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Paper

There is still press occurring and the first error has finally been spelled out [1] and [2]

Our article on hypertension says three measurement for diagnosis which is supported by the most recent NICE review "Ask patients with a single raised blood pressure reading of more than 140/90 mmHg* to return for a minimum of two subsequent clinics where their blood pressure can be measured using the best conditions available. " page 7 [3]

So not really an error. But some if I remember correctly only recommend two measurements. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:01, 21 May 2014 (UTC)

Says three here aswell [4] Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:13, 21 May 2014 (UTC)

Well, we all know that Hasty is wrong. It's ironic that the lay press trusts Hasty over our featured articles—which have been reviewed by medical doctors as well as knowledgeable editors. Axl ¤ [Talk] 22:04, 21 May 2014 (UTC)

Yes just goes to show how inaccurate the popular press is. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:46, 21 May 2014 (UTC)

AHA supports three measurements aswell [5]. It would be nice if everyone used citations like us so we could check their work. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:12, 21 May 2014 (UTC)

It is during at least two separate visits. So there is a two needed in their. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:43, 23 May 2014 (UTC)

• Now a Daily Mail story. Wiki CRUK John (talk) 10:25, 27 May 2014 (UTC)

And the Telegraph. Hasty is peddling his bullshit again. Axl ¤ [Talk] 10:28, 27 May 2014 (UTC)

Can someone please refresh my memory and remind me why this study is useless and must be removed from any article to which it is added? Let's ignore the "hypertension" thing for a moment. If I recall correctly, one issue Doc James identified with it was that it only looked at 10 articles, which weren't supposed to be among the best Wikipedia has to offer (that would be GAs and FAs, of course). So, perhaps a conclusion that should be drawn from this isn't the one Hasty drew or the one all the pro-Wikipedia cheerleaders are drawing. Perhaps we should just use this to remind ourselves why it's so important to improve our important articles--so we don't get embarrassed like this again. (Also, the main reason I am posting this is that it has completely usurped all the other stories on my "Wikipedia" Google News Feed. Jinkinson talk to me 02:09, 30 May 2014 (UTC)

This issue with this paper is that its data does not support its conclusions. Hasty first invented a new way to test the medical literature. And then he applied it to just Wikipedia without using a control (like also applying it to a medical textbook, emedicine, or medline plus). So we have a single data point which is meaningless. With this method we would likely find that a high percentage of textbooks, emedicine and medline plus are also "wrong". He has already more or less come out saying NICE is wrong as are a number of other recent review articles.

The conclusions is really that the peer reviewed literature does not agree with itself. Obvious to anyone who has read much of it. The other big issue is the quality of his "researchers". Medical students and residents are far from experts in research methods and distinguishing high quality from low quality sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:13, 30 May 2014 (UTC)

Medical articles in the news

A recent study of Wikipedia articles on medical subjects has just hit the news media:

"Trust your doctor, not Wikipedia, say scientists". BBC News. 27 May 2014.

The original journal article is here:

-- Impsswoon (talk) 12:23, 27 May 2014 (UTC)

Exact same issues as last time - old conversation hyperlink. I'm just going to repeat what I said before (with wikilinks to the relevant concepts this time around):

You can't just take some arbitrary convenience sample like they did and expect it to have any semblance of generalizability. Because of that, I have no clue what the asymptotic distribution of their sample might look like, but i can guarantee that it's NOT normally distributed and probably not consistent (the distribution estimators, I mean); or in English, that study is a brown paper bag containing a pile of shit which happens to be on fire.

Seppi333 (Insert 2¢ | Maintained) 12:55, 27 May 2014 (UTC)

See archived discussion at Wikipedia_talk:WikiProject_Medicine/Archive_48#Poor_paper_.5B4.5D_on_Wikipedia. (Why couldn't the article I cited get in the news? I guess "Wikipedia sux" is a better headline than "Wikipedia rocks".) Adrian J. Hunter^{(talk•contribs)} 12:55, 27 May 2014 (UTC)

More Wikipedian comments here. Axl ¤ [Talk] 13:45, 27 May 2014 (UTC)

What they have proved is that not all peer reviewed sources agree with each other. Nothing further. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:25, 28 May 2014 (UTC)

I read the paper. Residents and interns are the judges. I am surprised a bit that the BBC picked it up. Is anyone going to write the BBC -- tell 'em the paper is seriously flawed?

The paper is about "assertions" in Wikipedia. Ironic is that the paper itself is nothing but an assertion; the data is not presented. Nephron  T|C 00:49, 28 May 2014 (UTC)

Any the author refuses to provide the data for independent analysis. Agree we need to write the papers. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:53, 28 May 2014 (UTC)

Additionally why not a control group? How does Wikipedia articles compare to Uptodate articles using this method? You invent a new non standard method of quality assessment and then just study one set of content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:00, 28 May 2014 (UTC)

yep, and no comparison to other medical references, either text books or reference. a comparison to WebMD or pubmed, would be interesting. "inconsistent with peer-reviewed sources. Because our standard was the peer-reviewed published literature, it can be argued that these assertions on Wikipedia represent factual errors." = this is a familiar academic argument. "the article on concussions did not. This finding may have occurred because Wikipedia has a number of different contributors to each article and the contributors to this particular article were more expert." = the concussions editor gets a barnstar. (or it may have occurred from random chance or assessment error.) "physicians and medical students who currently use Wikipedia as a medical reference should be discouraged from doing so because of the potential for errors." = the conclusion in search of an argument. Duckduckstop (talk) 12:40, 28 May 2014 (UTC)

They certainly need to explain the validity of selecting Uptodate as the reference standard in the study. (And, from a purely journalistic perspective, the BBC needs to explain why they have given so much scientific weight to a study published in an osteopathy journal.) 86.181.67.132 (talk) 14:18, 28 May 2014 (UTC)

• Since we have 2 active threads on this (see 2 down), I'll post this twice. My CRUK blogpost on this is at Wikipedia – is it fit for patient consumption?. Wiki CRUK John (talk) 14:22, 28 May 2014 (UTC)
• Suggest we continue this 2 threads down, to avoid 2 conversations. Wiki CRUK John (talk) 15:04, 29 May 2014 (UTC)

do not let wp stop your ethics

There is a home page BBC article showing that 90% of medical articles have errors and that 70% of doctors unwittingly use WP. This is because wp hates experts. Some have even been banned for no good reason. I am not talking about disruption.

Another reason is because wp tried to defraud people by resisting disclaimers. All past proposals for a disclaimer that is easy to see have been rejected because we like to fool people. The only disclaimer is small and hard to see.

We ethical people in WP and especially you doctors should rise up and insist on a prominent disclaimer that WP is not peer reviewed and any quack or patient can write.

There should be a special standard for medical articles or a prominent disclaimer, not a hidden one. Stephanie Bowman (talk) 15:25, 27 May 2014 (UTC)

What User Stephanie Bowman says sounds important. I agree with some of her comment. An external link to the BBC webpage would be handy. Snowman (talk) 16:16, 27 May 2014 (UTC)

• I think that WP Medicine should not user the existing system of GA classification, partly because anyone can review an article and anyone can nominate an article. Any comments? Snowman (talk) 16:06, 27 May 2014 (UTC)
• See two sections up; this is the same old Hasty study we discussed a while back. It was picked by the Daily Mail yesterday, I presume because of this piece apparently writing up an interview with prof Hasty, and then on to the Beeb & Torygraph. If doctors use WP it is not "unwittingly". I'm doing a blogpost on this & my role, which the BBC mention. Wiki CRUK John (talk) 16:55, 27 May 2014 (UTC)

You can attack the BBC article. It is not the figure, 90%. What we should agree is that WP is not peer reviewed. WP editing is like crowd sourcing or gang mentality. Sometimes the result is good but sometimes bad. With medicine, there is a higher standard, but not in WP. So attack the BBC, but, really, let's get WP to be more professional. I see better and prominent disclaimers as the solution because WP is sure as hell not going to become peer reviewed or have full disclosures or real names in place of usernames. Please, let's do this!!

Stephanie Bowman (talk) 17:53, 27 May 2014 (UTC)

To be fair, this is not the BBC's or the Telegraph's fault. Hasty has subverted the medical journal process for the purpose of publishing crap, and he found a journal with so-called peer reviewers who are incompetent at their job. Axl ¤ [Talk] 19:05, 27 May 2014 (UTC)

I have found a number of GA articles that were passed as a GA at the time they contained very noticeable errors about basic science including physics and medicine. Perhaps, WP Medicine could have its own process for identifying a GA, to avoid the badge of a Good Article being given to an article written by editors that do not know much about a topic and reviewed by a reviewer who also does not know much about the topic. Snowman (talk) 21:51, 27 May 2014 (UTC)

It's at least a little the BBC's and the Telegraph's fault. They only bear no responsibility if we grant that the role of the media is to act as an unfiltered conduit that exercises no critical editorial judgement. Sure, they were duped, but they were duped because the intelligent follow-up question is a dying art. TenOfAllTrades(talk) 22:15, 27 May 2014 (UTC)

Okay, that's fair comment. Axl ¤ [Talk] 22:44, 27 May 2014 (UTC)

Okay of our top editors most (>85% have more than a BSc and 50% are health care providers). Our editors are mostly experts and this "hates experts" things is unfounded. Wikipedia is sort of peer reviewed. And additionally we also support most of our statements with references. This much cannot be said for the Hasty paper. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:30, 28 May 2014 (UTC)

By the way I spoke with Hasty today. He declined to release to us details of the so called "errors" they found. Says he might want to use the data again and wishes to protect the researchers. Thus no opportunity to determine if any real errors were found or to improve Wikipedia if there were. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:40, 28 May 2014 (UTC)

No surprise there. Does he know what we think of him and his study? Axl ¤ [Talk] 00:59, 28 May 2014 (UTC)

Might (big might) be worth a letter to the editor. Ian Furst (talk) 01:13, 28 May 2014 (UTC)

User: Stephanie Bowman, please excuse the lengthy response but I have to say that I bristled when you called into question my ethics for … ?not vigorously campaigning for a more prominent disclaimer. In my mind (and many others), being moral means that my thoughts and actions improve the well-being of others. Having reviewed manuscripts for years, I can tell you that politics and copy-edit can often play as great a role in publication as content. Wikipedia, while flawed, is highly democratic, strongly promotes the quality of the content over prose and gives wide, free access to relatively unbiased information. I believe Wikipedia’s moral compass is far greater than many peer-reviewed publications I’ve known, and Wikiproject Medicine in particular is constantly reaching for a higher moral plateau. There is no reason not to reach higher, but I don’t believe WP “stops the ethics” of its editors. Rather, it facilitates them.Ian Furst (talk) 01:38, 28 May 2014 (UTC)

I would be curious to know what Stephanie Bowman has to say about the ethics of Dr. Hasty, who believes he has identified a large number of errors in a widely-used resource, but declines to share them with anyone to facilitate their evaluation and possible correction. TenOfAllTrades(talk) 04:55, 28 May 2014 (UTC)

• Agree (and, btw, where's their reporting transparency?) 86.181.67.132 (talk) 08:08, 28 May 2014 (UTC)

• WP Medicine editors and reviewers could do an audit of a random selection of Wiki articles. Of course, this audit could be transparent and give an account of errors found. Also, the FA review process is more rigorous than a GA review, so it would be interesting to look back at some FAs to see what sort of things needed amending to bring articles from GA to FA. Snowman (talk) 09:24, 28 May 2014 (UTC)
  • Most of us here go through Wikipedia content and fix issues we find. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:31, 28 May 2014 (UTC)
• My CRUK blogpost now up Wikipedia – is it fit for patient consumption? Wiki CRUK John (talk) 12:15, 28 May 2014 (UTC)

• kudos to User:Jmh649, and User:Mdscottis. 1 down, 9 to do, to "their standard" i would say less an ethical issue, than a locus of control of medical information. the old channels don't like the new channels; why can't we all just get along? like the CRUK blog, call to action. Duckduckstop (talk) 12:53, 28 May 2014 (UTC)

Thanks! Another, better, story in The Independent today. Wiki CRUK John (talk) 16:17, 28 May 2014 (UTC)

At least the comments by people are reasonable even if the journalism is lacking. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:35, 28 May 2014 (UTC)

Try the comments on the Daily Mail's story! They can be called many things but I don't think "reasonable" is one of them. Wiki CRUK John (talk) 16:43, 28 May 2014 (UTC)

That should surprise no one. Reader comment sections are notorious even on the finest news sites, let alone the tabloids. LeadSongDog come howl! 17:00, 28 May 2014 (UTC)

So if we are talking ethics, it really would not be the end of the world if a few of these people died from using wikipedia for health care information. 188.28.129.18 (talk) 18:21, 28 May 2014 (UTC)

you'll excuse me if i sounded dismissive. we need clear standards of quality for medical education and information. perfection is an impossible standard. all information sources involve risk. all agree that peer review journals are the proper source material for an article for a general audience, but it is a moving target. it's unclear what is proven by randomly picking students to look at a small sample size, without a blind comparison. it's unclear that people would actually go to a GP, if you took away their WP, or that you can actually ban interns from reading WP. there are some semi-peer review processes here at WikiProject Medicine. it is quite a stretch to go from "inconsistent with peer-reviewed sources" to "errors" to "people died". more likely, "read WP" to "more pointed discussion with GP" better WP than drug advertising. Duckduckstop (talk) 19:03, 28 May 2014 (UTC)

The headline of the Daily Mail article shouts "Do NOT try to diagnose yourself on Wikipedia! 90% of its medical entries are inaccurate, say experts" A complete non-sequitur... Responsible medics simply don't recommend trying "to diagnose yourself" [sic] anyway, irrespective of the availability or otherwise of accurate information. Wikipedia certainly doesn't, and it's perfectly reasonable the authors of the study to reinforce that message, regardless of their findings. There are all sorts of self-diagnosis opportunities available other than Wikipedia: whether through word of mouth, books of various kinds, or elsewhere on the internet. Wikipedia's objective is indeed to provide reliable information that's freely available to everyone. At the same time, Wikipedia also freely recognizes its inherent limitations (though the claim that "90% of its medical entries are inaccurate" is extraordinarily vague and open to dispute). 86.181.67.132 (talk) 19:41, 28 May 2014 (UTC)

Agreeing with the last two commenters:

*"read WP" to "more pointed discussion with GP" better WP than drug advertising.

