Wikipedia talk:Manual of Style/Medicine-related articles

To-do list

• Add advice on how to incorporate the psychological, emotional, and social effects of health problems into articles.
  • should be infused throughout
  • may need some subsections, e.g., reaction to a life-threatening diagnosis
• Add advice on how to present costs.
  • accuracy ("the wholesale list price in Ruritania in 2017 according to Alice", not "the price")
  • WP:MEDMOS2020 results
  • any recommended metrics, such as cost effectiveness, cost per DALY averted,[1] etc.
• Turn bullet point on when to describe something as altmed into a section.
  • altmed vs folk medicine vs controversial vs disproven; avoiding altmed as disparaging term or a catchall for non-scientific
  • importance of representing that classification depends upon time and place
  • role of WP:DUE and WP:INTEXT attribution
• Add statement about gender-neutral language.
  • Avoid unexpected neutrality for subjects very strongly associated with one biological sex (e.g., pregnancy, menstruation, and ovarian cancer affect "women"[2]; prostate cancer and orchiditis affect "men") but encourage gender neutrality for all others (e.g., heart disease)?
  • Defer to MOS for any individual person.
• Reading levels
• Citing journal articles: Should we recommend standard citations or narrow ranges?
  • Should editors normally be using journal articles for content that appears on only one page in a long article? What happens when the page numbers haven't been assigned yet, or when the editor is reading it online and doesn't know what the official page number is?
• (Your idea here)

MEDLEAD

1. Should the WP:MEDLEAD section be deleted or kept?

2. If kept, should the "disputed or under discussion" tag be removed?

Crossroads ^-talk- 18:39, 9 February 2021 (UTC)

Original opening post follows below. Crossroads ^-talk- 18:39, 9 February 2021 (UTC)

Noting that said “original opening post” was written by me, not as an RFC rather a response to the removal of a dispute tag when the dispute had not been resolved. I would not formulate an RFC on the removal of a disputed tag without consensus as a “keep or delete”. SandyGeorgia (Talk) 00:26, 10 February 2021 (UTC)

There was no non-WP:SILENT dispute nor any active discussion, which is why the tag did not belong. More on this below. The closer definitely needs to address this tag matter and clearly lay out when it should be removed. Crossroads ^-talk- 00:59, 10 February 2021 (UTC)

Not true. WhatamIdoing (talk) 18:47, 10 February 2021 (UTC)

That is from November 2019 and had been archived ages ago. I repeat, there was no active discussion or non-WP:SILENT dispute. Having a dispute tag there well over a year later is a disgrace. Crossroads ^-talk- 20:02, 10 February 2021 (UTC)

Five thousand words on the talk page is not what most of us call a SILENT dispute. WhatamIdoing (talk) 20:23, 11 February 2021 (UTC)

---

Following on a malformed RFC that reached no consensus, WP:MEDLEAD remains disputed. Specifically:

Unnecesssary or redundant to WP:LEAD

• Many readers of the English Wikipedia have English as a second language (non-native language).
• When writing the lead, editors should ensure that they write a comprehensive summary of all of the main points of the article.
• It is sometimes useful to include citations in the lead, but they are not obligatory.
• Avoid cluttering the very beginning of the article with pronunciations or unusual alternative names; infoboxes are useful for storing this data. Most readers access Wikipedia on mobile devices and want swift access to the subject matter without undue scrolling.
• Two reasons for using them are: (1)As in any content area, direct quotes, data and statistics, or statements that are likely to be challenged should be cited.

Not necessarily accurate

• Language can often be simplified by using shorter sentences, having one idea per sentence, and using common rather than technical terms.
• One way to achieve this is to follow the order of the content in the body of the article, although this is not required.

Not relevant

• When translating content to other languages, the translation task force often translates only the lead; their work is facilitated by citations.

Disputed tags are not removed until ... the dispute is resolved.

My preference would be to delete the entire section as redundant to MOSLEAD, unnecessary or misleading. SandyGeorgia (Talk) 18:11, 7 February 2021 (UTC)

• I entirely agree with your preference to delete the whole section. It is either redundant or a disputed fork of MOSLEAD and other MOS guidelines that disagrees with them. There is nothing medical about the contentious style described in that section, nor does it reflect best practice by the community. Crossroads below mentions WP:LOCALCONSENSUS and that is what this disputed section has become: a minority practice encoded in a "project guideline". -- Colin°^Talk 10:37, 9 February 2021 (UTC)

• Delete - Thank you for your pithy, cogent summary SandyGeorgia. It says it all. Mark D Worthen PsyD (talk) [he/his/him] 23:29, 8 February 2021 (UTC)
• 1. Keep. 2. Remove the tag. It is a useful summary of WP:LEAD which people being pointed here regarding a medical article can read and digest easily. Why point them to MEDMOS and LEAD when it can be summarized here? Have it all in one place. We should not make it seem like leads are a free-for-all. Inexperienced editors very often insert their favored tidbits directly into leads or adjust the wording with no regard for the sources. There is also no reason to remove the encouragement to use common terms or to include citations for the reasons given. Particular sentences in the section can be discussed if needed. but more importantly, a WP:LOCALCONSENSUS cannot be formed here to remove the section, as the 2020 RfC a higher level of consensus, on this exact question found that MEDLEAD is not going to be fully replaced by MOSLEAD. The fact is that those disputing its existence lost that RfC and the unfounded claim that it was "malformed" is irrelevant; Ymblanter's closure has authority, not anyone's personal opinion of it. Regarding the "disputed" tags, those are for actual active disputes, not for anyone to delegitimize and WP:FILIBUSTER material they still want gone post-RfC. Disputes are sometimes resolved by forcibly overruling the minority; WP:CONSENSUS is not unanimity and no one is obligated to WP:SATISFY the holdouts. Crossroads ^-talk- 06:45, 9 February 2021 (UTC) Struck portions that are no longer relevant; tweaked bold statement. Crossroads ^-talk- 18:42, 9 February 2021 (UTC)

