Wikipedia talk:WikiProject Medicine

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List of archives

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

We need better health images — an IEG project!

Some images I've provided earlier One of the featured images I've uploaded An image showing the prevalnce of HIV/AIDS in the world as well as a cell infected by HIV. A image of the caloric reflex test

I've done a whole lot of work with images, from adding Sobotta's atlas of Anatomy to Wikipedia, working with X-rays, and contacting different organizations about errata concerning their images and uploading their works. I've also previously taken part in two rounds of IEGs for the Medical Translation Project. I want to tie these two together, focusing on getting images and videos out to a wider audience — both in English and in other Languages. Please take a look at the IEG I've drafted, all the details aren't finalized — but the focus is getting more image through collaborations guides on how to produce acquire images for Wikipedia!

If you feel this is worthwhile feel free to endorse or comment on the proposal — all your ideas are appreciated, and as the project isn't set in stone I will also respond to and criticism about what I plan on doing and what I plan on improving. Check it out here

Note: The page may see some substantial updating in the coming days

Best, CFCF 💌 📧 21:53, 12 April 2016 (UTC)

More "heat maps" would be great. We have a new tool for making these. Doc James (talk · contribs · email) 19:10, 13 April 2016 (UTC)

Created by the Gunnmap tool

Created through editing a human-readable SVG

Gunnmap is a free tool that can create heat-maps based off country data (all under a compatible license). There are also a number of other projects, and getting these to work within collaborations would be really useful, yes. Are those the tools you are referring to? CFCF 💌 📧 08:19, 14 April 2016 (UTC)

great idea, (heat-maps look good)--Ozzie10aaaa (talk) 10:30, 24 April 2016 (UTC)

May be an interesting opportunity to work with Figure_1- they might welcome a partnership opportunity. Their images are thoroughly anonymized and fairly comprehensive. Their ToS would appear to grant them at least in principle the ability to CC-BY license the images that their users upload. Richardjames444 (talk) 16:11, 30 April 2016 (UTC)

That definitely sounds interesting Richardjames444 — have you been in touch with them before, do you know if they are easy to reach out to? Carl Fredik 💌 📧 14:49, 9 May 2016 (UTC)

CFCF I have corresponded and spoken with their Community Management Associate on another relationship-building project they recently launched, and a couple of other matters. I think they're still small enough to be responsive and have been open to conversations. I would be happy to sound them out- but not sure of the wiki-process needed to approve such a thing. Richardjames444 (talk) 13:43, 11 May 2016 (UTC)

User:Ocaasi can probably point you in the direction of any relevant wiki-processes. WhatamIdoing (talk) 12:47, 12 May 2016 (UTC)

I will Be Bold and get in touch with them to see if they'll even consider the notion.Richardjames444 (talk) 19:16, 13 May 2016 (UTC)

New malaria drug (for us anyway), and broader question

I stumbled over this today: Arterolane which was pretty stubby. I started poking and lo, it was approved in India in 2012 and in a bunch of african countries in 2014, and we had nothing on that. I am going to expand it more, but here is the question.

The actual product is arterolane/piperaquine. So should I leave Arterolane stubby and create Arterolane/piperaquine and expand there, or just create the combination article and redirect it to the main molecule and expand that? Folks have created lots of (what i think are dumb) articles like Dihydroartemisinin/piperaquine as you can see in this template: Template:Chromalveolate_antiparasitics (if you look at Dihydroartemisinin you can see that all the action is there, and the combo article is just bleh/obvious). Thoughts? Jytdog (talk) 11:19, 26 April 2016 (UTC)

I think it is good practice to go with the INN. Doc James (talk · contribs · email) 18:36, 26 April 2016 (UTC)

Thanks. So you mean we should delete the articles on the combination products? INN doesn't name them separately per Drug_nomenclature#Combination_drug_products. Jytdog (talk) 23:15, 26 April 2016 (UTC)

You should follow the model used for Septra. WhatamIdoing (talk) 17:31, 27 April 2016 (UTC)

So that would appear to be the opposite of Doc James' thoughts on the matter - leave Arterolane stubby and flesh out the article on the combination drug. hm Jytdog (talk) 06:49, 28 April 2016 (UTC)

I think that is inline with what I said. This is a combination of the two INN names trimethoprim/sulfamethoxazole. I think we should continue this practice. Doc James (talk · contribs · email) 18:54, 28 April 2016 (UTC)

agree, seems reasonable--Ozzie10aaaa (talk) 09:40, 7 May 2016 (UTC)

Cervical spine disorder

This article has lots of problems. More eyes needed. -- BullRangifer (talk) 03:58, 27 April 2016 (UTC)

• Watchlisted... there's a connected contributor editor Jytdog and I encountered, their edits related to back pain and treatment have been concerning. Related AFD at Wikipedia:Articles_for_deletion/Detensor_Method. Zad68 12:54, 27 April 2016 (UTC)

This user https://en.wikipedia.org/wiki/Special:Contributions/Menalkhan92 wrote most of it and they are using refs from the inside net of the U of T. Gah. Doc James (talk · contribs · email) 18:46, 28 April 2016 (UTC)

[1][2]might be useful (update- have added on 5/9)--Ozzie10aaaa (talk) 10:50, 8 May 2016 (UTC)

Infectious disease (athletes)

Not sure what to make of this page. Reads more like a how-to page currently, though I suppose that infections related to athletes certainly could be a reasonable encyclopedic topic. Would it benefit from some pruning and a new title? Yobol (talk) 14:18, 3 May 2016 (UTC)

Agree this has potential but needs work. A variety of titles could be considered, including "sports hygiene", "infectious diseases in athletes", etc. Searching one global sports organization for "hygiene" reveals that they titled a chapter, "Infections Associated with Sports" (for what that's worth). — soupvector (talk) 15:12, 3 May 2016 (UTC)

Infections Associated with Sports, could work as a title--Ozzie10aaaa (talk) 10:43, 13 May 2016 (UTC)

Article on "basic symptoms"

I am creating an article on the "basic symptoms", referring to the subjective symptoms that precede a psychotic break; schizophrenia gets much focus here. I have not seen an article deal with this specifically, except the self-disorder and the early intervention in psychosis pages. I think it meets the standards for notability because in 2015 the European Psychiatric Association issued guidelines, backed by meta-analysis, recommending one of the subscales, the Cognitive Disturbances scale (COGDIS), in the early detection of psychosis. Another review article (free) goes over the basic symptom concept.