*There are all sorts of self-diagnosis opportunities available other than Wikipedia...

In general, thank goodness for the internet. More specifically, thank goodness for Wikipedia. Neither GPs nor specialists (can) know about all the obscure conditions (circadian rhythm disorders, for example!) Wikipedia usually does, and usually presents info so that the layman can understand it. Then the doctor who isn't too arrogant to listen can do further research and explain why the "self-diagnosis" fits or doesn't. Everyone wins. --Hordaland (talk) 21:19, 28 May 2014 (UTC)

• Best media story so far, from the news section of NHS choices (ie the National Health Service (England)) "Wikipedia 'not a reliable source' of health advice". They go into considerable detail on the study. And Hasty has done a short video. Wiki CRUK John (talk) 21:57, 28 May 2014 (UTC)

• For those of you with some degree of competence regarding this subject (that excludes me), I wonder what you all might think of getting together a more or less popular response to these recent reports for the Wikipedia:Wikipedia Signpost? Some sort of response to what might be some of the more sensationalist comments might be called for, some description of how you individuals with qualifications try to deal with the uncontrollable situation here, and maybe some proposals to improve the content relating to medicine overall, if anyone has any? John Carter (talk) 22:22, 28 May 2014 (UTC)

The NHS paper repeats the error that all these "researchers" were junior doctors. When in fact some were not doctors at all but medical students. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:42, 28 May 2014 (UTC)

Did I hear video :-)? How about one on how to use a paper on a diagnostic test (which this study essentially is) and why this paper falls short. Ian Furst (talk) 23:43, 28 May 2014 (UTC)

Sorry for entering "like a fly in the milk" (a Romanian expression). Among many other things, Wikipedia is about getting all the puzzles together, meaning information from several sources in one place, easy to read, easy to understand. This is the theory. In practice, many articles were written based on unreliable sources or no sources at all for some of the text (or even fake sources) and personal opinions. In particular, on ro.wikipedia, I noticed medical translations from English Wikipedia of low quality, inaccurate and incomplete. Another important issue is this. Different countries have different ways of seeing things in medicine. Just think of a person that read an English medical article and then the Romanian or French similar article and realizes they are not entirely the same regarding the treatment used, the definition, and so on. Who should that person believe, the English article or his/her native language article? Regards, Winter^eu (talk) 01:27, 29 May 2014 (UTC)

There are many high quality sources that contradict each other. Some sources for example say SSRIs are not very useful for most people, others sources say they are. When you use Wikipedia you should check the sources and consult an expert. Best cancer screening is another example. We of course should be reporting all major positions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:16, 29 May 2014 (UTC)

It's certainly an issue when dealing with treatment & screening in different countries, and especially when translating into languages mainly used in the developing world, one sadly can't assume that the readership has access to 1st world medicine. Wiki CRUK John (talk) 15:03, 29 May 2014 (UTC)

Producing "brains" and producing money are 2 different things. Ideally, you have both. --Winter^eu (talk) 23:33, 29 May 2014 (UTC)

@Wiki CRUK John: given you've done a blog post, Hasty has let slip one example which I've noted here. I've emailed Hasty to ask about MDD. Cas Liber (talk · contribs) 14:43, 29 May 2014 (UTC)

Nice one! I note that Hasty is actually somewhat more emollient towards WP in his video and interview comments (link to that in my blog), having got his headlines. When the dust settles we should maybe collect a bundle of links & write up the issues somewhere, for future reference. Is anyone going to write to the journal? Wiki CRUK John (talk) 15:11, 29 May 2014 (UTC)

• Let me note that I've written a blog post about this on my personal site: "Medicine, Wikipedia, and osteopaths: not a good combination" Looie496 (talk) 15:48, 29 May 2014 (UTC)

Looie did Hasty's researchers specifically use secondary sources or did they just use any peer reviewed source? Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:17, 30 May 2014 (UTC)

Here's what the Methods section says: "Reviewers were asked to identify every assertion (ie, implication or statement of fact) in the Wikipedia article and to fact-check each assertion against a peer-reviewed source that was published or updated within the past 5 years. ... The authors instructed the reviewers to use UpToDate (http://www.uptodate.com/) as the initial means by which to search for peer-reviewed sources. If UpToDate did not produce adequate results, then each reviewer was instructed to use PubMed (http://www.ncbi.nlm.nih.gov/pubmed), Google Scholar (http://scholar.google.com/), or a search engine of their choice." There is nothing about secondary sources. Looie496 (talk) 13:43, 30 May 2014 (UTC)

In your blog you state "For each assertion, the reviewer was then supposed to do a database search of recent review articles on the topic" Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:00, 30 May 2014 (UTC)

That was an error on my part; I've now fixed it. Thanks for pointing it out. (I've never used UpToDate, so I don't know what sort of articles it yields.) Looie496 (talk) 15:17, 30 May 2014 (UTC)

The BBC has updated their article a bit [6] Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:17, 30 May 2014 (UTC)

There are several points that occur to me.

First, I am not sure how any well-meaning patient could find specific treatment or management information on any published site. The result is almost always to widen the possibilities rather than narrow them and consequently, difficult to follow. My patients talk to me about this often so I don't think that we are unintentionally placing them at harm - personal viewpoint. Second, there was an interesting evidence-based study several years ago that asked the editors of prestigious journals to list the evidence-based criteria that they used to select articles for publication. The journals were then scrutinized to estimate how often the editors followed their own selection criteria. In some cases, it was as low as 10%. Editors have deadlines to meet too, seemingly. Fourth, I think the major responsibility is to avoid hidden agendas, hidden sponsorship, and hidden bias. This is such a problem, particularly sponsorship, that one would be hard put presently to make dogmatic statements on blood pressure control, diabetes control, Aspirin and Caffeine - and that's just the easy stuff! Speaking entirely personally again, I have found the "real time" nature of contributors comments, criticisms and suggestions has made me more cautious and more critical of any citation before listing it. Finally, it's really good to see everyone as passionate about this as they seem to be. Mdscottis (talk) 20:33, 31 May 2014 (UTC)

Looie, just FYI, you used the terms osteopaths and Doctor of Osteopathy incorrectly on that blog page and in its title. The correct terms are osteopathic physician and Doctor of Osteopathic Medicine, respectively. Osteopathy and Osteopathic Medicine are also not the same thing. Again, just FYI. TylerDurden8823 (talk) 07:51, 3 June 2014 (UTC)

A rebuttal

Planning on sending the following out as a rebuttal. What are peoples thoughts?

Is Wikipedia’s Medical Content Really 90% Wrong?

The journal article by Hasty et al published on May 1st 2014 basically took ten Wikipedia articles and ten “researchers” (either medical students or residents). Each Wikipedia article was then assessed by two of these researchers to try to determine how many statements of fact they contained. The first issue was that the number of statements of fact each reviewer found sometimes differed by nearly 100%. They then took these individual facts and the “researchers” compared them with the peer-reviewed literature as found on PubMed or the medical website Uptodate. They did not check to see if the sources Wikipedia was using were high quality or were accurately reflected. Additionally medical students and residents are hardly experts in medical research.

No errors in Wikipedia are mentioned directly in the original journal article. When I spoke with the lead author he declined to release the underlying data for us at Wikipedia so that we could correct the “errors” they had found, stating that he may 1) wish to publish more on the topic and 2) wished to protect the researchers. So much for independent verifiability in science. Hasty did make some claims to the popular press about errors on Wikipedia. Some of the facts he mentioned, however, accurately reflected some of the best available peer-reviewed sources. For example he claimed that blood pressure should only be checked twice to make the diagnosis of hypertension and that when we state three times we are wrong. However look at the National Institute for Health and Care Excellence (previous known as the National Institute of Clinical Health / NICE) on page 7 in this document http://www.nice.org.uk/nicemedia/pdf/CG18background.pdf It is thus a little ironic that the Telegraph, a UK paper, repeated this incorrect statement and the BBC covered the story so uncritically.

Wikipedia has strong recommendations for what counts as a suitable source. We recommend the use of secondary sources published in well-respected journals from the last 3-5 years, position statements of national or internationally recognized medical bodies or major textbooks. Is Wikipedia a perfect source? No, but it is just as good as many and better than most other sources out there. Or else why would the world be using it? Hasty's work did not have a comparison group. Basically he invented a new method to test the quality of medical content and then only applied this new method to one source, Wikipedia. Without a comparator this single data point is meaningless. I am curious what he would have found if he would have applied this to a NICE guideline or emedicine?

We recently surveyed our top contributors and asked about their backgrounds. What we found was that 52% have either a masters, PhD, or MD. Another 33% have a BSc. About half are health care providers. 82% are male, 9% are female and 9% classified themselves as other or would rather not say. This is very similar to results published by Nusa Faric in her master's thesis. Additionally we are working with a number of organizations including the National Institute of Health, the Cochrane Collaboration, and the UCSF School of Medicine among others to improve Wikipedia’s health care content.

What Hasty did show was 1) the peer-reviewed literature does not agree with itself (i.e., different peer reviewed sources come to different conclusions which is no surprise to anyone that has read much of it) 2) the peer-review process is sometimes flawed as he was able to publish a "peer-reviewed" article whose data does not support its conclusions. As someone who has read a lot of the peer-reviewed literature, this is also not surprising. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:56, 1 June 2014 (UTC)

Excellent rebuttal. I find it incredible that the authors are not willing to release the underlying data. If they "wish to publish more on the topic", they can always retrieve prior versions of the articles. In addition, they have already "protect[ed] the researchers" by keeping the identify of the reviewers confidential. Finally the unwillingness to share the data violates the journal's own guidelines:

As a general guideline, the methods should be written with enough detail that another researcher can replicate the study.
— JAOA Information for Authors

A fundamental tenant of the scientific method is reproducibility. If the data is not shared, reproducibility cannot be tested. Boghog (talk) 20:37, 1 June 2014 (UTC)

Good rebuttal and good comments. Since you (James H.) are planning to send this out, please fix the first sentence. It is incomplete or, perhaps, the word "took" should be something else. Otherwise, I made minor corrections: spelling, capitalization, punctuation (which you may, of course, revert if you wish). --Hordaland (talk) 22:03, 1 June 2014 (UTC)

Great idea James. I found the first paragraph (and 1st sentence of the second sentence) a little weak too academic as an intro. 2nd, 3rd and 4th paragraph are awesome. I would ditch the 5th paragraph, and use the 3rd as your conclusion. I've typed 2 paragraphs as alternates for ideas only.

I’m writing in response to Dr. Hasty’s article published on May 1, 2014 which states that Wikipedia’s medical content is wrong 90% of the time. Wikipedia has no shortage of medical experts (as you’ll read below), and we had them review Dr. Hasty’s article, hoping to improve our own standards.