  Delete the entire section.You are quoting (out of context) one fragment of one sentence of the RFC, and excluding precisely the most relevant portions. And no one “loses” an RFC; particularly one that found no consensus because the RFC was malformed, yet found the support arguments were stronger precisely because they reflected global consensus. SandyGeorgia (Talk) 07:06, 9 February 2021 (UTC)

  You appear to be double voting. And you are quoting the RfC out of context. Crossroads ^-talk- 07:11, 9 February 2021 (UTC)

  Actually, I didn't intend to be "voting" at all; the initial discussion was about the deletion of a maintenance tag, and you later converted it to an RFC. SandyGeorgia (Talk) 02:04, 10 February 2021 (UTC)

  RFCs don't need to be votes, and in some cases, shouldn't be. RFCs on how to write things often produce sub-optimal results if you do try to vote on them. WhatamIdoing (talk) 18:47, 10 February 2021 (UTC)

• Delete the section. I agree that it's redundant to MOS:LEAD. Most of the subsection makes the same point as MOS:INTRO. The bit about citing data links to Wikipedia:When_to_cite#When_a_source_is_needed which is a supplement to WP:V and covers the situation just fine. The translation task force is (unfortunately) no longer active. I certainly understand the procedural concern, but it's okay for us to revisit issues that were discussed to "no consensus" a year later. WP:MEDMOS need not comment on every aspect of crafting a medicine-related encyclopedia article, just the aspects that are unique to medicine. Ajpolino (talk) 08:16, 9 February 2021 (UTC)

  A note since there's been much subsequent discussion. My first preference is still to remove the subsection as unnecessary. I see and appreciate RexxS' point-by-point breakdown of where the text differs from other guidance, but I don't agree that these points merit a subsection of MEDMOS. Tips on writing clearly for a broad audience (including those for whom English is non-native) should go at Wikipedia:Make technical articles understandable and Wikipedia:Manual_of_Style/Medicine-related_articles#Technical_terminology, as they are not unique to the lead. I don't think med-related leads are intended to be more "comprehensive" than non-med-related leads, so perhaps that should be removed (or I should be educated)? The bit about the lead following the articles' section order is the only keeper for me. This practice appears very widespread for medicine articles, so I think keeping a sentence on that would be nice, perhaps at the top of content sections. Regardless of the outcome, I'd prefer to see the "disputed" tag removed. Not all paragraphs that have been disputed need the ugly tag to mark them as such. I think the tag is best reserved for sections actively being discussed. Ajpolino (talk) 01:29, 10 February 2021 (UTC)

  Ajpolino Here's a good example of why we should have followed the advice of the closer of the last RFC to take these points individually, one by one, rather than a yes-or-no RFC :) :) I, for example, would be willing to compromise on other areas, while the order of the narrative in the lead is the single item that I most strongly oppose in the whole lot. It was imposed as a fait accompli across a broad swatch of articles, with almost every single installation done by one editor only, giving the appearance it enjoys broad consensus, which has never been established. This imposition often resulted in inferior or confusing prose. At Tourette syndrome, the forced order was awkward enough that I requested for years that the article not be run TFA; it has now finally been corrected. For a comparison, see User:SandyGeorgia/sandbox2#TS forced order of lead_narrative; every condition is different and a forced order doesn't always work. SandyGeorgia (Talk) 02:01, 10 February 2021 (UTC)

  PS, it was also the item in MEDLEAD that most prevented me from being able to bring dementia with Lewy bodies to Featured status; note that neither of these FAs follow the order that had been forced upon them by fait accompli. While LEAD already tells us to cover the main points, MEDLEAD was before forcing us to do it in a way that resulted in awkward prose for some conditions. SandyGeorgia (Talk) 02:13, 10 February 2021 (UTC)

  As an unimaginative prose writer myself, I found the structure to be useful. I think the current wording One way to achieve this is to follow the order of the content in the body of the article, although this is not required emphasizes that the practice is completely optional. That said, I've seen Wikipedia:Manual_of_Style/Medicine-related_articles#Diseases_or_disorders_or_syndromes – which twice reiterates that it is "suggested" – enforced like it came on stone from Mt Sinai... Anyway, if someone mass-reorganized leads based only on that text in the past, shame on them (I, for one, don't wish to dig through the archives for details). But I think there's some value to the suggested order, just like I find some value to the prescribed section title name/order. Ajpolino (talk) 02:20, 10 February 2021 (UTC)

• Delete It's redundant and will give rise to poor prose. Graham Beards (talk) 10:10, 9 February 2021 (UTC)
• I think it is worth examining the consequence of MEDLEAD.

Paracetamol is an old and uncontroversial medicine we all have in our bathroom cabinets. Not counting the infobox, the short lead currently has 30 citations, including 4 double citations and two triple citations. 10 of those cited sources are not used in the body of the article, which is a consequence of the lead being written for the defunct translation project, independently of the body. The sentences are short and stubby. There is no flow whatsoever. Half the sentences begin with "It..." Like random facts being fired at you at speed.

Diazepam is another old established medicine. Again the lead text has 30 citation, including 5 double citations and two triple citations. One source is cited 10 times in the lead but isn't used in the body; another cited 6 times and also not used in the body. Nine other cited sources are only used in the lead. Again the prose is stubby, choppy and lacks flow. A third of the sentences begin with "It..."

Compare with some medical articles that represent our best practice.

Complete blood count has one citation in its long lead. Sentences are a more typical length, and the paragraph flows along. No sentences begin with "It".

Immune system has no citations in its lead. Prose is normal. The word "it" appears twice.

Buruli ulcer has one citation in its lead. Prose is normal. The word "it" does not appear at all.

Tourette syndrome has no citations in its lead. Prose is normal. Only two sentences begin with "It..."

Contrast also with the most controversial figure in modern politics:

Donald Trump has no citations in its long lead. Neither does his replacement Joe Biden. Barack Obama has four.

