simple explanation as to what they mean. With "health," MEDRS prominently describes its scope with a term that cannot be usefully linked to its own article, because the very first paragraph of that article immediately introduces a total lack of clarity as to what it is supposed to mean in this context. --Tsavage (talk) 02:21, 18 November 2015 (UTC)

Guy Macon's "01:03, 18 November 2015 (UTC)" summary is inaccurate (for example, I'm the editor who attempted to remove the Scientific American source, and WP:MEDRS was only one of the reasons; further, that text/source will be removed soon per the WP:RfC at that talk page), but I've already been over this matter with him more than once on this talk page; so has CFCF (the editor he is referring to in that post). For example, "health" has always been in the first paragraph, and elsewhere in the lead...and lower in the guideline, and was well-supported by medical editors. Guy Macon took issue with the second sentence of the first paragraph ("For this reason it is vital that any biomedical information") being changed to include "biomedical and health," as if that changes how the guideline was already being used. Furthermore, editors on this talk page clearly disagree about what "biomedical" applies to. Flyer22 Reborn (talk) 09:07, 18 November 2015 (UTC)

And all of this biomedical debating currently at this talk page started after this dispute, and the section above where I pinged Guy Macon and others. No matter how one defines "biomedical," WP:MEDRS encourages better sources than Scientific American, as is clear at Wikipedia:Identifying reliable sources (medicine)#Popular press. I'd left the Scientific American source in the Domestic violence article for a year to give editors a chance to update it with a better source; I only let it stay because WP:MEDRS is clear that Scientific American can be a decent source. But after the year was up, and I thought about (and further saw) how the content was presented without WP:Due weight, and was presented inaccurately, I removed it. Flyer22 Reborn (talk) 09:26, 18 November 2015 (UTC)

I think my legal analogy stands fine. A well-publicized and pseudo-controversial clarification of a vague threats-of-bodily-harm law to make it clearer that, yes, it does apply (as it always really did) to orally delivered threats would have the contextually major effect of reducing the incidence of jackasses threatening to beat the tar out of people, but it would remain actually a minor change to the law, with very little impact on society at large. See my three sentences beginning "1 and 2 are not logically inconsistent when analyzed correctly" again in this light, please. The cognitive dissonance is happening because of a commingling of entirely different concepts of "major/minor" and to what they refer. By way of another analogy, if I take a step to the right (with my hands on my hips), this is a very minor action. If another entity happens to be an ant that I stepped on, the consequences were major in the context of that entity, but this does not affect the fact that it was a minor, non-controversial action on my part with little effect on the world (except perhaps in the view of that ect of Jains who walk around staring carefully at the ground and sweeping it lest they step on an insect, I suppose).

The point being, we do not need to wring our hands over how "major" the effect will be if it's an effect that was always within the intent for which this guideline's consensus enacted it. It's simply about time that it was applied correctly, and unless written really poorly, it should have no negative effect, only the positive one of further restraining WP:FRINGE, WP:OR and WP:NOT#ADVOCACY problems affecting many articles due to PoV-pushing in these directions by parties who think that MEDRS is or should be easily WP:GAMEable by playing verbal shell-games with terms like "health" and "wellness". Fewer disputes like the ongoing one at ArbCom about electronic cigarettes (involving a lot of party-overlap with this discussion) would arise. Tsavage has a valid observation about the vagueness of the article Health, which dovetails with my concerns about applying the term here without clearly defining it and/or limiting the scope of the intended meaning. The obvious solution to that is, well, to clearly define it and/or limit the scope of the intended meaning.  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  12:13, 19 November 2015 (UTC)

SMcCandlish ☺: My intention in challenging your challenge of my comment criticizing this proposal isn't to start a further sub-argument, it is simply to not have my original statement discounted as a valid proposition, in order for you to "agree with the general thrust of this proposal." My argument isn't against clarification, per se, it is against "unless written really poorly," which this proposal seems to me to advocate.

You say, "The cognitive dissonance is happening because of a commingling of entirely different concepts of "major/minor" and to what they refer," which is the main point of my original comment, and is acknowledged in my reply to you: "If a "minor clarification" has major effects, then, from a practical standpoint, it is (also) a major clarification." Your legal and side-stepping analogies both suffer from the problem we have both identified: context matters. If you were knowingly side-stepping onto ant-infested ground, claiming that, "I only just took one little step," would seem disingenuous at best as a denial that you were out to kill ants.

(As for oral threats, you've given the hypothetical result a positive spin - "contextually major effect of reducing the incidence of jackasses threatening to beat the tar out of people" - while not acknowledging the equally plausible-sounding scenario where, being alerted to these "new" grounds, there is a rise in cases where other jackasses file oral threat charges that are really unwarranted by any reasonable consideration, further clogging up the judicial system, and ratcheting up overall stress and noise. There are things best left unsaid.)

My example, with highlighting subhead, was an attempt to provide a different framing of the underlying problem as I and some other editors see it, that the proposed step amounts to a significant (major) practical change. When editors argue simultaneously that it is only a minor change, but that it is a change necessary to correct the perceived scope of MEDRS, there is an apparent logical inconsistency that should be resolved so that all RfC input is about the same thing.

I don't think we are in disagreement, I find that "health" is obviously problematically broad (first of all, as my health link example indicates, it can't be usefully defined for this purpose), and I also wonder why "biomedical" is used in place of what the linked article says, in the first sentence, "is in general simply known as medical research," which is the actual title of the article, and seems much clearer to me (I have a pretty clear idea of what medical research is, I don't really of what biomedical refers to exactly...oh, it means "medical research") - aren't guidelines supposed to be straightforward and accessible to the general editor, as our content is supposed to be to the general reader?

The real major problem, IMHO, is that we seem to trying to fix actual problems with ever more specific rules, and this just cannot work in the anonymous Wikipedia editing environment. IMO, we should be concentrating on improving editor oversight processes, rather than trying to hardwire in more specificity to core policies that rely on general principles and common sense interpretation. --Tsavage (talk) 13:58, 19 November 2015 (UTC)

OK, I see where you're coming from better. Not sure I particularly disagree with much of that, but would insert some things. It's not mandatory that we link to articles on topics to say something in a guideline. Whenever we do, there's always a risk that the article content will change out from under us and be seen as altering the nature or applicability of the guideline (or policy or whatever). It's better to use links in examples, or as supplementary within the prose while writing the prose clearly and solidly enough that it still means what it means if you print it out on paper or if the linked article turns into crap. That naturally requires the kind of straightforward, accessible, common-sense codification of principles you're talking about. But when an area has real-world ethical consequences, we do in fact tend to insert specific anti-gaming, anti-misinterpretation wording that's quite detailed and tends to form definitions, scope clarifications, and line-item rules. WP:BLP largely consists of this, and it works fine, embedded within a more general-principles outline. The two approaches are not really mutually exclusive, it just takes work and care to integrate the one into the other.  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  14:10, 19 November 2015 (UTC)

Tsavage, the lead for Biomedical research is, well, wrong. Or at least sloppy. There is plenty of medical research that doesn't have any "bio" in it. Look at these clinical trials: [36][37][38] Those are all "medical research", but they're all socio-medical, not bio-medical. "Biomedical" is the biological side of medicine ("bio" + "medical"). WhatamIdoing (talk) 23:39, 21 November 2015 (UTC)

A different question

To some extent, what I'm about to say is a different variation on the idea of a logical flaw in the RfC than what is in the talk section just above. It looks pretty obvious to me that this RfC is already destined to end in "no consensus". And the discussion between me and WhatamIdoing in #Discussion question, above, got me thinking that the real problem is not going to be solved by whether we do, or don't, add the word "health" to the guideline. The issue is that there needs to be a better delineation of where MEDRS does, and does not, apply. The disagreements between editors arise when one editor believes that a particular bit of content does not fall within the scope of MEDRS, and another editor believes that it does. No amount of wordsmithing between "health" and "biomedical" is going to fix that. Please see #Discussion question for examples of content topics where one part of the topic probably should be sourced according to MEDRS and another part of the topic probably should not. In that section above, I suggested that MEDRS applies where the content is going to influence how our readers make decisions about their health, but it doesn't have to apply more widely than that. Instead of battling over the issues that editors are battling over in this RfC, I'd much rather that editors brainstorm on how, exactly, MEDRS should express where it applies, and where it does not. --Tryptofish (talk) 21:49, 3 November 2015 (UTC)