Instead what we found was that Dr. Hasty’s article has so many flaws in it, that we don't trust the results. For example, he used students and interns, to compare only 10 articles on Wikipedia to whatever they could find online. Although his results are only published in summary form, there appears to be deep disagreement between his own students on what “correct” is. We are unable to determine how Dr. Hasty’s observers could possibly make a conclusion of “right” or “wrong” with respect to Wikipedia’s information, if they can’t even agree among themselves. It is our conclusion, that a consensus of scientists and health care experts (which is largely who edits medical articles on Wikipedia) is far more likely to provide accurate health information than Dr. Hasty’s students and interns. We were so sure of it after reading the article, we asked Dr. Hasty for the raw data results so we could replicate the study (a common request in most publicly published articles), but he’s refused. Ian Furst (talk) 22:19, 1 June 2014 (UTC)

That's a nice rebuttal, James & Ian. I would like to see a more detailed analysis of the statistics, perhaps along the lines of testtestar's comment here. It's also worth mentioning that the paper was already two years out of date by the time that it was printed. Axl ¤ [Talk] 22:47, 1 June 2014 (UTC)

I agree with Axl's suggestion to incorporate testtestar's considerations. I've tried to pen a few lines that might fit in somehow:

While the general objectives of the study are relevant, its methods are fatally flawed. The evaluation of "accuracy" appears to be based on the assumption that "discordances" can be interpreted as likely "errors" on Wikipedia [when, as James says, taken as a whole the peer-review literature is notoriously discordant]. While this may sometimes be the case, the study does not tell us how much or how often, even within the small sample of highly relevant pages under review. An unvalidated method was used to "fact-check each assertion against a peer-reviewed source that was published or updated within the past 5 years". The study design implicitly assumes that uptodate.com (a clinical information website serving physicians) is a suitable reference standard for reliable clinical information. The real possibility that carefully sourced statements in Wikipedia articles may be at least as reliable as alternative statements contained in articles cited by uptodate.com is not adequately considered (the authors' claim is merely that "it can be argued that these assertions on Wikipedia represent factual errors"). It is unclear how "concordance or discordance" of statements was determined, and a particular concern is that when the individual reviewers (who were either medical students or residents) were unable to "fact check" statements on uptodate.com, they appear to have been instructed to dip in to the literature using PubMed, Google Scholar, or "a search engine of their choice"—scarcely appropriate criteria to identify the most reliable information available. Since the authors do not detail the content of the discrepancies and discordances that were identified (and Hasty has so far declined requests to release this essential information) there is no way their validity and potential clinical significance can be reviewed. Additionally, the statistical methods reported in the paper are inappropriate and uninformative. So the present study really does not provide useful information on the "accuracy" of medical statements in Wikipedia. Of course, this does not mean that Wikipedia is blind to its inherent limitations. It does welcome studies that shed light on the quality of its very varied content. 86.181.67.132 (talk) 09:32, 2 June 2014 (UTC)

Amplifying what others have said immediately and further above, to say "the “researchers” compared them with the peer reviewed literature as found on PubMed or the medical website Uptodate" is not really right - they were asked to compare them to a single piece of the peer reviewed literature, of their own choice. It seems from the account in the paper that each researcher made their own choice of piece, which makes the different figures for "discordances" less surprizing. How likely is it, in fact, that every "assertion" in any given fairly long WP medical article will ever be found in a single piece of p-r literature? Not very, I would suggest. We don't know what these articles were (I presume - it might be worth asking that), and their purpose may have been very different from that of an encyclopedic article. This is another key weakness in the study's method, which hasn't been mentioned much yet, and imo needs more emphasis, at the least by mention in the sentence I quoted at the start. Generally, I think it is good as a statement, but could usefully be accompanied by a longer analysis with more detail. Wiki CRUK John (talk) 10:13, 2 June 2014 (UTC)

Agree those discrepancies are unsurprising. A major sticking point is that Hasty is not providing key information to allow post-publication (or even appropriate pre-publication!) peer review of the study without the need for speculation. In the paragraph above I just tried to summarize some of the key methodological issues in a way that might be appropriate for a concise letter to the editor. Given the fundamental character of the issues, I personally feel it's better to go straight to the heart of the question without getting caught up in too much detail (though obviously we could briefly explain things like why the statistical analysis is meaningless). [Adding: I can't see anywhere in the article where it says that the evaluators were required to verify all the assertions from one page in a single peer-review article. My understanding is that they were expected to verify each statement separately.] 86.181.67.132 (talk) 11:13, 2 June 2014 (UTC)

John, the paper's reviewers were told to first check in UpToDate. If that was inadequate, the reviewers could then choose to check either PubMed, Google Scholar, or a "search engine of their choice". The implication is that if the reviewer did not find verification in UpToDate or their choice of search engine, the assertion was labelled as "discordant"—i.e. the assertion is "unverified". Axl ¤ [Talk] 12:00, 2 June 2014 (UTC)

No, that's not right. From the study:(Method section) "The authors instructed the reviewers to use UpToDate (http://www.uptodate.com/) as the initial means by which to search for peer-reviewed sources. If UpToDate did not produce adequate results, then each reviewer was instructed to use PubMed (http://www.ncbi.nlm.nih.gov/pubmed), Google Scholar (http://scholar.google.com/), or a search engine of their choice. Each reviewer then reported concordance or discordance between Wikipedia and the peer-reviewed sources." From the conclusion, as a limitation: "Third, we used any peer-reviewed reference as a standard that included an initial search through a subscription-only service (UpToDate)." They are not using UpToDate (not I think peer-reviewed in the normal sense) as the "peer-reviewed source" at all - perhaps it would have been better if they had been, though they would have had to use lots of its articles. The second quote (whose meaning becomes very misty when you look at it carefully - what meaning does "included" have? etc) led me to think a single source was used per reviewer per article, but I'm now not so sure about that. How many sources were used, or what they were, is not said - a rather crucial point. Footnote re the second quote here: It really is very unclear. Did they mean to say: "Third, we used any peer-reviewed reference as a standard that included had been found through an initial search through a subscription-only service (UpToDate)."? Wiki CRUK John (talk) 12:32, 2 June 2014 (UTC)

RE "...we used any peer-reviewed reference as a standard that included an initial search through a subscription-only service (UpToDate)." This is simply an acknowledgement that their reference standard wasn't everything it should have been. They mitigate the final identification of "any peer-reviewed reference" with the use of UpToDate as an initial quality filter. 86.181.64.67 (talk) 12:49, 2 June 2014 (UTC) [previously 86.181.67.132]

John, you are right. Thank you for pointing out my mistake. I agree with you. Axl ¤ [Talk] 13:21, 2 June 2014 (UTC)

Sorry, I'm not sure I follow... My reading of "standard" is as a methodological term (as in "gold standard") to refer to the term of comparison they used to assess each assertion on Wikipedia. As I understand it (though I may be wrongly interpreting their Methods/Results sections), this so-called "standard" was generated by a process that involved taking each single Wikipedia statement separately and identifying a recent peer-review article containing specific content that either agrees with or departs from that statement. When identifying a pertinent article with which to verify a particular assertion the evaluators were told first to look via UpToDate and, if that was insufficient, via another search engine. Am I missing something here? (For example, the example they give in their definition of "discordance" here is somewhat unclear: "Reviewer did not [my emphasis] find that “diabetes is a chronic condition” in a peer-reviewed reference.") 86.181.64.67 (talk) 14:58, 2 June 2014 (UTC)

You may well be right, but I think we agree it is not at all clear. I note that on this reading the study included 1549 different operations, each of looking at UpToDate or another 'source-finder', and then checking the actual p-r source - 1549 being the total of the totals column in Table 3 (a figure not given in study or table, which I had to add up myself). No doubt many sources covered several assertions, but that is a deal of work. But they seem, according to the method described, not to have been allowed to use any p-r sources already referenced in the WP article. All very odd. Wiki CRUK John (talk) 15:47, 2 June 2014 (UTC)

Though to be honest, pretty much par for the course. Detailing novel methods in a clear, concise and complete way is by no means an intuitive task. That's one reason why I feel we need to focus on key methodological issues. Like: Do the methods address the research question [though actually there wasn't one] appropriately? (No) Was the statistical analysis appropriate? (No). 86.181.64.67 (talk) 16:45, 2 June 2014 (UTC)

The journal article by Hasty et al published on May 1st 2014 basically took ten Wikipedia articles and ten “researchers” – I understand why you've written it this way, but to me, the scare quotes around "researchers" make it sound like we're denigrating these people. As Wikipedians commenting on a party that has critiqued us negatively, I think we need to take special care to get the tone right, and not sound condescending or combative. Sorry I can't suggest an alternative.

Agree about the scare quotes. How about 'evaluators'? 86.181.64.67 (talk) 14:02, 2 June 2014 (UTC)

Sounds good to me. Adrian J. Hunter^{(talk•contribs)} 14:16, 2 June 2014 (UTC)

Or you could shorten it by saying "ten medical students and residents", and thus eliminate the need to say that separately later. WhatamIdoing (talk) 15:37, 2 June 2014 (UTC)

Also, in addition to critiquing this (sadly well-publicised) study, would it make sense to draw attention or comparison to one of the (less well-publicised) peer-reviewed studies that found Wikipedia's medical content highly accurate? Eg see this comment I made earlier. Adrian J. Hunter^{(talk•contribs)} 13:52, 2 June 2014 (UTC)

Agree with comment about using quotes around researchers. It comes off as snobbish. I thought about using observers in my version, but the casual reader may not understand what that means in a scientific sense. I thought it best to identify them as students and interns. It will make sense to almost anyone reading it and makes for a good comparison to those who edit here. Ian Furst (talk) 14:04, 2 June 2014 (UTC)

A few other thoughts:

• "differed by nearly 100%" – suggest changing to "differed by nearly two-fold", which is more intuitive to me (at first pass, the existing text makes it sound like one reviewer found almost zero assertions)
• "Wikipedia has strong recommendations for what counts as a suitable source." – suggest clarifying the scope of this comment, eg change "source" to "medical source".
• "correct the “errors” they had found" – suggest removing the scare quotes and changing to "alleged errors" or "claimed errors" or whatever, per my comment on tone above
• "Or else why would the world be using it?" – not sure if this adds anything. To me it invites the obvious retort, "because the world is lazy". This might be a good spot to point to more favourable research.
• "I am curious what he would have found if he would have applied this to a NICE guideline or emedicine?" – this is not a question, so no question mark
• "82% are male, 9% are female and 9% classified themselves as other or would rather not say." – not sure what this has to do with anything.

Adrian J. Hunter^{(talk•contribs)} 14:16, 2 June 2014 (UTC)

I don't object to denigrating them. Although it wasn't really their fault—they were given a job for which they lacked the training and skills, and they were given poor guidance. Axl ¤ [Talk] 14:18, 2 June 2014 (UTC)

"National Institute for Health and Care Excellence" - should be said this is for the UK, or more accurately England and Wales only. Wiki CRUK John (talk) 15:54, 2 June 2014 (UTC)

• There is an undeclared conflict of interest between the researchers' (and indeed also the journal's) likely intellectual beliefs [7] about osteopathy and the critical stance (based on Wikipedia's "neutral point of view" policy) taken by the subject of the study.

  Like many other of the smaller peer-review publications, The Journal of the American Osteopathic Association does not openly embraces ICMJE guidelines, and (although their own indications regarding potential conflicts of interest [8][9] would not explicitly have encouraged the authors to make such a declaration). Nevertheless, I feel it's right that attention be brought to this evident intellectual COI (cf. some of WAID's observations below). 86.181.64.67 (talk) 07:41, 3 June 2014 (UTC)

  That situation might be better described as "bias" than "conflict of interest". WhatamIdoing (talk) 15:44, 3 June 2014 (UTC)

Technically, I think it could be described as a possible intellectual conflict of interest that may be perceived as a potential source of bias (ugh... now how long winded can I get??) 86.181.64.67 (talk) 15:54, 3 June 2014 (UTC)

Okay we have a publication venue. Am working on this further here User:Jmh649/Rebut. Have taken into account many peoples comments. Thanks Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:36, 4 June 2014 (UTC)

The Guardian has published a sensible report about the matter. Axl ¤ [Talk] 10:09, 6 June 2014 (UTC)

Yes, a nice example of responsible journalism. Thanks. 86.181.64.67 (talk) 12:47, 6 June 2014 (UTC)

Replicability

Several comments above are directed towards replicability. This study is replicable at some level. Here are the steps:

1. Pick ten people who know more than average, but are certainly not true subject-matter experts. Make sure, through years of interaction with them during their training, that they know what you think of Wikipedia.
2. Pick ten articles that are sort of related to the subjects you claim to be evaluating, but not exactly. For example, don't pick Cancer; pick Lung cancer. Make sure that you never explain why you picked the specific articles.
3. Skip the control group; just claim that "the peer-reviewed literature" is your control group. Participants might get confused if they need to do the same thing for Wikipedia and for their own textbooks.
4. Assign each person exactly two articles. This ensures that no one's work can be declared to be a statistical outlier. Ideally, make sure that no pair of people is working on the same article. If Alice works on cancer and diabetes, then Bob needs to work on cancer and hypertension. This will prevent any pesky complaints that Bob's results are always significantly higher or lower than Alice's.
5. Don't blind the participants to the source of the material. (If you do, then you've wasted all those years of telling them what you think about the source.) This is made easier by skipping the control group, since the participants won't have to wonder where a given statement came from.
6. Ask each of your participants to make a list of all the statements of fact in two articles. Don't worry if they come up with wildly different lists; you're not going to use proper statistical methods anyway, so that won't matter. Be vague about whether they should include the non-medical information in the articles in their lists.
7. Tell the participants to look up each fact in "the peer-reviewed literature". Don't worry about which source they pick, because they're all equally good, right? Discourage them from checking the cited sources. Assume that they're all experts in differentiating "published in a journal" from "actually a peer-reviewed article", because who cares if they check the statement against a letter to the editor or something in Medical Hypotheses?
8. Don't double-check their work. If one of them can't find a statement that "diabetes is a chronic condition" in the literature, then you definitely don't want to point out the existence of statements like "chronic diseases such as diabetes" and "type 1 diabetes mellitus, a devastating chronic disease" in review articles published shortly before they searched.
9. Assume that if your participant finds a difference with any (probably) peer-reviewed paper, or can't find a statement about the fact, then Wikipedia is wrong.