How ironic that many of our medical leads read like they were composed by tweet late at night by Donald Trump. There is nothing "medical" about this dreadful choppy style of writing or with overciting the lead. Editors are better served for guidance on writing leads with existing consensus community guidelines, and to follow best practice rather than worst practice. -- Colin°^Talk 10:37, 9 February 2021 (UTC)

Seems odd to say that only certain ones of those are the fault of MEDLEAD so it has to go; surely MEDLEAD covers and permits them all. And whether no/few citations is better is highly disputed. Politician articles are not comparable to medical and scientific topics. And certain clauses in MEDLEAD can be discussed and changed without deleting it entirely. Crossroads ^-talk- 19:31, 9 February 2021 (UTC)

• Keep - It's also worth considering the consequence of not having MEDLEAD which is not a guidance fork but an essential supplement. Without it we are left open to the banner of shame.

A tag that is very easy to add, but not so easy to remove. CV9933 (talk) 13:54, 9 February 2021 (UTC)

That banner template refers to the guideline Wikipedia:Make technical articles understandable, which also links to advice on writing an accessible summary at WP:MOSLEAD. Why do you feel those general community consensus guidelines are so inadequate that if MEDLEAD was removed, our medical leads be filled with "banners of shame". -- Colin°^Talk 14:25, 9 February 2021 (UTC)

Sorry Colin, I respect your position but I gave my Keep rationale. I didn't make comparisons with our fellow editors and a late night tweeter which you most certainly did above and you should really strike that because it is offensive. CV9933 (talk) 15:12, 9 February 2021 (UTC)

MEDLEAD clearly isn't "essential" (your words) enough that the banner template has to refer to it to guide editors how to fix the over-technical article. I didn't comment on any editor, just the prose, which is awful and conforms to the contentious "advice" in MEDLEAD. -- Colin°^Talk 15:48, 9 February 2021 (UTC)

• Note: I've converted this to an RfC. Crossroads ^-talk- 19:04, 9 February 2021 (UTC)

And now we have a new RFC, malformed precisely in the same way the last one was. The last RFC (poorly formulated by me, because it tried to address everything at once) ended at:

If somebody is interested in pursuing the cause further, I would suggest to try implementing changes one by one, identifying statements in MEDLEAD which the majority would perceive as problematic, and trying to change these.--Ymblanter (talk) 15:59, 28 January 2020 (UTC)

And yet, in spite of a No Consensus conclusion to that RFC, the disputed tag was twice removed by editors who did not take the suggested approach, and we now we have another RFC which asks the same malformed "yes or no" question, without attempting to address each piece. This is not an effective use of the RFC process (repeating the same problem that yielded no consensus last time). SandyGeorgia (Talk) 19:07, 9 February 2021 (UTC)

I, for one, offered to discuss possible changes (see this archive, my 16:50, 17 August 2020 and 16:16, 16 August 2020 comments). But no one ever offered any; they have remained dead-set on deleting the section entirely or else keeping it tagged as disputed. However, it is clear that that RfC did not solve the problem. So:

• Note to closer: We need a binary, definite closure to the RfC. The previous closure lended itself to multiple interpretations and the dispute has continued for another whole year. This closure needs to be 100% clear, definite, and enforceable on the simple question of whether MEDLEAD should exist, and without a delegitimizing tag. Crossroads ^-talk- 19:25, 9 February 2021 (UTC)
  • The problem, Crossroads, is the "advice" in MEDLEAD was, relatively recently in MEDMOS history, variously added by a couple of editors, without prior discussion and without ever having consensus. It has always been disputed and has always only reflected a minority editing style on Wikipedia. Generally, only statements that enjoy wide consensus should appear in Guidelines. Do you disagree with that? I think therefore the default position should be that this always-disputed section first be removed. Then editors who wish to add specific sentences of advice, propose them and gain consensus for them. That would be a most satisfactory step and in keeping with how guidelines should be created. We examine best practice, we agree on what can agree on, and we only add that. -- Colin°^Talk 19:51, 9 February 2021 (UTC)
    • Your claims that it 'never had consensus actually' and is too recent are questionable, unsourced, and in any case not an unbiased analysis (since you seek to delete the section). WP:IMPLICITCONSENSUS is a thing; if some people didn't want the section, why didn't they fight it? If they did but didn't succeed and consensus went against them, then their ongoing disagreement with the majority is not relevant. I repeat that WP:CONSENSUS is not unanimity. The last time the community's wide attention and consensus was brought to it was the Jan. 2020 RfC. There was not a consensus reached there to delete it, even though that was a prior possibility. Crossroads ^-talk- 20:04, 9 February 2021 (UTC)
      • I'm not sure how to "source" the absence of something. Feel free to point me at the talk page discussion where "Language can often be simplified by using shorter sentences, having one idea per sentence, and using common rather than technical terms" was first proposed and agreed by the community. Or "follow the order of the content in the body of the article". Or the need to mention "English as a second language". These have all been removed, and yet returned without achieving consensus. So yes it was fought. There are disputes on these talk pages going back years, and disputes on article talk pages where editors have demanded unnecessary citations or have so over simplified text as to be ridiculous, or have reordered text and broken the flow. But you know, the most important evidence is that editors creating our finest articles, articles on difficult topics that have survived main page appearance, totally reject and ignore the guidance here. If a content guideline doesn't reflect best-practice in article-space, it clearly doesn't have consensus. -- Colin°^Talk 20:54, 9 February 2021 (UTC)
        • There doesn't need to be talk page discussion before making an edit. The "Language can often be simplified …" text was added by Doc James 29 October 2019, removed by you 12 November 2019, restored by Doc James 21 October 2019]. That's just part of the long-running animosity between the two of you, and there's no evidence that anybody else cared. The text has been stable since then and the assumption is that it enjoys consensus until shown otherwise. Presumably now that Doc James is absent from articles here, you find this the right time to remove as many of his contributions as possible. Why not stop wiki-lawyering about prior talk-page discussions or "achieving consensus" and actually debate what you find problematic about the text. It would appear the only problem is that it was written by Doc James. --RexxS (talk) 22:03, 9 February 2021 (UTC)
    • Colin's mistake is to assume that edits have to have consensus before they are made. Wikipedia does not work like that and edits which not challenged are deemed to have consensus per WP:SILENT. It has only ever been disputed by Colin and it has reflected the style of the majority of editors working on medical content. The default position is that this section, which has enjoyed the consensus of most editors for considerable time, should remain until consensus is found to remove it. --RexxS (talk) 20:46, 9 February 2021 (UTC)
      • Edits to articles certainly do not have to be done before the consensus is established. However, non-trivial edits to guidelines certainly should. This one apparently does not "enjoy the consensus of most editors for considerable time", and I'll formally count myself in. While I do not often edit medical articles, I am as flabbergasted as Colin at the level of exposition in their lead sections, apparently inspired by MEDLEAD. And I had my run-ins with Doc James who, with all respect for his work, seems to have pushed the concepts of "simple language" and "same order as in article" disputed above, to the point of detriment of English language (cf Talk:Bed bug#First sentence). I used to think that the practice has been forged by a strong consensus at WP MED, but after the arbcom case I realize that the project had been plagued with disagreements for a long time. No such user (talk) 11:25, 10 February 2021 (UTC)