I would be happy to receive any feedback on this.

References

--Beneficii (talk) 15:07, 6 May 2016 (UTC)

Clarification: According to the 2nd source, basic symptoms precede a psychotic break, are present during psychosis, and tend to remain after psychosis abates.--Beneficii (talk) 15:39, 6 May 2016 (UTC)

The article has been created at basic symptoms.--Beneficii (talk) 21:23, 6 May 2016 (UTC)

It's been moved to a more specific name, basic symptoms of schizophrenia. Is that reasonably accurate?

I wonder whether it should be mentioned/linked in Symptom. WhatamIdoing (talk) 06:06, 7 May 2016 (UTC)

To be honest, I'm not sure. And yes, that name is accurate. Thank you.--Beneficii (talk) 17:29, 7 May 2016 (UTC)

Erowid as a reliable source

I've noted here before that it appears to me that an increasing number of folks are coming to Wikipedia to add content about how to make and use designer drugs.

Erowid is a pretty frequently cited source by these folks and used as an EL.

Here is what Erowid says about how they get the information on their website. Here is where they talk about how they handle other people's copyrights; they say they use stuff under fair use a lot.

I'd like to have a careful discussion about the reliability of Erowid for various kinds of content.

In my view this site:

• is not a MEDRS source for biomedical content; so citing this to support content about health effects, toxicity, psychoactive activity, etc is not reliable
• For pharmacology stuff where we often allow primary sources published in the biomedical literature, I would also say not reliable.
• For other content about legal status, history, etc I am less certain. I have taken a look at how they source stuff and some of it is pretty dicey to me - see their page on Ketamine deaths for example.
• As an EL, due to concerns about WP:ELNEVER, I would say no.

I'll note that there have been prior discussions:

• on this board here back in 2009. (not MEDRS)
• at RSN here in 2009; not much response but it was suggested "OK with attribution"
• at RSN here in Dec 2012 where the reaction was negative, one argument for it, and concerns were raised about WP:ELNEVER/hosting copyvio content
• at RSN here in Jan 2013 where some arguments for it, generally negative; again WP:ELNEVER was raised
• at RSN here in June 2014, only one response, a blanket no.

Thoughts? Am cross-posting at RSN. Jytdog (talk) 21:22, 6 May 2016 (UTC)

A lot of content on Erowid is self-published so I would generally avoid using it as a source. Sizeofint (talk) 04:41, 7 May 2016 (UTC)

Not reliable. Seppi333 (Insert 2¢) 04:43, 7 May 2016 (UTC)

What's your ELNEVER concern? WhatamIdoing (talk) 06:07, 7 May 2016 (UTC)

Apparently they host copies of copyright articles, and are pretty loose with their application of "fair use" in quoting papers. That is what I gather from the prior discussions linked above. Jytdog (talk) 14:48, 7 May 2016 (UTC)

They sound like a crowd sourcing platform so agree with others we should be using more reputable sources. Doc James (talk · contribs · email) 15:10, 7 May 2016 (UTC)

Is there any evidence that the site is using copyrighted material without permission? Erowid is a 501(c)(3) educational organisation, their site is hosted on Unitedlayer's servers in San Francisco and has been online longer than WP, it's not some rogue website hosted in Azerbaijan, out of reach of copyright holders. Prevalence 00:38, 9 May 2016 (UTC)

I have not heard elsewhere that they are hosting files without permission. Many papers in the Erowid library are not publicly accessible for copyright reasons. I infer that the content they do have publicly available they are hosting with permission. Sizeofint (talk) 01:48, 9 May 2016 (UTC)

ICD-10 and Zika

CDC map of active Zika virus transmission

Hi, all. I noticed over at the article about Zika fever that {{ICD-10}} links to the 2015 version of ICD. I'm not sure if the template needs to be updated to 2016 or not, but there's a real difference in nomenclature for Zika. The 2015 version goes to Emergency use of U06.9. In the 2016 version, U06.9 is Zika virus disease, unspecified, whereas plain U06 is Zika virus disease. It seems to me that the 2016 ICD-10 code U06 should be used in the infobox. These codes are all foreign territory to me (my background is in the physical sciences), so I thought I'd better ask here before I make any changes. — Gorthian (talk) 00:40, 7 May 2016 (UTC)

Happy to see it updated to the 2016 version. Doc James (talk · contribs · email) 15:11, 7 May 2016 (UTC)

Should I go ahead and update the whole template? Or just put in the 2016 link manually in the one article? I'm not going to touch the ICD-9-CM (though it looks even more out of date) because that one just baffles me. — Gorthian (talk) 17:22, 7 May 2016 (UTC)

do not see why not...thank you--Ozzie10aaaa (talk) 10:58, 8 May 2016 (UTC)

Medical app

Our offline medical app now has 5,000 to 10,000 downloads [3]. We have ZIMs in other languages now as listed here [4] Hope to figure out how to allow them to be added to the app soon.

Doc James (talk · contribs · email) 15:13, 7 May 2016 (UTC)

impressive[5]--Ozzie10aaaa (talk) 16:36, 7 May 2016 (UTC)

Have put together a notice to inform our readers about this here Things of maybe putting it on a dozen or so pages. Thoughts? Doc James (talk · contribs · email) 21:30, 16 May 2016 (UTC)

People get really emotional about non-content banners on article content - as we just saw with the "research" template. Seems OK to trial it on a few of the more highly trafficked medical articles (Zika maybe?) but be ready for blowback. Before a broader Phase II test an RfC would be good, and hopefully you are gathering data from this pilot that you can use to sell the Phase II.... Jytdog (talk) 21:45, 16 May 2016 (UTC)

Yes agree that may occur. How about 6 banners that rotate around our medical content with there not being more than 6 instances? Doc James (talk · contribs · email) 03:22, 18 May 2016 (UTC)

Dietary supplement NOAEL?

