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Merged Archive WikiProject Preclinical medicine: 1 Merged Archive WikiProject Clinical medicine: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 WikiProject Medicine Archives: Index, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171

Endothelial cell anergy

Is it just me or does that read like advertisment? --Julius Senegal (talk) 16:37, 1 July 2023 (UTC)

It needs some work to sound like a Wikipedia article, but this is not a bad article for a new editor. WhatamIdoing (talk) 12:17, 2 July 2023 (UTC)

Hmm, I am not sure if this particular concept is in fact called "anergy". Jo-Jo Eumerus (talk) 17:53, 2 July 2023 (UTC)

Clonal anergy is a thing, but this doesn't sound identical. WhatamIdoing (talk) 20:16, 2 July 2023 (UTC)

[1]--Ozzie10aaaa (talk) 21:35, 2 July 2023 (UTC)

German Neuroonkologie to English Neuro-oncology

Is it okay to copy German "Neuroonkologie" into English "Neuro-oncology"? Best regards, Wname1 (talk) 17:29, 5 July 2023 (UTC)

Yes, but when translating you need to add the {{translated page}} template to the article's talk page, to comply with the requirements of the CC-license. Also, I see your last attempt to add information was challenged, so I think whatever concerns were raised would need to be addressed. Draken Bowser (talk) 18:17, 5 July 2023 (UTC)

Indeed. I just declined a related importation request. Graham87 06:30, 9 July 2023 (UTC)

@Draken Bowser:The article Neuroonkologie is good, what else should be done so that it is in neuro-oncology. Best regards, Wname1 (talk) 06:58, 9 July 2023 (UTC)

You would need proper sources as footnotes for whatever information you'd like to translate and then add to the English article. Unfortunately, you've been challenged on the article talk page over adding footnotes that don't verify the claims you've been making, which is a serious concern. Before you attempt to expand the article, I suggest that you provide an explanation or acknowledge any mistakes made. That would probably make things easier going forward. Draken Bowser (talk) 07:42, 9 July 2023 (UTC)

@Draken Bowser:The German article "Neuroonkologie" is perfectly fine, there are about 48 references. Regards, Wname1 (talk) 08:59, 13 July 2023 (UTC)

That's fine, and no one has disputed the quality of the German version. The concerns were specifically about using footnotes that did not verify the text you added. Regards. Draken Bowser (talk) 10:26, 13 July 2023 (UTC)

@Draken Bowser: English "footnotes" in German "Fußnote" are like "Einzelnachweise" in German and in English "References". The "Neuro-oncology" there will be 48 "References", when "page importation" works. Regards, Wname1 (talk) 14:07, 13 July 2023 (UTC)

Unfortunately, there are more issues here. I have studied your Swedish translation of "neuroonkolgie" from last year. It is likely machine translated and I consider it a content fork of brain tumor, rather than an article on the discipline of neuro-oncology. Based on that I regret to inform you that I don't think translating the article to English is a good idea. Regards. Draken Bowser (talk) 11:25, 14 July 2023 (UTC)

I also note that your last comment to me on svwiki ended with "greeting phrases". This makes me believe that you machine translate your talk page comments. It wouldn't surprise me if your talk page comments on here are machine translated as well. The fact that you've translated "neuroonkologie" to about two dozen languages would also suggest use of machine translations. I don't know exactly what to do about this apparent cross-wiki issue. Draken Bowser (talk) 12:34, 14 July 2023 (UTC)

Good article criteria

The Wikipedia:Good article criteria have been changed to require an Wikipedia:Inline citation for basically all information, and specifically at the end of every paragraph (except the lead). I glanced at five articles in Category:GA-Class medicine articles (out of 344) just now; none looked fully compliant, but all looked close. If you are interested in any of these articles, please consider adding a few citations.

(Also, please join https://outreachdashboard.wmflabs.org/courses/Wikipedia/WikiProject_Medicine_reference_campaign_2023/students/overview ). WhatamIdoing (talk) 12:36, 6 July 2023 (UTC)

I suspect it's highly unlikely that most of the medicine GAs can be brought easily to the new standard, because a) many (most?) of them haven't been looked at for years, and are likely dated; and b) many of them were declared GA during a time when only the leads were being updated, so the bodies are not only out-of-sync, but may have had no attention to sourcing even at the time they were brought to GA. SandyGeorgia (Talk) 14:53, 10 July 2023 (UTC)

Seasonal infections

We don't seem to have an article on seasonal disease or seasonal infection. Seasonality is much more general (e.g., electrical usage is higher during the summer). What would you call this? WhatamIdoing (talk) 09:53, 8 July 2023 (UTC)

An omission. I have begun at User:CFCF/Draft:Seasonality in disease in draft-space so that it can go to DYK. Feel free to assist in the draft. I think it makes sense to discuss seasonality in all disease, because there is seasonality in things such as trauma, psychiatric disorder, heart attacks, neurological disorders as well. CFCF (talk) 12:08, 8 July 2023 (UTC)

That looks like a great start. Do you want to include something about heat illness? I believe heat waves cause a predictable seasonal pattern in deaths.

https://www.google.com/books/edition/Communicable_Diseases_6th_Edition/oaLDDwAAQBAJ?hl=en&gbpv=1&pg=PA17&printsec=frontcover mentions temperature and rainfall as the determining factors for seasons, and says they drive diarrhea and malaria. Its claims about pregnancy might also interest you, though I'm not sure how much of this is a global phenomenon. WhatamIdoing (talk) 21:17, 9 July 2023 (UTC)

I commend you for the draft! Since the autoimmune disease seasonal patterns are mentioned, I was wondering if it'd be relevant to mention the attempts at Climatotherapy for psoriasis. Also, there's this article for seasonality of COPD exacerbations that might be interesting - it associates it with respiratory infections of course (and other possible causes) [2]. Sto0pinismo^0_o 09:11, 10 July 2023 (UTC)

I think "seasonality in disease" makes sense. Out of the 2 suggested by @WhatamIdoing, I think "seasonal disease" is best because it's more generic. I'm thinking another plausible option could be "season-associated disease", in the same vein as HCAI. Also noting this. Dr. Vogel (talk) 12:12, 8 July 2023 (UTC)

See also article that I wrote: [3]. Seasonality of respiratory infections must me a separate article. D6194c-1cc (talk) 07:41, 10 July 2023 (UTC)

@CFCF: This article might interest you (direct link: ru:Сезонность респираторных инфекций). D6194c-1cc (talk) 09:56, 10 July 2023 (UTC)

pseudogout

Hi guys, would there be any consensus to rename calcium pyrophosphate dihydrate crystal deposition disease to pseudogout per WP:COMMON? I don't want to do a bold move or start an RM without checking what we here as a group feel first. For some more context, the article has never been at the "pseudogout" title, there are no previous RMs, and there are no previous moves in the opposite direction (the only moves were related to chondrocalcinosis being a different article, rightly so, because chondrocalcinosis can be caused by other conditions than just pseudogout). Dr. Vogel (talk) 02:26, 9 July 2023 (UTC)

For what it's worth, the term I have encountered the most is "pyrophosphate arthritis", though a quick PubMed search suggests that "pyrophosphate arthropathy" is more common. TompaDompa (talk) 02:47, 9 July 2023 (UTC)

Hi @TompaDompa, if it came to those 2, I think arthropathy would probably be more appropriate. What country do you practise in? (I'm in the UK, and my perception is pseudogout is by far the most common term here). Dr. Vogel (talk) 09:49, 11 July 2023 (UTC)

Also UK; I see pseudogout and occasionally crystal arthropathy when coding patients. WP:MEDTITLE, however, tends to ignore WP:COMMONNAME. Of note ICD11 uses calcium pyrophosphate dehydrate deposition disease. (Is "dehydrate" a typo?) Little pob (talk) 10:23, 11 July 2023 (UTC)

lol - ICD11 is such a mess - seriously, they only had one job.

Yeah true people say crystal arthropathy a lot, but the problem with that term is that it's ambiguous - both gout and pseudogout are crystal arthropathies (and so is pseudopseudogout!).

MEDTITLE does allow for "recognised medical name". But if it's not a term that our colleagues in other countries are happy with, then we'll have to go with some kind of mouthful.

But I am prepared to invoke IAR if anyone decides to use the name given by ICD11 :) Dr. Vogel (talk) 15:01, 11 July 2023 (UTC)

Terminology usage for routes of administration of drugs and other terms in article intros (seeking consensus)

I apologize if this post is going to get rather long. I will attempt to be as concise as possible but it is not something I can adequately explain without getting somewhat lengthy. While I hope people will read this post in its entirety, I am including a brief summary at the end which you can locate by finding the bold and all-caps word "SUMMARY" at the bottom of this post. I ask only that you please consider what I am saying with an open mind.

I recently made this edit, which I believe to be consistent with WP:MEDMOS which states, "Good encyclopedic writing will naturally teach the reader new words and help them build confidence with harder ones. While this can be done explicitly, with definitions in parenthesis for example, the most natural way to achieve this is to use the idiomatic words, the ‘proper’ words for something, in context. Good writing will allow the reader to pick up enough of the meaning from this context." Despite having made similar edits to numerous other articles without anyone ever reverting it or raising objection, my edit was reverted with the edit summary “Lay terms are preferred.” I then started a new topic on the article’s talk page and it was requested by the other editor that I instead post here to seek consensus on the issue, so that is what I am doing.

Personally, I would prefer if articles simply used the “correct” terminology for routes of administration, since as long as the term is linked to the relevant wiki article, then anyone who is unfamiliar with the term can simply click it to find out what it means, but I thought including both the lay term and technical term, one in parentheses, was a reasonable compromise. (However, I contend that the word “orally” is so common as to not even qualify as “technical terminology.” Terms such as “intravenous” and “intramuscular” are what I would consider very basic-level “technical terminology.”)

To help explain my rationale for this, I am copying this from my user page, which I wrote some time ago:

“I'm very concerned by the way Wikipedia articles related to medicine are being dumbed-down. People looking for simplified medical information have plenty of other online resources available. Changing things like 'intravenous' to 'injection into a vein' or 'myocarditis' to 'inflammation of the heart' is just plain patronizing. (The latter example could even cause potentially dangerous confusions as "inflammation of the heart" could also conceivably refer to conditions other than myocarditis, such as endocarditis or pericarditis.)

Some editors have even changed a word so common as 'orally' to 'by mouth'! People who don't know the meanings of words such as 'intravenous' and 'orally' probably aren't reading Wikipedia to begin with, but even if they are, then they can simply click the word to go to an article about it and find out what it means. Such simplified wording may be appropriate for Simple English Wikipedia, but there is no good reason to do this on the regular English version of Wikipedia, and countless reasons not to.

If you treat people dumb, then they will stay dumb, and nothing good can come from keeping people ignorant. Let's please keep Wikipedia a place to expand knowledge, and not a place to limit it. No other sections of Wikipedia seem to be subjected to this phenomenon of intentionally being dumbed-down, and, if anything, medical-related articles should be the last to be butchered like this.”

Here are a couple examples of problems with specific terms:

—The term “injection into a vein” is too ambiguous. I don’t know how other people interpret the term, but personally, when I hear “injection into a vein,” I think of IV push injections, as I think of “injections” and “infusions” as different categories. But the term seems to be used in Wikipedia article introductions to refer to IV push injection, pump infusions, drip infusions, as well as central venous catheters. It is certainly relevant and useful to many readers to differentiate between the different types of intravenous administration, as there are very significant differences between those different routes of administration. (And if our readers aren’t expected to either already know or be able to quickly figure out the meaning of the word “intravenous,” then is the word “injection” really that much simpler? Should we start saying “shot given into a vein” instead?)

—The term “by mouth” is also potentially ambiguous. In addition to oral administration, are not sublingual and buccal administration also “by mouth”?