You won't get exactly the same numbers, but you will get the same basic results. WhatamIdoing (talk) 16:22, 2 June 2014 (UTC)

Very well put. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:12, 2 June 2014 (UTC)

Review of Wikipedia quality

This is a great review of all studies looking at the quality of Wikipedia

• “The sum of all human knowledge”: A systematic review of scholarly research on the content of Wikipedia Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:31, 3 June 2014 (UTC)

...though the authors would have well advised to avoid the "systematic" claim. 86.181.64.67 (talk) 17:57, 3 June 2014 (UTC)

Why is that? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:06, 3 June 2014 (UTC)

Well, the paper appears to be a traditional (non-systematic) review of the literature, which generally makes much better reading but lacks the stringent methodological characteristics of a systematic review of the literature (see Box 1 - Terminology here). In the absence of any Methods or Results section (and with little discussion of study limitations) it's somewhat difficult to know quite what the researchers did. They certainly do seem to have conducted a systematic search of bibliographic databases (a requirement nowadays even for non-systematic reviews among major medical journals). They also do seem to present a representative survey of the results of available studies that have certain characteristics. However, I cannot see any systematic assessment of risk of bias in the studies that they deemed eligible to enter the review. Nor does there appear to have been a systematic synthesis of the quality of the individual studies. So, useful as the paper undoubtedly is, I don't think it could reasonably be classified as a "systematic review", at least in our field (social science journals are known to be less demanding). In plain English, the paper provides an extensive survey of available studies and digests their results in a way that could indeed be rather useful, but it does not really provide any reliable information about the quality of the methods used in those studies. So ultimately it can't really address questions about what we really know from the research. The paper also does seem to be presented rather from a Wikipedian perspective. 86.181.64.67 (talk) 09:49, 4 June 2014 (UTC)

They say they've used the Okoli and Schabram (2012) systematic review protocol but step 5 of that protocol says "Quality appraisal: Also known as screening for exclusion, the reviewer needs to explicitly spell out the criteria for judging which articles are of insufficient quality to be included in the review synthesis. All included articles need be scored for their quality, depending on the research methodologies employed by the articles." They seem to have excluded quite a number of articles addressing the quality of Wikipedia's medical content, if you compare what they have reported with what's available, but haven't explained their exclusion criteria or graded the included studies. Without knowing the strengths and weaknesses of the individual reported studies, we can't know how much credence to give to their claims. (Basically, what 86. said.) --Anthonyhcole (talk · contribs · email) 16:45, 4 June 2014 (UTC)

I think I've extracted all their assertions about our health/medical content and listed them with their sources here:

Extended content

Altmann U (2005). "Representation of medical informatics in the wikipedia and its perspectives". Stud Health Technol Inform. 116: 755–60. PMID 16160349. In 2005, an early examination of Wikipedia’s content coverage reported insufficient representation of medical informatics on Wikipedia, with many important topics missing. Mercer J (2007). "Wikipedia and "open source" mental health information". Scientific Review of Mental Health Practice. 5 (1): 88–92. Mercer (2007) reviewed some key mental health topics in Wikipedia and found them generally lacking in quality, mainly because of what he perceived to be the influence of contributors lacking genuine professional expertise on the subjects. However, he recognized Wikipedia’s importance and potential and recommended a number of measures that could hopefully improve the quality of articles. Unfortunately, most of these recommendations involved contributors revealing their real-world identities, which conflicts with Wikipedia’s strong policy of permitting anonymous participation and emphasizing quality of content over the qualifications of contributors. Devgan L, Powe N, Blakey B, & Makary M (2007). "Wiki-Surgery? Internal validity of Wikipedia as a medical and surgical reference". J. Am. Coll. Surg. 205 (3, supplement): S76–S77. doi:10.1016/j.jamcollsurg.2007.06.190. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) Devgan et al. (2007) surveyed medical doctors concerning 39 common surgical procedures. They could find 35 corresponding Wikipedia articles, with all of them judged to be without overt errors. The researchers could recommend 30 of the articles for patients (22 without reservation), but also found that 13 articles omitted risks associated with the surgical procedure. Pender MP, Lasserre K, Kruesi L, Del Mar C, Anuradha S (2008). "Putting Wikipedia to the Test: A Case Study". Conference abstract.{{cite journal}}: CS1 maint: multiple names: authors list (link) Pender et al. (2008) compared Wikipedia with UpToDate and eMedicine; they found roughly the same level of factual errors in these three sources. However, another source they compared, AccessMedicine, contained no factual errors in the three articles examined. Clauson KA, Polen HH, Boulos MN, Dzenowagis JH (2008). "Scope, completeness, and accuracy of drug information in Wikipedia". Ann Pharmacother. 42 (12): 1814–21. doi:10.1345/aph.1L474. PMID 19017825. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) In 2008, Clauson et al. (2008) compared medical drug information on Wikipedia and Medscape Drug Reference (MDR), a free online traditionally edited database. They found that Wikipedia could answer fewer drug information questions, e.g., about dosage, contraindications and administration. In the evaluated sample, Wikipedia had no factual errors but a higher rate of omissions compared to MDR. The authors could also find a marked improvement in the entries of Wikipedia over a just 90 days period. The study went on to mainstream media with headlines such as "Wikipedia often omits important drug information" (Harding, 2008) and even "Why Wikipedia Is Wrong When It Comes To Prescription Medicine” (CityNews.ca, 2008). However, as noted by some Wikipedians, the study neglected the fact that one of the Wikipedia manuals of style explicitly requests: "Do not include dose and titration information except when they are notable or necessary for the discussion in the article." Thus, in one of the eight examined question categories in Clauson et al.’s study, the omissions were quite possibly intentional. Clauson et al. (2008) found four factual errors in Medscape among 80 articles examined. Two of these occurred due to lack of timely updates. In contrast, they found no factual errors in Wikipedia. Clauson et al. (2008) compared Wikipedia and Medscape Drug Reference (MDR), a free online “traditionally edited” database, for medical drug information. They found that Wikipedia could answer fewer drug information questions, e.g., about dosage, contraindications and administration. In the evaluated sample, Wikipedia had no factual errors but had a higher rate of omissions compared to MDR. Moreover, Clauson et al. found a marked improvement in the entries of Wikipedia over a just 90 days period. Laurent MR, Vickers TJ (2009). "Seeking health information online: does Wikipedia matter?". J Am Med Inform Assoc. 16 (4): 471–9. doi:10.1197/jamia.M3059. PMC 2705249. PMID 19390105. Using search engine optimization techniques, Laurent and Vickers (2009) investigated the Google ranking of the English Wikipedia for health topics. The queries were 1726 keywords from an index of the American MedlinePlus, 966 keywords from a NHS Direct Online index and 1173 keywords from an American index of rare diseases (U.S. National Organization of Rare Diseases). They compared Wikipedia to .gov domains, MedlinePlus, Medscape, NHS Direct Online and a number of other domains. They found the English Wikipedia ranked among the first ten results in 71–85% of search engines and keywords tested, concluding that the English Wikipedia is an outstanding source in comparison to the other sources providing online health information. Laurent and Vickers (2009) demonstrated that Wikipedia topics on health information were getting updated expeditiously by new events and findings announced in news. Kim JY, Gudewicz TM, Dighe AS, Gilbertson JR (2010). "The pathology informatics curriculum wiki: Harnessing the power of user-generated content". J Pathol Inform. 1. doi:10.4103/2153-3539.65428. PMC 2929539. PMID 20805963.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link) Wikipedia seems to be rich enough about disease information to be useful as learning material. Kim et al. (2010) examined the usefulness of Wikipedia content in covering the pathology informatics educational curriculum, and found that it covers 90% of the curriculum with high-quality, comprehensive and current articles beneficial for both beginning and advanced learners; however, about half the articles were tagged as needing improvements such as more citation. Kim et al. (2010) recognized currency as the strongest aspect of Wikipedia articles, with an average of 112 revisions per article over one year in a sample of pathology informatics topics. They concluded that the more the article was of general interest to the Wikipedia community, the higher the number of edits and revisions was. Kim et al. (2010) assessed the pathology informatics topics on Wikipedia in terms of comprehensiveness, quality, and currency. They found that the examined articles are of good quality with few errors; they judged that the articles can be used in a course curriculum for teaching to beginner and advanced learners. Leithner A, Maurer-Ertl W, Glehr M, Friesenbichler J, Leithner K, Windhager R (2010). "Wikipedia and osteosarcoma: a trustworthy patients' information?". J Am Med Inform Assoc. 17 (4): 373–4. doi:10.1136/jamia.2010.004507. PMC 2995655. PMID 20595302.{{cite journal}}: CS1 maint: multiple names: authors list (link) Leithner et al. (2010) investigated the quality of Wikipedia information on osteosarcoma, a type of cancer, in three aspects of scope, completeness and accuracy. Three independent observers scored the answers to twenty questions. They judged that the information provided on English Wikipedia is good in terms of quality, but still inferior in comparison to that provided by professional health websites like the US National Cancer Institute (NCI). Thus, they suggested maintaining a high quality for Wikipedia articles by inserting external links to these professional sources. Leithner et al. (2010) investigated the scope, completeness, and accuracy of information for osteosarcoma on English Wikipedia in April 2009, compared with patient and professional sites of the US National Cancer Institute (NCI). Although they found Wikipedia’s information to be generally good, it scored lower compared to the two NCI versions (though this was statistically significant only for the professional version). Thus, they suggested adding external links to these websites on Wikipedia articles. Rajagopalan MS, Khanna VK, Stott M, Leiter Y, Showalter T, Dicker A, Lawrence Y (2010). "Conference abstract: Accuracy of cancer information on the Internet: A comparison of a Wiki with a professionally maintained database". Clinical Journal of Oncology. 28 (15, supplement): S1. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) Rajagopalan MS, Khanna VK, Leiter Y; et al. (2011). "Patient-oriented cancer information on the internet: a comparison of wikipedia and a professionally maintained database". J Oncol Pract. 7 (5): 319–23. doi:10.1200/JOP.2010.000209. PMC 3170066. PMID 22211130. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) Rajagopalan et al., (2010, 2011) examined Wikipedia’s cancer information in August 2009 against that in the US National Cancer Institute’s Physician Data Query (PDQ). They found that Wikipedia had similar accuracy and depth compared to the professionally-edited resource. Lavsa SM, Corman SL, Culley CM, Pummer TL (2011). "Reliability of Wikipedia as a medication information source for pharmacy students". Currents in Pharmacy Teaching and Learning. 3 (2): 154–158. doi:10.1016/j.cptl.2011.01.007. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) Lavsa et al. (2011) compared the drug information for twenty of the most frequently prescribed drugs in the United States with the drug package information and certain authoritative databases. They found that the Wikipedia articles were all incomplete in providing full drug information, often missed important details, and were often inaccurate. They recommended against its use by pharmacology students for drug information. As mentioned earlier, part of the missing information in health-related articles could be quite intentional, as Wikipedia policy advises not to include drug dosage information in articles.

If I've missed something or got something wrong, please feel free to add or correct. Anthonyhcole (talk · contribs · email) 15:23, 4 June 2014 (UTC)Wikipedia:WikiProject Medicine/Research publications

Anthony, many thanks indeed for compiling this summary. It should be added to Wikipedia:WikiProject Medicine/Research publications somewhere. Has anybody cross-checked between that page and Okoli et al.'s papers? And their website database at http://wikilit.referata.com (articles published up to July 2011 only)? I think it is highly important when summarizing Wikipedia research to list where possible the date or period when the WP data was obtained, eg, from above: "Leithner et al. (2010) investigated the scope, completeness, and accuracy of information for osteosarcoma on English Wikipedia in April 2009,...." . The oldest item here was published in 2005 so very probably researched in 2004, so is only of interest to historians of what the abstract rather charmingly calls "the Wikipedia". The Okoli website is I think useful here. Wikipedia changes even faster than medicine, and most papers published before (?) 2011 are likely to be seriously outdated. Wiki CRUK John (talk) 11:30, 9 June 2014 (UTC)

Proposal of retaining and fixing eMedicine template under Infobox disease

Introduction: eMedicine has been a quite popular portal relating to health and related issues with articles on wide range of important topics. The articles are primarily intended for physicians are are well referenced. Template:EMedicine and Template:EMedicine2 had been a part of Template:Infobox disease and have been acting individually or in conjunction to each other, as important external resources to many health related articles under WP:MED.