Tryp, see the RfC above this one and the withdrawn one above that one. Maybe it's time for some actual alternative proposals so participants can get a better sense of how the guideline can be used (and misused) based on the specificity or ambiguity of the language in the guideline. I agree that the enclusion or exclusion of "health" will not resolve anything because we dont have a common understanding of what "health information" comprises. Same issue with the prior RfC because different editirs had different understandings of the word "epidemiology" and its scope. I have tried to suggest some common ground for understanding but it has gone nowhere. Maybe you will have more success. Minor4th 22:41, 3 November 2015 (UTC)

I don't have a definitive answer. But I can see two general ways to approach it. I just looked again at the wording now on the page, and I see how it links to Wikipedia:Biomedical information – and that page actually makes exactly the kind of distinction that I think we need. So, in one possible approach, the problem resides in editors incorrectly applying Wikipedia:Biomedical information, and there needs to be some codification here that MEDRS does not deviate from that other page. The other possible approach is to better define where it says: "For this reason it is vital that any biomedical information is based on...", by indicating more specifically and narrowly what that blue link actually links to. An example of the latter would be something along the lines of: "For this reason it is vital that any biomedical information that could affect how readers make health care decisions is based on...". --Tryptofish (talk) 22:59, 3 November 2015 (UTC)

There is actually a problem with that definition in that some editors have suggested that it doesn't include a number of epidemiological concerns where the lay-reader is not likely to make a health choice based upon the information, even when other professional groups may. The issue might be that we are trying to hard to be concise with a one-size-fit-all definition (I don't agree).

For a constructive approach it may be better to instead include part of that essay as a subheader of MEDRS, titled "Topics covered" (or something to that effect). CFCF 💌 📧 23:10, 3 November 2015 (UTC)

Perhaps that could work. For example, this page could have a section titled something like "What is and is not biomedical information". That would be based upon the two corresponding sections of the essay page. And then "biomedical information" in the lead would be blue-linked to that page section. --Tryptofish (talk) 23:32, 3 November 2015 (UTC)

This common-sense approach does seem to be supported by the first paragraph of WP:MEDRS and it is also how i understood the rationale and spirit of the guideline:

Wikipedia's articles are not medical advice, but are a widely used source of health information. For this reason it is vital that any biomedical information is based on reliable, third-party, published secondary sources and that it accurately reflects current knowledge.

I think that health-related biomedical content in articles is special because it is indeed used by readers to make decisions about their health, both for prevention as well as diagnosis and treatment. Therefore, anything relating to etiology of disease or health, anything relating to direct explanation of human physiology, and anything relating to epidemiology of disease or health falls under this category. I would hope that all other content is also sourced as well as possible, but the stricter requirements for such content makes sense in this light. SageRad (talk) 18:37, 4 November 2015 (UTC)

Thanks! Yes, that's right, I think. Looking at Wikipedia:Biomedical information#What is biomedical information?, the following specific examples are listed as topics that potentially should be sourced according to MEDRS: attributes of a disease or condition, attributes of a treatment or drug, medical decisions, health effects, population data, and biomedical research. And, from Wikipedia:Biomedical information#What is not biomedical information?, these are listed as potentially not subject to MEDRS: commercial or business information, economics, beliefs, history, society and culture, legal issues, notable cases, popular culture, etymology and definitions, training, regulatory status, and medical ethics. Currently, the lead here links to that, and I think it does a reasonably good job of delineating the boundaries. On the other hand, it's just an essay, and there is no reason why the two lists cannot be revised here. Maybe an improved version of those two lists could be made into a new section of this page, MEDRS, and maybe that would be a way of clarifying the issues where editors keep disagreeing. --Tryptofish (talk) 18:52, 4 November 2015 (UTC)

The problem here appears to be that I, SageRad. and Tryptofish all appear to want to apply MEDRS to health-related biomedical content -- otherwise known as "content used by readers to make decisions about their health" while CFCF and Flyer22 Reborn want MEDRS to also apply to things like the rate of male-female vs. female-male domestic violence. The latter is an important scientific, statistical and sociological topic, and it can be argued to be "population data", but nobody is going to use the information to make decisions about their health. On the other hand, as Tryptofish has correctly pointed out several times, the number of editors who want to expand MEDRS so that it can be used to exclude sources that meet our WP:RS standard is small and the number of editors who want to weaken MEDRS so that they can sell their snake oil, fat burning pills and penis/breast enlarging products is quite large and very persistent. Of the two alternatives we are discussing here, I strongly prefer the wording of the lead paragraph that has served us well for at least five years, but I also think that we can come up with something that is better than either. Alas, to do that we need to somehow stop the discussion from being derailed by those who want MEDRS to apply to anything health-related (as interpreted by whoever is trying to apply MEDRS). :( --Guy Macon (talk) 19:19, 4 November 2015 (UTC)

You've probably oversimplified who I agree and who I disagree with, and I really would rather we move away from grouping editors into opposing camps. Instead, I would rather we focus more on what I just asked about above: what are the topics that should be listed as within MEDRS, and what are the topics that should be listed as not within MEDRS? --Tryptofish (talk) 19:30, 4 November 2015 (UTC)

Good comment, Guy Macon. Thank you for boiling it down. I would like to be clear that defining WP:MEDRS to apply to biomedical claims relating to human health does require MEDRS sourcing for the claims that you call snake oil, like fat-burning pills and the like. Those would have to produce good, solid secondary sources to support any claim as to their efficacy. It would simply exclude topics like the sociology of domestic abuse, which is what i think we want. I think we're all seeing that agenda pushing like trying to exclude knowledge about domestic abuse patterns in society is not good, and neither is snake oil pushing like advocating fat-burning pills that don't really work. I think the simple interpretation of MEDRS based on its true spirit is the solution. I think that this is all spelled out, albeit in subdued language, in the third paragraph:

This guideline supports the general sourcing policy with specific attention to what is appropriate for medical content in any article, including those on alternative medicine. Sourcing for all other types of content – including non-medical information in medicine-articles – is covered by the general guideline on identifying reliable sources.

"Alternative medicine" could be construed to include any possible snake oil, and "non-medical information in medicine-articles" could be construed to mean that content which a stubborn few try to exclude from articles by demanding MEDRS sourcing for sociological claims. SageRad (talk) 00:07, 5 November 2015 (UTC)

I agree with Tryptofish about Guy Macon representing people in inaccurate ways. He's done that all over this talk page as far as CFCF and I are concerned, and he refuses to stop, despite telling me to stop supposedly misrepresenting him. And he continues to act like CFCF and I are the only ones who feel that WP:MEDRS applies to epidemiology or, more specifically, to rates of male-female vs. female-male domestic violence, despite various other editors on this talk page agreeing with me and CFCF. Arguing that reports on the physical and/or psychological harm of domestic violence are not biomedical, whether about the rates of those aspects or not, and/or that this does not fall within WP:MEDRS, makes not a bit of sense to me. I made my feelings well known in the #Clarifying "biomedical" section above. And in the #Does MEDRS apply to Epidemiology? section above, I commented, "[...] I will go ahead and state, though, that of course WP:MEDRS applies to epidemiology. This is also covered in the 'Included' aspect of the WP:Biomedical information essay, under the listing Population data. That stated, this doesn't mean that we need to be overly strict with regard to WP:MEDRS-compliant sourcing for epidemiological material. Some epidemiological material requires a higher level of sourcing than other epidemiological material. And WP:MEDDATE is clear that we can make exceptions in areas 'where little progress is being made or where few reviews are published'." Flyer22 Reborn (talk) 02:08, 5 November 2015 (UTC)

I don't understand why editors are acting like WP:MEDRS is so strict. Like I told Guy Macon, "[Y]ou have a misunderstanding of the guideline; you are applying the five-year standard as though it is gospel. [...] [WP:MEDDATE] is also clear that newer is not necessarily better. If the older source is better, then we go with that, as medical editors commonly do at the Circumcision article." Furthermore, reviews are not the only sources that WP:MEDRS recommends. For example, a good book source is fine. Flyer22 Reborn (talk) 02:25, 5 November 2015 (UTC)