As a matter of general guidance for articles on dietary supplements with vague human health value, are actual data in mg/kg/day from rat studies needed for no-observed-adverse-effect level and lethal dose? This impresses as fringe information on a non-notable extract for an olive-derived supplement product at the early stages of basic and human research. See "Safety" section and talk for hydroxytyrosol. --Zefr (talk) 15:26, 7 May 2016 (UTC)

It's not up to you to judge the notability, importance, or value of the substance, which may be subject to change anyway. In the case of hydroxytyrosol, there basically exist published human studies for it.[6][7] This is a distraction from the point that a NOAEL, as per its very definition, helps separate a safe dose from an unsafe dose (once scaled for human metabolism). It is what is used when a TDI or ADI is unavailable. Hydroxytyrosol wouldn't be the first article on Wikipedia in which a NOAEL was specified, and it also won't be the last. --Hyperforin (talk) 16:16, 7 May 2016 (UTC)

Lots of unreliable/primary sources in that article (and hence undue weight and the risk of WP:OR). Have trimmed a bit. Alexbrn (talk) 16:25, 7 May 2016 (UTC)

Ebola virus disease

though not MEDRS (it is Nature), may be useful in article[8] if any editor is interested, thank you--Ozzie10aaaa (talk) 22:10, 7 May 2016 (UTC)

How does this project define abuse, misuse, self-medication, recreational and medical treatment when dealing with substance use?

Is there a consensus on how the words above are to be used in articles that fall under this project's authority? Is it purely from a legal and regulatory perspective? For example, a substance being banned means it can only be referred to as abused? If that is the case then what countries and territories take prominence? --Lo te xendo (talk) 23:54, 7 May 2016 (UTC)

We have been going with substance use disorder. Substance abuse should likely be merged into it. We use the medical terminology which has changed over time. Doc James (talk · contribs · email) 02:17, 8 May 2016 (UTC)

That didn't answer my question. Is there any distinction made between substance use and substance use that is harmful?--Lo te xendo (talk) 06:35, 8 May 2016 (UTC)

Have you found Wikipedia:Manual of Style/Medicine-related articles#Careful language yet? WhatamIdoing (talk) 06:39, 8 May 2016 (UTC)

I am not aware that this has been discussed or determined and there is nothing in WP:MEDMOS about this (there was in a very early version, that was deleted early). I guess we can use this an informal poll. I tend to use "abuse" for illegal use or harmful use (e.g. alcohol abuse).

Let me ask you something - there seems to be an influx of recreational chemists and ...enthusiasts for nootropics and other drugs. Do you know where this is coming from? Jytdog (talk) 06:52, 8 May 2016 (UTC)

Why should it be termed abuse by fiat? And how would you describe non-harmful and conditionally legal substance use, as in the case of União do Vegetal and Church of the Holy Light of the Queen with DMT and the Native American Church with peyote? Abuse should be based on harm in my opinion, as little weight as that'll carry here.

You should be happy to see the influx of recreational chemists and and other enthusiasts! Wikipedia could use more balance in this area. I don't think I'd describe , "using illegal substances is abuse" as a neutral point of view. This is especially the case given the emergence and legitimization of the transhumanist, entheogenic, psychedelic therapy and harm reduction/responsible drug use communities.--Lo te xendo (talk) 07:19, 8 May 2016 (UTC)

I tend to use "use" and just say "illicit use" or similar when necessary. Sizeofint (talk) 07:28, 8 May 2016 (UTC)

Hi Lo te xendo would you please answer my question? Thx. Jytdog (talk) 09:19, 8 May 2016 (UTC)

Jytdog I don't understand what you mean. Are you asking if there is an organized brigade of Walter Whites going on; or are you asking where this is coming from generally? I really doubt there is a brigade going on. And like I said it's probably just the people from the communities I mentioned "coming out of the closet". --Lo te xendo (talk) 14:53, 8 May 2016 (UTC)

Way to spout incoherent gibberish without answering the question of whether this is relevant or not. Has it ever come up in any discussion? Carl Fredik 💌 📧 19:53, 8 May 2016 (UTC)

We would likely follow DSM-V/ICD-10. Carl Fredik 💌 📧 10:33, 8 May 2016 (UTC)

So I see you're chuckingWP:GOODFAITH, WP:EQ, andWP:BITE out of the window all at the same time. I know I'm new here and I may be stepping on toes, but I'm just trying to understand whatever consensus there is. Try to be a little gentile dude. Remember I'm just a squishy little human like you are! --Lo te xendo (talk) 22:22, 8 May 2016 (UTC)

Lo te xendo you appear to have come to argue rather than simply talk. Please know that Wikipedia isn't a place for righting great wrongs nor for advocacy nor for use as a how-to manual. If you have any authentic questions or want to talk, I would be happy to, but I won't be participating further here for now. Jytdog (talk) 20:48, 8 May 2016 (UTC)

Jytdog,please don't wikilaywer at me. Nothing I've wrote so far can be described asrighting great wrongs, and neither advocacy, nor making ahow-to manual. I haven't even edited an actual article yet for Pete's sake. I just want to understand what the consensus is and if there is not I'd like to come to consensus [discussion]. --Lo te xendo (talk) 22:22, 8 May 2016 (UTC)

Do you believe it is credible to state you are new — and in the next post link 5 essays/policies — and to mention wikilawyering? Carl Fredik 💌 📧 06:46, 9 May 2016 (UTC)

Absolutely Carl, I've been lurking for a long while. I have a general idea of the policies and essays (I even have them bookmarked). And I'm also aware of how the social interactions play out on the talk pages: Someone waves a bunch a wikijargon at the n00bs to scare them away from mucking up their precious. That's why I mentioned wikilawyering. I'm informed enough to know that those policy links can be misapplied. You should be happy that a newbie actually bothered to read the rules before posting. 😊--Lo te xendo (talk) 09:41, 9 May 2016 (UTC)

I'm not lawyering anything; I am talking about the heart of what we are about here. If you are willing to tone it down and just talk simply I would be happy to talk. Jytdog (talk) 22:25, 8 May 2016 (UTC)

Jytdog: I don't know if this completely answers your questions, but this came up on my watchlist the other day: WT:WikiProject Psychoactive and Recreational Drugs#Task force: Inducing Altered States of Consciousness. I have no idea if it's related to your question, but it caught my attention because the first comment starts with, "We're a group of ~7 people interested in methods to induce altered states of consciousness..." PermStrump(talk) 21:01, 8 May 2016 (UTC)

That is super helpful Permstrump. I will check that out. I have been noticing this and it is somewhat troubling I had no idea that Wikipedia:WikiProject Psychoactive and Recreational Drugs even existed. Jytdog (talk) 22:42, 8 May 2016 (UTC)

JytdogI don't think my tone has been overly soapboxy or anything. I'm just concerned that you and other people here find it troubling that Wikipedia:WikiProject Psychoactive and Recreational Drugs exists. That doesn't sound like neutral point of view. --Lo te xendo (talk) 23:09, 8 May 2016 (UTC)

I believe that Jytdog means that it's troubling that he didn't know about this tiny WikiProject. It might only be that he didn't notice the name change last year. (It's the old "WikiProject Psychedelics, Dissociatives and Deliriants".) It ought to be listed at Wikipedia:WikiProject Medicine#Links.

