Wikipedia:Manual of Style/Medicine-related articles

This page proposes style guidelines for editing medical articles. Of course, the general rules from the Wikipedia:Manual of Style also apply when writing medical articles. These suggestions are not policy. This page is not intended to make you nervous and depressed due to excessive bureaucracy, but hopes to provide guidance and uniformity in medicine-related articles on Wikipedia.

To briefly summarise, here is a top ten of tips that may help to write good medical articles. Further discussion is provided below.

1. Avoid medical jargon; use plain English instead.
2. Avoid writing for (other) doctors; write for the Average Reader.
3. Use scientific names for disease articles.
4. Think twice before using eponyms.
5. Don't use disclaimers. The Medical disclaimer is part of the General disclaimer, and there is a policy against disclaimer templates.
6. Infoboxes are a nice way of summarising critical info.
7. Use appropriate sections. There is a standard order described below which may be helpful in many cases.
8. There are good reference systems and templates for some good online resources like PubMed which may come in handy.
9. At the end, start looking for the appropriate category or stub category.
10. Be bold and have fun!

General pointers

• Avoid medical jargon or writing from a doctor's point of view. This is very difficult for many doctor or med student Wikipedians.
  • Explain all unavoidable medical terms the first time they occur.
  • If the concepts required to understand the term are lengthy and only peripherally related to the subject you're working on, linking to another article that explains the term in depth is a good idea.
  • For terms related to anatomical position, you can link to Anatomical terms of location, e.g. [[Anatomical terms of location|lateral]].
  • If necessary, you can link to the wiktionary, like this: [[wiktionary:Arachibutyrophobia|arachibutyrophobia]].

• If the latest research findings arrived in your post-box today, great! But as you add them to an article make sure they are supported by background content. You might also want to consider waiting until other researchers have confirmed it, or it is integrated in review articles or medical books.

The naming issue

Most members of the project appear to be in favour of "scientific labeling" of medical articles, with redirects from layman terms (heart attack redirects to myocardial infarction, with appropriate explanations of the latter). As this seems to contradict Wikipedia's present policy, the issue has been raised in different fora, each time eliciting remarkably little response. It has now been mentioned on Wikipedia talk:Naming conventions#Medicine, and a message on the Wikipedia:Village pump will follow (see Wikipedia:Village pump#The names of diseases: policy?).

General policy appears to be, after the village pump discussion, that medical articles ought to be named scientifically, with good redirects in place.

A second issue is the use of eponyms: this comment comes from the article List of eponymous diseases (arguments pro and contra can be read there also):

In 1975, the US National Institutes of Health held a conference where the naming of diseases and conditions was discussed. This was reported in The Lancet (1975;i:513) where the conclusion was that "The possessive use of an eponym should be discontinued, since the author neither had nor owned the disorder." Medical journals, dictionaries and style guides remain divided on this issue.

In general, try to use the most accepted term to name the article.

Manual of Style/Medicine-related articles

Clinical data
Pregnancy category	AU: A
Routes of administration	oral, rectal
ATC code	N02BE01 (WHO)
Legal status
Legal status	AU: S2 (Pharmacy medicine) UK: General sales list (GSL, OTC) US: OTC
Pharmacokinetic data
Bioavailability	almost 100%
Metabolism	90 to 95% hepatic
Elimination half-life	1–4 hours
Excretion	renal
Identifiers
IUPAC name N-(4-hydroxyphenyl)acetamide
CAS Number	103-90-2
PubChem CID	1983
DrugBank	APRD00252
Chemical and physical data
Formula	C8H9NO2
Molar mass	151.17 g·mol−1
Density	1.263 g/cm3
Melting point	169 °C (336 °F)
Solubility in water	1.4 mg/mL (20 °C)

Disclaimers (not necessary)

There is discussion about whether disclaimers (e.g. Wikipedia does not give medical info, consult with a doctor,etc., for example this discussion) should be used in medical articles. Some people think they should be used. However, the general policy is to not use other disclaimers than the main disclaimer, which can be accessed from any page on Wikipedia.

The intro

A medical article should begin with an introduction which is short, snappy and interesting. Explain and define the condition in plain English. This is your brief chance to lure a reader into reading further. Include the most interesting bits from all the following sections, such as the main symptoms, main cause, treatment and impact on person's health and prognosis.

Infoboxes

Drugs

You can find it at Wikipedia:WikiProject_Drugs#Infobox. To the right you can find an example.

Disease

A tutorial on how to use the infobox is available at Template:Infobox Disease.