And I again point out that even though I have not been advocating that "health" be added to the guideline, this link shows that not only was it already in the introduction of the guideline, it was also lower in the guideline; CFCF adding it to the guideline does not make its appearance there a new aspect of the guideline, no matter how many times Guy Macon or others state or indicate that it is. Flyer22 Reborn (talk) 02:44, 5 November 2015 (UTC)

That is not true. The lead (first) paragraph was the paragraph that CFCF changed. The lead (first) paragraph was the paragraph that CFCF posted this RfC to get permission to change after multiple editors opposed his change to the lead (first) paragraph. Your diff shows zero changes to the lead (first) paragraph. "CFCF adding it to the [lead (first) paragraph of the] guideline does not make its appearance there a new aspect of the guideline" is a blatant falsehood. people are tired of you saying something that isn't true, and people are tired of me correcting your false claim. Just stop. Anything other than "any biomedical information in articles" in the lead (first) paragraph is a major change, and is not supported by any previous version that anyone has found. Please stop doing this. --Guy Macon (talk) 16:01, 5 November 2015 (UTC)

It is true. This is why I questioned if you are acting blind. I already told you, "so now you are only focusing on the first lead paragraph, not the other parts of the lead that were changed in August? As for what you stated in this edit summary, I have not been advocating to add 'health' to the lead; I haven't even yet voted on whether or not 'health' should be re-added; this is because I do have concerns that it might be used too broadly. 'Health' is still in the lead paragraph, though." Do you think you can confuse editors here by focusing only on the first paragraph of the introduction and acting like "health" was never in that introduction, that it was only there because CFCF added it? You can't. So stop it. Stating that "people are tired of [me] saying something that isn't true, and people are tired of [you] correcting [my] false claim." is clearly something you have backwards. Flyer22 Reborn (talk) 20:46, 5 November 2015 (UTC)

More stated here. Flyer22 Reborn (talk) 21:10, 5 November 2015 (UTC)

Flyer22 Reborn, I did not say (either) that Guy Macon is representing people in inaccurate ways. This entire back-and-forth has gotten off track from what I started this discussion section about: what are the topics that should be listed as within MEDRS, and what are the topics that should be listed as not within MEDRS? --Tryptofish (talk) 20:34, 5 November 2015 (UTC)

My wording was off and I considered tweaking that, but I was clearly referring to your comment that "You've probably oversimplified who I agree and who I disagree with, and I really would rather we move away from grouping editors into opposing camps." He does that over and over again, with different editors, and he's very much misrepresented me and CFCF. I'm tired of it. Just as much as he claims to be tired of me supposedly misrepresenting him. Thing is...I barely focus on him, but he repeatedly focuses on me, even though I have not been as active in these discussions as certain others. Flyer22 Reborn (talk) 20:46, 5 November 2015 (UTC)

Thinking about this some more, I notice how some editors used snake oil as an example. I actually think that everyone here agrees that we should not use non-MEDRS sources to claim that snake oil is a cure-all. Wikipedia is pretty good at dealing with users who come here to peddle obviously bogus products. The problem, instead, comes when editors have genuinely conflicting opinions about a topic. Editors do not have the same consensus about, for example, GMO foods that we have about, for example, phrenology. I'm also starting to notice that a lot of the needless drama here arises because editors define topics differently. Epidemiology is a good example of that. I think that editors would actually all agree that the epidemiology of which human populations have an elevated risk of type-two diabetes is something that properly falls within MEDRS – and that the epidemiology of people whose employers do not provide them with adequate health insurance is not something for MEDRS. Right? Those things ought to be no-brainers. So when editors argue about whether or not epidemiology is subject to MEDRS, the answer ends up depending on how a given editor defines it, how narrowly or broadly that editor applies the term. --Tryptofish (talk) 20:48, 5 November 2015 (UTC)

Agreed. Flyer22 Reborn (talk) 21:10, 5 November 2015 (UTC)

Agreed +1 Minor4th 21:50, 5 November 2015 (UTC)

I think you have hit the nail on the head as to why there is disagreement. The trick is finding language that satisfies both groups. AlbinoFerret 01:39, 6 November 2015 (UTC)

Yep. MEDRS does nott apply to, e.g., the epidemiology of the black plague in medi[a]eval Europe. It absolutely does apply to claims of efficacy of aromatherapy, even if someone defines that as a spiritual/religious practice. Despite some "don't you dare misrepresent me" fist-shaking, this section has come a long way toward identifying the way forward. And it's clearly does not include treating a figurative use ("the epidemiology of lack of insurance") as a MEDRS topic, which is not a medical claim of fact (though often is poor, misleading, and PoV-pushing violence; see, e.g., widespread condemnation both on and off WP of describing the rise in obesity and diabetes levels in affluent countries like the US and UAE as "epidemics"). The solution clearly does include, per WP:FRINGE and per WP:NPOV and WP:NOR generally, claims about negative health effects of GMO products and vaccines; the sheer popularity of those topics and the number of (mostly educated, middle-class) people who believe utter nonsense about them simply because it's been repeated enough times gives us a serious responsibility to not repeat it again (other than as a attributed quotations followed by a reliably sourced refutation).  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  20:12, 19 November 2015 (UTC)

Tryptofish, I'm thinking about the question: Will people use this to make decisions about their health? I don't think it's broad enough. As pointed out above, we also want to capture policy makers making decisions about other people's health. And we probably also want to cover things that aren't at all decision-related, but are hard science. Nobody is really going to make a "health decision" related to physiology or the number of atoms in a given drug molecule, but we still want to get it right. Following MEDRS and/or SCIRS (whichever is more relevant to the immediate subject) for hard science increases the likelihood that we'll get it right. WhatamIdoing (talk) 04:43, 6 November 2015 (UTC)

Thanks very much everyone! Yes, WhatamIdoing, how to figure out that question is the real task at hand, and it's surprisingly difficult. I've been thinking hard about it, and not getting very far. As you say, "decisions about their health" comes close, but does not quite suffice. I hope that many editors here will think about it and try to come up with new ideas. --Tryptofish (talk) 17:04, 6 November 2015 (UTC)

Agreed with WhatamIdoing. As for it being difficult to approach this in guideline language, how about just starting with the wording WaId used and adapting it with some other concerns raised. We could work on tweaking something like this: "The scope of this guideline includes information that some readers are likely to use to make health decisions, including claims of medical efficacy [add several other obvious things]. It also includes scientific data about medical topics, including biochemistry [add several more]. Socio-political claims about such data are subject to MEDRS when they are presented in Wikipedia's voice or presented as the consensus viewpoint in sources." The second sentence there would, for example, have thwarted that entire time-wasting and blood-pressure-increasing extended flamewar about whether electronic cigarette aerosol is (of course) a MEDRS topic. The third sentence would allow any article to exclude fringe nonsense as long as it's well sourced in MEDRS terms, and prevent the exclusion of real medical data from an article dominated by fringey quotations masquerading as fact.  — SMcCandlish ☺ ☏ ¢ ≽^ʌⱷ҅_ᴥⱷ^ʌ≼  20:12, 19 November 2015 (UTC)

Can you give some examples of "socio-political claims about the data"? Would things like "most patients dislike hospital gowns" or "there is much more government funding for breast cancer research than for prostate cancer" be "socio-political claims"? WhatamIdoing (talk) 23:42, 21 November 2015 (UTC)

This is insanity!

• Comment Look folks, when I first responded to the RFC it was too big to assimilate in any reasonable time. Now I find myself called a second time and on my screen it now is fifteen pages of spaghetti! Never mind my poor decaying attention span; doesn't that suggest, sight unseen, that there is something very, very badly wrong with the whole discussion? Skimming the text in ricochet mode it seems to me that there are several sane voices being drowned out, but trying to sort out a topic for a vote in this mess just won't work! I propose closing the RFC forthwith, but keeping it up for reference or for masochism, while we start another RFC or topic, as preferred, in which we put up just alternative proposals for vote or acclaim. Each alternative to have an appended justification not more than say 300 words (200? pick a number, but whatever it is must fit easily onto one page...)
  

