Wikipedia:Arbitration/Requests/Case/Medicine/Evidence

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Evidence presented by SandyGeorgia

WPMED tension is long-standing

The WPMED dispute erupted after the drug pricing RFC, but the tension has involved broader issues since at least 2012.

Wiki Project Med Foundation (WPMEDF) is a Wikimedia thematic organization and an advocacy organization with its own governing board and projects, aims, applications and interests, based upon Wikipedia content. It was started in 2012 by, among others, Doc James and Bluerasberry. WPMEDF requires an email address renewal every two years and has "frequent, ongoing internal communications via email". Members must assert when re-applying biannually that they support the WPMEDF (advocacy) mission. The overall mission of WPMEDF aligns with the principles of the Wikimedia movement but implementation aspects of WPMEDF projects and collaborations has not always aligned with the principles, policies and goals of English Wikipedia. As examples, the content on Wikipedia should be freely and easily created and can be edited online by anyone (for example, the Osmosis videos), the lead of an article should be a summary of its most important contents, and Wikipedia is not a sales catalog. Methods used in implementation of external projects—such as internet-in-a-box, translation task force, journal collaboration, and others—have created the appearance of conflicts of interest as well as conflict with the wider community.

For example, one of WPMEDF's Projects is an ... effort to get academic credit for contributing to Wikipedia. This desire for publication can put WPMEDF editors in conflict with overall aims of an encyclopedia anyone can edit, lend a motivation to semi-protect articles unnecessarily to assure minimal change in content, a motivation to edit war, and de-motivation to keep articles updated once preferred versions have been "set" in content review processes.

These issues have placed some WPMEDF members in tension with WP:MED founding members, many of whom were responsible for initially crafting the guideline pages for the Medicine Project, WP:MEDRS and WP:MEDMOS, who coincidentally are almost all Featured article writers. Longtime productive WPMED members have been alienated by seeing the MEDMOS guideline applied as if it were policy when that suits WPMEDF goals, while Wikipedia policy is ignored as if were guideline when that suits WPMEDF goals (for example, WP:NOT on drug pricing).

Current and former officers and advisers of WPMEDF include, but are not limited to:

1. User:Avicenno membership
2. User:Bluerasberry, secretary
3. User:CFCF
4. User:Doc James, founding member & co-treasurer
5. User:FloNight
6. User:JenOttawa
7. User:RexxS, chair

Some WPMEDF members have expressed conflicts of interest

The WPMEDF project to journal publish has led to conflicts of interest. Bluerasberry posted this study for discussion at WT:MED, where a potential conflict is seen: the article assessments being measured are often done by WPMEDF members who may support article assessments without reason, (Dyxlexia GA) or semi-protect the preferred version for purposes of publications (Excessive semi-protection).

• Bluerasberry posts about his interest in drug prices per employment with Consumer Reports
• Doc James mentions collaborations with numerous organizations, including the World Health Organization (WHO).

Five areas of fait accompli

The fundamental conflict has arisen not with the goals of WPMEDF or the apps and projects themselves, but in concerns about the accuracy of the medical content being pushed out via these apps, and the methods used to achieve these broad changes (which at times have been shown to compromise the integrity of English Wikipedia content). While the goals of spreading medical information to Lower and Middle Income Countries (LMIC) are laudable, concerns are that content spread to them should be accurate, timely and policy-compliant. The Osmosis videos, for example, had numerous errors, and could not be edited by anyone, and Wikipedia was used to further the commercial interests of a third party, rather than a community project that anyone could edit, yet were forced into the first sections of articles. Other examples on this Evidence page show that content on the English Wikipedia has been negatively impacted: that is the essence of the conflict.

• WPMED focus has shifted away from making sure the English Wikipedia has the best, most timely and most accurate medical information, to instead pushing information out the door via apps even when that information is shown dated or inaccurate. More focus on external apps has meant less focus on accuracy in overall content, and alienation of experienced editors.
• Similarly, disregard for accuracy and verifiability was shown when Osmosis videos were forced into articles-- even leads where Featured article writers had carefully curated the content for over a decade, only to find inaccurate and dated information added via videos that can't be edited
• The fait accompli was accomplished in each case with methods that at times appeared "stealth" or without regard for consensus-building, with poor use of edit summaries, edit warring, indications of tag-teaming, and with intimidation and accusations aimed at those who are critical of these approaches or who speak up about the problems.

Long-standing editors, concerned about the impact on English Wikipedia medical content have ended up a) retreating from medical editing, or b) on the receiving end of blunderbuss and bad-faith accusations when they speak up, and c) accused of "bludgeoning" because they fully engage dispute resolution, with policy-based reasoning, rather than by simply reverting their peers.

There have been broadly five areas of conflict, dating many years, in which one (occasionally two) editors—often editing too fast, rarely engaging talk (see Editcountitis section) and in topics where they are not experts—have installed controversial changes and personal preferences across hundreds to thousands of articles, and not always with full disclosure to other WPMED participants.

1. Re-ordering of sections of every medical article to a set order, although the MEDMOS list is explicitly only a suggestion for writing new articles or substantially rewriting existing articles. MEDMOS says:

   The following lists of suggested sections are intended to help structure a new article or when an existing article requires a substantial rewrite. Changing an established article simply to fit these guidelines might not be welcomed by other editors. The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition.

   • This wording was accepted as a guideline in 2007, based on consensus and review involving many editors.

2. Re-ordering the narrative of the lead in medical articles, although the accuracy and flow may be disrupted. Every condition/disease is different. But James re-ordered the leads of hundreds of articles and THEN inserted wording into MEDMOS to reflect HIS practice. Fait accompli, reflected recently in this discussion during the March 3 mainpage appearance of Tourette syndrome.

   • The earliest versions of the Simplified Leads indicates this work began in February 2014, with articles like African trypanosomiasis,[1] which were not likely to be watched by many editors.
   • By June 2016, hundreds of leads had been converted to this format, and there was a specific emphasis on Emergency medicine (James' area of practice).
   • On June 30, 2016, after having re-written hundreds of leads himself, James added the wording to MEDMOS: "It is also reasonable to have the lead introduce content in the same order as the body of the text", with the edit summary "added common practice". The issues with James' common practice became a source of conflict as he expanded this effort outside of his area of knowledge.

3. Altering language in the leads of hundreds of articles according to James' personal notions of what words are more easily translated or that he finds difficult.

   • These first three items appeared to be with the aim of using these tailored leads for external apps, with rewrites that contain weak prose, stubby sentences with poor flow, and that jump confusingly from one point to the next.
   • In March 2018, Jytdog inserted text about leads to MEDMOS that does not use the word “required” and is generally in line with broader guidelines. But James “adjusts” to wording that I remove for discussion.

   • Two weeks later, when defending the Osmosis videos that fail WP:V, James states that "the lead just needs to be supported by the body of the text, it does not need inline references itself."
   • A sample of James preferred wording is here.

   • A recurring issue (unheard) is attribution as required by Wikipedia. For example, most of the text at Wikipedia:WikiProject Medicine/Translation task force/RTT/Simple Asperger syndrome was written by User:Eubulides (before it was altered). It is forked without attribution to a short form, and then translated to other Wikipedias without attribution.
   • Fait accompli, October 2019, James inserts wording at MEDMOS, never having argued this case at any of the main, community-wide guideline pages (eg WP:LEAD or pages dealing with making language accessible).

4. Adding Osmosis videos to the first section of hundreds of articles (not to External links), amid concerns of COI and commercial motive, often with no edit summaries

   • SarahSV explored the COI and profit motive,
   • and a preferential agreement that the external videos would be inserted in the first section of Wikipedia articles
   • All but four of these videos were added by James, with incomplete edit summaries.

5. Adding drug prices to leads, with concerns about deficits in core policies of verifiability, original research, weight, NOPRICE and the lead guideline (and to be used in the same leads tailored for apps). Evidence of the fait accompli provided in other Evidence on the page.

   Note, while he is adding drug prices to leads only, James has acknowledged at another article that "the lead should not contain content not also in the body of the article."

Adding VideoWiki vidoes (an evolving conflict): with demonstrated inaccuracies, and still hard to edit, these videos are being inserted into leads of articles (rather than as External links). The quality is still problematic, details are still being worked out, and yet they have been inserted into a couple dozen articles already. (See WTMED archive) This is the same pattern seen in the other five instances.

Bluerasberry

Bluerasberry advocates for drug price inclusion against policy

Advocacy is the use of Wikipedia to promote personal beliefs or agendas at the expense of Wikipedia's goals and core content policies, including verifiability and neutral point of view.

Bluerasberry (WPMEDF) has been a force behind advocacy for inserting prices into pharmaceutical articles, backed by James (WPMEDF), who inserted prices into more than 500 articles, before, during and after a 2016 RFC that found no consensus for an exception to WP:NOT policy. Bluerasberry holds that the NOT policy does not apply because it is 15 years old, and that there was a plan for drug pricing content (emphasis added): [2]

The plan has always been that this price information is a pilot, and after we discuss the multiple major social issues around managing this, then we plan for a next set of development processes which include tools, more collaboration, policy development, and better control over this content.

Bluerasberry inserts deceptive NOPRICE redirects

In 2019, it was discovered that Bluerasberry had altered redirects, away from NOT policy and to an essay he created, in which he asserted an inaccurate statement:

• May 2009: Thumperward created the redirect WP:PRICE, pointing to WP:NOT
• September 2010: Eraserhead1 created the redirect Wikipedia:PRICES, pointing to WP:NOT
• October 2015: Bluerasberry created the essay Wikipedia:PRICES with the false statement: Wikipedia has no specific policy on presenting prices of products. At that time, WP:NOT read:[3]

  An article should not include product pricing or availability information unless there is a source and a justified reason for the mention. Encyclopedic significance may be indicated if mainstream media sources (not just product reviews) provide commentary on these details instead of just passing mention. Prices and product availability can vary widely from place to place and over time. Wikipedia is not a price comparison service to compare the prices of competing products, or the prices and availability of a single product from different vendors or retailers.

• October 2015: Bluerasberry changed the redirect of Wikipedia:PRICES to point to his essay.
• May 2016: Bluerasberry changed the redirect of Wikipedia:Price to point to his essay.
• The redirects to an inaccurate statement stood for over four years, until I corrected it in January 2020.

Bluerasberry canvasses at RFC

After a discussion about pinging the editors who had been reverted by James on drug price articles, Bluerasberry canvassed the Video Game Project.[4][5] Twenty-six editors editors who attempted to uphold policy were not pinged, while others were canvassed. Editors reverted were 7 student editors (now all gone), 6 IPs, and 13 still-active editors, including Hipal/Ronz and Seraphimblade (who had weighed in on the RFC or formulation), @Pol098, Jorge Stolfi, Surtsicna, Gprobins, Jrfw51, Garzfoth, Pol098, Zefr, D A Patriarche, David notMD, and Mparagas18: and others.

Bluerasberry alters talk posts to control the narrative

At the Talk:Simvastatin RFC, Bluerasberry:

• Altered the Support votes to convert them to a numerical count,
• while leaving the Oppose and Neither (which were all essentially opposes)—that tallied to almost the same number as the Supports-- as bullet rather than numerical points.
• I undid, saying not to alter others' posts and Bluerasberry reverted, leaving a misleading impression to RFC newcomers.

CFCF

As all medical editors have a shared concern about the quality of medical content, tempers can flare, discussion can become heated, and some editors simmer up quickly (but then simmer down quickly as well), and we generally can go on to being able to work together and defend each other in spite of our disagreements. [6] [7] [8] [9] But I have had a different experience with CFCF.

CFCF casts aspersions and refuses to provide diffs

During the December 2019 ANI,

• CFCF lobbed a blunderbuss of fabrications about Colin, without a single diff. After a series of adjustments, his post ends up at this.

These diffless fabrications include (but are not limited to)

1. "does not respect WP:BRD"
2. "massive issues with WP:CIVILITY"
3. "unclear editing goals (WP:NOTHERE)"
4. "often coming to issues which he lacks knowledge of"
5. "acting by changing tens or even hundreds of articles at once, totally ignoring consensus”
6. “disruptive per WP:POINTY. His style of editing is a danger to any collaborative work on this encyclopedia.”

• When questioned, CFCF declines to back up his accusations with diffs, but adds more to them (always with excess markup to highlight his position).
• After being questioned again, I suggest CFCF strike the falsehoods, and remind him that his personal views are unsupported (by diffs).
• CFCF again reiterates his position, without providing diffs.
• I remind CFCF that he is casting aspersions.
• See my evidence regarding Colin at Elitism and cultural changes at WPMED

CFCF engages in battlegound intimidation with blunderbuss accusations

A few weeks later, at Wikipedia:Manual of Style/Medicine-related articles/RFC on lead guideline for medicine-related articles (the worst RFC ever formulated, thanks to moi), I experienced a similar blast of battleground behavioral accusations from CFCF, which I experienced as an attempt to intimidate. For launching an (admittedly malformed) RFC, and then trying to work towards consensus on talk (and we did achieve some consensus on talk), CFCF charges me with WP:Disruptive, WP:Gaming, WP:Deadhorse, [10] WP:bad faith, Wikipedia:Tendentious editing, and WP:ICANTHEARYOU. [11]

Barkeep49—adminning the WP:MEDMOS issues—did not see a problem in my actions.

In November 2019, CFCF stated: "Colin — You really seem clueless here ... someone who is in far too deep water."

CFCF fails to AGF

During the 2018 Osmosis video discussions, CFCF said to editor Clayoquot, "this has been discussed extensively before this seems like conspiratorial thinking on your part in order to justify this inane discussion".

Similar (labeling good-faith edits as "disruptive") was seen in edit summaries when CFCF restored some Osmosis videos that had been removed for failing verification: [12] [13] [14]

CFCF closes discussions he is involved in, alters posts of others and uses excess markup on talk to control the narrative

During the March 2018 Osmosis video WT:MED discussions: CFCF

• closes and archives an ongoing discussion (with a misleading edit summary, "archival bug")
• which SarahSV restores,
• and Francis Schonken questions, and
• SarahSV points out that CFCF has a COI as an officer of WPMEDF, as does James, and
• TenOfAllTrades remarks: saying, "It is...problematic...that Doc James remains the current sole point of contact with Osmosis, and has taken upon himself the decision to terminate the collaboration with them. Bluntly, I have to ask—how did he assume the authority to estabish and terminate such relationships in the first place? While it is obvious from the ongoing RfC that the community objects strongly to the way that Wikipedia has been used as a marketing medium to build Osmosis' brand, and it is appropriate that we communicate that to Osmosis in no uncertain terms, it is also apparent that Doc James has not effectively assessed or understood the community's views over the last couple of years. Why is Doc James still holding himself out as Wikipedia's representative to Osmosis?"
• While Clayoquot remarks that CFCF has given no evidence the videos were based on Wikipedia leads, in spite of multiple complaints, and
• CFCF responds to his closing of the thread with, “I wanted to get rid of this shit-storm from this page”.

Again, on 9 December 2019, in an ongoing discussion, CFCF installed a new, second-level header that cut off my response from the section it was replying to and part of, and mischaracterized the dispute. I repaired and reminded CFCF. But the behavior persists:

On 28 March, following the 27 March close of the drug pricing RFC, Colin starts a discussion at WT:MED with a neutral heading, "RFC on pharmaceutical drug prices".

On 29 March

• 09:46 CFCF installs a non-neutral section heading "This is the wrong time to be having this debate (COVID-19 pandemic)" (impeding discussion and consensus building) while altering formatting on others' posts[15] [16], obscuring who is responding to whom
• 14:30 I begin: to restore my response formatting, and install neutral section headings to distinguish implementation from interpretation (as disagreement over the RFC close is emerging), which CFCF characterizes as personalization when it was he who took a neutral heading personally, remind CFCF about non-neutral headings and excess markup in talk page posts (that have the effect of highlighting one individual's views) and suggest a more neutral heading to his "Wrong time" section.
• 16:51 CFCF begins: removing my section heading, which I restore, and CFCF changes.
• 21:18 CFCF changes his “wrong timing” heading to a neutral heading and reasserts that "interpretation" is a personalized heading.

Over an entire day, while multiple editors were trying to discuss timing, interpretation and implementation of the RFC conclusions, a good deal of time was wasted on restoring sections as CFCF attempts to control the narrative.

Doc James

Conflicts of interest have impacted James' use of tools

Medical articles are often semi-protected—a practice that discourages editor recruitment and can result in outdated, inaccurate versions of articles. Leads only are maintained for the purposes of WPMEDF-inspired projects, with overall content stagnating. Medical Featured articles have seen once vibrant growth flatline since 2015 and fall out of date, as the focus of WPMED has moved towards off-en.Wikipedia projects and away from overall content improvement.

Semi-protection at times appears unnecessary. There seems to be a pattern that, once an article is promoted to GA or FA (or its contents "set" for the translation project or internet-in-a-box), the preferred version is imdefinitely semi-protected.

• Dengue fever is an outdated Featured article (FAC nominator James). I questioned why the article was semi-protected by James for “persistent vandalism” (Article log). The log link at that time showed two IP edits—one good, and one extremely minor instance vandalism. After I queried, James removed semi-protection, and the article has done just fine. Semi-protection was not needed, the article was outdated, but semi-protection prevented IPs from editing for seven years.

This over sized WPMEDF-project template was installed in the references section, pointing to an eight-year-old internal "peer review". Since that review would not hold up to WP:MEDDATE, it is surprising that medical editors would place it in the reference section, rather than External links.

• Gastroenteritis , a James GA, and its article log, protected by James for "persistent vandalism" and "poor quality edits". The history link for the latest protection shows, in the two months prior; the IP insertion of a good faith valid term that is nonetheless not-MEDRS-sourceable, but added to Society and culture, where MEDRS sources are not typically required; one instance of minor vandalism, and one good faith IP edit.

• Gout , a James GA, and its article log, protected by James, no reason given. At the time of protection, the month prior saw an edit that was good faith but not reliably sourced [17]; ^{See Update in response section} another good faith but not reliably sourced edit; [18] a valid IP edit; one IP removal of cited text; and one instance of vandalism that was oddly self-reverted by the same IP. No indication for semi-protection.

• Hepatitis C , a January 2012 James GA, protected in June 2012 (never before semi-protected) by James with the reason "Persistent vandalism: High quality article subject to lots of vandalism." The history log at the time of semi-protection shows a good faith IP edit, that was twice Huggle reverted; minor IP vandalism that was reverted by another IP; and an IP edit that is difficult to be viewed as vandalism because IPs may be unaware of MOS:CURRENT.

• Schistosomiasis, B-class, semi-protected by FloNight, who was a WPMEDF board member at the time, for "persistent disruptive editing" against good faith IP edits during an edit war with James.

Case study: Schizophrenia, James editwars with senior editors and content experts

James and Ozzie10aaaa have installed a set order of sections in every medical article, even though MEDMOS says:

The following lists of suggested sections are intended to help structure a new article or when an existing article requires a substantial rewrite. Changing an established article simply to fit these guidelines might not be welcomed by other editors. The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition.

Casliber is a practicing psychiatrist and prolific FA writer. I pinged him to the schizophrenia talk page in December 2019 because the article had fallen out of compliance with FA standards.

After Cas re-ordered the sections in the article to a narrative that he held better worked for the topic, James reverted in several edits without the courtesy of discussing with Cas. I reverted. James reverted again.

Yet another WPMED RFC is held, and found the suggested order of sections should not be altered, but a practicing psychiatrist and prolific FA writer surely knows how to structure an article on schizophrenia.

Case study: Down syndrome, edit war over an apostrophe

WPMEDF-inspired projects aim for standardizing the leads of English Wikipedia medical content in ways tailored to WPMEDF products, but not necessarily to Wikipedia guidelines.

I have followed Down syndrome intermittently since its 2006 WP:FAC and 2010 WP:FAR.

Diffs of extended edit war and first appearances by editors to dispute

James never had consensus, yet edit warred ten times to install a personal preference. When that failed, he started an RFC, and reinforcements who have either never before engaged the article or enter little reasoning to support their position, appear and support "per Doc James"; in this case, Ozzie, CFCF and Flyer22 Reborn.

Wikilawyering 1

At the Ethosuximide RFC, the closing admins had been pinged twice to clarify, but James interprets the RFC conclusion as applying to "numerical" prices only, and repings the admins for a third clarification after they had just been pinged by WhatamIdoing. Wugapodes responds: "I would encourage editors to read Wikipedia:The rules are principles and Wikipedia:Tendentious editing before trying to find more loopholes as my patience is growing thin." [19]

After Wugapodes clarified the RFC findings, James interspersed his own interpretation of that out of chronological order, and outdented it, creating the effect of highlighting his single interpretation and conclusion in the discussion.

Wikilawyering 2

WP:MEDLEAD has long been disputed. I started a December 2019 RFC on MEDLEAD, which was a well-and-good disaster, malformed by me, made worse by my attempts to fix it mid-stream—which I have many times acknowledged. I learned a lesson there from WhatamIdoing, who then asked WPMED editors to hold off on any more RFCs umtil the Drug pricing RFC concluded. Nonetheless, in spite of some blunderbuss by others at the MEDLEAD RFC, RexxS, Ian Furst and I achieved some compromise on talk.

After the inconclusive close of the MEDLEAD RFC, and during the drug pricing RFC, with pleas by WAID to hold off on further action, the talk page bot archived the dispute discussion on the MEDLEAD RFC. And yet, James removed the disputed tag from MEDLEAD, stating that there was no ongoing discussion. We subsequently made progress and seem to be at a position of some tentative consensus, but a more collegial approach would have been to un-archive the ongoing discussion, or raise the matter on talk; the dispute was clearly ongoing, but had been archived by the talk page bot.

