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A change to some of our headings

We had a meeting at Cancer Research UK at which we discussed simplifying some of our terms. We should discuss them one by one and then I guess have a support oppose to determine if we should move in this direction. The plan is to have a bot make the changes that have consensus.Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:36, 20 August 2014 (UTC)[reply]

Mechanism instead of Pathophysiology

The following discussion is closed and will soon be archived: Well supported; guideline adjusted to recommend (not require) this change. WhatamIdoing (talk) 23:33, 16 September 2014 (UTC) [reply]

Mechanism IMO is a similar term. Both are currently acceptable. I propose we use mechanism consistently. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:36, 20 August 2014 (UTC)[reply]

Agree Thanks JMH for starting this section off! I was waiting until I thought more people were back from vacation, but this page doesn't self-archive as quickly as project talk. Wiki CRUK John/Johnbod (talk) 22:15, 20 August 2014 (UTC)[reply]
Support "Mechanism" for clarity. Seppi333 (Insert 2¢ | Maintained) 22:42, 20 August 2014 (UTC)[reply]
Support "Mechanism" as a shorter, simpler word. (I'd rather not see mass changes made for any of these.) WhatamIdoing (talk) 01:38, 22 August 2014 (UTC)[reply]
  • Not sure For many other articles covered by MEDMOS, there are similar terms being used. Drugs have a Mechanism of action section, surgeries have "technique", and medical tests have "mechanism". For all of these, the concept is "How it works", but it sounds informal to have a "How it works" section even though I think that might be more understandable than mechanism plus it applies more consistently. Aside from the informality, is the concept of "How it works" what we are trying to express? How does that compare with "mechanism"? I checked a grammar board but got no good insight. I think a lot of people say "how it works" but it seems like something people would say, but not write. Blue Rasberry (talk) 15:34, 22 August 2014 (UTC)[reply]
  • Support mechanism. --Anthonyhcole (talk · contribs · email) 17:54, 23 August 2014 (UTC)[reply]
  • Support -- CFCF 🍌 (email) 07:07, 1 September 2014 (UTC)[reply]
  • Support this is an important accessibility issue. --101.116.66.140 (talk) 22:51, 9 September 2014 (UTC)[reply]
  • Support I absolutely agree that this will be a more accessible term for Wikipedia readers. TylerDurden8823 (talk) 02:00, 10 September 2014 (UTC)[reply]

Outcomes instead of Prognosis

The following discussion is closed and will soon be archived: Multiple options supported; guideline adjusted to recommend (not require) "Outcomes" and to accept the others as well. WhatamIdoing (talk) 23:37, 16 September 2014 (UTC) [reply]

Outcomes is simpler and more understandable. They are similar enough that I would support the change. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:36, 20 August 2014 (UTC)[reply]

An alternative could be Outlook. But I do rather like the plurality of Outcomes. That's a relevant aspect, imo (as briefly discussed at CRUK). 86.157.144.73 (talk) 20:43, 20 August 2014 (UTC)[reply]
Either outlook or outcomes. Wiki CRUK John/Johnbod (talk) 22:15, 20 August 2014 (UTC)[reply]
Support "Outcomes" for clarity. Seppi333 (Insert 2¢ | Maintained) 22:42, 20 August 2014 (UTC)[reply]
No opinion. What matters to me more is that the section exists. It's missing in far too many of our articles. WhatamIdoing (talk) 01:39, 22 August 2014 (UTC)[reply]
Oppose. "Outcome(s)" sounds too definite, too guaranteed. "Possible outcomes" might do, but IMO prognosis is a well-known word. --Hordaland (talk) 20:42, 22 August 2014 (UTC)[reply]
I like possible outcomes. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:15, 22 August 2014 (UTC)[reply]
Also fine with that. Wiki CRUK John (talk) 14:37, 23 August 2014 (UTC)[reply]
I like "possible outcomes". Blue Rasberry (talk) 14:07, 25 August 2014 (UTC)[reply]
Either is an improvement but I prefer "outlook". --Anthonyhcole (talk · contribs · email) 17:52, 23 August 2014 (UTC)[reply]
Support either. I more strongly favor outlook, but it isn't very important to me, as said previously both are an improvment.-- CFCF 🍌 (email) 07:07, 1 September 2014 (UTC)[reply]
Support Outlook aswell Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:39, 1 September 2014 (UTC)[reply]
Support the idea of outlook. I agree with WAID that the bigger issue is the absence of this section in many articles rather than what we name it. TylerDurden8823 (talk) 14:46, 1 September 2014 (UTC)[reply]

Outcomes ? Really? With "prognosis" completely removed, not even an alternate. So, how does that work for neuropsych conditions? It sounds like wording put through by editors mostly dealing with "diseases" (that have more of a defined beginning and end) than those dealing with "conditions", eg neuropsych conditions, that don't necessarily have an "outcome" ... one just lives with them. As I was absent when this silliness went through, I suggest we add back Prognosis, alongside this new Outcomes. SandyGeorgia (Talk) 10:47, 3 December 2014 (UTC)[reply]

Epidemiology?

Not sure if there is a simpler term we can use. Statistics maybe but it is not that similar. Can others think of suggestion? Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:36, 20 August 2014 (UTC)[reply]

Don't know what the answer is, but this title has always stood out for me as the classic example of how WP medical articles are not lay-reader friendly. Alexbrn talk|contribs|COI 20:02, 20 August 2014 (UTC)[reply]
Why not "population distribution" (i.e., what segments of a population are most affected by the disease or condition)? Per WP:HEAD, it is not necessary to repeat the title of the article in section headings and therefore it is understood that "population distribution" refers to the disease. Boghog (talk) 20:28, 20 August 2014 (UTC)[reply]
Suggest Frequency. Certainly not perfect, but good enough, imo. More specific than "Statistics" and simpler than "Population distribution", which would still sound forbiddingly technical to many lay readers, imo. Clearly a worldwide perspective is important, though many articles currently lack this even under the current "Epidemiology" heading. 86.157.144.73 (talk) 20:40, 20 August 2014 (UTC)[reply]
Certainly a change would be good. I also note that typically we have "causes", including eg % of cases attributable to smoking, in its own section, so that "Epidemiology" is just frequency/statistics, whereas an epidemiologist would I think typically feel that "Epidemiology is the study of how often diseases occur in different groups of people and why" (my bolding), and that our approach therefore only covers half his/her subject in the section named after it. Another reason to change. Really we just cover the demographics side in these sections, but that's another "ology". "Frequency" might puzzle some in this context, whereas "statistics" is pretty clear and straightforward, unless anyone has a better idea. Not sure about "population distribution", but it's possible. Or just "distribution"? If we used questions as headings it would be easier, but we don't. Wiki CRUK John/Johnbod (talk) 22:08, 20 August 2014 (UTC)[reply]
Yes agree that we usually split out half of epidemiology into causes and thus our epidemiology sections do not contain all the epidemiology. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:30, 20 August 2014 (UTC)[reply]
(edit conflict)Just "Distribution" would do nicely, I think. Implicitly includes demographics, prevalence, and avoids the lay reader's conception that it pertains to infectious disease only. LeadSongDog come howl! 22:34, 20 August 2014 (UTC)[reply]
Yes distribution may work. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:39, 20 August 2014 (UTC)[reply]
+1 for "Distribution". Fwiw, a classic definition of epidemiology is: "The study of the distribution and determinants of health-related events or states in specified populations..." In this section we summarize the distribution, while the determinants go under "Causes". All while trying to achieve or maintain a global perspective for the various populations. 86.134.200.29 (talk) 08:31, 21 August 2014 (UTC) [previously 86.157.144.73][reply]
My inclination is to try out an alternative like ==Distribution==, and to see where it works and where it doesn't. I'm not sure that Pregnancy#Epidemiology would be improved by changing it to "Distribution", which has a very geographical feel. ("Q: What is the distribution for pregnancy?" "A: Well, pretty much the entire inhabited world.") WhatamIdoing (talk) 01:42, 22 August 2014 (UTC)[reply]
That's not even correct in the geographical sense of distribution, but clearly we intend a statistical meaning, as we're still discussing epidemiology by another name. Some countries have far higher rates than others, or compare rural to urban. Certainly there are significant distributions against age, sex (d'oh!), religion, marital status, economic status, time since previous pregnancy, perhaps political orientation? And then there's the question of exposure to the, erm, "infectious" agent. Any of these could be subsections of interest to the reader. LeadSongDog come howl! 21:52, 22 August 2014 (UTC)[reply]

Populations affected? --Anthonyhcole (talk · contribs · email) 17:56, 23 August 2014 (UTC)[reply]

Maybe? Or maybe "People affected"? That might sound weird when you're writing about one of those rare diseases that kills babies in infancy, since "people" usually refers to adults. WhatamIdoing (talk) 05:58, 1 September 2014 (UTC)[reply]
Rather than having an across the board change as their might not be one term that works for all articles, we could simply add to the number of possible headings that can be used for this section and use which everyone is simplest and appropriate. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:20, 23 August 2014 (UTC)[reply]
I'm fine with that, but I think we are agreed that "Epidemiology" is generally a problem because a) lots of general readers don't understand it and b) we typically cover only the statistics/distribution part of it in this section. If we recommend a variety of terms we should probably come up with thinking as to when the different ones might be the best choice. For example, taking from above, I don't see that "Populations affected" works well with "Pregnancy". It might with "Dengue fever", but then so does "Distribution". Both do perhaps have a "very geographical feel", but I think "distribution" works better where things like age, gender and occupation are big factors. Most people will take "Populations affected" to mean "the populations of which countries". If we are getting a bot to make the changes I imagine we need to make a default choice, which people can then change manually where they think that best. Wiki CRUK John/Johnbod (talk) 22:59, 23 August 2014 (UTC)[reply]
How many other options can we come up with? I'd be happy to hear more ideas, even if they might only work for some types of articles. I'll add another to the list: What about something like "Characteristics of patients" (although we usually avoid the term 'patients')? WhatamIdoing (talk) 05:58, 1 September 2014 (UTC)[reply]

My immediate thought would be to use Those affected. -- CFCF 🍌 (email) 07:07, 1 September 2014 (UTC)[reply]

