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List of archives

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

What to do? The sources "copy and pasting" from us are getting to be of higher quality

Was working on our article on baby colic as it was a disaster. Was happily using this July 2012 review article to update and improve our content http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411470/. Came to the "5S" approach and they are word for word the same as us except that we had the content first being added in this massive edit [1] in 2010. Look back further this seems to have been a merge from here [2]. Which was than added in this massive edit here [3] by the same user in May 2010. Do we trust the peer review of this journal and can we simply use this paper to improve our summary of the "5S's" technique? Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:14, 29 June 2013 (UTC)

It looks like XKCD's prediction has come true [4]. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:18, 29 June 2013 (UTC)

The rest of the 2012 paper is copied verbatim from this 2004 paper in AFP. Do journal not check for plagarism? http://www.aafp.org/afp/2004/0815/p735.html It does not appear that what we have was plagiarized but I am not definitive. Anyway have reported it to the journal in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:48, 29 June 2013 (UTC)

The only pay-to-play journals I consider reputable are the PLoS group. I don't trust the BioMed Central journals (of which the Italian Journal of Pediatrics is one), particularly when the authors come from third world countries, which are notorious for plagiarism. They are supposedly peer-reviewed, but who is doing those reviews? Looie496 (talk) 14:11, 29 June 2013 (UTC)

Peer-review is supposed to look at content, not at writing. Plain old editors are supposed to be checking for plagiarism. In this case, it ought to be as simple and as cheap as using one of those plagiarism detection programs that so many schools are depending on. WhatamIdoing (talk) 10:00, 30 June 2013 (UTC)

"Anyway have reported it to the journal in question" -- meaning AFP (for copyright infringement) or Italian Journal of Pediatrics (for plagiarism)? Did you get any response? Klortho (talk) 12:34, 10 July 2013 (UTC)

Menstrual cycle and Menstrual synchrony articles

The former is more of a medical article; the latter is more of a theory-based article, but also deals with reporting information about current medical thoughts with regard to the menstrual cycle. I pointed out here and here to Altg20April2nd (talk · contribs) why he or she should not be adding medical information based on such old sources. The editor is using sources as old as 1937, when pubertal timing (including menarche), for example, generally isn't even the same as it was that long ago. On his or her talk page, I stated, "You should read WP:MEDRS and follow it. Using such old sources for historical information and theories, such as what is included at some parts of the Menstrual synchrony article, is fine. But not when it comes to asserting what the average menstrual length is in human females these days. Because you have not listened to, or rather have not heeded, my concerns about this, I am about to ask members of WP:MED to review your edits to the Menstrual cycle‎ article and to review any problematic additions to the Menstrual synchrony article."

So, yes, now I bring this matter to you all. Flyer22 (talk) 21:15, 4 July 2013 (UTC)

I see Danielkueh, who has been recently working on the Menstrual cycle article, reverted Altg20April2nd at the Menstrual cycle article here and here. Flyer22 (talk) 21:51, 4 July 2013 (UTC)

WP:MEDDATE is a good rule of thumb, especially for rapidly developing areas of science, but studies on menstrual cycle length isn't one of them. If you do know of any studies that have found that menstrual-cycle length has recently lengthened, shortened, become more regular or less regular (independent of birth control), please let me know.--I am One of Many (talk) 21:53, 4 July 2013 (UTC)

The more recent sources, like Danielkueh stated, report 28 days while the sources that Altg20April2nd was adding report 29.1 or 29.5 days. Flyer22 (talk) 21:59, 4 July 2013 (UTC)

And even if both groups of sources were reporting the same number of days, or are when comparing some other relatively new sources to the ones Altg20April2nd was adding, WP:MEDRS is clear that we should use the more recent sources. Flyer22 (talk) 22:02, 4 July 2013 (UTC)

I just saw this edit by you there. Flyer22 (talk) 22:07, 4 July 2013 (UTC)

One of the references inserted by Atlg20April2nd was a study by Chiazze et al. (1968). I just downloaded and looked through (briefly) this article. I won't go into too much detail except to say that the quantitative results from this study needs to be presented and interpreted with caution as it is very context specific. On. p. 379 for example, the authors state "When only those cycles between 15 and 45 days are considered.... the average length drops to 28.1 days...." In any event, this would too long and unnecessarily complex for the lead (WP:lead). Plus, WP recommends the use of secondary sources WP:V as the use of primary sources often results in original research WP:OR. So I am reverting it to 28 days unless there is a broad consensus to change it to 29.1 days. danielkueh (talk) 22:13, 4 July 2013 (UTC)

The problem is that 28-day cycles is not the average length, so you are citing a source that does not support what is in the article. So, there is no source for it, so I suggest the article should say the length of the cycle is unknown or simply state what is in the scientific literature. Actually, the way to do it is to cite the three main studies in this area, which were added, and report the range of results.--I am One of Many (talk) 22:36, 4 July 2013 (UTC)

I will respond on the article main page. And no, we don't rely on the primary sources. We rely on secondary sources so as to avoid original research. Please read WP:V, WP:OR, and WP:V carefully. Thanks. danielkueh (talk) 22:40, 4 July 2013 (UTC)

Apparently, Atlg20April2nd has been adding the 29.5 days information since 2010; obviously, it was removed before recently as well. Flyer22 (talk) 23:06, 4 July 2013 (UTC)

As a passing note, I think you will all have a more productive conversation if you stop using the word "average" and start saying "mean" and "median". The two aren't going to be the same. WhatamIdoing (talk) 14:51, 5 July 2013 (UTC)

One of your project's articles has been featured

Hello, Please note that Louis Pasteur, which is within this project's scope, has been selected as one of Today's articles for improvement. The article was scheduled to appear on Wikipedia's Main Page in the "Today's articles for improvement" section for one week, beginning today. Everyone is encouraged to collaborate to improve the article. Thanks, and happy editing! Delivered by Theo's Little Bot at 07:17, 5 July 2013 (UTC) on behalf of the TAFI team

Treatment of Tourette syndrome

Will some uninvolved editors please look at the recent IP edits to Treatment of Tourette syndrome (edit | talk | history | protect | delete | links | watch | logs | views)? SandyGeorgia (Talk) 14:34, 5 July 2013 (UTC)

Reverted and watchlisted. Looie496 (talk) 15:08, 5 July 2013 (UTC)

Thanks, Looie ... both of those IPs resolve to Brisbane, Australia, so a note about 3RR applying to an individual, not an account, might be in order. I was thinking a COI note might also be needed, but http://www.drbarbarablume.com is in Ventura, California, not Australia. Best, SandyGeorgia (Talk) 15:32, 5 July 2013 (UTC)

The IP has reinstated drbarbarablume.com sourced text after a note on its talk and 3RR notice ... perhaps semi-protection will help. SandyGeorgia (Talk) 11:53, 6 July 2013 (UTC)

Thanks! (Very busy summer ahead, so I appreciate the help and extra eyes.) SandyGeorgia (Talk) 12:16, 6 July 2013 (UTC)

Watching. Graham Colm (talk) 12:21, 6 July 2013 (UTC)

A physician's personal website is still used to source a statement in the article that is contradicted by secondary journal-published reviews. Would an independent editor please view the discussion on talk? SandyGeorgia (Talk) 23:28, 8 July 2013 (UTC)

I reverted the offending material again. I don't quite understand why you left it in place. Looie496 (talk) 23:57, 8 July 2013 (UTC)

3RR ... regardless if the text was obviously poorly cited and should have been shot on site, there are admins who will block me for even something like that. SandyGeorgia (Talk) 00:23, 9 July 2013 (UTC)

My view is that "tag teaming" is the only reasonable way to deal with unresponsive tendentious editors, so feel free to call on me in case of need. I would have reverted this earlier if your edit hadn't covered it up in my watchlist. Anyway, don't let one absurd block shake your confidence. Regards, Looie496 (talk) 01:07, 9 July 2013 (UTC)

My confidence is every bit as intact as my sense of reality :) Or better stated, just because you're paranoid doesn't mean they aren't out to get you :) :) Anyway, I do have recent reviews, have no reason to believe that text is accurate or can be sourced to a secondary review, but thought others who have journal access might unearth something ... so left it just in case. Best, SandyGeorgia (Talk) 02:19, 9 July 2013 (UTC)

Unsourced brand names for pharmaceuticals

I've just noticed at Fluoxetine#Other brand names that we have long list of names for the product as used in different countries, almost all of which are unsourced. Clearly this is less than ideal. Is there any general policy regarding how this should be handled? AndyTheGrump (talk) 19:09, 5 July 2013 (UTC)

Not that I am aware of. I guess one could either add a tag or find a ref to support. This is the sort of info that should go in Wikidata but of course with references. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:17, 5 July 2013 (UTC)

"Unacceptable Levels" (film)

Someone may wish to start a Wikipedia article "Unacceptable Levels" about the documentary film of the same name.