Ozzie10aaaa

Intersecting contribs Ozzie and Doc James

As demonstrated at Ivermectin, Simvastatin, and Down syndrome, Ozzie10aaaa frequently backs James in editwars and supports James in disputes on articles where Ozzie had never previously appeared, and without providing policy-based rationale. On Ozzie’s most common rationale, Wikipedia search engine reveals:

• Concur w/Doc James [20]
• Agree w/ Doc James [21]
• Agree w/ DocJames [22]

Analysis of a small portion of James–Ozzie intersecting contribs is at User:SandyGeorgia/Editor interaction. James encounters a dispute on an article where OZ has never before engaged, Ozzie10aaaa is there quickly, not fully engaging, but "agreeing per Doc James" with rare exceptions. In the majority of instances, while James had a long history at each article, Ozzie had no prior engagement, and only appeared when James encountered conflict. Ozzie disagreed with James in two instances.

In other MEDMOS discussions, Ozzie similarly supports James without providing reasoning.[23]

Case study in frustration: Chronic prostatitis/chronic pelvic pain syndrome, Ozzie10aaaa and James with an inexperienced user

At times, Ozzie appears unclear what he is reverting or why, or whether he has engaged and digested the discussion. At Talk:Chronic prostatitis/chronic pelvic pain syndrome in this discussion and this RFC a relatively inexperienced user, User:Thomas pow s, attempts to discuss with James. (It appears to have been a good faith discussion on Thomas' part, met with stonewalling, contradictory information, and Ozzie intervention.)

Article and talk interaction at Chronic prostatitis/chronic pelvic pain syndrome

After what looks like an excruciating encounter for a relatively new user, some content that could have been sourced was cut, and some theories were added because of this editor's persistence. This editor is gone.

Ozzie10aaaa does not resolve conflicts directly with editors

In December 2019, during a long back-and-forth between James and Colin, James asked Colin to stop pinging him. (This could be interpreted to mean pinging only to that discussion.) There was no comment about the pingie-thingie from other editors who were participating in the discussion, nor any request on Colin's talk; Colin initially refused to accept this request.

Less than three days later—having made no attempt to address or resolve or clarify the "pinging" matter on talk directly with Colin, and in spite of multiple instances of previous reminders to do just that—Ozzie escalated the incident in an ANI about Colin. (Colin agreed not to ping James anymore as soon as that was requested on the ANI.) At ANI, grudges came out of the woodwork, with many editors taking the opportunity to lodge baseless allegations about Colin.

Ozzie has a history of problems in this area: May 2015 reminder from several to discuss first; June 2015 concerns about Ozzie10aaaa's editing raised at ANI; July 2015 Ozzie brought a most odd AN3; March 2017 reminder "to fully understand the issues involved, before taking a side ... and read through the arguments and examples, and them vote"; and April 2018 reminder to speak directly to the editor before escalating.

Ozzie10aaaa has difficulties editing complex topics

Ozzie has some difficulties editing complex topics:

• April 2017 another editor corrects an obvious article inaccuracy, and Ozzie reverts the good faith edit, so the inaccuracy stands until another editor makes the same correction eight months later.
• At the same article, an IP removes nonsensical text about "prevent cells", which Ozzie reinstates, while another editor corrects, explaining in edit summary that there is no such thing as "prevent cells"-- the intended meaning was stops cells from.
• In January 2019, an editor adds a citation needed to Hypocalcaemia sourcing the text to the National Organization for Rare Disorders. Ozzie removes the MEDRS-compliant citation. After consulting with James, he reinstates the correct citation. For someone who frequently enforces MEDRS, he appears not to understand MEDRS.
• In May 2019, Ozzie tells an editor that section order "should always be followed" and an editor more fluent in the topic explains why the previous order was better. (Per WAID, "Doc James and Ozzie10aaaa quietly rearranged the order of sections in almost all WPMED-tagged articles a few years ago", and reinforced by James here, and Ozzie seems to misunderstand this guideline.)
• In July 2019, Ozzie reverts without reading source, and the editor reinstates and posts to Ozzie's talk, asking him to read the source.

A good portion of Ozzie's many edits are citation-bot assisted, updating epidemic data, and MEDMOS section heading adjustments. Most of them have no edit summaries. Otherwise, he seems to be at times editing above his comfort level and needing a lot of guidance.

Case study: Dyslexia, James exempts Ozzie GA from MEDRS

Dyslexia Dyslexia provides an example of my concerns about deteriorating content on Wikipedia and promotion/semi-protection of deficient medical GAs. Evo’s post about the gynormous peer review templates parked in the References section—a template which has nothing to do with References for this article and should be in External links—brought me to the Dyslexia situation.

See the full description and diffs of a troubling situation here.

In a Medicine Project where alt-quack editors are routinely whacked for not strictly adhering to MEDRS and MEDDATE, we have at GA Dyxlexia being spread across the internet via WPMEDF apps, and James advocating for an exemption from MEDRS for his Wikifriend Ozzie, with:

• non-MEDRS-compliant sourcing,
• and inferior primary sources supporting the text in the article for this font,
• in a GA written by others at Wikiversity but attributed to Ozzie10aaaa on Wikipedia,
• with an inferior lead on Wikipedia relative to Wikiversity,
• and a deficient GA promoted twice, once with support from Wikifriend Bluerasberry, and the second time with James specifically saying that this article should be exempt from MEDRS for reasons that do not hold water, and would not be accepted in any other article.

QuackGuru: Anti-woo culture and quid-pro-quo at WP:MED furthers disruptive editing

See Barkeep's evidence on Quackguru history

A bad dynamic has overtaken medical editing, and has become a role model for other editors. The notion that bullying and editwarring is necessary to combatting woo, trolls, quacks, and POV pushers is prevalent, and yet there is plenty of editwarring that has little to do with anti-woo. (Samples: general edit warring, Schizophrenia, Down syndrome, chronic prostatitis, drug pricing dispute, and general.)

That MEDRS has become an anti-woo bludgeon is a source of discomfort for some who helped write that guideline (myself included). Bullying and MEDRS bludgeoning has alienated several experienced medical editors.

Arbcom (Jytdog) and arb enforcement (QuackGuru) have recently made inroads towards changing this dynamic. A minority of medical editors (including James) expressed support,[24] or found no problem with the behaviors that led to arbcom action, defended the behaviors, or expressed dissatisfaction with arb actions. (Roxy the dog, Seppi333, Ozzie10aaaa, Boghog) James said: "we could technically over ride arbcom".

The cultural change is explained by WAID in December 2019:

SandyGeorgia's comment about the long-term changes in the group resonates with me. We used to be focused on writing brilliant articles filled with precisely delimited claims and superb sources. Then we went through an anti-woo phase: almost anything's okay, as long as it hurts the spammers and alt-med proponents ... Now we seem to be talking more about issues of health policy, which is a more approximate subject area with a focus on practicalities, like approximate prices.

Another way to deal with woo is to re-write articles to a higher standard, addressing the woo components directly, as I did years ago at MMR vaccine and autism, and have tried to do at the battleground pages of delusional parasitosis and Morgellons. The attitude that prevails in medical editing is seen in this discussion, where editors who possibly have a delusional disorder are called LUNATICS, and both Jimbo and a sysop are used as role models, and bludgeoning techniques are used to keep out perceived woo. In this perennial issue at Morgellons, I did the research to add content addressing the frequent questions.

With that as background:

• In this October 2019 ANI regarding QuackGuru's behavior, discussion stalled with Andy Dingley pointing out the MEDRS bludgeon, and medical editors James, Seppi333, Bluerasberry, and Ozzie10aaa, James again, and Roxy the dog being part of the reason ANI did not achieve consensus.
• In this March 2015 ANI regarding QuackGuru, no consensus was found with medical editors Jytdog and James weighing in in favor of QuackGuru
• In this May 2015 ANI, restrictions are imposed on QuackGuru, over sustained opposition from James.

Reviewing the history of editors involved in editwarring threads, and the multiple other case studies presented on this page, a quid-pro-quo appears to be an issue. Some editors mutually defend each other at ANI, AN3 and other dispute resolution fora, preventing community consensus on dealing with disruptive behavior.

Elitism and cultural changes at WPMED

WPMED has moved away from a culture where sustained and collaborative interaction and engagement on talk towards precision and accuracy in writing (qualities typified by Colin's editing, thoroughness, incisive analysis and comprehensive review, see here, here, here, and here for but a few samples) have been replaced by a hurried, attention-deficit, revert, revert, revert, "RFC to win", whack-a-mole culture. Concurrently, those editors (like Colin) who engage in sustained discussion are accused of "bludgeoning" and "walls of text"; yet, Colin is not a reverter. Sustained dialogue is a feature for editors engaged in FA writing, and a quality lost at WP:MED of late. This cultural change coincided with the uptick in WPMEDF activity, and the decline in FA-related activity, as a culture of "push as much content out the door via apps as we can, regardless of quality" took over.

Ozzie describes James as an "elite editor", and uses editcountitis to justify his (Ozzie's) frequent appearances to back James on articles where Ozzie has never before appeared. James uses the same justification, on more than one occasion.

Further, in contrast to the meme, On the Internet, nobody knows you're a dog, in medical editing, we confront ill-conceived commentary implying that "Doc" James has a better command of policy and medical sourcing (even on topics where he is less experienced) than other editors. Those "lesser important" (non-MDs) are inaccurately charged with poor timing for this arbcase, while the impact of an arbcase (forced by James' behavior) on our time (samples, [25] [26] [27] [28]) is discounted because we aren't saving the world from a pandemic.

I don't believe the "elitism" factor has an easy or apparent solution, and it is something we must live with, but the solution to the editcountitis problem might be less difficult.

• See User:SandyGeorgia/WPMED editcountitis

These numbers reinforce several issues, seen elsewhere in discussion on this Evidence page:

• The amount of editing by Ozzie and James is extreme, averaging about 100 edits per day from James, and 175 edits on one 9-hour editing session.
• Ozzie and James rarely engage on talk, relative to other editors.
• Both Ozzie and James are editing too much, too fast, and without adequately engaging on talk with careful attention to detail or sustained collaborative discussion.
• Ozzie follows James' edits to endorse James' positions without adequately engaging, which reinforces the overall cycle of non-engagement, replacing discussion with hastily-formulated RFCs.
• In contrast, those editors who do engage sustained discussion with incisive and policy-based analyses will see aspersions cast their direction and their reputations on Wikipedia destroyed.

Problems to be solved; I don't know how. I only know this culture alienated me from medical editing.

Lead restructuring

WP:OWN#Featured articles (policy) says:

Editors are asked to take particular care when editing a Featured article; it is considerate to discuss significant changes of text or images on the talk page first.

Here is the level of writing about Tourette syndrome from the CDC: https://www.cdc.gov/ncbddd/tourette/facts.html

User:SUM1 points out we are at that low level, describing James' leads as inducing headaches, saying What I do know is that any medical article maintained by Doc James has far too many short sentences in the lead and is incredibly disjointed to read. I wish I could change it to be more in line with basically every other article on the entire Wikipedia.

SUM1 gives an example of choppy, disjointed prose in a lead written by James at Harlequin-type ichthyosis:

"There is no cure. Early in life constant supportive care is typically required. Treatments may include moisturizing cream, antibiotics, etretinate, or retinoids. It affects about 1 per 300,000 births. There is no difference in rate of occurrence between sexes. Long-term problems are common. Death in the first month is relatively common. The condition was first documented in 1750."

Medical Featured article production has ended because James' imposes such leads on every article, and that kind of lead cannot pass FAC. (Meaning, I, for example, can no longer do what I do on Wikipedia, and basically gave up and stopped editing.)

While writing for the purposes of translation is a laudable goal, we must first aim for accuracy and precision in our English-language content. I experienced the lead rewrite at Tourette's in 2016.

• On October 15, 2016 (well after James had reordered the leads of many articles, see Fait accompli section) and with no prior request or discussion on talk, James rewrote the lead, ending here at 03:25. At 19:45, I started repair:
• [29] "Vocal" tics are distinguished from "phonic" tics in the literature, and the distinction is important and a frequent source of confusion.
• [30] "worsen and improve" is prejudicial language that is avoided, and does not accurately encompass the many ways tics fluctuate, described in almost all reviews as "waxing and waning". [31] "Waxing and waning" encompasses much more than the prejudicial "worsen and improve", and is terminology encountered in most TS literature.
• [32] "briefly" is just an inaccurate choice of words here; sometimes tics are suppressed all day while a child is at school
• [33] premonitory urges do not have to be "strong"; they can be a feeling like an itch
• [34] James completely dropped one sentence.

At that point, James begins discussion on talk for the first time. I then had to spend several days explaining all the errors he had introduced, and trying to get the article back to some semblance of accuracy. A lengthy discussion ensues, and I ultimately am obligated to accept James' re-ordering, having seen how the history has unfolded in other cases (editwar --> RFC --> several editors unfamiliar with the topic or sources come in to "agree w/Doc James", means it is easier to go along with James to avoid trouble).

James' goals were to a) simplify the language for translation (which was not revealed until well into the discussion) and b) reorder the lead according to his preference. The preferred order of narrative is not optimal for Tourette syndrome. And in trying to simplify wording, James introduced inaccuracies. He attempted to rewrite the lead of a topic he is not familiar with, without the courtesy of a notification first. Had James approached this collaboratively—that is, had he simply put a list of words he wanted to simplify, and allowed editors knowledgeable in the topic to work through them—the process would have been much more effective. And I would not have given up on maintaining all medical Featured articles. James is not a neurologist, or a urologist, or a psychiatrist, and this pattern repeats across articles that are not in his area of practice, contributing to ongoing conflict.

In 2018, I attempted a WPMED collaboration (epic fail). I had approached a rewrite of Dementia with Lewy bodies in 2018 (post-Osmosis video dust-up) after an exciting new consensus report was published in 2017, thinking it would be a way to re-unite WPMED in the kind of collaboration it once excelled at. I gave up after experiencing the dysfunction that had overtaken WPMED. The pattern at Tourette's and elsewhere repeated when James appeared unfamiliar with recent literature.

• At Talk:Dementia with Lewy bodies/Archive 1#Infobox inaccuracies, I had to spend a good bit of time convincing James that he was using old sources, when the 2017 DLB Consortium had completely changed the diagnostic criteria, such that text he wanted in the lead was inaccurate; he didn't appear to understand or be aware of the significance of the new findings.

• I reluctantly accepted James' piping of "lack of interest" to apathy, although I disagree that description is accurate or precise enough for medical writing, knowing it is expedient to go along with James rather than incur an RFC over a word. (Just as I reluctantly removed "wax and wane" from the lead at Tourette's.) Precision is lost for the purpose of translation, and apathy is not difficult to understand or translate. (Disclaimer: I work as a volunteer interpreter in a free clinic for Hispanic migrant workers.)
• All of this led to a lengthy discussion with James, where I pleaded with him to understand the impact his editing was having, in a discussion encompassing all of the issues in one. I pointed out James dishonesty at intentionally linking to a dated, archived source to justify his position, when newer sources and information were available; today, I retract that as dishonesty and assert it is more likely a reflection of James editing too much, too fast, in areas he does not know thoroughly, and not fully reading, engaging or digesting talk page discussions. (Discussed many times with James, for example here.) Hasty RFCs allow him a faster way of proceeding than actual discussion.
• In October 2019, an editor made good-faith improvements to the lead of DLB, resulting in smoother prose, but was reverted by James.

DLB ended up with such a poor lead that I disengaged and could not take it to FAC. (I re-engaged this year, precisely because and after some of the WPMED bullying has been dealt with by arb actions, and I am hoping to progress to FAC.)

A frequent problem is that James edits article leads only, and does not edit the body of the article to keep it in sync with the lead. After the 2016 experience at Tourette's, I unwatched most medical Featured articles, only checking on them occasionally. While I was absent, enough damage was done to Asperger syndrome that it was defeatured this week. (Similar problems exist in almost all medical featured articles, where the body is not kept in sync when the lead is edited, and they are almost universally outdated.)

• In March 2016, James restructured the lead, introducing considerable prose problems:

  While there is likely a genetic basis it has not been determined. Environmental factors are also believed to play a role. Brain imaging have not identified a common underlying problem. The diagnosis of Asperger's was gotten rid of in the 2013 fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and people with these symptoms are now included within the autism spectrum disorder along with autism and pervasive developmental disorder not otherwise specified. It remains within the tenth edition of the International Classification of Diseases (ICD-10) as of 2015.

• James returns in June to address one prose problem

• James simplifies language by piping “inherited from a persons parents” to heredity.
• While the body of the article says:

• There is some evidence that children with AS may see a lessening of symptoms; up to 20% of children may no longer meet the diagnostic criteria as adults ...
• In this edit to the lead only, James adds contradictory information

• "typically last for a person's entire life" without adjusting the text in the body or adding that to the body, and
• adds that "females are typically diagnosed at a latter (sic) age" which is not in the body of the article.

• At Dengue fever, an update to the lead has 40,000 annual deaths, which is not added anywhere to the body.
• At Schizophrenia, James adds 17,000 deaths in 2015 to the lead, but does not adjust the body, which says 20,000 in 2010.

These are samples only of the kind of editing I have seen at every Featured article, where focus on the lead only takes the lead out of sync with the body, neglects the overall content, and ultimately leads to Featured articles falling into such a state of disrepair that they must be defeatured, as Asperger’s was this week.

In all of these cases, James is editing outside of his area of practice, yet imposing his preferences in the lead, for the apparent purposes of translation. My concern is that, with a focus on producing leads for external apps, overall content is neglected and even degraded, and that James is simply editing too much, too fast, and in a way that leads to alienation of other editors. It has proven difficult to get James or his supporters to recognize this. The new WPMED pattern is revert, revert, revert, then conduct an ill-formed RFC "to win", rather than engage, discuss, understand, respect, apply policy-based reasoning and collaborate.

Drug pricing dispute

Fait accompli

At Ivermectin, in this September 2019 discussion, Hipal/Ronz and Doc James are in a drug price dispute. Ozzie10aaaa enters an "agree w/ Doc James", Seraphimblade disagrees, Quack Guru supports James. The only two independent opinions, who come from Wikipedia:Third opinion are:

• May His Shadow Fall Upon You, who notes the text is not in compliance with MOS:LEAD, and
• ReconditeRodent who evidences the fait accompli; RR provides for reasoning the fact that many other drug articles contain prices in the lead, likely unaware that they were mostly inserted by one editor, against policy.

Participation in RFC formulation

After the 7 December 2019 ANI close remitted all discussion of drug pricing to a single forum to formulate an RFC, between that time and 23 January 2020 when the RFC was launched, James engaged on 9, 10 and 16 December, and not again until 3 January. [35]

RFC participation affected by canvassing and WPMEDF entering “drive-by” commentary

( See also Down syndrome case study on WPMEDF "driveby" supports)

The second RFC on drug pricing attracted 40 editors (43 total in page history includes the three sysops adminning the process).

Of those 40 editors, 10% (4) were canvassed or were WPMEDF colleagues who did not engage the core of the issue, rather entered "drive by" commentary:

User:Axem Titanium was canvassed from the Video project [36] (see Bluerasberry canvassing section)

User:Avicenno (WPMEDF) entered a 6 February no policy-based reasoning, ILIKEIT opinion.

User:AbhiSuryawanshi (WPMEDF) entered a 3 February no policy-based reasoning, OTHERSTUFFEXISTS

User:Pratik.pks (WPMEDF- videos) entered a 3 February no reasoning at all—Pratik has five article edits on Wikipedia as of 15 April [37] and has mostly edited the Dengue fever video (a video that “Not anyone can edit”, based on outdated text, and yet installed in the lead of a Featured article)

The RFC was open fox six weeks (23 January to 7 March); three WPMEDF members who had no previous engagement entered "driveby" positions within three days of each other.

Simvastatin RFC

The second RFC on drug pricing closed on 27 March. Colin initiated discussion at WT:MED on 28 March. Differences in interpretation and how to implement surfaced quickly. On 29 March, WhatamIdoing took one of the clearest examples of non-compliant drug price text, at Simvastatin, and removed the text from the lead, while adjusting the text in the body. Edit war discussed in other evidence ensued, with James and Ozzie together reverting five other editors on 30 March.

With insufficient discussion on talk, and no discussion about how to correctly frame an RFC, James unilaterally launched another RFC only three days after the community-wide RFC closed. Similarly, he unilaterally launched another RFC at Talk:Ethosuximide.

• James set up the RFC as a "yes-no" !vote format and disallowed threaded discussion. (This is after months of RFC formulating, and two other RFCs, where WhatamIdoing many times outlined the problems with yes-no RFCs, but James didn't hear that.)