Issue: eMedicine articles could have url in two formats {{EMedicine2|article|806890}} or {{EMedicine2|emerg|43}} where 'emerg', 'med', 'radio' or 'ped' referred to the subject under which the article was classified. Both the formats were simultaneously active but a short while back eMedicine removed the subject based classification of its articles and the links to those redirected to the homepage instead. As a result, the Wikipedia templates with structures like {{EMedicine2|emerg|43}} were no longer working but ones with {{EMedicine2|article|806890}} are functional till date and are likely to remain so. Unfortunately, in apprehension that the template no longer works, it has already been removed from Template:Infobox disease. While there may be debates to whether resources like patient.co.uk are better sources as they are intended toward more neutral audience, the fact remains that before the technical issue with the links, eMedicine has remained as a valued resource and removal of this template would mean loss of useful resouces from medical articles. If a better source can be identified, it can surely be added thereafter.

Proposed solution: I suggest that the template be retained. The eMedicine templates bearing subject names may easily be tagged so that intervention may be made. A simple Google search with the Wikipedia article name on the page of which the non-functional link exists, will most often provide the link to the relevant eMedicine article and the requisite substitution with 'article|12345' can be done easily to get the links working again.

I am opening an opinion poll to on suggestion of Jmh649 (talk · contribs). Please support , oppose or discuss the proposal here so that appropriate intervention may be made. Diptanshu^Talk 07:22, 7 June 2014 (UTC)

Support retaining eMedicine template

1. Support Diptanshu^Talk 07:22, 7 June 2014 (UTC)

Support moving eMedicine from template to EL

1. Support - I would support keeping the eMedicine links, but at the same time move them to the external links section and treat them just like any other external link. I think we should not systematically include them, but there is no reason to systematically remove all of them all the sudden either. In many cases the emedicine articles provide a lot of useful information way beyond what is in the corresponding wikipedia article. On a cas-by-case basis it can then be decided if there are better sites to link to. --WS (talk) 20:45, 8 June 2014 (UTC)

I do not have a concern with them being in the EL link along with the others. This discussion is only about the infobox Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:15, 8 June 2014 (UTC)

I feel retaining the eMedicine links in the External links section would be just fine. I would just like to echo Wouterstomp's view expressed here. Diptanshu^Talk 12:50, 9 June 2014 (UTC)

I've moved this to its own subsection for clarity, please correct me if I have misidentified your statement of support. --LT910001 (talk) 09:05, 10 June 2014 (UTC)

1. Support I would support this, as it is a solution that preserves the links whilst removing the prominence accorded to eMedicine above other commercial and non-commercial sources. --LT910001 (talk) 09:05, 10 June 2014 (UTC)

Oppose retaining eMedicine template

• Oppose. Thanks for proposing this, Diptanshu.D, this is a useful discussion to have and I would like to hear what others think. I personally have never liked eMedicine. I have three reasons:
  1. Firstly, it's a for-profit organisation and so I disagree that we should be sending users in that way. I would agree if the websites were particularly good, but they're not.
  2. Secondly, the website has prominent advertisements and is written haphazardly in a way that is not very accessible to lay people and not easily verifiable. (I am looking at [10] and [11], two samples.)
  3. I would also not refer it to lay people for those reasons, and I would not refer it to practitioners or students because it is quite variable in style, only partially verifiable, an 'expert opinion' that is not backed by an expert or national body and does not seem to base its statements off any particular guideline, or at least does not state this (I could also be wrong here). I think that eMedicine shouldn't be included, and that any discussion about including something else should be a separate one. --LT910001 (talk) 09:56, 7 June 2014 (UTC)
• Oppose I used to be more supportive of this site however its quality / utility has significantly decrease over time.
  1. They used to provide greater information on a single page. Now I presume in an effort to increase the number of pages people click on they have spread the content over many pages This issue has been fixed
  2. They are commercial and sell the eyeballs of the viewers to industry.
  3. The NYTs has raised concern that they alter their article text to please advertisers [12]
  4. They require log-in to view conten
  5. Thus I am of the opinion that linking it in the infobox is too much prominence. Emedicine is usually links on DMOZ to which we link. I think we should put patient.co.uk in the infobox as it is better and they are happy to have us link to them. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:23, 7 June 2014 (UTC)

Fallacies of the logic discussed in the discuss section. Diptanshu^Talk 03:28, 8 June 2014 (UTC)

The argument is that we have two sites that are similar emedicine and patient.co.uk. I do not see a reason to link to both. I consider the latter to be better than the former. Thus I propose linking to the latter in the infobox rather than the former. Linking both IMO is too much clutter. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:44, 8 June 2014 (UTC)

• Oppose. I have always been averse to the use of external links, especially the blanket placement of links to a chosen website. From WP:ELNO, "one should generally avoid providing external links to... any site that does not provide a unique resource beyond what the article would contain if it became a featured article." This is Medscape's page for non-small cell lung carcinoma. I am not convinced that this has information that shouldn't reasonably be included in Wikipedia's analogous page.

Some pages such as treatment include extensive discussion of primary sources (controlled trials). Our guideline discourages such discussions. However our "Treatment" sections should typically include review papers or textbooks that give an overview of these primary sources. Interested readers can follow the sources provided. In any case, if a reader is really seeking such an overview, they would be better served doing their own PubMed search.

Pages such as this one give details of drug regimens. I do not think that Wikipedia's readers are interested in this sort of information. Axl ¤ [Talk] 19:21, 8 June 2014 (UTC)

"they would be better served doing their own PubMed search" and usually paying $40 each to be able to see the articles, which 90% of our readers are unable to understand anyway.

"I do not think that Wikipedia's readers are interested in" details of chemotherapy regimens, unless they're actually cancer patients or have a loved one with cancer. If you really believe that, then I'm betting that you haven't spent any time hanging around internet forums for (especially) breast cancer.

I'm not very sympathetic to systematically linking either of these websites, but I believe that some readers are benefiting from them. WhatamIdoing (talk) 21:44, 8 June 2014 (UTC)

I am sure that you are familiar with using PubMed. The vast majority of abstracts are free to read, including the large number of primary sources such as controlled trial reports. The summary on eMedicine provides rather less information than the typical primary source abstract. For the review papers, there are usually some free to read with the majority requiring a fee. As for the fee itself, that is the current model that many journals use. Perhaps you should write to them and complain.

Frankly, if a reader wants to read details of individual clinical trials but is unable to use a search engine or journal database, I don't think that spoonfeeding them a specific website is going to help their understanding of the disease.

The internet forum crowd are a self-selected group—hardly representative of the average Wikipedia reader. Such individuals aren't going to be satisfied with spoonfeeding from Wikipedia either. They will be doing their own searches. Axl ¤ [Talk] 22:17, 8 June 2014 (UTC)

Propose replacing eMedicine with patient.co.uk in the infobox

As a comparison here is the link of gout on patient.co.uk [13]. It has a button that will read the article.

• Support Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:33, 7 June 2014 (UTC)

Fallacies of the logic discussed in the discuss section. Diptanshu^Talk 03:28, 8 June 2014 (UTC)

• Support A more useful, mainly non-commercial resource for our readers that doesn't duplicate Wikipedia; it's one that presents frequently-updated evidence-based information and advice in a way that's geared for both patients and professionals. 86.181.64.67 (talk) 08:45, 8 June 2014 (UTC)

I've rethought this, based on some of the comments elsewhere. While I think this site is preferable, I think I have reservations about automatically linking (and thus effectively endorsing) any particular site. Also, patient.co.uk, almost by definition, represents a British viewpoint, whereas we should be striving for a worldwide perspective. (However, I can't see any particular preclusion to using the site as an optional external link.) 86.181.64.67 (talk) 09:29, 10 June 2014 (UTC)

Are you suggesting we should strive for a worldwide perspective by continuing our usual practice of almost entirely using US sites for links? Wiki CRUK John (talk) 12:54, 10 June 2014 (UTC)

No, certainly not. I've just been distancing myself from the idea of using blanket links to any particular site, although I think patient.co.uk is actually a rather good one. (The question of how best to provide a worldwide view raises particular challenges in medicine, imo. For example, treatment affordability varies widely.) 86.181.64.67 (talk) 20:59, 10 June 2014 (UTC)

That is certainly the case, but a rather different question. I imagine if there were a good broad coverage general medical site addressing developing world realities we would have found it by now, and used it to improve our coverage in this respect. In general I don't see too much difference in approach or information between the best sites in large Anglophone countries, though there are differences on things like screening. Economic & affordability issues are mostly ignored by both US and UK sites despite the differences in the national health systems. I do think we should link to other high quality sites, but there are actually rather a lot. I wouldn't mind some sort of standard box with short links to a few general ones, and some specialist ones as appropriate.Wiki CRUK John (Johnbod (talk)) 21:29, 10 June 2014 (UTC)

• Oppose. This is the website's page for "Lung cancer". It is a patient information leaflet. Wikipedia is supposed to be an encyclopedia. It is not supposed to be a linking service to patient information leaflets. The website fails WP:ELNO. Also, I do not want to see Wikipedia's medical articles become a tacit endorsement for one particular website's patient information leaflets. In my opinion, patient.co.uk is an even worse choice than eMedicine/Medscape. Axl ¤ [Talk] 19:34, 8 June 2014 (UTC)

I was thinking this one [14] Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:18, 8 June 2014 (UTC)

Ah, okay. Thank you for pointing that out. The page does seem to contain some information that isn't in Wikipedia's featured article, although the majority is duplication. The website also seems to be UK-centric. Overall, it would be an improvement over eMedicine, but I still don't think that it should be linked from Wikipedia's infoboxes. Axl ¤ [Talk] 13:14, 9 June 2014 (UTC)

We already have one US centric source in the infobox "MedlinePlus" Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:12, 10 June 2014 (UTC)

I would like to see MedlinePlus links removed from the infoboxes too. Axl ¤ [Talk] 08:23, 10 June 2014 (UTC)

• Oppose I don't think we should have patient.co.uk, emedicine or any other such link in the info-boxes, and I don't think they should be in External Links unless they've first been checked for errors.

The one thing I know enough about to check out is Circadian Rhythm Sleep Disorders, so I've read the articles about these on emedicine and patient.co.uk. The former is missing one whole disorder (in sighted patients, the most debilitating one) that should be there. The latter has an important error in a definition. I wouldn't choose to link to either until it's been corrected. (I have now written to both explaining what they've got wrong and offering an excellent article on NORD (click 'View Full Report') as a source. --Hordaland (talk) 11:43, 11 June 2014 (UTC)

Discuss

If eMedicine is a bad source, then why does WP:MEDRS currently allow it? Like I recently pointed out in this discussion, WP:MEDRS has it as one of the "usually acceptable sources in themselves, and can be useful guides about the relevant medical literature and how much weight to give different sources; however, as much as possible Wikipedia articles should cite the more established literature directly." If we are going to generally scrutinize this source, and I'm not saying that we should, then we should remove it from WP:MEDRS as an acceptable source...for consistency. Flyer22 (talk) 10:06, 7 June 2014 (UTC)

A good point if there's consensus that it's a poor source. My meaning is not that it is a bad source faactually, but just that it's not a helpful one to readers. And is it a for-profit corporation, rather than a not-for-profit, which I think we should be favouring if we're going to be providing links in the infoboxes to them. --LT910001 (talk) 10:17, 7 June 2014 (UTC)

Considering the average condition of medicine related articles on Wikipedia, most of the corresponding articles on eMedicine are categorically better, as I have observed. Moreover, most of the eMedicine articles have good inline references or at least a good bibliography, which I find valuable. Simply speaking, eMedicine can act as a good source for improving and rewriting Wikipedia articles. Diptanshu^Talk 10:41, 7 June 2014 (UTC)

Please consider going through the following journal article:

Volsky, PG; Baldassari, CM; Mushti, S; Derkay, CS (2012 Sep). "Quality of Internet information in pediatric otolaryngology: a comparison of three most referenced websites". International journal of pediatric otorhinolaryngology. 76 (9): 1312–6. doi:10.1016/j.ijporl.2012.05.026. PMID 22770592. {{cite journal}}: Check date values in: |date= (help)

If one of the most referenced sources of health-related information on internet is to be considered as a poor source, its an irony indeed. Interestingly indeed, for content accuracy eMedicine scores over Wikipedia and yet Wikipedian editors consider it to be a poor source. Moreover, the whole issue sparked off only after due to a certain reason, certain links from the site became non-functional. Why in the first place did the issue not reach a settlement earlier? Diptanshu^Talk 11:03, 7 June 2014 (UTC)

I am currently in the process of updating the emedicine links within the infoboxes by substituting subject with article and the appropriate numeral. I have already done it for around 30 articles. This is a simple task and can be completed. In case the links are functional, I hope it would perhaps be less opposable in reverting to the previous state where eMedicine links were a part of the infoboxes. Diptanshu^Talk 15:43, 7 June 2014 (UTC)

According to my estimates, there are about 4200 articles requiring the substitution (med 2095, ped 509, derm 346[15], radio 283[16], sports 243[17], neuro 277[18], emerg 392[19], rehab 18[20]). I admit that it is a bit of work but indeed doable if it preserves the resources of Wikipedia. Requesting inputs. Diptanshu^Talk 16:01, 7 June 2014 (UTC)