• Unacceptable Levels - Pollution just got personal: a new movie | Jennifer Sass's Blog | Switchboard, from NRDC (June 18, 2013)
• About | Unacceptable Levels
• Unacceptable Levels

—Wavelength (talk) 04:55, 6 July 2013 (UTC)

Thanks for starting it. Biosthmors (talk) 15:35, 8 July 2013 (UTC)

Request for help from AfC

Please review the issues tagged on Androgen deprivation-induced senescence - it apparently has something to do with Prostate cancer. Thanks. Roger (Dodger67) (talk) 14:29, 7 July 2013 (UTC)

New article on reverse T3

Dear Colleagues; I have written an encyclopedic article on reverse T3 that can be used to replace the stub that currently exists, if Wiki wishes. It has been reviewed by an editor and called "impressive." His concerns have been addressed and some sections accordingly re-written. His advice was to now post the new article on this site and ask for comments as a prelude to its use. My article can be found at: http://en.wikipedia.org/wiki/User:Njmcdaniel/sandbox#Summary. Would any interested editor with time give it a look? I believe this will be a useful addition to Wiki. Thanks, and please - let me know the next action step to move this project ahead. Thanks! Njmcdaniel (talk) 00:38, 8 July 2013 (UTC) (Alan).

A couple of useful guidelines are

• WP:MEDRS
• WP:MEDMOS

Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:46, 8 July 2013 (UTC)

Linking common terms

What are peoples thoughts on linking common terms such as "symptoms" in this edit? [5] Is this something we should routinely do or avoid? Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:41, 8 July 2013 (UTC)

I generally favor such links, although not if there are more important words to be linking in that sentence. Too many bluelinks in a sentence is not desirable. WhatamIdoing (talk) 14:41, 8 July 2013 (UTC)

Unless it is particularly obnoxious this falls into my personal category of "things to be ignored", along with changes from British to American spelling or vice versa. Looie496 (talk) 15:45, 8 July 2013 (UTC)

See WP:OVERLINK.—Wavelength (talk) 15:55, 8 July 2013 (UTC)

I'd go with leaving the hyperlink as it is. Though personally I think "symptoms" comes well under "everyday words understood by most readers in context", a quick skim of medical articles - see internal search for "symptoms" [6] - suggests that hyperlinking the word is usual here. Gordonofcartoon (talk) 16:08, 8 July 2013 (UTC)

Would wikilink "symptoms" if I wanted to make a distinction with "signs" close by. Another example of where I would wikilink this is " ... is a symptom not a diagnosis" where latter is also wikilinked. Questionable need to wikilink the word otherwise imo, but like Looie suggests, this is mostly harmless. Lesion (talk) 16:23, 8 July 2013 (UTC)

I think links are generally useful for words that are being used with a technical meaning. For instance, some readers may not be familiar with the distinction/overlap between "symptoms" and "signs". So, yes, I do think it's potentially useful, especially since we're trying to write for a wide range of users consulting Wikipedia for a variety of reasons. 86.161.251.139 (talk) 18:03, 8 July 2013 (UTC)

Positive/negative symptoms?

• On a related point, is there perhaps a weight issue in Symptom#Positive_and_negative_symptoms, given that this relatively large chunk of the page dedicated to symptoms as a general concept seems primarily to pertain to schizophrenia (Schizophrenia#Positive_and_negative_symptoms) [7]? 86.161.251.139 (talk) 18:32, 8 July 2013 (UTC)

That section is pretty minimal. I don't think positive/negative symptoms could be mentioned in any less space without actually deleting the content completely. Maybe the rest of the article is just a bit underdeveloped at this stage? Deleting that content would also take away most of the references ... which in truth is a poor reason to argue against deleting content ... but basically I think the article as a whole would benefit more from an expansion of the other sections rather than removing this part. Lesion (talk) 18:45, 8 July 2013 (UTC)

Yes, I agree this sort of imbalance tends to be part and parcel of relatively brief pages. 86.161.251.139 (talk) 19:00, 8 July 2013 (UTC)

Wernicke's encephalopathy

Further guidance likely needed for a new editor here. They keep adding lists of primary sources (case studies in the instance) Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:50, 8 July 2013 (UTC)

I have contacted the editor in Spanish and explained to him in our language the importance of secondary sources and better English. I have to say that after a quick search I have also seen a similar pattern of editing by this user in the Spanish article. --Garrondo (talk) 20:27, 9 July 2013 (UTC)

Thanks Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:35, 9 July 2013 (UTC)

DSM 5

I have a copy today. It looks like a lot of new names for more or less the same thing. I assume we will redirect most of these to the old terms? The last thing we need is somatic symptom disorder. undifferentiated somatoform disorder and somatization disorder. I have redirected them both to the last.Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:49, 9 July 2013 (UTC)

Agree redirect the less notable terms. It's going to be a while before people catch up. See also Wikipedia_talk:WikiProject_Psychology#Somatoform_disorder_and_DSM_V. Lesion (talk) 10:41, 9 July 2013 (UTC)

Mental retardation apparently got renamed Intellectual disability (intellectual developmental disorder)—yes, the parenthetical bit is part of the name. The original plan was to call it intellectual developmental disorder, by way of distinguishing it from the same intellectual difficulties being due to TBI or dementia. I'm not sure what to do with their final choice of name, which will look like we've disambiguated the page title. WhatamIdoing (talk) 14:21, 9 July 2013 (UTC)

We don't have to follow ICD or DSM names (our guidelines provide for that) ... if we did, Tourette syndrome would be the ridiculous article title of "Combined vocal and multiple motor tic disorder [de la Tourette]". SandyGeorgia (Talk) 14:24, 9 July 2013 (UTC)

Agree, we don't have to follow sources like the ICD and DSM-- where a clear consensus is demonstrable in the sources as to the most notable name. In disputed cases, the MOS tells us to seek out international standards, giving as an example the ICD, but I wouldn't interpret this as being universally mandatory. In all these cases mentioned so far I would guess that most of the sources are using the "old" term, and I suspect this will be the case for a while to come. Old habits die hard... Lesion (talk) 14:32, 9 July 2013 (UTC)

Agree, ICD, at least, has to serve as a tool for internationally standardized classification/coding (eg for epidemiological and surveillance purposes), rather than universal naming of... erm..., unspecified. 86.161.251.139 (talk) 15:43, 9 July 2013 (UTC)

I don't think that these new names are going to catch on at all in most cases, especially given the intense criticism the DSM-5 has gotten; a lot of the medical community, like the lead of the DSM-5 article currently states, feel that the DSM-5 "forces clinicians to make distinctions that are not supported by solid evidence, distinctions that have major treatment implications, including drug prescriptions and the availability of health insurance coverage." I also agree that we should use the medical terms that are most common, following Wikipedia:Manual of Style/Medicine-related articles#Naming conventions. Flyer22 (talk) 14:53, 9 July 2013 (UTC)

And as for the part of the naming conventions guideline that states "Where there are lexical differences between the varieties of English, an international standard should be sought," giving the World Health Organization, ICD-10, and DSM-IV-TR as examples (I suppose we'll be updating the DSM mention), there are not enough lexical differences; as we know, it's only the DSM-5 using these new names. Flyer22 (talk) 15:01, 9 July 2013 (UTC)

Actually, in the case of Tourette's, it is the ICD-10 that uses the name that few journals use ... in the case of TS, neither ICD nor DSM reflect the most common usage in journals, but ICD-10 is worse than DSM. SandyGeorgia (Talk) 15:08, 9 July 2013 (UTC)

Sandy, do you mean worse with regard to naming? Or worse in general? Or both? And are you specifically speaking of the ICD-10 versus the DSM-5, or the ICD-10 versus the DSM-IV-TR and DSM-5? Flyer22 (talk) 15:24, 9 July 2013 (UTC)

I'm speaking of naming ... the huge majority of secondary revievs and reliable sources refer to it as "Tourette syndrome". The ICD-10 calls it the overdone, Combined vocal and multiple motor tic disorder [de la Tourette], which we wouldn't use and which would make an awkward article title, and which even the leading UK TS researcher (Robertson MM) doesn't use in article titles. The DSM refers to it as Tourette's disorder, which is still rarely used by researchers, but that name is not as bad as ICD. (Scan the secondary reviews listed in the sources at TS and you'll see that most use Tourette syndrome-- in recognition that the "significant impairment or distress" criterion was removed in DSM-IV-TR, because impairment is not necessary for a TS diagnosis, hence the preference researchers have for "Syndrome" over "Disorder".) In terms of the content (ICD vs DSM-IV-TR vs DSM-V), Tourette's has been spared the controversy-- there are few problems with all three, and V made minor but logical and well-accpeted adjustments relative to IV-TR. SandyGeorgia (Talk) 15:59, 9 July 2013 (UTC)