• James removed attempts by others to hold threaded discussions, and altered the posts of others, running the page like an ArbCom clerk, with no threaded discussions allowed.[38] [39] [40] [41] [42]

• James positioned the RFC as if the dispute was whether two sources verified the text, rather than whether the text complied with the conclusion of the RFC about drug prices in the lead—obtaining the desired answer by asking a misleading question.
• Ozzie10aaaa supports within minutes.
• WhatamIdoing explains the problems with the RFC statement, and removes the requirement for no threaded discussions, which is reinstated by James. A meta-discussion about how to run an RFC ensues, and James is reminded that the question should have been worked out in advance.
• Bluerasberry alters the format of the !votes (see Bluerasberry evidence above) so that by the time other editors begin showing to the discussion, they see a misleading RFC question, allowing only a yes-no !vote, where threaded discussion is disallowed, and Support votes are numbered but Opposes are not, and discussion of what the actual dispute is about is buried somewhere below. [43]

Most of the editors opining do not appear to have read or understood what the actual issue is (because it's buried below), but WPMEDF officers and members, having limited previous engagement, support:

• Avicenno (WPMEDF officer) does not engage discussion
• Ian Furst (WPMEDF) offers sound reasoning for his support but that very same reasoning indicates he may not have read the discussion, or realized he is answering the wrong question
• JenOttawa (WPMEDF former officer) supported without appearing to engage the discussion
• Myoglobin (Osmosis) emails James at 14:13 9 April and supports at 15:52 9 April
• AbhiSuryawanshi (WPMEDF) supports per WPMEDF colleagues James and Bluerasberry
• CFCF (WPMEDF officer) supports
• Bluerasberry (WPMEDF officer) supports
• RexxS (WPMEDF officer) also supports, but does engage the full discussion that was moved below, and offers reasoning

With a just-closed community-wide RFC finding no consensus to breach WP:LEAD or WP:NOT for drug prices in the lead, local consensus is overriding global consensus based on WPMEDF support.

Inadequate use of edit summaries contributing to tension

There are concerns thoughout the evidence of reverts being made without edit summaries, and changes that are known to be controversial being made without adequate summaries. The edit summary issue has contributed to the tension at WPMED, as it lends a "stealth" appearance to the edits and makes it hard for other editors to be aware that controversial changes are being made.

• August 2008, James is reminded to use edit summaries
• May 2010, James reminded by two editors to use edit summaries
• January 2012, James again requested to use edit summaries
• June 2014 Another edit summary request
• July 2017, a conflict arises over missing edit summaries and forced re-ordering of sections
• March 2018, Clayoquot discussion of edit summary issue on Video insertions,

• complete with personalization by CFCF ("this seems like conspiratorial thinking on your part in order to justify this inane discussion. Carl Fredrik talk 12:59, 28 March 2018") and an
• agree w/ CF--Ozzie10aaaa (talk) 13:07, 28 March 2018

• July 2019, James asked to avoid using edit summaries to cast aspersions.
• August 2019, James continues adding videos to leads without an edit summary (and not in External links, where external videos belong, if at all)

After discussion at WT:MED about using edit summaries on controversial drug price edits,[44] which was adopted by others,[45] [46] [47] [48] James continues without (see as an example edits at Simvastatin and his contribs

• April 2017, Ozzie reminded to use edit summaries
• October 2017, Ozzie reminded to use edit summaries
• December 2018, Ozzie reminded to use edit summaries

Ozzie indicated he would try (without providing an edit summary :) Ozzie is still not using edit summaries consistently or helpfully, although I explained to him that he can set a reminder in preferences.

SG: responses to other evidence

Regarding James evidence, [49] he had never before asked me not to ping him. After he first asked on 31 March, he had an acknowledgment from me within 13 minutes. James misrepresents my statement about "arrogance" and fails to AGF. It would be arrogant of me to demand people not to ping me because it makes extra work for my arthritic hands; I can change my preferences if needed.

The vaccine section at Dengue fever was updated a month after I tagged the section, and the Research section remains dated, while the References section reflects some WP:MEDDATE issues, and the Epidemiology section needs an update.

James says "The claims around dengue are false." I don't want to continue a content dispute here, but the "false claims" should be addressed. This is the lead I tagged in January 2019. "The vaccine, however, is only recommended in those who have been previously infected" is inaccurate. The current lead says: "As of 2018, the vaccine is only recommended in individuals who have been previously infected or, in populations with a high rate of prior infection by age nine." The update was made at my instigation; the body of the article is still out of sync with the lead, and there are still tagged updates needed. My concern (as indicated in this primary study) is that during the Crisis in Venezuela this article should be timely and accurate. Inaccurate statements about vaccines impact people where Dengue has and will escalate. Others might say, SOFIXIT: in the past, I have been accused of COI and threatened with topic ban by a now-banned editor; I had dengue fever when I lived in Venezuela, so am concerned I will be similarly charged if I make substantive edits to this article. SandyGeorgia (Talk) 15:11, 22 April 2020 (UTC)

James' response lists vandalism that well pre-dates the semi-protection at Gastroenteritis.

James' response about Gout shows a misunderstanding about good-faith misinterpretation of a source, versus vandalism.

Update: As James points out, one of the edits interpreted as vandalism (and the semi-protection) occurred in January 2012, while the source was accepted for publication in March 2012 and published in July 2012. We cannot know if the IP (who has no other contribs) had advance knowledge of the publication, and interpretation of that edit as vandalism at that time could not have been avoided. The overall conclusion remains: there doesn't seem to be enough indication for indefinite semi-protection in any of these cases, and I am happy to see that James is willing to adjust these. SandyGeorgia (Talk) 14:14, 22 April 2020 (UTC)

---

FeydHuxtable, thank you for the considered evidence (I don't believe I ever saw that "leading light" reference). I turned my attention prematurely to the Workshop page because it has been impossible to pull up diffs for several days due to something going on with the server, so I was trying to make use of my time. I am aware that Workshop proposals are for generating ideas and discussion; please take note of what kinds of remedies I am not suggesting. Bespoke remedies to a novel situation will be needed for us to return WPMED to its former standing, my evidence is aimed at showing why the standard measures may not work, generating ideas for what will work, and I doubt that any of us want to lose any of the few valued medical editors we have. We all just want to be able to edit: for almost five years, I haven't been able to. I also agree that S Marshall has it about right; well-intentioned people trying to do too much, too fast, and not realizing how they are impacting the editing of others. I hope my-- and everyone's-- contributions are equally valued. Best regards, SandyGeorgia (Talk) 22:57, 16 April 2020 (UTC)

Also, regarding the timing to "launch attacks on Doc James", the timing was James' choice. Barkeep49 initiated this case after James appeared to ignore a community-wide RFC, edit warred, and launched two more local RFCs. Noting that James had time for 175 edits in a 9.5-hour editing session on 16 to 17 April. SandyGeorgia (Talk) 17:53, 17 April 2020 (UTC)

---

Regarding Ozzie’s statement, I the arbs can pass judgment on whether such "harassment" ever occurred (particularly since that block was removed quite quickly, before I even knew it happened).[50] SandyGeorgia (Talk) 18:10, 21 April 2020 (UTC)

Ozzie, regarding this statement, Colin and I have been involved at WPMED from its earliest days, in the development of MEDMOS, MEDRS, and at multiple FACs, FARs and Featured articles. Which of those interactions concerns you? Perhaps this one, which is not in the normal suite of articles we edit, and where Colin disagrees with me? SandyGeorgia (Talk) 16:56, 26 April 2020 (UTC)

---

Regarding Ian Furst’s statement about Down's syndrome, I began editing Down syndrome on 2006-12-02 00:16 and Colin on 2006-12-08 23:36 (related to the peer review and Featured article candidacy); James began editing DS on 2009-06-14.[51] The disputed text was present at every stage of content review, according to the Article milestones.

• 2006 Peer review [52]
• 2006 Featured article candidate [53]
• 2010 Featured article review [54]
• 2012 Peer review [55]
• 2014 Good article [56]

and was only removed by James in 2016,[57] when he began inserting his views of leads on every medical article. SandyGeorgia (Talk) 19:43, 21 April 2020 (UTC)

---

Where T.Shafee(Evo&Evo) describes as "unconstructive friction", the full discussion is omitted from their link, and is at Wikipedia talk:WikiProject Medicine/Archive 134#Featured article removal candidates. What started as a post to solicit help maintaining FAs (where there was a good deal of helpful commentary from MILHIST members), turned to addressing inaccurate and discouraging commentary from CFCF.[58] Specifically, the statement, "FA … lacks understanding of what concessions need to be made for medical articles" is odd, considering two former FAC delegates (SandyGeorgia, Graham Beards) and one current FAR Coordinator (Casliber) are medical editors. I point out the inaccuracies,[59] and that CFCF is not in a position to criticize how the process works as he hasn't participated there,[60] and CFCF calls that an "ad hominem".[61] With now two statements that WPMEDF members are not concerned to keep medical FAs up to date,[62][63] and with these roadblocks thrown up when Featured article reviews are mentioned at WTMED, the effort has had to move off of the Medicine project page, to a grassroots effort which has seen good results (example Wikipedia:Featured article review/Chagas disease/archive1, with editors also willing to begin repairs to Dengue fever).

I have have stricken the statement that the template is a WPMEDF project. SandyGeorgia (Talk) 14:04, 24 April 2020 (UTC)

SG response to editcountitis

Statements have been made on this Evidence page and elsewhere impugning the motives of those who fully engage dispute resolution. In relation to the amount of text contributed by editors who scarcely engage at all, [64] [65] [66] [67] the percent contributed by those who do appears inflated. EDITCOUNTITIS charges that WhatamIdoing, Colin and SG contributed 60% of the RFC do not account for a) WAID drafted the RFC, so had KB due to the orginal writing; b) Colin provided almost all of the (incisive, policy-based) price analysis; and c) I (SG) re-posted to the page at someone else's request a copy of a long quote from the formulation phase. (Which doesn't mean I am not known for a long history of apparently genetic verbosity, contrasted with WAID's and Colin's incisive and precise analyses.) Further:

At WhatamIdoing's urging, the principals in the dispute and formulation of the RFC held off until later in the process, so as not to impede or influence commentary from others.

In my case:

• 23 Jan: RFC launched
• 31 Jan: 8 days in, SG first post is six words
• 12 Feb: 20 days in, SG asks for clarification on Bluerasberry's "plan" for drug pricing
• 12 Feb: 20 days in, SG adds KB by providing a quote from earlier discussion that another editor had requested [68]
• 18 Feb: 26 days in, SG begins responding

• At that point, the trends were already clear and 38 of the 40 respondents had already opined. The RFC closed on 7 March, so there was ample time for people to respond to my comments.

The RFC was formulated over seven weeks (7 December to 23 January), and discussion encompasses three archives. Formulation was made difficult because of the time spent in trying to find a single sample (from the over 500 inserted) of drug price text that met all other policies (WP:V, WP:OR, WP:WEIGHT), so a strong example could be used to ask a neutral question about whether that price info met WP:NOT and should be included per WP:LEAD. Much time was lost because not one example could be found that did not appear to have multiple other policy-based or source-to-text-integrity problems. For that reason, how to position an RFC had to be re-cast several times, and discussion of two RFCs occurred (that is, how can we determine if NOT and LEAD are met, if we don't have a sample that is otherwise policy compliant, so we will have to deal with that first).

• Edits to Drug pricing RFC
• Edits to WT:MEDMOS during the RFC formulation (some of these edits are to other topics on the same page)

Many medical editors weighed in on the Simvastatin RFC, and the Ethosuximide RFC, yet never participated either in the formulation of the broader RFC, or the broader RFC itself, and now appear to want to overturn it. Those include: JenOttawa, Whispyhistory, CFCF, Myoglobin, RexxS and Flyer22 Reborn. Ozzie10aaaa did not participate in the formulation, but did add one brief comment to the RFC.[69] Although Ian Furst did not participate in either, he did indicate multiple times that he was following and reading.

Evidence presented by Doc James

Agree that the issues at WPMED have been ongoing for years. A fair bit of it involve incivility, efforts to silence voices though intimidation, and to close down discussion. We are seeing this in the most recent round of discussions around prices but it is not new.Doc James (talk · contribs · email) 20:43, 7 April 2020 (UTC)

Inappropriate behavior by Colin and Sandy

Some discussed at this ANI in Dec of 2019 with respect to Colin. On Dec 2nd I requested that Colin stop pinging me.(Dec 2nd at 19:04) I had previously requested, a number of years back that they not post on my talk page, which they also did not follow. Colin replied to this request “James As long as you won't drop this issue, you'll get pinged whenever I mention your name.” and he not only pinged me in the reply but continued pinging.[70]

After being brought to ANI and being threatened with a block they backed down. SandyGeorgia was the first one to respond and did not appear to have any concerns with their behavior. They have continued on the pinging tradition with 6 pings on March 30th, all to bring my attention to a single discussion I was obviously watching.[71][72][73][74][75][76] Sandy has criticized me multiple times for requesting unwanted pings to stop, Mar 31st stating "you disallowed pings and were not keeping up with discussion". On Apr 7th they calls those who make such requests "arrogant".

When the harassment team initial stated they were developing a tool to silence unwanted pings, I did not think such a thing was needed as I assumed all one would ever have to do was politely ask. I have now changed my position on this and fully support the development of such a tool.

Consensus being misinterpreted

A 2016 RfC concluded "Except in the cases where the sources note the significance of the pricing (which did have consensus), there is no consensus to add the pricing to the articles." We have plenty of sources that note significance. Plus there was no consensus for removal of prices.

There have also been efforts to shut down develop of consensus through RfCs such as here "Wrong RFC."

General audience

Many editors at WP:MED have spent a significant amount of time improving the readability of the leads of medical articles. A published analysis found that the reading levels changed from grade 15.7 in 2008 down to grade 12.7 in 2018.

The work is supported by guidelines such as “Strive to make each part of every article as understandable as possible to the widest audience of readers who are likely to be interested in that material.”

WP:MEDMOS has summarized this as “The lead of an article, if not the entire article, should be written as simply as possible without introducing errors or ambiguity.” since 2015.[77]

There however was attempts by Colin and Sandy to remove this wording in 2019 without discussion.[78][79] And a push to use more complicated wording though a compromise was reached.[80] This involved small adjustments like using “loss of interest” rather than “apathy” added here [81] adjusted here [82]

Colin stated Mar 2018 “I have seen too many times Doc James pervert our article content to suit his pet projects, which are not aligned with English Wikipedia. Four years ago I saw him spend his time dumbing down our leads to baby language in the assumption that this made it easier to translate or with the idea that this was Simple English wikipedia, for those who find English hard to read.” And this insulting of writing for a general audience continues to Apr 23 2020 with "Doc James does not write about cost, he adds factoids".

Here is a list of more than 1,300 leads I have worked on and I would invite people to decide for themselves if these are inappropriately dumbed down or written in baby language.

Consistent organization

There have been efforts to improve the consistency of the layout of disease and medication related articles over the last 10 years. This makes the WP easier to use, especially by those who do so frequently. It also makes our content easier to maintain. The suggested ordering is present at WP:MEDMOS and is supported by the majority of the community. Yes there can be exceptions but these generally need justification.

Collaborating between languages

Sandy attempted to remove the fact that there is no rule against citations in the leads of articles from MEDMOS in 2018.[83] Translation between languages, a project being working on since 2012, would not be possible without references in the lead. These efforts have resulted in the translation of more than 6 million works of text by the Wikipedia:WikiProject_Medicine/Translation_task_force Efforts have concentrated on translating the leads of articles due to feedback from a number of languages. The attempt to remove this text occurred despite this having been discussed multiple times.[84]

Making our content more global

Wikipedia’s content is often US / EU centric. In collaboration with the World Health Organization WP:MED/WPMEDF worked to improve our coverage of all medicines listed in the WHO Model List of Essential Medicines. This is a list of medications that should be present in all health systems due in part their efficacy, safety, and cost. As part of these efforts the WHO released the 2017 list under a CC BY SA 3.0 IGO license. These efforts worked to add a decent summary, including details on use during pregnancy and discussion of cost. The latter of course bringing us here. Well there appears to be consensus on including the numerical prices of medications in the leads of articles when those medications are expensive in the United States such as pyrimethamine and onasemnogene abeparvovec, some appear unwilling to allow prices of any sort in LMIC anywhere in the article despite 1) plenty of sources discussing costs of essential medicines generally 2) a book published by the WHO which has these details. I am happy to consider changes; the details in question can be presented without interpretation and within the body of the article rather than the lead, and I hope that the other people involved will accept this also. I am also happy to put the question to the community. Also many have suggested improving our coverage of costs of medications including User:Nbauman back in 2014.[85] Yes it is more difficult to include coverage pertaining to LMIC as high quality sources are harder to find, but when such sources are available Wikipedia should not actively avoid providing appropriate details. The population of LMIC is 6.4 billion (85%) out of 7.5 billion people as of 2018. https://data.worldbank.org/income-level/low-and-middle-income That I editing via consensus and working to develop consensus can be clearly shown in this RfC and other RfCs.

Other formats

Wikipedia needs to be not only in a language that people can understand but also a format that they can use. We do and can adjust our content rules to make enWP universal, and we have from the very start. The goal was to make a free encyclopedia, free for anyone to adapt, and enWP and the foundation have always kept the other purposes of society in mind.

I have collaborated to develop offline apps in various languages and offline distribution systems. We are not just writing enWP for online use, we are also writing enWP for offline use. And the changes that make enWP better for offline users also makes enWP better for online users.

I have supported multiple video collaborations including with the Khan Academy,[86] HealthPhone,[87] Osmosis,[88] and WP:Videowiki. Rich content, such as video, was the second most requested improvement in the 2015 readers survey.[89]

Comments such as “VideoWiki, as an attempt to get editors to create and edit videos for Wikipedia, is a failure. The videos are rubbish too.“ [90] Sure the efforts are a work in progress but so is all of Wikipedia.

Other collaborators

Yes WPMEDF has collaborations with the World Health Organization, the National Institutes of Health, the Center for Disease Control and Prevention, Our World in Data, Cochrane, the University of California School of Medicine, HealthPhone, Internet-in-a-Box, Kiwix (Wikimedia Switzerland), Translators Without Borders, ECGepedia, VideoWiki, Turnitin (copyright detection tool), and Radiopedia, among other organizations. These have led to release of content under open licenses and positive recognition for our movement. The goals of WPMEDF are inline with those of the Wikipedia editing community and these efforts have generally advanced our mission. We are not going to succeed at collecting the sum of all human knowledge by ourselves.

Response to other evidence

With respect to the semi protection of gout, this was in 2012 following a brief episode of semi-protection not being effective. The good "faith edit" to gout that SG described added the text to the "cause" section of the article "gout may also cause the sex organ to shrink in men and render the sex organ inoperable if left untreated". The source they found that supposedly supports this does not mention shrinkage and was published after the edit in question.[91] That SG is trying to present this edit as good faith is strange. I do not clearly remember all the details from 8 years ago, but we did have a pharmaceutical company trying to promote their medication for gout User:Gout2012. I have removed protection from the pages in question.

With respect to gastroenteritis, replacing the name of a disease with that of a probable living person is vandalism.[92] Other IP vandalism.[93][94][95][96][97][98][99][100][101]

The claims around dengue are false. When a vaccine came out in Dec 2015 it was added that month.[102] When concerns about the vaccine came out in 2017 they were rapidly added that month.[103] When Sandy tagged the article Jan 28 2020 claiming that the most recent WHO article on the dengue vaccine was old they were simple mistaken.[104] What was there was a Sept 2018 paper by WHO.[105] which is still the most authoritative source on the topic. Yes there is a closed source analysis of the paper by Elsevier which does not really say anything different.[106]

We have an entire section on the Down_syndrome#Name. Most of our medical articles only contain one of these minor spelling variations. I started the RfC in question. The majority disagree with my position and the new version is now in place. This is how Wikipedia works, not seeing the big deal.

With respect to Graham Beards concerns about my edit summary in this edit on March 30th 21:58.[107] This was preceded by a discussion on their talk page March 30th 2020 at 19:21 to which they never responded.[108] They had previously removed all details of cost March 30th at 16:37 from simvastatin.[109]

Graham’s comments make it appear like I either added or supported the addition of Twitter and FB as references. I did neither. In fact I have removed such links.[110] GB did not feel WPMED deserved credit for work done on COVID19 despite User:Whispyhistory working a lot on the topic.[111] With respect to the claim that I do not see him as a peer, I did recommend that the journalist who wrote this piece reach out to him due to their involvement. Simple put I do view them as a peer.

Per the rotavirus vaccine this account in 2016 added further details regarding price to the body of the article.[112] Sure the details in the lead should have been updated aswell and I have done so based on the newer and more details references.

Evidence presented by Colin

Doc James, Blue Rasberry and QuackGuru are advocacy-editing over drug prices

The community has since 2007 required prices to be exceptional, not routine; to reject the "ephemeral trivia" of "street prices" "that can vary widely from place to place and over time" and not be "a price guide to be used to compare the prices of competing products, or the prices of a single product across different countries or regions". This policy statement came from two lengthy discussions (here and here).

The earliest medical discussion on drug prices is this one from 2010. There was very much support "to remove such information on sight" and reaffirming policy requirement for notable issues concerning price. This prompts User:WhatamIdoing to add prices to the MEDMOS list of things (along with dose and titration) that should not be included in articles "except when they are extensively discussed by secondary sources". The MEDMOS change is swiftly synchronised with the Wikipedia:WikiProject Pharmacology/Style guide by User:Anypodetos. This view requiring prices to be exceptional and notable is repeated at this discussion in 2014 on the Pharmacology Style guide.

The advocacy to include drug prices in all articles begins in this discussion at WT:MED from June 2015 started by User:Bluerasberry, who wants a "List price for month supply (US)" infobox field. This idea is strongly rejected by several users. James picks up the idea with this discussion in August 2015 which is on the talk-page of the {{Infobox drug}} template and is about the infobox and wikidata, not article leads. Ozzie10aaaa supports, though is short on justification. Bluerasberry, on the other hand, is effusive with advocacy reasons to include prices. There is strongly held opposition and no consensus to add prices to wikidata, infoboxes and never once is there a suggestion to add price sentences to the lead.