WP:MEDMOS says The term drug abuse is vague and carries negative connotations. In a medical context, it generally refers to recreational use that carries serious risk of physical harm or addiction. However, others use it to refer to any illegal drug use. The best accepted term for non-medical use is "recreational use". That last sentence probably answers part of your questions. WhatamIdoing (talk) 23:37, 8 May 2016 (UTC)

Thanks WAID that was helpful on both counts. Don't know how I missed that when I searched MEDMOS before. ack. Jytdog (talk) 01:53, 9 May 2016 (UTC)

Because the section has almost no organization or logic to it. Your choices are either to read every single word, to have read every single word in the past (and now remember at least some of them), or to get lucky with your keyword search. And I say that as one of the editors who has worked on that section without even attempting to address its problems. If anyone's got a brilliant idea, then please "be bold". (Hmm, maybe using bold-face formatting on some of the keywords would help make it more scannable.) WhatamIdoing (talk) 06:25, 9 May 2016 (UTC)

Incidentally you're all welcome to join the project! I initiated the name change last year but the project has mostly remained dormant. I'm letting the Altered States group work out of the project for now since very little else is going on. Sizeofint (talk) 01:56, 9 May 2016 (UTC)

Most of the current language was added to MEDMOS here in March 2007. That's a long time. The last bit about "he best accepted term for non-medical use is "recreational use." was added here in Feb 2014. The guideline was under active discussion at that time and this was not discussed one way or the other. Jytdog (talk) 02:42, 9 May 2016 (UTC)

Jytdog What's your opinion on how it should be worded? — Preceding unsigned comment added by Lo te xendo (talk • contribs) 03:47, 9 May 2016 (UTC)

I think it is important that we do not fall prey to the idea that the ordinary medical use of the word is "not neutral". While this is an arguably important discussion to have — neutrality does not come into it. Using the word "abuse" to refer to any illicit or illegal use is completely fine — and entirely neutral. That said it may not be the most preferable phrasing, but we should at least get the facts straight and not give fringe views undue prominence. Carl Fredik 💌 📧 06:53, 9 May 2016 (UTC)

"Illegal" is maybe not the precise concept, either. When we speak of an "illegal drug", we mean a drug that is generally illegal for anyone to possess or sell, e.g., heroin. But it's also illegal in most of the developed world to give a prescription pill to someone who has a legitimate medical need for it. So, for example, if you have a couple of Zofran pills, and someone in your family develops nausea in the middle of the night, then it's usually illegal to give your leftover pill to your family member. The "legal" action (for lay people, at least) is to let your family member suffer until the pharmacy opens in the morning. This isn't generally considered "drug abuse" despite the illegality of it. WhatamIdoing (talk) 08:56, 9 May 2016 (UTC)

Slow your roll Carl. You haven't bothered to look at the sources you said we should follow. The ICD-10 doesn't define the use of illegal substances as abuse. It does however define Harmful use/Psychoactive substance abuse as: A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected psychoactive substances) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol).Lo te xendo (talk) 09:07, 9 May 2016 (UTC)

I'm actually not arguing for the position — only maintaining that it is not faulty on the grounds of neutrality. The points you make WhatamIdoing are valid and are conducive to a mature discussion — rather than dismissing a relevant view.

But to complicate the example you make — there are most assuredly those who would categorize the non-prescription use of any drug as abuse. It isn't sufficient to wait until the pharmacy opens as Zofran is a prescription-only drug (at least in many locales).

I for one would definitely call the non-prescribed use of antibiotics abuse, and that position is supported by a number of health agencies. (See: [Antibiotic misuse]) Carl Fredik 💌 📧 09:28, 9 May 2016 (UTC) 

References

I disagree with you on the neutrality issue Carl. Substances are not universally legal or illegal in all areas and in some cases substances are conditionally legal. This is the case with Espirita Beneficente Uniao do Vegetal and Church of the Holy Light of the Queen and Native American Church. But for some reason you called my use of them as an example "incoherent gibberish". I don't think I'm the one dismissing a relevant view here. I'm just seeking consensus and making sure that a neutral point of view is applied with due weight to all sides. --Lo te xendo (talk) 10:01, 9 May 2016 (UTC)

That was primarily directed at the brigade comment — as for sanctioned use, while it is a pretty controversial issue it also falls within the realm of legality — thus making the topic moot.

But to address the core of your argument — harm is far more difficult to define than legality. Harm is also hard to assess on a both personal and professional level, and there are very few methods which can claim to do so well.

I've had patients who when probed about their drug use say:

I don't have any problem with drugs!

While at the same time being admitted to the psychiatric ward because they assaulted people in a state of drug-induced psychosis.

Carl Fredik 💌 📧 12:26, 9 May 2016 (UTC)

As for the neutrality issue — we have to remember that the entire dialogue and what we perceive as neutral and biased is affected by our cultural norms and values:

If we had this discussion in the 1920s it would have covered calling any use of alcohol misuse. I don't think we can say that it is possible to have a fully neutral stance when it comes to value-judgements. The only possibility we have of being neutral is to gleam all available positions and then make the case for which language is to be used within which context. While the discussion is worth having I don't think it can result in any policy document, because any time we mention use/abuse it will have to rely on context with a weighing of legality, harm and any number of other relevant factors. Carl Fredik 💌 📧 12:34, 9 May 2016 (UTC)

