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Merged Archive WikiProject Preclinical medicine: 1 Merged Archive WikiProject Clinical medicine: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 WikiProject Medicine Archives: Index, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171

Black box warnings project

I was disturbed to find that some drugs with FDA-mandated Black box warnings have articles that are missing any mention of the box or the risk. It's disturbing to me that someone would create a page and mention minor side effects but leave this out. Looking to drum up interest in a project to programmatically identify and (manually?) remedy all such articles. Anyone? RudolfoMD (talk) 02:31, 4 August 2023 (UTC)

Does anyone know of an official list of drugs with black box warnings? WhatamIdoing (talk) 16:53, 4 August 2023 (UTC)

Not reliable, but a starting place: https://pharmafactz.com/list-of-black-box-warnings/

Better ? https://hospitals.vchca.org/images/pharmacy_hca/20200623_BBW.pdf

SandyGeorgia (Talk) 17:01, 4 August 2023 (UTC)

Good question. Neither of those sources lists Brincidofovir.

I have made a complete list: https://nctr-crs.fda.gov/fdalabel/ui/spl-summaries/criteria/343802 (query: https://nctr-crs.fda.gov/fdalabel/ui/#/search/spl-summaries/criteria/343802) using The FDALabel Database. It allows Presence of... specific sections of the prescribing information (e.g., BOXED WARNING) per the main page documentation. It produces a result of >16k labels with boxed warnings. https://nctr-crs.fda.gov/fdalabel/services/spl/summaries/csv/criteria/343802.

Broad strokes: It seems like it would be appropriate to put the relevant info into wikidata and have https://en.wikipedia.org/wiki/Template:Infobox_drug#Input_from_Wikidata cause it to be displayed.

RudolfoMD (talk) 05:14, 5 August 2023 (UTC)

That could be a useful approach. User:Andrawaag, is this Wikidata idea something that User:ProteinBoxBot could handle? One would ideally want both to have the information added to Wikidata and also to have the bot watch for human-involved errors. WhatamIdoing (talk) 00:18, 6 August 2023 (UTC)

Thanks for the feedback and relaying the idea to @Andrawaag. If we proceed, this way, how is sourcing handled? In each article or in Wikidata?

(Since opening this discussion, someone reverted my fixing the omission of the fact that a drug had a black box warning. That omission is what prompted me opening it. https://en.wikipedia.org/w/index.php?title=Brincidofovir&diff=prev&oldid=1168856210 ) RudolfoMD (talk) 04:51, 12 August 2023 (UTC)

@RudolfoMD, I think that a "both/and" approach to sourcing is better than "either/or". Sources are pretty easy to add in Wikidata. It doesn't look easier, at first glance, but all you do is:

1. Look for "Add references" to the side of whichever detail you're adding a source for, and click on it;
2. In the confusing little box, start typing in the kind of source you're adding (e.g.,: "URL", "PubMed", "PubChem", or "ISBN");
3. Choose the correct item from the list (e.g., "PubChem CID" if you have the official compound id number);
4. Paste the id number/URL into the next field.
5. Click "publish" for the item (about 2–3 cm above where you originally clicked on "Add references").

It handles everything else about the citations automatically.

Here, of course, you need to supply a source. I suspect the reason @Sundayclose reverted you is because you added a source in ==External links== instead of in <ref>...</ref>tags. (For the actual purpose of Wikipedia:External links, your link to PubChem should replace the dead URL that's there now, rather than being added after it, and we don't usually put those in citation templates. I'll go fix that now.) WhatamIdoing (talk) 23:20, 12 August 2023 (UTC)

NB: I'm proposing a project to programmatically identify and remedy all such articles. Not go through 16,000 drugs, and for those with articles, perform manual steps on each of a significant fraction of them! Maybe this (WT:MED) isn't a good place to connect with folks with the relevant skills.