  • Support "distribution" I think this feels the most generally applicable - I agree that there may be situations where it doesn't quite fit but I think they're more likely to me minority cases. Distribution is also not necessarily geographic - it can also be socioeconomic, ethnic, etc. So, yeah, 'distribution' gets my vote HenryScow (talk) 16:51, 18 September 2014 (UTC)[reply]
  • This is a bunch of very good proposals; simplifying language is always a good idea, as long as it doesn't come at the cost of accuracy.
So I oppose [Update:weakly oppose (see later discussion)] any of the above alternatives to "epidemiology". When one checks the definition of epidemiology it's clear that none of the proposed terms are anywhere near a synonym for it - even if one excludes the part of epidemiology that has to do with causes of disease. Moreover, if one checks some random featured articles on diseases, none of the above alternatives would be an inclusive heading to the relevant section: in acute myeloid leukemia epidemiology contains information on the percentage of AML within all leukemias; in Alzheimer's disease a fine distinction is made between incidence and prevalence; and in Asperger syndrome half the epidemiology section is dedicated to comorbidities. All these cannot be considered to be included in "distribution", "populations affected", or any alternative I've read or can come up with. NikosGouliaros (talk) 20:18, 1 November 2014 (UTC)[reply]
Since this has revived a bit, I'd point out that the sections of this set of proposals that have closed have both done so using "guideline adjusted to recommend (not require)...." and nothing previously allowed is now outlawed. I think it would be helpful if the two above, the only commenters who support no change at all, could comment on the following questions:
a) Do you agree that "Epidemiology" represents a significant problem in terms of WP:AUDIENCE?
b) Do you agree that there is a problem in that much of the subject of "Epidemiology" is normally covered in other sections, per WP:MEDMOS?
c) Do you agree that there a large number of disease articles where the alternative headers discussed above would fit the section contents, where they exist and as they currently are in year 13 of Wikipedia? Wiki CRUK John (talk) 13:32, 3 December 2014 (UTC)[reply]
If they were "recommend (not require)", why was Prognosis removed? What purpose does that serve? This business:
  • Outcomes: For the prognosis. May also be labeled "Possible outcomes" or "Outlook".
is a bunch of words for what is commonly known as "Prognosis", and I can see no reason for three new suggestions to replace one common one, that has served us well for years. Why all this fiddling anyway? SandyGeorgia (Talk) 14:49, 3 December 2014 (UTC)[reply]
And, PS, no, I do not agree that Epidemiology is an Audience problem: as can be seen by the difficulty in coming up with a word to replace it, it is what it is, and there is not a better word that covers it. If some of the new suggestions are better for some articles, a) why are we up to three (or four if you bring back prognosis, which is the most common), and b) no, I don't think any of the current choices are better than prognosis. If we are going to be driven by external models, let's just go to Mayo and use some gibberish like "Coping and support" ... they have no prognosis section, under any name, and every place you go on the internet has something different, but Prognosis is quite common. SandyGeorgia (Talk) 15:17, 3 December 2014 (UTC)[reply]
Because, at a guess, but I will see if I can find specific research on this, about 3% of the general population will know what a "prognosis" is, and that's in English-speaking developed countries. I'd guess "epidemiology" is even lower. That's why no professional writing, online or off, directed at patients, carers or the general public will use this term, at least unexplained. For years we have had policies like WP:AUDIENCE, Wikipedia:Make technical articles understandable, WP:JARGON and Wikipedia:Manual_of_Style/Medicine-related_articles#Writing_for_the_wrong_audience and very widely ignored them. The idea now is to start taking them more seriously. Whether the current MEDMOS wording exactly matches the closing comment by WhatamIdoing of the section here is a question. Wiki CRUK John (talk) 15:07, 3 December 2014 (UTC)[reply]
I can't find specific research on these words, but there is a good deal of research on the subject, which is why we have always had these policies (this and this are recent examples, with lots of others in the refs). I can't understand why you complain about using "external models" in this respect when that is exactly what MEDMOS and MEDRS insist on for this and almost everything else. You rightly often complain about medical students dumping ill-considered material in med articles, but surely part of the reason for this is precisely that much medical WP content looks like a place for them to do that, to them and their under-instructed instructors, and the lack of resistance to jargon is part of that. You've answered the first question above, what about the other two? Wiki CRUK John (talk) 16:39, 3 December 2014 (UTC)[reply]
I am not seeing a much easier term than epidemiology. Doc James (talk · contribs · email) 17:33, 3 December 2014 (UTC)[reply]
I don't think that the percentage of people who don't know what a prognosis is are likely to be the same population accessing the internet for health information. So, no, I don't think we should be dumbing down our content in those instances where the medical word is the best word for the situation (that applies to Prognosis and to Epidemiology ... I don't have a problem with Mechanism instead of Pathophysiology, although I do think that Mechanism is very limiting for the many conditions where the mechanism is unknown, but the pathophysiology is well studied.

As to whether these suggestions were meant to be just that, see the section headings above on this page, where the discussions were for one term instead of another. There may be a problem with my reading comprehension, but to me, that means replacing one with another, as in, eliminating one. SandyGeorgia (Talk) 15:43, 4 December 2014 (UTC)[reply]

Maybe, but both sections closed so far have been in terms of "...guideline adjusted to recommend (not require)...". To say "I don't think that the percentage of people who don't know what a prognosis is are likely to be the same population accessing the internet for health information" simply flies in the face of all the very considerable body of research on who these groups (especially the latter) are. You're just wrong about that I'm afraid. I won't go into the problems with the specific terms again - well rehearsed already. Wiki CRUK John (talk) 16:16, 4 December 2014 (UTC)[reply]
My delayed answer to dear co-editor Wiki CRUK John:
a) I am no native english speaker and don't reside in an english-speaking country; therefore I cannot be certain about how intelligible "epidemiology" is to the average reader; I have no reason to doubt you when you say it isn't.
b)I hadn't thought about that, but I do not particularly mind; the "patterns" and the statistics are among the core issues of epidemiology of a disease and are still included in the "Epidemiology" section of medical articles.
c) This, I cannot deny. However, a guideline recommending "distribution" will lead to many relevant sections with information that exceeds the definition of this word be termed "distribution".
Finally, it wasn't clear to me from the beginning that these words would be additional suggestions instead of replacements of previous terms.
In any case, and mainly because I'm not a native english speaker and my opinion cannot be given the same value as a native speaker's, I'm toning it down to weakly oppose. NikosGouliaros (talk) 15:49, 5 December 2014 (UTC)[reply]
Thanks for this considered response. I expect these two terms can be used pretty freely in Greek without losing general readers! Wiki CRUK John (talk) 16:49, 5 December 2014 (UTC)[reply]
My handy Consise Oxford Dictionary has a simple, common-sense definition for the noun epidemiology: the "study of epidemics". While it clearly has become far more general than that to readers in the medical community, many readers will continue to think that is what it means. The same source explicitly contrasts "epidemic" with "endemic". Using "epidemiology" in infectious disease articles will not surprise many, but using it for non-transmissible endemic diseases (or for lifelong conditions as SandyGeorgia raised) will, at best, confuse lay readers. Why not simply have a small selection of alternative section headings in MEDMOS, to be applied as required? LeadSongDog come howl! 17:15, 11 December 2014 (UTC)[reply]
Indeed. I've been surprised by a couple of very intelligent lay people who thought the term was restricted to infectious diseases. Wiki CRUK John (talk) 17:26, 11 December 2014 (UTC)[reply]

Contraindications

Earlier this year the heading "indications" was changed to uses. This followed a discussion in 2011. A "use" may not be indicated; it could just be optional, so the meaning was changed a bit here.

Should "contraindications" likewise be changed to be the opposite of "uses"? A contraindication is a strong deterrent, but sometimes there is discouragement which is not a contraindication. For example, sometimes doctors and mothers somehow decide to have caesarean section surgery when it is not medically indicated, and various authorities say that this ought not happen and people should not be choosing to have surgeries without a medical indication. Similarly, there are other treatments which are discouraged but not contraindicated. Wikipedia was criticized for not giving information about FDA drug safety alerts, which again frequently are not contraindications but may be reasons to avoid using something. Is it the intent of this heading to usage warnings which are not contraindications?

Does this heading need to exist at all, or should it just be part of uses? There is always a uses section in articles. The contraindications section may or may not appear.

Other names could be "When to not use", "Uses to avoid", "Reasons to avoid", "Usage warnings", or just "Warnings". Note that for drugs we already have an "adverse effects" section and for procedures a "risks and complications" section in addition to the contraindications section of each of those.

I like "Warnings". Does that fit here? Blue Rasberry (talk) 21:51, 16 September 2014 (UTC)[reply]

I don't like ==Warnings==. I think that we'll end up with fights about whether only official warnings should be included, or whether adverse effects should be included, or whether this is the right section for "call your doctor if you experience..." medical advice. (The "right section" for that last one is "on some other website".)
"Reasons to avoid" is my current favorite out of your list, but I'm flexible. WhatamIdoing (talk) 23:24, 16 September 2014 (UTC)[reply]
Indications is a legal term as is contraindications. The preferred term IMO is side effects. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:47, 17 September 2014 (UTC)[reply]
Actually, indication is not (just) a legal term. A suspected broken bone is a very good indication for getting an X-ray of said bone, for example. WhatamIdoing (talk) 23:54, 9 October 2014 (UTC)[reply]
Contraindication says (unrefed) "Relative contraindications may also be referred to as cautions, such as in the British National Formulary.", but suggests no alternative term for absolute contraindications. As I said last time, I'm softer on "contraindications" than "indications", partly because the former is really only found as a medical term. I like "reasons to avoid" best of the suggestions so far. I think (as we discussed last time) both these terms are even less familiar to UK readers than US, and a search of the huge NHS Choices website shows no use of "contraindication" at all, while the 20 uses of "indication" all seem mainly directed at prefoessionals rather than patients [1]. So an alternative is very desirable. If we do use it as a header we should begin the section with something like "Reasons not to use this drug/treatment include ....", instead of eg "Simvastatin is contraindicated with pregnancy, breast feeding and liver disease.[6]", as we typically now have. The article Contraindications to thrombolysis currently manages to avoid completely either explaining or linking the term at all! This seems to be our only "Contraindications only" article, and should surely be merged back - I've tagged it for the project. Wiki CRUK John (talk) 10:53, 17 September 2014 (UTC)[reply]
Support "reasons to avoid". "Side effects" doesn't cut it, as total avoidance in some cases is necessary. --Hordaland (talk) 13:29, 18 September 2014 (UTC)[reply]
And side effects is a whole different concept. Pregnancy is a contraindication for all sorts of things, but not a side effect of them. Wiki CRUK John (talk) 15:04, 18 September 2014 (UTC)[reply]

References in the lead

Currently there is confusion around if references are needed in the lead or not. My position is that we should have references in the lead and this is for a couple of reasons:

  1. Our readers expect them. I used to not add refs to the lead and people would come along and add "citation needed". Used to get into small edit wars to remove them. A huge drain on time.
  2. Am working to improve and translate the leads of key medical articles into as many other languages as possible. So far have 51 articles ready Wikipedia:WikiProject_Medicine/Translation_task_force/RTT(Simplified)L. Other languages of course need references to. Thus everyone referencing the lead helps support this effort.