I think this is a really good conversation to be having because I agree with the statement in the current wording of MEDMOS: "drug abuse is vague." I think we should avoid saying "drug abuse" and "drug misuse" where possible, because I've read the same exact disagreements on several talkpages that basically boiled down to misunderstandings, either between people from the UK vs US, or because editors couldn't get on the same page about whether the term was being used in a medical vs colloquial way. They are the kind of disagreements where an outsider reading in retrospect can see that they actually agree with each other, but they're both unaware of the other person's connotation with the same word. For example, in the UK, "misuse" is basically synonymous with the old DSM-IV diagnosis of "substance abuse" (substance use disorder—mild, in the DSM-5) and I've seen a couple of times where American editors changed "misuse" to "abuse" because they thought misuse sounded like it was minimizing what the source said. One of the reasons the DSM-5 got rid of the words abuse and dependence because those words have several commonly used meanings outside of their medical definition, so they changed it to avoid confusion. In practice and in research, a lot of people stopped using "abuse" and "dependence" and started using "substance use disorder" years before the DSM-5 came out for the same reason. IMHO we should avoid those terms in WP articles for the same exact reasons. I think when the source is talking about problematic use, "substance use disorder" is the best way to go (and I'd leave out mild, moderate, severe, unless that was explicitly pertinent for a particular topic). "Use" or "recreational use" seem fine to me as a more casual way to talk about using substances without implying that all recreational drug use automatically meets criteria for a clinical diagnosis. PermStrump(talk) 18:29, 9 May 2016 (UTC)

One of the delights of Wikipedia is learning something new every day. I'd have guessed that "drug misuse" meant failing to follow the directions on the label, e.g., taking a double dose of an NSAID in the hope that your headache would go away faster. WhatamIdoing (talk) 06:05, 10 May 2016 (UTC)

Wikipedia:Categories_for_discussion/Log/2016_May_7#Category:Medical_outbreaks

It is proposed to rename: Category:Medical outbreaks to Category:Disease outbreaks. Please comment there. Also Outbreak looked very dire to me (so much so I altered the lead). Johnbod (talk) 19:37, 8 May 2016 (UTC)

give opinion(gave mine)--Ozzie10aaaa (talk) 22:50, 8 May 2016 (UTC)

Medical pre-conference on Jun 22nd 2016 at Wikimania

Can people please indicate if they are planning to attend here Doc James (talk · contribs · email) 21:17, 8 May 2016 (UTC)

AfD/Prenatal and perinatal psychology

People might be interested in this AFD for the article Prenatal and perinatal psychology. The article is basically an arbitrary mix of statements related to prenatal or perinatal something, so it's hard to tell if there is actually a unified subject worth talking about. I think there might be a fringe group, but I'm not sure if it's notable enough for an article as the terms are so broad that it's hard to google. PermStrump(talk) 22:31, 8 May 2016 (UTC)

Huh. I'd have expected that to be "psychology of pregnant women", with a special emphasis on postpartum depression, identity crises, and similarly mainstream things, but the article seems to be talking about the psychology of the baby (both before and after birth). WhatamIdoing (talk) 23:40, 8 May 2016 (UTC)

I think "fetal psychology" would have been a more appropriate title, but I suppose they picked something that could be easily conflated with other things. They had me for a minute. I got there from clicking a link in the "see also section" on the child development article, so originally I thought it was supposed to be an expansion of the developmental psychology article or something, but that it had attracted a lot of fringe. I finally realized it's just straight up fringe. They also have their own definition of perinatal, which I don't think anyone else in the medical community shares. I've always heard it used to refer to the few weeks before and after birth. They consider perinatal to start at labor and last through childbirth until "establishing breastfeeding." I wonder if they consider the perinatal period indefinite for people who aren't breastfed. PermStrump(talk) 13:27, 9 May 2016 (UTC)

feature comparison pages for consumer medical devices

WP has a number of pages with tables comparing software technologies (both commercial and non-commercial). With the proliferation of medical devices being marketed to consumers, would it be appropriate to develop similar pages to compare features (not prices) for cardiac, glucose, apnea, etc., monitoring. AFAICS, there is no such wiki repository on the web; at best, such tables are rare and not updated. Given the national (and international) health focus, this would seem a most helpful addition. For examples of software comparison pages, see Comparison of open-source operating systems, Comparison of file comparison tools, and many others shown from a WP search for <comparison table software>. Thoughts and guidance welcome. humanengr (talk) 12:02, 9 May 2016 (UTC)

if such references exist Wikipedia:Identifying_reliable_sources_(medicine) for what your proposing, and is done in an encyclopedic manner..i don't see why not...--Ozzie10aaaa (talk) 12:23, 9 May 2016 (UTC)

thx, Ozzie10aaaa. The sources here would, in general and as for the software tables, be vendor literature and review articles. I would expect it to be encyclopedic as editors contribute info on devices as they learn about them. I've broached the possibility of a wiki on some fora wrt devices monitoring irregular heartbeats, and have seen some interest there. I think this is at the point where it makes sense to mock up a page in my sandbox. Agree? humanengr (talk) 17:44, 9 May 2016 (UTC)

I think you should get more opinions on this before going forward (though I don't see an immediate problem)--Ozzie10aaaa (talk) 17:49, 9 May 2016 (UTC)

thx and understood … FYI, then, there was some preliminary discussion on this at Wikipedia:Teahouse/Questions#WP policy on commercial product comparison pages. humanengr (talk) 17:58, 9 May 2016 (UTC)

Everything in the first list of open-source operating systems is free, so that's kind of different. My first thought is that it sounds like it would become WP:SPAMBAIT, even if that wasn't the original intention. Are there countries where patients get to pick which medical device their doctor uses? I'm wondering how exactly having that information in table form will be helpful/encyclopedic for the general public. PermStrump(talk) 18:43, 9 May 2016 (UTC)

My focus is on devices sold directly to consumers either in stores or online rather than devices doctors use. Re that latter set, iiuc, in the U.S. at least, folks do ask doctors about particular devices that require prescriptions. So maybe 'devices doctors use' or 'devices requiring prescriptions' would a) not be included; b) be included as a separate table; c) be included with a column to indicate those constraints? Re the 'open-source' list, I shouldn't have included that as an example. But Comparison of file comparison tools does have commercial products and has not been spammed. (That is the case for the other software comparison pages as well.) And I now see that page includes prices for the commercial products. Re utility for the general public; my entire reason for starting down this path is that I found it incredibly difficult, after seeing some devices in my local pharmacy that monitor irregular heartbeats, to identify and get specifications re the full range of such devices. HTH humanengr (talk) 19:25, 9 May 2016 (UTC)

Permstrump, the English Wikipedia is agnostic about commercialism. Nothing on Comparison of iOS devices is free. The fact that something costs money does not affect the subject's eligibility for an article at all. WhatamIdoing (talk) 06:27, 10 May 2016 (UTC)

• One of the key ways we keep promotional garbage out of our articles about health is that the guideline for sourcing content about health is MEDRS; we use reviews published in the biomedical literature or statements by major health organizations to source biomedical content (like how well a device works and whether it is safe). This is where health-related content is really different from video games or consumer products. In those topics editors are open to using low-quality bloggy sources (pushing RS as far toward bottom-scraping as it will go) but for health content we try to raise source quality. So I don't know if you could find enough good enough sources to do what you have in mind. This is probably the most surprising thing editors encounter who enter health topics from other topics within WP.