Any discussion NOT to be in the same section.
Example:

• Proposal 1 that every article adheres at a minimum to Wikipedia's citation rules, irrespective of the topic or context, subject to reasonable challenges as always; that in technical matters in particular disciplines, higher or more specialised standards of citation may be required in particular contexts -- for example, in an article concerning mosquitoes, a section on medical or epidemiological aspects of malaria might contain claims that need citations according to MEDRS standards, but it does not follow that every citation in such a section falls under MEDRS direction, let alone the whole article.
  
• Proposal 2 that every article adheres at a minimum to Wikipedia's MEDRS citation rules throughout in case there should....
  

etc. What we need here is a bit of sense, sense of what readers need, what editors need if they are to meet those needs, and what will make WP look like the kind of encyclopaedia that people can trust to contain what is needed and to exclude what cannot be trusted, without insulting readers' intelligence, whether they happen to be professionals or schoolchildren. JonRichfield (talk) 08:04, 4 November 2015 (UTC)

I agree. A hundred pages of discussion ensures that only people who obsessively track this page are up to date with all nuances. This is no way to have a discussion. By the way "I told you so", that this discussion is going to be an enormous waste of time. Unfortunately I failed to take my own advice. Kingsindian ♝♚ 08:45, 4 November 2015 (UTC)

I agree as well. I especially like John R's refreshing common sense, in particular his final statement. petrarchan47คุก 09:10, 4 November 2015 (UTC)

If all of this has been a waste of time, then it's only because editors didn't stick to clarifying what biomedical is supposed to cover; clarification is why I started the #Clarifying "biomedical" section above, after all. The above WP:RfCs are not what I had in mind. Flyer22 Reborn (talk) 13:18, 4 November 2015 (UTC)

CFCF's WP:RfC placed under another WP:RfC (#Does MEDRS apply to Epidemiology?) is the WP:RfC that stays most on track, since it's essentially asking if epidemiology falls under "biomedical." Flyer22 Reborn (talk) 13:24, 4 November 2015 (UTC)

← Thanks; I agree that this is insane, and there is not really any hope of reasonable voices being heard in this setting (which, frankly, is the case with most RfCs; they're intended to solicit outside input, but they usually just devolve into another platform for the original combatants to hold forth). The oddest thing, for me, is listening to people expound their ideas about why WP:MEDRS exists. I'm repeatedly hearing that MEDRS exists to keep people from making poor health decisions on the basis of bad information (the implication being that, since our domestic-violence coverage doesn't directly influence people's medical decisions, there's no need to apply MEDRS).

Well, not really. I mean, yes, one of the most important justifications for the sourcing standards set forth in MEDRS is to prevent the real-life harm that could result from providing inaccurate or misleading medical information. But the purpose of MEDRS is broader than that (I feel justified to speak here, as one of the people closely involved in this guideline's creation). The overarching purpose of MEDRS is to ensure that our coverage of medical and health-related issues is the best it can possibly be. The guideline is a summary of standards that ensure article quality and accuracy, derived from the collective experience of editors who have written tons of high-quality medical and health-related content. MastCell ^Talk 17:59, 4 November 2015 (UTC)

• This particular inmate at the asylum would like to make a suggestion. At #A different question, above, there is an idea about a different approach, and more eyes there could be helpful. --Tryptofish (talk) 18:26, 4 November 2015 (UTC)
• I don't know about you, but I'm hearing reasonable voices and even reasonable ideas from a couple of less-than-reasonable voices. Tryptofish's question in particular is producing some useful comments right now. Now if you'd just let me banish everyone from the page for a month or two, we could get back to work...  ;-)
  Also, I think I'm going to have to start drafting WP:MEDDUE. I'd hoped to put it off until I'd finally finished dealing with the long-overdue merger of INDY and 3PARTY, but perhaps it can't wait any longer. Most of our serious disputes are due to people using MEDRS as a substitute for DUE ("Don't exclude Archer because his POV is a very small minority; instead, exclude him because it 'fails' MEDDATE!"). WhatamIdoing (talk) 04:10, 6 November 2015 (UTC)

That sounds good to me WhatamIdoing and jolly good luck to you! I assume that the outcome will include dealing with doubts about when a guideline applies to only part of an article. I get the impression that some voices urge that the presence of any passing remark on matters that could be of medical concern in an article, implies that the whole article is subject to MEDRS or related guidelines. There already have been remarks about epidemiology of bicycles, and I would point out that many biological articles such as mosquito or spider include sections of medical relevance, whereas the rest of the content of the article could only be degraded by such irrelevant constraints. In short, common sense should trump doctrinaire authoritarianism. May the force .... and all that! JonRichfield (talk) 06:46, 8 November 2015 (UTC)

• MEDRS is used on health-related topics. User:Kelapstick disagrees. Why? QuackGuru (talk) 20:37, 29 December 2015 (UTC)
  • QuackGuru, I have no opinion on the matter. There was an edit war ongoing, I protected the page and changed the wording to what I consider the status quo prior to the edit warring, which happened to coincide with the status quo before the RfC. This is permitted by our protection policy. This matter is further elaborated on my talk page, and I don't wish to repeat myself. I was brought to the page per a request at RFPP, and I am not going to take part in this discussion any more. --kelapstick^(bainuu) 20:42, 29 December 2015 (UTC)

• Per this post, which tracks with diffs [39] that "biomedical" never included "and health" in the lede, shows the reasoning for the RFC. The change was edit warred in, and some of it still remains. kelapstick did not abuse anything, but returned part of the page to its pre RFC stable version. WP is not governed by might of numbers in a revert war, but by discussion and consensus. Waiting for the close of the RFC before changeing the proposed wording is a sound administrative decision. AlbinoFerret 21:00, 29 December 2015 (UTC)

Involved close

CFCF is involved, and it is inappropriate for him to close this RFC and attempt to archive it, on a holiday of all days. I have requested an uninvolved admin close at WP:ANRFC AlbinoFerret 23:00, 25 December 2015 (UTC)

I would agree. It's really necessary to have an uninvolved close of any contentious RfC. I also see edit warring going on about the "and health" phrase -- that phrase must feel like a volleyball at this point. SageRad (talk) 09:03, 31 December 2015 (UTC)

Uninvolved close

I can't remember the technical side of closing one of these; do we normally use {{archive top}} and {{archive bottom}}, or is the nowiki-ing of the RFC template and a close decision/rationale sufficient?

Closing this as biomedical, i.e. without "health". The numbers are approximately equal (per WP:NOTAVOTE, I didn't count precisely), but the strongest point is the issue raised by many "biomedical"-only people of the scope: by noting the far broader scope of "health", including everything from seatbelt usage to public health policies. Per WP:CONLIMITED, the broad community needs to be consulted for something affecting the broad community, and people who use chemistry and biology journals to write about pesticides and organic foods, or people who use non-medical reliable sources to write about bicycles and seat belt usage, won't have paid attention to this page and won't have had their views represented. Those opposing the inclusion of "health" don't seem to have been adequately answered when they challenge the issue of redundancy versus scope expansion; QuackGuru makes a good point in saying The lay reader does not know what the term "Biomedical" means, but the idea of inserting "health" merely as an explanation for the lay reader seems to have been outweighed by the idea of inserting "health" as an expansion of the page's scope, i.e. lots of supporters of "health" didn't address the topic of merely explaining things, while those opposing generally held that this was an expansion, rather than a clarification for the layman. Final note — some of the votes were simply weak, and they tended to be much more on the "and health" side. Short is fine, e.g. We want to have a simpler wording and adding health simplifies it and too broad, but per Doc James, Tryptofish, Jytdog, etc. and as per several others above. Biomedical is clear to me simply need to be given less weight, not to mention votes without rationale, and I'm seeing more of the latter sort in votes on the "and health" side than on the other. Nyttend (talk) 14:14, 31 December 2015 (UTC)

PS, Ryk72, I ignored your statement because this isn't the excluded middle fallacy: nobody said or implied that these were the only two options. If you feel like it, go ahead and make a proposal along the lines of your suggestion. Nyttend (talk) 14:16, 31 December 2015 (UTC)

Review articles and SPRINT

How do we handle the SPRINT trial? http://www.nejm.org/doi/full/10.1056/NEJMoa1511939 DOI: 10.1056/NEJMoa1511939

WP:MEDRS says that ideal sources are systemic reviews . However, some WP editors have taken the position that systemic reviews, and not clinical articles or editorials, are the only sources we should use.