In August 2015, James begins adding MSH Price Guide based prices to the leads of drug articles. After inserting prices in 30 articles, James removes "pricing" from the "do not include" list at both style guides: here and here. He justifies the edit by citing the 2004 Pharmacology Style guide discussion. That discussion was very much against routine prices. The discussion resumes, provoked by opposition to James's change to the style guide, and BlueRasberry continues advocating for prices.

After adding prices to 100 drug articles by May 2016, James informs WP:MED of what he has been doing by starting a poll-style RFC. It is somewhat unclear what the RFC is actually proposing, other than a vague confirmation of what James has done, which isn't described in any detail. Ozzie10aaaa offers James his support, without any rationale. BlueRasbery joins in with his advocacy. James notes "Doctors Without Borders has done a fair bit of work to increase price transparency [113] and this is something they are interested in collaborating on." About 40 participants discuss and are numerically split evenly.

Admin User:Jc37 closes the RFC in July 2016: "Except in the cases where the sources note the significance of the pricing (which did have consensus), there is no consensus to add the pricing to the articles." Despite a lack of consensus to add prices, and an explicitly requirement for the sources to "note the significance of the pricing", James continues to add prices solely sourced to product price databases, which contain no commentary on the price at all. By the end of the 2016, over 300 drug articles have MSH Price-guide "developing world" prices, and currently 530 drug articles have explicit price statements in their lead (User:Colin/ExistingPrices). As User:Colin/PriceEdits shows, the vast majority of the edits to insert prices have no edit summary or the vague "added".

There is an edit war at Ivermectin in September 2019 over prices. In the talk page discussion, James notes industry lobby/censorship, lawsuits about TV commercials and industry hiding costs. At WP:NOT's talk page, James notes industry transparency issues and makes a comment about his personal experience. At WikiProject Pharmacology, James makes further advocacy comments. At WP:NOT, James says (without providing evidence) that "Every essential medicine has extensive coverage / discussion of its pricing by reliable independent sources" (there are 500 WHO essential medicines).

In October 2019 QuackGuru edits MEDMOS in support of James's article-lead pricing, and edit wars over this (see Barkeep's timeline). A long discussion begins WT:MED, mostly involving James and Colin. CFCF makes a personal attack on Colin. James posts about the pharmaceutical industry suppressing medication price information and then accuses Colin: "That you are pushing the industry position to try to WP:CENZOR Wikipedia is concerning." James goes on to create a subheading "Knowledge equity" where he expands his advocacy case. . The discussion continues on the MEDMOS talk page. Here QuackGuru says "NOT does not apply to medical content." (presumably referring to WP:NOT). James argues that relying on "the popular press" would lead to a US bias (presumably referring to WP:NOTPRICES policy requirement for mainstream media sources). JzG raises a concern about making the RFC conclusion watertight.

After over a month's gestation and much discussion, the RFC opens on 23 January 2020. James argues that prices are critical to human health and hyperlinks to an advocacy organisation's story: "Secret medicine prices cost lives". James tries to dismiss that WP:NOTPRICE ever had consensus. James selectively quotes WP:NOTPRICE. QuackGuru says readers may want to compare prices to other similar drugs. BlueRasberry argues that WP:NOT does not apply here and that he is not concerned about current article content. Later he makes a further dismissal of WP:NOT. BlueRasberry notes his previous employment relationship with Consumer Reports.

The RFC closes after two months on 27 March. A few editors remove price content from a few articles. The prices are restored by James, and edit warring occurs (see Barkeep's timeline). On 13 April, James criticises the RFC and those who drafted it.

Doc James reverts and edit wars on drug prices

User:Colin/PriceEdits contains all edits on drug prices on 530 articles since 2015. They were all added by Doc James. Attempts to remove prices are swiftly reverted by Doc James, occasionally aided by Ozzie10aaa and QuackGuru.

• Abacavir remove restore after 16 minutes.
• Aciclovir remove restore after 7 hours
• Ampicillin remove restore after 6 minutes
• Aspirin remove restore after 4.5 hours
• Buprenorphine remove restore
• Buprenorphine/naloxone remove restore after 16 hours remove restore after 15 hours remove restore after 1 minute
• Cholecalciferol remove restore after 4 minutes remove restored next day remove restore next day remove restore next day remove restore six minutes.
• Clarithromycin move to body restored to lead next day.
• Clindamycin remove restored next day.
• Condom remove restore
• Emtricitabine/tenofovir remove restore after 9 hours.
• Ethosuximide remove restored after 5 hours.
• Gabapentin remove restored after 5.5 hours.
• Gentamicin remove restored after 5 days.
• Ivermectin Massive edit war involving Doc James, Ozzie10aaaa, QuackGuru vs Ronz and Seraphimblade. See User:Colin/PriceEdits#Ivermectin.
• Lactulose reduced restored next day revised restored after 9 minutes.
• Metformin remove restored after 45 minutes.
• Methocarbamol remove restore.
• Risperidone remove restore.
• Salbutamol remove restore after 3 hours.
• Simvastatin Edit war involved Doc James and Ozzie10aaa vs WhatamIdoing, SandyGeorgia, Graham Beards, Hipal/Ronz, Seraphimblade. Examples: remove restore after 17 hours remove restore after 3 hours remove restore after 1 hour remove restore after 13 minutes.
• Thiamine remove restore after 3 hours.
• Valaciclovir remove restore after 5 days.
• Valproate remove restore after 6 days.
• Vitamin C remove restore after 14 hours

Response to evidence by Ian Furst

Ian Furst, I cannot find a single time when I have been critical of you personally. I have been critical of VideoWiki, which has largely been promoted by James, but that is content plus a set of tools, and we clearly disagree on its merits. My only personal interaction with you I can recall is when we crossed paths in 2013 over an issue (with another editor) at Water fluoridation, an article that I played a minor role in aiding Eubulides to get to FA. I gave you some friendly advice about potential COI in an article you were drafting and you thanked me for helping a newbie.

Wrt VideoWiki criticism, here are just a few examples of issues in articles today.

• Each of the following videos have <font> tags visible in the Closed Captions, and have done since they were created a year ago: HIV/AIDS, Cholera, Cystic fibrosis, Polio, Hypertension, Influenza, Malaria, Multiple sclerosis, Sepsis, Urinary tract infection. [Note: this was fixed by James after my post. An example of the problematic timed-text can be found at commons:TimedText:Wikipedia-VideoWiki-Hypertension.webm.en.srt.]
• Any images included in the video that are square or portrait-shaped, are squashed to 16:9 landscape. Examples at 2:18 of HIV, 1:24 of Cholera, 2:28 Cystic fibrosis, the first two frames of Polio, a very squashed pregnant lady with Hypertension at 2:34 who also has Malaria at 2:04. The archive footage at 0:32 of Multiple sclerosis is so vertically distorted as to appear barely human. The worst is really the poor little lad at 2:23 of Sepsis. [Note: this was somewhat fixed by James after my post. The video now contains images in the correct aspect ratio, but behind them is a blurred stretched version of the image which is often quite distracting, for example the lead frame at Sepsis. ]
• Major_depressive_disorder has an upside-down photo. You can even see it on the script page. [Note: this was fixed by James after my post.]
• There is a video, which I won't name here, that in the very first frame identifies by name a person with a socially stigmatising disease. The source image was taken down on Commons with a DMCA notice after lawyers contacted WMF, citing the distress it was causing their client. James commented at Commons on the case, and patched up the article lead image after its removal. The image was removed by Commons-delinker from the VideoWiki script. However, the VideoWiki video still contains it seven months later, and is still present on a major article that gets about 5000 hits every day (I can email diffs/links to arbs)

WP:NOTYOUTUBE warns about the problems that occur because the scripts and videos have nearly nobody watchlisting them. They clearly also have nearly nobody watching them either. The above presentation errors would all have been quickly spotted and resolved if they had occurred in articles or with still images, yet are still present a year later. Ian accuses me of "hyper-critical remarks about the quality". Judge for yourself. Would we accept HTML tags all over article content, or thumbnails with terribly squashed people in them, or images that even after they are legally removed from the wiki text, are still rendered to viewers of the page seven months later? -- Colin°^Talk 21:43, 21 April 2020 (UTC)

Wrt Simvastatin, Ian Furst says pricing long preceded Doc James and was "Always with allowed sources". Partly true. The diff Ian supplies shows that User:Rod57 added the price unsourced in 2008. In fact, it took Rod57 four years to get around to adding the reference! Simvastatin in 2008 represents the very normal and policy-compliant situation where Wikipedians comment on the tiny minority of drugs with notable cost. As the first major statin to come off-patent in 2006, it was a very attractive generic, especially compared to the blockbuster atorvastatin, the biggest selling medicine of all time, which was still expensively under patent. Atorvastatin's patent expired in 2011 and today it is (in the UK) almost identical in price to simvastatin. So for those few years between 2006 and 2011, the relative cost difference between the two drugs was notable and did indeed get coverage in "mainstream media", which WP:NOTPRICES requires. Today, though, simvastatin is just another generic statin. The cost/benefit arguments of having a percentage of the population on prophylactic medication is true of all such statins, and not specific to that one drug. The argument for Wikipedia specifically discussing the (relative/absolute) price of simvastatin is today hugely weaker than it was in 2008.

The real change that James, encouraged by Blue Rasberry, introduced and enacted alone, was to routinely add prices to all drug articles, to do so at length in the article lead, and to conduct original research and cherry-picking of product database records to invent a treatment cost that no secondary source mentions. -- Colin°^Talk 16:53, 23 April 2020 (UTC)

Doc James does not write about cost, he adds factoids

When James removed the constraint on adding price from both medical style guides (see above), User:Johnbod objected, saying "I'm in favour of discussing it where it is exceptionally high, & discussed as such in sources (see above), but we do not want people adding the (inevitably) USD prices of standard cheapish out-of-patent drugs, & proposing their favourite sources etc. Or international tables... Something needs to be added to say so." and warned "I don't think we should just remove all MOS controls on the topic. Inappropriate factoids often get added by well-meaning editors, & editors need a simple MOS reference to quote when removing them.". How precient. After the most recent RFC a couple of test edits were made to remove some database-sourced prices from two articles (see Barkeep's evidence). James restored those prices and expanded on the cost section in the body with yet more prices: Simvastatin and Ethosuximide. I shall discuss cost text in the workshop/analysis. James's edits demonstrate not only a disregard for consensus but a poor and ultimately harmful approach to adding content to Wikipedia, which frequently brings him into conflict with editors. This isn't article writing, it is just factoid insertion.

Response to evidence by RexxS

• While we all agree a "price" is a numerical value in some currency, RexxS suggests that "pricing information" means "general prose descriptions like 'relatively inexpensive'" There is no evidence presented that any editor has considered that meaning before, and it seems unlikely to catch on since "information" can be presented in many ways, verbally or numerically. Strictly, "pricing" is a verb, and refers to the process by which companies and health systems agree on a price to charge and pay. But editors have clearly used both words to refer to numerical prices in articles. As a general topic, we all agree that drug pricing merits articles. The conflict, until very recently, has been nearly exclusively over the inclusion of numerical prices in articles, and I suggest the RFC and its closure was primarily interested in such prices. I suggest that if there is uncertainty about what an editor or closing admin meant by their choice of words, that they be asked. The issue of using adjectives or relative prices has received comparably little discussion, and the hasty addition of such clauses into article leads by James, followed by the creation of two poll-style RFCs, is part of the reason why this Arbcom was instigated. The issue of describing drug costs verbally needs further work.
• RexxS offers only two NOTPRICE interpretations, but does not supply any evidence that any editor holds them. I am not aware of any editor who thinks "no prices or pricing information relating to drugs should be in Wikipedia". Nor am I aware of any editor who has suggested or protested against the kind of price comparison service RexxS describes. One editor has proposed adding an external link to GoodRX in the infobox, but not gone as far as to suggest Wikipedia offer that service today. BlueRasberry, James and QuackGuru have all strongly advocated that Wikipedia should be a price comparison service between drugs: that American readers may discover that WonderStatin is cheaper than SuperStatin and be empowered to ask their doctor for a cheaper prescription.
• RexxS's description of editor-interpretations of NOTPRICE is significantly lacking in the aspects that many editors have felt to be vital. Cherry-picking of only some of this policy, or at times the denial it even exists (as James, Ozzie and BlueRasberry have all done), is what brings us to Arbcom.
• Wrt the 2016 closing statement, RexxS appears to make a fundamental error of logic. I shall expand on this in the Workshop, but essentially WP:NOT is about not doing things, and one cannot use it to suggest we are therefore compelled to do some things. There are further obstacles to including text on Wikipedia, not least WP:WEIGHT.
• Wrt the 2020 closing statement, RexxS quotes only a minority of points. In addition to the removal of prices from the lead, the closing statements made it clear (first and second bullet points) that prices derived solely from drug product database are not permitted -- they need to come from secondary sources that include commentary on the significance of that price. This, at a stroke, means nearly all the prices James has added to drug article leads should be removed, and not transferred to the body as James did. Since the main focus of that RFC was on prices derived solely from a drug product database, it is notable that this key finding is being overlooked by some.
• The statement "Since the 2020 RfC closed, prices have been systematically removed from the lead of articles" is not supported by any evidence. I am aware of four articles where editors removed prices from the lead, shortly after the RFC closed. There are 540+ articles with such prices.

Atorvastatin

• 30 March. User:Graham Beards removes prices from the lead, edit summary: "deleted drug "cost" from the Lead as per RfC". This RFC closed saying prices should not be in the lead and prices should not be solely sourced to drug product databases, which two prices here (US and UK) were.
• 30 March. User:Doc James restores the prices to the body, and adds a statement "Atorvastatin is relatively inexpensive" to both the body and lead, citing a textbook. The edit summary "adjusted" is the same one James used in conflict to restore prices to Ethosuximide and Simvastatin. The database-sourced prices should not have been restored.
• 1 April. User:Hipal asks on talk "How about removing all mention of pricing from the lede per the RfC and the content policies cited there?"
• 2 April. User:Hipal asks again "Any objections to my removing it from the lede per RfC and policies?"
• 4 April. User:Hipal removes "and is relatively inexpensive" from the lead, edit summary: "per recent RfC, pricing information in lede is almost never appropriate - nothing here demonstrates it is one of the few exceptions"
• 4 April. User:Hipal notes his removal on talk.
• 4 April. User:Doc James reverts Hipal with Twinkle, edit summary "No support for this". Admin Doc James is now edit warring.
• 4 April. User:Doc James comments at talk "Of course plenty of objection and we have a RfC here Talk:Simvastatin#Clarification_of_RfC were support is overwhelming."
• 22 April. User:Seraphimblade reverts James, edit summary "WP:NOPRICES as well as an explicit RfC." Admin Seraphimblade is now edit warring.
• 22 April. User:RexxS reverts Seraphimblade, edit summary "revert removal of sourced information per Wikipedia talk:WikiProject Medicine/Archive 84 #Price of medications. This is not a price". Admin RexxS is now edit warring.
• 22 April. User:RexxS writes on talk "Following a unilateral decision to remove the phrase "and is relatively inexpensive", I have restored it." Rexx introduces his novel distinction between "price" and "pricing information" (the former being numerical and the latter textual, according to RexxS).
• 22 April. User:Seraphimblade reverts RexxS, edit summary "Mentions of cost are price, and are covered by the 2020, not 2016, RfC. "Inexpensive" is mentioned only in passing by one source in a brief blurb. That is not the type of in-depth coverage the new RfC requires for lead inclusion, which is why it has repeatedly been removed. It stays out". Admin Seraphimblade continues to edit war.
• 22 April. User:RexxS reverts Seraphimblade, edit summary "Don't edit war - there is an open talk page discussion that you have not engaged in". Admin RexxS continues to edit war.
• 22 April. User:Hipal says on talk "RexxS, you're edit-warring. Your interpretation of the RfC has no consensus."
• 22 April. User:RexxS says on talk "Hipal your partisan stance is already well-known. The edit warring was begun by Seraphimblade when they redid their bold removal of content which was reverted. I am editing in accordance with consensus; they are not. I already know what belongs in lead sections."
• 22 April. User:Hipal on talk objects to being dismissed.
• 22 April. User:RexxS on talk RexxS appears frustrated that Hipal does not accept RexxS's terminology, which he says originated with Hipal: "The differentiation between prices and pricing is absolutely clear, and you're the one who made it." RexxS says to Hipal: "I no longer believe you are making a good-faith attempt to resolve differences". RexxS warns: "I'll continue to edit according to policy."

Doc James: Solo Performer

The areas where James brings himself into greatest conflict are where he makes widespread controversial edits, without seeking or gaining consensus, by stealth and editing alone rather than in collaboration with others.

Osmosis videos

James, in his evidence, states that "Rich content, such as video, was the second most requested improvement in the 2015 readers survey" What we don't know, because they weren't asked, is if this rich content is "The article subject as a seven minute video in a lecture format aimed at Canadian medical students, top and tailed with promotional logos and links for a subscription learning platform." It could instead be readers wanted interactive features (BMI calculator), animated diagrams or short video clips, something all of us agree on. User:Colin/OsmosisEdits documents the edits made to add or remove the Osmosis videos to 308 articles. Only 21 additions (7%) had the meaningful edit summary "added video"; 152 (50%) have the meaningless "added"; 124 (41%) are blank and 9 (3%) suggested other activity. These videos were added by James without community approval and by stealth.

If you need a reminder of how awful they were, try File:Candidal infections.webm, where it opens with a !hilarious joke about Candida vs Canada. Oh, yeast infections are always a great source of much needed humour in an encyclopaedia. Or try File:Breastfeeding.webm, where it opens with the claim that breast milk has all the nutrients a baby needs for the first year of life. In fact, all medical authorities state solid foods should be weaned from 6 months. Or try File:Tic Disorders.webm, where listeners are introduced to the DSM-5 tic disorders and told individuals with these disorders all suffer from tics. But DSM-4's "suffer from" was dropped like a hot potato from later editions after an outcry from experts, researchers and patient groups.

These videos were not there to supplement our articles with illustrative clips, but to entirely replace the need to read them, justified by the pseudo-scientific woo that some people are "visual learners". They were not scripted by or composed by a community of editors working on an online platform open for anyone to edit. They were created by a private company who want to sell subscriptions to their training videos. As RexxS notes in his evidence, when editors started trimming off the promotional top and tail, relations with Osmosis soured. Wikipedia has always been firmly against sponsored content and advertisements; James introduced it to over 300 high profile articles without asking.

Translation task force

The English-Wikipedia part of the Translation Task Force is James. It has been a source of conflict with English Wikipedia for many years. It mainly affects article leads, for that is all that gets translated. Conflicts include an early push for all medical articles to use the same few citation templates (other Wikis don't have our variety), the forcing of excess citations into the leads, the dumbing down of our leads to make translation easier (apparently), or the insertion of material into the leads alone (e.g. drug prices).

As James notes in his evidence, James has simplified more than 1300 leads. This task-force page has been used by James, from June 2014 to the present day, to tick off each article as he works on it. To see what goes on, you need to look at the date of the "Simplified" link. Carbamazepine was simplified on 28 March 2015. If you look in the history of Carbamazepine on this day, you see James began editing at 23:02 and stopped at 23:52. He then copied the lead over to the Simple Carbamazepine page that gets translated. The steps follow this pattern:

• The paragraphs in the lead are re-ordered per James's preferred order.
• Sections missing from the lead are summarised and included.
• Citations are added to the lead even though they aren't needed. Occasionally sources updated.
• The language is simplified or dumbed down, depending on your POV.

You'll find this for every simplified version. The Wikipedia article lead is adjusted by James to conform to the needs of the Translation Task Force and then forked to produce a petrified Doc-James-approved version that is later translated.

Drug prices in leads

This is well documented elsewhere in the evidence. User:Colin/PriceEdits lists 530 articles with prices in the lead. With hardly any exception, all the prices in leads were added by James, sourced to drug product price databases. He began this task without asking anyone if adding the prices to the lead met community approval, and when in 2016, after adding 100, he did ask, he didn't get consensus to continue adding them. Yet he still did. And here we are at Arbcom.

Other

There are 500 medicines in the WHO Essential Medicines list. This binary fact was added by James to every such drug lead as: "It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system."

The Top 300 Drugs from ClinCalc.com have had their US sales rank and prescription totals added by James to the end of the lead with the sentence "In 201_, it was the ____th most [commonly] prescribed medication in the United States, with over ___ prescriptions". These two data values, if of note, seem more appropriate for an infobox than in prose. In the lead, it should surely have to be more notable (e.g. in the top 20, or the biggest seller of its class of medicine).

Doc James: Dumbing down Wikipedia

Examples

• Carbamazepine edited

• "is an anticonvulsant and mood-stabilizing drug" changed to "is a medication".
• "was discovered by chemist Walter Schindler at J.R. Geigy AG (now part of Novartis) in Basel, Switzerland, in 1953" (body text) added to lead as "Carbamazepine was found in 1953 by the Walter Schindler".

• Ethosuximide edited

• Infobox "routes_of_administration - Oral (capsules, oral solution)" changed to "routes_of_administration - by mouth (capsules, solution)"
• "is a succinimide anticonvulsant" changed to "is a medication" + "Ethosuximide is in the succinimide family of medications."
• Short stubby sentences: "Side effects are generally minimal." -- "Ethosuximide is taken by mouth." -- "How exactly it works is unclear." -- "Ethosuximide is avaliable as a generic medication."