It seems to be the norm that there are a large degrees of inconsistencies within the majority of medical articles, with the simplistic terms being used at the beginning of an article’s introduction, but then terms much more technical than “intravenous” or “orally” appear in the rest of the article, sometimes even in the very next paragraph. For an example, see the article for ondansetron. The first paragraph uses the terms “by mouth,” “injection into a muscle,” and “into a vein,” yet the very next paragraph uses the terms “QT prolongation,” “serotonin 5-ht3 receptor antagonist,” and “muscarinic receptors.” Do we really expect the same reader to not be able to handle terms like “intramuscular” but to be totally comfortable with “serotonin 5-ht3 receptor antagonist”? In either case, if they aren’t familiar with any of those terms, they are all linked to their respective Wikipedia articles and can be clicked and then the reader can easily find out exactly what they mean.

For an even more extreme contrast, see the introduction in the article for natalizumab, which assumes our readers don’t even know the word “nausea,” as it says “nausea (feeling sick),” (which, by the way, would only be a proper explanation of the word for those who understand British English, and not American English), yet assumes our readers have no problem knowing (or figuring out) what “cell adhesion molecule alpha4-integrin” means?

I understand the concerns about making medical articles accessible to those who may have virtually no familiarity with medical concepts, but that shouldn’t be at the expense of information that is useful and important to readers who do have an understanding of (marginally) technical terms. If both terms are provided, then every potential reader should both comprehend what is being said, and will not be without information that is notable to them, nor would there be risk of confusion due to ambiguity. For examples of the compromise format that I am proposing: “orally (by mouth)”, “slow drip infusion (injection into a vein)”, or “IV push (injection into a vein)” or, if preferred, the order of which is first and which is in parentheses could be reversed, such as “by mouth (orally).” I can’t fathom how such a compromise could cause any harm, but there are many ways in which it would be an improvement over using only the more basic term alone. This is the way it already is in some articles; for example see the first paragraph of the article buprenorphine, which in the first paragraph provides both the basic terms and the proper terms, thus clarifying things and avoiding misconceptions or ambiguity for those who are familiar with the terms, and helping to educate those who are not familiar with the terms. Everyone wins that way!

Done in the way I am proposing, readers who are proficient in medical terminology will have the information they are seeking and will not feel patronized (I know I certainly feel patronized every time I see “by mouth” instead of “orally”), whereas readers who have little familiarity with medical terminology will be able to learn new terms and expand their knowledge. (Isn’t the whole point of Wikipedia to expand knowledge?) Just saying “by mouth” or “injection into a vein” without also using the “real terms” can do nothing but keep people ignorant instead of expanding their knowledge. If someone doesn’t know these terms, then ask yourself “why?” It’s because they haven’t been exposed to them. Isn’t it better we give them that exposure to teach them what they mean instead of keeping them in ignorance?

I would appreciate if other editors could respectfully share their thoughts about this matter and hopefully a consensus can be reached. Even if you think the simple terms are better, then I ask what harm could there possibly be from having both terms together? And if anyone has a better idea of a compromise other than using a term with parentheses, then please share your idea.

SUMMARY: There has been disagreement as to whether medical articles, especially articles about medications, should use terms such as “by mouth,” “injection into a vein,” “injection into a muscle,” etc. or if terms such as “orally,” “intravenous” (or more specific terms such as “slow drip infusion” or “IV push injection”, etc.), “intramuscular,” etc. should be used to describe routes of administration. Or, as a compromise, using both kinds of terms together, for example: either “orally (by mouth)” or “by mouth (orally).”

I contend that only having the more simplistic term without the “real” terms can lead to a number of problems, the specifics of which I detailed above. I also think using the “real” terms and “basic” terms in combination is consistent with WP:MEDMOS which states, "Good encyclopedic writing will naturally teach the reader new words and help them build confidence with harder ones. While this can be done explicitly, with definitions in parenthesis for example, the most natural way to achieve this is to use the idiomatic words, the "proper" words for something, in context. Good writing will allow the reader to pick up enough of the meaning from this context." I cannot see how this compromise could cause any harm, but I can see how plenty of harm can come from just using the basic terms without the “proper” terms. For specifics of what harm I mean then please read my entire post above, but some of the issues are that the simple terms (used alone) are often too ambiguous, do not provide sufficient information for many of our readers, and ignore an opportunity to educate those who aren’t familiar with the terms. (The point of Wikipedia is to educate and expand knowledge, isn’t it?)

I understand some editors may have other views, which is why I propose the compromise solution of using both terms together, one in parentheses, but I am certainly open to hearing other ideas. I hope to get respectful input from other editors so that a consensus can be reached. Vontheri (talk) 09:24, 10 July 2023 (UTC)

There are pros and cons with using more scientific vs lay terminology. I personally believe that avoiding jargon and words that readers are less likely to know needs to be balanced with avoiding ambiguity and there isn't a one size fits all solution. Using multiple terms is also detrimental to readability, and the purpose of encyclopedia articles is to teach people new concepts not new vocabulary imo. (t · c) buidhe 18:48, 10 July 2023 (UTC)

I'm not convinced that most of our readers aren't already familiar with very basic-level technical terms. (Are there really very many people out there who know how to read and know how to access Wikipedia who don't know what "orally" means?) "Injection into a vein" is certainly ambiguous in that the term is applied to such varied methods of administration, from IV push injection to infusions to central venous catheters. Distinguishing between those varied administration methods isn't so much about teaching vocabulary as it is about avoiding ambiguity and teaching different concepts. I don't think of "injection" and "infusion" as exactly the same concepts.

I'm not saying we should say "cerebrovascular accident" instead of "stroke" or "renal calculus" instead of "kidney stone" every time those concepts are mentioned, but I do think that when it comes to very basic level terms that barely even qualify as "technical terminology" then it's patronizing to our readers to use such basic terms as "by mouth," especially when those basic terms appear so nearby to terms like “cell adhesion molecule alpha4-integrin.” Vontheri (talk) 03:25, 11 July 2023 (UTC)

My local pharmacy has been giving directions for taking pills "by mouth" for years. Are they patronizing me? WhatamIdoing (talk) 07:39, 11 July 2023 (UTC)

In my view, yes, I feel patronized by that. My prescriptions say "by mouth" maybe 80% of the time and "orally" maybe 20% of the time. Also keep in mind that people who aren't intellectually capable of accessing the internet also need to take prescription medications. Someone intellectually capable of accessing Wikipedia is almost certainly also intellectually capable of understanding the word "orally." Whether or not it's patronizing was not a primary part of my argument, however. The primary reasons are as I listed above in my original post. Vontheri (talk) 08:07, 11 July 2023 (UTC)

I think you need to give up on this "intellectually capable of accessing the internet" line. Have you seen a toddler with an iPad? You don't have to know how to read to be able to "access the internet". WhatamIdoing (talk) 21:20, 11 July 2023 (UTC)

I don't think that's patronising at all. We can't not have the lay terms. We should probably have both, but we musn't do away with the lay terms. Dr. Vogel (talk) 09:46, 11 July 2023 (UTC)

Whether or not something is patronizing is ultimately a matter of opinion. It was never meant to be one of my main arguments. The other points I made were about more objective issues, such as the problems with the ambiguity of "injection into a vein." I think having both terms is a good compromise. Vontheri (talk) 10:01, 11 July 2023 (UTC)

Yeah but I think that @WhatamIdoing's point (please correct me if I'm wrong) is that if it's not patronising, then it's therefore useful (and appropriate) for communication. Dr. Vogel (talk) 10:06, 11 July 2023 (UTC)

This discussion went into a tangent about what is patronising or not, I don't think that's relevant. I agree with the proposals, with a preference for "by mouth (orally)", exactly because there is ambiguity in 'by mouth' alone. The style of communication should be accessible, but not inaccurate. The spirit of WP:MEDMOS seems to trend that way as well. Sto0pinismo^0_o 16:12, 11 July 2023 (UTC)

There is ambiguity in "orally" as well, since sublingual and buccal administration are also forms of "oral" administration. Orally means "by way of the mouth"; the word does not exclusively mean "by swallowing".

I personally dislike "injection into a vein", especially since I think of injections and infusions as different things, and I wonder sometimes whether it could be adequately replaced with "via a vein". WhatamIdoing (talk) 21:33, 11 July 2023 (UTC)

Perhaps we should say "swallowed orally" instead of "orally" and just "swallowed" instead of "by mouth"? Although in a medical context regarding drug administration, I'm pretty sure that "orally" virtually always means "swallowed".

In addition to injections and infusions, I've also seen the term "injection into a vein" used for medications administered by central venous catheters. Central venous catheters are a bit more complex than what is implied by both the terms "injection into a vein" and "via a vein." Imagine a patient seeing a Wikipedia article say a medication they are about to be prescribed is administered "via a vein", and them expecting an injection, only to find out they are going to have a tube sticking deep into their body for several days or more! And isn't buccal administration technically "via a vein" as well, despite not being injected? Vontheri (talk) 03:57, 12 July 2023 (UTC)

Then a simple 'oral', linked to Oral administration should suffice in an encyclopaedic article, as in Amphetamine. At best, this information could even be improved by adding 'oral tablets' when it applies, etc. Sto0pinismo^0_o 09:28, 12 July 2023 (UTC)

I have also felt that some Wikipedia articles are "dumbed down," and I have made a few edits regarding this, only to have them reverted. I agree that complex medical terminology may not be appropriate, at least not without further explanation, but changing rather basic words like "insomnia" to "trouble sleeping," "nausea" to "feeling sick," and "orally" to "by mouth" seems unnecessarily simplistic and not totally accurate. "Feeling sick" is a broader term than "nausea" and can mean many things. I once changed "injection into a vein" to "intravenous infusion" because an infusion is not exactly the same as an injection, and "injection into a vein" was not accurate in the context of the article. It was immediately reverted. Perhaps "intravenous infusion" is borderline, but I think the average (and even below average) reader would know the words "insomnia," "nausea," and "orally" and really does not need to have these fairly basic words dumbed down. As far as words like "intravenous" and "infusion," links can be provided for the few readers who do not know these words, and they can click to learn more. I think there is a balance to be found. I don't like overly technical language when unnecessary or using a "big word" when a simpler word is just as adequate, in an attempt to sound pompous; nor do I like unnecessarily simplistic words being used because it is assumed people don't know basic words like "orally," "nausea," and "insomnia." GeodeRose (talk) 23:34, 11 July 2023 (UTC)

This reminds me of something I read a few years ago: An elderly woman went to the doctor and said that she had been constipated for days. The doctor recommended a laxative and gave her the usual advice, and she left. A few days later, she went to the emergency room with the same complaint, saying the recommended laxative hadn't helped. The doctor prescribed a strong laxative and referred her to a specialist. A few days later, the specialist called: "Remember that woman you sent to me? I've got her on a good treatment plan, and she's much improved now. Also, she didn't have constipation. She had diarrhea."

Perhaps more relevant to the local situation, is your average reader always a native English speaker? The English Wikipedia (also French and Arabic) get a lot of people for whom English is a second or third language. We don't necessarily need to worry about "reading" per se, as people get information from Wikipedia via smart speaker, but we do need to worry about whether people actually know what the words mean.

The "word (other word)" approach works well in many articles. In other cases, perhaps when we are more confident, we can use whichever words we want (and we must Wikipedia:Use our own words), but link to the relevant article (e.g., Oral administration) as a "just in case" fallback option for anyone who needs to check that word. WhatamIdoing (talk) 08:16, 12 July 2023 (UTC)

I know plenty people who have difficulty remembering which is left and which is right, or what way to turn a screwdriver to fasten a screw. So the constipation/diarrhea story doesn't tell much much more than people often mix up opposites words and that their doctor was negligent in even asking "when did you last go, and what did it look like". So negligent, I wonder if the story is made up by wherever you read it in order to make a point.

The non-native thing keeps coming up but I think there are problems with naive approaches to helping such readers. For a start, someone with very poor English is going to be reading via Google Translate, and we are simply at their mercy as to what they make of our words. Most of the rest aren't children and so they use the grown-up "proper" words for "oral" and "intravenous" in their own languages. Many of them will know the grown-up words in English and so be puzzled to read "inject into a vein" or "by mouth" instead. Indeed some of my foreign friends are jealous of English having so many words for things compared to their languages and love learning new ones.

While I hope not many children need to know the word "intravenous", any child in the UK knows "oral" as "Oral B" is the biggest brand of toothpaste and toothbrushes. I guess that may be so in the US too. And adults don't need a PhD or MD to know what "oral" is... type "oral" into Wikipedia's search box and you'll discover the NSFW topic I'm talking about! And it is the lay term!