There are no systematic reviews that include SPRINT.

Does this mean that until it is discussed in a review article, we should ignore SPRINT, in articles like Hypertension and Management of hypertension, where it is not mentioned, and which cite articles from 2014, 2013, 2012 and earlier? --Nbauman (talk)

Wait for secondary coverage. There's no hurry. Alexbrn (talk) 19:19, 1 December 2015 (UTC)

So you advocate leaving the articles with information that is incorrect and misleading, according to the latest published research and expert opinion.

And if they read about SPRINT in the news media, and want to find out more about it in Wikipedia, you don't think we should tell them. --Nbauman (talk) 20:14, 1 December 2015 (UTC)

No, I advocate our articles reflecting properly settled knowledge. Using primary sources and lay press isn't a safe way to do that. Sometimes very significant primary studies may be included, to be decided on a case-by-case basis by the usual process of consensus. Alexbrn (talk) 20:20, 1 December 2015 (UTC)

Agreed, the process on how to cover such topics is clear, take this up at hypertension if you find it should be included. CFCF 💌 📧 20:36, 1 December 2015 (UTC)

In any discussion at Hypertension, they would refer back to MEDRS. I just want to make it clear. You are saying that primary sources can be used on a case-by-case basis, by consensus of the editors of the specific article. Does everybody else here agree with that? --Nbauman (talk) 20:42, 1 December 2015 (UTC)

Of course. Wikipedia is always ruled by consensus over rules (hence WP:IAR). That said, there needs to be an exceptionally strong case to go against the grain of the WP:PAGs and one should always beware the falsity of a spurious WP:LOCALCON. Alexbrn (talk) 20:45, 1 December 2015 (UTC)

(edit conflict) Just read the damn guideline. CFCF 💌 📧 20:46, 1 December 2015 (UTC)

Different people read the guideline and come to different conclusions. Are you willing to accept my conclusions? --Nbauman (talk) 22:44, 1 December 2015 (UTC)

I'm with Nbauman here. SPRINT is Level 1 evidence that has been vetted by a DSMB, the NHLBI, and the editorial staff of the NEJM. The first two even made the decision to terminate the trial early because of how important they felt it would be to communicate the results to the outside world. I'm not saying we should say that current listed recommendations in Hypertension#Management are necessarily out of date. But to not even mention the existence of the trial (in conjunbction with its many important inclusion/exclusion criteria [namely CVD risk and no diabetes]) in the "Research" section of management of hypertension is doing a disservice to our readers. NW (Talk) 23:45, 1 December 2015 (UTC)

It is an excellent question regarding how SPRINT is going to affect medical practice. I discussed this issue at the NIH and with the Cochrane Hypertension Group in the last couple of weeks. Secondary sources are being worked on as we speak and will be out soon.

Yes more aggressive BP management decreased the risk of death by about half a percentage point in those at high cardiovascular disease risk per this trial. While rates of serious adverse events were increased 2.3%.

As others have said "The full importance of this study will not be known until the results are scrutinized by those with a critical eye for methodological biases and this study is viewed as part of the totality of evidence available on this important clinical question."

I agree with User:NuclearWarfare the results should be discussed in a research section of the management of hypertension article. Doc James (talk · contribs · email) 08:28, 3 December 2015 (UTC)

I would just add that the SPRINT trial was published in the NEJM along with 4 other articles commenting on them. Those 4 articles are secondary sources. They're not "third-party" secondary sources, but if the NEJM published a review article next year, I don't think anyone would exclude that under MEDRS. At any rate, SPRINT is not "research" in the same sense that in vitro, animal or database studies are research. --Nbauman (talk) 00:27, 4 December 2015 (UTC)

Analogizing SPRINT to the JUPITER trial: we have two large multicenter RCTs of cardiovascular prevention. When JUPITER came out in the New England Journal of Medicine, there may have been "secondary" sources the same week. But there was also quite a lot of controversy that led to serious disagreement in Archives of Internal Medicine many months later. You would have never known about the disagreement in the field from just reading the text of the JUPITER Trial article, and Wikipedia's readers would have been really poorly served if we had said immediately changed cholesterol and cardiovascular disease to read "everyone over 60 should be getting their CRP checked and taking statins now now now". We can and should mention SPRINT as recent research in the management of hypertension article but waiting until review articles come out to reassess Hypertension#Management seems wise to me. NW (Talk) 00:46, 4 December 2015 (UTC)

"Do not reject a high-quality study-type" ?

MEDRS says

Do not reject a high-quality study-type because of personal objections to: inclusion criteria, references, funding sources, or conclusions.

I know this has been discussed recently, and I may be being dim, but what does rejecting a study-type look like? Is it saying something like "I deny this is a even a systematic review because it is funded by cigarette manufacturers?" How can a "study-type" have "inclusion criteria, references, funding sources, or conclusions"? Those properties can only belong to instances of a type (i.e. an actual study), and not to a "type" itself. Alexbrn (talk) 06:02, 4 December 2015 (UTC)

Yes, "type" could be dropped. Johnbod (talk) 12:45, 4 December 2015 (UTC)

But then, is it actually right? In my experience the mentioned properties are often taken into account when evaluating sources. Alexbrn (talk) 12:53, 4 December 2015 (UTC)

I'm not sure the meaning is changed much. "Do not reject a study of a high-quality type because of ..." expresses what is presumably the intended meaning more grammatically. Johnbod (talk) 15:21, 7 December 2015 (UTC)

The "study-type" wording is new. It used to say "high-quality type of study". The word high-quality refers to the type of evidence (see: the entire rest of the section that this sentence is in), not to the overall reliability of an individual source. The main point to be made here is "No, you don't get to reject the meta analysis in favor of your cherry-picked randomized controlled trial, merely because you have a personal objection to some characteristic of the meta analysis". WhatamIdoing (talk) 01:54, 8 December 2015 (UTC)

Well we should go back, though "Do not reject a study of a high-quality type because of ..." is clearer, as it is an individual rejection that is being talked about. Johnbod (talk) 13:31, 8 December 2015 (UTC)

I see it as specifying that in this context, quality refers to its position on the hierarchy of evidence. "High-quality study" on its own could potentially refer to primary sources, and is also considerably more subjective. I don't think the objection being addressed is "I deny this is even a systematic review" as much as "This systematic review should be excluded/attributed because of my personal opinions about its inclusion criteria/references/etc," as opposed to objecting based on e.g. the weight of competing sources. This was discussed a few months ago in Archive 15 - it's the entire archive, but the second half is probably more relevant. Sunrise (talk) 02:30, 6 December 2015 (UTC)

WhatamIdoing recently proposed changing that wording to emphasize source quality over source type, since the way the language reads, we can't actually reject a meta-analysis that uses industry funded research that's been red-flagged as having possible conflict of interest. I thought that proposal might be a good idea, but still think there's issues with it, and yeah, we don't want to remove "type" because then we'll get primary studies. Now, the question is, if we have cigarette manufacturers funding studies that show cigarettes have no association with lung cancer and those get picked up in a meta-analysis, what do we do then? LesVegas (talk) 14:58, 7 December 2015 (UTC)

FTR: You have apparently not understood my proposal. WhatamIdoing (talk) 02:11, 8 December 2015 (UTC)

We describe the results of the meta-analysis, and we frame that within the suggestions of RS on the likelihood of bias. A good idea in general and it doesn't require us to rewrite any guidelines. Richard Keatinge (talk) 15:16, 7 December 2015 (UTC)

And we consider if such a deranged proposal is WP:DUE. There is more than sufficient evidence of the contrary that it is impossible that such a meta-analysis could be of acceptable quality. CFCF 💌 📧 15:20, 7 December 2015 (UTC) 