I see. This discussion has made me think about gender identity disorder versus gender dysphoria; there is significant debate about whether or not to call this condition a disorder because of some research suggesting that it is not a disorder and the stigma that the term disorder causes the transgender community (even saying "condition" can be considered offensive to some transgender people, and I only use it in this case when I don't know what word to use in its place that wouldn't cause offense and/or to be clearer). The diagnosis (that may be better to use than "condition") is still referred to as "gender identity disorder" by most of the medical community, but the article was changed to Gender dysphoria not long after the DSM-5 was published. The article currently states "formerly known as gender identity disorder (GID)," but, like I just noted, it's not "formerly" for the medical community, except for the DSM-5 (and researchers who are personally preferential to using the name gender dysphoria). So I'm interested to know your and other WP:MED participants' thoughts on this matter. I know that some (maybe all) of our transgender editors, such as Sceptre, Bonze blayk and Picture of a Sunny Day, would be against moving the article back to Gender identity disorder (I linked their names so that they will be aware of this discussion). And given what I stated in this paragraph about this topic, this matter may be an exception to following the medical terms that are most common. Flyer22 (talk) 16:28, 9 July 2013 (UTC)

Flyer22? Perhaps you overlooked my formal recusal from editing articles dealing with "transgender issues" towards the end of the ArbComm Case on "Sexology"… I've updated my user page to clarify this. - thanks, bonze blayk (talk) 17:32, 10 July 2013 (UTC)

Our wording in MEDMOS ("The article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources ... ") has worked for Tourette syndrome: that is, regardless of the vagueries of ICD, DSM, etc, almost every highest quality journal article calls it "Tourette syndrome", and that is the name most used and recognized by medical sources. I'm not sure what the situation is for the gender diagnosis, but I do not believe we must be beholden to either DSM or ICD-- gotta do your homework on that one :) SandyGeorgia (Talk) 16:41, 9 July 2013 (UTC)

Yes, per my initial statement above, I agree that we do not have to be "beholden to either DSM or ICD." I'm not sure about some other people's homework, but my homework on that is solid. Flyer22 (talk) 17:06, 9 July 2013 (UTC)

I think the issue of "high-quality" here is important. Because on that basis alone, mental retardation should have been changed well before the DSM changed it (they are rather late to this). This is one for which there is even a law in one country (USA - Rosa's Law). Particularly for terms related to disabilities and mental health, the pejorative use of terms is a real issue. That significant parts of professions are slow to reflect these changes is not a reason to stick with terms. It's a question of where in the arc of progress on sensitivity we want to be. Not too early (or you get too far ahead of people and make changes that don't end up "taking"), but not leaving it so that Wikipedia is using terms like mental retardation (which was already regarded as not acceptable 20 years ago in disability and progressive authoritative medical circles).Hildabast (talk) 16:50, 9 July 2013 (UTC)

I'm not sure your argument works in terms of Wikipedia policies-- we are not advocates, we follow sources. Of course, if the preponderance of "high quality" sources agree with your take on the naming, then we're good. SandyGeorgia (Talk) 17:00, 9 July 2013 (UTC)

This is the same as being 20 years out of date on clinical practice: and it's to do with setting the bar high enough on what "high quality" means, to relate to reputable conventions, not practise in literature that may be high quality on other grounds, but facing journal policies that are out-of-step or simply finding old habits hard to break. I don't think this is an issue of advocacy versus sources: it's about staying current and putting the effort in - it's not as simple as what's the terminology in the papers we're citing. Truly finding out what the "preponderance of high quality sources" say would be a research exercise for which you'd need a source.Hildabast (talk) 17:08, 9 July 2013 (UTC)

I'm afraid I'm still not following Hildablast's post (of 17:08) ... if I am understanding it correctly (which I may not be), it seems to be saying we should advocate for change and consider medical sources as "out-of-step", rather than follow sources, which is not Wikipedia's role. It is not up to us to say the highest quality journals may be "finding old habits hard to break". We report what the highest quality sources say. In the case of the article name for Tourette syndrome, following sources works for the title; in the gender case, I don't know the situation. SandyGeorgia (Talk) 17:48, 9 July 2013 (UTC)

Hildabast is concerned about the use of MR rather than ID, not about transgender issues.

As a point of fact, if you look at the titles in review articles over the last ten years, about half use MR and half use ID. There is something of a pattern to it: Fragile X has "MR" and Down syndrome has "ID". MR is out of date socially and in some cultures, because children used that (like all the previous names) as a taunt on the playground. "What are you, specially abled?" just doesn't have the same ring and so hasn't caught on. If you look at other languages, the names usually translate to something similar to either MR or ID. We have "mentally held back" (that's what "to retard", e.g., flame retardant, means); other languages have "cognitive incapacity" (Spanish), "mental handicap" (French), and "mentally hindered" (German; the last word also means disability in general).

What none of us have, thanks to the DSM5's last-second change, is a name that explains why this particular kind of disability-affecting-the-intellect is importantly different from all of the other disabilities-affecting-the-intellect. In fact, they've muddied the waters even further by expanding the age range due to purely financial/legal considerations. Previously, anyone who developed a disability-affecting-the-intellect by smearing his drunken brains on the highway at the age of 21 had a TBI. Now, he has what used to be called MR, because it happened before the end of the expanded "developmental period", and this label means that the patient gets a different type of financial support in the U.S. WhatamIdoing (talk) 19:02, 9 July 2013 (UTC)

Yes, I'm talking about mental retardation - and yes, it would be language-specific. How long any medical practice takes to spread out to all cultures from wherever it starts makes language similar to other aspects of practice - if you waited for the change to be a majority in every culture, only things not researched widely would change within the same generation the profession at an international level changed. I'm arguing that you'd have to do proper research to really determine this by research, and it might not be the best measure anyway: it's showing when has this become a long-accepted issue, not necessarily when is it a good time to make the change. But for example, if major societies, their guidelines and their journals make the switch - whether or not they are the majority of the literature - that might be the point at which you say, it's only a matter of time now till it filters through the majority of authors and the majority of journals' editorial policies. You can see this phenomenon of course in the WP itself. The decision can be made about the title, but does that mean that the majority of contributors never type that word any more? Not necessarily. That wouldn't invalidate the decision by the community (as the community organizes itself) to have made that determination, and for it to be just a matter of time till it was routine. Just because something is high quality methodologically, doesn't mean it's representing the social development of a profession - it mightn't even be written by people from that profession. When policy changes, and when widespread implementation changes, can be two separate things. One may happen before the other.

For the ones I've researched, there's a critical mass of opinion leaders reached, then policy/practice of the professional leadership changes, and then practice of others slowly catches up (much like many changes in clinical care, in fact). I don't know of examples where the accepted opinion of profession leadership changes, and the majority doesn't eventually follow - be interested to hear of any. They're usually more on the conservative side. Waiting for the latter - that a majority of journals/authors change (how determined without knowing you've got a representative sample?) - may mean being out of date by a decade or two (as Wikipedia is with some women's health language, while having made the change around the same time as the profession - not the literature - in others), because an error-prone measure may be used. My point being, a compelling case may be made at the point there's major international consensus or consensus from multiple major societies on something, rather than waiting for the literature method - especially when you can't rigorously research the literature anyway. Hildabast (talk) 23:00, 9 July 2013 (UTC)

From the looks of it, this one has gone the other way: first opinion leaders, then the general public, and finally the professionals are playing catch-up. I suspect that one reason for professional resistance is because the first few proposed alternatives, like developmental disability, were so wildly imprecise as to be useless for professional purposes. WhatamIdoing (talk) 01:28, 10 July 2013 (UTC)

I'm very puzzled by these arguments. DSM isn't something that's updated regularly: it was last updated in what, 2001? The debate about mental retardation for quite some time has been not about what to call it - that was settled some time ago (see this article from 2011 saying the debate had been going 15 years then, and was settled from a policy and professional POV. The MeSH heading was changed to which that WP article links does not say mental retardation either. The profession is debating something else around its classification - which would have been happening regardless of what you call it. By the time Rosa's Law came along, this acceptance had already happened. This is up there with Mongoloid for Down Syndrome, or spastic for cerebral palsy or moron. Just because it's such a long time between ICD and DSM revisions says nothing about this specific term. Hildabast (talk) 02:31, 10 July 2013 (UTC)

Rosa's Law was introduced two years before your source says that it was settled from a professional POV. That indicates that the legal system moved faster than the professionals.

