User talk:ColumbiaLion212
June 2015
Hello, I'm Happysailor. I noticed that you recently removed some content from Cranial electrotherapy stimulation with this edit, without explaining why. In the future, it would be helpful to others if you described your changes to Wikipedia with an edit summary. If this was a mistake, don't worry, the removed content has been restored. If you think I made a mistake, or if you have any questions, you can leave me a message on my talk page. Thanks. - Happysailor (Talk) 15:45, 26 June 2015 (UTC)
Conflict of interest in Wikipedia
Hi ColumbiaLion212. Along with working on health related content in Wikipedia I work a lot on conflict of interest issues.
Your account is what we call a single purpose account and your edits are promotional for Cranial electrotherapy stimulation. I'm giving you notice of our Conflict of Interest guideline and Terms of Use, and will have some questions for you below.
Hello, ColumbiaLion212. We welcome your contributions to Wikipedia, but if you have an external relationship with some of the people, places or things you have written about on Wikipedia, you may have a conflict of interest or close connection to the subject.
All editors are required to comply with Wikipedia's neutral point of view content policy. People who are very close to a subject often have a distorted view of it, which may cause them to inadvertently edit in ways that make the article either too flattering or too disparaging. People with a close connection to a subject are not absolutely prohibited from editing about that subject, but they need to be especially careful about ensuring their edits are verified by reliable sources and writing with as little bias as possible.
If you are very close to a subject, here are some ways you can reduce the risk of problems:
- Avoid or exercise great caution when editing or creating articles related to you, your organization, or its competitors, as well as projects and products they are involved with.
- Avoid linking to the Wikipedia article or website of your organization in other articles (see Wikipedia:Spam).
- Exercise great caution so that you do not accidentally breach Wikipedia's content policies.
Please familiarize yourself with relevant content policies and guidelines, especially those pertaining to neutral point of view, verifiability of information, and autobiographies. Note that Wikipedia's terms of use require disclosure of your employer, client, and affiliation with respect to any contribution for which you receive, or expect to receive, compensation.
For information on how to contribute to Wikipedia when you have a conflict of interest, please see our frequently asked questions for organizations. Thank you.
Question
Wikipedia is a widely-used reference work and managing conflict of interest is essential for ensuring the integrity of Wikipedia and retaining the public's trust in it. As in academia, COI is managed here in two steps - disclosure and a form of peer review.
Disclosure is the most important, and first, step. Would you please let me know if you have any relationship with companies selling Cranial electrotherapy stimulation devices?
You can reply here - I am watching this page. Once you do, we can take it from there. Thanks in advance for talking! Jytdog (talk) 15:02, 20 July 2015 (UTC)
Response to COI
Dear Jytdog:
Thank you for the invitation to engage in a dialog re: the editing of the Cranial Electrotherapy Stimulation page. I am fairly new to editing Wikipedia and initially created my account for the purpose of editing the page. I am a subject matter expert as a result of working for a medical device company, but am not paid to promote any product or write Wikipedia content. I discovered the page to contain misleading information and wished to correct it. Cranial Electrotherapy Stimulation is a technology category that is in the public domain (all CES tech that I’m aware of is out of patent), so there are no companies or private interests that control or exclusively benefit from Cranial Electrotherapy Stimulation, and those companies that do make CES devices are very small, unlike the giant pharmaceutical companies that produce competing products. Indeed, one of the obstacles that CES companies have faced is the overwhelming influence of competitors that often use well-placed, influential surrogates to disseminate misinformation about CES.
Following is my assessment of content on the page that is grossly misleading:
There is insufficient evidence to determine whether or not CES with alternating current is safe and effective for treating depression.[6]
[6] Kavirajan HC, Lueck K, Chuang K. Alternating current cranial electrotherapy stimulation (CES) for depression. Cochrane Database Syst Rev. 2014 Jul 8;7:CD010521. Review. PMID 25000907
This extremely misleading statement is supported (in citation) by a published literature review, not a clinical trial, and the publisher of this review is a small undergraduate teaching college within the University of Bristol.
In a 2010 literature review, published in a much more respected journal, Journal of Psychosocial Nursing and Mental Health Services, the conclusion is reached: “To date, whether used alone or in conjunction with pharmaceutical agents, CES has been shown to be an effective and economical therapy for mild to moderate depression.”