Will add something along this line to our MOS unless people oppose. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:46, 4 September 2014 (UTC)[reply]

  • I completely agree that referencing the lead of medical articles is important. Ideally, the lead of Wikipedia health articles will be a well referenced plain language overview of the topic that can be re-used separately for a brief standalone article for either translation or as simple introduction to a topic. Sydney Poore/FloNight♥♥♥♥ 13:49, 4 September 2014 (UTC)[reply]
  • Support It seems like a good idea but this is a change at odds with many years of precedent as presented at Wikipedia:Manual_of_Style/Lead_section#Citations. I would like to see a lot of support from health editors before this is put into MEDMOS. This might also be a good time to confirm WikiProject Medicine's stance on the necessity of citations. In much of Wikipedia, citations are optional. In medicine it is my understanding that information is deleted without discussion when it is not backed with citations. Perhaps the broader idea here is that all health content on Wikipedia must be followed with citations after every sentence, with the complementary idea that it is desirable for as many statements on Wikipedia as possible to be backed with citations. Blue Rasberry (talk) 13:59, 4 September 2014 (UTC)[reply]
The style I use if a ref supports an entire paragraph is have the ref at the end and hidden refs after each sentence. It makes it a lot easier to figure stuff out if text is rearranged or someone adds a citation needed tag Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:47, 4 September 2014 (UTC)[reply]
Bluerasberry You are saying that most of WP violates WP:VERIFY? That is terrible! Jytdog (talk) 13:18, 13 December 2014 (UTC)[reply]
The proposal above is not so much at odds with Wikipedia:Manual of Style/Lead section#Citations; that guideline is clear that it's a good idea to add citations to the lead for controversial or otherwise likely to be contested matters. Well, medical text (not all of it, but a lot of it) is likely to be contested. I prefer citations in the lead for any Wikipedia article, since so many Wikipedia editors (even experienced Wikipedia editors) don't consider that what is in the lead might be cited lower in the article. It's the same type of thing that leads to WP:Citation overkill; for example, a Wikipedia editor not considering that an entire paragraph is likely sourced to the one reference at the end of the paragraph (it's often the case that the editor simply was too lazy to read the source).
Blue Rasberry has started a discussion on this matter at Wikipedia talk:Manual of Style/Lead section. Flyer22 (talk) 16:22, 4 September 2014 (UTC)[reply]
  • Support. I tried to do this on the dextroamphetamine page, but they were removed by User:Seppi333, and then he told me that in order to make them in line with other amfetamine-related articles I had to place the references in some footnotes, which takes up some unnecessary time, especially seeing how I was only going to place just one pertinent reference for each point, hence there'd be no issue of clutter (If you would like to see this discussion see here). Brenton (contribs · email · talk · uploads) 17:25, 4 September 2014 (UTC)[reply]
  • support any claim made about health is highly likely to be contentious and since there is a high likelihood of people assuming that "Its in Wiki, it must be true" we should be extra cautious about putting people's health in jeopardy. -- TRPoD aka The Red Pen of Doom 21:56, 6 September 2014 (UTC)[reply]
  • Oppose. The general WP manual of style is stringent enough by saying refs can be added for controversial claims. I do not agree with above commenters that most health claims are controversial, only a small minority are and they are the exception rather than the rule. Furthermore I fully support the translation project, but I don't think that is reason enough to change guidelines for article content on this Wikipedia. --WS (talk) 22:07, 6 September 2014 (UTC)[reply]
  • Support. Will save my sanity at subsequent FA noms. Seppi333 (Insert 2¢ | Maintained) 22:34, 6 September 2014 (UTC)[reply]
  • Support. I agree with the statement above that readers expect references in the lead. I think the absence of references in the lead can cause a lot of confusion for readers since some of them may not be willing to scroll lower and see that the content in the lead is just the brief summary and that the references come later. I don't see any particular harm in having the references in the lead and again in the body of the article. Is it a bit redundant? Yeah, but as an encyclopedia it is always best to remember that these articles are meant to be read and it's important to appreciate the readers' perspective. Even if this is at odds with years of precedent from Wikipedia guidelines, I think this can be a positive change. TylerDurden8823 (talk) 23:01, 6 September 2014 (UTC)[reply]
  • Oppose. Wow, this thread sure shows a lot of confusions piled on top of confusions.

    WP:Verifiability policy trumps WP:Manual of Style and other guidelines; any facts added to a WP article's lead have to have citations somewhere in the article. If the facts are not in the main body of the article and cited there, then they have to be cited in the lead. That also means rewriting is in order, because something in the lead should also be mentioned in the main body of the article, as the lead is just a summary.

    WikiProject Medicine does not maintain its own manual of style, but a Wikipedia Manual of Style sub-page, and it is subordinate to the main one and to the general rules in the not-field-specific sub-pages like MOS:LEAD; it is not "our [i.e. this wikiproject's] MOS" in distinction to WP's MOS. This is a matter of policy, at WP:LOCALCONSENSUS. If some participants in WP:MED want to do something notably divergent from the mainstream MOS, they should seek consensus outside their topical camp, to change the broader guidelines (either to apply more generally what these wikiproject participants want to do specifically, because it's a better approach, or to account for what these wikiproject participants want to do as an explicit topical exception to general practice, and why). Note WP:ADVOCACY, WP:SOAPBOX and WP:FACTION and the failure of WP:Esperanza; no wikiproject is an entity unto itself, a club, an organization, in a position to engage in collective wikipolitical activism positions; there is no "WikiProject Medicine's stance on" anything, except on the off-chance that something actually gains unanimous wikiproject participant support, and even then that's simply what some editors with a similar interest agree on, and does not represent any kind of supervote on Wikipedia.

    The notion that facts in medical article leads are unusually likely to be challenged is false; rather, facts in leads that are not sourced in the main body are likely to be challenged, regardless of topic, and facts anywhere within medical articles are more likely to be challenged than facts in more trivial topics like fiction fandom. That it's happened more than average with regard to medical articles' leads is side-effect of this wikiproject's habit of translating the leads (only) of foreign-language Wikipedias' medical articles to create stubs here, and has nothing to do with the general reliability of medical info on WP or its likelihood of being challenged, vs. political, botanical, or other information people care about the accuracy of. Putting citations where they belong has nothing imaginable to do with "putting people's health in jeopardy" (see hyperbole and argument to emotion).

    Further, this idea would be a massive change to Wikipedia policy, site-wide, and is not a decision some wikiproject can make in a vacuum: "the lead ... will be a well referenced plain language [sic] overview of the topic that can be re-used separately for a brief standalone article for either translation or as simple introduction to a topic." That is absolutely not what lead sections are or intended to be. This wikiproject's habit of creating en.wikipedia stubs by perhaps uncritically translating just the lead of articles at other-language Wikipedias is something that needs to be questioned, not something we need to intentionally encourage more of.

    Another example of nonsense is "In much of Wikipedia, citations are optional." That's not true at all. But neither is the opposite claim, "information is deleted without discussion when it is not backed with citations"; that's generally untrue except in cases where there's good reason, e.g. because it seems to violate WP:Biographies of living people policy, seems to be fringe theory or pseudoscience, or is patently POV-pushing. (What usually happens is questionable material gets challenged with {{citation needed}}.) When something actually factual is deleted, restore it with a citation. If it was already cited elsewhere in the article, reinstate it without a new citation and note that it's already cited. If someone still deletes it, seek WP:Dispute resolution, as the other editor is the one in error. If they want to insist on a citation at that spot, even in the lead, you can go ahead and put one there to mollify them, but no one has the magical right to re-re-re-remove information from the article simply because it's not cited the exact way they want it to be cited. It's usually not worth arguing with these people, and the redundant citation in the lead will eventually be removed by someone else as redundant.

    Re: WP:Citation overkill (an essay) and this wikiprojects' penchant for engaging in it, and the suggestion to cite after every sentence: There is no WP rule that citations should be used after every sentence. Universally, they should be used after every fact or string of facts that come from a single source. There's no problem adding more citations to the same source (unless it rises to the level of citation overkill), if several discrete but contiguous sentences came from the same source, especially if they're discrete enough that someone might insert other material between them. But some sentences require multiple internal citations when facts in them come from separate sources. I.e., there is no relationship of any kind between "a sentence has ended" and "facts need citations".

    PS: Some of the concerns here are invalid, and are coming from some kind of "this is WikiProject Health" position, where the purpose of our articles on medical topics is imagined to be providing health advice. But this is forbidden by the WP:What Wikipedia is not policy (and could raise legal issues in many jurisdictions, too).  — SMcCandlish ☺ ☏ ¢ ≽ʌⱷ҅ᴥⱷʌ≼  23:27, 6 September 2014 (UTC)[reply]