Also as you acknowledge the work would be WP:OR. We summarize accepted knowledge here, we don't create it. Also, Wikipedia is WP:NOTHOWTO and WP:NOTCATALOG. Finally, this would become an absolute magnet for spammers. We can't even list the brand name of a drug with out spammers from generic companies around the world wanting to come and add the brand for their version of a drug.

I don't think this is a good thing. Jytdog (talk) 19:57, 9 May 2016 (UTC)

• • Thx for the feedback, Jytdog. You raise a number of good QA issues. Re MEDRS: Presumably, as marketed devices have gained regulatory approval, wouldn't that cover at least some minimal standard of "how well a device works or whether it is safe"? Wrt the concern of MEDRS re "primary sources … often include unreliable or preliminary information, for example early in vitro results which don't hold in later clinical trials", not-yet-approved devices could either not be included or so marked. Re reviews: A key initial source for info on cardiac monitors would be the reviews Prof. James W. Grier has kindly put online (https://www.ndsu.edu/pubweb/~grier/Comparison-handheld-ECG-EKG.html, http://www.favoriteplus.com/prodimages/reviews/ecg-comparison.pdf). (The former was commended at http://a-fib.com/guide-to-diy-heart-rate-monitors-handheld-ecg-monitors.) But 1) there are other devices that are on the market (presumably passing regulatory criteria) not in his reviews, 2) those pages and others similar would benefit from a tabular, user-friendly, front-end. That would seem to support argument for a wiki table online somewhere for that purpose. Re WP:NOTHOWTO: This would not be a 'how to', though the reviews cited might contain some such info. Re WP:NOTCATALOG: This is more than a catalog; it would compare specifications. Reviews cited might have links to such embedded but that would not generally be included directly. Re generics: Is that an issue wrt devices as it is for drugs? Re the WP:OR issue: How do manufacturer's user manuals rank wrt that criteria? They are often the only source directly or indirectly published that clearly indicates specifications. humanengr (talk) 21:18, 9 May 2016 (UTC)

The things posted by that professor are exactly the kind of bloggy garbage sources that are not OK here but that are just fine over there in software/gadget land. A "review" is a Literature review/systematic review/meta-analysis - academic papers published in the biomedical literature. Not somebody's blog "reviewing" products. Please actually read WP:MEDRS before you reply again. Thanks. Jytdog (talk) 21:53, 9 May 2016 (UTC)

MEDRS does not address product design specifications; it addresses product performance. humanengr (talk) 00:08, 10 May 2016 (UTC)

That is true but claiming that that any design element (or lack thereof) has some better safety or efficacy does require MEDRS sourcing. Unclear to me how much you will be able to say that is meaningful. What I am saying here is my own take on things, of course. Others may differ. In general (in my view again) our coverage of medical devices needs a lot of work; I am just not happy about product guides in WP in general for the WP:OR. WP:NOTHOWTO aspect of them. Jytdog (talk) 01:34, 10 May 2016 (UTC)

I agree with the points Jytdog raised. It sounds like something that might be on Consumer Reports, but I'm failing to see the encyclopedic value and I there are several sections of What Wikipedia is not that probably apply. Besides what people have already said, I'll add WP is not an indiscriminate collection of information. To be blunt, it sounds like it would quickly turn into an indiscriminate collection of linkspam. PermStrump(talk) 02:54, 10 May 2016 (UTC)

Speaking of Consumer Reports: Bluerasberry, do you have any thoughts about this idea?

Also, Jytdog, I'm not seeing anything up there that sounds like "you acknowledge the work would be WP:OR". It sounds like the goal is to include only information that is actually verifiable in a suitable source. For example, presumably there no MEDRS issues at all in saying "only runs on Windows boxes", but that is informative. As a someone accustomed to a Microsoft-free computing environment, I would need that information if I ever had to deal with a medical device. An investor might look at a long string of "Windows-only devices" and see a market for an Android-oriented device, since there are more Android devices than Windows desktop computers in the world. I don't see any reason why this type of non-biomedical information needs to be supported by the ideal sources for WP:Biomedical information. WhatamIdoing (talk) 06:27, 10 May 2016 (UTC)

• I see two issues being discussed here. One is the value on Wikipedia of comparison articles, and the other is whether WP:MEDRS should guide a comparison article on consumer medical devices.

About comparison articles - there are many comparison articles listed at Category:Software comparisons. My personal opinion of these is that most or all of these deviate from typical Wikipedia practice of providing citations to verify content. The current practice is that these charts are made without matching their information with references. I advocate that all content in Wikipedia be matched with citations to sources, and since these sorts of articles include more original research than is allowed in other sorts of Wikipedia articles, I do not recommend this model of presentation. If somehow someone committed to making one of these comparison articles and had citations for every entry in the table, then I think that would be great. If these kinds of comparison articles could in the future be generated from information in Wikidata, then I think that would be best.