J Psychosoc Nurs Ment Health Serv. 2010 Nov;48(11):37-42. doi: 10.3928/02793695-20100701-01. Epub 2010 Jul 22.Cranial electrotherapy stimulation for the treatment of depression.
Gunther M1, Phillips KD.
More importantly, there are at least two well-controlled clinical trials that have been published in respected peer-reviewed journals that provide statistically significant evidence of CES safety and effectiveness in treating depression:
Krupitsky et al. The administration of transcranial electric treatment for affective disturbances therapy in alcoholic patients. Drug and Alcohol Dependence 27:1-6, 1991
J Affect Disord. 2014 Aug;164:171-7. A Clinical Trial of Cranial Electrotherapy Stimulation for Anxiety and Comorbid Depression, doi: 10.1016/j.jad.2014.04.029. Epub 2014 Apr 21.
I attempted to add this evidence to the page, yet it was repeatedly deleted.
Critics of CES research may point to the fact that subject sizes for most studies are not large when compared with drug studies, but CES study subject sizes are typical of non-invasive medical device studies. Drug studies need to be much larger because drug therapy is a chemical intervention and causes much more serious side effects. Critics may also point to the fact that CES studies examine varying patient populations and that device brands used in the studies have slight variance in electrical output. Varying patient populations are more representative of the real world, and the variance in output of different device brands is too small to skew data. The three most important aspects of studies – quality of controls, statistical significance and rigorous peer review – are soundly met in the studies listed above. In short, the Effectiveness section of this page should not be allowed to mislead the reader into thinking that there is a complete lack of evidence when in fact there is sufficient evidence
Another sentence on the page which, left alone, is very misleading:
The exact mechanism of action of CES is unclear.[9]
9. Rosa MA, Lisanby SH (2012). "Somatic treatments for mood disorders". Neuropsychopharmacology 37 (1): 102–16. doi:10.1038/npp.2011.225. PMC 3238088.PMID 21976043.
The author of the source (Dr. Lisanby) has a documented conflict of interest with CES. Dr. Lisanby recused herself from the 2012 FDA Panel on CES Reclassification as a result of having a conflict of interest – she has financial ties to Transcranial Magnetic Stimulation, a competing technology. Interestingly, Transcranial Magnetic Stimulation is listed in the See Also section of the Cranial Electrotherapy Stimulation page, along with Trancranial Direct Current Stimulation, another competing technology. In short, Dr. Lisanby’s review is an inappropriate citation for a statement which misleads readers into thinking that the way CES works is a complete mystery. It is not a mystery.
The mechanism of action of most brain related interventions, whether drug or device, are never completely clear, because the brain is so complex and imaging is only beginning to tell the whole story. But the way CES works is by no means a complete mystery. There is very strong evidence, published in respected journals, that CES stimulates the production of serotonin and other neurochemicals responsible for reducing and eliminating depression, anxiety and insomnia:
Liss. S. and B. Liss. Physiological and therapeutic effects of high frequency electircal pulses. Integrative physilogical and behavioral science 31:88-94, 1996
Shealy et al. Cerebralspinal fluid and plasma neurochemicals: response to cranial electrical stimulation. J. Neurol. Orthop. Med. Surg. 18: 94-97, 1996
Shealy et al. Depression: a diagnostic, neruochemical, profile & threapy with cranial electrical stimulation. J. Neurol. Orthop. Med. Surg. 10: 319-321, 1989
2005Gilula MF, Kirsch DL. (2005). Cranial electrotherapy stimulation review: a safer alternative to psychopharmaceuticals in the treatment of depression.Journal of Neurotherapy, 9(2), 2005.doi:10.1300/J184v09n02_02
Kennerly, Richard. QEEG analysis of cranial electrotherapy: a pilot study. Journal of Neurotherapy (8)2, 2004.
My efforts to provide this research have been met with repeated deletion.
The page as it stands right now seems intentionally designed to make readers think that Cranial Electrotherapy Stimulation is a risky, unproven technology. Not only is there sufficient evidence, but CES is prescribed by thousands of doctors, many at the top of the psychiatric field. The New York City Health and Hospitals Corporation recently approved the device for use in its 11 hospitals – including Bellevue, Jacobi and Metropolitan Hospitals. The page should reflect the scientific evidence and broad clinical support the technology has behind it.
Sincerely
ColumbiaLion212 (talk) 19:00, 21 July 2015 (UTC)ColumbiaLion212