Due weight would indeed be important. I think that LesVegas is trying to make the point that a really high-quality study type should almost always be mentioned, however grave the suspicions surrounding it. Richard Keatinge (talk) 15:53, 7 December 2015 (UTC)

Despite the oft-repeated assertions that MEDRS requires us to use industry-funded sources, we most certainly can and do reject meta-analyses for all kinds of reasons – just not (a) in favor of weaker evidence and (b) due to personal objections to funding sources. We cheerfully reject bad meta-analyses in favor of good ones every day of the week, and we also reject sources that have been discredited by academics ("impersonal" objections), or carefully limit them to their proper WP:DUE weight. WhatamIdoing (talk) 02:11, 8 December 2015 (UTC)

These decisions are indeed a matter of weight and consensus. I would still start with a feeling that a large meta-analysis is generally worth mentioning in some context, and that serious doubts about its validity should form part of that context. Richard Keatinge (talk) 10:47, 8 December 2015 (UTC)

Yeah, I am inclined to agree with Richard Keatinge here that mentioning meta-analyses, systematic reviews and the like is usually a worthwhile endeavor and if there are noted issues with those based on funding, methods, or whatever, and we have criticisms which explicitly identify the junk sources, those criticisms should definitely be mentioned. If we have a meta-analysis which was funded by big tobacco, it's still notable even if it's garbage science. It's not for us as editors to question a published meta-analysis. It's for us as editors to just state what sources say, including critical sources. And there's plenty of criticism out there which are easily obtainable and can be easily included. Even the recently famous Coca-Cola study is worthy of inclusion here on WP, although probably 3-4 sentences of scientific rebuttals should follow. I wonder if we should include something in MEDRS saying just that, i.e., "however, if you include high quality study-types with questionable research due to funding sources, methods, etc, please ensure that criticisms also be included, should explicit criticisms of the source in question be available." Shouldn't we add something like that to make it more understandable? LesVegas (talk) 21:10, 8 December 2015 (UTC)

My point was that such an article will never be published in any respectable journal, and we can't act upon hypotheticals that are so unlikely that they will never come to pass. If such a study were ever published it is absolutely correct that editors question it, just not with personal objections. I don't find the current wording to be ideal, but those suggestions are simply superfluous, and don't address the issue at all – there will be a period in which there are no rebuttals for which that wording will actually cause a worse situation than what we have now. As has been mentioned before a WP:MEDDUE guideline is very much needed so that we can avoid this endless and mostly unproductive debate. CFCF 💌 📧 21:51, 8 December 2015 (UTC) 

CFCF that's simply not correct, there is an ample amount of research that has been published in very respectable journals and criticized thereafter. I have provided a lot of this very research in varying diffs during the RfC process. I may need to make a note of this in the current RfC, since it appears your opinion is based on not reading these diffs. So much research is industry-funded that researchers would have a hard time conducting meta-analyses if it was all government or independently funded. LesVegas (talk) 23:28, 8 December 2015 (UTC)

This is an entirely unrelated discussion about your example about cigarettes. You have multiple times raised extremely unlikely hypotheticals, but they are made no more likely just because you once provided some unrelated diffs. CFCF 💌 📧 20:40, 9 December 2015 (UTC)

A large meta-analysis might be worth mentioning in some context, but it might not be worth mentioning at all. To give a very relevant example, 167 meta-analyses about acupuncture have been published in the last five years, and even if merely a tenth of them are "large", then we cannot and should not mention all of them in Acupuncture. In that case, it's probably best to pick those that are most reputable and most representative of the overall literature. WhatamIdoing (talk) 04:36, 9 December 2015 (UTC)

Spot on WhatamIdoing. It's good to discern the possibility of a useful consensus. Richard Keatinge (talk) 20:17, 9 December 2015 (UTC)

Yes, agreed Richard, and I agree with WhatamIdoing there as well. Of course there's no way one could mention 167 meta-analyses in an article. I have, in the past, proposed something similar on the Acupuncture article, and am curious if we should add this into our guideline somewhere. Namely, what I proposed was that we mention claims for conditions that Cochrane says something about. So if Cochrane says, "Acupuncture is good for migraines" we can use meta-analyses for migraines. But when Cochrane says, "There's not enough evidence to suggest Acupuncture is efficacious for allergic rhinitis" we don't mention it, meta-analysis or not, or just mention a whole list of conditions which Cochrane says Acupuncture may or may not have benefit for. What seems to happen on that article is that editors will post every single meta-analysis that gets published, good and bad, and edit wars ensue on both sides. So not only is WhatamIdoing's suggestion practical, it also avoids edit wars on articles like that. And I really think something to this affect should be written into the MEDRS guideline. LesVegas (talk) 23:12, 9 December 2015 (UTC)

That is really more "MEDDUE" than "MEDRS", but it might be interesting to figure out how to address that. WhatamIdoing (talk) 06:01, 11 December 2015 (UTC)

You're really trying to interpret this in a way that furthers your point of view at every level LesVegas. Cochrane reviews are considered some of the most authoritative, and would be WP:DUE for exactly the example you say they aren't. CFCF 💌 📧 06:06, 11 December 2015 (UTC) 

WP:CGTW#8 keeps coming to mind. Alexbrn (talk) 06:21, 11 December 2015 (UTC)

CFCF, the Cochrane database has a lot of "no good evidence found" results in it. That doesn't mean that we need to go over to Cough syrup and say that there's no good evidence about whether cough syrup causes Alzheimer's. (Even though there isn't! I just ran a systematic review on the subject myself.  ;-) Unless a lot of sources are talking about whether cough syrup causes Alzheimer's, there's no need to mention the subject at all. By contrast, there are a lot of sources talking about acupuncture for allergic rhinitis (including approximately one review a year specifically on the subject of allergies and acupuncture, e.g., PMID 25269403), so in that instance, I would include it in the list of "sometimes used this way, but there's no good evidence either way" (or whatever the result of the studies is). WhatamIdoing (talk) 07:24, 11 December 2015 (UTC)

SO if this text boils down to "don't remove strong sources for capricious reasons" can't we say in more plainly? Or even remove it altogether as it's kind of obvious. Alexbrn (talk) 06:21, 11 December 2015 (UTC)

The text exists because we've had problems with this area. Also, nobody believes that their reasons for removing a strong source is capricious. WhatamIdoing (talk) 07:24, 11 December 2015 (UTC)

Then this should be dealt with by normal consensus-building. Sorry, but I really don't think that we need any change to MEDRS. If anything useful were likely to emerge from this mass of verbiage, I suspect we'd have seen it by now. Richard Keatinge (talk) 13:12, 11 December 2015 (UTC)

Is Dean Ornis's book a reliable source?

Dr. Dean Ornish's Program for Reversing Heart Disease shows up on scholar. Is it a reliable source to cite in support of statement that a low fat, plant based diet, exercise and stress management programme has been clinically proved to result in reversal of heart disease? Please qualify your replies.[40] Yogesh Khandke (talk) 05:41, 5 December 2015 (UTC)

No because of WP:MEDRS (also WP:REDFLAG &c.). Alexbrn (talk) 05:48, 5 December 2015 (UTC)

Redflag doesn't apply here, quoting MEDRS would be making a circular argument. Yogesh Khandke (talk) 07:07, 5 December 2015 (UTC)

WP:REDFLAG is part of WP:V which is policy. It applies everywhere. If you're going to make a claim about some lifestyle changes being capable of "reversing" heart disease, this is exceptional. You are going to need multiple super-stength sources (like reviews in top-tier medical journals). Not a popular diet book from one rather controversial guy. Alexbrn (talk) 07:29, 5 December 2015 (UTC)

Have you read the book and its references?Yogesh Khandke (talk) 07:52, 5 December 2015 (UTC)

No, and it wouldn't matter if I had. You have your answer based on WP:PAGs, and it is an obvious case. I suggest we close this (also this is not really the right place to discuss this, the page is for discussion of the MEDRS guidelines itself, rather than questions on particular sources). Alexbrn (talk) 08:05, 5 December 2015 (UTC)

Pasting policy links doesn't help, quote text followed by link, please. What do you make of the fact that it shows up on Google scholar? How significant or otherwise is that? Please qualify reply. Yogesh Khandke (talk) 08:24, 5 December 2015 (UTC)

We are not required to exactly explain each and every aspect of why that is a horrible source – that is just bizarre. Alexbrn has perfectly summarized why it is a horrible source, and if you can't cross-reference his statements with the linked guidelines/policy pages it is not his or any other editors duty to educate you. CFCF 💌 📧 11:12, 5 December 2015 (UTC)

Shut up and get out is no answer. Alexbrn mentions above that this isn't the right place to discuss particular sources, will the right forum be suggested? Pl. Yogesh Khandke (talk) 12:05, 5 December 2015 (UTC)

Despite this not being the right place, you now have your answer. Please don't WP:FORUMSHOP this around as it would be disruptive. You'll get the same answer wherever there are experienced editors. Alexbrn (talk) 12:08, 5 December 2015 (UTC)

Please be civil, don't indulge in personal attacks. I'll wait for others look at this so I've struck off my last comment. Yogesh Khandke (talk) 12:27, 5 December 2015 (UTC)

Agree it is not a good source. Doc James (talk · contribs · email) 12:43, 5 December 2015 (UTC)

I'm sorry no; its not a reliable for MEDRS content.