Flyer, there's no agreement that eMedicine is a "bad source". It's not the best source, but it's perfectly acceptable to cite it for moderate-level claims. For example, I would normally accept it as a source in a ==Treatment== section to support a claim that X, Y, and Z are commonly used treatments, or that X is the first-line treatment. WhatamIdoing (talk) 18:53, 7 June 2014 (UTC)

Yeah, I was making the point of "Is it actually bad or poor if our medical guideline calls it usually acceptable?" Flyer22 (talk) 19:00, 7 June 2014 (UTC)

It is boarderline. There are better sources. Another issue with using it as a source is that it changes with time. And now seems to be a good time to replace emedicine with something less commercial. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:26, 7 June 2014 (UTC)

I agree we should be replacing it with something less commercial. Jmh649 and other users, as well as patient.co.uk, what are the other widely-used medical sites that we might consider here?--LT910001 (talk) 22:12, 7 June 2014 (UTC)

There are many informative sites that sell eyeballs of visitors. Probably that is better than selling products as the latter carries more scope of bias. eMedicine, of Medscape is not a non-profit organisation like Wikipedia. It is beyond discussion as to whether that is a merit or demerit as it enables eMedicine to maintaining a particular standard of its articles (be it good or bad); Wikipedia articles vary from Stub to FA class with most of the articles grouped in the Stub and Start class. Unless the quality of virtually all articles on medical topics are raised to at least C class, criticising the quality of articles on eMedicine. The purpose should be to provide accesible good medical information which both Wikipedia and eMedicine does. Both are primarily accessed by users after landing there from a Google search (or any other search engine for the purpose). Since both of these are usually in the first page of the result, if we cannot provide adequate contents, users would automatically go elsewhere, eMedicine being the most prominent other destination due to its expanse and popularily. It is meaningless to debate on this issue till then. If anyone observes any particular bias or wrong information on the corresponding article on eMedicine, it would be worthwhile to discretely point it out on the Wikipedia talk page of the article. Let us see a substantial amount of such points before we dump eMedicine as a bad source which it is not. If there can be better sources, why are we not striving towards making ours the best source (if that is possible) with users needing to go anywhere else. Till then I would plea not to strip at least 4200 Wikipedia from mentioning a good source (where people would go anyway based on search results provided we cannot offer adequate information). Replacement with better sources is not equivalent to deletion of useful resources simply because they have a scope of fallacy. Diptanshu^Talk 03:07, 8 June 2014 (UTC)

@Jmh649: Logic of such ridden quality is not expected from the Preseident of Wikipedia Medical Foundation, who also happens to be the topmost contributor of medical articles of 2013[21].

They used to provide greater information on a single page. Now I presume in an effort to increase the number of pages people click on they have spread the content over many pages

Please specify when exactly was their content on a single page. Multiple page layout of eMedicine is not new.

They are commercial and sell the eyeballs of the viewers to industry. The NYTs has raised concern that they alter their article text to please advertisers [12]

They are not selling some products directly and hence the articles cannot be biased toward the particular product or advertiser especially because of the fact that Google chooses which ads to display, not eMedicine primarily. It can be argued that similarly biased editors can be there too on Wikipedia.

Furthermore, the view of one Virginia Heffernan expressed in The New York Times in 2011 cannot be regarded as the view of NYT. Based on this logic, I am now thinking of adding contents to Wikipedia with the reference as I think so. Surely, Jmh649 will consider it valid.

Jmh649 Can you please specify that what exactly is the source of the informatin in the Virginia Heffernan article that Her father is a retired professor of English literature. Please argue that somebody is not promoting somebody here on Wikipedia. Sources to such articles are like [22] which boast 1.7k followers. Are you sure that nobody here is pulling up the web-ranking of some random blog? Diptanshu^Talk 03:36, 8 June 2014 (UTC)

They require log-in to view conten

In general eMedicine does not require login for reading articles. I have been reading both Wikipedia and eMedicine articles but do not remember having logged onto eMedicine for centuries and yet I had no trouble reading through their articles.

..I think we should put patient.co.uk in the infobox as it is better and they are happy to have us link to them.

This is not mutually exclusive to eMedicine.

Sorry for having to be so rude but I feel that beurocrats on Wikipedia too have a scope of biasing contents on it. So do we dump Wikipedia too? After all, there is documented fact (stated earlier) that Wikipedia articles are the ones containing most omissions and errors too? Diptanshu^Talk 03:28, 8 June 2014 (UTC)

1. One can see the changes in structure to emedicine over time via the waybackmachine. Indeed back in 2008 they had more info on a page [23] They became much worse and are now a bit better. In fact they now have a "show all" button [24] which links to all the info on a single page.
2. Yes good point this is not the position of the NYTs but an article in the NYTs and yes that article is from 2011.
3. You look around their website and this will come up [25]
4. There is only so much stuff we should put in the info box. If we have patient.co.uk we do not need also emedicine as they are similar and the former is better than the latter IMO. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:44, 8 June 2014 (UTC)

In response to You look around there website and this will put up [26] by Jmh649,I would like to point out that one that directly visit the same page [27] without logging in. Look who is trying to mislead the discussion! In any case, the strongest point he has is that there is not adequate space in the infobox for both patient.co.uk and eMedicine. Ironically enough, patient.co.uk does not seem to have an article page on the mentioned topic altogether [28] other than a forum page [29]. So what are we fighting? I would like to ask another question. Is everyone sure that anybody here (name unmentioned) does not have any personal interest in patient.co.uk? I fear that the discussion is not going to go anywhere unless there are other participants. I prefer to become a bit aloof as it might soon seem that there is a personal conflict going on here. Diptanshu^Talk 05:16, 8 June 2014 (UTC)

We're not fighting. You asked for the opinions of other users, which have been provided. It's clear what us three think, let's wait and see what other users think. --LT910001 (talk) 05:24, 8 June 2014 (UTC)

As LT910001 says, this is a relevant question. Ok, it may have been triggered by a technical glitch, but doubts about the suitability of linking emedicine pages in the infobox have been raised on this page before, eliciting some strong opinions (eg here). So the underlying question is not new (and it's not personal). 86.181.64.67 (talk) 11:23, 8 June 2014 (UTC)

Per " Is everyone sure that anybody here (name unmentioned) does not have any personal interest in patient.co.uk?" it appears that you are saying that I have some "personal interest" in the site patient.co.uk? Implying that I am receiving financial gain or something else nefarious. While the answer is no. I accept no monies for what I do on Wikipedia. Seriously what is wrong with this place? As soon as someone holds an opinion contrary to that of anyone else they immediately are accused of having a conflict of interest. I have been accused of being in the pay of pharma, I have been accused of being anti pharma, I have been accused of profiting from cognitive behavior therapy [30]. It is not just newcomers who are bitten.

Patient.co.uk does have a page for gout and it is here [31]. It also has a page for pseudogout here [32]. Yup sorry no page for "gout and pseudogout" combined. We here at Wikipedia do not have one either. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:36, 8 June 2014 (UTC)

I was also pretty taken aback to read the above comments. Arguments can get pretty heated here, but I do not feel there is any need to make personal attacks ("Logic of such ridden quality is not expected from the Preseident of Wikipedia Medical Foundation...") or accuse users of COI. This promotes an unhealthy atmosphere and is unnecessarily polarising. If we do or do not include this link, it will not be the end of the world.--LT910001 (talk) 22:31, 8 June 2014 (UTC)

Dear James and LT910001, I clearly know that James noway has any personal interests in patient.co.uk and I know that his efforts are sincere. But I wanted to point out a fallacy of logic. I have done a similar thing when I mentioned about the article on Virginia Heffernan. I never think that anybody is promoting her father, neither do I think that the provided information is wrong. I just think that it is a first hand information that is beyond referencing. While such things are always going to be there on Wikipedia and cannot be fool-proofed, issues can be there with other things too. Things that eMedicine says might seem commercially biased but that need not always be the case as is not the case of James promoting the inclusion of patient.co.uk. But even there the possible scope can indeed give a scope of consfusion, the analogy of which I have created by questioning James's neutrality which I am anyway sure of. Diptanshu^Talk 12:21, 9 June 2014 (UTC)

There are lots of sites on the internet that offer the patient/general reader biomedical information. (I've started a comparison project here.) If our article is inadequate and there is an adequate one out there, shouldn't we just link to it or them in our infobox while the Wikipedia article is developing? Shouldn't the decision about which sites to link to be up to the given article's writers and editors? --Anthonyhcole (talk · contribs · email) 08:09, 8 June 2014 (UTC)

Through the entire discussion here, I wanted to simply echo Anthonyhcole's words If our article is inadequate and there is an adequate one out there, shouldn't we just link to it or them in our infobox while the Wikipedia article is developing? I think that the corresponding eMedicine articles are often better than ours and that was the rationale of including the links. Diptanshu^Talk 12:21, 9 June 2014 (UTC)

Also, I think it's worth bearing in mind that some of these sites do things for our users that Wikipedia doesn't and can't do (per WP:NOTHOW), like give evidence-based advice. Obviously, we want to get our choices right. 86.181.64.67 (talk) 08:58, 8 June 2014 (UTC)

I've been sitting quietly reading all of this, and until now didn't really care one way or another. I'm now strongly on the side of removing the links. Not because of their quality or Wikipedia's, but because it's a commercial website. I never gave the links a second thought (prior to this discussion), but now I don't think Wikipedia should be in the business of systematically linking to commercial interests. Leave that to the commercial search engines. Like it or not, Wikipedia is probably the first choice for medical information worldwide and who we link to is important. For me, there are 3 important criteria that the medicine project should consider in links 1) are we creating a systematic link 2) is it to a for profit entity 3) does it have a declared or undeclared bias. And, if the implication was that James is somehow on the 'take', I think he's owed an apology. Ian Furst (talk) 13:59, 8 June 2014 (UTC)

WP:EL treats for-profit and non-profit websites alike. We don't care if they make some money, so long as the content is suitable for our purposes. Most non-profits are trying to make money off their websites, too. WhatamIdoing (talk) 21:33, 8 June 2014 (UTC)

Yes we should link to the best site available. The ones with less advertising is easier to read and thus IMO better. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:19, 8 June 2014 (UTC)

An interesting discussion. I fear that our position on ELs to advert-supported sites may not have properly considered reader privacy. To my thinking there should as a bare minimum be an advisory to readers that the link is taking them to an external site which WMF cannot control. This is medical content, after all. The potential for the DoubleClicks of the world to exploit readers' attention to a specific condition is very real and should not be enabled by a wp:EASTEREGG link. LeadSongDog come howl! 13:43, 10 June 2014 (UTC)

Assistance needed in Academic Dispute

I was recommended by a third opinion mediator (Stfg) to bring to your attention and reach resolution of a dispute between two editors. Your expert medical opinion is sought. I hope I'm doing this correctly; if not, I apologize. The problem began when I was not allow to add additional information and sources (all the edits I made were deleted) in two separate entries. This was done unilaterally by a Wiki contributor or editor, Staug73. First, the journal I cited was denigrated. Subsequently the journal Surgical Neurology International was approved as a notable entry in Wikipedia, and the object of criticism became elaborated, so that I was still unable to edit those entries Psychosurgery and History of psychosurgery, which I felt needed work. Staug73 then began to denounce the author of one of the articles that I felt needed inclusion, both as to information and as well as reference source. (As to the additions needed in those articles, incidentally an administrator agree with me that some additions would be helpful. May additions even corrected false information in one of the articles). Some of the additions were made, but when I again attempted to edit the entries to add more information and references sources, Staug73, made very serious, but in may opinion, baseless, capricious, and even malicious accusations against one of the main author (and article) I was trying to cite. Staug73 accused the neuroscientist of "copying" from two articles, articles which were in fact cited by the author, as well as additional references I was able to insert after some struggle.