Idea! I'm thinking a smaller / more feasible project would be to add those of the 16,000 drugs with articles to a category - i.e. Drugs with Black Box warnings, and with the https://nctr-crs.fda.gov/ citations on the category page. User:Andrawaag - any thoughts on this (or the original) idea?

PS This is a good place to establish if it's an uncontroversial bot task; if it is, we could make a WP:BOTREQ - hopefully a good place to connect with folks with the relevant skills. RudolfoMD (talk) 09:46, 1 September 2023 (UTC)

RudolfoMD, your ping above to Andrawaag will not be received by them because you added it on to an already existing post. See Help:Notifications; for a ping to work, it has to be a new post with a fresh signature. SandyGeorgia (Talk) 11:03, 1 September 2023 (UTC)

About the category idea: How would you handle former black boxes? Remove the category, or keep it (because it used to have one)? WhatamIdoing (talk) 16:02, 1 September 2023 (UTC)

It might also be possible to add that information (and a source) as a comment on the US legal status to {{drugbox}}. See Template:Infobox drug/legal status for more information on that. WhatamIdoing (talk) 16:05, 1 September 2023 (UTC)

Are most readers in tune to categories? I think the infobox idea might be better ... SandyGeorgia (Talk) 16:48, 1 September 2023 (UTC)

Page views say that more readers go to cat pages than editors. (I assumed that they were really just being used by editors, and I asked someone at work to pull the numbers for me. I was wrong. The skew isn't as huge as, say, page views for a popular page like Taylor Swift, but some readers do use them.)

It would be possible to do both/and. In fact, the infobox could trigger the category. WhatamIdoing (talk) 01:34, 2 September 2023 (UTC)

Do other competent authorities have similar schemes - if so should they be considered for addition to articles as well?Nigel Ish (talk) 17:33, 1 September 2023 (UTC)

EMA has the inverted triangle, drugs under additional monitoring but not really comparable. Was trying to see if these could be found through DrugCentral, but it doesn't look like it's possible, only get the U.S. labels it seems. fiveby(zero) 17:50, 1 September 2023 (UTC)

PMDA has Yellow Letter / Blue Letter, eg. Diclofenac etalhyaluronate "Shock and anaphylaxis by Joyclu 30mg intra-articular injection" fiveby(zero) 18:10, 1 September 2023 (UTC)

EMA = UK European Medicines Agency; PMDA = Japan Pharmaceuticals and Medical Devices Agency.

It's beginning to sound like this is too much for an infobox, and maybe it could be a template similar to {{Medical condition classification and resources}} SandyGeorgia (Talk) 18:38, 1 September 2023 (UTC)

Don't let me complicate something that started out as a more straightforward task, just looking for other resources. fiveby(zero) 19:13, 1 September 2023 (UTC)

We're already listing regulatory approval in several countries; we could change the infobox item from something like:

• US: ℞-only
• EU: Rx-only

to:

• US: ℞-only ◼︎
• EU: Rx-only ▼

(Ideally with links under the symbols and citations to support the claim.) WhatamIdoing (talk) 01:38, 2 September 2023 (UTC)

I anticipate that

• US: ℞-only ◼︎
• EU: Rx-only ▼ would be incomprehensible to a large fraction of users, and
  • US: ℞-only ◼︎⚠️
  • EU: Rx-only ▼⚠️ would be a bit better, but not good... And I agree with fiveby. Success seems more likely if we aim to achieve a small task at scale. At least until someone with bot skills shows interest. (If that's someone already reading or commenting, please speak up; I've not seen anyone say they have any.)

RudolfoMD (talk) 23:26, 8 September 2023 (UTC)

I've got some domain knowledge and could help out with code. I'm a little surprised that there is not an existing bot verifying {{drugbox}}. Looks like CheMoBot by Beetstra and BogBot by Boghog are doing some work, but do not verify against any external compendia. If we go to the trouble of adding a field to the infobox, should probably later add a task to verify the existing fields in passing.