Sources are reliable per the content they support and are not reliable or non reliable unless the content the source supports is specified. I suspect there are WP compliant sources which identify exercise, diet, and stress management as impacting heart disease so it might be worth checking on that while making sure that what you are looking at in relation to MEDRS content is strictly WP compliant.(Littleolive oil (talk) 17:03, 5 December 2015 (UTC))

Absolutely right, LittleOliveOIl. There is no consensus amongst scientists that a low fat, plant based diet has been clinically proven to reverse heart disease. But I do think that if the OP wants to attribute, ala "According to Dean Ornish, a low fat, plant based diet can reverse heart disease" would be perfectible acceptable. It just doesn't pass the WP:V test to state it like it's an indisputable, proven fact. LesVegas (talk) 18:09, 6 December 2015 (UTC)

One might want to be somewhat more cautious in the statement (e.g., "some kinds of heart disease" rather than all types – I'm pretty sure that even Ornish would not claim that it worked for every single subtype). But you can use WP:INTEXT attribution and careful editing to provide WP:DUE weight to this minority POV. WhatamIdoing (talk) 02:15, 8 December 2015 (UTC)

According to Ornish's book it is clinically proven that a diet, stress management and exercise programme - has demonstrated a reversal in heart disease as demonstrated by various parameters. You could look it up, the programme is also available here for perusal. "This proven, non-invasive program consists of 18, four-hour sessions focused on comprehensive lifestlye changes in four equally weighted elements." And this - "UCLA Health is proud to offer Dr. Ornish's Program for Reversing Heart Disease (Ornish Reversal Program), the only scientifically proven program to stop the progression and even reverse the effects of heart disease. This nationally recognized program has been so effective in undoing years of damage to the heart that Medicare made the decision to cover it under a new benefit category-intensive cardiac rehabilitation-making it the first integrative medicine of its kind to receive this level of support" This is a UCLA[41] Yogesh Khandke (talk) 15:26, 8 December 2015 (UTC)

Well, you could attribute it both to UCLA and Ornish. And it may very well be true, and certainly is "clinically proven" to Ornish's standards. But stating it as though it were an indisputable fact would require consensus statements of several large bodies of scientific groups, such as the NIH, or NHS. We have very large studies that also conflict with that information, such as the Framingham Study, just to name one. Just because UCLA adopts this or Ornish believes this, doesn't allow us to state it as an objective fact and in Wikipedia's voice. LesVegas (talk) 17:43, 8 December 2015 (UTC)

(ec)It's promotion, which is not encyclopedic. It's in many ways the very opposite of what we're trying to achieve through MEDRS. --Ronz (talk) 17:45, 8 December 2015 (UTC)

On the facts, UCLA's claim that this program (of which diet is only one of four equally weighted components) is "the only scientifically proven program to stop the progression and even reverse the effects of heart disease" is wrong. Bariatric surgeons also claim that gastric bypass reverses heart disease (e.g., PMID 17903770).

However, I believe that the low-fat diet is appropriate to mention. Ornish might be one of the most popular promoters of it, but the efficacy of that diet is and has been a significant viewpoint for that subject. The POV shouldn't be excluded merely because Ornish feels more like a salesman than like a scientist. WhatamIdoing (talk) 04:53, 9 December 2015 (UTC)

I used to think that Dean Ornish was a nutrition faddist and maybe a quack, until I read his articles in the major peer-reviewed journals. http://jama.jamanetwork.com/article.aspx?articleid=188274 Intensive Lifestyle Changes for Reversal of Coronary Heart Disease JAMA. 1998;280(23):2001-2007. doi:10.1001/jama.280.23.2001 (among others). I'm sure his work has been mentioned in review articles. One way to find it would be to search Science Citation Index for review articles that mention Ornish's articles, but I don't have access to Science Citation Index since the New York Public Library stopped subscribing. --Nbauman (talk) 17:18, 9 December 2015 (UTC)

That article is from the last century. I think the problem is that Ornish has become more ... alternative in more recent years and his later stuff we won't generally find in MEDRS. Gorski is interesting on this.[42] Alexbrn (talk) 17:23, 9 December 2015 (UTC)

I see an unfortunate situation amongst editors who feel the need to act as the editorial board here on Wikipedia and demand that all research must go through them, or some skeptical pundit, first. We shouldn't be doing that. The question of if Ornish's claims are reliable or not doesn't have anything to do with whether or not Ornish some editors think is a quack or what Gorski says about him, but rather what Ornish's claims are reliable for. No, they are not reliable for the claim that "a low fat, plant based diet, exercise and stress management programme has been clinically proved to result in reversal of heart disease," we have to have broad scientific consensus for a claim like that, but Ornish's statements are reliable for the claim that "According to Dean Ornish, a low fat, plant based diet, exercise and stress management programme has been clinically proved to result in reversal of heart disease." So, yes, Yogesh Khandke, there's no reason you can't add that claim, as long as it's attributed to Ornish. LesVegas (talk) 17:57, 9 December 2015 (UTC)

there's no reason you can't add that claim ← except that, WP:WEIGHT would need to be agreed. That a view exists does not automatically qualify it for inclusion. Secondary sources help evaluate due WP:WEIGHT. I don't know how this works in the case or Ornish, but it is nevertheless something that needs to be weighed. Alexbrn (talk) 18:27, 9 December 2015 (UTC)

Well Gorski doesn't determine what weighs, first of all, and neither does whether or not Ornish has alternative views. Some editors feel the need to censor anything that doesn't jive with an old, rigid 20th century view of medicine and when questioned, say, "well, it doesn't weigh heavily enough". I don't agree with Ornish at all myself, but I think editors should at least strive to be objective enough to admit he's a prominent figure and that his views should be mentioned where they're appropriate, as long as they are attributed. Yeah, if we acted like Ornish was God and wrote his claims in Wikipedia'a voice, that would be undue weight, no doubt. But mentioning what a leading figure believes, where appropriate, is not. LesVegas (talk) 18:37, 9 December 2015 (UTC)

If Ornish has "alternative" views then that is significant since WP:FRINGE comes into play, meaning that the "alternative views" should not be aired unless they're recognizably contextualized within the mainstream view. But I don't think anybody is disagreeing here. Alexbrn (talk) 18:44, 9 December 2015 (UTC)

Alternative views are not the same as fringe views. LesVegas (talk) 19:52, 9 December 2015 (UTC)

To quote WP:FRINGE "We use the term fringe theory in a very broad sense to describe an idea that departs significantly from the prevailing views or mainstream views in its particular field. For example, fringe theories in science depart significantly from mainstream science and have little or no scientific support". So the notion that lifestyle changes can *reverse* heart disease is obviously WP:FRINGE. Alexbrn (talk) 19:58, 9 December 2015 (UTC)

LesVegas—Here I am prompted to remind you that it is neither the purpose of Wikipedia to right great wrongs nor to present divine truth, but to report what is verifiable. CFCF 💌 📧 20:44, 9 December 2015 (UTC)