  • 2¢: I'm just going to point out that this proposal is not actually at odds with the MOS (specifically, MOS:LEADCITE). That policy section doesn't indicate a particular way to deal with citations in the lead. The case-by-case basis clause ("The necessity for citations in a lead should be determined on a case-by-case basis by editorial consensus" - note that this language does not mean an article-by-article basis) isn't at odds with this proposal since, in this context, all WP:MED-tagged articles are the current "case" under consideration. Seppi333 (Insert 2¢ | Maintained) 23:50, 6 September 2014 (UTC)[reply]
Indeed, there is much wrong with SMcCandlish's initial post in this section. On a side note: SMcCandlish told WP:Manual of Style editors that they perhaps need to keep an eye on MOS:MED, as if MOS:MED can't offer advice on formatting medical articles and generally follow that advice. Flyer22 (talk) 23:56, 6 September 2014 (UTC)[reply]
And specifically regarding "information is deleted without discussion when it is not backed with citations," that is often true. Happens all the time on Wikipedia, even in common sense matters, as many experienced Wikipedians know. In other words, it's not always a "violate[s] WP:Biographies of living people policy, seems to be fringe theory or pseudoscience, or is patently POV-pushing" matter that causes the deletion. The WP:Verifiability talk page has had recent discussions about that type of thing. Many Wikipedia editors don't know of or rather ignore the WP:Preserve policy. Flyer22 (talk) 00:09, 7 September 2014 (UTC)[reply]
  • Oppose All articles should follow the general English Wikipedia guidelines. If the lead section is properly constructed and summarizes the rest of the article, then it doesn't need any citations. Of course, while an article is being built up, the "lead section" may contain new information, and citations are needed. But in a properly constructed article, there should be no new information in the lead and hence no need for citations. Wikipedia is not an academic journal. Peter coxhead (talk) 07:59, 7 September 2014 (UTC)[reply]
  • Infoboxes first The lead, by its nature, is a general summary in ordinary text. As it is summarising the body of the article, there ought to be some sort of cross-reference between the lead and the body to make sure it all hangs together. Appropriate structures for doing this seem to be lacking. In the meantime, please consider infoboxes, such as the one for dextroamphetamine, which is the example given above. Infoboxes are intended to contain discrete, hard facts, rather than general statements and so would be a better place to start requiring detailed citations of these hard facts. In the case of dextroamphetamine, you currently have to go quite a long way down the infobox before you find any citations. But note that some content there may be implicitly citing a reference. For example, we are told that the IUPAC name is "(2S)-1-phenylpropan-2-amine". Is this implicitly citing IUPAC as an authority or do they just provide general rules rather than definitive names for every compound? I look around and find the NCBI page. This seems to be a good reference and agrees about the IUPAC name. But I notice that the 2D and 3D representations of the structure seem to be different. This seems quite a big deal. Perhaps the infobox templates should have their parameters in pairs - one parameter for the fact and one for the the supporting citation. If there's no citation then the fact is not displayed. With a tight, formal structure like that, we might get somewhere. Andrew (talk) 08:08, 7 September 2014 (UTC)[reply]
It's not just medicine-related articles where sourcing in infoboxes is an issue. Editors seem to believe, wrongly, that briefly presented information in an infobox doesn't need sourcing, whereas it is subject to the same considerations as any other part of the article. It certainly helps if infoboxes have explicit parameters for references (e.g. taxoboxes for organisms have |synonyms= and |synonyms_ref=). Peter coxhead (talk) 08:26, 7 September 2014 (UTC)[reply]
  • Oppose a special guideline per SMcCandlish. Note that I am only opposing the proposal that there be a different standard for medical articles, not an increase of citations in the lead either by changing the main guideline or in the course of your editing per WP:IAR if nothing else. There is just too much bureaucracy already without having it where the first paragraph is or isn't referenced inline based on what the topic of the article is. Wnt (talk) 09:38, 7 September 2014 (UTC)[reply]
User:Wnt as you will noteDoc James (talk · contribs · email) (if I write on your page reply on mine) 00:45, 17 September 2014 (UTC)[reply]
  • Support The opposition is severely miss-guided to what issue this tackles. Most cases are trivial to correct, and there is no reason to go through "dispute resolution" for any of them. The case is rather one of work-load. By having such a policy we make the job of policing articles much much simpler. -- CFCF 🍌 (email) 11:48, 7 September 2014 (UTC)[reply]
    Nay, I think that when we define what a "lede paragraph" is, we're creating an expectation in the reader. Maybe the reader should be expected to trust that the lede is a general summary of the article and not expect to see claims verified there. Maybe that doesn't work well so we should verify claims there. But either way, the reader is going to have to develop a mental image that "this is how a Wikipedia article works". If we have different standards on it for different types of content, then there will be less clarity as to whether a lede of any given article is questionable or not. Wnt (talk) 12:48, 7 September 2014 (UTC)[reply]
    This isn't a reader focused change, and anything summarized in the lede must still be present in the full article–this is not changed. The only difference is us actually giving the citation used for statements in the lede. Having this type of policy simplifies the writing of good ledes and allows for more time spent working on improving content, and less on discussing why poor edits are removed. -- CFCF 🍌 (email) 14:14, 7 September 2014 (UTC)[reply]
    Well, the OP said "our readers expect them" - and it may be true. Bear in mind that I don't think that we can even accurately categorize articles as medical vs. non-medical, because I think there is a smooth continuum between these, and even an arbitrary distinction would rely on a very specific philosophy of what is medical on which people will disagree. Wnt (talk) 15:25, 7 September 2014 (UTC)[reply]
  • It depends on exactly what you add. I don't mind having citations in the lead, especially for well-developed articles that are being translated. However, I don't want to see people saying that they're "required by MEDMOS". For the specific case of articles for translation, it might be better to recommend this on the advice to translators page, on how to prepare a page for translation. WhatamIdoing (talk) 16:41, 7 September 2014 (UTC)[reply]
  • Support In order for our health articles to be useful for reuse, they need to have a plain language comprehensive summary that is supported by references. We know that Wikipedia English article leads are regularly being reused for translation. We know that the lead of our articles are being reused by other organizations to explain health concepts in plain language. And we know that Wikipedia medical articles are regularly read by people with pretty different potential levels of comprehension of the topic. We need to keep this in mind and structure the articles so that we are useful for these different audiences. For example, we know that medical students and clinicians use Wikipedia articles and benefit from a greater level of detail than the average reader. So, it is appropriate for the body of the article to cover the topic with more complex language and concepts. But the general reader should not have to read to the bottom of the article and try to comprehend the more complex vocabulary and concepts in order to find the references. So there are valid reasons to add references to the lead of articles and mentioning this in the manual of style will help everyone understand why it is needed. Sydney Poore/FloNight♥♥♥♥ 20:52, 7 September 2014 (UTC)[reply]
Very well put, agree completely. -- CFCF 🍌 (email) 05:54, 8 September 2014 (UTC)[reply]
Wikipedia is not a medical encyclopedia. Articles on all sorts of topics are used by all sorts of readers. There's no reason to treat medical articles differently in this respect, even supposing a clear-cut separation were possible. Peter coxhead (talk) 21:42, 8 September 2014 (UTC)[reply]
Thanks for sharing your thinking. Actually there are loads of good reasons for treating medical articles differently. :-) And many regular editors to Wikipedia health articles are up to the challenge of creating high quality content that is CC BY-SA licensed and can be read by a broad range of readers on Wikipedia English, or reused off Wikipedia English. I hope you will reconsider your objection because I think that it is short sighted to have a one size fit all approach for all types of articles when there a sensible reasons to use different approaches. Sydney Poore/FloNight♥♥♥♥ 23:03, 8 September 2014 (UTC)[reply]
Many WikiProjects could claim that there are "loads of good reasons" for treating their articles differently (and indeed some of them have done so). I always distrust 'slippery slope' arguments, so an exception could be made for medical articles without necessarily setting a precedent, but the reasons would have to be more convincing to those outside the project than I've seen so far. Also, a discussion here cannot over-ride the existing MOS; if the project wants to change the MOS there needs to be a discussion there. Peter coxhead (talk) 13:06, 9 September 2014 (UTC)[reply]
  • Support References in the lede are a convenience to our readers who may not go on to examine the rest of the article. For a FA quality article you could be sure that the lede content is expanded in the body. But most articles are not at the standard, so to remove doubt there should be references up front. Referencing should apply to important facts,not just controversial statements. Verifiability trumps style, so that is why we need references. Graeme Bartlett (talk) 22:11, 8 September 2014 (UTC)[reply]
  • Support Especially per the last two (FloNight and Graeme Bartlett. Wiki CRUK John (talk) 09:39, 9 September 2014 (UTC)[reply]
  • Oppose The lead is a summary of an encyclopedic article. Refs in the lead are therefore redundant, except under certain circumstances. See Manual of Style for those. Medical articles are largely based on current science, and should therefore not be any more controversial than any other "type" of article also based on current knowledge. There is nothing special about medical articles here. GenQuest "Talk to Me" 17:29, 10 September 2014 (UTC)[reply]
Your response shows a striking lack of understanding of the subject matter. Medicine is highly controversial, and there are constantly those who push new unproved treatments onto Wikipedia. Medical articles are uniquely controversial and any statement at all is open to controversy, and it would be fully legitimate to accept references in the lede of medical articles purely on that basis. (Without needing to change the main MOS). -- CFCF 🍌 (email) 06:55, 11 September 2014 (UTC)[reply]
There is nothing uniquely controversial about medical articles. POV-pushers abound in articles about history, religion and politics, to name but three. Peter coxhead (talk) 10:52, 11 September 2014 (UTC)[reply]
It is not the likelihood of controversy but the potential risks of incorrect information that is special about medical articles. Armenia–Azerbaijan relations is highly controversial but mistakes or bias in the English Wikipedia article are unlikely to kill anyone. That's not so with Alternative cancer treatments. Wiki CRUK John (talk) 11:34, 11 September 2014 (UTC)[reply]
Your response shows a striking lack of understanding of Wikipedia. It is NOT, and does not purport to be, anywhere near a primary reference work, especially in the field of medicine. If non-sourced info is added to the article or the lede, it should be removed. The structure of the WMoS is what governs that. Medical articles may be near and dear to you, but they carry the same weight as any other article in this little encyclopedia. Besides, if someone is using Wikipedia as their main source of medical knowledge, they have other issues in their life, lack of common sense being the most prominent diagnosis. GenQuest "Talk to Me" 15:19, 11 September 2014 (UTC)[reply]
GenQuest, I'm pretty familiar with WP:CITELEAD. It says (direct quotation), "The presence of citations in the introduction is neither required in every article nor prohibited in any article." I'm not sure how people get from what CITELEAD says to claiming that citations in the lead are redundant and shouldn't be used except for specific, explicitly authorized exceptions. WhatamIdoing (talk) 15:39, 11 September 2014 (UTC)[reply]
  • Support We want to make our articles more easily verifiable by our readers. I agree that this is especially key as people life may be in the balance. BLPs receive `special` acknowledgement. But precedent is not an issue. This is an issue of common sense. The proposal is not a requirement for refs in the lead just an explicit allowance of references in the lead. They are already allowed implicitly. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:01, 11 September 2014 (UTC)[reply]
    • What special allowance is being proposed? I see "My position is that we should have references in the lead and this is for a couple of reasons..." That looks like a soft requirement (Should rather than shall). What is the actual proposal.? Protonk (talk) 19:56, 11 September 2014 (UTC)[reply]
      • ”Ａｄｄｉｎg references to the lead is reasonable but not required as long as the text in question is supported in the body of the article"Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:19, 12 September 2014 (UTC)[reply]
        • Seems fine to me. I can support that. Protonk (talk) 11:53, 12 September 2014 (UTC)[reply]
        • As I understand it, direct quotations must be sourced at every instance, including the lead. In practice, contentious negative matter (especially if not widely known) about living people is also commonly "required" to be cited in the lead. It might be preferable to write only, "Adding references to the lead is reasonable but not normally required". WhatamIdoing (talk) 00:50, 26 October 2014 (UTC)[reply]
  • Oppose. All facts in the introduction should be in the main body of the article . Introductions are easier to write without in-line references. Snowman (talk) 18:19, 9 October 2014 (UTC)[reply]
  • In my mind, WP:LEADCITE is clear, and we don't need to do anything on this page that may put us at odds with that more general page. In application, LEADCITE means we often add citations in the lead (for quotations, hard data that may need verification, anything surprising or controversial), but we aren't obligated to cite summarizing info. SandyGeorgia (Talk) 15:46, 4 December 2014 (UTC)[reply]
    • The "problem" being addressed here is that, although LEADCITE is clear to you and me, some editors apparently believe that LEADCITE says "editors must omit citations from the lead". WhatamIdoing (talk) 09:19, 5 December 2014 (UTC)[reply]
  • Oppose. Lede is only a summary of what is below. It should never be independently referenced as this would go against what WP:lede is meant to be. Thus, no new information in lede, only what is in the body. If I come across an info in the lede that is not mentioned in the body, I kick it down. kashmiri TALK 11:45, 13 December 2014 (UTC)[reply]
Yes the ideal is to have all content in the lead also in the body. This proposal does not change that. Doc James (talk · contribs · email) 04:13, 17 December 2014 (UTC)[reply]
  • Oppose - per WP:LEAD, lead is only a summary of the body and only controversial statements need to be cited there. When I look over articles and find a citation on a non-controversial statement in the lead, this is actually a useful sign that someone added content only to the lead (don't have statistics, but it is a good tip in my experience), which is something that needs fixing. wrt to the spirit of the proposal, that people's life may be in the balance... we are WP:NOTMANUAL and see the disclaimer. We do need to take our responsibility to provide accurate health information seriously but redundant obligatory citing in the lead is just more work, and has no point. Jytdog (talk) 13:37, 13 December 2014 (UTC)[reply]
Sure and the solution is to often add it to the body of the article. Doc James (talk · contribs · email) 04:12, 17 December 2014 (UTC)[reply]

Propose to add "types" section for some articles

I have doubts about out to phrase this, but I think an optional "classification", "variation" or "types" section should be added to the list of recommended sections for treatments, procedures, and tests when multiple unrelated therapies exist which from the consumer perspective give the same benefit.

Consider a class of drugs grouped by function, like anticoagulants. This is a grouping by effect, but not by the entries in the MEDMOS outline. The anticoagulant warfarin has all kinds of side effects, but some weird exotic anticoagulants are completely different in what they are and how they function so their Contraindications, Adverse effects, overdose, interactions, mechanism, physical properties, pharmacokinetics descriptions could be completely different. In other cases, some or all of these might apply to treatments which have radical differences but somehow achieve the same effect in the same way.