It looks like this:

Manual of Style/Medicine-related articles

Sections - diseases/disorders

Usage

For consistency, the top level headers should be limited to those specified below. The order below is recommended but in some cases it may be appropriate to present the sections in a different order (for example, if a disease is largely eradicated, then the history of the disease may be more important than the symptoms).

There are some basic headings that are essential to any medical condition article – these are indicated with a "*". The other headers may not apply to all articles. More flexibility can be used when using lower-level headings. Where a heading below has a choice (/), pick the most appropriate.

SECTIONS FOR MEDICAL ARTICLES

Section title	Comments	Examples
Classification	Describe the varieties of the condition, and explain how they are differentiated.
Signs and symptoms*	When possible, wikify the symptom/medical sign.
Causes	Etiology is not plain English! Items such as pathogens, genes, or environmental factors may be appropriate in this section.
Pathophysiology/Mechanism	The hard bit: discuss the main abnormalities. This section can (justifiably) escalate into technical terms.	...decreased FEV1 in COPD due to bronchial obstruction and/or decreased elasticity.
Diagnosis *	Tests commonly performed to establish a diagnosis. Also mention characteristic biopsy findings here.	C-reactive protein, X-rays...
Treatment/Management *	Discuss and link to the key drugs and drug categories, surgical treatments and other therapies. Acute and chronic aspects of the condition often require different treatments. If aggressive treatment is not always appropriate, consider including watchful waiting as an alternative. Long-term monitoring or frequent check-ups may be required.
Prognosis	What is the median survival, what complications can be expected? Be extremely careful when writing about prognosis. Reference every claim, and make sure you understand the data yourself before committing anything to paper. Include simple explanations of any limitations to the data	Median survival is 1 year, but some patients may survive up to 10 years.
Prevention/Screening	Most of us forget to talk about this enough.
Epidemiology	If not touched upon earlier in the article, mention incidence or prevalence, economic and societal impact, sex differences, age groups and other predisposing factors.
History	Often this is fascinating. Good resources are WhoNamedit.com for eponymous diseases (see below for template), and good review articles (e.g. NEJM or the clinical reviews in J Clin Invest). Did you know that Hippocrates was aware of the significance of clubbing?
Social Impact	Many conditions have a section discussing the impact on the person in society, legal issues, stigma, public heath concerns, etc.
Notable cases	This section should be absent in most articles. Sometimes, this list can expand beyond control and become bigger then the article itself, or it may be hard to acertain if some celebrities really have the condition. The following rules of thumb apply: From Wikipedia:Biographies of living persons: "Articles about living persons require a degree of sensitivity and must adhere strictly to Wikipedia's content policies." This probably expands to the recently deceased. "Be very firm about high-quality references, particularly about details of personal lives. Unsourced or poorly sourced negative material about living persons should be removed immediately from both the article and the talk page. Responsibility for justifying controversial claims rests firmly on the shoulders of the person making the claim." This is also covered under Wikipedia:Verifiability. From Wikipedia:Lists (stand-alone_lists)#Lists_of_people: "Selected lists of people should be selected for importance/notability in that category and should have Wikipedia articles (or the reasonable expectation of an article in the future)." However exceptions to the requirement of notability in that category is possible, since it also states: "List of Elbonians would include persons who are famous in any category and who belong to Elbonia." The notability criterium is covered under Wikipedia:Notability (people) and for fictional characters maybe Wikipedia:Notability (fiction). An option that might satisfy everyone is to create a separate list article and link it, when the list contains enough info to stand on it's own. Maybe "notable cases" or "Notable individuals" is a better header than "Famous people with DISEASE_X" or "People famous because of FEATURE_Y". Similar sections may be "DISEASE_X in popular culture", "Cultural references" or others.	Examples can be found in articles Eyebrow, Hernia, Heterochromia, Tourette syndrome and List of people with epilepsy.
See also	Links in this section should be used sparingly. If two topics are truly linked, it should be possible to define that relationship with a sentence in the main article, and provide the wikilink there.
Notes*	For sources cited in the main article regarding a specific fact.	The prevalence of extreme obesity (body mass index > or = 40 kg/m²) in the United States in 2003-2004 was 2.8% in men and 6.9% in women.
References*	see below. Sources used in researching the overall topic, such as the entire section of a textbook on the subject.	Sabiston textbook of surgery, 17th edition, Townsend et.al.(e.d.), Elsevier-Saunders.
Further reading/Bibliography	Here you can mention books or sources that can be consulted by interested readers. It should be a generally appreciated reference work, or a work containing information that is too specific for a general encyclopedia like Wikipedia.	Atorvastatin#Further_reading
External links	Links in this section should be used sparingly. If an external link is provided, it is better to tie that link to an assertion in the article, and then use the Reference section instead of the External links section. Significant international and (English-speaking) national organisations may be included here if they contain useful material to supplement the article. However, their number should be kept in check –Wikipedia is not a collection of links. This is an encyclopedia, not a promotional tool for charities however worthy, nor is it trying to be resource for those seeking help. Further guidance is available at Wikipedia:External links.