• Valproate edit

• "is an acidic organic compound that has found clinical use as an anticonvulsant and mood-stabilizing drug" changed to "is a medication"
• Short stubby sentences: "Long acting formulations exist." -- "It is unclear how valproate works."
• "Valproic acid was first synthesized in 1882...In 1962, the French researcher Pierre Eymard serendipitously discovered the anticonvulsant properties of valproic acid...It was approved as an antiepileptic drug in 1967 in France..." (body text) is condensed for the lead to "Valproate was first made in 1881 and come into medical use in 1962".

• Ibuprofen edit edit

• After the opening sentence, James added a series of sentences about NSAIDs and ibuprofen's side effects which are not a summary of the body, but come from a new source: "About 60% of people improve with any given NSAID and it is recommended that if one does not work that another should be tried, Ibuprofen may be a weaker anti-inflammatory than other NSAIDs. Compared to other NSAIDs it may have less side effects such as gastrointestinal bleeding. At low doses it does not appear to increase the risk of myocardial infarction; however, at higher doses it may. It may result in worsened asthma." The source (BNF) says patients "respond" rather than personally "improve" as the article claims. There's a lot of "may" here. The source says its "anti-inflammatory properties are weaker", not "may be". The source says "fewer side-effects" and we have "less side-effects", which grammar pedants won't like. Wrt risk of myocardial infarction, it is odd here that James has not substituted "heart attack". For higher doses we are told "it may [increase the risk of MI]". A "risk of" is already a "may" situation, and the source is in no doubt of the association with increased risk. The final sentence is stubby and is a good example of the vague use of "it" throughout this paragraph. Ibuprofen doesn't cause heart attacks and make your asthma worse sitting on your bathroom shelf. This is a pill many of us will take occasionally, whereas some people will take it regularly, for arthritis, say, and here the reader could do with knowing what "it" might give you a heart attack.
• "synthesised" changed to "made".
• In the second edit, the lead paragraph gains "It may also be used to close a patent ductus arteriosus in a premature baby." Most readers won't have the first clue what a patent ductus arteriosus is, it doesn't have a reader-friendly name, and it is complex to explain how ibuprofen (given IV) might help close this. This factoid really doesn't belong here.
• Short stubby sentences: "It can be used by mouth or intravenously. It typically begins working within an hour." Here we have the weird "used by mouth" rather than the idiomatic English "taken orally".

• Hepatitis B edit edit

• The Epidemiology section concludes with a statement, added by James, that "In the United States about 19,000 new cases occurred in 2011 down nearly 90% from 1990". This makes the confident claim that these cases actually occurred and that 19,000 is an approximation to the real figure. The source gives a figure of 18,800 so it is a reasonable approximation. But crucially, it is actually an estimated value. The actual number of cases reported to the CDC in 2011 was only 2,890. They then take into account underreporting of cases and asymptomatic infection to mathematically calculate and estimate the likely true incidence. The latest figures for 2017 give the number of reported cases as 3,409 and the estimated number of infections as 22,200 and importantly their confidence interval is 12,600 to 54,200. That's a big range: it could be half this or over twice this. This lack of correlation with what our sources really say, is unfortunately a common feature of James's edits, and naturally is a source of conflict among editors trying to make sense of the Covid19 pandemic. We also saw it with the drug prices, where figures were claimed to be approximates but were actually given in four figures to the cent, and the method of calculation, involving cherry-picking records, meant they were effectively just random numbers.
• The two terms that any readers of an encyclopaedia section on disease epidemiology have to understand are incidence and prevalence. We cannot shy away from those words. The careful writer uses them in a way that the reader can infer their meaning, even if they are unfamiliar with them or get them confused. James's edit removed both words from image captions. "Prevalence" was replaced by "Frequency" and "Incidence rate" with "New cases of". Not only have we now got captions that use different terminology to the body text, but they are simply wrong. Both incidence and prevalence are measures of frequency (the frequency of new cases occurring over a time period and the frequency of current cases respectively) so this replacement muddies what measure the map is telling the reader. Both are typically expressed as a rate (e.g., per 100,000 people) rather than a total figure for an entire country. Therefore the substitution of "incidence rate" with "new cases of" is completely incorrect.

Observations

In James's evidence, he cites "a published analysis" on the "Readability of English Wikipedia's health information over time". What James neglects to mention is that this paper was co-written by James himself and published at our own WikiJournal of Medicine. The paper relies on readability formulas, which are a peculiarly American pseudo science. Naively simple algorithms, designed before A.I. was a thing, count long words and sentence length and perform some dubious maths to concoct a score corresponding with an American school grade. The article Readability Formulas: 7 Reasons to Avoid Them and What to Do Instead by Jarrett and Redish provides a good overview of their problems and how good writers focus on something other than a grade score generated by a computer. Even if we accept the claim that easy and difficult texts are correlated with lower and higher scores, it does not follow that lowering the score means the text is easier to read and understand or that is engaging in any way.

Wikipedia, as a hyperlinked encyclopaedia is different from text that must simply be understandable or enjoyable: it is primarily educational. Part of that educational role is to teach readers or give them confidence with words they don't know or are unsure about. We can do this with definitions like a dictionary, but the primary way people learn words and learn how to use words is to see them used in context in high quality writing. Writing accessibly about complex subjects, as many areas of medicine are, in a way that draws the reader in and holds them requires some talent and skill. What can you do if you lack these? You can improve the readability score in several mechanical ways: remove or replace words or concepts you think are hard, write short stubby sentences, and dilute the difficult stuff with more text. James does all of these.

• In Carbamazepine, Ethosuximide and Valproate articles, the class-of-drugs -- "anticonvulsant drug" or "mood-stabilizing drug" -- is just removed and we are only told it is "a medication". We are simply no longer teaching the reader something that had a multi-syllable word.
• In hundreds of Wikipedia articles, the idiomatic English "taken orally" has been replaced by James with "is used by mouth". This is such a weird expression. Oral might not be an everyday word, but it isn't university-level either. Any parent will have used an "oral syringe" to give a child Calpol. It isn't a "mouth syringe". Our readers expect us to use the proper words, and not be patronised: "oral medication" is a thing.
• In the leads, new chemicals are no longer "first synthesized", they are "first made". But chemical synthesis is a thing. It is a specific kind of making. New drugs are no longer "discovered", they are "found". Like a chemist just came across them in the street, or perhaps had lost them the day before. But drug discovery is a thing. You cannot learn about chemicals and drugs without appreciating these terms.
• When preparing the leads for the translation effort, James may expand the lead by summarising article content. He doesn't research the topic and improve the body -- the body isn't touched. This is low-hanging fruit: summarise what is already there.
• The leads are then augmented with boilerplate sentences about WHO Essential Medicines, US sales rank and prices in several regions of the world. The reading age of the lead goes down because none of this extra padding is teaching you any new concepts.

The article I linked earlier gives a good example of the flaws of naively simplifying words just because they appear technical or advanced. The authors decided to replace the official term "Security Deposit" (we even have a wiki article on it) with "Promise Money", thinking this was easier for their audience of "low-income, low-literacy tenants". But these adults knew the term "Security Deposit" already, even if individually the words "Security" and "Deposit" are financial jargon; they were perplexed by "Promise Money", even though "promise" and "money" are simple words.

Evidence presented by Ozzie10aaaa

Good faith effort/discussion

• Talk:Ethosuximide#RfC demonstrates a good faith effort on Doc James part to discuss whatever issues, however if you read the text the RfC is rejected--Ozzie10aaaa (talk) 23:27, 7 April 2020 (UTC)

SG

• 1.response to SandyGeorgia,.....yes I often keep an eye on Doc James due to his Wikipedia:WikiProject_Medicine/Stats/Top_medical_editors_2019_(all), as a consequence I try to chime in on any medical articles he may be on (AFTER READING, AND DECIDING WHAT IS BEST FOR ARTICLE), he is an elite editor and therefore I try to learn as much as possible from him. However I do not always agree w/ Doc James as SG noted on their post or on many occasions I simply do not give an opinion, thank you--Ozzie10aaaa (talk) 19:42, 20 April 2020 (UTC)

2.SandyGeorgia has been BLOCKED before for Personal attacks/Harassment...is something that should be taken into consideration--Ozzie10aaaa (talk) 17:33, 21 April 2020 (UTC)

Hi Sandy, I've just blocked you for this edit. Accusing others of sockpuppetry without providing evidence is a personal attack. You have been warned not to do this in the past on multiple occasions ([114][115]). If you wish to retract the allegation or provide evidence, I will be happy to life the block. Mark Arsten (talk) 16:17, 25 June 2013 (UTC)[116]--Ozzie10aaaa (talk) 21:51, 27 April 2020 (UTC)

3.Per SG...GA written by others at Wikiversity but attributed to Ozzie10aaaa on Wikipedia...I would answer this however???(this is an example of the above comment #2 personal attack/harassment), thank you--Ozzie10aaaa (talk) 21:27, 27 April 2020 (UTC)

Colin

• 1.reponse to Colin,...…(see above answer to SG, thank you)--Ozzie10aaaa (talk) 19:47, 20 April 2020 (UTC)

2.copied from the Main page response...... (With regard to Colin's indication ...I agree w/ Doc James, it should be checked in my edits that 1. I have on several occasions "agreed w/ WAID [WhatAmIDoing]" (on other articles/matters) , 2. as well as many other editors...I don't/never will write a "wall of text", I usually keep it simple, 3. and most important I don't always agree w/ Doc James, therefore I do not support/do not comment on the article/matter whatever it might be, thank you--Ozzie10aaaa (talk) 13:43, 2 April 2020 (UTC))--Ozzie10aaaa (talk) 20:29, 20 April 2020 (UTC)

3.Wikipedia:Administrators'_noticeboard/IncidentArchive1025#User:ColinWikipedia:Administrators'_noticeboard/IncidentArchive1025#User:Colin On 12/5/19 I opened ANI for incivility--Ozzie10aaaa (talk) 00:56, 26 April 2020 (UTC)

4.SG/Colin interaction...as you may note (in the above #3), SandyGeorgia responded in defense of Colin within 30/40 minutes of my ANI post, furthermore the committee may be interested in interaction timeline between the two, going back some time, thank you--Ozzie10aaaa (talk) 16:06, 26 April 2020 (UTC)

Evidence presented by bluerasberry

Conduct, not content, is the source of conflict

The nominal subject of this case is "inclusion of prices of drugs in Wikipedia articles". I feel that there has not yet been civil discussion on this topic.

Evidence presented by Hipal/Ronz

Doc James has added pricing information to the lead of hundreds of articles

Judging from my own sampling (User:Hipal/scope), as well as that of Colin (User:Colin/ExistingPrices and User:Colin/PriceEdits, included in his evidence), Doc James has been adding pricing information to hundreds of medicine articles. It appears to include all of Category:World Health Organization essential medicines (currently 463 entries), minus the few (nine?) entries that are not specifically medicines). My sampling has found articles not Colin's list (Artesunate/mefloquine (edit | talk | history | protect | delete | links | watch | logs | views) and Artesunate/pyronaridine (edit | talk | history | protect | delete | links | watch | logs | views)).

Doc James has added pricing information only to the lead of most of these articles

Doc James, with extremely few exceptions, has placed pricing information only into the article lead.

Content problems in pricing information added by Doc James

As seen in User:Colin/ExistingPrices, User:Colin/PriceEdits, User:Colin/PriceMistakes, and in the WP:MEDMOS2020 RfC; the pricing information added by Doc James is rife with content violations. There are widespread WP:V/WP:OR problems in the way data has been used, interpreted, and presented. Pricing information is being given undue weight. Cherry-picking of information is common, mostly for RECENTISM purposes. Doc James' focus is to present recent pricing information, without regard to pricing history.

Content dispute in Ivermectin

The dispute at Ivermectin started as concerns over including pricing information in the lead of the article:

• [117] removed on 6 September 2019 by Hipal with edit summary: "NOPRICES, especially in lede - maybe in article body with proper context? Please avoid linkspam refs"
• [118] This material was initially added on 16 January 2016 by Doc James with the edit summary "added"
• [119] The content expanded by Doc James the same day with no edit summary

Behavioral problems at Ivermectin

The edit-warring and other problems at Ivermectin are well documented. I want to highlight my first interaction with Doc James in this dispute:

• I start the discussion by focusing on policies (NOT, POV, and MOSLEAD) [120]
• Doc James' response is to revert with the edit summary "It was fine"[121] and comment that price is important for medicines in general, and that there are efforts to censor such information [122]
• I ask for it to be removed from the lead if sources are not available. I ask for any wide consensus for such edits to be identified. [123]
• Doc James' response is to ignore my requests and to instead mention industry lawsuits about pricing in commercials for medicines in general. [124]
• I ask for sources, but the ones provided in response do not mention Ivermectin
• I respond, If you are trying to have an exception to NOT and POV so we start adding prices for medication articles in general, this is a poor way to try to do so. Better if you started with a medication that's notable for it's pricing
• After getting no further response, I ask for a third opinion.

This small interaction demonstrates what appears to be typical behavior by Doc James:

• Poor edit summaries, dismissive of any discussion or dispute
• Lack of response to requests
• Avoiding mention of related discussions and consensus, even when specifically called to do so
• A general lack of understanding of policies, guidelines, and general consensus as it applies to the situation
• Advocating for pricing information for medicines in general, without regard to relevant policies, guidelines, or general consensus
• A battleground mentality toward efforts to apply policies and guidelines to the situation

Related behavioral problems at IPhone 11

• IPhone 11 (edit | talk | history | protect | delete | links | watch | logs | views)
• At the Ivermectin talk page, Doc James identified IPhone 11 as an example of pricing in another article. [125]
• I remove the content from IPhone 11 "per NOPRICES, POV" [126]
• Doc James restores it because it has "been in the article a long time" [127]

An RfC was starting, resulting in "Consensus is against including a chart that includes pricing information of the iPhone 11 in various countries." [128] In the discussion, Doc James once again cites an essay for the inclusion of the information while ignoring policy. [129]

The behavior here demonstrates that Doc James, QuackGuru [130], Ozzie10aaaa [131], and Bluerasberry [132][133][134][135] take their behavior beyond medical articles to support their pov about pricing information.

Related behavioral problems at User talk:Doc James

• User_talk:Doc_James/Archive_157#Prices_for_medications
• Doc James continues to selectively ignore past RfCs, policy, and consensus. Instead he once again refers to the essay [Wikipedia:Prices.https://en.wikipedia.org/w/index.php?title=User_talk%3ADoc_James&type=revision&diff=918879676&oldid=918876780]
• Doc James does not respond to my multiple requests asking him to stop edit warring.[136][137]
• Doc James once again offers a BATTLEGROUND explanation and justification for his editing We know that the pharmaceutical industry is trying really hard to hide medication prices with ongoing legal cases in the United States.[138]
• Doc James does not respond to my question about what was brought up in the 2016 RfC.

Related behavioral problems at Wikipedia talk:What Wikipedia is not

Wikipedia_talk:What_Wikipedia_is_not/Archive_57#Clarification_requested_for_product_pricing_(Sales_catalogues)

• Doc James starts with, "The prices of medicines and transparency around them is key to public health per NGOs such as UNICEF[139] and MSF[140]. These groups are working to improve transparency in this area. Many within the pharmaceutical industry are trying to decrease transparency around medication prices with lawsuits currently ongoing in the US.[141] We are not censored obviously. " [142]

• "Further concerns with respect to attempts to suppress this information, an account that was pushing to remove medication prices from buprenorphine/naloxone has just been blocked for undisclosed paid editing" [143]

• He ends with, "Every essential medicine has extensive coverage / discussion of its pricing by reliable independent sources." [144]

Again, Doc James expresses a BATTLEGROUND mentality, and the need to RIGHTGREATWRONGS. His solution is to declare that every essential medicine has the necessary sources for the inclusion of pricing information.

Disputes upon closure of MEDMOS2020 RfC

• Atorvastatin (edit | talk | history | links | watch | logs)

• Ethosuximide (edit | talk | history | links | watch | logs)

• Pyrimethamine (edit | talk | history | links | watch | logs)

• Simvastatin (edit | talk | history | links | watch | logs)

• Trimethoprim/sulfamethoxazole (edit | talk | history | links | watch | logs)

Doc James has continued to add pricing information during this arbitration

• Addition to Sulfasalazine on 13 April [145]
• Expansion at Febuxostat on the 15th [146], Salbutamol on the 12th [147]
• Rework and expansion in Methocarbamol on the 14th [148]

Evidence presented by {D A Patriarche}

Against including any pricing info

I was not aware of edit warring; I am glad to have it drawn to my attention. I had assumed the widespread insertion of pricing info was evidence of GF & WP consensus, & bowed to what I took to be policy. However, I am strongly against including this information, most especially in the lead. Some of my arguments were published on the Methocarbamol Talk page: Talk:Methocarbamol#Marketing - cost in 2018-19, but received no response from Doc James or any other editor.

Methocarbamol is a drug of particular interest to me, partly because it's a "poor sister" to contemporaneous drugs such as the benzos. It's very widely prescribed and taken OTC but comparatively little research has been published. Because of its enormously wide use OTC, especially in analgesic compounds for back pain, the "pricing" information seemed particularly egregiously misleading to me. I am a former medical biophysics researcher with a continuing interest in the field. --D Anthony Patriarche, BSc (talk) 05:03, 13 April 2020 (UTC)

Evidence presented by Jorge_Stolfi

Distortion of Wikipedia's goals

I have clashed with DocJames on several articles.
For one thing, he seems to have decided that he "owns" articles on pharmaceuticals, and proceeded to edit them according to specific idiosyncratic rules, with a rigid layout for the head section; and shows little tolerance for views of other editors. Most pharmaceuticals are also chemical substances, however he insists that the corresponding articles be cast as "pharmaceutical articles", in his standard "pharmaceutical" format and with a "Drug" infobox instead of a "Chemical" infobox. In at least one case, ascorbic acid, the article had to be split in two, one about vitamin C as a drug, and another one as chemistry of ascorbic acid -- instead of placing that contents as separate sections of the same article.
Another problem is that he has sought to organize the articles on medical drugs according to the WHO list of essential medicines. In vain I tried to explain that Wikipedia is not meant to mirror the content or organization of external databases, even if authoritative (which that list is definitely not).
Finally, he insists on listing the market price in the head section of every drug article. While that information does not seem to have commercial motives, it is inappropriate for Wikipedia because it is ephemeral, may vary a lot from country to country, and is better obtained directly from external sources rather than from Wikipedia. My attempts to remove those lines were promptly reverted by DocJames, ignoring my justifications.
More than a complaint about DocJames's behavior, this comment of mine should be read as a complaint about the attempts of many editors to turn Wikipedia into a federation of partial encyclopedias, each managed by a clique of editors of one specific WikiProject, who assert "ownership" of those articles and thus act as if their preferences had priority over those of other editors.
Wikipedia would be infinitely better if all WikiProjects were closed and their guidelines deleted, if every topical sidebar or navbox like {{Template:Thermodynamics sidebar}} was eliminated from individual articles and turned an index section in the main article of the topic.
Also, every infobox like {{Template:Infobox drug}} should be reduced to a button that the reader had to click to expand into the full box. Then an article on something that is both a chemical, a drug, a fuel, and a foodstuff could have all four infoboxes -- instead of only one, arbitrarily chosen.
However, there does not seem to be a space in Wikipedia where those systemic diseases could be discussed...
--Jorge Stolfi (talk) 07:41, 13 April 2020 (UTC)

S Marshall's evidence

On another RfC within the scope of WP:MED

On electronic cigarette: Doc James reverts my changes and suggests I could try RfC. I began the RfC Doc James suggested on the same day. Doc James expressed confusion about what the RfC was asking. I explained, and please will Arbcom also note from that diff where I specifically asked Doc James to slow down and read attentively (emphasis in the original diff). Cunard closed the RfC with consensus for the changes I proposed. Doc James then claimed (on my talk page) and claimed (on the article talk page) that he thought the RfC that I'd begun at his suggestion was about a pipe link.

Analysis

Doc James isn't basically an obstructive editor, although he does display an awful lot of confidence in his own judgment. And this isn't a deliberate tactic to exert control and ownership of article content. His behaviour does have that effect, but it's not intentional. It's because his attention is spread so thin. His watchlist is so big, and he's active on so many pages, and he makes so many edits per day, that he can't follow the sequences. Therefore he doesn't make the connections that would be obvious to someone more focused.

With hindsight, my RfC could have been more clearly-worded, although nobody else who participated experienced any confusion.

Evidence presented by FeydHuxtable

SandyGeorgia, Colin & Doc James are serious editors, we're extremely lucky to have them. So it's distressing to see them squaring up on a board that traditionally see's a decisive winner.

SandyGeorgia and Colin were amazing MEDS editors

Back in Jan 2019 I noted it would be good if Sandy & Colin returned to being "leading lights on the MEDS project. " . That was based on considerable attention to their work (as explained here.)

Sub optimal time to launch attacks on Doc James

As others have noted, this can be seen as a conduct dispute. Given the nature of submissions so far, this case is no longer just about drug prices. The outcome has a bearing on the Docs future participation in senior roles.

Granted, theres much valid criticism that could be levelled at the Doc and his crew, S Marshall's point is an excellent example. Yet medicine is an especially challenging area. Articles have an above average potential for harm, aggravated by motivated editing from cranks & shrills. So little wonder a group of "good" editors with clique like qualities emerged. It's not easy to diff, but on balance the current MEDS team seem a huge net positive – and article quality likely to suffer if they're taken down.