Naive approaches forget that e.g. "oral" has identical or nearly identical equivalents in other European languages and "by mouth" does not. "intravenous" is "intravenosa/intravenoso" in Spanish and Portugeuse, "intravenös" in German, "intraveineuse/intraveineux" in French. If you are an adult in one of these European countries then you already know the "correct" word for oral/intravenous and yet when you go on English Wikipedia, you "discover" that the English don't have a word for it and have to write "by mouth" or "injected into a vein". That's actually an educational negative and a gross failure of translation.

Google Translate does a great job and AI tools continue to improve. We need to stop treating non-native-English readers as simpletons. When they read our works, with the proper words for things, translated into their languages, they will see the proper words for things in their language. And if they read them untranslated, they will be pleased to note that our proper word is nearly the same as their proper word. Easy-peasy. If we try to second-guess which words they might struggle with, we'll be wrong. And when we do that but write immediately next to it, "route of administration", which is jargony and bureaucratic officialese, we just look a bit silly. -- Colin°^Talk 14:11, 12 July 2023 (UTC)

The desire to avoid words perceived to be jargon is quite inconsistent. Sometimes I think that perception is wrong and in conflict with our mission to be an educational resource, an encyclopaedia, rather than an patient information leaflet or an NHS help page. The latter have an extreme desire that their readers understand just enough, but no more, in order to take their medicine or know when to see their doctor. The NHS website is not afraid to use words like "poo" and "tummy" though draws the line at using baby words for what's in your underpants. For example diazepam uses the term "rectal" even though I doubt many people use that word in every day conversation. The NHS uses second person ("you'll need to take this for four weeks") which is more direct and conversational than the prose we find here. Their conversational style means that once they've said the drug is a tablet, they assume you know where to stick it. Wikipedia, with its info boxes and its tediously formulaic leads, ends up stating this information in a template way. A good writer would have mentioned the words "tablets" at some point in the prose and the reader would be informed without anyone having to worry about whether to say "by mouth" or "orally".

The main place this terminology appears is in info boxes. Have you looked at a drug info box? Valproate. Are we really thinking that the number one priority for making the article accessible is that after the jargon term "Routes of administration:", we write "by mouth" rather than "oral". Which is sandwiched in between "Pregnancy category: Au: D" and "ATC code: N03AG01 (WHO)". This is a drug who's carton has a large (many cm) icon of a pregnant woman inside a red circle with a red line across. The #1 information the drug company is telling anyone picking up this drug box is that it should not be given to pregnant women. Our article infobox? "Au: D".

We should stop fretting about this and teach our reader the proper words for basic medical facts. I'm all for avoiding unnecessary jargon but an encyclopedia that fills its info box with meaningless crap like "IUPAC name 2-propylpentanoic acid CAS Number 99-66-1 PubChem CID 3121 IUPHAR/BPS 7009 DrugBank DB00313 ChemSpider 3009 UNII 614OI1Z5WI KEGG D00399 ChEBI CHEBI:39867 ChEMBL ChEMBL109 NIAID ChemDB 057177 CompTox Dashboard (EPA) DTXSID6023733 ECHA InfoCard 100.002.525" and labels this attribute as "Routes of administration", has other problems. -- Colin°^Talk 07:53, 12 July 2023 (UTC)

@Colin this bit made me laugh out loud: "This is a drug who's carton has a large (many cm) icon of a pregnant woman inside a red circle with a red line across. The #1 information the drug company is telling anyone picking up this drug box is that it should not be given to pregnant women. Our article infobox? "Au: D".". Thanks for that - I'm having a tough day at work today.

I think one thing does not preclude the other, i.e. our prose and our infoboxes serve 2 very different purposes. I find our infoboxes very useful for looking up the odd technical detail when I need to, without having to read through text. But our prose is there to be read and it needs to be as accessible as possible, so that the only difficulty is the concept itself and not the language, otherwise the reader has 2 gaps instead of 1.

I feel that we need to keep our text as jargon-free as possible, and the example you give of NHS websites using words like "tummy" and "poo" is an extreme - we don't need to use informal words, just not jargon. Or just not only jargon, and least of all in the lead. Dr. Vogel (talk) 14:56, 12 July 2023 (UTC)

Neither I, nor anyone else, is proposing that we only use the less-basic words ("jargon"), just that we use both terms, at least when it comes to routes of administration in introductions and info boxes.Vontheri (talk) 20:54, 12 July 2023 (UTC)

I think the infobox, for drug articles, is clearly an experts-only zone. Nobody ever, on receiving their prescription from the pharmacist, said, "I say, madam, would if be possible, perhaps, that you could offer me some assistance as to the route by which I am supposed to administrate this medicinal compound?" So if we are going to begin with the officialese of "Routes of administration", next to our ATC codes and whatnot, then we might as well use the official term. And be consistent, so someone reading several info boxes doesn't read several terms for the same thing.

For body text, we can be more clever than thinking, as so many of our medical articles do, that we need to follow a template for how to write the text. There are only specific times we need to mention how it was taken. As a general rule, for the lead and much of the body, there isn't a reason to mention it, and I think generally we don't. Most medicines taken outside of a hospital setting are taken orally. They are tablets. It is only really notable when this is not the case. For example, we describe it as a cream that one rubs onto the affected area, or a gel one rubs into the skin to be absorbed, or eye drops. It comes naturally in the sentences. I have no problem if some body text says "injected into a vein (intravenous)" as long as we acknowledge that English does have a word for this, rather than pretend it doesn't or that even if it did, our reader is too stupid to know it. Mostly, when the body text needs to be specific about route of administration, it has already scared the reader with a section heading "Pharmacokinetics" and continues with talk of "plasma concentrations" and "cytochrome P450 enzymes". Scattering simple language in among that just looks foolish. In these advanced sections, I don't think it is good even to use the "injected into a vein (intravenous)" formula. Because if your intention is that someone lacking even that word can understand the sentence, what are you going to do with cytochrome P450 enzymes"? If you really wanted a Pharmacokinetics section that anyone could follow, you'd need to have section lead sentence(s) that had a very very basic overview. -- Colin°^Talk 08:00, 13 July 2023 (UTC)

I don't often get very involved in talk page discussions, so please forgive my lack of familiarity with this process, but exactly how and when do we determine that a consensus has been reached, and what happens after? It's my impression that, at least at this point, the consensus is at least leaning in the direction of using both terms together, such as "term 1 (term 2)", but that there may be variability or exceptions based on the exact section or part of the article. Is that the impression others have as well? Vontheri (talk) 16:14, 13 July 2023 (UTC)

Sometimes what the consensus isn't is more important. Nobody seems to object to using a both/and approach in principle, and nobody thinks language like "orally" or "intravenous" is the worst problem with writing articles.

I think your next step is to copyedit a dozen articles. Aside from improving the articles, it would let you know if your ideas about improvement will scare up any opposition (I don't expect any). WhatamIdoing (talk) 14:50, 14 July 2023 (UTC)

I think your next step is to copyedit a dozen articles.

:grin: Governance and abstraction must be shackled to the honest toil of the concrete and useful. Talpedia 15:35, 14 July 2023 (UTC)

The problem is that it has resulted in opposition when I changed "by mouth" to "orally (by mouth)". That was the catalyst for me making this thread to begin with. See here. (For some reason that editor hasn't posted in this thread to explain the reasoning for their objections, despite me informing them of it.) What should I do if that happens again? Refer the other editor to this thread? Vontheri (talk) 03:22, 15 July 2023 (UTC)

Medical privacy discussion

I have started a discussion about medical privacy at Talk:Caster Semenya#Medical privacy. I would love to get the opinions of folks from WikiProject Medicine, as this seems to be an important topic that hasn't gotten widespread discussion (as far as I can tell). How do we properly balance the interests of our readers against the right to privacy of our subjects? Nosferattus (talk) 00:05, 12 July 2023 (UTC)

commented--Ozzie10aaaa (talk) 12:37, 23 July 2023 (UTC)

Discussion at List of intersex Olympians

 You are invited to join the discussion at Talk:List_of_intersex_Olympians#Suggestion_gathering:_improvements_to_coverage_of_intersex_and_DSD_athletes , which is within the scope of this WikiProject. Kingsif (talk) 06:31, 12 July 2023 (UTC)

thank you for post--Ozzie10aaaa (talk) 12:09, 13 July 2023 (UTC)

Student editing notice

https://dashboard.wikiedu.org/courses/Wesleyan_University/Foundations_of_Contemporary_Psychology_(Summer).

https://dashboard.wikiedu.org/courses/Wesleyan_University/Foundations_of_Contemporary_Psychology_(Summer)/articles/edited?

--Whywhenwhohow (talk) 20:34, 14 July 2023 (UTC)

Naloxone / harm reduction

There is currently a discussion about whether it is due to name harm reduction providers/organizations in the naloxone article at Talk:Naloxone I have removed names of several organizations that were dropped in the article Special:Diff/1165371309 and another editor believes such name drops have a place in the article. I wanted to get broader input on this. Thank you Graywalls (talk) 21:04, 14 July 2023 (UTC)

If the organizations are involved in distribution or advocacy of naloxone then I think it is most likely notable and has at least a minor place in the article. If they are just general harm reduction organizations and distribution or advocacy of naloxone is not a major part of what they do then it is probably not notable in the naloxone article. Vontheri (talk) Vontheri (talk) 07:18, 15 July 2023 (UTC)

I would suggest leaving comments at Talk:Naloxone rather than here to avoid splitting discussion more than necessary. Prezbo (talk) 08:33, 15 July 2023 (UTC)

Then that would be hundreds of needle exchange programs and local governments. It would be easily possible to gather sources for them quite easily. Rather than name any specific organization, I think the more reasonable approach is to say they're commonly distributed by drug users health clinics/needle exchange programs in more generic way especially for the naloxone article so it conveys the information without resulting in a coat rack like Narcan is offered to the community from organizations/agencies, such as Washington State Department of Health, OnPoint NYC Multnomah County, Oregon,City of San Francisco Graywalls (talk) 08:04, 15 July 2023 (UTC)

References

Prezbo - Next time I will do that. Looks like it's too late now for this thread, though.

Graywalls - Don't let me be the tie breaker, but I think generally saying something like "commonly distributed by this type of organization and that type of organization etc." is better to avoid listing hundreds of organizations. I would probably find it notable to mention a couple specific organizations if there is some specific reason that makes them notable. For example, I would find it notable to mention the organization that was a pioneer and was the first to advocate for and/or distribute naloxone. Or an organization that has distributed far more naloxone than other organizations or that was the primary party involved in changing laws or things like that. Those are just examples. Simply being an advocate or distributor of naloxone is not enough to be notable in the naloxone article since there are such a large number of such organizations, but if there is something specifically significant about the organization's activities with naloxone then I would think it is probably notable. Perhaps a separate article in list format called something like "list of naloxone/narcan distributors or advocacy organizations" would be a good place to list all such organizations in their entirety. Those are just my thoughts. Vontheri (talk) 06:51, 16 July 2023 (UTC)

Draft:Post-finasteride syndrome

See #Proposing undoing of mutliple edits removing majority of secondary/tertiary sources from Post-SSRI Sexual Dysfunction article

I reviewed a draft on Draft:Post-finasteride syndrome by User:Xardwen, and they and I are unsure what to do next. There was previously an article on the syndrome, which was then cut down to a redirect to Finasteride. There are questions as to whether there is a well-defined or definable syndrome, and either creating an article or redirecting are contentious. There were persistent attempts by unregistered editors and new editors to recreate an article. The conclusion was to put the parent article finasteride under ECP protection, and to make the redirect from Post-finasteride syndrome to Finasteride a permanently locked redirect. When I reviewed the draft, I advised the author to discuss at Talk:Finasteride and obtain a rough consensus as to whether to recreate an article on the syndrome. There hasn't been any discussion there, and then there hasn't been any discussion at WikiProject Pharmacology. So my question is both what to advise the author to do next, and what I should do next. Robert McClenon (talk) 04:26, 15 July 2023 (UTC)

Probably the best approach would be to expand Finasteride, if warranted, and then if the PFS stuff becomes too big, argue for a split. The draft contains the eyebrow-raising claim that "as of 2023, there appears to be an emerging consensus among the medical community that it represents a real and serious, if rare, iatrogenic disorder" sourced to the journal Annals of Medical and Health Science Research, which does not appear to be reputable and in any case says no such thing, which rings a loud warning bell. The protections currently in place are there for a reason. (Add: and, looking at the user's contributions there seems to have been a concerted effort to shift the POV across the Project on this topic, with less-than-stellar sourcing, e.g.[4]). Bon courage (talk) 14:55, 15 July 2023 (UTC)

The editor also wrote Post-SSRI sexual dysfunction, which I tried to clean up but tbh I'm still not sure if the article should exist. (t · c) buidhe 06:19, 16 July 2023 (UTC)

As the Finasteride article currently stands, there is already a substantial section on PFS; I personally feel that a separate article is warranted to give adequate space to discuss the reported symptoms, research, and controversy surrounding PFS.