        RexxS is correct that bold edits can be made here, @No such user. Bold edits to policies and guidelines are explicitly permitted in WP:PGBOLD. (He's technically wrong about Colin being the only person who opposed it, but Colin did start the most recent discussion about it.) WhatamIdoing (talk) 18:50, 10 February 2021 (UTC)

        RexxS is incorrect to say "Colin's mistake is to assume that edits have to have consensus before they are made". I didn't say that or assume that. I proposed that since this section has never had consensus, and since it is clearly disputed for multiple reasons by multiple editors in good standing, that the clearest path out of the mess would be to remove it and make separate proposals for inclusion. Although WAID is correct that WP:PGBOLD guideline editing is permitted, it isn't the recommended approach for contentious additions reflecting one's own personal editing style (WP:PGCHANGE, WP:WPEDIT and WP:TALKFIRST).

        There is a difference between articles and guidelines wrt consensus. If someone disputes a statement in an article and adds a {{fact}} template then it isn't (a) up to editors to find a source disputing the fact or (b) up to editors to come to a consensus about the fact itself. We instead answer a different and hopefully easier question: are there reliable sources for the fact and does the weight of quality secondary literature warrant its mention when discussing this topic? Editors then aim for consensus on those questions. If they can't find those things, the sentence is removed. But policy and guideline does not have external sources and there is no secondary published literature on editing medical articles for Wikipedia and original research is fine. So instead the minimum standard for inclusion in a guideline is "does this statement have consensus support among editors and describe best practice among the community". If it doesn't then it goes. It is that simple. So while WhatamIdoing is correct that anyone can add a brain fart / nugget of wisdom without asking first, all that matters for keeping it is whether it reflects the consensus of editors. And that's all that should matter for any closing admin.

        Wikipedia is a broad enough church that if one editor wants to write a lead strictly following the order of section in the article, and another editor likes the freedom to vary a bit if it helps introduce ideas for the lead in an economical way, then they don't have to fight to get their way of doing it into a guideline. Best if the guideline says nothing. Same for citations or sentence structure, etc. I'm sure we all have our idiosyncratic styles. All of us here want Wikipedia articles to be accessible, readable, reliable sourced, etc, and nobody is wanting the opposite in the guideline. But we have different approaches to that goal. Let us agree this is something we disagree on, remove it, and go our separate ways about writing great articles. -- Colin°^Talk 10:13, 11 February 2021 (UTC)

• Let's examine the assertions in the opening post. These are deemed Unnecessary or redundant to WP:LEAD:

  Many readers of the English Wikipedia have English as a second language (non-native language). - I have WP:LEAD and WP:MEDLEAD open and it is plain to see that LEAD makes no mention of second language. Yet it is a fact that editors would do well to bear in mind when writing medical leads; because the English Wikipedia is much larger than any other Wikipedia, it becomes the "go-to" medical resource for much of the world, and it is important for editors to understand that in their choice of words for the lead of medical articles. The advice is clearly neither unnecessary nor redundant.

  When writing the lead, editors should ensure that they write a comprehensive summary of all of the main points of the article. - LEAD only requires editors to "summarize the most important points", with no guidance on how to determine those. MEDLEAD is much clearer in requiring a comprehensive summary, a point only touched on in LEAD where it advises that the lead "can stand on its own as a concise version of the article". MEDLEAD extends and improves LEAD on this issue. It clearly is not redundant, and would only be unnecessary if someone believed that a medical lead should not be "a comprehensive summary of all of the main points".

  It is sometimes useful to include citations in the lead, but they are not obligatory. - this expands on LEAD's MOS:CITELEAD but not by enough, IMHO, to make it worth labouring the point.

  Avoid cluttering the very beginning of the article with pronunciations or unusual alternative names; infoboxes are useful for storing this data. Most readers access Wikipedia on mobile devices and want swift access to the subject matter without undue scrolling. - at MOS:FIRST, LEAD covers the part about pronunciations and alternative spellings, but omits the issue of alternative names, which is particularly relevant for drug articles. We should make it clear that the opening part of an article is not the place to list a potentially unlimited variety of proprietary names, so we can shorten the redundant part of this guidance, but we do need to document our convention not to provide alternative names in the lead.

  Two reasons for using them are: (1)As in any content area, direct quotes, data and statistics, or statements that are likely to be challenged should be cited. - This is indeed redundant to MOS:CITELEAD and it could be removed without compromising our guidance. The second reason is that the translation task force often translates only the lead, but I believe that the source for translations can be moved away from enwiki, so this guidance will eventually become unnecessary.

  The following are supposed to be "Not necessarily accurate":

  Language can often be simplified by using shorter sentences, having one idea per sentence, and using common rather than technical terms. - I disagree that this is inaccurate. Writing less complex sentences definitely lowers the bar on reading ability needed, and replacing jargon with common words is already policy. Nevertheless it could be argued that it may be over-prescriptive, and can lead to a lack of flow in the prose. This is not an easy balance to strike and it may be better not to mention in this context, although it could be better explained in a more nuanced way at WP:JARGON.

  One way to achieve this is to follow the order of the content in the body of the article, although this is not required. - this is clearly useful advice to fledgling editors who often have difficulty in working ouit what to put in the lead and how to organise it. More experienced editors will naturally choose to vary the flow of the lead to ensure that ideas build upon others, but that is certainly not proscribed by this advice, and it would be a disservice to new editors to remove advice that they may benefit from in their days.