What can be easily demonstrated is that Covid is causing abnormal stress to editors with the most relevant real world expertise. This mirrors real life where nurses have took their own lives due to the stress. At least two editors with RL expertise in infectious disease recently expressed a desire for a permaban or courtesy vanishing, which the young doctor later clarified as partly due to Sandy & Colin.

Some have said if folk have time to edit war over prices in articles, they have time to discuss. That would be fine if this was just about prices, but as above the fate of outstanding editors seem at stake. Even though she's a party to this case, Sandy has already laid out 8 remedies for Doc James and his crew, which in context seem severe. Talk about being previous, the evidence phase hasn't even closed, the Doc might change his position. Sandy's multiple edits to the case these last few hours suggest she's on a mission. Jytdog may have been overly aggressive, but his resignation to the community at his Arb case was angel like in comparison. Granted, knowing some of the history, Colin and Sandy's recent actions may be justified. There's literally > 1000x to this than there was to the portal case, so it's hard to form an accurate opinion. Hence not posting many diffs against them, though it would be easy to build a submission suggesting they're more at fault than Doc James. IMO it's currently not realistic to expect the community to carefully attend to this. It's to be hoped the side too busy saving lives to properly defend themselves isn't rewarded with severe sanctions.

Evidence presented by AlmostFrancis

Response to evidence by SandtGeorgia (SG)

SG claims that their is a direct conflict of interest between Wikipedia and WPMEDF as it pertains to encouraging colleges to give academic credit to Wikipedia work. SG then gives a list of reasons that would seem to fit better with the Feautured Article process, which as far as I know has never been considered a COI. SG give no evidence to support her assertion about WPMEDF and as far as I an tell the assumption would be that the article would be edited in the standard way.

Evidence presented by Barkeep49

Timeline of MOS Dispute

• July 28, 2006 WP:MEDMOS created as a proposed guideline
• April 29, 2007 MEDMOS becomes a guideline with Colin and Sandy Georgia each having contributed substantially to the writing.
• April 8, 2008 First mention of drug cost/pricing on the guideline talk page (discussing what scenarios it would be included)
• July 16, 2010 WhatamIdoing introduces language about not including drug pricing following a discussion at WikiProject Pharmacology
• September 4, 2015 Doc James removes the prohibition in MEDMOS on including drug pricing linking to a discussion at the Pharmacology WikiProject
• May 15, 2016 Doc James starts an RfC at WikiProject Medicine to include pricing in medication articles. References three prior discussions: [149] [150] [151]
  • July 9, 2016 jc37 closes the RfC with the close of Except in the cases where the sources note the significance of the pricing (which did have consensus), there is no consensus to add the pricing to the articles. There were several ways to present this information proposed in the discussion (such as wikidata). Please feel free to start a follow-up discussion regarding that.
• September 30, 2019 Doc James makes a change to the guideline saying pricing/costs may be included if reliably sourced
• October 1, 2019 QuackGuru creates a new section on product pricing in MEDMOS expanding on James' language.
  • A series of edits [152] [153] [154] [155] by Doc James and QuackGuru ensue about placement and wording.
  • October 11 WAID further adjusts the wording and formatting of the pricing section
• November 14, 2019, after not having edited the guideline for just over 6 years, Colin makes a series of edits that changes multiple sections of the guideline including article titles, LEAD, and product pricing.
  • QuackGuru reverts Colin's change to product pricing minutes later.
  • Over the next 5 days QuackGuru makes a series of further changes in response to Colin's edits, including one to product pricing whose edit summary is Add neutral worded content. See WP:CIR.
  • November 21, 2019 DocJames further reverts some of Colin's changes.
• November 21, 2019 QuackGuru opens a discusson at Talk page for WikiProject Medicine about MEDMOS.
• December 5, 2019 01:15 Ozzie10aaaa opens an ANI thread reporting Colin for incivility and excessive pinging of Doc James.
  • December 5, 2019 09:08 NilEinne proposes an indef block of Colin. There is some support but a majority oppose.
  • December 5, 2019 10:50 Colin proposes a TBAN on Doc James from drug pricing. There is a little support but a strong majority oppose.
  • December 6, 2019 10:33 Guy proposes a four point plan for moving forward. There is nearly unanimous support.
  • December 7, 2019 19:53 Barkeep49 closes thread enacting Guy's proposal and adding two implementation notes as closer.
• December 8, 2019 Kashmiri removes the product pricing section.
  • QuackGuru reverts two minutes later.
  • Peter coxhead reverts three minutes after that.
  • Barkeep49 fully protects the guideline 22 minutes later.
• December 21, 2019 Tryptofish creates a proposed 2020 RfC format
  • December 26, 2019 Tryptofish creates a second 2020 RfC format draft which is publicly shared January 2nd.
• December 22, 2019 SandyGeorgia launches an RfC on the guidelines for the lead
  • January 28 Ymblanter closes the RfC as no consensus.
• January 1, 2020 WhatamIdoing proposes an 2020 RfC structure
  • After discussion and revision this would be the template for the 2020 RfC which is launched
• January 7, 2020 Barkeep49 updates AN on the dispute both on the 2020 RfC and conduct. This includes asking for closers.
  • Over the next few weeks, Ymblanter and Wugapodes volunteer to be closers.
  • January 20, 2020 Rosguill responds to a plea from WhatamIdoing to be the sysop to certify the 2020 RfC is neutral
• January 7, 2020 Casliber launches an RfC about the order of sections in the guideline
  • February 9, 2020 Cunard closes the RfC as no change.
• January 23, 2020 Barkeep49 launches the 2020 RfC on pricing
  • March 7, 2020 Ymblanter marks the 2020 RfC as closing
  • March 27, 2020 Wugapodes closes the 2020 RfC

Closing statement

* Editors are generally opposed to inclusion of prices in the lede. While basic calculations are not considered original research, the pricing statements in the examples require interpretation of primary sources that may not be straightforward. This makes the editorial claims difficult to verify, and especially so for drugs whose prices are not widely discussed in published sources. In addition, there are concerns that proper explanation of the situation for the indicated price would give the price undue weight. There is no consensus on whether drug prices should be included in articles at all. Where secondary sources discuss pricing extensively (insulin being a frequently cited example), that information may be worth including in the article; where there is little discussion of pricing in secondary sources, it generally should not be included. Drugs which fall into the grey area between these extremes should be discussed on a case-by-case basis. Where pricing information is included, claims should be sourced to reliable, secondary sources and not solely primary source data from price databases. Whether to include prices in the infobox was not widely discussed but is unlikely to find consensus. Arguments against inclusion in the lede would similarly apply to inclusion in the infobox, and editors should be aware that inclusion of prices in the infobox is likely to be opposed in most cases. Thank you to everyone who participated!

• • The closing would end up with several clarifying statements by the two closers
• January 24, 2020 Barkeep49 removes full protection from the guideline.
• January 25, 2020 Barkeep49 topic bans AlmostFrancis under discretionary sanctions from all Medical MEDMOS discussions broadly construed for this comment.
• March 28, 2020 Colin opens a discussion about the 2020 RfC at the WikiMedicine Project
  • Discussion remains ongoing

Post RfC Case Study: Simvastatin

March 28, 2020 WhatamIdoing removes information from Simvastatin citing the RfC March 29 Doc James in a series of edits adds information about the drug being low cost cited to a new source and also starts a talk page discussion about the new source March 30 Graham Beards reverts citing the RfC About 3 hours later Doc James reinstates the revert and further adjusts in a series of edits 25 minutes later Hipal partially reverts Doc James 5 minutes later Hipal starts a discussion at WikiProject Medicine about Doc James addition 5 minutes later Doc James adds new pricing information 55 minutes later WhatamIdoing replies to the talk page discussion disagreeing with Doc James 12 minutes later Doc James replies 14 minutes later Doc James opens an RfC about the disagreement Just over an hour later Seraphimblade reverts citing NOPRICES and information unsupported by the reference 15 minutes later Ozzie10aaaa reverts Serphaimblade 4 minutes later Sandy Georgia requests page protection at WP:RFPP 1 minute later Sandy Georgia reverts Ozzie10aaaa citing the RfC 13 minutes later Ozzie10aaaa reverts Sandy Georgia 7 minutes later Sandy Georgia tags the disputed information A couple hours later Whywhenwhohow adds additional price information 40 minutes later Ymblanter fully protects for three days

• March 30, 2020 Barkeep49 requests an ArbCom Case be opened
  • April 7, 2020 the case is formally opened
• April 12, 2020 Doc James removes the disputed tag around the LEAD in the guideline
  • 43 minutes later Sandy Georgia reverts
  • 4 minutes later Doc James restores and opens a discussion on the guideline talk page
  • April 13 Colin removes a sentence
  • 41 minutes later Sandy Georgia makes further changes to the section
  • April 14 Sandy Georgia adds a citation needed tag
  • April 15 Doc James adds a reference to address the citation needed tag

QuackGuru History

• Block log includes:
  • 5 editwarring blocks
  • 3 disruptive editing blocks
    • 1 additional disruptive editing blocks where the block sysop accepted an unblock request
  • 2 Personal attacks or harassment: continued disruptive editing, edit warring, harassing other editors blocks
  • 3 Arbitration enforcement blocks
  • 1 overturned indef block
• July 23, 2011 topic banned from pseudoscience and chiropractic, broadly construed, for one year.
• October 6, 2015 topic banned from acupuncture
• November 17, 2015 warned by ArbCom about e-cigs
• April 19, 2016 topic banned from Vani Hari and the talk page for 3 months
• August 23, 2017 topic banned from all articles and edits related to religion, broadly construed by the community

Observations

For a case with 14 parties ultimately we're here because of Doc James' insistence that pricing belongs in the articles of hundreds of drugs. On its own this isn’t a problem. What is a problem is that he has taken what can, in the reading most sympathetic to his point of view, be read as a lack of consensus from two different RfCs (2016 and 2020) and used that to justify his actions. I am also not aware of any incidents where Doc James respected a removal of the information. Every instance I am aware of, when information has been removed the removal has been reverted frequently but not always by Doc James. Plainly speaking over the years of this dispute the group of editors that have wanted to see this information included has been more aggressive in their stance than those who don't think it should be included (or at least not included as widely as it has been). This group is also larger numerically among the "regulars" of WikiProject Medicine than those who oppose its inclusion. This had, in my opinion, the effect of making those opposed to its inclusion more aggressive in discussion which has had its own negative side effects I'll discuss later.

Since the 2020 RfC ended I am unaware of James, and others favoring inclusion, adding it to new articles and am aware of those who think it should be removed attempting to do so (see Atorvastatin, Ethosuximide, Pyrimethamine, Simvastatin). However, when following these limited removals - all by different editors -  there was no engagement or discussion. It was revert and then when/where discussion was opened a bit of a rush to an RfC.

I found this rush to the RfC particularly troubling for a couple of reasons. First James had not really engaged in any meaningful way with the formulation of the 2020 RfC. Now I think this could be defended because editors who did object to the way the RfC was being formulated were brushed aside or were unwilling to hold-up the RfC and also tended to come into the conversation one at a time rather than ever being present as a "group". So to the extent James finds fault with the RfC, substantial participation, outside of comments on January 6, in formulating it could have meant a lot. It's frustrating to read him complain after the fact, despite entreaties for participation beforehand.

The rush to RfC at two of those areas is also troubling because it seems to suggest that RfCs are a substitute for discussion which, as our Dispute Resolution policy reminds us, is Talking to other parties is not a mere formality, but an integral part of writing the encyclopedia. Discussing heatedly or poorly – or not at all – will make other editors less sympathetic to your position, and prevent you from effectively using later stages in dispute resolution. (emphasis added) Except there really isn't a way that later stages, in this case RfC, are prevented by not discussing. Instead after a widely attended and commented on RfC, centrally notified, was closed having two local RfCs, while overall discussion was underway about what the centralized RfC meant, was not an effective method of dispute resolution. Especially when the RfCs opened were so explicitly set up to encourage voting rather than discussion (which thankfully and to his credit, Doc James did walk back). Having multiple simultaneous RfCs is, as WAID has noted, troubling in its own way and something for which there is some history here.

However this seems to be a reaction to the style chosen by those opposing price inclusion. Lacking in numbers among the regulars they have turned to discussion. This works fine for some editors - WhatamIdoing seems to be respected by all and engage in useful conversation with all. But it works less well for other editors; namely Colin. Colin rightly prides himself on having been a driving force behind the creation of MEDRS and an important editor in the creation of MEDMOS. He also prides himself on never reverting a second time. He can also rub editors the wrong way (diffs introduced to show for Doc James, Tryptofish, and RexxS). On the whole Colin is willing to walk back comments that cross the line of incivility. In fact in my experience when asked every editor in this dispute was willing to do so (examples: [1] [2]).

I think there is a fair comment to be made that Colin can bludgeon a discussion (3 4). However, WP:BLUDGEON is an essay. So despite being commonly used, so common it became part of the December 2019 ANI consensus and close, there's not actually well developed behavioral practices around it. So telling someone how to bludgeon is easy (say less in fewer edits) but showing when they've cross the line is something I cannot do with any confidence and I don't think any sysop can beyond a "I know it when I see it" criteria which again doesn't help an editor know when they've crossed a line between helpful participation and bludgeoning. Case in point: the second BLUDGEON diff I offered above shows that WAID was closely behind Colin in terms of bytes and ahead of him in number of edits but no accusations of bludgeon has been directed towards them. Why is this? I have my theories but they're just that. So to the extent that Colin causes consternation with bludgeoning I think it's on the community to refine that term if they want to see BLUDGEONing sanctioned.

Beyond the points about Colin and Doc James I haven't really observed anything that rises to the level of an ArbCom FoF or remedy from any of the involved editors individually.

Evidence presented by Graham Beards

Doc James acts as though he his exempt from our policies

Here is an extract of a comment I wrote in 2018 [156] and it is sad to note that nothing has changed.

"He (James) has a cavalier attitude to the core principles of Wikipedia and collaborative contributing. He seems to think consensus means agreeing with him and never considers for a second that he might be wrong. His arrogance knows no bounds. He is difficult to work with and often doesn't bother with edit summaries. It seems to me that James strives to dumb down Wikipedia when others strive to improve it as a solidly reliable source. Our policies on verification and so forth have done us proud. James's hard work and apparent popularity must not be used undermine and negate our core principles".

All of this is still happening. The lack of edit summaries, or worse, the untruthful ones are a particular concern. He reverts edits with the summary "adjusted". As he did here [157] when I deleted a vague comment about the cost of atorvastatin (a drug I have to take every day and turned to our article for other information).

With regard to our coverage of the coronavirus pandemic, which to be frank was worse than poor to begin with, I had to point out to the Medicine Project that a pandemic was actually happening and that our less experienced editors were alone at the helm! When James and other Med Project members finally came to help all regard for WP:MEDRS was left behind and Facebook and Twitter were being allowed as sources.[158]

James seems to think that he is above his peers (e.g. me) in a (non-existent) Wikipedia editors pecking order. Graham Beards (talk) 18:24, 19 April 2020 (UTC)

James' oversimplified prose

James has invited us on this page to comment on his writing style. He includes Rotavirus vaccine on a list of articles he has "improved". I started this article and many of you will know that the virus is of special interest to me. The Lead of this article is a paradigm of James' excessive dumbing down. It consists of piecemeal factoids and has no flow. And here's a diff with typical fundamental grammatical error. [159] (quote "the current versions is not").

For another example, here's a direct quote from an uninvolved editor writing at Talk:Coronavirus disease 2019/Archive 1#Doc James obsession with oversimplifying these articles to the point there are unreadable:

"User:Doc James seems to have an obsession with over-simplifying articles to the point that the majority of English speaks find these articles unreadable and stupid...The facts of the matter are that anyone who doesn't speak fluent English isn't going to seek medical advice or information in English, they will seek information in their own language. Please stop over-simplifying these articles to the point that they are becoming useless for the majority of the population."

And another editor here Talk:Coronavirus_disease_2019/Archive_2#The_standard_of_English_being_used_in_these_articles:

"Trying to read in simple English is cumbersome and doesn't flow easily. It conveys too little information across more words and is generally more vague. We are presuming that any reader of normal Wikipedia would have reasonable literacy skills and would have come across healthcare information before, so there's no reason to remove "normal" words from this article...I think that anyone who is unable to read in normal English should be guided to the Simple English Wikipedia."

I am also interested in hepatitis B – which I worked up to GA many years ago and is still on my watchlist. Presumably in the belief that an understanding of two fundamental concepts, "incidence" and "prevalence", in epidemiology, are not needed by our readers, James "simplifies" them to "frequency" and "new cases" [160], which is completely incorrect. They are proportions and are usually given with a population denominator (e.g. per 1000 people). James then says he understands the terms on the talk page [161] but the evidence is to the contrary in my mind. Whenever James' name appears on my watchlist, I have to check what he has done.

Added misleading cost prices to Rotavirus vaccine

In this edit [162], James added the prices of rotavirus vaccines. These were incorrect. He wrote "The wholesale cost is between 6.96 and 20.66 USD as of 2014." But in 2014, the cost of the Rotavac vaccine course of three doses in India was Rs. 162 (about 2 USD). What was worse was James' addition changed the focus of the article to cost prices and numerous later additions by others to the article were of questionable neutrality in this regard. When one editor added that the costs were widely variable, James reverted with a dishonest edit summary [163]. The cost-benefit analysis of vaccine programs is complex to say the least. (See for example: "Re-evaluating the cost and cost-effectiveness of rotavirus vaccination in Bangladesh, Ghana, and Malawi: A comparison of three rotavirus vaccines". Vaccine. 36 (49): 7472–7478. November 2018. doi:10.1016/j.vaccine.2018.10.068. PMC 6238205. PMID 30420039. {{cite journal}}: Cite uses deprecated parameter |authors= (help)). To add prices to this article (based on a source that is not WP:MEDRS compliant) was irresponsible.

(Since writing this, James has updated the article, but the "prices" are still given. [164])

In vaccination programs and schedules the cost of the vaccine is just one, often minor, component of the overall cost. There is the cost of administration and whether or not it can be given in combination with other vaccines, storage and the strict maintenance of a cold chain, shelf-life and other practicalities that have to taken into account. These all vary with location, which can be village-to-village in remote areas. It is impossible to quote an accurate cost, even as range, in an encyclopedia.

Evidence presented by RexxS

The disputes need to be seen as philosophical, not behavioural

Unusually, I'd like to present narrative testimony, rather than a series of assertions about behaviour. I do this because I continue to believe that attempts by ArbCom to understand the issues will be distorted if they view the case solely through the lens of a behavioural dispute. I also believe that a better understanding of the proper scope of this case case requires a full understanding of its history and context.

First of all, I contend that the vast majority of parties to this case are respected, long-term editors who have made considerable contributions to the field of medicine on Wikipedia over many years. It should be taken as a given that every single party's foremost aim is to improve Wikipedia, although there exists a wide range of opinion on how that is best achieved. I'll supply metrics on editor contributions if anyone wishes to challenge my initial contention.

Secondly, I contend that there is a broad philosophical difference on the question of innovation on Wikipedia. There are not two distinct camps, but there is a spectrum of affinity to two distinct positions: one which wishes to preserve the established encyclopedic conventions of highest quality, sourced, textual content, supplemented by images; and another which wishes to experiment with new formats, new outlets for content, and new sources of information. For what it's worth, I see that same difference of philosophy not just in the medical field, but I'll confine my evidence here to medicine.

Finally, I contend that where some editors push hard to innovate on a particular issue, a flash-point often occurs where other editors resist the changes involved. This is partly due to differing philosophical leanings, and partly due to problematical personal interactions, and I acknowledge my own inability to work with some editors, where I just seem to "rub them up the wrong way". I'll adduce examples of where these flash-points have occurred over several years, and I'll give my understanding of what was happening.

Background

I'd like to make clear my own background: I've been editing for more than 12 years. I have some expertise in technical issues and hyperbaric medicine. I am a founder member of WikiProject Med Foundation, now known as Wikimedia Medicine (WMMED) since it was granted thematic organisation status as an international affiliate to the Wikimedia Foundation (WMF). I have served as secretary to WMMED and now am privileged to serve as its chair. For six years, I've also been a trustee of Wikimedia UK (WMUK), the UK chapter affiliated to the WMF. I maintain that I have no conflict of interest between either of those affiliates and my contributions to the English Wikipedia, because the affiliates' aims are aligned by their constitution with those of the Wikimedia movement. Nevertheless, the members of WMMED are international, and represent many different countries and languages. That predisposes them to taking a different view on innovation from editors working principally on a single Wikipedia.

Translations

One of the first tasks undertaken by WMMED was to identify a number of vital health articles, and then to translate them into as many different languages as was possible. An organisation called "Translators Without Borders" partnered with WMMED to do translations, both on a rolling programme and on demand whenever a medical emergency occurred in a region where there was little Wikipedia health information available in the local languages. The first target was to translate the lead section of those vital articles as widely as possible.

That presented consequences such as the problems caused by a lack of sourcing in the lead of articles, which needed to be carried over to the short translated articles being created in multiple language Wikipedias. That lead directly to initiatives to source the lead section of medical articles and the advice in WP:MEDLEAD to provide citations. Similarly, the advice to keep language simple and to make sure that the lead contained a comprehensive overview of the topic were partially driven by a desire to make the translations as rapid, accurate and comprehensive as possible.

That naturally created a tension with other editors who wanted to see the guidance in MEDLEAD match that in MOS:LEAD. That has recently produced edit wars over the wording, multiple debates on the talk pages and eventually an RfC.