Regarding the claim about emerging consensus on the nature of PFS, the relevant quote from the review is as follows: "Based on the existing literature, the medical community believes that these patterns of symptoms constitute the basis for PFS in individuals predisposed to epigenetic susceptibility. The medical community must define and characterize the pathophysiological mechanisms underlying PFS, and more attention should be devoted to patient education and counseling as well as to developing novel management modalities. Further highquality clinical studies are needed to evaluate the potential neuropsychiatric side effects of finasteride in humans and to establish whether finasteride has any exact causal relationship with suicidal ideation and other reported side effects." This seems like an explicit acknowledgement, by the authors of this review at least, of consensus among the medical community that PFS is a legitimate disorder, and warrants further research and investigation; I acknowledge that I may have been too bold in my statement to this effect in the draft, and will re-phrase accordingly.

Regarding my "concerted effort to shift the POV across the Project" on the subject of PFS, guilty as charged- I personally feel that the level of skepticism surrounding PFS that has been expressed on the Wiki is disproportionate to the amount and quality of peer-reviewed research on this subject. I will make an effort to provide more high-quality sources to support this position.

Xardwen (talk) 04:03, 17 July 2023 (UTC)

Concerning post-SSRI sexual dysfunction, the clinical decision aid I'm subscribed to (updated as of June 2023) has the following verdict: "...there is no compelling evidence that SSRI-induced sexual side effects persist after discontinuation." It makes me think this syndrome is not exactly recognized. Draken Bowser (talk) 13:42, 17 July 2023 (UTC)

No indeed. I've been attempting to clean up but the article was spinning hard and the sourcing was terrible (including a mention of reddit forums) & often misrepresented. When it's cut back down to sensibly-sourced stuff, it should probably be re-merged to the SSRI article, as per previous consensus. Bon courage (talk) 14:59, 17 July 2023 (UTC)

There is nothing at post-SSRI sexual dysfunction worthy of coverage that is not already at selective serotonin reuptake inhibitor#Sexual dysfunction. I'd support a merge back, recognizing that there are at least eight SPAs recruited to the article. SandyGeorgia (Talk) 14:22, 18 July 2023 (UTC)

Agreed, seems like the best option. Draken Bowser (talk) 14:47, 18 July 2023 (UTC)

Anaplastic oligodendroglioma to Oligodendroblastoma or glioblastoma

At the article Anaplastic oligodendroglioma is written "In the course of the disease, they can degenerate into WHO grade IV glioblastoma."

If you go to "International Classification of Diseases for Oncology" (https://en.wikipedia.org/wiki/International_Classification_of_Diseases_for_Oncology#938%E2%80%93948_Gliomas) and then look at M9451/3 and M9460/3, it gives the impression that you get oligodendroblastoma instead of glioblastoma.

What is right now? Regards, Wname1 (talk) 09:28, 15 July 2023 (UTC)

After "XH9QF3 Oligodendroglioma, anaplastic, IDH mutant and 1p/19q co deleted" on [[5]], "ICD-11 for Mortality and Morbidity Statistics (Version : 01/2023)" is the next "XH7CX7 Oligodendroblastoma" to be viewed 1 time below. Via "XH7W59 Oligodendroglioma, NOS" there are then 5 times the "Glioblastoma" where above the "Glioblastoma" the topic "Astrocytoma, anaplastic" can be seen. Here it is "Glioblastoma" for "Astrocytoma, anaplastic" and for the "XH9QF3 Oligodendroglioma, anaplastic, IDH mutant and 1p/19q co deleted" then theoretically below currently the "XH7CX7 Oligodendroblastoma". Wname1 (talk) 08:05, 20 July 2023 (UTC)

It's about whether the name "highly malignant oligodendroglioma, grade IV" on https://flexikon.doccheck.com/de/Anaplastics_Oligodendrogliom on the subject of anaplastic oligodendroglioma is correct or whether Wikipedia is correct with "glioblastoma" for anaplastic oligodendroglioma or whether the WHO "XH7CX7 oligodendroblastoma" on the subject of anaplastic oligodendroglioma is correct. Wname1 (talk) 18:44, 20 July 2023 (UTC)

Need input at Wikipedia:Articles for deletion/Post-Vac

  (t · c) buidhe 06:17, 16 July 2023 (UTC)

Medical law and Health law

There's a merge discussion (to merge Medical law into Health law) in need of some more views before closing; if you're in the mood, please head over to Talk:Health law#Merger proposal. Klbrain (talk) 10:27, 16 July 2023 (UTC)

commented--Ozzie10aaaa (talk) 12:04, 18 July 2023 (UTC)

Commented according to [6]. D6194c-1cc (talk) 12:40, 18 July 2023 (UTC)

Proposing undoing of mutliple edits removing majority of secondary/tertiary sources from Post-SSRI Sexual Dysfunction article

See post-SSRI sexual dysfunction

See #Draft:Post-finasteride syndrome

Dear Wikiproject Medicine editors,

I believe that in multiple edits, user @Bon courage has removed tens of secondary and tertiary sources whilst claiming they are "original research" or "primary sources". In my opinion this has brought down the quality of the article significantly.

Here is a sample of the edits (there are many more):

link, their claimed reason for deleting | why I think they shouldn't have been removed

1, "original research" | user has removed all sources which comply with wp:MEDORG and WP:MEDRS (NHS,Medicines and Healthcare products Regulatory Agency, British National Formulary,FDA,American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5),Textbook of Rare Sexual Medicine Conditions, and the textbook Psychiatry and Sexual Medicine: A Comprehensive Guide for Clinical Practitioners).

2,"trim OR" | removal of wp:MEDORG compliant sources from Health Canada, NHS and Hongkong Department of Health.

3,"original research and some awful sourcing"| as mentioned in wp:MEDRS "News sources may be useful for non-biomedical content, such as information about "society and culture" – see WP:MEDPOP"

which the news articles were under the society and culture section.

4,"re-base on secondary source" | removes many many review articles (secondary sources) and their content

This source (5) is one of the sources that could have been used to improve the etiologies section, instead of wiping the section.

6"no secondary sourcing" | It removes the whole society and culture section which had mentioned a BBC panorama and other news articles WP:MEDPOP applies here. (link1 and bbc panorama link)

PSSDnetwork and ... were mentioned in the news articles which would be compliant with WP:MEDPOP

7 , primary, would need MEDRS|another wp:MEDORG, from Medicines and Healthcare Products Regulatory Agency which the editor is calling primary for some unknown reason.

It's very strange to see removal of so many compliant sources and claiming them to be "original research".

I propose an undoing of the edits made, a minority of changes that were proper should be applied after undoing in my opinion. In case the edits were due to not being familiar with wp:MEDORG or WP:MEDRS please refer to this MEDRS flowchart guideline.

After removing all the mentioned(and not mentioned) compliant sources, the same user has said that "it should probably be re-merged to the SSRI article, as per previous consensus."(from years ago) which was related to lack of enough wp:MEDRS compliant sources.

How is removing so many compliant sources while calling them "Original research" or "primary sources" then pushing for a merge a good idea?

In case my understanding of the policies is faulty, please correct me. FallingPineapple (talk) 22:49, 17 July 2023 (UTC)

This is being discussed in the Finasteride section above, but just to take your first example, the NHS (which is usually a good source, agreed) cannot be used to make statements about PSSD with a source which makes zero mention of PSSD. The page was fairly transparently being used to abuse Wikipedia for the purpose of WP:ADVOCACY of a POV without proper sourcing, and the mention of reddit (good grief) leads us a post suggesting coordinated editing of this article to push an agenda.[7] That's not going to fly. You should be aware of WP:MEAT and WP:COI. Bon courage (talk) 05:12, 18 July 2023 (UTC)

"the NHS (which is usually a good source, agreed) cannot be used to make statements about PSSD with a source which makes zero mention of PSSD."

The following is from the source.

"Sexual side effects usually pass after the first couple of weeks. However, very rarely, they can be long lasting and may not get better even after stopping the medicine." source

"Symptoms of sexual dysfunction occasionally persist after discontinuation of fluoxetine treatment.

Priapism has been reported with all SSRIs." 2 FallingPineapple (talk) 06:52, 18 July 2023 (UTC)

It's about one drug. No "syndrome" of any kind is mentioned. Your stretching it from one to the other is WP:OR. Bon courage (talk) 06:57, 18 July 2023 (UTC)

In the leaflets from Medicines and Healthcare products Regulatory Agency mentions the term SSRIs/SNRIs as a general term.

"Medicines like Fluvoxamine Tablets (so called SSRIs/SNRIs) may cause

symptoms of sexual dysfunction (see section 4). In some cases, these

symptoms have continued after stopping treatment." [1]

or

"Sexual problems:

Medicines like sertraline (so called SSRIs/SNRIs) may cause symptoms of

sexual dysfunction (see section 4). In some cases, these symptoms have

continued after stopping treatment." 2

Can these be used as tertiary sources? FallingPineapple (talk) 08:02, 18 July 2023 (UTC)

Those pages (archived version of them anyway) don't mention PSSD or any "syndrome" at all. We should be using the WP:BESTSOURCES directly on the topic, rather than arriving with a pre-determined agenda and trying to twist sources into fitting it. Bon courage (talk) 08:42, 18 July 2023 (UTC)

@FallingPineapple, perhaps this might be clearer:

There is an important difference between "long-term side effects" and "a syndrome". If you want to write about a syndrome, you normally need sources that use the exact word syndrome in it. WhatamIdoing (talk) 15:13, 18 July 2023 (UTC)

Easily four (and probably more) new SPAs spinning an article, with the Reddit, probably warrants an ANI or an SPI rather than discussion confined to WT:MED. SandyGeorgia (Talk) 06:07, 18 July 2023 (UTC)

And this is a copy-paste (much too far back for REVDEL), so all of Xardwen's work now needs review for copyvio or too-close paraphrasing. SandyGeorgia (Talk) 07:46, 18 July 2023 (UTC)

There are at least eight SPAs, all coming from the same internet fora. SandyGeorgia (Talk) 11:09, 20 July 2023 (UTC)

And there is recruiting today at a different forum. SandyGeorgia (Talk) 15:21, 18 July 2023 (UTC)

@Draken Bowser, Bon courage, and Buidhe: the conflation with PSSD and DSM-5 has been plastered elsewhere. See Escitalopram. SandyGeorgia (Talk) 10:46, 20 July 2023 (UTC)

As has the evident falsehood that it has been somehow officially recognised by the EMA. A lot of campaigning and/or useful idiocy in other words. Wikipedia of course won't be falling for that! Bon courage (talk) 12:31, 20 July 2023 (UTC)

@Bon courage: that, unfortunately, comes directly from Peleg (2022), a secondary review which appears to misstate the facts. The 2023 review I just added (Tarchi) may be useful, but I'm out of time, and will be busy for the next two days. Perhaps you can do something with Tarchi. SandyGeorgia (Talk) 12:42, 20 July 2023 (UTC)

Yes, it's an apparent falsehood which has found its way into secondary sources - but that just calls into question the quality of those secondary sources. In evaluating sources, that they contain such errors is a major consideration - the idea that a medicines agency can establish a condition is WP:EXCEPTIONAL and it seems the EMA themselves have explicitly disowned this misinformation, assuming the written answer in the UK parliament[8] came from them. Bon courage (talk) 13:19, 20 July 2023 (UTC)

I will not be able to work on this today or tomorrow; someone who can access the full article needs to look at whether Peleg (2022) at post-SSRI sexual dysfunction should be entirely removed. I suggest that Tarchi 2023 is a better source all round. SandyGeorgia (Talk) 15:10, 20 July 2023 (UTC)

PS, here's what I can see of what Peleg says. From their own documents, I've seen NO indication that's what the EMA said at all, and Peleg even gets the name of the European Medicines Agency wrong: "PSSD gained official recognition after the European medical agency concluded that PSSD is a medical condition that persists after discontinuation of SSRI's and SNRI's." So, source may be dubious overall. SandyGeorgia (Talk) 21:14, 20 July 2023 (UTC)

Well... I'm first curious whether there's a footnote (in the body of the paywalled article) that supports this.