I've agreed the point about translation. So that's my take on the issues raised. I apologise for not addressing the yes/no nature of the RfC, but I suppose I can summararise my views as Keep, but trim to what can be agreed as a compromise. --RexxS (talk) 20:46, 9 February 2021 (UTC)

RexxS, the problem is that, as past discussions got automatically archived without resolution, the dispute tags were removed without reason, and now we have another “yes/no” RFC, which was precisely the problem last time. Another unfortunate time sink, which does not evidence learning from history about how to put together an RFC that will yield a conclusive result. We cannot expect a definitive conclusion per the Garbage in/garbage out factor.

So I am still at, delete the whole thing, so it can be rebuilt if needed based on consensus, and not based on repeating failed history. The last discussion had a pinging problem that ended up at Arbcom, with a proposed finding, and we again have questionable cross posting in this new effort.

Considering the text has been continuously disputed for over a year now, through several instances of inappropriate pinging which failed to generate consensus for the text, it seems that is the only way we can begin to determine if there are any areas of compromise, without this tendency to dredge up old unresolved issues. Still at delete it all. SandyGeorgia (Talk) 23:13, 9 February 2021 (UTC)

Of the various special features at MOS lead, the one which I think is probably hte most important is keeping the language as straightforward as possible for a multilingual reference work, which will also help the English speaking readers with less scientific background. Of the special features which should be removed, the most important is the excessive referencing. If the lead is written properly, referencing should not be necessary, unless there is a specific numerical fact.Of the various adaptations made for translation, this is the least helpful to the `en (Personally, I think thes ensity of referencing in most medical articles is excessive--we are a general encyclopedia that covers medical topics, not a mdical encyclopedia/ . Certainly we should reference more than a place like the popular lay medical sites, but we are not aimed at physicians.). DGG ( talk ) 05:04, 10 February 2021 (UTC)

The last discussion's pinging was of everyone from the 2020 RfC, which is appropriate per WP:APPNOTE; the ArbCom stuff involving a deceased editor was not about that at all. You have been told it was APPNOTE before. There was nothing wrong with that cross-posting either; it's a noticeboard and fringe theories are a problem in medical articles. Please do not WP:BLUDGEON the process. The only editors "continuously disput[ing it] for over a year now" are you and Colin. [3][4][5][6][7][8][9][10][11] Also, if the section is kept, that tag will not be staying indefinitely if any editor still disagrees with some of the wording, as Colin has claimed. [12] WP:FILIBUSTER would apply to such behavior. Crossroads ^-talk- 00:09, 10 February 2021 (UTC) expanded Crossroads ^-talk- 00:36, 10 February 2021 (UTC)

Obviously, if it were true that only two editors oppose this text, previous RFCs and other discussions would not have reached no consensus. Your statement is untrue. SandyGeorgia (Talk) 02:25, 10 February 2021 (UTC)

One example, here. SandyGeorgia (Talk) 01:49, 19 February 2021 (UTC)

• Delete the section. While I may concede that it's useful to have WP:LEAD summarized here, so that the editors do not need to jump back and forth to get the complete advice, I agree with SandyGeorgia that it's best to delete the whole thing and start rebuilding it from clean slate, step by step and with clear consensus. As I said above, I'm appalled how leads of many medical articles are an unreadable, overcited mess written in 3rd grade English, wrongly or rightly based on MEDLEAD advice. No such user (talk) 11:42, 10 February 2021 (UTC)

  Third-grade English is an exaggeration. Most of them score at the high school level. It's very difficult to get an accurate measurement, though, and there are all sorts of problems with readability scores in general. This webpage from the US Agency for Healthcare Research and Quality explains some of the problems with relying on them. (This comment gets a score of grade 9 according to the Automated Readability Index.) WhatamIdoing (talk) 18:59, 10 February 2021 (UTC)

• delete per Graham Beards rationale--Ozzie10aaaa (talk) 00:19, 11 February 2021 (UTC)
• Delete, or at least pare down to med-specific material (don't rehash MOSLEAD), per SandyGeorgia, Graham Beards, et al. There is something here, but it can be gotten at much more concisely without setting up a WP:POLICYFORK of MOS:LEAD, basically. It should say something that, when distilled, comes down to "See MOS:LEAD. In addition, for medical articles also do/don't: X, Y, Z." I have a lot of experience at the "WP:Writing policy is hard" work of making MoS material agree with other MoS material, to not be redundant or just useless WP:MOSBLOAT, to be unlikely to cause POLICYFORKing, to be well cross-referenced, and to be supplementary in nature when that is what's needed. So, feel free to rope me into working on the redraft if/when it comes to that.  — SMcCandlish ☏ ¢ 😼  18:28, 13 February 2021 (UTC)
• Keep, but trim to what can be agreed as a compromise per RexxS. We are deluding ourselves if we think most new editors have read or will read MOS:LEAD. Most of the objections can be resolved by a further Rfc. A proposal to rebuild from scratch will take for ever, & is likely to grind to a halt, leaving us with nothing. Johnbod (talk) 19:19, 13 February 2021 (UTC)
  • We are deluding ourselves if we think new editors read MEDLEAD too. The problem hasn't so much been that newbies lacked guidance on writing leads of medical articles, as that some experienced editors wanted a policy fork with which to demand medical articles conform to their own style. They say nobody reads the instructions, except it seems, people who want to hit you over the head with them. MEDMOS enjoyed 11 years without MEDLEAD. It is a relatively recent problem and one we could well do without. -- Colin°^Talk 21:13, 13 February 2021 (UTC)
    • Gee, since nobody reads the instructions, why don't we just delete MEDMOS and MEDRS and MOS too? Crossroads ^-talk- 22:34, 13 February 2021 (UTC)
• Delete the whole section. Specifically per the rationale provided by SandyGeorgia on 7 February. I don't find any of the text in the section particularly helpful, some are at odds with community practice, and most just duplicate MOSLEAD. I also agree that having these here tends to lead to a lot of conflict as I don't think they lead to particularly good writing. The general principles of having something that is easy to read and what not are already in MOS:LEAD. Lastly, regarding the instructions relating to the translation task force and second language speakers. This it the English language encyclopedia so I think that whatever words are required to describe the text in the lead is what should be used and it's weird and frustrating to have someone tell me I should not be speaking this language but rather trying to think about people who don't when I'm writing here on the English language Wikipedia. It's hard enough trying to write good prose for my fellow English language speakers. The purpose of this encyclopedia simply isn't for translation to other places (that's actually an off wiki project) or to help others understand what is written from a study of language perspective (that's the Simple English Wikipedia). Not to say these aren't very important projects and groups, but just that this isn't the venue for that. --Tom (LT) (talk) 09:15, 15 February 2021 (UTC)
• Delete the whole section. Specifically per the rationale provided by SandyGeorgia on 7 February. Jaredroach (talk) 03:50, 18 February 2021 (UTC)
• Delete. It might be well intentioned, but it is resulting in leads being written in what reads to me like baby talk, with repeated citations at the end of every sentence (ie the same source cited repetitively short sentence after short sentence) that are often US focused (eg CDC material) & not the same as those in the body. The underlying code in med-project-owned leads (and I used "owned" deliberately) with all the hidden messages can also be extremely off-putting to editors not in the medical project. Espresso Addict (talk) 01:42, 19 February 2021 (UTC)