Leaving drugs aside, I was looking at strength training and thinking about how to talk generally about the topic when there are so many different variations of this practice as a rehabilitation treatment.

I think that adding a "Types of treatment" heading immediately below the uses section would address the problem in these cases. With that section in place, the reader can get an introduction to the idea that multiple treatments exist. This could also apply to "surgeries and procedures" and "medical tests". Some time ago I tested a "classification" section on c-section because there are actually several variations on the procedure which all deliver a baby but in very different ways. With medical tests, I again think many readers are more interested in the end result than in technical information about the ways that the tests work, so being able to note that variations in the tool exists would be a worthwhile addition to the MEDMOS. Blue Rasberry (talk) 17:53, 14 November 2014 (UTC)[reply]

"Types" for diseases too?

For disease articles, could ==Types== be a useful alternative to ==Classification==?
"Types" might be an appropriate and more reader-friendly option, imo, for selected content that is intended for lay readers (per WP:AUDIENCE). 109.157.83.50 (talk) 16:38, 23 November 2014 (UTC)[reply]

Fine with that. Wiki CRUK John (talk) 09:14, 24 November 2014 (UTC)[reply]
not fine with that ... too much of this going on. We aren't writing for one outside group on one individual topic. I'm finding it a concern that one UK Cancer Group (editing as ips no less) is pushing through such broad changes to MEDMOS based on one disease. SandyGeorgia (Talk) 10:39, 3 December 2014 (UTC)[reply]
See my talk. SandyGeorgia (Talk) 14:28, 5 December 2014 (UTC)[reply]
Hardly, and 109.157.83.50 (familiar to the Medical Wikiproject for years under various guises) has no connection with the CRUK project, or cancer, other than helping with volunteer editing like many others. A poor breach of WP:AGF Sandy, and, as it happens, completely wrong! You might want to set out arguments why "types" is not applicable to anything much but cancer, if that is your position. That "We aren't writing for one outside group" is rather the point. Wiki CRUK John (talk) 10:50, 3 December 2014 (UTC)[reply]
PS, I also disagree with the change (above) of "Outcomes" instead of "Prognosis" ... see my comments under the old discussion above, which I missed. We have to take care not to represent only a "disease" model, that is, conditions that have a somewhat defined beginning and end, as opposed to "conditions" that one lives with. Outcomes would sound utterly stupid in Tourette syndrome, and there was nothing wrong with Prognosis. So much work to be done in here, and we're dorking around with sections that worked. Ditto, how would I use "Types" for most neuropsych conditions? SandyGeorgia (Talk) 10:54, 3 December 2014 (UTC)[reply]
You seem to have missed the point that these are adding alternatives not mandating changes. What % of our WP:AUDIENCE actually know what a "prognosis" is, do you think? Wiki CRUK John (talk) 10:59, 3 December 2014 (UTC)[reply]
Not missing the point, "prognosis" has been dropped from our guideline, so we now have multiple articles and FAs out of compliance with the most common word for just what it is in most cases ... prognosis. I could understand providing perhaps one more choice for editor discretion, but we now have three choices instead of one common word, and multiple articles out of compliance (FAs must comply with MOS), since the common word was dropped. SandyGeorgia (Talk) 15:24, 3 December 2014 (UTC)[reply]
If we label it as types IMO this should be a subsection of diagnosis. Often this sort of content is rather technical. Doc James (talk · contribs · email) 11:39, 3 December 2014 (UTC)[reply]
Really, folks, don't be trying to change a guideline just when an article is at FAC. Discuss the guideline before, or discuss the guideline after, but editing an article to introduce a brand new concept at the time an article is at FAC, and then trying to change the guideline to reflect that, is not the best way to either gain consensus for a change or argue that the article at FAC is stable and complies with MOS. SandyGeorgia (Talk) 15:20, 3 December 2014 (UTC)[reply]
It does say "If relevant. May also be placed as a subheading of diagnosis" and "Do not discourage potential readers by placing a highly technical section near the start of your article." Doc James (talk · contribs · email) 16:10, 3 December 2014 (UTC)[reply]
Three thoughts:
  • The reason that "prognosis" is in bold-faced text is because—like all the other bold-faced words—it is suggested as a section heading.
  • "Don't be trying to change a guideline just when an article is at FAC" means "don't be trying to change a guideline ever", because there is always some article at FAC. Furthermore, these proposals were made in August, which by my calendar is "before" any current FACs.
  • It would be difficult for any article to be "out of compliance" with headings that are explicitly labeled as "suggested" rather than required, especially when the introductory text says that there are many times when you will want to do something different. I expect FAC folks to be able to use their best judgment, rather than applying rules like a robot, even if Sandy's not there to guide them. WhatamIdoing (talk) 15:21, 4 December 2014 (UTC)[reply]
  • 1. Thanks for the clarification that dropping Prognosis as suggested was unintended: I've rectified. 2. There is very rarely a medical article at FAC, and when there is, editing an article to make a change to that article based on a suggested guideline that is still under discussion does not speak well to crit 1e (stability). 3. I expect you do. That FAs must comply with MOS guidelines is in the criteria; whether they do under the current FA administration is debateable. SandyGeorgia (Talk) 15:31, 4 December 2014 (UTC)[reply]
On the actual question: ==Types== is going to work very well for some conditions, especially conditions that have explicitly labeled subtypes. Using ==Types== rather than ==Classification== for Diabetes mellitus's Type 1 and Type 2 is preferable, because it follows the sources more closely: they say "types", we say "types". For other conditions, possibly including Leukemia, I might prefer ==Classification==.
One of the problems with ==Classification== is that it could be classification going down (Diabetes mellitus is subdivided into Types 1 and 2) or going up (Diabetes mellitus is an endocrine disorder). ==Types== is clearer about its contents.
My preference is for what the OP suggested: an alternative, to be used when it seems more appropriate, with neither ==Types== nor ==Classification== being officially preferred more than the other. WhatamIdoing (talk) 09:29, 5 December 2014 (UTC)[reply]
small note from the OP: ...though I have to say I find the opening Classification section in this recent potential medrs on diabetes is presented both simply and clearly. 109.158.8.201 (talk) 13:22, 31 December 2014 (UTC), previously 109.157.83.50 etc [reply]
Support that. It is noticeable that in fact most disease articles I see don't have such a section at all, even when, as with many cancers, they are crying out for one. Diabetes mellitus is an example, putting it all in the lead to the near-exclusion of everything else, and pancreatic cancer didn't have one until I added it recently. Having the alternative section title may encourage people to actually follow MEDMOS. Wiki CRUK John (talk) 10:42, 5 December 2014 (UTC)[reply]
I see that for diseases. I do wish people would keep in mind, when changing these guidelines, that not all "conditions" have underlying disease processes. Classification works quite well for many neuropsych conditions, and there is no such thing as "Types" for Tourette syndrome as an example. That is the whole point I'm trying to get across, that seems to have led to the upset of IP 86. SandyGeorgia (Talk) 14:31, 5 December 2014 (UTC)[reply]
It's not a question of "diseases" versus "conditions". It's a question of whether the subject actually has "types" (think "subtypes") or not. Tourette syndrome has no types. Birthmarks do. You can't use "Types" for Tourette. You could use it for birthmarks. WhatamIdoing (talk) 22:44, 5 December 2014 (UTC)[reply]

The page seems to be growing unnecessarily. Per the comment above that all bolded words are now suggestions, we also have:

So, why do we need four possible choices, and how is the new-to-Wikipedia editor to sort which to use? What was wrong with one, perhaps two, terms? Really, this all seems to be fiddling for the sake of fiddling, and I'm not yet convinced clarity has been added. SandyGeorgia (Talk) 16:58, 5 December 2014 (UTC)[reply]

Sandy, in eg your version of 8 June 2010, this was: "Causes (e.g. Risk factors, Triggers, Genetics/Genome, Virology (e.g., structure/Morphology, replication))". These are possible sub-sections, or things to cover, and always have been. Wiki CRUK John (talk) 22:08, 5 December 2014 (UTC)[reply]
That version, to my understanding, always showed one suggestion: Causes. The parenthetical afterwards provided examples of what was meant by or meant to be included in Causes. Now we've got some unclear to vague suggestion on this talk page that anything in bold might also be a section heading (we lost the parenthetical and attached some significance to bolding). SandyGeorgia (Talk) 22:12, 5 December 2014 (UTC)[reply]
Yes, there probably needs to be some copyediting to make things clearer. Yes these are contents (and probably don't need bolding) but Prognosis and Outcomes are alternatives. Wiki CRUK John (talk) 22:17, 5 December 2014 (UTC)[reply]
There are different options because, as Sandy keeps reminding us, different subjects have different needs. If the only aspect of etiology you need to talk about is risk factors, then you can (and probably should) name the section ==Risk factors== rather than ==Cause== (and definitely rather than "Cause" followed immediately by a subheading "Risk factors").
I expect the new-to-Wikipedia editor to use two main approaches: First, I expect the new editor to pick whatever's first in the list, because it's the most prominent. Second, I expect the new editor to pick whatever's most relevant, because I assume that editors, even new ones, use their best judgment. And I expect that my main approach is to cheerfully change the new editor's choice of section heading if I believe that I can improve on it. WhatamIdoing (talk) 22:38, 5 December 2014 (UTC)[reply]

Denigration of medical history by making it sit toward the back of the bus

As you will see, except for the notable case of medical specialties articles and articles about diseases that are historical-only, WP:MEDMOS recommends we put history toward the end of the article. I recently had a section on vitamin D history moved from middle to end of article so it would conform to the nazified straight-jacketted unified military order type structuring of all biomedical articles on Wikipedia. My response was this:

I can live with the history going farther down, though I'm not sure I like it for a vitamin. Vitamins were discovered, like atoms or electrons or chemical elements. The physics and chem articles treat their subjects with more attention to history of discovery. The further you get into the life sciences, the less attention history gets. I came up from chemistry as an undergrad, and noticed that by the time we got to medicine, there's was very little history left (and what their was, was wrong-- I can remember being told that Semmelweiss got push-back because he wanted doctors to use soap and water). In medical school, they tell you this lack is because they have no room in the curriculum for the history of medicine. That's a lie. The truth is they don't care, and would put it at the end even if there was room. As here. But quite often I think it helps understanding to put an abbreviated history up front (with a detailed one later), so the thing you're discussing doesn't just appear to come out of no where. BTW in pharmacology they also are not as likely to slight history. For example, Goodman and Gilman in The Pharmacological Basis of Therapeutics (now in 12th ed.) start out discussion of every drug with its history, and it doesn't seem to hurt. So what's the problem?

I know, you're going to tell me to take it to TALK:MEDMOS. Okay, I will. SBHarris 02:38, 11 December 2014 (UTC)[reply]

We put the more clinical information first and the more history stuff latter generally. This is the ordering for thousands of articles.
Some argue to have epidemiology put first with some good reason aswell. Changing it around is a massive effort. I think consistency is generally a good thing. Doc James (talk · contribs · email) 03:05, 11 December 2014 (UTC)[reply]
I don't care if it's a massive effort. If the readers are better served, we could make that massive effort. After all, it'd be no more massive than the one you've undertaken to make things match the MEDMOS for several years.
I have trouble thinking of Vitamin D as a "drug". Humans make it naturally. It probably ought to be structured more like Hemoglobin (which puts "Research history" first). WhatamIdoing (talk) 04:01, 11 December 2014 (UTC)[reply]
I think you're saying we already did the work, and changing it would take a lot more work. Are you satisfied with that argument? Maybe you shouldn't have done the work in the the first place. Or maybe you should have had some discussion before doing that much work.