I also wonder whether the article could be corrected. Getting the name wrong looks like a translation error; the fact that it's not true means the sentence probably should be removed. The managing editor for the journal appears to be https://www.linkedin.com/in/sue-goldstein-299a6434 if anyone's already signed up with LinkedIn and wants to inquire about the possibility. (I only spent two minutes looking, but I didn't see a simple "Contact us" form on the journal website, only the generic publisher one and a Twitter link for the journal.) WhatamIdoing (talk) 15:32, 21 July 2023 (UTC)

Source request

Can anyone access https://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2023.32.14.678 and if possible, email it to me? SandyGeorgia (Talk) 19:35, 27 July 2023 (UTC)

Merge proposal

Now live at Talk:Selective serotonin reuptake inhibitor#Merge proposal. Draken Bowser (talk) 11:39, 29 July 2023 (UTC)

Disorder subtypes

I've noticed that there are quite a few missing articles that are just subcategories of diseases that already have their own Wikipedia pages. I was wondering if disease subtypes should have their own Wikipedia articles or just be redirected.

For example, Acrofacial dysostosis Catania form, Acrofacial dysostosis Preis type, Acrofacial dysostosis Rodriguez type, Acrofacial dysostosis Weyers type, and Acrofacial dysostosis, Palagonia type are all missing articles however we have a wikipedia page for Nager acrofacial dysostosis. Should these be redirected or made into articles?

Forgive me if this topic has already been discussed, I am new to editing wikipedia. CursedWithTheAbilityToDoTheMath (talk) 01:18, 22 July 2023 (UTC)

Yes, those should generally be redirects. From the titles and some of your edit history, I'm guessing you're going through Wikipedia:WikiProject Missing encyclopedic articles/Missing diseases? Most of those aren't missing -- it seems to be a dump from some kind of medical encyclopedia that uses a different title structure to us, and a lot of the time covering very rare or speculative concepts that may not clearly correspond to clear-cut 'things' (e.g. a syndrome defined in a much more speculative era of medical genetics that doesn't actually correspond now to a specific genotype). Most of what's on it should be redirected to existing articles. Vaticidalprophet 01:55, 22 July 2023 (UTC)

Yeah I;ve only found about 3 actual conditions with enough documented cases to make an article. I've mostly been doing redirects.

Thanks for the clarification and help! CursedWithTheAbilityToDoTheMath (talk) 02:00, 22 July 2023 (UTC)

You're welcome! Yeah, there are a few legitimate ones on there, but even then the titles are usually wrong. The whole WP:RA/WP:MEA complex is surprisingly useful even today, but you need to get a good feel first both for what's inclusion-worthy and what's structured right even if it is. Vaticidalprophet 02:10, 22 July 2023 (UTC)

Yeah I've noticed the naming issue. I think I'm getting the hang of things but I still have to remind myself when to just call it quits instead of getting in over my head. Browsing through missing links has been surprisingly helpful as it gives me a place to start and helps me learn the more technical sides of editing. CursedWithTheAbilityToDoTheMath (talk) 02:25, 22 July 2023 (UTC)

@CursedWithTheAbilityToDoTheMath, thanks for doing this work.

By the way, we have a sort of tagging system for redirects that you might be interested in. They're called the "R from" templates. So, for example, if you are redirecting a title that might be suitable for an article (perhaps it's a borderline case), then you can add {{R with possibilities}} at the bottom of the redirect page. If you a redirecting an exact synonym, you can add {{R from other name}}. There are dozens of these, and they're not mandatory, but you might find them interesting. You can find the list at Wikipedia:Template index/Redirect pages. WhatamIdoing (talk) 18:07, 22 July 2023 (UTC)

Thank you so much! This was exactly what I was looking for! I will check it out and start using the templates to prevent any future confusion. CursedWithTheAbilityToDoTheMath (talk) 19:56, 22 July 2023 (UTC)

Theranostics

Hello, Medicine WikiProject,

Can we get some eyes on this new article? I know little about the medical field except my own experience as a patient so I'm not sure if this field is fringey or mainstream. But it just plopped down in main space, fully formed, today and I'm a little skeptical about articles by new editors that present entire areas of science and have so little page history to show how our understanding of the subject has evolved over time. Thanks for any editors with medical knowledge who can okay this one. Liz ^{Read! Talk!} 21:28, 24 July 2023 (UTC)

Fastily, what was User:Alan Crofts 2023 before you U5'ed it? I echo Liz's concerns, as the "new" article is already showing up in Google searches for the term, as we might expect it to be. Jclemens (talk) 04:05, 25 July 2023 (UTC)

Here's the text of the page at time of deletion. As written, it's spam, although if it's notable someone can probably clean it up... -FASTILY 05:09, 25 July 2023 (UTC)

Hello. I am Alan Crofts, author of the article and medical affairs expert. I have written the article myself and populated it with all the references. I believe it is important to have a page dedicated to theranostics as it is a new promising field and I am quite sure we will hear more about it. May I have more information on why the article I have written has been flagged as spam and deleted? I am willing to improve it as much as I can. Thanks, Alan. Alan Crofts 2023 (talk) 07:13, 25 July 2023 (UTC)

Hi, @Alan Crofts 2023. The original uses language like "remarkable progress" and "revolutionized the field", which is not what encyclopedia articles usually sound like. There have been revolutions in medicine – vaccination, sterile surgical fields, antibiotics – but it's too soon to know whether this is one of them.

It's also wordy. Consider this bit: "The evolution of theranostics has been driven by collaborations between researchers, clinicians, and industry partners. By combining expertise from various disciplines, scientists and medical professionals can address the complex challenges associated with developing and implementing theranostic strategies." The underlying fact in here is something like "It is an Interdisciplinary field". What you originally wrote sounds a lot nicer, but what we might suggest is:

• no metaphorical Evolution,
• no driving forces (except when someone's actually Driving),
• no commercial interests euphemized as "partners",
• no implying that only the best ("expertise") of each discipline is used,
• no sciencewashing ("scientists and medical professionals", but the patients, managers, support staff, funders, etc. contribute nothing at all?), and
• no overegging the problem space (I'm sure they "address the complex challenges", but they probably also do a lot of routine and boring work, too).

I'm sure it seems like I'm being overly picky – and I am! A smaller amount of this kind of language is normal, natural, acceptable, and even desirable – but I wanted to give you an idea of some of the little bits that might get mentally classified as "spammy" or "flowery" instead of "just the basic, boring facts". WhatamIdoing (talk) 16:03, 25 July 2023 (UTC)

Hi @WhatamIdoing. This is really useful. I will work on this feedback and resubmit the page soon. Alan Crofts 2023 (talk) 08:15, 26 July 2023 (UTC)

You don't have to resubmit anything. The article is "live" already. Just find a sentence you'd like to try re-writing, click the edit button, and make your change. If you do one sentence and check back tomorrow, you can find out if other editors thought your change was on the right track (by checking, e.g., to see whether they reverted your change, left it alone, or changed it even more). WhatamIdoing (talk) 15:43, 26 July 2023 (UTC)

How is combining diagnosis with therapy an 'emerging field'? Looks like good old fashioned bullshitology to me... AndyTheGrump (talk) 11:08, 25 July 2023 (UTC)

Not necessarily? The idea of combining diagnosis with therapy is an everyday medical activity ("If this treatment works, then you have ____"), but it's not just someone making up whatever they want. WhatamIdoing (talk) 15:12, 25 July 2023 (UTC)

Failing WP:V because of missing article titles making it hard to look articles up. SandyGeorgia (Talk) 12:53, 25 July 2023 (UTC)

Citations now filled in, some issues remain. SandyGeorgia (Talk) 14:33, 25 July 2023 (UTC)

Small instances of too-close-paraphrasing found already, but with most journal articles not available online, there may be more. SandyGeorgia (Talk) 12:54, 25 July 2023 (UTC)

Cannot find reason for concern wrt copyvio, but have not completely ruled it out. SandyGeorgia (Talk) 14:33, 25 July 2023 (UTC)

This sort of text, plus the numbered refs within the article, are suggestive that a deep-dive for copyvio is warranted.

• Molecular imaging methods, such as PET and SPECT, can be employed to visualize and quantify tumor characteristics, such as hypoxia or receptor expression, aiding in personalized radiation dose optimization¹⁰.

SandyGeorgia (Talk) 15:12, 25 July 2023 (UTC)

I took a quick look at the draft and have listed the first 6 references. Can we start by assessing the references and see if they meet WP:MEDRS? Here is what I found:

• ref 1 Review article (weak secondary source),
• ref 2 narrative review (I had to look this one up, please correct me if I am wrong),
• ref 3 appears to be a commentary in Nature Medicine ,
• ref4 commentary/maybe a review article (likely not meet MEDRS but I only skimmed the abstract) ,
• ref 5 appears to be a commentary ,
• ref 6 is a powerpoint presentation https://www.ema.europa.eu/en/documents/presentation/presentation-theranostics-nanoparticles-peter-dobson-oxford-university_en.pdf.

I do not have time to finish this list right now as I had to search for each one manually. The next is ref7 or 8 in the PET section.JenOttawa (talk) 13:29, 25 July 2023 (UTC)

I had never heard of theranostics before but can see some clinical practice guidelines and statements from medical bodies are starting to refer to it. Example I found using a quick google search is [9] from the american urology association. Are there any textbooks or systematic reviews vs the narrative reviews? I think that the commentaries/presentation citations should be removed but could be used to look for stronger sources. I think if much stronger sources are used and the wording like "valuable insights", "crucial role", "pivotal role" are avoided you could try to redo it and resubmit. Just my two cents... I have never created an article and have never had to decide if an article is justified/notable so others on here will likely be much more helpful than me. I hope that this helps a little bit @Alan Crofts 2023:. JenOttawa (talk) 13:53, 25 July 2023 (UTC)

I was completing the incomplete citations as you were looking them up. Done now; some I could not find. SandyGeorgia (Talk) 14:31, 25 July 2023 (UTC)

Systematic reviews are excellent sources if you are trying to prove the efficacy of a treatment or otherwise answer a statistical question. They are not really pointful sources for, well, almost anything else. They are not inherently bad sources for anything else, but they're not necessarily better than other secondary sources.

A quick trip to https://books.google.com indicates that there are many books written about the subject. The one whose title appeals to me is Theranostics: An Old Concept in New Clothing, but it is published by IntechOpen,[10] an open-access publisher about whom we have no article (@Headbomb), so I don't know if it's a reputable publisher. Theranostic Imaging in Cancer Precision Medicine from Frontiers also sounds suitably generic. WhatamIdoing (talk) 15:20, 25 July 2023 (UTC)

InTech is a vanity press. Headbomb {t · c · p · b} 15:23, 25 July 2023 (UTC)

Headbomb what about https://onlinelibrary.wiley.com/doi/full/10.1002/VIW.20200134 ?? SandyGeorgia (Talk) 15:25, 25 July 2023 (UTC)

John Wiley & Sons is a reputable publisher. Surely you must have come across them before. Headbomb {t · c · p · b} 15:28, 25 July 2023 (UTC)

Yes, so why is it not PubMed-indexed, as they usually are? SandyGeorgia (Talk) 20:45, 25 July 2023 (UTC)

Not currently indexed for MEDLINE. Citations are for articles where the manuscript was deposited in PubMed Central (PMC) in compliance with public access policies.