About considering consumer medical devices on par with traditional medical devices - Consumer Reports has not published deep opinions on the matter. Different staff in-house have raised this issue every week for months. Personal medical devices are sold as a consumer novelty, and come with instructions that they should not be used to guide medical decisions. At the same time, the consumer perception of the devices is that they do provide health data for guiding health care decisions, and even health care providers make decisions based on data reported by these consumer devices. There is a disconnect between how activity trackers and home testing kits are overtly marketed and how consumers perceive that marketing and respond. I would love for Wikipedia to provide clear information on the matter, but I am not aware of any organization which has published white papers or taken clear positions for consumers about what to expect of these devices. The best information that I have to offer from Consumer Reports on the matter is Better Healthcare: Your Medical Data, which is an introduction to the concept that consumer devices might produce data that can be used to influence health care decisions. Even the basics in this field are controversial and uncertain. It is difficult to know where to begin in discussing these things. If there is a discussion on this, then I expect that the sources cited would not come from medical journals, but rather from product review organizations. Those would not be MEDRS sources of the sort typically used here. Blue Rasberry (talk) 17:33, 11 May 2016 (UTC)

Would it suffice for such tables to include a caption, footnote, or field for regulatory approval and caveats? Maybe something like: "The manufacturer has provided reasonable assurance of the device’s safety and effectiveness [as per FDA]; regulatory approval does not indicate satisfaction of any specific quality standards; and (unless otherwise indicated) entries do not satisfy WP:MEDRS criteria."? Also, FWIW, Prof. Grier’s link (cited above) does broach regulatory approval issues with links to further discussion. As I now see that Prof. Grier still intends to construct a summary table, I’ll wait before proceeding further. I trust the above foray will prove helpful more generally. Thank you all for the feedback. humanengr (talk) 05:14, 17 May 2016 (UTC)

Merge Chiropractic technique articles?

There is currently discussion concerning a merge of different very short stub articles on chiropractic techniques. The articles have included non-MEDRS-compliant material as well as giving light to only one side (pro-chiropractic) — thus falling under WP:POV. The rationale for merging is that they would be more manageable.

• Wikipedia:Fringe_theories/Noticeboard#General_Discussion_of_Above_Chiropractic_Articles

Please comment. Carl Fredik 💌 📧 14:48, 9 May 2016 (UTC)

give opinion(gave mine)--Ozzie10aaaa (talk) 16:31, 9 May 2016 (UTC)

Wikipedia Tools for Google Spreadsheets

Wikipedia Tools for Google Spreadsheets is a tool which calls all sorts of Wikimedia data and places it into Google Sheets. Using Google Chrome and Google Sheets in Google Drive is required for using the tool. It is made by User:Tomayac.

I have not yet been able to manipulate the data in the way that I want, but I like that this tool gives me some way to ask questions and collect some data to answer questions that I have about Wikipedia articles and how editors and readers engage with them. I am trying to learn how to make monthly traffic reports for sets of articles - the tool seems set up to make traffic reports, but still I am having a little trouble. If there is anyone else interested in reports, I would join in discussing any part of the tool at meta:Wikipedia Tools for Google Spreadsheets. Blue Rasberry (talk) 16:01, 9 May 2016 (UTC)

might help[9][10]--Ozzie10aaaa (talk) 19:52, 9 May 2016 (UTC)

User:Tomayac the most interesting bit for me is pageviews. Is it possible to get pageviews per month rather than day out of it? Doc James (talk · contribs · email) 02:25, 10 May 2016 (UTC)

Suggested Move of High-Importance Article

I have recently suggested the move of high-importance article for this project, the West African Ebola virus epidemic to a new name. If anyone wants to look at the proposed move, it is at Talk:West_African_Ebola_virus_epidemic#Requested_move_9_May_2016. Just wanted to let this project know in case they have any discussion to add. Thanks, Gluons12 (talk) 19:56, 9 May 2016 (UTC).

• more opinions(gave mine)--Ozzie10aaaa (talk) 22:50, 9 May 2016 (UTC)

Suicide bag

Not quite sure where to bring this up, but there are several articles on suicide methods that make me really uncomfortable and I think they're arguably illegal. Not sure if the best way to handle it was to view them as medical articles and keep an eye that they're not making biomedical claims without proper sourcing or if there's some other legal avenue to pursue. They're really good using a tone that sounds unbiased, like it's an objective discussion on the ethics of suicide, but they're really just pro-suicide sites and they're really dangerous. These people like to tag anything about suicide prevention as lacking NPOV or as demonstrating a "American" perspective. Reddit and other social media sites don't allow content or even links to websites that explicitly tell people how to comment suicide. Since they can't link to these articles, people will tell each other "Google suicide bag and read the wikipedia article." I would think if this content is illegal enough for reddit, it shouldn't be on wikipedia.

I think it could be argued that some of these are encouraging suicide. The suicide bag article is about exactly how to make your own suicide bag, including a diagram, with easily accessible items. The hardest thing to get would be helium or a propane-butane mixture and the rest are household items. Then look at what links there, literally any article about bags (purses, backpacks, etc.) links to suicide bag. Suicide methods is exactly what it sounds like and this is what links there: Teenage suicide in the United States, suicide prevention. Basically any article about suicide links to an article that tells you specifically how to kill yourself. Lots of them have a handy dandy suicide infoboxes that link to suicide methods. alt.suicide.holiday is an article on former usenet group that is clearly just a pro-suicide article.

This 2012 study showed that pro-suicide content on social media can increase the risk of completed suicide because it normalizes and glorifies the act and provides people with access to information about lethal methods. It specifically mentions methods using gas. This 2015 study discusses an increase in helium-related suicide deaths as a direct result of discussion about it in online forums. There have been stories in the news over the years about people who have been convicted for encouraging suicide on internet forums. Here's one from 2010 about a woman who was convicted for encouraging suicide online. What do other people think? PermStrump(talk) 14:35, 8 April 2016 (UTC)

insofar as the article suicide bag it seems well referenced--Ozzie10aaaa (talk) 17:42, 8 April 2016 (UTC)

This might be a good topic to take to the WP:VILLAGEPUMP. Obviously Wikipedia is not censored in so far as the content is not illegal in the United States (i.e. libel and child pornography). The dividing line is not always clear though I would think in this case the line is the difference between is and ought. Sizeofint (talk) 07:29, 9 April 2016 (UTC)

The article's subject itself is notable and therefore is worthy of an entry in Wikipedia. However I am concerned that Wikipedia and/or the editors of the article might be construed as assisting suicide, especially if a high-profile case is reported in the media (e.g. "Robin learnt suicide technique from Wikipedia"). This article requires a formal legal assessment. Axl ¤ [Talk] 10:27, 12 April 2016 (UTC)

I don't know about legal assessment. I reviewed it and I think it is stays on this side of WP:NOTHOWTO. I noticed that for a while it had a suicide hotline hatnote, like this. It was taken off pursuant to this RfC at the Suicide article. Jytdog (talk) 11:15, 12 April 2016 (UTC)