In Wikiproject elements we decided that an imposed template that is the same for every chemical element would not be a good thing, because chemical elements are different, and the various sections for each one are bloated or sparse or even missing with regard to the others. It doesn't make SENSE to do them all the same way. Nor really does it make sense for medical topics.

If you look at medical topics reviewed in journals (for example the reviews of diseases that NEJM does periodically) you will not see that they are NOT all done the same way. Why should they be? If you look at medical texts, you find that most do not have histories, but those that DO, invariably have it up front as chapter 1. I am looking at Sabiston's massive Textbook of Surgery, for example. And in books where history exists as bits in the text, in various chapters, it's invariably up front in the chapter. For example, in Goodhart and Shils Modern Nutrition in Health and Disease, a standard text, many chapters have no history. But the ones that do (vitamin chapters, etc) the vitamin history always begins the chapter. Never is history, if it exists, stuck toward the end.

So I challenge you to find me some examples of it done otherwise from your own bookshelf or the secondary review literature. So far as I can see, nobody in the medical review literature does it the WP way, except Wikipedia. That's kind of outrageous. It may not violate the letter of NPOV to cover information differently and with a different emphasis than the literature you (are supposed to) summarize, but it certainly violates the spirit of NPOV. SBHarris 04:06, 11 December 2014 (UTC)[reply]

I was following the MEDMOS at the time. But yes what I am saying is you need a good reason to change it and I am not seeing one.
Many sites have a ordering and naming of sections including nlm [2] and emedicine that they consistently apply across topics. Doc James (talk · contribs · email) 04:27, 11 December 2014 (UTC)[reply]

talking about history, I just went strolling through the achives.

  • I have some sympathy with this view, but would say: firstly, our history sections are typically rather short and poor in medical articles, where they exist, so often deserve to be left at the end, and secondly, in most areas of WP it is the other way round, and the usual convention is to put history first after the lead, which imposes its own tyranny, and is often inappropriate, partly because they are often so long. Surgery is another area where moving history up might often be appropriate, to after a descriptive section. Wiki CRUK John (talk) 09:45, 11 December 2014 (UTC)[reply]

I worked on the original section headings/orderings of MEDMOS. There never was a "best order" or "best set of headings". Let's be quite clear: MEDMOS has never defined the order or sections in medical articles nor even which sections a medical article should/must contain. The most it has ever done is "encouraged" and "suggested", with the focus on new articles or complete rewrites. And it has always made it clear that simply changing the order/name of sections to meet the guideline is disruptive and unwelcome. Despite this, Doc James has been on a one-man mission to mandate section ordering "per MEDMOS". I'm not at all surprised that your attempt to introduce a logical order to the sections got reverted by him.

The section headings and the ordering of sections/article-text is a matter for editors of the article and should be decided by consensus on the article talk page, as with any other content issue. As noted above, and in MEDMOS itself, there is huge variation among articles that fall under our umbrella. MEDMOS does not and never has require an order or set of sections, and if someone changed it to do that I'd be among the first to ask for its official-guidance status to be revoked. The edit summary "Not should be towards the top per WP:MEDMOS" is absolutely 100% bullshit. -- Colin°Talk 10:09, 11 December 2014 (UTC)[reply]

some strong emotion here! What MEDMOS says now is "Changing an established article simply to fit these guidelines might not be welcomed by other editors. The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition." That is indeed very guideline-y (as in, not policy) language, so cannot be cited as an Authority. Seems like something to be discussed on Talk indeed. It also seems very hard to resolve on any kind of objective basis. Which is all the more reason for everybody to do their best to remain calm and do their best to convince each other, which yelling and name-calling (the Reductio ad Hitlerum in opening post is unfortunate) rarely does. Opening this discussion was a very good thing, though.
All that said, I think the current order in MEDMOS does give people want they want upfront for health-related content, which is better, practically. (personally, I like history sections for drugs and often flesh them out, as i am interested in the process and business of how drugs get discovered and brought to market. I don't mind that history is at the end in drug articles and I think it would be strange if it were put upfront.)
With respect to the vitamin D article.. three is a LOT going on there. Physiological roles, supplementation, history of science. That's a lot. And MEDMOS wasn't built to deal with articles like this, where a natural substance is also manufactured and used in a health context (same thing for, say IL-2) Very debatable what to have go first. I believe history was last for a long time, and Sbharris would have to get consensus to change the order. A better edit note in the revert would have been "please get consensus on Talk for this", but the reversion itself was correct, I think, under just plain BRD. Jytdog (talk) 14:27, 11 December 2014 (UTC)[reply]
The reversion itself was incorrect. Not only did it misquote our guideline into claiming some authority/mandate it doesn't have, but no, BRD does not entitled editors to revert at will, and is an essay for dealing with controversial edits on controversial subjects. Actual policy at Wikipedia:Editing policy is routinely ignored by, cough, a certain editor, who thinks that anyone doing something he doesn't like needs to gain his prior approval. Sbharris's change was a good-faith edit designed to make a logical order to that article (I make no judgement on whether it did improve, because that's not what is important here). Therefore, per editing policy, it is actually up to James to either improve it further or to explain on the article talk page why the article is better as it was before, with argument specific to the text in that article. I've already seen one expert chased away from Wikipedia because of this ownership-of-all-medical articles behaviour, and blind insistence no imposing MEDMOS sections. Jytdog, we don't need consensus to make edits. Let me repeat this. We don't need consensus to make edits. If you hang around James then you might get that impression, but please folks, go actually read our policy. Which part of " Improve pages wherever you can, and do not worry about leaving them imperfect. Preserve the value that others add, even if they "did it wrong" (try to fix it rather than delete it)." and "Be bold in updating articles, especially for minor changes and fixing problems. Previous authors do not need to be consulted before making changes. Nobody owns articles. If you see a problem that you can fix, do so." is so hard to understand? -- Colin°Talk 13:16, 12 December 2014 (UTC)[reply]
Hi Colin, thanks for your remarks. I don't see things quite the same way. I think if other editors disagree with a change I make, they can revert it, and it is up to me to go to Talk and get consensus for the change I want. Of course we want people to be bold - nothing would happen without that. But consensus is the foundation of this whole place, and in my view every version of an article exists, based on the current consensus of the editors working on that page. Other people may disagree with my edit on grounds of policy or guideline, or on the basis of their own preference is no policy or guideline provides some community-wide consensus upon which to judge whether edits are OK or not. Looking at the page history, Sbharris boldly did a major reorganization of the page (good on him!) (without prior discussion, which was probably unwise); Doc James reverted him on the basis of MEDMOS (which is a guideline, but the reversion could just as well have been "major organization and I don't agree; let's discuss). I just checked the Talk page and it looks like rather than opening a discussion there and making arguments for his preferred version per BRD, Sbharris came here with a bit of a rant. Which is not great behavior. This seems like a pretty normal content dispute. Resolving it will come down to consensus of the editors working there, once a discussion actually gets opened. That's how I see it. Jytdog (talk) 13:45, 12 December 2014 (UTC)[reply]
What you call "not great behavior" is pretty inevitable. The most efficient way to deal with a reversion which is ostensibly on the basis of some policy or guideline or guidance or habit or controlling favorite opinion essay, when you disagree, is to go to the TALK page for the guideline and find out just what consensus for it exists. As here, where we found out that the thing was put in 3 years ago without discussion, and the same people who did that, have been beavering away for years getting it their way, and now are arguing it's too much work to undo!

The proximate problem with doing things the way you suggest, is that can't ever pin down down somebody who thinks they have "imaginary consensus" on their side. On the article TALK page, they just point to the guideline. On the the guideline TALK page, then other people get all annoyed and want you to go back to the article TALK. If you are lucky you can get what we got here, which is to find out that this is a submarine guideline being applied innappropriately, since it was never discussed properly by the community, and doesn't even meet consensus as a guideline. That's what we wanted to know. And here you are, upset that I finally forced a discussion where the facts and history came out. Shame on me.

But now I would like to insert some language in MEDMOS to remind people that article heading substructure is not set in stone, and is not worth changing solely to conform or "harmonize" (to use the hated E.U. term) with examples on MEDMOS. We gaven't been over this nearly as thoughtfully as some of the stuff in MEDRS, and I think it's "not great behavior" to pretend that we have! SBHarris 18:34, 12 December 2014 (UTC)[reply]

but Sbharris, the language is already in the guideline. If folks are not remembering and using that, that is on them, not the guideline. :) So its there. No need for drama nor Godwin. fwiw, please look down the road. If you want to start the process of trying to change the order in MEDMOS now, you could of course do that. And let's say you succeed after a big long RfC (which is probably what it will take). That version will also contain the same disclaimer about not forcing changes to section-order through, based on MEDMOS. And you will still have to go back to the Vitamin D Talk page and make your arguments there, to gain consensus of the folks who care about that article, for the order you want. And then follow the normal DR processes for content, if consensus doesn't come easy. The order of the Vitamin D article is ultimately just a content dispute (especially since MEDMOS gives latitude) and no drama board will give you the time of day, until you have used the article Talk page. Good luck! Jytdog (talk) 19:08, 12 December 2014 (UTC)[reply]
The present guidelines are inadequate. The suggested place for the history section varies with the type of article, but no reason is given in any case as to why these suggestions are being made. Who decided? Why? We just have these fiat templates. The section does indeed say that none of this is set in stone and can vary with the article, but it also says: The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition. For me, that means the article should begin at the beginning, and with the etymology and history of the disease or whatever. How are you going to "progressively develop concepts" if you're hit with the latest knowledge immediately? That's the function of the lede/lead. After that, the MEDMOS cautions: "Do not discourage potential readers by placing a highly technical section near the start of your article." ;'p) Well, if your first section is the history, you can pretty well guarantee THAT won't happen, can't you?

Look, most of WP is constructed with etymology and history first. If you look at the most popular article on en.wiki, The United States of America, that's how it's constructed. The same with most other countries. States in the union sometimes have history first and sometimes geography, but history is always at least second. Technology? If you look up airplane, automobile, computer, you get etymology and history first. Nobody complains that they just want to know how the dang machine works, and don't have time even to scroll over the history that they're not interested in. Skipping over history doesn't take very long, after all.

I didn't go through the topic range of the entire Wikipeda, but biography is chronological is most cases. Articles on animals start with origin and evolution. Topics in chemistry and physics are mixed, but start with discovery history more often than not. Astronomical objects generally start with characteristics, and history is way down at the end (Like medicine)-- unless the history is interesting like Halley's Comet. For the entire Universe, however, the two "histories" (history of the Universe and history of its observation) come first.