My guess is that this is seen as too unrelated to medicine to include. But it's a guess. Headbomb {t · c · p · b} 21:06, 25 July 2023 (UTC)

If that is the case ... interesting ... unrelated to medicine :) SandyGeorgia (Talk) 17:53, 26 July 2023 (UTC)

The topic seems to meet notability as there are scores of secondary reviews. But there is some poor and incomplete sourcing, perhaps some WP:UNDUE, and tone issues that need to be addressed. I've filled in the missing citation information, and flagged the secondary reviews as such, so someone else can take it from there on cleanup. SandyGeorgia (Talk) 14:43, 25 July 2023 (UTC)

Amazing work helping here Sandy Georgia! Sorry, I did not realize that the drafted article was still 'live'. I was going off of the pastebin text version linked at the start of this conversation. Have a great day! JenOttawa (talk) 14:53, 25 July 2023 (UTC)

Thanks to you, too ... I have only scratched the surface, and done for the day. Someone else needs to take a very deep dive here. There is a lot of repetition and redundancy, along with the sourcing issues. SandyGeorgia (Talk) 15:22, 25 July 2023 (UTC)

References

Low-fat diet

The article low-fat diet is in a bad way and needs expansion and better clarity from someone who is experienced in medical editing. Timeshifter a user who has left a lot of bold text on the talk-page has strong views on the subject, there is a current discussion about some 2015 systematic reviews and a low-carb diet author David Ludwig [11].

My understanding of low-fat diets is that they were indeed recommended by health and medical organizations in the 80s and early 90s, back then there was some misunderstandings about fat and there was an outdated idea that all fats are bad. The American Heart Association for example, used to recommend a low-fat diet (reduction of total-fat) but as research progressed and new data emerged it was realised that polyunsaturated fats are beneficial in the diet and there is no reason to reduce all fats or total fat intake, instead the culprit for increasing cardiovascular and cancer risk is saturated fat which should be limited, not unsaturated fat or total fat intake. All of the health and medical organizations like the AHA currently recommend a balanced diet similar to the Mediterranean diet and Nordic diet which includes nuts, seafood, seeds and vegetable oils high in polyunsaturated fatty acids but low in saturated fats.

The low-fat diets of the 80s and early 90s such as Nathan Pritikin, Dean Ornish and John A. McDougall are very much on the fringe of nutrition. Most modern nutritional textbooks are not recommending a low-fat diet. I can definitely help improve the article with a "history" section making clear how the consensus has shifted over the last 30 years.

I am requesting help from experienced medical users to remove/improve any out-dated reviews on the article in the "health effects" section. There are multiple discussions on the talk-page. Unfortunately there is still some confusion about this topic with the outcome being that some people are mislead by low-carb conspiracy blogs into thinking the current consensus from governmental, dietetic and medical organization guidelines are still recommending low-fat diets. There are a lot of references on this but this quick Harvard Health Publishing article gives a good summary if users here are not aware about this, "For the last half of the 20th century, most major health organizations, including the American Heart Association, recommended a low-fat diet. Yes, they did, but the message has changed dramatically. Now, the American Heart Association, the federal dietary guidelines, and other nutrition authorities have shifted away from advising people to limit the total amount of fat in their diets" [12] Psychologist Guy (talk) 20:32, 25 July 2023 (UTC)

Oh, that likely explains why he's over at Wikipedia talk:Identifying reliable sources (medicine) complaining about a supposed lack of transparency in systematic reviews. WhatamIdoing (talk) 15:53, 27 July 2023 (UTC)

Autistic meltdown

A redirect was turned into an article with all manner of marginal sources and medical claims cited to advocacy sources; ongoing original research and synthesis need evaluation. Maintenance tags don't stick. SandyGeorgia (Talk) 14:51, 27 July 2023 (UTC)

The same editor created Autistic shutdown with the same issues, that I haven't even had time to look at. SandyGeorgia (Talk) 15:15, 27 July 2023 (UTC)

That one had copyvio from the first versions = G12. SandyGeorgia (Talk) 15:47, 27 July 2023 (UTC)

I think that having an article on that subject is reasonable, but I'd suggest that editors go into it with somewhat lowered expectations for what's possible. I'm not sure that the research has been done that would make an intellectually impressive article. We might like to treat it something like, say, chemotherapy side effects, and try to add things like a list of common manifestations, risk factors, the precise frequency of meltdowns for different subgroups (e.g., children vs adults, verbal vs non-verbal people, adults living independently vs at home vs in a congregate setting), the best ways to manage the side effects, etc. Instead, I suspect that what's available is at the level of undergraduate teacher training: potentially practical and usually accurate, but imprecise, sometimes vague, and often expressed through narrative stories instead of statistics. WhatamIdoing (talk) 16:15, 27 July 2023 (UTC)

I'm not necessarily against having an article there -- as long as it's not junk, which it was :) And it still struggles :) SandyGeorgia (Talk) 16:17, 27 July 2023 (UTC)

And we've now got Autistic burnout as well.

How far this WP has fallen since the days when Eubulides had cleaned up the walled garden of the autism suite of article, resulting in two featured articles-- now defeatured, and the entire suite overtaken by advocacy. SandyGeorgia (Talk) 19:56, 27 July 2023 (UTC)

The article on autistic burnout is well-sourced with recent literature and the topic has been covered outside of the academic literature as well, eg by the NYT, seconding its notability. It can certainly be extended but I again fail to see how this topic/article is an example of "advocacy". I'm the main author of that article and I'm not editing Wikipedia to advocate for or against anything. (To be honest, I find such a suggestion quite offensive.)

Instead of complaining about the current state of articles, particularly the ones that might be "fashionable" terms in social media discourse or are the subject of media reports, let's work on improving them, just as WhatamIdoing is doing for Pathological demand avoidance and I've started to do for eg ARFID.--TempusTacet (talk) 20:22, 27 July 2023 (UTC)

Are we allowed to state the DSM-5 criteria as in ARFID? I thought they were copyright protected. Draken Bowser (talk) 20:54, 27 July 2023 (UTC)

I'm not a copyright expert but I don't think the criteria meet the threshold of originality required for copyright protection. DSM criteria are quoted often, eg, here for ARFID (or in various academic publications) and diagnostic criteria cannot be paraphrased without potentially changing their meaning, so a direct quotation is the only option to accurately describe the DSM-5 ARFID diagnosis. What cannot be copied are the accompanying texts, which make up the majority of the DSM.--TempusTacet (talk) 21:09, 27 July 2023 (UTC)

I remember having this disussion before. I think the problem was more to do with *every* page containing the DSM criteria. Talpedia 21:47, 27 July 2023 (UTC)

From the perspective of the article, it makes sense to quote the diagnostic criteria, so I believe it's justified in this case. I can certainly see that simply quoting diagnostic criteria without embedding them in text could lead to copyright issues (and would also be relatively useless for the readers).--TempusTacet (talk) 21:52, 27 July 2023 (UTC)

From the perspective of the article, it makes sense to quote the diagnostic criteria

I don't really disagree. The issue is that in a kind of "tragedy of the commons" what makes sense for a single article because of fair use potentially ceases to be fair use when applied at scale. Talpedia 08:22, 28 July 2023 (UTC)

We most certainly cannot violate DSM's copyright, and the APA has taken us to task for it before. We had scores of articles shut down after they wrote to legal. SandyGeorgia (Talk) 21:54, 27 July 2023 (UTC)

Why are you demanding long quotations in autistic meltdown (that are certainly above a threshold of originality) but are demanding the deletion of quoted criteria phrased in a technical language? What guideline suggests that the former are OK but the latter are not?--TempusTacet (talk) 21:59, 27 July 2023 (UTC)

I suggest that you understand those matters before you editwar a COPYVIO back into an article again. If you don't understand what several of us typed above, maybe you need a copyvio admin to do the honors. The APA has taken us to task before, and caused us to take down scores of articles. The single or two-sentence quotes I have asked your for at autistic meltdown, to assure you are accurately representing sources, are nothing of this nature, and if you don't understand that, or WP:MEDRS, please work to do so before editwarring. SandyGeorgia (Talk) 22:10, 27 July 2023 (UTC)

I've never had any issues quoting DSM or ICD diagnostic criteria in publications. As long as a text is engaging with a quotation, it's fine at least under US law, and you will find plenty of examples on the internet and in print. Nobody has suggested that the quoted diagnostic criteria have to be deleted aside from you. People have just wondered whether the quote is fine and you have not even engaged with that question. Happy deleting!--TempusTacet (talk) 22:14, 27 July 2023 (UTC)

Well, now you're on Wikipedia, so get used to real standards. Did You Read What I Typed Above? The APA wrote to legal and made us take down scores of articles. You are becoming tenditious; please read before responding. SandyGeorgia (Talk) 22:16, 27 July 2023 (UTC)

@MER-C, Moneytrees, and Diannaa: See the history at Avoidant/restrictive food intake disorder (editor reinstating direct text from DSM-5 after I removed it once). Must I really go back and search archives for the time that Moonriddengirl had to respond to removing DSM material from almost every condition on Wikipedia after the APA wrote to legal for takedown? SandyGeorgia (Talk) 22:21, 27 July 2023 (UTC)

I'm not interested in continuing discussions with you. You seem to be very convinced of your own position and expertise and I'm not interested in constantly being discredited and told by you that I have no clue or that my ability to read academic sources needs to be questioned, when I'm the one of us who actually has access to the source you're now constantly mentioning as the definitive reference on the topic. I'm not going to argue with you, I just know that you'll not be able to provide a single example where the APA has objected to a quotation such as the one in the ARFID article, as it would be unfounded and not enforceable under US copyright law. Let your and my editing speak for itself.--TempusTacet (talk) 22:25, 27 July 2023 (UTC)

I have it bookmarked: Wikipedia:Copyright problems/2010 March 9#DSM Complaint (Ticket:2010030910040817) — Diannaa (talk) 22:36, 27 July 2023 (UTC)

The DSM-5 criteria have been quoted in the article since 2014. I don't see why this is suddenly becoming a problem.--TempusTacet (talk) 22:37, 27 July 2023 (UTC)

That would be because you called our attention to the article, and Draken Bowser and Talpedia noticed it, so we thank you. SandyGeorgia (Talk) 22:43, 27 July 2023 (UTC)#

This makes no sense, particularly your most recent revert. If quoting the DSM-5 is a problem, then all revisions since 2014 are a problem and virtually all longer quotes on Wikipedia are a problem, no?--TempusTacet (talk) 22:52, 27 July 2023 (UTC)

I'm sorry REVDEL doesn't make sense to you; copyvio admins will decide how far back to go, but they are always/often reluctant to go so far back in articlehistory that the entire article is wiped out. The most recent copy-paste is the most urgent. SandyGeorgia (Talk) 00:15, 28 July 2023 (UTC)

Thanks so much, Diannaa; perhaps we can get Tempus to read that :) Most appreciated, since I've been spinning my wheels all day on these issues. SandyGeorgia (Talk) 22:40, 27 July 2023 (UTC)

I don't see anything there that indicates that the specific quotation in ARFID, which has been there since 2014, is problematic. Neither is it the sole content, nor is it unnecessarily lengthy, nor does the text fail to engage with the quote. If the APA really believed that quoting criteria in this way is problematic, it had almost a decade to object.--TempusTacet (talk) 22:45, 27 July 2023 (UTC)

It's OK if you don't understand. It's not OK if you do it again. SandyGeorgia (Talk) 00:16, 28 July 2023 (UTC)

TempusTacet, I'm coming a bit late to this discussion. Don't know if is resolved for you. I recall the issues way back with DSM. There is a link above. I think this explanation is best: "The problem for the WMF is that material that may be fair use in one article becomes a different issue in aggregate. If we replicate their diagnostic criteria in each article related to the disorders, it seems like we could wind up reproducing the entire book--or at least most of it--which is decidedly not fair use". Copyright is complex and not very rational at times and Wikipedia often has to err on the side of "if in doubt, leave it out". The community accepted the advice we got way back in 2010 and I don't think the matter is up for negotiation. -- Colin°^Talk 18:02, 30 July 2023 (UTC)