In short I agree with Stfg that: "... expert knowledge is required to opine on the use of the Faria reference. I recommend asking a question at Wikipedia talk:WikiProject Medicine." The dispute is available from Talk:History of psychosurgery, particularly Talk:History of psychosurgery#Faria reference. Additional information is available from User_talk:Randykitty#Assistance Required and User_talk:Randykitty#Do you remember this edit? LeBassRobespierre (talk) 20:52, 8 June 2014 (UTC)

Your edits are still here [33] Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:22, 8 June 2014 (UTC)

Not on the history article. Wiki CRUK John (talk) 10:56, 9 June 2014 (UTC)

An uninvolved comment, purely regarding Wikipedia's editorial guidelines, without entering into any questions of actual content: The abstract of the paper in question states "A history of these developments up to the 21st century will be related in this three-part essay-editorial, exclusively researched and written for the readers of Surgical Neurology International (SNI)." So from the standpoint of Wikipedia's guidelines on identifying reliable medical sources (WP:MEDRS), which are rather more stringent than the general sourcing guidelines (WP:RS), this would certainly have to count as a primary source. Even though MEDRS guidelines may be waived when writing on the history of medicine topics, we are reminded that primary sources must always be handled with care anywhere on Wikipedia (per WP:PRIMARY). In the presence of a content dispute such as this, use of reliable secondary (or tertiary) sources is obviously preferable. 86.181.64.67 (talk) 09:41, 9 June 2014 (UTC)

I don't see this a primary source issue, given that most of the argument seems to be about the 19th century, and one of StAug's complaints is that the article relies heavily on other sources. Wiki CRUK John (talk) 10:56, 9 June 2014 (UTC)

While, as John underlines, this historical topic would not technically be subject to MEDRS, I thought it might be useful anyway to consider potential reliable medical sources that aren't currently cited on the page. A quick look at PubMed brought up:
- Lapidus et al. History of psychosurgery: a psychiatrist's perspective. World Neurosurg 2013 PMID 23419707
- also, perhaps: Herbert Jasper. A historical perspective. The rise and fall of prefrontal lobotomy. Adv Neurol 1995 PMID 7771315
Either might be worth considering (though unfortunately they're not open access). 86.181.64.67 (talk) 12:11, 9 June 2014 (UTC)
- And a few more historical articles that may be pertinent: Patel et al 2013 PMID 23159652; El-Hai 2008 PMID 19248679; Feldman 2001 PMID 11270556. 86.181.64.67 (talk) 13:04, 9 June 2014 (UTC)

• I have looked at those article in World Neurosurgery and Adv Neurol and these sources are good reliable sources that also should be cited or at least added to sources. Thanks, 86.181.64.67 (talk .LeBassRobespierre (talk) 14:37, 11 June 2014 (UTC)

To clarify, I didn't mean to imply that they necessarily have to be cited. Rather, that they could prove to be potentially useful NPOV sources; unlike Faria's articles which, personally, I think should be used only to reference that particular POV. 86.181.64.67 (talk) 18:10, 11 June 2014 (UTC)

It's not a primary source. Remember that secondary is not a fancy way to spell 'good source'.

I've looked briefly at the article history. Here's one of the disputed edits[34]:

Psychosurgery developed as a result of this growing problem. In fact, some of the first psychosurgeons or promoters of psychosurgery were psychiatrists.

("This growing problem" appears to refer to "Treatment of insanity has evaded practitioners", which was separately deleted.)

User:Staug73's edit summary is, "Not a good source, anyway sentence is meaningless - who would you expect to be involved in psychosurgery?" I understand this to mean that Staug agrees that the sentence is factually accurate, but doesn't want to have it present anyway (perhaps it's supposed to be insulting to modern psychiatrists?).

I don't see any good reason to omit this. The source appears to meet plain-vanilla WP:RS (which is all that is required for non-biomedical information like this), Staug appears to admit to its verifiability and accuracy in a back-handed way, and it is not unreasonable or UNDUE to say that this technique was promoted by the experts of the day, rather than by quacks or random physicians who didn't know much about the subject. So I'd include this. Perhaps Staug can tell us more about the objections. WhatamIdoing (talk) 15:40, 9 June 2014 (UTC)

Thanks everyone for contributions so far. This was I think the edit in question the text that I removed: “Treatment in insanity has evaded practitioners from ancient times to the 20th century, as a result the mentally ill have been treated harshly, and in the 18th and 19th centuries mostly committed to crowded hospitals and asylums”. The source given is a chapter in HW Haggard’s The Doctor in History. I don’t think the source supports the statement and I asked on the Talk page for a more specific page reference but got no answer. That left “Psychosurgery developed as a result of this growing problem” making even less sense. As for “In fact, some of the first psychosurgeons or promoters of psychosurgery were psychiatrists” – you would expect psychiatrists to be involved with psychosurgery at some stage because it is a treatment for psychiatric disorders. The first promoters of psychosurgery however were actually neurologists (Moniz and Freeman). Psychiatrists on the other hand were among notable early critics of the procedure (Sobral Cid for example). The contributions of psychiatrists, neurologists and neurosurgeons (as supporters or critics) is an interesting topic but can’t be summed up in a sentence like this. Likewise the question of what psychosurgery developed from is a complex topic and there are debates in the literature which perhaps deserve a mention. Again it cannot be summed up in a couple of sentences and the sentences here (as well as not being supported by the source) don’t altogether make sense. Before the 20th century doctors did have treatments for insanity and harsh treatment isn’t a problem that only occurs in past eras.

This isn’t about an academic dispute. It is about an editor setting up an account to promote the work of one person. I looked through the edits made by LeBassRobespierre, including 2 IP addresses that I think are the same editor, and I couldn’t find an edit (other than perhaps one or two minor ones) that isn’t in some way linked to Miguel Faria. In addition most of the edits are cut-and-paste. Staug73 (talk) 16:24, 9 June 2014 (UTC)

I have however added a bit about role of psychiatrists in promotion of psychosurgery. A major problem with Miguel Faria's article is that he relies almost exclusively on one article (Robison et al) to cover a large part of psychosurgery history. In places he closely paraphrases. LeBassRobespierre thinks that is okay as long as there is a footnote. I am not so sure. I think there comes a point where you should either quote, or at least have an in-text attribution. And, in the spirit of credit where credit is due, if there are two articles of the same type published not too far apart and saying the same thing, I would rather give credit to the authors who said it first. And in some places the Robison et al article is carelessly paraphrased, leading to errors. Staug73 (talk) 18:28, 9 June 2014 (UTC)

Staug73, do you have any ideas about how you could build on what LeBassRobespierre is doing? Perhaps expanding it while leaving in Faria would be appropriate. The thing about Faria's bibliography is that reliable sources aren't required to cite their sources at all, and they commonly don't cite all of their sources (just giving one example is often enough), so the fact that you don't approve of the fact that only one source is cited is kind of irrelevant. (We also don't care about citing the first person; we need it to be verifiable to something that's (at least) good enough, so we don't reject verifiable and appropriate information because the source is good enough but not necessarily the best.)

If there's a dispute about the nature of "some of" its early proponents, then I think that is a good thing to explain. But I'm not sure that Sobral Cid is proof that psychiatrists were opposed to psychosurgery in its early-modern days; if I've got the dates right, Cid was just fourteen years old when the psychiatrist Gottlieb Burckhardt published the results of psychosurgery, as described in the article. (How is it that we don't have an article on José Sobral Cid (see w:pt:José Sobral Cid) yet?) WhatamIdoing (talk) 21:44, 9 June 2014 (UTC)

• Staug73 various accusation are false, and invariably assume bad faith on my part for my persistent editing of the two entries he has taken for his own. He has also attacked one of the authors of the articles I cited. I invite you all to visit the two entries Psychosurgery and History of psychosurgery and note that he has taken possession of the two entries, as his private satraps, and will not let anyone else edit. The "cut and paste" he claims, are false; they were cited passages or rewrites; and even if they were true, he could have edited them to everyone's satisfaction and the useful references kept. He cites the same authors over and over and had kept the two entries stale until I began editing. He even perpetuated false claims such as that all of the operations performed by Gottlieb Burckhardt — incidentally a psychiatrist and the first psychosurgeon — were topectomies of the frontal lobes, when in fact, portions of the parietal and temporal lobes were also excised. As far as "the first promoters of psychosurgery," it would have been easy enough to add "and neurologists" to the sentence without a complete deletion, as well as deletion of the reference source. I was trying to link the conditions of mental illness, inadequate care, and unsatisfactory medical ethics as to the development of psychosurgery. It did not develop in a vacuum. I think Faria's 3 part article is essential in this regard and in integrating all of these historic developments to a comprehensive whole. I also attempted to add other sources all of which were deleted. Regarding Staug73's claim "The source given is a chapter in HW Haggard’s The Doctor in History. I don’t think the source supports the statement." Well it does, and if he had been as conscientious as he claims to be about those entries he would have found that Chapter 27 in Haggard's book is about the terrible conditions in which mental patients were treated and the subsequent beneficial reforms of Philippe Pinel in the 18th century, pages, 355-370. This Haggard and Burckardt errors are only two of many examples where Staug73 accuses falsely without checking. As to the alleged mysterious IP adress, I have no need to use any such subterfuge as I'm a signed and committed Wikipedian. Let him show what he think he has! Again, he accuses and attributes "bad faith" without cause. I do sincerely thank you all for your input. LeBassRobespierre (talk) 18:21, 9 June 2014 (UTC)

LeBassRobespierre on your user page your say you have edited extensively the Paul Bucy article. But in the history there is only one (minor) edit by LeBassRobespierre. So I assumed you were Special:Contributions/173.187.98.34. Otherwise what extensive editing did you do on the Paul Bucy page? And this address Special:Contributions/71.30.182.50 added a tag to Psychosurgery, and a long cut and paste about Miguel Faria into Neuroethics with your usual edit summary “Added essential information with references, book and journals”. Not you? If not, apologies. As for cut and paste: You added three sentences to Deep brain stimulation. I have put the text from Miguel Faria's article in brackets after the text from the edits.

DBS of the septal areas of patients with schizophrenia have resulted in enhanced alertness, cooperation, and euphoria. Patients with narcolepsy and psychomotor seizures have also reportedly experienced euphoria and sexual thoughts with self-elicited DBS of the septal areas (Faria: DBS of the septal areas of schizophrenics have resulted in enhanced alertness, cooperation, and pleasurable sensations, even euphoria. Patients with narcolepsy and psychomotor seizures have also reportedly experienced euphoria and sexual thoughts with self-elicited DBS of the septal areas.)

In fact, beneficial results have been documented in the neurosurgical literature, including a few instances in which deeply depressed patients were provided with portable stimulators for self-treatment. (Faria: The beneficial results of DBS in major depression have also been documented in a few instances in which patients were provided with portable stimulators for self-treatment.)

And again you say have extensively edited this article.

Yes Haggard tells the story of Philippe Pinel, and Dorothea Lynde Dix, and Florence Nightingale and Henri Dunant, in this chapter – but what has it got to do with psychosurgery? Staug73 (talk) 19:15, 9 June 2014 (UTC)

PS Perhaps you forgot to log in on occasion? If an editor forgets to log in then the edits will come up as an IP address. Staug73 (talk) 20:04, 9 June 2014 (UTC)

• You finally got two things correct. Yes I'm 173.187.98.34, and I must have forgotten to log in at those times. No big deal, those are entries I listed in my user page in non-contested entries. And for the first time you also imply good faith! So, as you can see those unsigned edits by me were innocent unsigned posts in uncontested territory. But you did try to lump me with some other IP user who had performed some vandalism, and you are still trying to link me now with some other unknown users, but those other IPs are not me. I did not make those other edits! As far as the chapter in HW Haggard’s The Doctor in History reference, it supports what I wrote: “Treatment in insanity has evaded practitioners from ancient times to the 20th century, as a result the mentally ill have been treated harshly, and in the 18th and 19th centuries mostly committed to crowded hospitals and asylums.” This has already been alluded to as been useful by WhatamIdoing, who correctly writes: "I don't see any good reason to omit this. The source appears to meet plain-vanilla WP:RS (which is all that is required for non-biomedical information like this), Staug appears to admit to its verifiability and accuracy in a back-handed way, and it is not unreasonable or UNDUE to say that this technique was promoted by the experts of the day, rather than by quacks or random physicians who didn't know much about the subject. So I'd include this." You have also gone over an administrator, who suggested that my additions were appropriate. Randykitty wrote, "Much depends on whether you accept Faria's article as a valid source for WP. If it is, then there is nothing wrong with adding it to the articles that you list." As far as the Deep brain stimulation, it still needs work, just as Electrical brain stimulation, which only had one reference when I got to it also needs work. My edits significantly improved those entries as anyone here can witness if they visit. The Faria and other references were essential to improve those articles. Other references are still needed, as the tags in both entries testify. And if my good faith additions needed polish, it could have been very easy for you to make minor edits. We should be here to help Wikipedia, not to start deletion fights. That was the reason I quit editing, after having done quite a bit of useful work in the two months I have been a contributor. LeBassRobespierre (talk) 21:05, 9 June 2014 (UTC)

I see that in the last addition, Staug73 is beginning to backpedal, but not enough. Let him again post completely the alleged sections, which he has been calling "copying," not just a brief phrase but the whole alleged paragraph to the ends, as to include the attributions of the "paraphrased authors," and the numbered references, which are invariably cited (but he purposely omits). I was the source of both the Robison et al and Faria's references, not Staug73. Although the Robison et al and Faria articles cover similar grounds, initially, as histories of psychosurgery, the articles quickly diverge in very different directions. Robison goes on to describe the various stereotactic surgical procedures and technical equpment, whereas Faria covers the basic sciences, specific neuroanatomical lesions, neurophysiology, the limbic system, all of the psychosurgical procedures (effects and results), the problem of violence and mental illness in society (past and present) and ethics, which Robison et al barely covers. It is for that reason only that Faria's articles need citation, in addition to Robison et al, HW Haggard, Mark and Ervin, Jose Delgado, Stephen P. Salloway (The Neuropsychiatry of Limbic and Subcortical Disorders) and a miriad others still not used and cited. Yet I have not been able to add info and edit solely on the opposition of one person!LeBassRobespierre (talk) 18:58, 9 June 2014 (UTC)