There's also a little ethical issue here. Once we start supplying drug warnings i think it kind of imposes a duty to be accurate and up-to-date.

Should get some feedback from those bot authors already touching the infobox before starting. fiveby(zero) 01:06, 9 September 2023 (UTC)

Well, after looking at some of the drug articles and thinking about this more, i don't think i want to touch any of those articles, sorry. fiveby(zero) 03:37, 9 September 2023 (UTC)

Thanks for that. It would be helpful if you could explain what discoveries led to your hesitance - what hurdle or hurdles your looking at some articles made apparent, especially any surprising ones. (I accept you are free to choose, of course.)

Would it be right to say that the ethical issue you raise is very close to one that exists for those other bots editing drug articles - in that once a botmaster starts supplying drug info arguably it might impose a duty to keep it up-to-date? Or are they thus far all adding info that can't become out-of-date? I doubt that the FDA often removes black box warnings. RudolfoMD (talk) 08:29, 9 September 2023 (UTC)

As far as hurdles go i think the presentation to the reader would require the most consideration and a few other issues would probably arise. Labels are for a drug product which the consumer has in hand whereas the WP articles are for the drug and in some cases drug combinations. Just technical issues which can be overcome and i think what you suggest would be a doable and fairly simple improvement.

But looking at the drug articles they are listing contraindications, adverse effects, and interactions. They are purporting to provide comprehensive consumer safety information. I'm sure editors are covered by the medical disclaimer, but that is buried in the footer and two clicks away—in my opinion not good enough for the reader. You were disturbed to see the black box warnings missing from articles, i'm leery of attempting to provide drug safety information at all. I would want to have a professional i could trust looking over my shoulder to ensure i was doing things correctly and that it was an actual benefit to the reader vs. simply sending them elsewhere to obtain that information.

I don't see that the other bots are touching anything that would be a safety issue, tho i could be wrong. fiveby(zero) 15:19, 9 September 2023 (UTC)

Glad to see you back at work, RudolfoMD; if you all come to some consensus on this, and can develop a clear algorithm, you're more likely to get attention via a post to Wikipedia:Bot requests. But that shouldn't be initiated without a clear algorithm. SandyGeorgia (Talk) 16:06, 9 September 2023 (UTC)

"A clear algorithm" in this case probably means a list of drug articles with the source that supports the claim. Once that information is in hand, it might even be possible to use WP:AWB to do it, especially if the goal is just to put an item in the infobox. WhatamIdoing (talk) 22:30, 9 September 2023 (UTC)

But, a list of drugs (and their UNII FDA UNII identifier issued by the FDA / Unique Ingredient Identifier) with the source that supports the claim is in my 05:14, 5 August 2023 (UTC) comment, above. So what is lacking?

Wikidata

I looked at adding the info to Wikidata. https://www.wikidata.org/w/index.php?search=Q879952&title=Special%3ASearch&profile=advanced&fulltext=1&ns120=1 indicates that no entries use the property Boxed warning (Q879952) yet, right? So what's a good / is there one correct way to add to WikiData info on which drugs have boxed warnings (i.e. FDA-mandated Black Box Warnings)? I just can't grok what statements I should add.  I don't see that binary values are supported (0/1 or No/Yes...). Can someone add the info for one drug, like maybe add Q879952 in a way they think is correct, for, say, acetaminophen? RudolfoMD (talk) 02:48, 20 September 2023 (UTC)

Requested move at Talk:Sluggish cognitive tempo#Requested move 12 August 2023

There is a requested move discussion at Talk:Sluggish cognitive tempo#Requested move 12 August 2023 that may be of interest to members of this WikiProject. —usernamekiran (talk) 08:39, 30 August 2023 (UTC)

• commented--Ozzie10aaaa (talk) 12:36, 1 September 2023 (UTC)

Pharmacists can order Jynneos (Smallpox vaccine). NPOV issue.