Thanks, Colin. There's certainly a difference between copying entire diagnostic criteria and accompanying texts, which is unfortunately done frequently on Wikipedia, and citing specific parts of diagnostic criteria within context, though. The former doesn't make sense from an encyclopedic perspective anyway, so the question whether this is allowed legally doesn't need to be raised, but the latter is definitely fine even without invoking fair use. I've checked with the plagiarism/copyright folks over here and there is no issue with quoting copyrighted works as long as one is engaging with the quote, ie it's not just done to reproduce an entire text/work. (Aside from that, the diagnostic criteria make up just a small part of the DSM, so the fear that the entire book would be reproduced on Wikipedia is unfounded, and it's questionable whether diagnostic criteria meet the threshold of originality.) Do you happen to know who Wikipedia's contact at the APA is/was? Might be worth clarifying what their current position is. They've either given up tracking down even reproductions of diagnostic criteria or changed their approach/focus, also considering that the DSM-5 is apparently available for free here and all DSM-5 criteria we're talking about here are part of this public domain publication by the Substance Abuse and Mental Health Services Administration. (The WHO has been publishing the ICD-10 and ICD-11 freely accessible for a while now, which might also have an influence.)--TempusTacet (talk) 18:34, 30 July 2023 (UTC)

It is against privacy policy to reveal the names of correspondents, but it hardly matters as said employee may no longer be employed. If you want to get a release statement from them, see Wikipedia:Requesting copyright permission. This will have to be sent by an official address of the publisher. --Moonriddengirl ^(talk) 23:11, 30 July 2023 (UTC)

• I'm not clear what you mean by "citing specific parts of diagnostic criteria within context" but if that involves reproducing that copyright text, ...
• "fear that the entire book would be reproduced on Wikipedia is unfounded". That's not what the quote said. It clearly said "or at least most of it". Even "much of it" would be too much.
• "it's questionable whether diagnostic criteria meet the threshold of originality." Really? WMF legal council and a number of highly experienced editors wrt copyright issues for the last 15 years are all spectacularly wrong and you, TempusTacet, are the only person who has noticed this glaring error?
• I'm not seeing why you think the "public domain publication" you linked is actually public domain. Free is not the same thing as public domain. Nor why you think finding a DSM 5 document on the internet made it legally free or that this makes the text public domain. Even if DSM 5 were published at no cost, that doesn't make it public domain text. There are very good reasons why a body like that would insist on retaining full copyright control. For example, so nobody can publish text purporting to be DSM 5 but actually altered to say something different. TempusTacet, I'm not getting any "oh I'm interacting with a world expert on copyright" vibes. More just someone who's done some googling and thinks everyone else is wrong. I don't think arguing about this is productive. Copyright law is not rational and not entirely knowable. We just deal with it. -- Colin°^Talk 15:22, 31 July 2023 (UTC)

Two of our most indisputably best copyright editors (Moonriddengirl and Diaanna) have already opined here. Perhaps the best real-world IP expert I know (Elcobbola) might review some of the statements made in this discussion.

Would anyone care if we refactor the entire copyright discussion to its own sub-section, as it's a detour to the main discussion topic here? If would be much easier on Elcobbola, for example, to not have to read the entire other discussion. SandyGeorgia (Talk) 15:33, 31 July 2023 (UTC)

This is difficult to parse on its own, and I see a number of references to past actions, statements, etc. of which I am unaware or to which I do not have access. Notwithstanding that disadvantage, perhaps the following observations will be of some use (I've tried to present it in a digestible form, so forgive the tortured format--it is meant only to serve that goal}:

• I do not see the basis for the purport that this publication is in the public domain:

1. The fourth page includes: "This publication was developed for the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality (CBHSQ), by RTI International, a trade name of Research Triangle Institute, Research Triangle Park, North Carolina, under Contract No. HHSS283201000003C" (underlining added). While the SAMHSA is a public agency within the U.S. Department of Health and Human Services, the RTI is an independent NPO to which 17 U.S.C. § 105 (which I assume is what was being implicitly invoked) would not be expected to apply.
2. At best page three implies joint-authorship; without a means of disentangling SAMHSA from RTI authorship, it should be assumed to have a copyright.
3. The public domain assertion has the appearance of being the "Government hosting" misconception referenced in the free images dispatch; we would need additional information (e.g., What are the terms of Contract No. HHSS283201000003C? Did the federal government receive, but then release copyright?) to assess this document.

• The specific work, or portion thereof, being discussed (text sought to be included) is unclear to me. If we are discussing "diagnostic criteria and accompanying texts," there may be a legitimate possibility that the former could be ineligible for copyright as facts of the world.

1. Originality is “the bedrock principle of copyright” and “the very premise of copyright law.” (Feist Publications, Inc. v. Rural Telephone Service Co., Inc., 499 U.S. 340, 347 (1991))
2. To quote the Copyright Office, lazily and verbatim: "'No one may claim originality as to facts ... because facts do not owe their origin to an act of authorship.' Feist, 499 U.S. at 347 (internal citation omitted). A person who finds and records a particular fact does not create that fact; he or she merely discovers its existence. As a result, facts 'are never original' and Section 102(b) of the Copyright Act 'is universally understood to prohibit any copyright in facts.' Id. at 356. '[This] is true of all facts – scientific, historical, biographical, and news of the day.' Id. at 348")
3. Similarly, "Section 102(b) of the Copyright Act expressly excludes copyright protection for 'any idea, procedure, process, system, method of operation, concept, principle, or discovery, regardless of the form in which it is described, explained, illustrated, or embodied in such work.'"
4. Again, I have no clue what the referenced diagnostic criteria are, and thus whether originally expressed. (If this were a news report, I would be reading the title, not the article--this is not the domain of the intellectually honest; I am entertaining a hypothetical to assist those with genuine relevant knowledge.) To me, as an uniformed layperson, "diagnostic criteria" reads as "indicators one may analyse and rely upon in the formation of a diagnosis". If, and only if that is correct, I suspect the medical community may consider these to be facts. This is perhaps in need of further discussion.

• I know nothing about the referenced DSM Complaint, and do not have access to the ticket (2010030910040817) or the content it presumably referenced. I make no secret about being skeptical of Godwin on copyright matters, and would give no weight to the comment above of "Really? WMF legal council and a number of highly experienced editors wrt copyright issues for the last 15 years are all spectacularly wrong." This is a fallacy, a particularly unnecessary one, with no place in serious discussion. What is the legal foundation for the opinions, rather than the persons expressing it? Were "WMF legal council and a number of highly experienced editors" referencing both "diagnostic criteria and accompanying texts" in the aggregate? Would "diagnostic criteria" alone, if different, change the assessment? That the exorbitant cost of litigation in the US is used as a bullying tactic is very, very well-known; acquiesce to a request should not necessarily be considered to have any relationship to the legitimacy of the request.
• Per WP:NFCC: "Articles and other Wikipedia pages may, in accordance with the guideline, use brief verbatim textual excerpts from copyrighted media, properly attributed or cited to its original source or author (as described by the citation guideline), and specifically indicated as direct quotations via quotation marks, <blockquote>, {{Quote}}, or a similar method." To move forward, I might suggest that specific text proposed for inclusion should be articulated so it can be assessed against "real world" and proprietary criteria. Эlcobbola _talk 22:49, 31 July 2023 (UTC)

Got to say, I am kind of wary of these articles - is this a topic that is commonly mentioned in books, reviews etc. about autism? Jo-Jo Eumerus (talk) 21:37, 27 July 2023 (UTC)

The short answer is: Yes. The main question seems to be the title of the article, "meltdown" is mostly used from a therapeutic/pedagogical perspective eg by parents or teachers, to describe a range of behaviors. It is not a medical or psychiatric term. (Similar to "stimming".)--TempusTacet (talk) 21:50, 27 July 2023 (UTC)

The long answer is no; see Talk:Autistic meltdown for a full-day's work. The only good sources explain and put it in context as a colloquialism for other behaviors. And in the last few weeks to month, several just like this have popped up, usually with not a single MEDRS source. The autism walled garden has been growing in the ten or so years since Eubulides left, and Colin and I gave up on the entire suite. Stimming is quite a recognized and defined thing, covered in legions of secondary reviews; this is not. The article has had to resort to a marginal publishing house, Skyhorse Publishing to go beyond the colloquialism that Fred Volkmar (editor) publications place it at. SandyGeorgia (Talk) 22:14, 27 July 2023 (UTC)

As I already said: "The main question seems to be the title of the article".--TempusTacet (talk) 22:28, 27 July 2023 (UTC)

I also see some questions about whether this is a topic distinct from similar behaviours in normal children. I mean, repetitive behaviours is a key ASD symptom so Stimming being a topic is plausible, but the sources don't make a strong claim that the topic under discussion here is distinct. Jo-Jo Eumerus (talk) 07:32, 28 July 2023 (UTC)

Stimming sample, secondary-source broad autism overview: PMID 36507695 (I would be interested to see similar for "autistic meltdown", "autistic shutdown" or "autistic burnout"). SandyGeorgia (Talk) 15:04, 28 July 2023 (UTC)

Table 1 in the literature review of this paper has a couple of citations on meltdown and shutdown, though it mentions that what it considers to be the overall topic of "Burnout, Inertia, Meltdown, and Shutdown (BIMS)" has had little formal study. From a quick search on Google Scholar, there are a few other papers that are using the same BIMS acronym, so we might want to consider this as a single broader topic instead of three or four discrete ones when searching for secondary sources. Of course the paper I've just cited is a primary source, as it is another interview based one similar to those in the subsections below. What is useful here I think is the citations in the introduction section, and the terminology it uses, as a datapoint for trying to find any secondary sources. Sideswipe9th (talk) 18:59, 28 July 2023 (UTC)

Best I can tell, the sources they link are all primary, and not of the highest quality kind (generally, the methodology can be summed up as interviewing or surveying autistic people, sometimes online, hence highly biased).

But this is very helpful and does point to a possible solution until/unless some good sources become available -- merging all of them to one article on BIMS, to at least control the proliferation of poorly sourced content. SandyGeorgia (Talk) 19:28, 28 July 2023 (UTC)

Autistic burnout

Re The article on autistic burnout is well-sourced with recent literature and the topic has been covered outside of the academic literature as well ... TempusTacet (talk) 20:22, 27 July 2023 (UTC) we have differing definitions of well-sourced; I haven't yet found a good one on that topic. SandyGeorgia (Talk) 21:55, 27 July 2023 (UTC)

Autistic burnout: every source but one, a book, is primary or advocacy, and most are based on surveys of people with autism.

• The first line of the article is plagiarized from a non-MEDRS source, here. (Because that exists from the first revision, the article may be a G12 candidate.)
• PMID 32851204 is a primary source (of the worst kind, based on an internet survey).
• PMID 36637293 is a primary source that reads like a Master's thesis at best.
• PMID 34088219 is a primary source.
• PMID 36637292 is a primary source.
• PMID 35416430 is a primary source.
• PMID 36605565 is a primary source analyzing online posts.
• PMID 37359683 is a primary source.
• autism.org is an advocacy website.

I cannot find a single secondary review mentioning the term in PubMed.

Google books turns up numerous entries of the self-help type. (At least one of them offers a different definition of the term than the one plagiarized from a magazine in the article now.[13] That 2023 book indicates no research on management, and yet the article has a Management section (we shouldn't be giving Management advice if there's no research.)