Has anyone here (except for LeBassRobespierre) actually read the article by Faria? I wonder if I could ask someone to just read the conclusions here [35] if you scroll down to conclusion. It is only about 700 words so it won't take long. It sums up what the whole article is really about - the author's views on criminals. All else being equal, and there is nothing in the article about psychosurgery that can't be found elsewhere, I think the better source for a Wikipedia medical article - even a history one - is the less political source. There is no particular connection between psychosurgery and violence. There were a few experiments on prisoners in the US in the 1970s but they were abandoned and, as far as I know, there is no-one else advocating their return. It is a very particular interest of this one retired neurosurgeon. Staug73 (talk) 07:48, 10 June 2014 (UTC)

Editorially, I think this series of papers could perhaps be characterized as a set of 'viewpoint articles'. Certainly, in WP terms, they do advance an individual POV. (I believe Wikipedia tries to take account of the different POVs on a topic that are deemed significant, based on policies and guidelines.) 86.181.64.67 (talk) 08:27, 10 June 2014 (UTC)

Small question: How can "treatment in insanity" "evade practitioners"? What is "treatment in insanity"? Do you mean "treatment of insanity"? How can "treatment" "evade" someone? It's not an animate (or even inanimate) being or object, and therefore is incapable of evasive manuevers. Do you mean "elude"? Softlavender (talk) 22:51, 10 June 2014 (UTC)

• Softlavender, "elude" is certainly better and it should be "treatment of insanity." I agree. Any other suggestions? LeBassRobespierre (talk) 12:27, 11 June 2014 (UTC)

Well, personally, I'd put it in straightforward terms rather than these poetic and metaphoric passive-voice terms. Plus it's not even factual -- we do have, and have had, treatments for insanity. So I'd say what you actually mean, or state the concrete actual facts, rather than striving for some vague poetic wording that no one is really going to fully understand even if it's worded a little better. Softlavender (talk) 23:21, 11 June 2014 (UTC)

Draft at AFC needs help

Please review WT:Articles for creation/Synergistic Solutions for Health and Healing for sourcing, notability, etc. Roger (Dodger67) (talk) 21:29, 8 June 2014 (UTC)

Little of the draft is actually relevant to the title. Promotional. Non-notable subject. Please delete it. Axl ¤ [Talk] 22:35, 8 June 2014 (UTC)

Deepak Chopra: RfC: Move criticism up lede?

Talk:Deepak_Chopra#RfC: Move criticism up lede?

Should we move criticism of Dr Chopra up the lede? Right now it's in the second half of the final para.

Balaenoptera musculus (talk) 12:30, 9 June 2014 (UTC)

BMJ offering free accounts to Wikipedia medical editors!

Neat news: As with Cochrane, BMJ is offering 25 free, full-access accounts to their prestigious medical journal through The Wikipedia Library and Wiki Project Med Foundation. Please Signup this week: Wikipedia:BMJ --Ocaasi ^{t | c} 14:00, 9 June 2014 (UTC)

Nice! JFW | T@lk 20:05, 9 June 2014 (UTC)

Infobox should have topic titles

While we are talking about the topic of infoboxes, I'd like to ask what the feeling would be about separating content into categories in the 'infobox disease'. This is done in lots of infoboxes, see for example {{Infobox ship begin}} and {{Infobox station}}

We seem to have two types of links in the infoboxes - identifiers, like ICD 9 / 10, which are formal systems that categorise the disease, and further reading, which represent links to other sources. I think categorising them would be useful to readers, as it would give some indication as to what the strange numbers and acronyms mean here (For an example of a completely incomprehensible infobox, see Pseudohypoparathyroidism). Thoughts? --LT910001 (talk) 07:08, 10 June 2014 (UTC)

The question is: Should we add subtopics to the disease infobox?

A collapsible subbox could be used for the identifiers subsection (for an example of an infobox with collapsible subsections, see Testis determining factor) --LT910001 (talk) 08:24, 10 June 2014 (UTC)

Support

• Support as proposer for reasons of readability, as discussed. --LT910001 (talk) 07:08, 10 June 2014 (UTC)

Oppose

• Oppose - Seems unnecessary to add titles to infoboxes which usually only contain a handful of links. 188.29.83.40 (talk) 07:42, 10 June 2014 (UTC)

This may improve readability by allowing us to make the 'identifiers' subsection collapsible. --LT910001 (talk) 08:24, 10 June 2014 (UTC)

Discussion

Currently we have a bunch of identifiers and one "further reading". If we had a second "further reading" item I would be supportive. Maybe we could have a hierarchy of what we link to as a second item?

We already have one really simple item "MedlinePlus". It would be good to have one slightly more complicated item. This could be NCI PDQ if it exist (for colon cancer)[36], patient.co.uk if it does, and emedicine if neither the previous two exist.

We do this for medication related articles. A bot made all the changes a couple of years ago. We could also have the bot move the emedicine links not used in the infobox to the EL section. User:Diptanshu.D would that address your concerns? Doc James (talk · contribs · email) (if I write on your page reply on mine) 08:09, 10 June 2014 (UTC)

Yep. If DD could redirect discussion to the thread above to prevent WP:MULTI I'd be grateful, I was just wondering if we could make some subsections and/or collapse the 'identifiers' section, for readability. --LT910001 (talk) 08:24, 10 June 2014 (UTC)

I would like to see all "further reading" links removed from the infoboxes. Axl ¤ [Talk] 08:27, 10 June 2014 (UTC)

Two thoughts:

• Let us not use the complex and extremely odd {{infobox ship begin}} as a model for anything. It doesn't even work unless you wrap the series of templates inside a wikitext table.
• Would someone please add a new parameter, |field= or |specialty=, so that I can add actual content to them, namely that Whatever cancer belongs to the medical specialty of oncology? WhatamIdoing (talk) 01:23, 11 June 2014 (UTC)

I do not like hidden content. Happy to see the specialty parameter added. One thing to keep in mind is a lot of disease belong to many specialties. Usually not more than two though. Have we put our articles into categories by profession yet? Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:48, 11 June 2014 (UTC)

By "hidden", I assume that you mean MOS:COLLAPSEd content. It's generally a bad idea for WP:ACCESS reasons.

We have put some of them into cats by profession. Except for dermatology, probably not most of them. WhatamIdoing (talk) 15:17, 11 June 2014 (UTC)

Finally managed to get an image from my work

I finally managed to get an image from my work. After jumping through a ton of hoops and getting approval from a ton of people, but nothing in writing, I finally managed to get this one released because they wanted it on our website as well.

Sadly, I have no idea what this is a picture of (Vasculature of porcine skin under fluorescence - smooth muscle actin with AlexaFluor 488 means nothing to me) and whether or not it would be useful in any articles. Does anyone have any ideas? Zell Faze (talk) 15:59, 10 June 2014 (UTC)

@Zellfaze: Yes, this is a fluorescent antibody technique stain of actin (one of the proteins that makes up muscle) in smooth muscle tissue, which is one of the three major kinds of muscle. This image specifically shows the actin in the smooth muscle that makes up the walls of the arterioles and venules in the skin of the pig and contribute to thermoregulation. I've put the image in fluorescent antibody technique and dermis#Stratum reticulare. (Obviously anyone can remove/move it...SOFIXIT and all that.) Thank you for the image! Keilana|^{Parlez ici} 16:40, 10 June 2014 (UTC)

Thank you Zell! That's great. WhatamIdoing (talk) 01:41, 11 June 2014 (UTC)

Wikipedia talk:Articles for creation/Non-islet cell tumor induced hypoglycemia

Dear medical experts: This article is up for review at AfC if anyone would like to take a look. —Anne Delong (talk) 19:36, 10 June 2014 (UTC)

Although this syndrome is caused by a disparate group of tumours, there does seem to be a single unifying pathogenesis. A literature search does show suitable references. I have added a reference.

Several references already in the draft are primary sources and therefore inappropriate. The draft requires clean-up. However it is a notable topic. Axl ¤ [Talk] 19:55, 10 June 2014 (UTC)

Thanks for taking time to look at it. I have added a comment on the submission pointing here. —Anne Delong (talk) 18:38, 11 June 2014 (UTC)

Timtrent declined the draft. I asked him about it here. Axl ¤ [Talk] 10:20, 12 June 2014 (UTC)

Draft:Eunice Rivers Laurie

... and here's another medicine related topic up for review at AfC. —Anne Delong (talk) 19:51, 10 June 2014 (UTC)

• Never mind; I fixed this one up and accepted it myself. —Anne Delong (talk) 18:39, 11 June 2014 (UTC)

Proposal: Rare disease resources and Template:Infobox disease

Proposal

As there is considerable discussion above I would like to give light to the issue of rarer diseases and the infoboxes. A number of rare diseases lack any links to additional readable material, although there are sources out there with the goal of providing high quality reviewed information.

Two such are:

• The Rare disease database

Operated by the Swedish Socialstyrelse, and is a database of rare diseases with in-depth articles on each entry. This database is well-researched and available in English. Created by a government agency.
(Some of the patient group information is Sweden-centered, but otherwise the information is not nation-specific.)

• Orpha.net

A European organization with the goal

Orphanet is the reference portal for information on rare diseases and orphan drugs, for all audiences. Orphanet’s aim is to help improve the diagnosis, care and treatment of patients with rare diseases.

Both these resources are non-profits, and both have valuable information that could be used on Wikipedia.
I suggest adding their entries into the Template:Infobox disease

Here is an example article: Aicardi syndrome

• Rare disease - Aicardi syndrome
• Orpha.net - Aicardi syndrome

Equivalent links:

• NIH - NINDS:[37]
• Medline: [38]

Thoughts?

-- CFCF (talk · contribs · email) 22:56, 10 June 2014 (UTC)

Yes would be supportive of the idea. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:52, 11 June 2014 (UTC)

I've already "voted" against putting any links in indiscriminately, either in the Info-box or into External Links. But I agree that rare diseases need, as External Links, such resources as you suggest above.

You mention one entitled "Rare disease database". There is another! National Organization for Rare Diseases, NORD, a non-profit organization, also has a

• "Rare Disease Database". Its entry for
• Aicardi syndrome is here and here is another:
• Non-24-Hour Sleep-Wake Disorder.

Their abstracts are free and one can see two full reports per day for free. Recommended! --Hordaland (talk) 15:18, 11 June 2014 (UTC)

WP:External links says that you can put external links into an infobox. Sometimes, doing that means that you can get rid of the ==External links== section entirely, which reduces the amount of spam that an article is likely to attract. WhatamIdoing (talk) 15:21, 11 June 2014 (UTC)

That's fine with me as long as one can actively choose which link(s) to put there. --Hordaland (talk) 15:49, 11 June 2014 (UTC)

Dehydration cleanup

I have cleaned and rewritten dehydration (massive diff), but some errors likely remain. Could someone peruse the new version to make sure we are not saying anything particularly stupid, please? FiveColourMap (talk) 23:35, 10 June 2014 (UTC)

Categorizing BLPs

The proposed expansion of WP:EGRS that has been discussed at Wikipedia talk:Categorization/Ethnicity, gender, religion and sexuality#Adding another group of people to this guideline for the last couple of weeks might interest some people here. WhatamIdoing (talk) 01:47, 11 June 2014 (UTC)

I posted before but note again - all these talks are related to a wave of pressure coming from Wikidata to standardize all kinds of classification, perhaps through the new Wikidata games. The games have proven to be a popular way to get people to do mass amounts of sorting and article checking. Discussions like this one are becoming a lot more relevant because suddenly they have tremendous immediate impact through these games. Blue Rasberry (talk) 16:46, 12 June 2014 (UTC)

cervix at Peer Review

Look, I think the article on cervix is looking pretty good and kudos to all who've gotten involved to date - I'm listing it at Peer Review - Wikipedia:Peer review/Cervix/archive1 - to try and help give it a shove to FAC. Cas Liber (talk · contribs) 02:14, 11 June 2014 (UTC)

Draft:Chronic Wound Pain

Here's a medical-related draft that's up for review at AfC. —Anne Delong (talk) 18:31, 11 June 2014 (UTC)

Replacing cite doi instances

At this recent discussion there was broad consensus on converting instances of {{cite doi}} and of {{cite pmid}} to {{cite journal}}. That apparently fell off the rails when the discussion was archived. There is currently a related discussion at Wikipedia:Bot_owners'_noticeboard#User:Citation_bot_-_mass_creation_of_sub-templates. LeadSongDog come howl! 21:19, 11 June 2014 (UTC)

Oil pulling

Can someone with medical expertise please have a look at recent additions to the article Oil pulling? Although the additions are referenced, they look dubious to me and seem to rely on sources that are not compliant with WP:MEDRS. Thank you. Deli nk (talk) 16:53, 12 June 2014 (UTC)