I'm not sure how to edit Smallpox vaccine to say so but Pharmacists can order it (in US), but the article says it's Rx-only (in US) https://www.uspharmacist.com/article/pharmacists-staff-can-provide-monkeypox-vaccines-therapeutics#:~:text=Pharmacists%2C%20Staff%20Can%20Provide%20Monkeypox%20Vaccines%2C%20Therapeutics Can someone help?

Separately, I could use some input at Talk:Pneumococcal polysaccharide vaccine#Relevant? Vaccine injury claims are not covered by the US National Vaccine Injury Compensation Program (VICP). re. the article having a NPOV. RudolfoMD (talk) 08:16, 31 August 2023 (UTC)

Replied there (after seeing the claims at WP:ANI). SandyGeorgia (Talk) 13:42, 31 August 2023 (UTC)

naloxone and issues from perspectives of administering personnel

Naloxone

I think this section is inappropriate, but I have a feeling that arguing about it will bad for my health. Posting here in the hope that someone else may feel motivated to ride in to the rescue. Prezbo (talk) 06:16, 5 September 2023 (UTC)

Discussion at Talk:Naloxone#Reaction_following_reversal_with_naloxone Graywalls (talk) 07:21, 5 September 2023 (UTC)

Why would you change the section heading?[1]Prezbo (talk) 07:33, 5 September 2023 (UTC)

I believe the new heading summarizes it better, because it is a content dispute. Do you find it disagreeable? Why not articulate your content concerns and why you believe it is undue rather than unhelpful comment like "it will be bad for my health" ? Graywalls (talk) 07:40, 5 September 2023 (UTC)

It’s rude to change text that someone else wrote on a talk page, and I’m pretty sure there’s a rule against it somewhere. But I guess it doesn’t really matter. Prezbo (talk) 07:42, 5 September 2023 (UTC)

Changing your actual comment would be, but changing the heading as far as I know is not an issue. I restored the title you originally designated. I don't really care which title is used. Graywalls (talk) 07:43, 5 September 2023 (UTC)

Changing POV section headings in centralized noticeboard discussions is not especially rare. Ideally it'd be by an uninvolved editor, but honestly, uninvolved editors don't tend to touch "posting here in the hope that someone else may feel motivated to ride in to the rescue" conversations on this page. (No comment on the merits.) Vaticidalprophet 07:48, 5 September 2023 (UTC)

• I've had a poke and dealt with the usual problem of dubious biomedical stuff built entirely from primary sources. But this is only part of it: the article as a whole has a lot of poor sourcing (and there's plenty of decent stuff available). Bon courage (talk) 08:48, 5 September 2023 (UTC)
  • Bon courage, Since I am not quite sure what claim constitutes "biomedical" and the threshold that relate to different types of claim, I asked RSN to clarify. Graywalls (talk) 09:22, 5 September 2023 (UTC)

    Simpler to refer to WP:BMI. Bon courage (talk) 09:42, 5 September 2023 (UTC)

    "it has not been thoroughly vetted by the community." Graywalls (talk) 09:48, 5 September 2023 (UTC)

    This warning is on the majority of the essay templates. That boilerplate in particular, however, can only be applied when there is a consensus to link directly to the explanatory essay from the policy/guideline page it is expanding upon. Little pob (talk) 11:51, 5 September 2023 (UTC)

  Overall, I think Bon courage is correct that we could improve the article with a couple of really high-quality sources. If anyone's got 10–20 minutes and would like to find and share a "MEDRS ideal" source, I think it would be appreciated.