• Wikipedia talk:Manual of Style/Medicine-related articles/Archive 10 #Not writing for patients or professionals – debate over reading levels
• Wikipedia talk:Manual of Style/Medicine-related articles/Archive 10 #LEAD redux – list of lead-related discussions from Wikipedia talk:Manual of Style/Medicine-related articles/Archive 9
• Wikipedia talk:Manual of Style/Medicine-related articles/Archive 10 #Lead – argument over wording
• Wikipedia:Manual of Style/Medicine-related articles/RFC on lead guideline for medicine-related articles – "Should WP:MEDLEAD be in sync with WP:LEAD?"

Internet-in-a-box

Another initiative by WMMED was a partnership with Internet-in-a-box (more detail at meta:Internet-in-a-box), which aimed to make available Wikipedia's medical content in a number of languages to areas where no internet access existed. A device was produced that used a tiny computer working as a wireless access point and serving all of the medical content via Kiwix (a WMF sponsored project to distribute content offline on small memory cards). That was used in many places throughout the third-world, and found use as part of emergency response to disasters where the infrastructure had been destroyed.

While working on VideoWiki last year (see next section), we were presented with evidence that multimedia presentations such as videos had far better results in communicating health information for people who could understand spoken English, but not read it. Hardly surprising, of course, but it lead several of us to conclude that there would be extra value in including videos in content delivered offline (where the target audience is often poor in reading English), even when consensus was against placing such videos on the English Wikipedia. As a compromise, I created Template:OnlyOffline which excluded its content from the online Wikipedia, but allowed it to be read and delivered offline by readers like Kiwix. Believing that the template would have general use, I requested a CSS class be created at

• MediaWiki talk:Common.css/Archive 18 #Styling for offline content (July 2019)

The use of the template was challenged at its talk page. It started cordially, but descended into unpleasantness, spilling over into criticism of the VideoWiki project and the Internet-in-a-box project in general:

• Template talk:OnlyOffline #Uses (August 2019)

That lead to a lengthy and rather acerbic proposal to delete the template:

• Wikipedia:Templates for discussion/Log/2019 September 2 #Template:OnlyOffline

Videos

As stated above, WMMED looked at evidence indicating that readers who don't have English as their first language often respond better to short video clips to summarise key medical information. At present, YouTube is the biggest publisher of such clips and it's a jungle, with fringe medicine and dangerous advice being afforded equal footing with evidence-based medicine. That lead to an attempt to source good quality short video clips that gave an overview of various conditions.

As far back as 2013, there was an exploration of the possibility of using Khan Academy's videos in a collaborative venture, but it came to nothing as we couldn't overcome the copyright problems.

• Wikipedia talk:WikiProject Medicine/Archive 41 #Khan Academy

Osmosis

A commercial company called "Osmosis" produced about 300 video clips and released them in April 2017 under a CC-BY-SA licence suitable for Commons. They can be found at c:Category:Videos from Osmosis. When some of these were used in Wikipedia articles, objections were raised in March 2018:

• Wikipedia talk:WikiProject Medicine/Archive 110 (yes - the whole archive)

The initial complaints were that the Wikipedians were unable to edit the videos, that the facts were not verifiable, and that the videos contained an advert for Osmosis at the start and end. I did my best to answer these objections by editing some of the videos and removing the first few and last few seconds. Compare File:Abscesses.webm and File:Abscesses 1.webm, for example. Osmosis were unhappy with the derivatives and it soured relations.

• Wikipedia talk:WikiProject Medicine/Archive 112 #Osmosis's attribution requirement

Eventually an RfC was started, which resulted in the decision to terminate the collaboration. James removed all of the videos used on Wikipedia.

• Wikipedia:WikiProject Medicine/Osmosis RfC
• Wikipedia:WikiProject Medicine/Osmosis RfC #Update - the decision

VideoWiki

The issues identified with the Osmosis initiative led James to look for a collaboration that could deliver videos that could be created by Wikimedians from a script. The idea was that the script would be editable by anybody to update and add references. By July 2018 a working version of a tool was added to wmflabs and a documentation page created on Meta. The latest versions are at:

• Videowiki
• meta:VideoWiki

In November 2018, a WikiProject was set up, dedicated to working on collaboratively created videos:

• Wikipedia:WikiProject Videowiki

This was announced at WTMED in February 2019 and received considerable feedback, particularly concerning the accessibility of subtitles, but sadly the discussion descended into acerbic dialogue.

• Wikipedia talk:WikiProject Medicine/Archive 122 #Video Wiki (long)

A post talking about the New England Journal of Medicine's increasing use of videos also sparked a negative response:

• Wikipedia talk:WikiProject Medicine/Archive 129 #NEJM Quick Take as an example of proliferating video culture

In January 2020 a complaint was made about the small number of editors actively engaged in creating videos:

• Wikipedia talk:WikiProject Medicine/Archive 131 #VideoWiki -- the multimedia encyclopedia that nobody edits

Drug pricing

There is considerable friction between editors on the questions surrounding the inclusion of the pricing of drugs on Wikipedia. This extends to basic issues such as terminology, where some editors make a clear distinction between "price" (meaning a numerical value like "$0.25 per mg") and "pricing information" (meaning general prose descriptions like 'relatively inexpensive"); while other editors believe these terms to be completely interchangeable.

NOTPRICE

Wikipedia has a policy, often referred to as WP:NOTPRICE, which is part of part of Wikipedia:What Wikipedia is not, that states:

Wikipedia articles are not ... Sales catalogues. An article should not include product pricing or availability information unless there is an independent source and a justified reason for the mention. Encyclopedic significance may be indicated if mainstream media sources (not just product reviews) provide commentary on these details instead of just passing mention. Prices and product availability can vary widely from place to place and over time. Wikipedia is not a price comparison service to compare the prices of competing products, or the prices and availability of a single product from different vendors or retailers.

This has been taken by some editors to mean that no prices or pricing information relating to drugs should be in Wikipedia, because databases of prices don't indicate significance, and prices vary over time and location.

Other editors believe that this section is to prevent Wikipedia becoming a price comparison service where the article on Acme Manufacturing Inc lists all the prices of the widgets that it sells; or from content where an editor tabulates the prices of widgets offered by numerous different manufacturers. The assertion there is that the cost of a drug is an encyclopedic topic relevant to the drug and should be included in the article when reliable sources discuss it.

RfC 2016

To address some of the conflict surrounding drug pricing, an RfC was created by James in May 2016 to examine consensus for the inclusion of pricing in medical articles, and he gave examples of where prices could be found:

I have been including pricing information in medication articles. We have a good source here that gives the price range found internationally and in a number of countries in the developing world. Often the variation between prices is less than 5 fold. I have also been providing the US price as presented in this book but there are other good options. The US is not only a large portion of the EN speaking population but a large percentage of our readership. Also most other countries are somewhere between the global price and the US price.

• Wikipedia talk:WikiProject Medicine/Archive 84 #Price of medications

The Rfc was well attended. Opinions differed very strongly, and discussion was extended. The close by Jc37 concluded:

Except in the cases where the sources note the significance of the pricing (which did have consensus), there is no consensus to add the pricing to the articles. There were several ways to present this information proposed in the discussion (such as wikidata).

This notes a consensus to add pricing to articles where the sources note the significance of the pricing.

Many editors (myself included) believe this is the consensus that governs the issue of drug pricing (as opposed to prices) in Wikipedia articles. This is very much in line with the sort of sourcing that applies to any aspect of a medical topic on Wikipedia.

Current interpretations of this RfC range from a belief that it has been entirely superseded by a later RfC to a belief that it allows drug prices in articles whenever a secondary source discuses the significance of the drug's pricing.

RfC 2020

The breadth of interpretation of the 2016 RfC left detailed questions unresolved, in particular the issue of having drug prices in the lead of articles. The drafting process of the RfC was extensive and not all editors were happy with the wording. Eventually Whatamidoing created a draft, which was edited between 2 January 2020 and 23 January 2020 when Barkeep49 launched it as an active RfC. Links to details can be found at

• Wikipedia talk:Manual of Style/Medicine-related articles/RFC on pharmaceutical drug prices

The RfC settled on a format of a question, followed by a commentary on the International Medical Products Price Guide, and three examples of drug articles which contained wholesale prices (per month or per day or per dose) in the lead. The question posed was :

These examples of drug prices for generic pharmaceutical drugs have been taken from the leads of articles. Do you think that this content complies with Wikipedia's standards for verifiability, due weight, no original research, what Wikipedia is not, and how to write a lead section?

• Wikipedia:Manual of Style/Medicine-related articles/RFC on pharmaceutical drug prices

The Rfc was well attended (although personally, I was unhappy about the manner in which the debate was conducted and chose not to participate). Opinions differed very strongly, and discussion was very extended. The close by Wugapodes and Ymblanter has three principal conclusions:

Editors are generally opposed to inclusion of prices in the lede ... There is no consensus on whether drug prices should be included in articles at all ... Whether to include prices in the infobox was not widely discussed but is unlikely to find consensus.

Since then, there has been conflict over interpretations of the close and several questions asked of the closers.

• Wikipedia talk:Manual of Style/Medicine-related articles/RFC on pharmaceutical drug prices #Post RFC Addenda

Some editors have taken the decision to remove all mention of pricing from the lead of medical articles, and that has met resistance from editors who believe the RfC only addressed the question of prices in the lead.

RfC at Simvastatin

Since the 2020 RfC closed, prices have been systematically removed from the lead of articles.

In some cases, the RfC has been used as a justification for removal of any pricing information from the lead also, and in at least one case, the removal of an entire section on Cost from the body of an article.

Early on 30 March 2020, James began a discussion at Talk:Simvastatin #In depth discussion to establish that Simvastatin was a relatively low cost drug. Only Whatamidoing engaged in discussion with him. Later that day, the Cost; section was removed entirely from the body of the Simvastatin article. This section was restored and amended, and removed and restored by a variety of editors until fully protected. (for anyone reading the history: LMIC = low and middle income countries; ACA = Affordable Care Act.) Disagreement remained.

At the same time, the phrase "It is relatively low cost" was removed from the lead of Simvastatin. As a result, late on 30 March 2020, James opened an RfC at the talk page, asking the question

Should we state " Simvastatin is relatively low cost." at the end of the 4 paragraph of the simvastatin article?

• Talk:Simvastatin #Clarification of RfC

There was considerable consternation over James' initial request for each commentator to keep to their own section, and he was convinced to withdraw that stipulation.

The RfC is still open. It has attracted a good range of participants and there is considerable discourse, some of which is productive, but much of which consists of editors stating or restating a fixed position. Of course it is difficult to find a compromise with a binary question that requires a yes or no answer, but that has been a feature of the most recent RfCs.

For what it's worth the RfC is currently showing a sizeable majority of editors in favour of including that phrase in the lead. I believe that indicates that the majority of editors find the general topic of drug pricing encyclopedic, and that the previous RfC which addressed prices should not be used to remove a phrase like "It is relatively low cost" from the lead of articles. In my humble opinion, inclusion depends only on the due weight that the discussion in the body of the article gives to summarising that discussion in the lead (as it is for the summary of any other discussion in the article). If my opinion proves to gain acceptance, that will mean a decision would have to be taken on an article-by-article basis, but it will mean that the 2020 RfC can't be used to blanket-ban pricing information from the lead. It may be that acceptance that the 2020 RfC can't be extrapolated beyond its remit will go some way to reducing flash-points by focusing debate on the underlying principles and policies, such as WP:DUE and MOS:LEAD. I sincerely hope so.

Evidence presented by Ian Furst

Timing of this is horrible

Myself, and many others in HC, are deep in mitigation and management of COVID. I would participate more but my energy is needed elsewhere. Time for a meaningful debate is just not available even if we find time to comment on talk pages. The lack of a word limit makes this doubly-hard. Also, tensions are high for everyone right now due to COVID which may influence passions and positions.

Conflict:Content

I do not perceive the conflict on WP:MED any worse than other pages. In fact, I find it less partisan, more evidence based, and generally civil. Especially with the number of articles we collaborate on. I have no means to measure the conflict:content ratio but my perception is it's low.

WPMEDF

The Wikiproject Medicine Foundation’s mission is “To make clear, reliable, comprehensive, up-to-date educational resources and information in the biomedical and related social sciences freely available to all people in the language of their choice on and off line.”[165] not to somehow subvert the purpose of Wikipedia to an alternate path. Last year, we made an application through Gates to bring Wikipedia to war ravaged areas with Internet in a box. That is the work of WPMEDF (among many others). The WPMEDF has made no claims to MEDMOS, the goals of Wikipedia, and “WP:MED founding members” should have no claim on WPMEDF or it’s membership. I find it troubling that experienced editors, with a long history of editing without COI, should have to defend their charitable affiliations over what is, largely, a content dispute. I also worry about the precedent set if this line of argument is entertained.

Conflict scope is relatively narrow

The conflict is isolated to a few very niche areas of WP:MED. For instance, an edit and then the question, "Should we state " Simvastatin is relatively low cost." at the end of the 4 paragraph of the simvastatin article?" resulted in the current conflict. Yes, it's around pricing but if we accept that there is no community consensus for this, the statement itself (with a reference) is nothing compared to many of the topics dealt with in WPMED. Of the ?thousands of edits that are made and managed on WP:MED monitored articles, we do pretty well at building consensus. This interaction between James and Sandy from just 3 days ago is civil and closer to the normal[166].

Simvastatin case

With respect to current content conflict: pricing in the Simvastatin article has been present since 2008 [167] and long before Doc James. First as a cost/benefit issue then as an essential medicine issue. Always with allowed sources. The attribution to Doc James as the source of conflict are misleading in my opinion.

edit>>revert>>edit>>discuss>>RfC when other guidance fails

Regarding the broader content issue of discussing relative pricing; there is no consensus among WP:MED editors despite the RfCs, therefore, page discussions and RfC's have resulted. The path of edit>>revert>>edit>>discuss>>RfC is the prescribed process and Doc James (and many others) has followed it. See example in previous section; more available. Without community consensus this is the appropriate pathway to resolution of content issues imo.

Doc James will engage with anyone willing to discuss

I see a lot of blame being thrown at Doc James for not resolving conflict but he is following the rules and is an active content contributor to all of these articles. He does not claim ownership nor does he roll over when he disagrees with an edit. He has saved medical content from conflict of interest editing with bold edits. On the other hand, other editors, who have never contributed to a page make unsourced content changes then claim foul when Doc James reverts it. Just two examples already in evidence in this Arbcomm case:

• Doc James contributed to Atorvastatin regularly for 9 years only to have the pricing info deleted with the editor commenting "deleted drug "cost" fromm the Lead as per RfC"[168]. That was the editors only contribution to the article and now a claim that Doc James didn't leave an adequate edit summary in reverting that edit.

• Doc James contributed and edited Down Syndrome for a decade only to have an editor drop in and add an alternative name in the lead which he edited to the infobox[169]. A battle resulted about where this content should go (and is now cited as evidence about his incivility) without mentioning that the instigating editor appears to have no other interest in content creation on this page[170] except to see this single edit in the first sentence. I would urge Arbcomm to read the Talk page of this; Doc James started the discussion, started the RfC, and offers some very compelling arguments for his position. With that, the consensus is split and the added text is still in the first sentence. Regarding the "...we have a history of being the two most prolific medical editors on English Wikipedia" comment cited above (a) that is factually correct and (b) it was not braggadocious but in response to an editors dismissive response to Ozzie agreeing with Doc James.

Walls of text and changing questions in RfCs

A significant issue with building consensus is the use of walls of text and editors rapidly changing scope and context of (originally) pointed RfC’s...

• As entered in evidence above, and in answer to the question "Should the lead of ethoxuximide summarize the section on cost as "As of 2008 it was generally affordable in many areas of the world." by Doc James on Apr 5 (a modification from a previous sentence on March 31), I offered an answer[171] that is quoted as arbcomm evidence as "Ian Furst may not of realized he was answering the wrong question". When the flow of the talk page is reviewed[172] it can be seen my answer was in response to the RfC question. The critique (I believe) is aimed at the difference between the NOPRICE argument I discussed vs LEAD and WEIGHT. Left out, is that Sandy had originally opposed (the RfC in general) and the original sentence based on NOPRICE[173] then Sandy and Colin had left 2400+ word ‘updates’ under the RfC in which Sandy states, “...but don't mind if we mention relatively low cost in the body,”[174] and the conversation shifted to LEAD and WEIGHT without changing her opposed stance in the RfC above. Now, the insinuation is I’m a puppet for James after a thoughtful response to an RfC on a 13 word sentence.
• This RfC[175][176] on lead structure resulted in no consensus in large part because every piece of opinion (from me at least) was met with walls of text. At one point, we had a chart of 7 aspects of the lead with 4 positions. Unless you were willing to argue 28 points, consensus was impossible without dedicating full-time to the RfC, in an effort to follow the arguments. I felt that I spent a ton of time on that one RfC and still added only 6% to the text. SG, on the other hand, monopolized 50%. Another example of walls of text from Colin and SG are here [177] where multiple editors appear frustrated by their conduct, “I've had enough of this garbage. I am now taking this page off of my watchlist. Do not ping me or ask me to come back. --Tryptofish (talk) 00:03, 26 April 2018 (UTC)” or here [178], an RfC I purposely avoided knowing it would be an issue, and where 60% of the text is from WAID, SG or Colin.
• This RfC[179] which asked for acceptable wording suggestions resulted in a 1,900 word (initial) response from Colin without offering a suggestion on wording then subsequent walls of text each time James posted.

Other efforts to block content creation

Accepting that there is not consensus to add or removing certain drug prices, I believe that the walls of text we've seen in the discussions about MEDMOS, LEAD and Talk pages are designed to discourage and exhaust the editors who are attempting to add the content. This is based on my previous experience with Colin during his mission to stop VideoWiki[180]. To repeat, myself, James and Pratik came together for a 6 month push to make the platform Wikipedia compliant and engaging. At each stage of development and in almost any forum we needed to post, Colin would participate with 1,000+ word comments, links to his essay on his opposition to video, dismissive remarks about the project, hyper-critical remarks about the quality, and belittle stated reasons for the project. Examples can be found in the discussions about a namespace for scripts, templates for offline discussion, even congratulations on a Slate article and minor edits of related files on Commons. Constant critiques like, "...boring Siri slide show...", "...better of watching a video created by an Indian government agency...", "...glorified PowerPoint slideshows with tedious robot narration...", "...half-baked "solution" to a problem Wikipedia does not have...", etc... by the same person in multiple forums of Wikipedia is both exhausting and a little frightening. It certainly made me second guess posting in many discussions and it absolutely took much of the enjoyment out of volunteering for the project.

Summary

I hope this helps explain why myself, Doc James, and many others choose to engage with quicker edits, revisions, talk, and RfCs where a decision is needed. Normal discourse, in certain circumstances, is nearly impossible when Talk page discussions are met with walls of text, whataboutism, and constant modifications to the target issue. This should be enjoyable for all, and I applaud the deep engagement of all involved to the Wiki movement, however the vilification of James is misplaced imo and the tactics used to dominate discussions is pushing editors to the sidelines. Ian Furst (talk) 12:41, 21 April 2020 (UTC)

Evidence presented by Evolution and Evolvability

Conduct

I've found conversation on WT:MED getting heated way more frequently than other wikiprojects I've been involved in. This sometimes gets in the way of productive discussions, even when I think participants fundamentally agree. Writing FAs / improving lead readability / forming outside partnerships / video content / translation / offline content are presented as incompatible or competing in a way that sets up unconstructive friction and that I don't think is necessary (example discussion).

Since there are also a number of specific content questions being simultaneously brought up, I'm not sure getting into the details of content questions is really the point, but I'll briefly respond to a couple of comments above.

Pricing

To the extent that this is also about content, I've already commented in the earlier RfC that I think that including pricing in medical articles (drugs and others) is notable in most cases. I really don't think inclusion of medical drug prices is advertising or promotion (often the opposite).

Video content

The collaboration with Osmosis was a good idea, since video content is an under-utilised potential for a non-paper encyclopedia (and something I've found readers often bring up). However, the main problem was lack of editability such that a video with a single error had to be excised in its entirety and in the end all were removed (I imagine a bit disappointing for he contributors). Granular and collaborative video editing via videowiki was a reasonable response to this. I've not seen it unfairly pushed on anyone who doesn't want to contribute.

Encouraging academics to contribute to Wikipedia

Again, I think there are false dichotomies drawn between internal FA processes versus external quality assurance and academic outreach activities (Cochrane collab, journal publishing etc). Articles involved in these partnerships are not protected at a greater rate than others (as far as I can detect), and all participating partners are explicit that any content in Wikipedia is a) decided by the Wikipedia community and b) is expected to continually evolve.

Template

Since Template:Academic_peer_reviewed was also brought up here, I just want to add a couple of notes about it.

1. It's not a WPMEDF template, it's used for a range of articles (category), and indeed the dengue article is the only one of its kind for which that template is omitted.
2. The peer review performed by Open Medicine was not internal.

T.Shafee(Evo&Evo)^talk 06:54, 24 April 2020 (UTC)

Evidence presented by WhatamIdoing

I've been trying to figure out what the locus of this case is, and I don't think I've entirely figured it out. However, I think this might be useful for people to know:

No simple "sides"

It would be a mistake to classify most WikiProject Medicine editors as being wholly pro-prices or anti-prices. Most editors do not hold extreme views in either direction and support the inclusion of some price information without supporting the inclusion of some other price information.