  @Espresso Addict, if you find the hidden messages to be harmful in any given article, then I encourage you to remove them from that article. Some people find it helpful (especially if there's a problem with the first sentence or paragraph getting longer and longer, when the information logically belongs elsewhere in the lead), but when you're editing an article anyway, and it's in your way, it's okay to remove it. WhatamIdoing (talk) 16:35, 19 February 2021 (UTC)

  WhatamIdoing: I've not found making any edits to medical project leads to stick, to the point that I've largely given up bothering trying to edit them at all. I'm not sure if the medical project realise the extent to which their guidelines – or at least the way in which their guidelines are applied in the wild – drive away editors with relevant expertise. Espresso Addict (talk) 21:38, 19 February 2021 (UTC)

  Espresso Addict very much so ... which is why this whole lead issue has mattered so much for so long. We have seen considerable deterioration in content precisely because new editors are discouraged from participating, and articles were pushed up to “GA” (not always worthy) and protected there, where the content in the bodies of the article is dated and inaccurate, while the leads are as you describe. And yet other editors can’t fix the issues because of OWNERSHIP. It has been a big problem, precisely as you noted. If I am ever part of that problem, please do approach me on my talk. SandyGeorgia (Talk) 22:19, 19 February 2021 (UTC)

  Faulty ping, Espresso Addict. SandyGeorgia (Talk) 22:17, 19 February 2021 (UTC) What you describe is also part of why we so desperately need to reconcile both WP:MEDMOS and WP:MEDRS back to something like what was originally written in them over a decade ago; they have become unreadable messes. SandyGeorgia (Talk) 22:20, 19 February 2021 (UTC)

  Thanks, SandyGeorgia – No, not you; I don't think we've overlapped on medical articles. I'm probably lazy and conflict averse, and should fight my corner harder, but I don't want my pleasure writing to be full of conflict and struggle, so I wander away to write bios of plant pathologists where I have no expertise but the water's calmer. And if an admin coming up 15 years/50k edits feels excluded... Espresso Addict (talk) 22:44, 19 February 2021 (UTC)

  Espresso Addict, can you clarify what you mean by "hidden messages". Are these the HTML comments like <!-- Prevention and Treatment -->, or do you refer to some other "message" such as an edit notice? These HTML comments presumably served as scaffolding when constructing the lead, and could be argued now form a restriction on editors ability to reorder content for readability. It is ironic that this contested MEDLEAD says "editors should ensure that they write a comprehensive summary of all of the main points of the article. One way to achieve this is to follow the order of the content in the body of the article" when many medical leads were written for the translation project, and completely ignored both existing lead content and also the article body. Instead they are an independent topic summary that bears no relation to the rest of the page in terms of content or sources. -- Colin°^Talk 14:48, 20 February 2021 (UTC)

  Colin: I meant hidden html comments. Most longer medical leads seem to be straitjacketed by them, and I don't think I've seen them used in that fashion in articles any other topic. They certainly seem to imply that one is not permitted to consider a different lead ordering or paragraph division. I agree that many medical leads look as though they were written straight down from one or two sources independent of the article content; sometimes they are substantially different from the text and it can be difficult to reconcile the two. I hadn't realised that was a consequence of the translation project. Espresso Addict (talk) 15:27, 20 February 2021 (UTC)

  We should probably be holding a separate RFC on getting rid of them (or just start doing it), except that the damage to articles is so widespread that I suspect that will not be an easy task. Reconciling these leads that were written stand-alone to mimic NIH or CDC factsheets with what is actually in the articles has proven to me, more than once, to be daunting. They are the largest cause behind defeatured medical FAs; for five years, leads were maintained stand alone, with no regard for what was in the body of the article, and fixing all of that now is a chore. Autism is one dreadful example, and it gets 5,000 pageviews a day. SandyGeorgia (Talk) 15:31, 20 February 2021 (UTC)

  I deleted them from here [13] and will continue to do so whenever I come across them. Graham Beards (talk) 16:09, 20 February 2021 (UTC)

  I don't think an RFC is required to remove HTML tags that no reader sees and no guideline mentions. Leads in medical articles do not belong to one project or one editor. Markup can, as noted above, be removed by anyone who thinks it is impeding their ability to edit the article. Mass removal would probably be better advertised before actioned, and discussed centrally rather than on one project noticeboard or one guideline page. It sounds like something a bot writer could do, as I'm sure we all have better things to do than spend time removing hidden markup. -- Colin°^Talk 16:30, 20 February 2021 (UTC)

  Mass removal of all hidden text would be disruptive. Some articles have that to forestall drive-by IPs changing text to their personal opinions without regard for sources lower in the article (a reason to have citations in the lead by the way) or for discussions on the talk page. This isn't to say that all extant hidden text is good, just that not all of it is bad and can be handled on a case by case basis. Crossroads ^-talk- 19:26, 20 February 2021 (UTC)