Quick list of sections

To quickly start an article with these sections, you can copy-paste them from this list:

{{Infobox_Disease |
  Name           = {{PAGENAME}} |
  Image          = |
  Caption        = |
  DiseasesDB     = |
  ICD10          = {{ICD10|ICD10Group|Major|minor|Linkcode|Minorlink}} |
  ICD9           = {{ICD9|xxx}} |
  ICDO           = |
  OMIM           = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID         = |
}}

==Classification==

==Signs and symptoms==

==Causes==

==Pathophysiology==
 
==Diagnosis==
 
==Treatment/Management==
 
==Prognosis==

==Prevention/Screening==
 
==Epidemiology==
 
==History==
 
==Social impact==
 
==Notable cases==

==See also==

==Notes==
{{subst:reference}}

==References==
 
==Further reading==
 
==External links==

References and footnotes

Further guidance is available at Wikipedia:Citing sources, Wikipedia:Footnotes and Wikipedia:Guide to layout.

General use

Citing sources for edits is mandated by Wikipedia:No original research and Wikipedia:Verifiability, which are policy! You can find out what are reliable sources here.

Ideally every medical article should have

• a few historical references (e.g. first reported case, discovery of pathogenesis)
• one or two recent systematic reviews in core journals (like Nature, Science, Cell,...).
• Textbooks are equally valid sources.
• Some databases (like OMIM or eMedicine) provide in-depth peer-reviewed information (but remember, nobody's perfect).

In particularly hot topics, it may be tempting to add very recent studies on the latest developments; this may not always be the best idea - it may be enough to broadly signify a trend without endeavouring to keep the reference list completely up-to-date with the very latest studies.

Ideally any online reference will be to an open sites that do not restrict access to non-professionals or require a subscription. Template:PMC (see below) may be very helpful to this end.

• References - are sources used as background to a whole topic and should be included as a bulleted list (start each line with an asterisk '*'). Citation details may be manually formatted, but the use of generic citation templates helps standardise their appearance.
• Footnotes - are sources provided to expand or verify specific details in the text. The same manual or template formating of citation details is used, but additional markup is needed to generate the footnote numbered links (e.g. ^[1]). WP:Footnotes describes cite.php, the latest of several methods, as summarised below:

Cite:php system (<ref> tags)

For footnotes enclose the citation details within the <ref> details </ref> tags, at the relevant point in the article. Each reference may optionally be given a name, as <ref name="xxx"> details </ref> which allows a duplicate link to the same footnote to be added later in the article using <ref name="xxx"/> tag.

The <references/> tag then lists out the numerically numbered footnotes with backlinks to the main article. This tag should be the only item within the '==Footnotes==' section.

e.g.: <ref name=hedley>Hedley AA, Ogden CL, Johnson CL, et al. 2004. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. ''JAMA'' ; '''291''': 2847–50. PMID 15199035</ref>

and to use this reference again in the article, you can use <ref name="hedley"/>.

• When creating the list of footnotes, Wikipedia:Footnotes#Style_recommendations mentions that for articles with large numbers of footnotes, a reduced size may be shown by use of:

<div class="references-small"><references/></div>

• In order to help editors unfamiliar with this system of footnotes, explanatory text may also be included by using either the template:

  {{subst:Footnotes|100%}}

  Or, to show reduced size footnotes (to a standard 92%):

  {{subst:Footnotes|92%}}

  Both of these automatically adds the following hidden text, to explain the cite:php system to editors who are not familiar with it:

<!--See http://en.wikipedia.org/wiki/Wikipedia:Footnotes for an explanation of how to generate footnotes using the <ref> and </ref> tags, and the template below -->

Use of PubMed

Abstracts of most medical journals are freely available at PubMed which includes a means of searching the MEDLINE database.