Again, Wikipedia is not a Washington Manual for medical interns, or a PDR, or WebMD, a how-to or advice book. This is emphasized over and over, and so why do we have this (implied) time constraint that we have to get to the meat of (say) choking without a digression on Henry Heimlich (whose role come way later). But that's not how Wikipedia is meant to be used and this faux-urgency which saves us from scrolling over history, should have no place in our construction of WP medical articles. There is no hurry for the reader, that we need to be thinking about, in the backs of our heads, as we write. It's an encyclopedia, not a help-me book. If we don't skip history to get the nitty-gritty for the United states and airplanes and the Universe itself, we surely have no good reason to do it for vitamin D. You know? SBHarris 23:12, 12 December 2014 (UTC)[reply]

i've said all i have to say. good luck! Jytdog (talk) 23:28, 12 December 2014 (UTC)[reply]

Jytdog, you say "Doc James reverted him on the basis of MEDMOS". He didn't. I thought I was quite clear. I thought the guideline was quite clear. The guideline gives no basis for the revert. There is no community consensus for setting section headings in stone. Sbharris should, feel free to have and to order sections how best for each individual article. It is quite understandable that when people get stupid things forced on them that they rant and complain. I wish WP:MED would wake up and realise is has a long-term editor-behaviour problem here rather than reach for the auto-defence button whenever "on our ours" gets attacked. I personally would like to see a topic ban on Doc James arranging/reverting article sections. One only has to look at the contribs to see such actions are not done on the basis of deep thought and considered work on an article, but randomly like guerrilla warfare and it seeds editor discontent. But I have better things to do with my life that battle against a project which chases experts away [3][4] and has completely forgotten our Wikipedia:Editing policy in favour of fighting good-faith editors. -- Colin°Talk 08:24, 15 December 2014 (UTC)[reply]
HI Colin thanks for the ping. I wasn't defending Doc James at all. When I wrote "on the basis of" I just meant "that's the reason he gave." I actually supported what you said - that selection and order of sections in a given article depends on consensus of the editors working on that article. Because sectioning depends on consensus, making a big change from the standing version also requires consensus. consensus! MEDMOS provides some foundation for a discussion (it is a guideline) to reach consensus but is especially not normative for sectioning, due to the explicit disclaimer in that part of MEDMOS. Did you not find all that in what I wrote? I am sorry if you didn't - that was my intention. Jytdog (talk) 14:13, 15 December 2014 (UTC)[reply]
Jytdog, thanks for the clarification but you are supporting what James did -- that SBHarris was wrong to change the order without gaining article consensus first, and hence James right to revert (even if the edit summary is wrong). I'll tell you why this is wrong: it isn't how James is allowed to edit. Every time this happens, I see WP:MED members rise to the defense of WP:OWNership with an "ends justifies the means" or "some collateral damage expected" or even with utterly non-policy justifications like "consensus before edit". On the 12th October 2013, James reordered the sections "per MEDMOS" without any article talk page discussion at all. I've seen this OWNership before and it drove off an expert. Everyone else is "required" to gain consensus for making changes except the one editor with all WP:MED articles in his watchlist.
Today, Jimbo wrote: "I don't think it's possible to recruit experts without warmness and welcome mats. If we want good contributors, we need make sure that when they are newbies they are supported and made to feel welcome. The myth of "good contributors are naturally cantankerous" is just false and it's a shame that some in the community think that it's worthwhile putting up with nasty people if they make good contributions - what they miss is how many good contributors we lose when the culture is not healthy, especially for newbies." Now I wouldn't use the word "nasty" in this situation, but plenty other adjectives are suitable. The "does a lot of good work" editor-defense is busted. Consensus is not another way to spell "agree with me". I appreciate that many WPMED members feel they are in a battle but you are attacking good faith editors, established and newbie, by hitting the revert button whenever the last edit in an article in your watchlist doesn't have your name on it. MEDMOS does not exist to piss people off who might otherwise make a contribution to article content. Seriously, "gain consensus before editing" is not policy. Do you really think WP was founded on this principle? Do you really think you will attract editors if the first thing they have to do is explain to a group of people, none whom are remotely expert in your subject, why your edit is an improvement and get the majority to agree? Has an article ever been written by endless RfC? Or when editing an article on a vital body chemical, one first has to explain why this is not the same as a pharmaceutical drug in order for the MEDMOS police not to revert your edits? Do these things make this a welcome place? Are these edits warming or chilling? Is "rv per MEDMOS" a sign of a healthy culture or an dysfunctional insular one? -- Colin°Talk 14:49, 15 December 2014 (UTC)[reply]
Hi Colin, I am very interested to hear your thoughts on the fundamentals of editing in WP. (I mean that, and I will start a thead on your Talk page to continue). As far as I can see this page is for talking about MEDMOS and to the extent this thread is OK (the vitriol and personal attacks are really not OK) it is about a) changing the order of sections in MEDMOS and b) the "authority" of sections described in MEDMOS. I've said all I have to say on that, and I don't see how this thread can progress much further. Action items are proposing a change to the order of sections (really a matter for another thread) and strengthening the disclaimer language (also a matter for another thread), in my view. To the extent you are concerned about Doc James editing style that would be a matter for RfU or RfA.... but I really am interested in what you say about the basics of collaboration here. I'm not sure I agree but want to hear more. Thanks. Jytdog (talk) 14:55, 15 December 2014 (UTC)[reply]
I agree this page is for talking about MEDMOS, which includes how MEDMOS should be used. The thing I'm most concerned about is that this is the umpteenth time I've seen editors get upset with "per MEDMOS" reverts/changes. And yet when it is raised, and "no, MEDMOS doesn't say that" is clarified for the umpteenth time, nothing happens to the editor abusing MEDMOS. Instead, we see the poor good faith editor gets attacked for being upset and is told fairy stories about the made-up fictitious policy called "gain consensus before you dare edit". But for umpteenth time, it is trivial to discover that the editor who claims this fictitious policy (which you repeat) doesn't actually believe it applies to himself: he edits without prior consensus. And if you look further back, you see History was put up the top of Vitamin D many years ago in some edits that rearranged sections for "better article flow", also undiscussed. That's what happens in a wiki. This wikiproject is complicit it letting editors be ill treated and rallies round to protect its own when attacked for it. I see above a mild rebuke by WhatamIdoing but nobody else daring to say "wrong about MEMDOS", "wrong about prior consensus required", "wrong to revert", "wrong to believe inter-article consistency is more important than in-article flow". If I saw those kind of comments I might be encouraged about the future of medical articles on WP. This isn't just a "Topic ban James from "per MEDMOS" edits" RfU issue. It's a WP:MED needs to sort itself out and be warm and welcoming issue. And until WP:MED fixes itself then there's no point in an RfU. -- Colin°Talk 16:07, 15 December 2014 (UTC)[reply]

I am interested in what you are saying about the culture you see as having grown up inside ProjectMed - I very much appreciate these kinds of critiques, as each of us is trapped in his or her own head, and groups do fall into bubbles or groupthink, and it is healthy to try to get out of our heads and to try to see the bubble and adjust, if things have gone astray. I have been doing some of that with regard to consensus v evidence, as you probably recall from the discussions at WT:MEDRS. I think the conversation you are trying to have here, would be more productive at WT:ProjectMed. and fwiw, the less flame-y, the less personalized, and the more clearly you identify the core issues, the more likely it will be that lots of folks will engage in a thoughtful and productive discussion... but I am sure you know that. And I am sure you know that changing culture is not something that happens overnight. (there are those who work to make change in slow and steady ways, and those who protest/riot to shake things up... it takes all kinds. I don't know which kind you are) It will be particularly interesting to me, to see how the endless war between quack-fighters and alt-med pushers fits into and affects the discussion. I would be very open to participating in that discussion there, if you want to start it. Jytdog (talk) 16:37, 15 December 2014 (UTC)[reply]

and again, I encourage Sbharris to work calmly and use WP's great WP:DR processes to try to win consensus for his vision of the Vitamin D article. that article also has some long running wars, and people with strong POVs (about what the appropriate RDA is, whether supplementation is good for anything, etc). A long and considered discussion to reach consensus on article structure would probably be a welcome change from all that. Jytdog (talk) 16:41, 15 December 2014 (UTC)[reply]
Oh may the Lord protect us from "long and considered discussions" on talk pages. Lead us not down the path of WP:DR to make good faith improvements. Save us from those who demand "consensus" is a precondition to editing.
Vitamin D:
Twice this article (at least) has been rearranged when editors read the material and felt it would be better ordered differently. Twice this article has been rearranged by an editor misinterpreting MEDMOS on multiple levels. None of these times has the editor discussed their change prior to making it. Which is absolutely per policy. Jytdog, it's personalised because it is one editor repeatedly abusing this guideline. Yet rather than appreciate the problem here, you rebuke Sbharris and claim he needs to jump though the hoops of DR and lengthy talk page discussions before he can improve the article. The core issues are an imagined MEDMOS that never existed, James, and protectionism at WP:MED. I've raised this before at WP:MED and was made to feel as welcome as Richard Dawkins at a prayer meeting. I'm raising it on this page, because it is this page where the problem has most recently occurred and made worse by this project. The response to Sbharris's original posting should have been (a) MEDMOS says nothing about vitamins and (b) MEDMOS merely suggests, not requires. Followed by a rebuke of James for yet again pissing people off over this nonsense. I await hell freezing over... -- Colin°Talk 18:36, 15 December 2014 (UTC)[reply]
ok, good luck. if you are trying to get me interested in the problem, o persuade me to help in some way, you are doing the exact opposite. I am done here, and unwatching. Jytdog (talk) 19:32, 15 December 2014 (UTC)[reply]
Jytdog, you are part of the problem, so I don't expect you to welcome what I'm saying. On 11th December, James added a Society and Culture section to Vitamin D. It contains sub-headings on dietary reference intake (a health/nutrition guideline), dietary sources, and industrial usage. I await reports of recreational vitamin D usage or references in popular music. The edit summary did not say how this improved the article. The talk page did not seek consensus among editors for this change. This is (currently) the only vitamin article with such a section. Why would anyone add such a ridiculous section with such inappropriate content to this article? Because MEDMOS has such a section for Drugs. Why did this edit not elicit a WTF reaction from WP:MED members? You guys all know this has been going on for years. It is loosing you editors. Do something about it. -- Colin°Talk 20:15, 15 December 2014 (UTC)[reply]

saw your ping. Sorry you think i am part of the problem. You appear to me, to very angry and disappointed and bitter and helpless-feeling about where things stand - I am ignorant of the history of how we got where we are, and it is clear you lived through it. i really am sorry. But you seem so angry that I don't know how to talk productively with you, and I am uninterested in being a surface for you to grind your anger on. I think things could be improved too. If you want to actually talk, I would be very interested in that. For now, I really don't see a way forward in this particular conversation. Jytdog (talk) 20:28, 15 December 2014 (UTC)[reply]