  Can you give an example? Graham Beards (talk) 19:39, 20 February 2021 (UTC)

  Here, one of many: [14] And the burden of proof really lay with those proposing radical actions like mass removal of hidden text. That capability exists for a reason. Crossroads ^-talk- 19:59, 20 February 2021 (UTC)

  That's not what we, well I, was talking about. It is the hidden headings that dictate the structure of the Lead. See the example I gave above. Graham Beards (talk) 20:42, 20 February 2021 (UTC)

  No, that's not what is being discussed at all. If there are specific issues that affect specific articles, for which an edit notice or HTML comment offers advice, then those may be justified case-by-case. Many medical leads were created from a template with scaffolding corresponding MEDMOS sections, and the scaffolding left behind acts as a deterrent to editors improving the content if they think the lead should be structured differently. Imagine being told, by some historical editor, that you can only mention "transphobia" in paragraph two, and not in paragraph three, and "hate speech" goes in paragraph four. It isn't really the wiki way. -- Colin°^Talk 21:43, 20 February 2021 (UTC)

  I'm happy for hidden html to be used to advertise specific consensus on wording, such as in trans woman or the umpteen coronavirus articles, although it's a shame the links to discussions aren't clickable. (I don't know if there's a way of making clickable-in-edit-mode links?) Also happy with notes of the form <!--The value for this given in XYZ popular review is incorrect, please don't change unless based on a different reliable source; see discussion on the talk page.--> or the like, where there actually is an explanatory note on the talk page.

  On the scaffolding instructions, how often do new editors or IPs actually try to reorganise the lead? It's surpassingly rare in my experience. Usually what they do is add new material willy nilly at the bottom that belong in the body, and I've not seen any evidence that instructions stop them. Personally I think the capsule sentence or two should usually form a mini-summary that then gets expanded in the succeeding lead paragraphs, so that what Google & the logged-out mouse-over text picks up is sensible, but this is contra-indicated by the structured summary that invariably puts symptoms up front. Espresso Addict (talk) 12:42, 21 February 2021 (UTC)

  > if there's a way of making clickable-in-edit-mode links

  AFAIK that's not possible in any wikitext editor, and even in the visual editor (which lets you open regular links in another tab), you currently can't open links that are inside . One typical thing to do for a major content note (e.g., the lead sentence in Trans woman) is to supplement it with a FAQ or similar note on the talk page, and place the links there. WhatamIdoing (talk) 18:17, 21 February 2021 (UTC)

  @Espresso Addict and WhatamIdoing: I sometimes have put a hidden note in an article saying something like

  <!--Please review the discussions at and preceding https://en.wikipedia.org/wiki/Talk:No%C3%ABl_Coward/Archive_2#RfC:_Should_an_Infobox_be_added_to_the_page? before considering adding an infobox -->

  many browsers will allow you to highlight the url and then popup a right-click menu that allows "go to https://en.wikipedia …" which becomes a quick workaround for making an almost clickable link inside a comment, etc. HTH --RexxS (talk) 01:50, 22 February 2021 (UTC)

• Delete, per multiple arguments above, and specifically per the rationale provided by SandyGeorgia on 7 February. Basically, I think the stringency of the MEDRS guidelines should generally provide sufficient encouragement for appropriately close sourcing of the sorts of key biomedical claims that we want to get *summarized* and *explained* for general readers in the lead (and avoid encouragement of somnolent^{1 1 1 1 1 1... (ref. StatPearls, or whatever)} approaches, however well intentioned). Adding: Coming from a profressional background in medical writing, I also believe that we have enough scientific-editorial timber-scratching to do anyway, without unnecessarily ballast. What we really need to do, every time, is to try to make each individual lead as clear and helpful as possible for our *general* readership, while respecting and honouring our wp-encyclopaedic mandate. We know that it's the most read part of the article, and we want to try and get it right and make it clear each time for our interested readers. 2c, 86.186.155.212 (talk) 15:55, 19 February 2021 (UTC)

• Keep. How is having guidance on the lead for medical articles that different than having guidance on how we set up medical articles? For example, what if people want the history section in a medical article to come first? History sections usually comes first on Wikipedia pages. It seems to me that most medical editors would say it should come last per WP:MEDMOS. And what if someone wanted the culture stuff to come first? What's so bad about the order of the lead following the order of the article? The guideline doesn't demand the lead follow the order of the article. It's an option.

Higher up, someone linked to some big discussion. Well, from there,[15] I think John Cummings and some others have a point about writing leads for laypeople and translation stuff.

Higher up, I think RexxS has given pretty good reasons for why this guideline should have guidance on leads. I don't agree with having guidance on all the other things for setting up a medical article except for the lead. RandoBanks (talk) 10:13, 16 March 2021 (UTC)

RandoBanks, editors are not objecting to the idea of having guidance for the lead in medical articles. However, nobody has ever come up with guidance for the lead that (a) is anything to do with medical articles vs any other kind of article and (b) has any consensus among medical editors. MEDMOS does not actually say medical article sections "should" follow a certain order, and anyone who reorders an existing article "per MEDMOS" hasn't actually read MEDMOS carefully. We all want our leads to be accessible to lay people (many of those objecting to the simplistic advice in MEDLEAD are laypeople). We have historically found that the "optional" aspects of MEDLEAD are not considered optional by those who added them, and it just leads to trouble. -- Colin°^Talk 16:38, 16 March 2021 (UTC)

Hello. WP:MEDMOS is guidance, I understand that. It guides users toward best practice. From what I understand, our guidelines are supposed to do that. While WP:MEDMOS doesn't say medical article sections should follow a certain order, medical articles usually follow a certain order. I know that with different types of guidance on Wikipedia, users say something about "per" some guideline. So when you say "We have historically found that the 'optional' aspects of MEDLEAD are not considered optional by those who added them", that can be said for all of our guidelines. Have you seen any of the discussions at Wikipedia talk:Manual of Style? Argument after argument there, and most of the guidance at Wikipedia:Manual of Style has less than "it is optional, everyone" wording.