I suspect that we have different experiences. I've actually talked to physicians in the last couple of years who have been genuinely surprised to hear that MR is considered offensive and outdated by parents and advocates. Perhaps all the ones you talk to got the memo a long time ago. WhatamIdoing (talk) 15:51, 10 July 2013 (UTC)

If the DSM had gone with its original proposal, I would have personally recommended the page move to IDD, despite the current ICD still using the old name and the future ICD reportedly planning to use the popular, rather vague "intellectual disability". But with this odd parenthetical name appearing in the DSM, I'm just not sure that it's a good encyclopedia article title, and so I've done nothing. WhatamIdoing (talk) 01:28, 10 July 2013 (UTC)

I don't think the article needs to be called that: "intellectual disability" is the MeSH and professionally used term (search PubMed and that's what you'll predominantly see in titles): they are acknowledging that it may begin in the developmental period. Hildabast (talk) 03:07, 10 July 2013 (UTC)

Whereas Heart attack takes one to a WP:MED page, Transgender doesn't. Turning to Gender identity, the #In the DSM subsection summarizes terminological issues discussed in the page linked as Further information: gender identity disorder (a WP:PSYCH page). So, seen in the round, maybe Wikipedia is actually already putting the "medical" model into some sort of perspective? 86.161.251.139 (talk) 17:42, 9 July 2013 (UTC)

IP, there was discussion last year and earlier this year about what WP:MED wants to label as being within its scope; see the WP:MED Wikipedia:Articles for deletion/Gynandromorphophilia and WP:MEDRS Proposed change to opening words discussions (especially the former discussion). Though "psychology" and "psychiatric" do fall under "medical," not all articles dealing with those topics will be tagged as falling within WP:MED's scope, especially if the topic is significantly more a social topic than a medical topic...which the topic of transgender is. Sometimes it is decided that an article dealing with a psychology and/or psychiatric topic is better left tagged with Wikipedia:WikiProject Psychology and/or Wikipedia:WikiProject Medicine/Psychiatry task force. Any type of psychology and/or psychiatric topic is still brought to this talk page, of course, especially considering that WP:MED is the most active of the three projects (with Wikipedia:WikiProject Medicine/Psychiatry task force being the significantly less active one).

On a side note: While checking up on Wikipedia:WikiProject Psychology earlier this hour, I came across the article Wikipedia:Psychology; that article needs to be deleted (if not a notable topic) or fixed up better than that. Flyer22 (talk) 18:42, 9 July 2013 (UTC)

My post wasn't intended to be about projects, as such. Rather, I was trying to get a feel, from a general users' perspective, of how the the DSM-titled page fits in to Wikipedia's presentation of transgender topics as a whole. My impression is that if a user comes to Gender dysphoria via more general pages, such as Transgender then the DSM diagnoses appear within a broader social context. If on the other hand, a reader goes straight to Gender identity disorder then the controversy surrounding that term/diagnosis (and, by implication perhaps, the medical model as a whole) is still apparent. So, overall, I feel a broader picture does come across—one in which the psychiatric/medical establishment may conceivably be playing catch up. 86.161.251.139 (talk) 20:25, 9 July 2013 (UTC)

Considering the title format, which marks it as a project page, and that it is placed in Category:Wikipedia essays, I see that it is an essay. But it still needs cleanup and should be tagged as an essay at the top of the page. Flyer22 (talk) 18:48, 9 July 2013 (UTC)

If we weight all recent high quality sources (which would include the DSM and ICD) plus some textbooks and review articles we should be good. We will not be the first and we will not be the last to switch over. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:23, 9 July 2013 (UTC)

Note: At the Gender dysphoria talk page, an IP has brought up the matter of retitling the Gender identity disorder article to Gender dysphoria, and describing the diagnosis as "formerly known as gender identity disorder (GID)." Flyer22 (talk) 22:57, 9 July 2013 (UTC)

THE introduction of the article on Gender Dysphoria says "Gender dysphoria, formerly known as gender identity disorder (GID)" but they are totally different things. As written in the Gender Dysphoria talk page, putative expert James Cantor wrote the statement that "Gender identity disorder is as clear an identity disorder as one gets".

An Identity Disorder is an entirely different psychological phenomenon from a Dysphoria (which in unsophisticated language is an anxiety with a melancholy). Gender Identity Disorder should never have been moved (really renamed) to Gender Dysphoria. Gender Dysphoria can stay, in a DSM-5 context, but Gender Identity Disorder needs to be reinstated.

Removing GID endorses a purely American perspective. GID may be obsoleted in the DSM but it is still current in the ICD (International Diseases) wherein Gender Dysphoria does not exist. See ICD-10 F64.2 and F64.8. The ICD is backed by the entire United Nations Organisation but the DSM 5 is backed only by one professional association and so is much less authoritative than the United Nations. We should not be beholden to either DSM or ICD but following only the DSM where the two clash is clearly wrong. The ICD is a more authoritative source than the DSM. The fact that the patient population for the two overlap substantially is not a reason to describe two totally different concepts in psychology as if they were one and the same. Wikipedia should be describing concepts in psychology, rather than stigmatizing diagnoses as such. Is Wikipedia to become a purely American bully thing? If not there needs to be two separate pages, one for Gender Identity Disorder and a totally separate one for Gender Dysphoria with a mention that Gender Dysphoria is is only an American fashion. 71.3.97.37 (talk) 23:59, 9 July 2013 (UTC)HenryHall

I really don't want to make these changes myself, I am not a Wikipedia expert. But the recent changes to Gender Identity Disorder desperately need to be reversed out. And, I would suggest a "Not to be confused with Gender Dysphoria" or "See also Gender Dysphoria" added. 71.3.97.37 (talk) 12:50, 10 July 2013 (UTC)HenryHall

IP (Henry Hall), gender dysphoria is gender identity disorder; the only differences between them with regard to the DSM-IV-TR and the DSM-5 is that the DSM-5 calls the diagnosis "gender dysphoria" and has somewhat altered the criteria. The name was changed for the DSM-5 because, as the Gender dysphoria article notes, the term gender identity disorder was considered stigmatizing because it has the word disorder in it. Creating a separate article for gender dysphoria would be creating a WP:POVFORK. They should be covered in the same article because they are the same topic, with slight differentiations in the DSM-5. This discussion is partly about not creating WP:POVFORKS just to cover the DSM-5 changes with regard to diagnoses. And as can be seen from above, with regard to comments by me and others, your points about changing the article title back to Gender identity disorder, and removing "formerly known as" are valid. I reiterate, like you do, that the diagnosis is not "formerly known as gender identity disorder"; it still is known by that name in the majority of the literature on the topic.

By the way, when you state "Gender Identity Disorder should never have been moved (really renamed) to Gender Dysphoria," I'm interested to know if you are only referring to the Wikipedia article title or are also referring to the DSM-5 using the latter name. Considering that you have categorized gender identity disorder and gender dysphoria as two different things, I suppose you are only referring to the title of the Wikipedia article. Also, since it may help, I've invited James Cantor to this discussion by linking his username in this paragraph; WP:Echo will let him know of this discussion now. Flyer22 (talk) 17:19, 10 July 2013 (UTC)

Where I wrote should "never have been moved (really renamed)" I was indeed referring to the Wikipedia article. The DSM is whatever it is, it matters nothing what we think it should be. But really, an Identity Disorder is not a Dysphoria; they are totally separate concepts in psychology. The fact that the two sets of diagnostic criteria are very similar does not make the two disorders the same thing. The previous sentence is crucial. Psychiatry as a whole has very low validity which is a term of art meaning that one set of very similar symptoms fits many different disorders. Gender Dysphoria as defined in the DSM is strictly an American thing; it is a minor thing compared with ICD GID which is worldwide and more authoritative. Both GD and GID are current concepts in psychology (unless you take a strictly American view of things) 71.3.97.37 (talk) 17:50, 11 July 2013 (UTC)HenryHall

IP (HenryHall), what I stated above about gender identity disorder being gender dysphoria isn't about identity disorder being different than a dysphoria in some contexts; it's about the fact that "the only differences between [gender identity disorder and gender dysphoria] with regard to the DSM-IV-TR and the DSM-5 is that the DSM-5 calls the diagnosis 'gender dysphoria' and has somewhat altered the criteria." Researchers, not just American researchers, have been using the names gender identity disorder and gender dysphoria interchangeably for years. Googling the two names together (whether regular Google, Google Books or Google Scholar) shows that. It is often the same diagnosis in the literature (not just American literature), with the DSM-5 now having somewhat different criteria for it, though sources occasionally distinguish between them; see, for example, this source (page 1127) that distinguishes and, it seems, touches on what you mean about distinguishing. I understand that gender identity disorder can be considered an aspect of the more broader application of the term gender dysphoria. However, if you read WP:POVFORK, it is clear that separate articles should not be created in this case. Again, your points about changing the article title back to "Gender identity disorder" and removing "formerly known as" are valid. But your insistence that gender identity disorder and gender dysphoria "are totally different things" is not supported by research; some researches distinguish them somewhat (again refer to the source in this paragraph), but never have I seen them totally distinguished. Note again that I am not speaking of differences in the terms disorder and dysphoria. Or the concepts of identity disorder vs. dysphoria in psychology. I am speaking of gender identity disorder vs. gender dysphoria.