An article is plausible here, but this isn't that article. This is yet another sub-topic, not mentioned at Autism spectrum#Other features, because no secondary reviews cover it; that (main) article is not covering what the NYT article in External links summarizes as common comorbidities. The walled garden is growing again; this is what Eubulides and I cleaned up back in 2008, at the point that we had a featured suite of autism articles (now destroyed). SandyGeorgia (Talk) 08:52, 28 July 2023 (UTC)

It looks like "autistic burnout" is mentioned in seven articles. WhatamIdoing (talk) 17:27, 28 July 2023 (UTC)

Yep, that list tipped me off to bigger and still depressing problems; removed a copyvio from the mess that is at Occupational burnout. I'm sure there are also all kinds of MEDRS issues there as well, and probably more copyvio, but how deep can one person dig. SandyGeorgia (Talk) 18:05, 28 July 2023 (UTC)

Occupational burnout is going to remain a mess unless and until the real world decides what they want that condition to encompass. This will realistically require them determining how to differentiate between depression, which generally cannot be cured by getting a completely different job (or becoming independently wealthy), and unhappiness, which sometimes can be. WhatamIdoing (talk) 19:21, 28 July 2023 (UTC)

Yes, but there are other problems in addition to those; the active disengagement of most WP:MED editors wrt MEDRS-needs. SandyGeorgia (Talk) 19:31, 28 July 2023 (UTC)

That article, and several others around workplace stress, have been the site of a long-term war between an editor and a persistent sock, both of whom have real-world expertise in workplace psychology. While it's a mess, I don't think that the relative absence of WPMED folks is really the biggest problem. Also, it's not tagged for WPMED, but even if it were, it still wouldn't be one of our most-read articles, so WPMED folks who were looking for a project might not prioritize that one.

I do wish that the articles around autism, which are extremely popular, were in better shape, but I understand that the major change to the definition a while back prompted a dearth of high-quality up-to-date sources. Things are probably much better now on that front, but it is a really challenging environment. WhatamIdoing (talk) 01:53, 29 July 2023 (UTC)

Autism therapies has more than doubled in size since Eubulides' reliably-sourced version, and there are likely copyvio, UNDUE and MEDRS issues there as well. (I believe most of the "autistic burnout" links were added by one editor, but have not yet checked all.) SandyGeorgia (Talk) 18:13, 28 July 2023 (UTC)

Autistic masking is making numerous statements about cause, etc without using WP:MEDRS sources. SandyGeorgia (Talk) 18:15, 28 July 2023 (UTC)

Sample of general decline across autism suite (History of autism)

Autism spectrum is WP:MED's seventh-highest viewed article.

I offer History of autism, at an unmanageable, unreadable 13,000 words, including boatloads of trivia, uncited content, UNDUE content, excessively long quotes, off-topic material, failure to use WP:SS, marginal sourcing, and based on what I've seen elsewhere, probably plenty of copyvio and MEDRS breaches, too.

• Tools-authorship
• Autism history before damage
• History of Asperger before damage

This kind of editing is seen across all autism articles. Cleaning up the walled garden of advocacy would take the years-long effort that Eubulides once did, maintaining the suite at FA and B-class level; I wonder if anyone cares anymore to undertake such an effort on one of WP:MED's most visible articles. SandyGeorgia (Talk) 16:29, 28 July 2023 (UTC)

Noting the irony of a 13,000-word "start class" article. SandyGeorgia (Talk) 16:48, 28 July 2023 (UTC)

I think you're using "walled garden" to mean something different from Wikipedia:Walled garden? WhatamIdoing (talk) 17:31, 28 July 2023 (UTC)

Yes, it appears so ... I am using it to mean articles that the broader community (specifically, WP:MED) has stopped engaging, and are being edited towards one POV by an exceedingly small and limited group of editors. SandyGeorgia (Talk) 17:42, 28 July 2023 (UTC)

But if you look at this recent (2023) spate of articles, there are both kinds of walled gardens (little broad community input, generally one editor, and a series of articles that basically link to each other). SandyGeorgia (Talk) 18:17, 28 July 2023 (UTC)

The last time I looked at any of the autism articles in depth was during a merge proposal between the autism, Asperger's syndrome, and autism spectrum articles between February and April 2022. While that did eventually lead to autism being merged into autism spectrum as the state of the literature didn't really consider those to be separate entities any longer, there's still a bunch of articles in the autism spectrum template that need updating, trimming, merging, and deleting as contextually appropriate.

Unfortunately the enormity of the task, along with more than a little distraction, has left me feeling overwhelmed at even contemplating tackling it. I wouldn't even know where to begin right now. I'm more than happy to help out, but I think we might need to plan this out because of how many articles are a problem here. Sideswipe9th (talk) 18:38, 28 July 2023 (UTC)

Sideswipe9th the task is doable if enough WP:MED-knowledgeable editors care. And the way to do it is just the way that Eubulides and I did it a decade ago, when we had two editors creating a walled garden of POV advocacy and non-notable topics. I put all the articles in to a chart (since moved to Eubulides' user space) to help us prioritize our work, as there was so much to do. Then we started chipping away at them, prioritizing the least important and least viewed 'til last.

You can look at almost any one of these articles and see that huge swatches can be simply removed (over quoting, copyvio, no MEDRS sources, failure to use WP:SS etc).

Your BIMS (Burnout, Inertia, Meltdown, Shutdown) post above is a good starting point re the walled garden, creating multiple articles on one as-yet-to-be-MEDRS-sourced concept. A huge part of the problem is that so many editors gave up on the suite years ago, and it has all deteriorated, in spite of autism being a highly viewed topic/page. SandyGeorgia (Talk) 19:21, 28 July 2023 (UTC)

I put all the articles in to a chart (since moved to Eubulides' user space) to help us prioritize our work, as there was so much to do That would be perfect. After being hit by the autism and ADHD double whammy, my working memory is awful, and when a task is this large it's super easy to get overwhelmed. Any sort of structure on this would be immensely helpful.

You can look at almost any one of these articles and see that huge swatches can be simply removed Yeah, I fully agree. There's also a fair amount of outdated content, and what could best be described as "legacy articles" that are out of sync with the current state of the literature as the terminology has moved on.

I'm happy to help out here, just really need some sort of structure for what our plan is. Sideswipe9th (talk) 19:31, 28 July 2023 (UTC)

I can do that if real life ever gives me a break, but between the very bad stuff (multiple family health matters) and the very good stuff (trying to invest millions in a surprise bequest for my church), I have been utterly swamped, and the end is yet in sight. But as you know, when I get going on a project, I go full on and make it happen :). Just don't want to start this until I can really dig in, and know I can't right now. Every time I think I see a light at the end of the tunnel, it's a train. SandyGeorgia (Talk) 19:34, 28 July 2023 (UTC)

Sample 2 (Autism and memory)

Another example of the kind of editing spreading throughout the autism suite: Autism and memory.

The aticle relies on many primary sources, and extremely dated secondary reviews, and yet a recent review, PMID 37431322 states that "None of the studies found a significant association between WM and ASD symptoms" and several reviews indicate that results are mixed. So we have more than 3,000 dated words, that could probably be reduced to a 100 as part of the main article, if written correctly using recent reviews. What is happening across the suite is that people are using primary and dated sources to synthesize articles-- not understanding that what you may do in a research paper, you may not do on Wikipedia. Another article that should be gutted and re-written to recent secondary sources. SandyGeorgia (Talk) 13:59, 29 July 2023 (UTC)

Requested move at Talk:Fugue state#Requested move 28 July 2023

There is a requested move discussion at Talk:Fugue state#Requested move 28 July 2023 that may be of interest to members of this WikiProject. SilverLocust 💬 10:21, 28 July 2023 (UTC)

commented--Ozzie10aaaa (talk) 15:17, 28 July 2023 (UTC)

Iffy Redirects

Hello, WikiProject Medicine,

I came across an editor creating redirects to SARS-CoV-2 Alpha variant and I noticed that there are over 50 redirects to this article. I realize that this is not a high priority task but if anyone could look through them and nominate the ones that are invalid or made up to WP:RFD, you'd be helping keep this place tidy. Thanks very much. Liz ^{Read! Talk!} 18:39, 28 July 2023 (UTC)

There are 57 redirects at the moment:

• B117
• VUI - 202012/01
• VUI-202012/01
• B.1.1.7
• H69/V70
• VUI – 202012/01
• VOC-202012/01
• B117 strain
• B117 strain COVID
• B117 strain COVID-19
• B117 strain coronavirus
• B117 COVID
• B117 COVID-19
• B117 coronavirus
• U.K. Coronavirus variant
• UK Coronavirus variant
• U.K. Covid-19 variant
• UK Covid-19 variant
• U.K. COVID19 variant
• UK COVID19 variant
• COVID-19 UK variant
• COVID-19 UK strain
• UK coronavirus variant
• Variant B117
• Variant B.1.1.7
• 501.V1 variant
• 501.V1
• B1.1.7
• U.K. variant
• UK variant
• U.K. strain
• UK strain
• B117 pandemic
• Variant Under Investigation in December 2020
• VOC - 202012/01
• 20B/501Y.V1
• B.1.1.7 lineage
• First Variant Under Investigation in December 2020
• UK COVID-19 variant
• British virus
• UK covid variant
• U.K. covid variant
• Kent variant
• Kent virus variant
• 20I/501Y.V1
• Variant of Concern 202012/01
• B.1.1.7 variant
• Kent variant COVID-19
• COVID-19 Alpha
• Alpha variant
• Lineage B.1.1.7
• Kent variant COVID
• Alpha (SARS-CoV-2 variant)
• Covid alpha
• Alpha (SARS-CoV-2)
• Kent COVID-19 variant
• Covid-uk-20

The "British virus" links to a section, and all the others are to the article in general. One of our more virology-focused editors, such as Graham Beards, would know the nomenclature better than me, but nothing stands out to me as being patently unreasonable. WhatamIdoing (talk) 02:05, 29 July 2023 (UTC)

Requested move at Talk:Menstrual synchrony#Requested move 21 July 2023

There is a requested move discussion at Talk:Menstrual synchrony#Requested move 21 July 2023 that may be of interest to members of this WikiProject. ❯❯❯ Raydann^(Talk) 10:57, 29 July 2023 (UTC)

thank you for post--Ozzie10aaaa (talk) 12:10, 1 August 2023 (UTC)

Commented. Dr. Vogel (talk) 12:48, 1 August 2023 (UTC)

Merger input welcome

Received request to merge the Post-SSRI sexual dysfunction article into the Selective serotonin reuptake inhibitor article on July 29, 2023. Reason: (See ongoing discussion following an AfD decision. Join the discussion >>>HERE<<<). GenQuest ^"scribble" 15:47, 30 July 2023 (UTC)

Pandemic's over! (redux)

There's a RfC[14] about having Wikipedia say the COVID-19 pandemic is over and that it should be referred to in the past tense. Med editors may find this of interest. Bon courage (talk) 17:11, 31 July 2023 (UTC)

More precisely, it is about overturning an old "consensus item" from the talk page. According to the RfC's OP at least, the RfC is for "either a new standard first line or to allow for the editor liberty to later decide one". Even if the item is removed, it would still require a new consensus to change the text of the article to past tense. An odd technical point perhaps, but worth pointing out IMO. Crossroads ^-talk- 23:53, 31 July 2023 (UTC)

Right - the gist is that Wikipedia should take a project-wide stand against the WHO (which it shall deem unreliable in the light of what many newspapers are saying), and make all references across the encyclopedia refer to the COVID-19 pandemic in the past tense. Bon courage (talk) 05:29, 1 August 2023 (UTC)

Credibility bot

I am reaching out to this project because it uses templates from WikiProject X, including {{Load WikiProject Modules}}. I am working on building a new project to make it easier to set up WikiProjects with built-in bot reports. As a proof of concept, see Wikipedia:Vaccine safety/Sources. For medicine in particular, it may make sense to narrowly focus on sources that are definitely unreliable, since that seems easier to pick out. If this is something you might find useful, your support and general feedback at User:Credibility bot would be appreciated. Thank you. Harej (talk) 21:34, 31 July 2023 (UTC)

Listing DSM and ICD diagnostic criteria

I'm currently trying to update an article and I wanted to add the ICD-11 and DSM-5 criteria and specifications for the disorder. I was wondering how to list the criteria without any copyright issues. I checked the discussion archives and wikipedia's manual of style and I can't seem to find a clear answer. Any advice would be appreciated. CursedWithTheAbilityToDoTheMath (talk) 04:35, 1 August 2023 (UTC)

Wikipedia:Wikipedia Signpost/2023-08-01/Tips and tricks

This gives an overview of various citation tools out there. I figured many of you would get something out of this. Headbomb {t · c · p · b} 06:11, 1 August 2023 (UTC)