I'm not really sure how you psychoanalysing this is relevant. Do you have a different reason for why James can reorder the sections at will without being told to seek consensus beforehand, but those who disagree with him must? Is that just something I am imagining or making up? Do you have another explanation or support for the "Society and Culture" section addition to vitamin D? Perhaps I missed the "long and considered discussion" before making such a radical and unique change to a vitamin article. I guess vitamin D has cultural aspects I was hitherto unaware of. Are you aware that WPMED lost a newbie neurologist who was treated like a vandal, had "per MEDMOS" forced upon him, and was required to follow pre-consensus WP:DR steps before making any edits to an article that isn't even controversial. We're making the same mistakes. -- Colin°Talk 20:59, 15 December 2014 (UTC)[reply]
I wasn't aware of the Talk:Epilepsy debacle until today, and it was certainly rather depressing to read. But there were a number of editors in those discussions, and it is not unreasonable to say that a consensus of sorts prevailed, though a narrow one. Nobody could accuse James of lacking boldness in his editing, but he is extremely active and productive all over the subject area, and naturally has a lot of respect from other editors. If he sees a consensus against him in a discussion he will respect that in my experience. But yes, he often won't initiate the discussion; you have to do that. The lobby for a consistent set of section headings is strong, certainly for diseases/conditions. Wiki CRUK John (talk) 22:26, 15 December 2014 (UTC)[reply]
John, this project could do with reassessing it's automatic "is extremely active and productive" defense and really examine the edits and behaviour. Other projects have their own highly productive but ultimately wikipedia-destructive editors. If you followed Jimbo's speech at Wikimania you will be aware of his call for us to stop supporting this so blindly. There is absolutely no reason why Epilepsy should have been become the kind of article where dispute resolution and seek-consensus-before-any-edit measures were enforced and there is one editor to fault for that. No reason at all why educated gentlemen could not have cooperated on that article. I see the same thing happening at Vitamin D. We now have the (shamefully short) paragraph on dietary sources of vitamin D placed inside the ridiculous "Society and culture" section. The actual article is largely unreadable with highly technical sections at the beginning. Does anyone here not boggle at that? Why should any editor here be forced (as above) to do battle with such misguided and unthinking behaviour? There is zero, absolutely zero, consistency among vitamin articles and zero absolutely zero reason to treat a vitamin like a pharmaceutical drug (no more than sugar or fat). And even if we were dealing with a drug, there is zero support in MEDMOS for demanding inter-article consistency in the face of reasonable article-flow rationale. Such consistency is a very low-down-the-priority-list "nice to have". I once also blew the trumpet for James and defended his over-enthusiasms, but when I actually found myself on the other side of the dogmatic editing style, complete ownership of articles, and actually examined the edits... I was sorely disappointed. The text, such as any makes much sense, really does not match the sources, and the real experts are chased away by our very own Randy in Boise MD. The MEDMOS that I helped create is being used to wreck vitamin D and when someone comes here to complain they are chased away and told they should learn to edit-by-consensus always. -- Colin°Talk 08:40, 16 December 2014 (UTC)[reply]

"Mechanism" or "Biology"?

I would like to propose "Biology" as a section heading for disease articles, in place of "Mechanism".

While I fully support the communication/accessibility aims of adopting "Mechanism" as a heading instead of "Pathophysiology", I do have serious misgivings about the appropriateness of the term. As I mentioned at the meeting before Wikimania at CRUK, I've spent years trying to help writers deploy the term appropriately , reserving it for (postulated) biological mechanisms of disease, rather than pathophysiological considerations in general. I think our current "Mechanism" sections tend to concern the biology of the disease in question, rather than the actual biological mechanisms. (For instance, a reported association between a given disease and a particular gene mutation is not in itself a mechanism; researchers look for mechanism/s to explain the association.)

In the discussion here regarding the change, Blue Rasberry raised a somewhat related concern. I suppose I should really apologise for not coming up with this alternative proposal at the time.

Wouldn't "Biology" be just as simple as a heading... And rather more correct? 109.158.8.201 (talk) 12:03, 27 December 2014 (UTC)[reply]

I have never seen the term used like this. Do we have refs that use it this way? Doc James (talk · contribs · email) 12:57, 27 December 2014 (UTC)[reply]
Well, "biology of disease" is used quite commonly (eg [5], [6], etc). I agree that "Biology" [of disease] is not a straight synonym for "Pathophysiology" (which regards the study of disturbances in organic function [7]), but imo the two concepts are closely enough related (per [8]) for our purposes. In practice, I think "Biology" [of a disease] is a suitably broad term to cover the kind of content that normally goes into these sections, including genetics, molecular biology, pathophysiology, biomechanics, etc, etc. 109.158.8.201 (talk) 13:55, 27 December 2014 (UTC)[reply]
I think we first need to get our definitions straight. The MOS currently reads:
Shouldn't the link be changed from pathophysiology (functional changes associated with or resulting from disease or injury) to pathogenesis (source or cause of an illness or abnormal condition)? Boghog (talk) 13:33, 27 December 2014 (UTC)[reply]
The difference between "pathophysiology" and "pathogenesis" is analogous to "mode of action" (cellular) and "mechanism of action" (molecular). So on second thought, perhaps the scope of this section should include both. Hence "biology" (including molecular biology) for a section heading may not be such a bad idea. Boghog (talk) 14:03, 27 December 2014 (UTC)[reply]
(edit conflict) Agreed... My impression is that what actually tends to go into these sections is often (though certainly not always) basically information about the "biology" of the disease, which often gets relatively little coverage elsewhere in the article. Obviously, I think there should be nothing here to prevent (sub-)sections on the "Mechanism/s" [of the disease] / Pathogenesis. 109.158.8.201 (talk) 14:12, 27 December 2014 (UTC)[reply]
A revised definition would then read:
Yup, that'd be good, imo. 109.158.8.201 (talk) 14:14, 27 December 2014 (UTC)[reply]

Mechanisms of drugs are often as much about chemistry as biology. Most of the antihyperphosphatemia drugs act by mechanisms in which anything that could reasonably be called "biology" is peripheral. Ditto for bile acid sequesterants. Nucleosides have been around for 60 years, but sofosbuvir is the antiviral of the decade because of better chemistry - its a prodrug that overcomes barriers to oral bioavailability and drug entry into cells. Cancer drugs alkylate DNA and penicillin alkylates PBPs. Forgive me if I'm sounding partisan here, but as someone who spent 20 years in drug discovery as a medicinal chemist, I see calling mechanism "biology" akin to calling Europe "Germany". Formerly 98 (talk) 14:24, 27 December 2014 (UTC)[reply]

Please keep in mind that there are two sections in the MOS, one covering diseases and a second, drugs. I completely agree with you on the later (I have also spent 20+ years in drug discovery as a medicinal chemist), but the current discussion is about the former. Boghog (talk) 14:35, 27 December 2014 (UTC)[reply]
Per Boghog's comment (edit conflict), please note that my proposal only regards articles on diseases etc. (Also, as regards biochemical considerations in disease articles: in the biomedical context at least, "biochemistry" is generally commonly considered to be a branch of the "biological sciences" [9].) 109.158.8.201 (talk) 14:46, 27 December 2014 (UTC)[reply]
Or maybe the reverse?. ;-) Boghog (talk) 15:23, 27 December 2014 (UTC)[reply]
Well, yes... and certainly in the context of Life, the Universe and Everything ;-) (though I think it should be ok within this particular editorial context). 109.158.8.201 (talk) 15:47, 27 December 2014 (UTC)[reply]
While meant to be humorous, the cartoon does accurately reflect an underlying reality. Biochemistry is the chemistry of life and the ultimate molecular explanations of disease are fundamentally chemical in nature. Boghog (talk) 13:40, 28 December 2014 (UTC)[reply]
...and fwiw, my allusion to the book was meant to be a humorous take on that ultimate mechanistic point. 109.158.8.201 (talk) 15:44, 28 December 2014 (UTC)[reply]
On a serious note, I don't see anything about the definition of biochemistry as "the study of the composition, chemical structures, and chemical reactions of living things" that defines it as a part of biology. I interpret that definition as saying exactly the opposite. The words "biology" and "biological" don't even appear in the definition. "Composition", "Chemical structure", and "chemical reactions" are all clearly refering to chemistry. I'd also note that the most widely cited biochemistry journal is published by the American Chemical Society.Formerly 98 (talk) 15:44, 27 December 2014 (UTC)[reply]
Seriously, I think the position on the MeSH tree of "Biochemistry" beneath "Biological Science Disciplines" highlights the editorial sense, at least from a broadly biomedical perspective. 109.158.8.201 (talk) 16:15, 27 December 2014 (UTC)[reply]
Not to quibble, but MeSH also lists biochemistry as a subdiscipline of chemistry. Formerly 98 (talk) 22:43, 27 December 2014 (UTC)[reply]
Fwiw, my point was that it can be seen as a branch of the biological sciences (not that it must be seen in that way). 109.158.8.201 (talk) 00:45, 28 December 2014 (UTC)[reply]
...or to put it another way: Is the broad term "Biology" (as used in "biology of disease", tumor biology, etc, etc) editorially pertinent here? Imo, yes. And I'm suggesting that this term doesn't suffer from the semantic restrictions and associated editorial inconsistencies to which the current advice to use "Mechanisms" (as in "pathogenesis") as a heading is almost inevitably prone. 109.158.8.201 (talk) 16:45, 27 December 2014 (UTC)[reply]
Yup, the proposal only regards articles on "Diseases, or disorders or syndromes". I think "Biology" could be a reasonable default term, per Boghog's wording above (fwiw, personally I'm not a fan of editorial straightjackets, but I realize other editors' mileage on editorial flexibility varies). 109.158.8.201 (talk) 16:03, 27 December 2014 (UTC)[reply]
I oppose the use of "Biology" as the preferred heading, because it is actually too narrow and ultimately not descriptive. I find "mechanism" more useful because it describes how a particular condition arises and leads to symptoms. When I hear "biology" I think of diseases caused by other organisms, but it wouldn't be the term of choice in conditions that relate to physical phenomena (e.g. trauma or poisoning). I think I am with Formerly 98 here. JFW | T@lk 22:26, 27 December 2014 (UTC)[reply]
Well, that's certainly a fair enough view, and I agree we shouldn't be forcing square pegs into round holes – a possible concern imo with having a single default heading. In that case, should we expect "Mechanism" sections to focus specifically on "how a particular condition arises and leads to symptoms"? Frankly, that's not what I'm always seeing at the moment. And I'm not at all sure it would be desirable to restrict ourselves in that way... 109.158.8.201 (talk) 00:43, 28 December 2014 (UTC)[reply]
I also oppose for similar reasons. "Mechanism" is a more useful and appropriate title. --Tom (LT) (talk) 23:04, 27 December 2014 (UTC)[reply]

Arbitrary break - 2c

  • Following the opposition expressed above I'll withdraw this specific proposal. At the same time, I'd like to reiterate that I think the editorial issue it was trying to address is genuine. For instance, in a cancer article we really shouldn't need to be providing highly relevant content (which doesn't seem to fit in elsewhere under MEDMOS) about the clinical significance of precancerous lesions in a section (titled "Mechanism") regarding tumor biology. But that's how it seems to turn out at the moment...

    Fwiw, my own 2 cents would be that MEDMOS is trying to do too much, in that it's seen simultaneously as a Help guide for newbies and a style manual for everyone, as well as a sort of checklist for GA/FA, etc. And so it ends up being inappropriately rigid, and (arguably) editorially stifling. But that's a separate issue really... 109.158.8.201 (talk) 12:22, 28 December 2014 (UTC)[reply]

Mechanisms I think is sufficient Doc James (talk · contribs · email) 13:18, 30 December 2014 (UTC)[reply]
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