  Naloxone distribution is in the news in the US, and next year is election season, so this article may see some politically motivated activity in a few months, if we don't get it cleaned up before then. Solid articles tend not to attract biased "help". WhatamIdoing (talk) 16:57, 5 September 2023 (UTC)

  O God, I might have guessed US politics was in the mix . Bon courage (talk) 17:01, 5 September 2023 (UTC)

  Good idea. I added something from the UK Practice Guideline which cover the 'aggression' angle.[2] See what you think. Bon courage (talk) 17:30, 5 September 2023 (UTC)

• Was going to post a heads up here about a RSN thread relevant to this wikiproject, but it's the same subject. What I think could use some additional attention is the perspective that it is acceptable to include RS-but-not-MEDRS about medication side effects as long as the side effects are framed as merely descriptive of one professional's experience. i.e. if you frame it as the effects of naloxone then its MEDRS but if you were say framing it as the experiences of those administering naloxone ("X% of those administering naloxone experienced... ") then its no longer MEDRS. — Rhododendrites ^talk \\ 20:53, 5 September 2023 (UTC)

  Just another clever-clever attempt to try and do an end-run around MEDRS by adding a layer of indirection, reminiscent of the "if we just report what the quack doctor said, then it's reportage so not medical" ploy. However, WP:BMI is defined as (my emphasis) "information that relates to (or could reasonably be perceived as relating to) human health", so would catch this; perhaps more importantly NPOV would not be satisfied: why would any primary account of "the experiences of those administering naloxone" have any WP:WEIGHT if it was ignored by secondary sources? (and it if wasn't ignored, than those secondary sources could be used). Bon courage (talk) 04:38, 6 September 2023 (UTC)

  I think the RSN point someone made about trying to come up with a "sociological" rather than "biomedical" angle was just your typical "trying to look clever on the internet but not actually helping" which was then swiftly rowed back on multiple timed when they realised that. When faced with someone pushing an agenda, that is not the time to have an intellectually nuanced argument about edge cases. And anyway, "sociological" is about things like the US election causing an increase in agenda pushers at Wikipedia, not about whether the emergency service staff experience violence from the patient immediately after administering one particular drug. It's a "bigger picture" subject. -- Colin°^Talk 08:19, 6 September 2023 (UTC)

Reader research

The new article, "I’m comfortable with it: User stories of health information on Wikipedia" at https://firstmonday.org/ojs/index.php/fm/article/view/12897/11286 might be interesting to editors here.

WhatamIdoing (talk) 19:23, 6 September 2023 (UTC)

Mediation @ Biological effects of high-energy visible light

Hey folks, can I get some mediation at Talk:Biological effects of high-energy visible light#Dermatology before I resort to WP:3RR? Cheers. Curran919 (talk) 14:33, 11 September 2023 (UTC)

Saturated fat

This topic has been raised before on this board regarding a problematic source, so apologises for going over old ground but input from some experienced users would be useful. Unfortunately it is always the same fringe sources that are being cited from the low-carb community on this topic. See talk-page discussion on saturated fat article regarding a 2017 meta-analysis from Steven Hamley which argues against scientific consensus. The Hamley meta-analysis has been cited before on Wikipedia talk-pages related to red meat and saturated fat. It was agreed that it is an unreliable source in at least 2 places, (I have lost where that conversation is, but it must be in the archive somewhere), I will try and find it but some familiar users here may remember those conversations.

The Hamley meta-analysis [3] challenges the findings of the Hooper 2012 meta-analysis [4]. The 2012 Hooper meta-analysis found a small effect, the Hamley meta-analysis found no significant effect. We have more recent and reliable data on this topic, so there is no reason to cite either of these sources.

There is a more on topic meta-analysis from Hooper which also contains a meta-regression [5] from 2020, this source is high-quality and is cited on the saturated fat Wikipedia article. I suggest that we do not cite the Hamley meta-analysis, there are many reasons for this. See the talk-page discussion. Psychologist Guy (talk) 16:55, 12 September 2023 (UTC)

@Psychologist Guy, are you looking for Wikipedia talk:WikiProject Medicine/Archive 152#Saturated Fat, shifting consensus, Cardiovascular disease (CVD), and general health or Wikipedia talk:WikiProject Medicine/Archive 164#Salim Yusuf ?