Wow, this is a clear WP:KETTLE only the world's blackest pot is accusing a chrome kettle of blackness because it's reflecting your black self back to yourself. Righting great wrongs? What, like what you two are doing in trying to censor the encyclopedia from anything alternative minded whatsoever, claiming fringe everywhere you can? All I am suggesting is to add in what's verifiable. And what is verifiable is that Dean Ornish believes a plant based diet reverses heart disease, not that a plant based diet DOES reverse heart disease. When you've removed the plank from your eye, perhaps you'll see clearly enough to reply on point. LesVegas (talk) 22:20, 9 December 2015 (UTC)

"There is no alternative medicine. There is only medicine that works and medicine that doesn't work." Dawkins, 2003—At Wikipedia we present what is verifiable, and presenting fringe views in top level articles is not due weight. CFCF 💌 📧 08:08, 10 December 2015 (UTC)

Ornish has played by the rules and done the work of publishing in the medical literature. With 49 citations in PubMed so far, he may be wrong, but he's not a fringe view and even if he's not in the mainstream, he's at least a significant minority view. --Nbauman (talk) 06:33, 10 December 2015 (UTC)

But his fringe views are not published in the medical literature... Otherwise why would we be discussing using his pop-sci book? CFCF 💌 📧 08:08, 10 December 2015 (UTC)

Exactly. The issue with Orish AIUI is that while de does indeed "play by the rules" in his scientific publishing, he then, free from the shackles of peer-review and editorial oversight, makes pronouncements in the popular media which are inconsistent with the conclusions that could properly be drawn. Any such overblown views are obviously fringe views wrt medicine: if they weren't we would be able to source them from mainstream sources, rather than needing to pluck them out of a lifestyle book. I don't know how "significant" a minority view they are - that would require some measure of following from respected sources I'd suggest. Alexbrn (talk) 08:08, 10 December 2015 (UTC)

A few passing comments:

• Yes, Ornish's book is "reliable" for what Ornish says. Ornish's view actually is a significant POV. "Fringe" means almost nobody holds that POV. It doesn't mean that the POV is objectively right or wrong.
  • Consequently, the question isn't "Does this diet actually do what he says it does?" The question is "Is this generally accepted?" How shall we find out? Well, let's do a little mental exercise: Imagine that you called up a dozen cardiologists in your area. Imagine that they all take your call. You say, "Hey, my aging mother has ____ heart disease. Should she be following a low-fat diet and eating lots of vegetables instead of bacon and hamburgers?" What do you think the answer will be? Do you think that any of them will object to a low-fat diet, no red meat, and lots of veggies? I'll give you a hint: Some early research on Ornish's Program for Reversing Heart Disease is given a positive review by the American Heart Association. There might be a few that say eliminating saturated and trans fats is more important than the overall level, and you might find a few who wonder whether your hypothetical mother would actually follow the diet, but I suspect that you will find exactly zero in your sample who explicitly reject a low-fat, low-meat, high-vegetable diet.
  • As Nbaumann said, Ornish's research is certainly present in the medical literature. He publishes articles himself (e.g., [43]), and others write about his ideas (e.g., [44]). One might publish a popular book for many reasons ranging from a desire to teach actual patients (rather than other researchers) to a desire to save time in clinical practice by saying "Here, just read this" instead of explaining for the 10,000th time to a desire to be a millionaire. There's nothing wrong with publishing a pop science book. I hear that even some certifiably evidence-obsessed researchers like Ben Goldacre and David Gorski have done that.  ;-)
• Dawkins' definition of alternative medicine is a (small) minority POV. There is quite a lot of stuff that doesn't work in conventional medicine, e.g., arthroscopic knee surgeries for chronic arthritis. But nobody says that surgery is "alternative" – not even Dawkins. (They have a different name for that: it's bad medicine.)
• It's not our job, as Wikipedia editors, to decide whether Ornish's book exceeds the evidence in his studies. Really: Not. Our. Job. Whether there's good evidence behind it doesn't really even matter. What matters is whether Ornish's POV is supported by garden-variety non-researcher cardiologists. And it is held by quite a lot of them, and therefore it is DUE to mention the existence of the POV. We don't have to say that it works (although it does, for some people); we don't have to say that it works better than other options (which it probably doesn't). We merely need to say that this POV exists. We don't need to cite the pop-sci book to do this (although, in principle, I have no objection to citing a pop-sci book for such a purpose); Ornish and others have certainly published enough over the years that we could cite the medical literature directly for a claim that this POV exists. WhatamIdoing (talk) 06:41, 11 December 2015 (UTC)

The issue that's been at hand is Ornish's claim of reversing heart disease, not whether a low-fat diet (which Ornish incidentally supports) is a generally good idea. If the idea of a low-fat diet has general currency as being a good thing among cardiogists (and yes I'm sure eating healthily and getting exercise and other lifestyle things are), then I doubt that's down to Dean Ornish's book. Alexbrn (talk) 07:01, 11 December 2015 (UTC)

It doesn't really matter if Ornish's book is the reason that cardiologists believe that a low-fat, plant-based diet, coupled with moderate exercise, stress-reduction practices, and good social support, have positive outcomes for patients. The fact is that they do believe his plan is a (NB: not "the only", but "a") reasonable one for patients to follow. Therefore, this POV should be included somehow. DUE says, "If a viewpoint is held by a significant minority, then it should be easy to name prominent adherents". It is, in fact, very "easy to name prominent adherents", e.g. Ornish (also the authors of The China Study and many others). That's one of the key reasons that we know that mentioning this is DUE and not FRINGE.

On the merits of the diet, I think you need to look past the sales pitch. It's not really hard to "reverse" some heart diseases. Most people can (temporarily) "reverse" dyslipidemia by not eating anything (or not much) for two or three days. Also, I believe you'll find that Ornish's claim is actually "halt or reverse", and that he counts any improvement, no matter how partial or slight, as "reversal". It would be very surprising indeed if a vegetable-heavy diet combined with moderate exercise made heart disease worse, wouldn't it? So why would anyone be surprised to hear that eating more veggies and less fat, while getting moderate exercise, "halts or reverses" heart disease? WhatamIdoing (talk) 07:51, 11 December 2015 (UTC)

cardiologists believe that a low-fat, plant-based diet, coupled with moderate exercise, stress-reduction practices, and good social support, have positive outcomes for patients ... this POV should be included somehow ← I don't think there'd be any argument about that, particularly if the "somehow" meant getting a WP:RS/AC source for asserting what "cardiologists believe". But it's beside the point. The question being posed here was whether Ornish's book could be cited "in support of statement that a low fat, plant based diet, exercise and stress management programme has been clinically proved to result in reversal of heart disease". Alexbrn (talk) 08:00, 11 December 2015 (UTC)

That question has been answered: The pop-sci book is certainly a reliable source (even under MEDRS) for making the statement that Dean Ornish believes this. The obvious follow-up question is, is saying that DUE? IMO the answer is "yes". WhatamIdoing (talk) 15:27, 11 December 2015 (UTC)

Yes for where? If on the article on Dean Ornish, of course—but it certainly is not due at Heart disease or any other top level articles.CFCF 💌 📧 16:26, 11 December 2015 (UTC)

It should definitely be on Dean Ornish, without question. I agree with CFCF that it shouldn't be on Heart Disease unless it's in a section accompanied by a lot of other methods or theories on treatment of heart disease, but I wouldn't think Ornish's theory alone is prominent enough to act as the standalone theory or method to be on that page. Certainly there are other articles where it absolutely belongs, such as Plant-based diet, an article where it isn't at yet. LesVegas (talk) 18:51, 11 December 2015 (UTC)

Agree, otherwise our top-level articles on all manner of chronic diseases would start filling up with diet-based claims of "reversal" sourced to the new wave of very prominent media doctors who seem to be publishing pop-sci books in this area. We might even need to include something in our Death article ;-) Of course if there are well-sourced claims then it all becomes much simpler. Alexbrn (talk) 11:19, 14 December 2015 (UTC)

Patiromer

Patiromer, a recently expanded article about a hyperleukemia drug, is currently a Did You Know? nomnee. It might be helpful if someone famiiliar with MEDRS could comment at the nomination page. —David Eppstein (talk) 08:02, 31 December 2015 (UTC)