• The PubMed site is: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
• To add a link to a PubMed article number (but without the whole reference), use: PMID xxxxxxxxx . Wikipedia automatically recognises "PMID", and will automatically provide a correct link to the abstract. However, try to use complete references instead of just a PMID-link.
• You can also link to freely available articles in the PubMed Central using {{PMC|xxxxxxxxx}}.
• You can also use PM(C)ID in references, e.g. this one from bariatrics: <ref name=hedley>Hedley AA, Ogden CL, Johnson CL, et al. 2004. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. ''JAMA'' ; '''291''': 2847–50. PMID 15199035</ref>

Some tools have been created to help add a full reference to wikipedia articles:

• Diberri's tool to convert a PMID reference number to a wikipedia template:cite journal reference is: http://diberri.dyndns.org/pubmed.html
• To add Wouterstomp's handy bookmarklet that uses Diberri's tool to make a wikipedia reference when used on a PubMed abstract page, do the following:
  • Create a bookmark within Internet Explorer (i.e. Favorites >> Add to Favorites...) with a suitable name.
  • Then right click on the bookmark just created and select Properties
  • Paste across to the URL box the following javascript line in its entirety: javascript:(function(){var url = location.href;var pmid = url.match(/list_uids\=(\d+)/);if( pmid ) w=open('http://diberri.dyndns.org/wikipedia/cite/?type=pmid&id=' + pmid[1],'add','width=800,height=300,scrollbars,resizable');})();
  • When the Bookmarklet is clicked whilst on a PubMed abstract page, it will open a new window with the properly formatted wikipedia citation for the article. The { {cite journal} } template may now be copied and pasted across.

Other resource templates

RESOURCE TEMPLATES FOR MEDICAL ARTICLES

Template	Info	Code	Examples
OMIM	OMIM provides a lot of useful info with regards to genetic diseases.	{{OMIM|xxxxxx}}	Online Mendelian Inheritance in Man (OMIM): 190685
"	To help reduce overlinking (e.g. this article) when multiple consecutive links are required.	{{OMIM2|xxxxxx}}	Template:OMIM2
MedlinePlus	Info from NIH.	{{MedlinePlus|000195}}	MedlinePlus Encyclopedia: 000195
"	To help reduce overlinking (when multiple consecutive links are required).	{{MedlinePlus2|xxxxxx}}	Template:MedlinePlus2
eMedicine	This is a very big and reliable source. When you want to link to http://www.emedicine.com/med/topic1653.htm, use {{eMedicine|med|1653}}	{{eMedicine|XXX|xxx}}	med/1653 at eMedicine.
"	To help reduce overlinking (when multiple consecutive links are required).	{{eMedicine2|XXX|xxx}}	derm/146
WhoNamedIt	This is an excellent reference for eponyms in medicine. When you want to link to http://www.whonamedit.com/synd.cfm/1792.html, use {{WhoNamedIt|synd|1792}}	{{WhoNamedIt|XXXX|xxxx}}	synd/1792 at Who Named It?
GPnotebook	This UK website provides an easy access for general practitioners and may be an interesting source.	{{GPnotebook|xxxxxxxxxx}}	. GPnotebook https://www.gpnotebook.co.uk/simplepage.cfm?ID=1053818915. {{cite web}}: Missing or empty |title= (help)
Diseases Database	Nomen est omen.	{{DiseasesDB|xxxxx}}	Diseases Database (DDB): 3347
SUNY Downstate Medical Center	For anatomy figures.	{{SUNYAnatomyFigs|xx|xx|xx}}	Anatomy figure: 12:03-02 at Human Anatomy Online, SUNY Downstate Medical Center

Other good online resources

See also: #Reliable sources in medicine

• National Organisation of Rare Disorders
• Merck Manuals
• The Virtual Hospital
• Ganfyd.org : ganfyd is a UK project, using mediawiki and restricted to qualified people (as a reaction to medical articles in wikipedia that can be edited by anyone). They have some 1600 medical articles.