It can be difficult to explain WP:DUE weight to people who are convinced that they know The Truth™, but this is probably a question of due weight, rather than reliability per se. You might be able to pound on WP:MEDDATE if a short-term "win" is all you care about, but a WP:YESPOV approach might solve the problem long-term. That means saying that there is a current scientific consensus that saturated fat is harmful (to some degree), and that there is a significant minority viewpoint that saturated fat is likely neutral. The idea is that recognizing the existence of their POV, in a neutral manner, might make them less likely to try to change the mainstream POV to match theirs.

I suggest citing reputable medical textbooks rather than journal articles whenever possible in this article. Here are a few that might give you an idea of the options available: [6] [7] [8] [9] WhatamIdoing (talk) 21:38, 12 September 2023 (UTC)

Prediabetes

More eyes needed, thanks. See Talk:Prediabetes#Potential screening topics CV9933 (talk) 18:30, 15 September 2023 (UTC)

thank you for post--Ozzie10aaaa (talk) 13:09, 20 September 2023 (UTC)

Persistent vandal

FYI, see here. SandyGeorgia (Talk) 17:34, 16 September 2023 (UTC)

All I see is a capitalization change, which does not feel like "editing (or other behavior) deliberately intended to obstruct or defeat the project's purpose" (per Wikipedia:Vandalism) to me. It feels a lot more like "When I was 10 years old, my teacher told me to use Title case for page titles, so I'm trying to help by correcting what I believe are capitalization errors". WhatamIdoing (talk) 21:17, 16 September 2023 (UTC)

sudden unexpected postnatal collapse

I was just reading about the terrible case of Lucy Letby and was struck by a word that appears 44 times in that article with no definition: "collapses". It's not wikilinked to anything, either, so I googled it and found an awful lot of coverage of "sudden unexpected postnatal collapse". Thought about leaving a message on the talk page, but perhaps this is a better venue to solicit someone to start that article (or create an appropriate redirect). — Rhododendrites ^talk \\ 15:12, 18 September 2023 (UTC)

On the broader question of the word "collapse" in a medical context, see Wikipedia:Articles for deletion/Collapse (medical). TompaDompa (talk) 19:30, 18 September 2023 (UTC)

Human placentophagy could use help

Stumbled on this article via two clicks from De agri cultura... who'd a thunk. Anyway, I noticed it was stuffed with citations to geneabirth.com and a book called "Placenta: The Forgotten Chakra", making some dubious claims with a lot of WP:SYNTH. I cut out a lot of it, but it could still use some attention. — Rhododendrites ^talk \\ 12:37, 20 September 2023 (UTC)

Chiropractic woo through the backdoor

If you go read the article chiropractic, it says it’s a crap pseudoscience (well, in a different tone and with sources, but you get the idea). I suppose there are thousands of hawk-eyed editors watching it and all is fine.

Could any of those divert some attention to the article veterinary chiropractic? The tone there is, let’s say, more positive. The lead features all the classic hits:

• Veterinary chiropractic is a fast-developing field that is complementary to the conventional approach (Yes, there is a source. No, it is not MEDRS-compliant.)
• a holistic medical approach that focuses on restoring homeostasis in the body and allows for the body to naturally heal itself (appeal to nature)
• It cannot be placebo, placebo does not work on animals. Yes it does. Many scholarly publications stopped using the term "placebo effect" and moved on to "caretaker effect", precisely because "placebo" implies a false belief of the patient about the nature of the cure received. There’s a couple of studies demonstrating a caretaker effect in humans when the physician tells them, explicitly and clearly, that they are getting a sugar pill - but they went through the doctor’s office, examination, trip to the pharmacy etc. so they had the "ritual of healing" that triggers the caretaker effect. Rant over.
• It is not pseudoscientific bullshit. It is a controversial method due to limited evidence. Yes, for a Wikipedia editor that is synonymous, but not for the average reader.

Tigraan^{Click here for my talk page ("private" contact)} 13:51, 20 September 2023 (UTC)