As an example, since I removed database-sourced drug pricing from one article after the massive RFC on MSH's IMPPG database concluded that database-sourced drug pricing violates NOR, it might seem convenient for someone to paint me as being on the "anti-price side", but it's not true. Similarly, people might think it convenient to present Tryptofish as being on the "pro-price side", but I have long supported including more price content than Tryptofish (contrast, e.g., our views in the 2016 RFC). I removed this price because my understanding of the RFC outcome is that this is not acceptable. We should be suspicious of oversimplifications and us-versus-them sentiment.

NB that in this I apparently differ from User:RexxS, who seems to indicate that the first sentence of the first bullet point is a sort of topic sentence, and that everything else in that bullet is about what's acceptable in an article's lead but not the body. I believe that the second sentence is the key outcome for the RFC: "While basic calculations are not considered original research, the pricing statements in the examples require interpretation of primary sources that may not be straightforward." NOR bans the use of primary sources except when the interpretation is "straightforward". Content that violates NOR will still violate NOR even if it's cut out of the lead and pasted into the body.

History of the 2020 RFC on drug prices

To expand upon Barkeep49's #Timeline of MOS Dispute, I add:

• The 2010 advice in MEDMOS said "Do not include dose, titration or pricing information except when they are extensively discussed by secondary sources, or necessary..." [e.g., when understanding the next bit of the article requires knowing some of these numbers]. It was never a blanket ban. Note also that it expects secondary sources (e.g., one that analyzes changes in prices over time, or between countries, or contrasts the cost of one treatment with another), while NOTPRICES asks for an independent source (e.g., a passing mention in any newspaper article) plus a "justified reason" (undefined).
• In December 2019, ANI decided that the most salient problem was content and demanded an RFC on how to handle drug prices. Several editors spent the next six weeks talking about what the RFC should say. We considered multiple formats (e.g., a question with pro/con statements, a vote vs a discussion, etc.) and multiple questions (e.g., everything at once, a small question about content in the lead that isn't in the body, a proposal for what MEDMOS should say, etc.). The question we settled on was about whether the current price-related content that Doc James wrote using MSH's IMPPG database as the (sole) source (i.e., not including articles such as Insulin, which contain price content from other sources) complied with Wikipedia's guidelines and content policies.
  • I drafted the January RFC, but I can't claim any credit for the original idea of focusing on this source. I thought it was a good idea, because I thought that the narrower scope would let us build consensus and identify some best practices on a smaller, more objective question before trying to tackle more general, subjective points.
  • My own plan was to use the comments from this narrower question to develop a second RFC, at a later date, on what advice MEDMOS should provide. I still think this is needed, but so long as people can't agree whether "There is no consensus on whether drug prices should be included in articles at all" means "the WP:ONUS is on you to prove consensus to add anything about prices to any article" or "nothing's prohibited, so we can add as much as we want, and others have to prove that there's a solid consensus for removing it", then I don't think we're ready to proceed to general advice yet.
  • In December, ANI thought that clarity on the content questions was the key point, and I still agree with them. Looking at the behavioral issues, it appears that we might need the kind of clarity that leaves no room for judgment, like "every article about drugs must include some content from this database" or "the use of this database is banned in all articles", but I do think that clarity on the content issues, written in a way that is impervious even to a determined advocate, would solve the immediate problems.

Evidence presented by User:Some1

Behavioral issues by Doc James, QuackGuru, Ozzie10aaaa, and Bluerasberry extend beyond medicine-related articles

I see that Hipal/Ronz has added information regarding the iPhone 11 article to their evidence section. I want to expand on this a bit more since I participated in the RfC and saw several other problems that others have mentioned in their evidence that also pertains to this non-medicine-related RfC.

iPhone 11 timeline:

• 16:47, 27 September 2019 Hipal/ Ronz removes the Price table on the iPhone 11 article citing "per NOPRICES, POV"
• 16:28, 30 September 2019 Doc James shows up three days later and undoes Hipal’s edit, stating that this has "been in the article a long time” (Note: This was Doc James' first ever edit on this article)
• 17:51, 30 September 2019 Hipal undoes Doc James' edit a little more than an hour later “per NOT, POV - see user talk page”
• 18:00, 30 September 2019 QuackGuru shows up 9 minutes later, reverts Hipal, and re-adds the table with an edit summary of "Please start a RfC and consider pinging me when it is started. The prices improve this article per Larry Sanger's WP:IAR." (Note: this was QuackGuru's first edit ever on this article)
• 18:11, 30 September 2019 Discussion begins on talk page with QuackGuru supporting the prices
• 18:22, 30 September 2019 11 minutes later, Doc James joins in and also supports per WP:PRICES (So far, there's only Doc James and QuackGuru supporting the price table, and Hipal and Yamla opposing the price table; RfC hasn't begun yet)
• 16:05, 9 November 2019 Ghostofakina removes the price table stating it is unnecessary
• 17:33, 9 November 2019 QuackGuru reverts and re-adds the table back with the edit summary: useful content per WP:MEDPRICE
• 20:06, 9 November 2019‎ Ghostofakina reverts QuackGuru, stating Useful though it may be, this violates WP:NOPRICE. There is no price section in iPhone 11 Pro, XS, XR or X, and information on pricing is already found in the iPhone article.
• 20:27, 9 November 2019‎ QuackGuru reverts Ghostofakina again, with the edit summary: helpful content on pricing (start a RfC if you disagree)
• 00:47, 10 November 2019 RfC was officially started by Taewangkorea (uninvolved editor). Link to the full RfC: Talk:IPhone_11/Archive_1#RfC_about_including_pricing_information_in_article (To avoid any confusion, my username was previously Someone963852 before my username change)
• 14:18, 10 November 2019 13 hours later, Ozzie10aaaa joins in and votes the same way as Doc James [181][182]
• 15:53, 13 November 2019 Bluerasberry shows up and supports "per WP:PRICES, which is an essay to which [he] contributed."
• 13:10, 23 November 2019 Bluerasberry makes a comment. Currently, there's 4 supports (Doc James, Quack Guru, Ozzie10aaaa, and BlueRasberry) and 7 opposes.
• 14:12, 23 November 2019 An hour after Bluerasberry's comment, QuackGuru creates a new topic titled "List of mobile phone prices" on the WikiProject Medicine talk page
• 21:51, 24 November 2019 WhatamIdoing responds "It's true that WP:Other stuff exists... However, the price of mobile phones is not relevant to this particular group of editors."
• 00:30, 26 November 2019 QuackGuru adds pricing information to the article
• 00:34, 26 November 2019 Seraphimblade reverts a few minutes later stating that “WP:NOPRICE is policy.”
• 00:50, 26 November 2019 QuackGuru then goes to the talk page and asks for an explanation "10 sources"
• 01:07, 26 November 2019 17 minutes later, Seraphimblade gives a detailed explanation for the revert:

  I can read the content the sources supported, and I can read the policy. WP:NOPRICE is clear: Unless the price is significant, we omit it. If it's significant, there will be a lot more to say about it than just "The price is $X.XX". It's not enough for sources to just mention the price, they would also need to go into detail as to why that's significant or important. Otherwise, it's just a factoid, and general practice is to omit it. I did read the sources you cited above, and they just mention the price, and in a couple cases say it's similar to its predecessors. They don't say much else about it, or that it's anything of note.

• QuackGuru doesn't respond on the iPhone 11 talk page, but instead goes to the Wikipedia talk page (Talk:Wikipedia) to get another explanation for the revert. Seems like the edits got hidden or deleted but I believe the below are the timestamps:

  01:36, 26 November 2019 diff hist +364‎ Talk:Wikipedia ‎

  12:14, 26 November 2019 diff hist +318‎ Talk:Wikipedia ‎

  21:02, 26 November 2019 diff hist +356‎ Talk:Wikipedia ‎

• 20:31, 25 December 2019 Almost two months later, the RfC was concluded with 4 supports and 10 opposes and the consensus being against including the chart of prices on the iPhone 11 article.

PRICES/NOPRICES is not the only problem

As seen from the evidence and diffs above, problems that I'd noticed:

• All of the Support votes in the RfC came from Med project editors who are also trying to push drug prices: Doc James, QuackGuru, Ozzie10aaaa, and Bluerasberry
• Doc James and QuackGuru's first ever edit on the iPhone 11 article were to add prices with no additional justification as to why it'll improve the article
• QuackGuru reverts any removal of the price table and demands others start RfCs if they disagree [183][184], despite the WP:ONUS being on them for inclusion
• Doc James, an admin, ignoring Wikipedia policy (WP:NOPRICES/Wikipedia:What Wikipedia is not An article should not include product pricing or availability information unless there is an independent source and a justified reason for the mention.) and instead cite WP:PRICES, an essay, as a reason for their vote without providing any strong or additional justification [185] in order to push prices to the article
• Ozzie10aaaa joins in quickly after the RfC has started and votes the same way as Doc James [186][187] Similar to Doc James, Ozzie10aaaa has no further justification of how WP:Prices would improve the article, just "Per Wikipedia:Prices"
• Bluerasberry supports the inclusion of the table mainly because of "WP:PRICES, which is an essay to which [he] contributed" [188] with his examples of "drug prices" seeming a lot like WP:Advocacy instead of improving the article itself
• QuackGuru adding a single "iPhone 11 retails for $699." line to the iPhone article [189], making the article read like it is a sales catalogue
• QuackGuru posting about mobile phone prices to the WikiProject Medicine page which another editor said was irrelevant to the project; complaining on the Talk:Wikipedia page even though they got an explanation for the revert already in the discussion they started on the article talk page
• An RfC was started by an uninvolved editor and lasted almost two months because this small group of editors wanted to push prices into the article per their "essay", demanded RfC's to be started if editors disagreed, and refused to WP:LISTEN. Besides the 4 total support votes all coming from Doc James, QuackGuru, Ozzie10aaaa, and Bluerasberry, the rest of the editors who participated in the RfC all opposed the inclusion of prices (10 opposes).

This was my one-off experience seeing this POV price pushing and related behavioral problems in action just by participating in the RfC. Hopefully these problems won't continue spreading to any more non-medicine-related articles.

Doc James and Blueraspberry's advocacy on Wikipedia

From Wikipedia:Advocacy:

Advocacy is the use of Wikipedia to promote personal beliefs or agendas at the expense of Wikipedia's goals and core content policies, including verifiability and neutral point of view. Despite the popularity of Wikipedia, it is not a soapbox to use for editors' activism... advertising... or other forms of advocacy. Wikipedia is first and foremost an encyclopedia which aims to create a breadth of high-quality, neutral, verifiable articles and to become a serious, respected reference work. Some editors come to Wikipedia with the goal of raising the visibility or credibility of a specific topic, term or viewpoint leading to disproportionate coverage, false balance and reference spamming. When advocates of specific views prioritize their agendas over the project's goals or factions with different agendas, battling to install their favored content, edit-warring and other disruptions ensue. Wikipedia operates through collaboration between editors to achieve the encyclopedia's goals.

• Doc James: [190] "We know that the pharmaceutical industry really really wants to suppress the cost of medications" "Wikipedia is not censored."
• Blueraspberry: [191][192] "For drugs knowing whether a dose is $1 versus $10 versus $100 versus $1000 is essential... prices are messy to report globally but somehow Wikipedia articles need to communicate when a product exists to benefit and be accessible for the poverty, lower, middle, or upper economic class of consumers... do not care about exact prices, but prices are one way to distinguish products for the lower class versus the upper class." "wish that Wikipedia could communicate which products are for everyone and which ones are luxury products."

Others above have provided extensive evidence of Doc James and Blueraspberry's advocacy and related behavioral issues with specific examples in their sections, especially regarding Doc James inserting prices into hundreds of articles without any concern for WP:DUE, WP:NOPRICES, WP:V, WP:OR, WP:NPOV, ignoring consensus, and edit warring and starting RfC's to get them in because of WP:IDHT issues. (At the time I'm writing this (April 26), there are currently two RfC's open under the Wikipedia:Requests_for_comment/All "Math, science and Technology section": Talk:Ethosuximide and Talk:Simvastatin, both started on March 30, 2020 by Doc James, 3 hours apart and both about costs and prices.)

Doc James reverts and re-adds video before discussion on the 2019–20 coronavirus pandemic‎‎ article

Talk page discussion about the video

• Doc James adds a video that he created to the lead of the 2019–20 coronavirus pandemic‎‎ article
• Matthiaspaul removes it: Removed video from lede. This gets displayed as a big distracting empty box with scripting disabled, and we certainly don't need a video here.
• Doc James re-adds the video
• Doc James starts a discussion after he re-added the video back in
• Ozzie10aaaa joins in an hour later and supports Doc James
• Matthiaspaul responds:

I don't think there is any consensus to incorporate the video into the lede of the article at all, nevertheless it was added by Doc James twice, which is not covered by WP:BRD any more.

We are an encyclopedia, not a video site. Foremostly, our medium is text enriched with static illustrations. While an occasional animation is okay (as is, IMHO, a link to a quality video in the External Links section), many people consider "moving" contents a distraction and annoyance. If a video would be actually needed to convey the message, it means that we failed in our core discipline to explain the topic in prose.

In the case of videos, users not having suitable plugins installed and scripting enabled may f.e. just see a large empty box instead of a video. This looks very odd, in particular in the lede of a high-profile article such as this one. It completely ruins the page layout and makes people stop reading the article beyond the lede. I would appreciate for the video to be removed again. (A link to it under EL would be fine with me.)

But ultimately the editor's thoughts and opinions on the video didn't matter, because the "consensus" was 3 to 1 with Doc James, Ozzie10aaaa ("video is very good...IMO"), and Ian Furst ("Disclosure that I was part of the development of the Videowiki platform."; first ever comment on the article's talk page and contributor to the video) supporting the video.

Evidence presented by Tryptofish

I began editing Wikipedia in 2008. Early in my editing time, I worked on schizophrenia and some related pages, but I switched fairly soon to focusing most of my science-related editing on basic neuroscience, pharmacology, and physiology, rather than on medical content. In the spring of 2018, however, I came to observe a significant instance of the conflicts in the case area: about Doc James' addition of medical videos to multiple pages. The history of the conflict goes back quite a few years before that, but this is a time period of which I can speak from personal observation.

March–April 2018

March 26: Colin opens discussions in which he expresses concern about the videos, at WT:MED: [193], and at Jimmy Wales' talk page: [194]. I did not participate in either of those discussions, but most of the named parties in the case feature prominently there.

March 28: I saw an RfC announcement of an RfC that Doc James had initiated in response to those discussions, and I decided to participate in it. I made several contributions: [195], [196], [197], [198], [199]. Please note that I was largely disagreeing with Doc James, and expressing opinions that were usually similar to those of Colin and SandyGeorgia.

The Discussion section of the RfC begins with an interchange between Doc James and Colin: [200], [201], [202]. Please note the contrast in tone: Doc James is polite and encouraging of other opinions, whereas Colin is mocking and sarcastic. Looking back at the discussions starting on March 26, above, there is a similar pattern.

Seeing that exchange, I said this: [203]. As best as I can tell from memory and from the editor interaction tool, that diff is the first time that Colin and I had directly crossed paths.

March 29: An ANI complaint begins, generating heated argument but no action: [204]. I say this: [205].

March 30: Doc James recognizes and accepts that community consensus was against him, and promptly fixes all of the edits that he had made: [206]. This is also noted later in the RfC closing statement: [207]. Thus, in this particular instance (and I do not mean to extrapolate to any other events in the history of the overall dispute), Doc James sought community input via an RfC when he recognized that there was a problem, readily accepted that consensus was against him, and made the effort to enact the consensus himself.

Roughly at the same time, there was also heated and lengthy discussion at Doc James' talk page: [208]. I joined that discussion fairly late into it, on April 2.

April 2: I make some comments on Doc James's talk, trying to be helpful: [209], [210], [211], [212], [213], [214], [215], [216], [217], [218].

March 30: Now, going back a few days, I have a brief and not-particularly important discussion with WhatamIdoing: [219], [220]. No big deal, but I mention it only because it led to another discussion, between SandyGeorgia and me at my talk page: [221], [222]. Please note several points. It's a very friendly talk, and Sandy explicitly notes that she regarded me as neutral in the ongoing dispute. When I reply, please note in context what I said about not wanting to say anything bad about Doc James et al. – I'm saying that "I do not consider myself to be on either 'side'".

Following from that, Colin cites my comment at Doc James' talk page as if I were taking sides with Doc James, and, surprisingly, says that I "sound exactly like an apologist for sexual abuse in the workplace": [223], [224]. WhatamIdoing astutely and correctly notes in her evidence section that editors may tend to regard me as pro-prices, even though I have repeatedly said the opposite. That's been a problem throughout this overall dispute: editors are regarded as being on "sides" even if they are not.

Anyway, I decided, based on my discussion with Sandy at my talk page, that I would like to work with her on some content work, improving the page on Dementia with Lewy bodies. Please go to here: [225], on Archive 2 of the talk page, and read down to the bottom of the archive page, then continue with Archive 3, going as far as here: [226]. Don't worry about the content, but instead, focus on the vibe between Sandy and me. You will see that, over a lot of editing, it was consistently friendly, collaborative, and productive.

The situation changes on April 18, here: [227]. Sandy and another editor (not a party here) disagree about "should" language, as in people with this disease should take such-and-such medication, in the context of WP:NOTHOWTO. I largely agreed with the other editor. As the discussion goes along, Casliber makes this edit: [228], and says this on the talk page: [229]. There's some further discussion, and a growing sense that the sentence needs to be changed further. So I make this edit: [230], and say this on the talk page: [231]. In hindsight, my talk page comment comes across as smug, and I am sincerely sorry about that. But, taken in the context of Casliber's comment, and of all the editing I had been doing there up to that point, it's hardly a major disruption. And when Sandy further improves on my edit, I readily agree that her version was better than mine: [232]. It went similarly with other similar changes: [233], [234]. Some differences of opinion, but it all gets worked out.

But Colin then entered the discussion, saying this: [235]. Please look at that closely. He isn't really trying to help me understand earlier discussions of which I might not be aware, nor looking for ways to get to consensus. He is tut-tutting me, and schooling me, in a condescending way that makes it sound like I should defer to those who are wiser than I am. I respond: [236]. Colin then replies in a more helpful way: [237], and I try to work with him: [238]. But Colin doubles down: [239]. There is a direct line connecting those comments to me with the comments on this evidence page about "factoid" editing: [240]. I hope that ArbCom does not regard editors who make multiple small edits as inferior, because the community sure doesn't. And it strikes me as ironic that, whereas Colin cares so much about WP:NOTPRICES in the recent dispute about drug prices, he was so dismissive of WP:NOTHOWTO back then. In any case, I decided that I should just walk away at that point: [241], and I never edited that page again.

I have not looked in detail into how Colin interacts with other editors, but I'm aware of this edit summary from a link provided in the most recent ANI case: [242]. There's certainly things to be said about Jytdog, but a lack of reading comprehension is not one of them. Also, Literaturegeek posted some evidence here and then changed their mind: [243], [244]. In my opinion, it was within the case scope, and seems to document a lot of incivility directed at Doc James.

Recent RfC on drug pricing

In the last days of drafting the RfC, Barkeep49 urged editors doing the drafting to be attentive to the need for the RfC to be neutrally worded: [245], [246]. Rosguill served as am uninvolved administrator to evaluate the draft for neutrality, and identified some potential problems: [247]. Ronz/Hipal made some helpful edits to try to address those concerns: [248]. The overall discussion is at Wikipedia talk:Manual of Style/Medicine-related articles/Archive 12#Polishing the draft, and is rather sprawling, but I get the impression that, outside of Ronz/Hipal's editing, there was a lot of resistance to going along with Rosguill's recommendations.

About the RfC itself, the closing statement is here: [249]. In evaluating the various evidence in this case, it is worth noting that editors would typically look at that closing statement to find the results of the RfC. If an editor is suspected of ignoring the consensus, it is important to evaluate whether that editor was aware, at the time, of any modifications of the close that were posted elsewhere. Subsequently, Colin requested further clarification of the closing statement at WT:MED: [250], and got this reply: [251]. This was later copied to the RfC talk page, but editors would have to look there to find it. I think the two closers did an admirable job with a difficult task, and am not finding fault with them, but these significant revisions leave me with some discomfort. I could imagine posing the question as something like "Editors disagree about the meaning of the part that says "no consensus" (diff, diff). Could you please clarify that, with particular attention to presenting prices in the lead, the roles of WP:OR, WP:V, and WP:WEIGHT, the role of WP:NOTPRICES, the presentation of prices in infoboxes, and the roles of secondary sources versus primary databases. Thanks." Instead, the question was non-neutral, and pretty nearly dictated Colin's preferred close while asking the closers to simply say OK to it. I'm not saying any of that was a violation of policy, but it just doesn't sit right with me.

Although they are opinions, rather than evidence as such, I will close with these two sets of comments, from before the drafting of the RfC began: [252], [253], and after the close of the RfC: [254], [255]. --Tryptofish (talk) 23:51, 27 April 2020 (UTC)

Evidence presented by {your user name}

{Write your assertion here}

Place argument and diffs which support the first assertion; for example, your first assertion might be "So-and-so makes personal attacks", which should be the title of this section. Here you would show specific edits where So-and-so made personal attacks.

{Write your assertion here}

Place argument and diffs which support the second assertion; for example, your second assertion might be "So-and-so makes personal attacks", which should be the title of this section. Here you would show specific edits where So-and-so made personal attacks.