I've looked around, and I can't remember seeing the history or culture section come first in a medical article. I think it's good that the culture section doesn't come first because I can't see that being best practice. So because medical articles usually follow a certain order, I don't feel it's anything to harrumph over where WP:MEDMOS says, "When writing the lead, editors should ensure that they write a comprehensive summary of all of the main points of the article. One way to achieve this is to follow the order of the content in the body of the article, although this is not required." Taking a look in the archives about the lead, and checking out that most of the discussions about the lead in the archives have been about citations in the lead, and what RexxS has said above me, I have a different opinion to yours. I agree with the thought that if this guidance is removed, then probably no guidance on the lead will be added to the page in the future. IMO, RexxS's approach of working out any kinks in the current content is the best approach. RandoBanks (talk) 23:56, 16 March 2021 (UTC)

It’s not labeled as such but Morgellons is pretty much History first, or almost first. There are others similar. Back to what was mentioned by Ajpolino in his Buruli example; this forced order seems to work for some disease model articles, but less well for others. SandyGeorgia (Talk) 01:25, 17 March 2021 (UTC)

Ketogenic diet, a featured article, has the History section first (after an introductory paragraph on Epilepsy), and parts of it are summarised in the middle of the lead. Tourette syndrome, another featured article, has aspects of history in various parts of the lead, where they are most relevant. Dementia with Lewy bodies has its sole historical lead-fact as a clause in the middle. The problems with the "retain and improve" suggestion have already been discussed, and aren't workable, as years of dispute over this show. It has at its core the wrong-headed assumption that non-consensus opinions added by one user should be retained in the guideline until editors can come to some consensus over their replacement. Most editors here think these one-person opinions don't belong here at all, and aren't keen to waste more time on them. They have caused enough damage already. -- Colin°^Talk 08:55, 17 March 2021 (UTC)

RandoBanks could you please be more specific? You said, "Taking a look in the archives about the lead, and checking out that most of the discussions about the lead in the archives have been about citations in the lead, and what RexxS has said above me, I have a different opinion to yours", but best I can tell, you have not indicated what view you have about citations in leads.

Cites may or may not be placed in the lead. Depends. RandoBanks (talk) 11:20, 9 April 2021 (UTC)

SandyGeorgia (Talk) 18:14, 31 March 2021 (UTC)

• Delete - there is no information in MEDLEAD that is by necessity applicable to medical leads only - all points apply to either all leads or all material in medical articles. It is counterproductive to have yet more guides for editors to wade through Cas Liber (talk · contribs) 20:57, 1 April 2021 (UTC)

Current example of issues raised above

Ajpolino (unjustly) referred to himself as an “unimaginative prose writer” because he followed the order that had been established in numerous medical articles by fait accompli and found it useful, but an example from today shows that, while the suggested structure can sometimes work well for a disease article like Buruli ulcer, it won’t work for others— in particular, articles that don’t follow a typical “disease” model like FAs immune system, ketogenic diet, dementia with Lewy bodies or Tourette syndrome.

Because it is at Featured article review, I was looking at the overlap between menstrual cycle and menstruation (a whole ‘nother mess, but I digress). BOTH of these articles had leads that followed an order prescribed by inline HTML comments, and both of them as a result were pathologizing a normal part of being a woman, reducing menstruation to a disease, overemphasizing dysfunction, and covering topics out of order before they were defined. Please view the old and edited versions to see the problems, including the inline hidden comments which forced this disease model onto non-disease articles.

• Menstruation, the old version
  • Used the term “menstrual cycle” before it defined (or linked) it,
  • Did not define normal functioning of the menstrual cycle until the last paragraph
  • Discussed malfunctioning or disruption (disease model) in the second paragraph (before normal functioning was even described) even though PMS only affects about 20% of women !!!
  • Misrepresented the 80% figure relative to what the source says (this is the most clear example of male editing a female topic I have ever encountered on Wikipedia) to make it sound like most women have problematic periods (holy hysterics !)
  • Had the first paragraph diving into specifics before generalities were even defined.
• The version after I attempted to correct some of this (allowing for the fact that my computer is in repair and I am typing from an iPad, please fix anything you see):
  • Defines what menstruation is before it starts pathologizing women to PMSers.
  • Then correctly represents the 80% stat relative to normal menstruation.
  • Removes ridiculous citations where almost entire paragraphs are cited to one source, but the citation was repeated for each sentence.
  • And corrects other miscellaneous MOS issues and factual inaccuracies.

Same thing occurs at menstrual cycle. This is a clear example of how our content has suffered because of these lead prescriptions (not to mention no women tending these articles adequately) where these prescribed inline hidden comments had FOR YEARS discouraged improvements,[16] resulting in a normal part of being a woman being presented as we might present a disease like Buruli ulcer. This model did not work for either of the medical FAs I wrote, but it was doing a large disservice to women by pathologizing normal states. SandyGeorgia (Talk) 18:04, 22 February 2021 (UTC)

This is a good argument for why order of presentation in the lead shouldn't have firm rules. But WP:MEDLEAD didn't say that it does. It says: One way to achieve this is to follow the order of the content in the body of the article, although this is not required. "One way" and "this is not required" are very clear that this isn't some sort of law. I'm not saying that the sentence should necessarily stay, but the text of MEDLEAD can't bear the full blame. It certainly didn't mandate hidden text. Crossroads ^-talk- 22:52, 22 February 2021 (UTC)

This "Do this but don't have to" wording also appears wrt the citations, and in practice it hasn't worked due to behavioural issues. It isn't so much a compromise wording as a stalemate between editors who only see their half of the sentence, use it as a leg to stand on, and edit war to retain their style. Crossroads, even if encouraging a certain order in the lead was a bright idea, nobody has explained what is medical about it. So really the place to argue for that sentence is MOS:LEAD. -- Colin°^Talk 09:57, 23 February 2021 (UTC)

Yes, it's been our long experience that a pseudo-rule is worse than remaining silent on the matter.  — SMcCandlish ☏ ¢ 😼  11:32, 3 April 2021 (UTC)