Perhaps, someone else is interested in weighing in on this? I think I've stated all I'm going to state about it in this discussion. Flyer22 (talk) 18:45, 11 July 2013 (UTC)

I agree that the ICD 10 is a more global source than DSM 5 and should trump the DSM 5 on Wikipedia when the two are in conflict. As people familiar with my past comments on Wikipedia are probably aware, I don't personally believe being transgender is a disorder or a psychiatric condition of any kind. Being trans is simply a natural biological variation in my opinion, like being tall or having red hair. However, transgenderism/transsexualism is commonly regarded as a disorder by the transphobic medical establishment, which is, of course, controlled by cisgender people. I don't really have a problem with Wikipedia acknowledging this reality in a NPOV way. And I think it's true that "Gender Identity Disorder" is probably the most accurate label to summarize the current majority medical opinion on transgender people and our lives. So I would be fine with changing the "Gender Dysphoria" article back to "Gender Identity Disorder," and to be honest, I was sort of taken aback when the article was renamed earlier this year after very little discussion. There's no reason that the DSM 5 should trump the ICD 10 or the majority of medical sources when one is looking at a medical concept (and Gender Identity Disorder/Gender Dysphoria (as a formal diagnosis) is a medical/psychiatric concept). In contrast, I was opposed earlier this year to the existence of an article on "gynandromorphophilia" because it was a non-notable, fringe theory developed by James Cantor and Ray Blanchard that is of little interest to the medical community, in general. But GID is a significant theoretical phenomenon in the medical community, and I am OK with having an article about it and having the article under the name "Gender Identity Disorder." Rebecca (talk) 21:29, 11 July 2013 (UTC)

P.S. Thank you for notifying of this discussion, Flyer 22. I appreciate being kept in the loop. Rebecca (talk) 21:32, 11 July 2013 (UTC)

You're welcome, Rebecca/Picture of a Sunny Day. Thank you for weighing in on this matter. In your case, I was clearly wrong above when I stated that "I know that some (maybe all) of our transgender editors, such as Sceptre, Bonze blayk and Picture of a Sunny Day, would be against moving the article back to Gender identity disorder." That's what I get for assuming. And as can also be seen from above, Bonze blayk is no longer commenting on transgender topics on Wikipedia. Flyer22 (talk) 21:49, 11 July 2013 (UTC)

Have started the discussion around ID verses MR verses other again here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:24, 10 July 2013 (UTC)

MEDMOS originally mentioned ICD and INN as "international standards" to be used when resolving "lexical differences between the varieties of English". In September 2008, a talk page discussion suggested adding DSM to the list as Casliber said it often was used outside of the US rather than ICD. Although this was a well-intentioned change, it is an American standard so doesn't actually resolve "lexical differences between the varieties of English". There was never any intention that ICD or DSM should be regarded as the gold standard source of article names with higher authority than "commonly used in recent, high-quality, English-language medical sources". These were merely to distinguish between, say, two "commonly used" terms. It avoids all they tiresome debates where people count Google results or PubMed title counts: those are going to be US-spelling-biased. Also, there are some names where wikipedians debate which name is best for various reasons, and these debates have already occurred among the experts and the results published by international organisations or committees. I suspect MEDMOS needs a bit of tweaking there if people are interpreting it to mean DSM decides our article names. Colin°^Talk 10:27, 10 July 2013 (UTC)

Rehydration therapy and Oral rehydration therapy

I've stuck a WPMED template on the previously blank talk page of Management of dehydration. This page is the redirect for the key search term, "Rehydration therapy". I've also linked to Management of dehydration in the Oral rehydration therapy lead (as well as to Fluid_replacement#Intravenous). I'm wondering whether anything else might readily be done to co-ordinate the content of these two pages regarding a simple, life-saving intervention. 86.161.251.139 (talk) 08:31, 9 July 2013 (UTC)

Looks good as a nested article from Dehydration#Treatment. As I understand it this is the structure that the MEDMOS recommends. Could be argued to merge the content of the later pages you mention into this new page. Or make it into a parent article for both... Lesion (talk) 10:36, 9 July 2013 (UTC)

A summary style approach feels right to me too, and preferable to merging. Dehydration#Treatment already links to Management of dehydration as the "main article". I wonder whether turning Oral rehydration solution (renamed as such?) into a subpage of Rehydration therapy (also renamed?) might help sharpen the focus of those two pages. 86.161.251.139 (talk) 12:31, 9 July 2013 (UTC)

Wikidata progress report

The first goal of the Wikidata Medicine task force is finished. All the strings from the diseases infobox can now be entered on Wikidata. See for example:

• Huntington's disease

Our next goals are to create properties for the anatomy infobox and the drugbox (50% done). At the same time were also trying to gather further information like symptoms, affected organs and tissues and affected species. We could use more suggestions on what useful information to acquire. For example if a disease has a vaccine, when and how often it should be administered or what kind of analytics and imaging are used for a diagnosis. We are also working on tagging all medical subjects on Wikidata, so we can generate statistics for different Wikipedia languages. I leave you with this simple query which lists all the diseases where the discoverer is known "http://208.80.153.172/wdq/?q=claim[486]_AND_(claim[61])". The data is still incomplete and were lacking really useful information but it shows what kind of lists we will be able to generate soon. --Tobias1984 (talk) 10:30, 9 July 2013 (UTC)

Okay so how far out are we from knowing there are X number of medical articles in Swahili? And next of course it would be great to know how many page views these articles get in total.

Would especially love to know how many page views this subgroup of 80 medical articles get in other languages. We have the English data here [8] Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:42, 9 July 2013 (UTC)

I am currently looking into how we could display that information with Limn (see http://reportcard.wmflabs.org/ for general wiki stats). I think it would be nicer to be able to track those 80 articles over time.
I am hoping to answer your "number of medical articles in Swahili" sometime this summer. As I said we first need to apply properties like MESH ID to all medical items so we have a way of querying them. Bots are already gathering the information, but we have to be a little of information, because a tremendous amount of data is currently being acquired. --Tobias1984 (talk) 20:56, 9 July 2013 (UTC)

Can we apply the tag on the talk page that states WP:MED to Wikidata? We define medicine more broadly than simply having a MESH code. And this would not pick up subpages. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:55, 9 July 2013 (UTC)

Yes, several pages may legitimately require the same MESH code, and certain pages cover more than one code. On a side note, outside WP:MED I've encountered situations where I haven't been able to insert/fix a clear-cut interwiki language link because I get an error code telling me that the link has already been taken by another page—one which legitimately requires the same link. I hope this isn't going to happen in the future with ICD, MeSH codes etc: it would be a real loss imo. 86.161.251.139 (talk) 22:40, 9 July 2013 (UTC)

ICD, MeSH and other identifiers will not be constrained to only one page. There are also plans to fix the problems with the interwiki-links by allowing links to redirect pages. This is naturally difficult because there are no intrinsic boundaries where one subject ends and the other begins. One Wikipedia could have one entry for HIV, while another could have a few entries concerning the diagnosis, the treatment, the virus itself and the history of HIV. This is probably a topic where no "perfect" solution will be ever found and the interwiki-links might need a more dynamic and flexible approach. --Tobias1984 (talk) 12:12, 15 July 2013 (UTC)

What's the plan forward? Modifying the infobox template so it uses wikidata if no value is entered locally? Actively moving the data to wikidata (removing it from the article code itself)? In the short term this would probably benefit other language wikipedia's most, as they can easily reuse the data from here and it the long-term it would be a nice centralized place to keep all data up-to-date. Searching around, I see a few infoboxes of other projects have been modified to use wikidata, but nothing large-scale yet. --WS (talk) 09:05, 10 July 2013 (UTC)

My concern would be that moving the codes to Wikidata would indirectly (but perhaps almost inevitably?) lead to the interests of Wikipedia users being somewhat sacrificed in favour of metadata interests. Would code insertions remain at least as flexible as they are now (to handle Wikipedia article overlaps, multiple codes, etc)? Would inserting/updating/expanding/fixing codes become less intuitive? (For example, following the Wikidata interlinks move I've rapidly gave up on fixing things like the en language link in it:Clacson, which should be Vehicle horn rather than Horn (acoustic), as it is now—I guess I'm not the only one who feels that life's just too short...) 86.161.251.139 (talk) 13:21, 10 July 2013 (UTC)