Sections - medications

Quick list of sections

To quickly start an article with these sections, you can copy-paste them from this list:

{{drugbox |
| IUPAC_name = 
| image = {{PAGENAME}}.png 
| CAS_number = 
| ATC_prefix = 
| ATC_suffix = 
| PubChem = 
| DrugBank = 
| chemical_formula = 
| molecular_weight = 
| bioavailability = 
| protein_bound = 
| metabolism = 
| elimination_half-life = 
| excretion = 
| pregnancy_AU =  <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US =  <!-- A / B            / C / D / X -->
| pregnancy_category =  
| legal_AU =  <!-- Unscheduled / S2 / S3 / S4  / S8 -->
| legal_CA =  <!--                             / Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK =  <!-- GSL         / P       / POM / CD / Class A, B, C -->
| legal_US =  <!-- OTC                   / Rx-only  / Schedule I, II, III, IV, V -->
| legal_status = 
| routes_of_administration = 
}}

  ==History==
  
  ==Chemistry==
  
  ==Mechanism of action==
  
  ==Effects==
  
  ==Metabolism==
  
  ==Toxicity==
  
  ==Mechanism of toxicity==
   
  ==Toxic dose==
   
  ==Risk factors for toxicity==
   
  ==Natural history==
   
  ==Diagnosis==
   
  ==Treatment==
   
  ==Prognosis==
  
  ==Veterinary use==
  
  ==Dosage==
  
  ==Available forms==
  
  ==Production==
  
  ==Legal status==
  
  ==Cultural references==
  
  ==See also==
  
  ==Notes==
  {{subst:reference}}

  ==References==
  
  ==Further reading==
  
  ==External links==

Navigation template

Formatting standards are being defined, see discussion here. An overview of navigation templates from Wikiproject Drugs is available here.

Reliable sources in medicine

See also: Other good online resources.

In general, Wikipedia articles should rely on reliable secondary sources, although the section below describes mainly primary sources. Good secondary sources are, for example, medicine textbooks.

Peer-reviewed scientific publications

Scientific journals are the best place to find primary source articles about experiments, including medical studies. Any serious scientific journal is peer-reviewed. Many articles are excluded from peer-reviewed journals because they report what is in the opinion of the editors unimportant or questionable research. In particular be careful of material in a journal that is not peer-reviewed reporting material in a different field. (See the Marty Rimm and Sokal affairs.)

The fact that a statement is published in a refereed journal does not make it true. Even a well-designed experiment or study can produce flawed results or fall victim to deliberate fraud. (See the Retracted article on neurotoxicity of ecstasy and the Schön affair.)

Honesty and the policies of neutrality and No original research demand that we present the prevailing "scientific consensus". Polling a group of experts in the field wouldn't be practical for many editors but fortunately there is an easier way. The scientific consensus can be found in recent, authoritative review articles or textbooks and some forms of monographs.

There is sometimes no single prevailing view because the available evidence does not yet point to a single answer. Because Wikipedia not only aims to be accurate, but also useful, it tries to explain the theories and empirical justification for each school of thought, with reference to published sources. Editors must not, however, create arguments themselves in favor of, or against, any particular theory or position. See Wikipedia:No original research, which is policy. Although significant-minority views are welcome in Wikipedia, the views of tiny minorities need not be reported. (See Wikipedia:Neutral Point of View.)

Make readers aware of any uncertainty or controversy. A well-referenced article will point to specific journal articles or specific theories proposed by specific researchers.

Avoid citing the popular press

The popular press generally does not cover science well. Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease. Also, newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. They also tend not to report adequately on the methodology of scientific work, or the degree of experimental error. Thus, popular newspaper and magazine sources are generally not reliable sources for science and medicine articles.

What can a popular-press article on scientific research provide? Often, the most useful thing is the name of the head researcher involved in a project, and the name of his or her institution. For instance, a newspaper article quoting Joe Smith of the Woods Hole Oceanographic Institution regarding whales' response to sonar gives you a strong suggestion of where to go to find more: look up his work on the subject. Rather than citing the newspaper article, cite his published papers.

Which science journals are reputable?

One method to determine which journals are held in high esteem by scientists is to look at impact factor ratings, which track how many times a given journal is cited by articles in other publications. Be aware, however, that these impact factors are not necessarily valid for all academic fields and specialties.

In general, journals published by prominent scientific societies are of better quality than those produced by commercial publishers. The American Association for the Advancement of Science's journal Science is among the most highly regarded; the journals Nature and Cell are notable non-society publications.

Keep in mind that even a reputable journal may occasionally post a retraction of an experimental result. Articles may be selected on the grounds that they are interesting or highly promising, not merely because they seem reliable.

Using (stub-)categories

Categories

At the end of the article, place use [[Category:THECATEGORY]] in all the categories it belongs in, but please use the lowest appropriate sub-level.

Useful top-levels to start looking under include:

• Category:Medicine
• Category:Diseases
• Category:Medical treatments
• Category:Drugs

More can be found on this subpage of the medicine portal.

Stub categories

You can choose suitable stub category templates from this page.