The goal would be to manage all data globally. This would benefit all Wikis because no time would be consumed keeping the infoboxes up-to-date. Especially for new pages it would save a lot of time because the infobox, interwiki-links, categories etc... would be generated automatically. I think the wiki-wide-deployment of this is still at least a year away and hopefully user-interface and flexibility issues will be gone by that time. In conclusion I want to point out again that most work will be done by bots and all we need is an occasional visit and maybe a few corrections on the items of the article your currently working on. This will enable us to do to incredible things in the future. Just think how our articles will benefit from dynamic content like this for example link --Tobias1984 (talk) 12:43, 15 July 2013 (UTC)

Thanks for this update. I'm happy about this progress. I especially like the idea that someone could do the work once, and have it automatically reach any language Wikipedia that wanted it. That's much more efficient than doing each page by hand. WhatamIdoing (talk) 15:03, 15 July 2013 (UTC)

• Vaguely related to this: what should we be doing, if anything, about edits like this: [9]. Are all such links now handled by wikidata? Lesion (talk) 10:48, 10 July 2013 (UTC)

Yes normally, that should go to wikidata and edit links under the language list allows you to do that. Except in this case the editor in question was probably hindered by the existence of separate wikidata entries for the norwegian wikipedia article and the one containing the english and other language versions, which will result in an error message when trying to add it. This complicates things a lot, if you then want to add a link you have to merge the wikidata entries and request deletion of one of them. --WS (talk) 11:54, 10 July 2013 (UTC)

Is this issue because I moved the TMD page recently? Do you have to move the associated wikidata page too? Lesion (talk) 12:28, 10 July 2013 (UTC)

No it is probably just because the Norwegian article didn't have any interwiki links before and thus ended up with its own entry. But the way of fixing this is sadly totally unobvious at the moment. --WS (talk) 14:06, 10 July 2013 (UTC)

Obtundation

http://en.wikipedia.org/wiki/Obtundation

I think we should clarify the differences between this and the other stages

163.40.114.55 (talk) 23:00, 9 July 2013 (UTC)

Thank you for your suggestion. When you believe an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the edit this page link at the top.
The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes—they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to). If you'd like some advice on selecting ideal sources, see WP:MEDRS. WhatamIdoing (talk) 01:32, 10 July 2013 (UTC)

Bot tagging medical articles that lack a PMID or DOI

I have placed a request for a new bot at Wikipedia:Bot requests#Bot tagging medical articles that lack a PMID or DOI. I would request you to discuss the utility of such bots and to expedite the formation of such a bot if such a requirement is felt. Diptanshu^Talk 16:27, 10 July 2013 (UTC)

Study on tracking of those searching health information online

I can't access the study. It has the title of "privacy threats when seeking online health information". Coverage here. Out of the 20 websites, did the author include Wikipedia? If not, maybe a reply or email is in order. Biosthmors (talk) 18:29, 10 July 2013 (UTC)

Wikipedia was not included. It was a 'convenience sample' that included websites ranging from pubmed and nejm to men's health and fox news health. --WS (talk) 19:24, 10 July 2013 (UTC)

DARE?

I haven't spotted any mention of DARE in MEDRS, and I feel it could be useful to include it. I've started a thread on the MEDRS talk page: DARE guidance?. 86.161.251.139 (talk) 10:38, 11 July 2013 (UTC)

Attempt to use primary source to refute secondary one

Is occurring at omega-3 fatty acid. [10] Wondering if I could get others opinions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:02, 11 July 2013 (UTC)

Possible reference spamming

The contributions of an editor popped up on my watchlist, which appears to me to be ref spamming a particular series of books. Is this appropriate behavior? If not, what should be done? Yobol (talk) 00:54, 12 July 2013 (UTC)

Context is everything. In general:

• Are the refs applicable to the sentences they're appended to? (That's good)
• Are there any authors that appear consistently in the papers/refs cited? (that can be an indicator of selfpromotion, which again needs finer contextual analysis, and if it exists (but the citations are otherwise good) a gentle word of caution/encouragement)
• Are the refs properly formatted, or does the editor need to be guided to correct any problems with them?

etc! In this case, from the userpage and userhistory and looking at today's edits [topical expertise, 6 years as editor with 8,000 edits, well formatted refs, a variety of authors named in each (mostly from the same textbook, but that's ok), other edits that fix elements not related to the book] - the editor probably deserves a barnstar, or a "thank" notification. S/He is probably reading a book, and thinking "oh, this paragraph would be a good citation for our article".

Hope that helps. –Quiddity (talk) 02:32, 12 July 2013 (UTC)

Do not see many edits pertaining to medicine. The further reading section should go after the reference section. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:49, 12 July 2013 (UTC)

Fowler's positions

There are 3 pages: Fowler's position, Semi-Fowlers position, High Fowlers position. Plus, semi-Fowler's is on the pages needed to create list. A new page isn't needed - the apostrophe should just be in the two pages where it's missing, and if these typos are common, to re-direct the ones without apostrophes to them.Hildabast (talk) 12:37, 12 July 2013 (UTC)

Thanks for noting. I moved these pages, and that automatically left the redirects. It's easy, actually: Wikipedia:Move#How_to_move_a_page. On a page one clicks move after clicking the drop down triangle. Then one specifies a reason and clicks move page, FYI. Best. Biosthmors (talk) 14:00, 12 July 2013 (UTC)

Thanks - and thanks for the pointer. Hildabast (talk) 14:03, 12 July 2013 (UTC)

You're welcome! Biosthmors (talk) 14:33, 12 July 2013 (UTC)

I think these kinds of pages ought to be merged, with the titles redirecting to specific sections. WhatamIdoing (talk) 14:42, 12 July 2013 (UTC)

That sounds good to me - they're rather vague differentiations anyway and even all together not likely to be a massive topic. These pages are rather surgery-focused and don't have the childbirth aspects in there, which is surely what's driving a lot of people to look it up. Which is why they hit my radar. May tinker. Hildabast (talk) 15:29, 12 July 2013 (UTC)

Obesity disease status

The American Medical Association recently reclassified obesity as a disease instead of simply a medical condition. Firstly, what is the status of obesity outside the US? Second question: why isn't a condition with deleterious consequences caused by other recognized risk factors always a disease to begin with? Is this just convention or is there a default definition? Disease seems to imply that obesity is certainly a disease. EllenCT (talk) 19:26, 12 July 2013 (UTC)

On your second question, according to this, it's more about knowing the etiology. Biosthmors (talk) 09:37, 13 July 2013 (UTC)

Aside from the popular perception of obesity as a comical trait, the status of "disease" very much depends on definition of the term. In general in the UK, obesity per se is not regarded as a disease—there are many obese people do not suffer ill effects and are not ill. Rather, obesity is regarded as a modifiable risk factor associated with a number of diseases such as metabolic syndrome and obstructive sleep apnoea.

I suspect that the reclassification by the AMA is due to a number of reasons, some of which may be political or economic in nature. Obesity is a growing problem (pardon the pun) in the USA and many other countries. By calling it a "disease", it draws more attention to the condition. This may have ramifications for the potential to draw funding for research into the condition and welfare for obese people. Axl ¤ [Talk] 09:48, 13 July 2013 (UTC)

The question isn't really whether it's a "disease", but whether it's "a" disease. It could be three or four of them (e.g., is "I love French fries" obesity really the same disease as "My thyroid is broken" obesity?). That's why knowing the etiology is important for declaring something to be a proper disease rather than a syndrome. WhatamIdoing (talk) 14:50, 13 July 2013 (UTC)

Regarding obesity related to hypothyroidism, I don't think that any healthcare professional would regard obesity in that context as a disease. Rather, it is a symptom or sign.

Hypertension is in a similar position to obesity. (Primary) hypertension typically does not have symptoms but it is a risk factor for several serious diseases (or complications?). On the other hand, "primary obesity" has traditionally been regarded as self-inflicted, thus eliciting little sympathy from healthcare professionals or from society in general. That attitude has slowly changed over the last decade or so, reflected by the change in the AMA's stance.

In any case, these issues are incidental to Wikipedia. Wikipedia's articles must reflect the dominant phrases in the literature. Axl ¤ [Talk] 18:44, 13 July 2013 (UTC)

Axl, you say primary obesity has "traditionally been regarded as self-inflicted". What other direct cause is there? While I accept there are indirect factors that lead to a "more energy consumed than expended" lifestyle and that solving a weight problem is far from trivial, I'm not aware of any new scientific understanding beyond "too much calorie-rich food eaten". I'm interested that one "expert" said this will put obesity on the "level of asthma", a disease with poorly understood environmental and genetic causes, no clear preventative measures, and for which nobody is considered individually responsible for their own condition to any degree whatsoever. -- Colin°^Talk 19:20, 14 July 2013 (UTC)

One very recent proposal is that obesity may be an infectious disease [see PMID 23235292 (warning: primary animal study) and PMID 20804522]. Of course this proposal is a long way from being widely accepted. Boghog (talk) 19:46, 14 July 2013 (UTC)

Interesting research. The statement "obesity may be an infectious disease" is somewhat overstating the research though, which suggests it may be a factor for people who already each too much calorie-rich (high fat) food. The mice who ate a normal diet didn't get fat whether they had this germ or not. Unlike asthma, primary obesity is not only preventable but a treatable, albeit with difficulty. Like smoking cigarettes. Colin°^Talk 10:06, 15 July 2013 (UTC)

Human breast milk

Is there any reason why human breast milk shouldn't be moved to human milk? Biosthmors (talk) 08:48, 13 July 2013 (UTC)

Not that I can think of. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:13, 13 July 2013 (UTC)

• WP:COMMONNAME, perhaps - I think the former is the more common usage, though it is redundant. -- Scray (talk) 14:18, 13 July 2013 (UTC)
• I think that plain old breast milk would be the most common name. WhatamIdoing (talk) 14:46, 13 July 2013 (UTC)

I agree with WhatamIdoing - animals' milk is never referred to as breast milk. Hildabast (talk) 19:27, 13 July 2013 (UTC)

Yes will move to breast milk. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:35, 13 July 2013 (UTC)

I concur. "Breast milk" is the most common name and resolves the redundancy, and no one refers to any non-human milk as "breast milk". (Of course, all milk comes from some form of breast or analogous structure, so there is an inherent redundancy there too, but somehow the entire English-speaking world readily overlooks it, and Wikipedia is descriptive, not prescriptive, in its interpretation of common name.) Wilhelm Meis (☎ Diskuss | ✍ Beiträge) 23:30, 13 July 2013 (UTC)

It's not really redundant. All mammals have mammary glands. "Breast" is the older word for the upper front part of the chest, not specifically to a woman's milk-producing parts. You can see the old use in quotations at Feet of clay and Pharisee and the Publican. Its use now to refer especially to female mammaries is probably an example of the euphemism treadmill. WhatamIdoing (talk) 03:22, 14 July 2013 (UTC)

I suspect you're right after all. Wilhelm Meis (☎ Diskuss | ✍ Beiträge) 06:44, 14 July 2013 (UTC)

 Done Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:56, 13 July 2013 (UTC)

Striae gravidarum stub

There was a merger proposal in late 2012, suggesting striae gravidarum go to the stretch marks page. I commented on the talk page that I agree, after I wrote a section on stretch marks for the pregnancy page. The stub looked to be pretty dreadful, and I didn't create an internal link because of that. I've just looked at the treatment section properly after someone commented the primary sources weren't necessarily useless. Now I feel strongly this stub needs to go as a priority, because I don't want to spend on it, but it can't stay online like this. The first primary source it uses is for a topical tretinoin and it's not in pregnancy - topical tretinoin is FDA category D for all trimesters of pregnancy because of its teratogenicity.

So I now looked at the stretch marks page. It is also in a bad state. The real value that it should have had, would have been treating the scars, but it doesn't really do that - and it's also poorly based (and wrong) on prevention of striae gravidarum (will edit). But it would be great if the stub could be resolved, without having to spend time editing it. Hildabast (talk) 12:57, 14 July 2013 (UTC)

Cancer

A user recently added "Phytochemicals from dietary plants and spices have been shown to prevent cancer initiation, promotion, and progression by exerting anti-inflammatory and anti-oxidative stress effects, and have been shown to induce apoptosis in cancer cells and suppress tumor growth in vivo." to the lead of the cancer article. I have moved it to the research section but even there I am not sure. Thoughts? Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:20, 14 July 2013 (UTC)

MEDRS query

Could some folks please have a look at this series of edits to MEDRS? I am short on time, and unable to determine the overall change, but at a quick glance, I'm concerned that MEDRS is diminished by this series of edits, and it appears that the edits are supported by something like ... two ... editors participating at talk. In multiple sections above, I am unable to decipher the meaning of posts by Hildablast, and I am severely pressed for time through August, so I recognize I may be missing something (and apologize in advance if that is the case), but my concern is that the guideline may have been weakened by alterations to long-standing text based on input from only two or three editors. SandyGeorgia (Talk) 15:13, 15 July 2013 (UTC)

I briefly contributed to the discussion on the talk page. Overall, I support the changes, although there is one phrase that I believe is unnecessary. Axl ¤ [Talk] 23:07, 15 July 2013 (UTC)

Actually the phrase that I was uncomfortable with has since been removed. Axl ¤ [Talk] 23:11, 15 July 2013 (UTC)

- FWIW, the sentence that Axl was uncomfortable with [11] actually pre-existed this series of edits: see [12]para 2.
- I find Hildabast's talk-page contributions crystal clear—given her level of expertise in EBM theory, she is likely to pick up on points which passed the rest of us by. I do think it's better to use the terminology appropriately (as simply worded as possible, without being simplistic). 86.161.251.139 (talk) 09:14, 16 July 2013 (UTC)

A part of this discussion was split to my talk: [13] SandyGeorgia (Talk) 11:14, 16 July 2013 (UTC)

Trip database

why is this happening? This Trip database identifies primary sources ... why are we encouraging new editors to source incorrectly? SandyGeorgia (Talk) 16:44, 15 July 2013 (UTC)

Can someone explain a) where it came from, b) why we are encouraging the use of primary soures, and c) how I can get that bot to not visit TS talk? [14] SandyGeorgia (Talk) 16:52, 15 July 2013 (UTC)

It does seem a little self defeating to have a banner advising MEDRS which gives one of the suggested links for sources to a repository that lists both primary and secondary sources. I followed the link from another page [15], and Cochrane Reviews do seem to be displayed first, but lower down in the results there are primary sources. There is a side menu on the right with options to narrow the search results to systematic reviews etc. Maybe the link could point to one of these narrowed search results, as the links in template giving PubMed search results do above. Nice template btw not sure who made it, but thanks for going to the effort. Now we just have to hope that people will read the talk page before adding their primary source ... =D well might dissuade some people anyway. Lesion (talk) 17:04, 15 July 2013 (UTC)

The discussion happened on this talk page in May. I think it's an awesome idea and a great template. Thank you all concerned. But I also agree with Sandy that we should be pointing to reviews, meta-analyses, etc. and not primary sources. Is it possible to tweak the TRIP link as Lesion suggests? --Anthonyhcole (talk · contribs · email) 17:21, 15 July 2013 (UTC)

Not sure what others are seeing, but for me the Trip results are pre-sorted in decreasing order of evidence quality. That seems to be exactly what we want: to find the best available evidence that relates to the topic. We might narrow it to publications in the past five years as with this. A few cautionary words in the Trip discussion might be worthwhile, but I don't see a fundamental problem.LeadSongDog come howl! 18:24, 15 July 2013 (UTC)

The first 50 results on my test search were all secondary. Fifty-one onwards RCTs start popping up. It's still awesome. Really thank you. But if it were possible to eliminate primary sources altogether, that would be super awesome. --Anthonyhcole (talk · contribs · email) 18:46, 15 July 2013 (UTC)

Does this look better? The categoryid list seems to enumerate the article types to include. Some experimentation will clarify what each of those values means. LeadSongDog come howl! 20:14, 15 July 2013 (UTC)

Yep. I looked at the first 120 and they were all secondary from 2012 & 2013. --Anthonyhcole (talk · contribs · email) 20:26, 15 July 2013 (UTC)

I think the template is great, and it is probably one of the best ways of encouraging wise editing. I have nevertheless noticed that in the case of Huntington's disease it makes a strange thing saying potentially useful sources of information about Huntington%26%2339%3Bs+disease . I suppose it will not be the only case. Can it be fixed?--Garrondo (talk) 20:23, 15 July 2013 (UTC)

• I agree with SandyGeorgia that this system has problems and will give primary sources sometimes but the intent is to standardize a process which will usually send people to good sources. Anyone who is willing to start at Trip and do research is someone that I would assist guiding if they had trouble understanding MEDRS. I would love to hear more criticism if others have any. I like this template but would like all problems with it documented. I am posting a link to this so that the problems Sandy and Garrondo found will be recorded. Here is the template's talk page - Template talk:Reliable sources for medical articles. Blue Rasberry (talk) 20:30, 15 July 2013 (UTC)

Why is this thing being installed by bot, and does anyone know how to make the bot STOP ??? I don't have time to sort it ... but this seems to be another chapter in the Build An Encyclopedia Via Bot While Making Editorial Decisions By People With Brains Harder and Harder. I do not want this misleading info on talk pages of articles I edit; if someone wants to deal with primary sources on another article, or if the list for a particular article is sound, they can install it on talk-- why is it being done with automated tools? The links for the articles I primarily edit are not generally articles we should be encouraging new editors to use, and it is not hard to see that this blanket referral of articles will lead to problems with new editors who use sources inappropriately. Again, those who want to deal with that can and should by adding the link, but will someone PLEASE stop the bot (preferably the person who started it)-- this should not be an automated task. Editorial discretion should be used. The template is labeling frequent primary sources (simply because free full text is available) as sources we should be using ... I can't wait to deal with new editors on that. SandyGeorgia (Talk) 22:25, 15 July 2013 (UTC)

If it's just the Trip link that is causing concern, would it be sensible to remove that link from the template rather than stop the bot doing this task. The PubMed links seem OK to me, and suspect with some tweaking the Trip link could work the same. Lesion (talk) 22:34, 15 July 2013 (UTC)

It's not the only one causing concern-- the PubMed links are going to anything that is free full text even when not reviews, and in every case I have checked is returning sources that shouldn't be used, or returning nothing. The concern is that a bot should not be adding this to talk pages ... it should be a matter of editorial discretion. We should not impose bad sources on talk pages in an automated fashion-- it will cause problems with new editors who push a POV, or don't understand DUE weight, or don't know how to correctly weigh sources. This Is A Bad Idea. SandyGeorgia (Talk) 22:37, 15 July 2013 (UTC)

There's no absolute reason we should discourage new editors from editing say, a FA or a GA ... any given user has as much a right to approach such an article as a neglected stub. A banner of advice about sourcing policy could be argued to be more needed on pages that are likely to attract edits based on primary sources ...

Having said that, (whoever made this template) are the links functioning as intended on all pages, and if not, could this be fixed at all ? Lesion (talk) 22:40, 15 July 2013 (UTC)

Where did I say my concerns were limited or restricted to FAs or GAs? I am seeing this on every article I edit. The advice is wrong; it is listing sources are useful only because they are free full text available ... which has nothing to do with ... anything. The question is, why is this being installed by bot? If some editors determine the links are appropriate for some articles, they can add them. They are not appropriate for the articles I edit, and since they are being installed based on a transclusion of an infobox, my next recommendation will be to remove the blooming infoboxes which force us to link to inaccurate information anyway. SandyGeorgia (Talk) 22:46, 15 July 2013 (UTC)

It seems to me that the chances of anybody actually using those templates are pretty low. When I try to visualize the sort of person who would click on that link and then systematically start reading things in order to improve our article, I come up empty. So it seems to me that all of this is kind of moot -- we're really just cluttering the talk page with more stuff that nobody will look at. Looie496 (talk) 22:51, 15 July 2013 (UTC)

Okay so I started this template. Consensus for it was developed on this page as linked above. TRIP database shows secondary sources first (they are in green and they label these as secondary sources). I am sure we can get rid of the primary source if people wish. Pubmed does a good job of linking to secondary sources. If you are seeing stuff that is not secondary sources in these pubmed links please let me know. Discussion for improvement can occur here as well Template_talk:Reliable_sources_for_medical_articles

Yes there is not going to be free content for every search. But not everyone has access to full no free sources and thus why it was added. Sorry about the strange text in the name. I have fixed it by changing PAGENAMEU to PAGENAME.

With respect to building an encyclopedia by bot these edits are not being made to the main space of any article and they of course never will be. This is simply to help editors find sources. All content edits still require humans.

What we link to can be adjusted. Is it a bad idea to try to direct people to high quality searches for evidence? I fo not think so. This is better than a google search which would otherwise be the default. Nowhere in the evidence box does it say that an editor can through away their brain and just use whatever is provided blindly. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:00, 15 July 2013 (UTC)

By the way template does not properly handle apostrophe's in article titles. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:15, 16 July 2013 (UTC)

The out-of-place apostrophe in your comment is amusing.  :) -- Scray (talk) 01:52, 16 July 2013 (UTC)

Yes and I do not use them properly either :-) We have the ability to just show secondary source at TRIP. I have update the template so that it ONLY lists secondary sources here [16]. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:08, 16 July 2013 (UTC)

I disagree with SandyGeorgia and Looie this time: the template even if not 100% perfect in the sources it points out, can be a good start point for interested users. Moreover, it has the advantage that it gives a link to MEDRS at every medical talk page, and also says how to find potentially useful (bolded mine, but maybe there is a way to remark that they are only potential). I would say that damage the template can bring is minimal, whereas benefit still has to be seen (although as Looie says it will probably not be huge).--Garrondo (talk) 06:34, 16 July 2013 (UTC)

Have bolded "possibly useful" to decrease potential confusion. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:49, 16 July 2013 (UTC)

This seems to be a case of throwing out the baby with the bath water. While imperfect, I think the advantages of this template outweigh the disadvantages. It is important to note that the template also includes a link to relevant review articles listed in PubMed before the Trip link. As already mentioned several times above, ideally the Trip link should also be filtered to return only review articles. Boghog (talk) 08:15, 16 July 2013 (UTC)

Has already been changed to ONLY show secondary sources as per the request here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:22, 16 July 2013 (UTC)

Opps, sorry. I obviously didn't read the entire thread. The major shortcoming of the template now appears to be fixed. Thanks for taking care of this. Boghog (talk) 08:29, 16 July 2013 (UTC)

Thank you for, at least, the correction to remove the primary sources from the list (which was a surprising oversight that leads to concern about how many experienced eyes are following WT:MED these days). Using a bot to recommend sourcing is still sub-optimal for a multitude of reasons I don't have time to outline today, but which I am certain editors will experience once the university term starts. This discussion was split to my talk page: [17] At minimum, I do not want automation taking over on talk pages where real brains, real eyes, and real editor discussion is needed, and anyone who thinks POV pushers and unknowledgeable students won't use these lists to advantage has perhaps not spent enough time editing articles where same dominate. Please stop the bot addition to talk pages and allow those editors who can ascertain that the list is useful to manually install the template on talk pages of articles they watch. SandyGeorgia (Talk) 11:20, 16 July 2013 (UTC)

If students and POV pushers started using secondary sources exclusively it would allow more productive conversations to begin a lot earlier. Doubt it will solve the issues with students by any means as they have mostly revolved around plagiarism and misrepresentation of sources. WP:MEDRS already recommend source types and the links we are providing is to sources that potentially meet MEDRS requirements. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:30, 16 July 2013 (UTC)

More to the point, where were the knowledgeable eyes on WP:MED issues when a template was designed and installed via automation that was recommending primary sources on talk pages? I am glad that part is fixed, and hope my point is made-- this has taken unnecessary time and is something that I am quite surprised to see no one picked up on earlier. SandyGeorgia (Talk) 11:45, 16 July 2013 (UTC)

IMO it is precisely for articles where students and other people without prior knowledge on wiki policies where it is specially interesting: as I have already said, it both provides them with a link to MEDRS and a link to some sources which in average are of far higher quality than those they usually use when they end up here. I would say however that it will be specially useful in the less developed (and less watched) articles, since it is in them in which it is harder to check refs but I neither find any convincing argument to think it will be harmful.--Garrondo (talk) 11:47, 16 July 2013 (UTC)

The secondary sources all came before the non secondary sources. And each were marked clearly by what type of source they were. The reference box gave no guarantee that the sources linked to could be used without the application of proper editorial judgement and it still dose not. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:51, 16 July 2013 (UTC)

Have the primary sources been removed now, or not? The template language still indicates they are there:

For a list of review articles from the last 5 years at PubMed, click here (limit to free articles or to systematic reviews)

Part of the problem was that the inclusion of "free articles" resulted in primary sources. If that has been addressed, the template text is wrong. If it hasn't been addressed, we still have a problem. The language (and the "or") is confusing ... is it reviews only? Is it reviews "or" free full text (which was the problem before that yielded primary sources). Please clarify the text. Also, since the template was not subst'd, will the corrected text show on articles, or does the bot need to fix them all? <groan> ... In addition to the problem of "who is minding the store" these days, since no one apparently noticed during the bot test that we were recommending primary sources on article talk pages. SandyGeorgia (Talk) 12:00, 16 July 2013 (UTC)

From what I understand it has been fixed and language is correct: now you can choose to see all kind of reviews, only free reviews (systematic or not), or only systematic reviews (free or not). --Garrondo (talk) 12:10, 16 July 2013 (UTC)