Sizeofint, Did you mean the idea lab or the main village pump? I'm trying to put together a more cohesive argument so it does sound like I'm just trying to censor wikipedia. Jytdog, that's a good point about NOTHOWTO. Something definitely didn't feel encyclopedic about it to me, but I couldn't put my finger on it and I think you hit the nail on the head. I don't know if it's a coincidence or someone who read this thread, but for the past 2 days an IP editor has repeatedly removed the diagram from the Suicide bag article on the grounds that it's OR. It's a bit of a slow motion edit war. I think they each have 2 reverts now, but there have been a few hours in between each one. I wonder how long it will go on. I never would have considered arguing that an image was OR, but I think the IP has a good point. I'm not getting involved yet though, because I'd rather focus my energy on trying make a policy that specifically addresses this topic. If that fails, my back up will be NOTHOWTO for the majority of the text and OR for the image. Axl, that's also my concern (that it could be construed as assisting suicide) plus that it likely is assisting suicide based on the 2015 study that I linked above. PermStrump(talk) 18:24, 12 April 2016 (UTC)

I was talking about gaining wider input from the community at the village pump. Sizeofint (talk) 20:37, 12 April 2016 (UTC)

we have disclaimers all over the place; i see the concern about bad press but the disclaimers are WMF and as I understand it they are solid. And Permastrump what i wrote was I think we are OK per WP:NOTHOWTO. There are a few places it could be tweaked but generally it is good. There aren't actually instructions there. Jytdog (talk) 18:36, 12 April 2016 (UTC)

Hi all. I've been talking to medical doctors, researchers, and major suicide awareness charities about this article, and some others, for the past two years, with full in-person meetings every few months. Their view is that not only is Wikipedia classed as a "pro-suicide" website in terms of the information it provides, but that the occasional spikes in attention that come to these articles are probably reflected in real-life suicide attempts. They are particularly concerned about the diagram: their research indicates that the existence of the diagram does cause suicides and attempts at suicides that would otherwise not happen. We've been a bit stuck on how to move forward with this on Wikipedia, though - a big discussion about it could work both ways. Chase me ladies, I'm the Cavalry (Message me) 14:28, 14 April 2016 (UTC)

Can you tell us what standards they use to decide whether an information source is "pro-suicide"? WhatamIdoing (talk) 04:14, 15 April 2016 (UTC)

I don't know how many people are researching this so I kind of wonder if I'm about to quote any of the people Chase me ladies, I'm the Cavalry has been talking to, but here's how Collings and Niederkrotenthaler (2012), and Kemp et al. (2011) define prosuicide websites... Sites that:

• have detailed suicide instructions or descriptions of suicide methods
• advocate suicide or describe suicide methods in detail
• are permissive or encouraging of suicidal behaviors
• promote or enable suicide by describing suicide methods.

Both papers put prosuicides sites in direct contrast with "suicide prevention, and suicide support" sites that offer resources, psychological, social, or practical support to reduce suicidal behaviors. Collings and Niederkrotenthaler said, "many websites [have] life-promoting characteristics (such as the opportunity to contact a support service) and potentially suicide-promoting characteristics (such as detailed descriptions of suicide methods) have been found to be closely intertwined" This is definitely true on reddit where they like to call themselves "pro-choice" and claim to be places for "discussion about the moral, ethical, and religious implications about the right to choose the time of your own death." But they all contain links that tell you ways to kill yourself. They are NOT "pro-choice" or "suicide neutral" as they claim. Same with the Wikipedia article that sounds "NPOV." It's really just a prosuicide site that normalizes, glamorizes and encourages suicide attempts in individuals who are already high-risk. This is all supported by the studies I've linked, especially Gunnell et al. (2015). PermStrump(talk) 06:27, 15 April 2016 (UTC)

Permstrump I hear and understand your passion on this, but it seems that you want WP to take a moral stance. Have a look at Abortion. Is that a "pro-abortion" article because it doesn't have hotline information for counseling? (real question for you). I could see someone arguing that.

I also want to note that we have a whole article on Suicide methods and a Template:Suicide_sidebar. There has been some of this kind of discussion at both talk pages over the years (!) as well as Talk:Suicide and they get shot down each time. Jytdog (talk) 06:54, 15 April 2016 (UTC)

Jytdog, this isn't a moral stance, if I'm honest. The article on abortion does not tell people how to perform an abortion (especially not with at-home methods) - instead it talks about the procedure from a medical/scientific standpoint. Secondly, I would argue that our general goal - "a world in which every single person on the planet is given free access to the sum of all human knowledge" - means that we shouldn't be promoting suicide methods in the way we currently are. Moral issues aside, (and this may seem quite cold, but) if vulnerable people use the information on our site to end their lives unnecessarily, then we're not adding the the world's knowledge - we're working to reduce it. Chase me ladies, I'm the Cavalry (Message me) 14:20, 15 April 2016 (UTC)

WhatamIdoing, to answer your question: I don't know the specifics, but two key points came through: first, that Wikipedia articles are often a "how-to" guide rather than a sensible, neutral analysis, and secondly that the vast majority of people who are looking for suicide methods online turn to Wikipedia as a source.

Jytdog: Re: the abortion article, is there notable documentation in peer reviewed sources that say Wikipedia.specifically. is contributing to a public health issue by facilitating people to follow through with abortions that are illegal in their jurisdiction by normalizing, glamorizing, promoting, and providing access to the means for performing self-abortions at home (normalizing them by discussing them at length without balance from opposing viewpoints and linking to list articles and websites about regular people who have had abortions with a focus on how quick and painless their abortions were; glamorizing them by listing all of the celebrities who had abortions and the exact methods they used; promoting them by inserting pro-abortion infoboxes in every article someone on the fence might visit, and links at the bottom of completely unrelated articles to articles detailing abortion methods; and providing the means by detailing all of the information someone would need (including illustrated diagrams) to perform a "quick and painless" self-abortion at home without a medical provider using easy to access household items)? Because if that were the case, then yeah, I'd say we should definitely rethink what we're doing with our abortion articles. Because that's exactly what the suicide articles do and that's exactly what scholars have directly connected to spikes in actual suicides that correspond with spikes in page views of wikipedia articles on that method following major news reports on noteworthy people committing suicide. Gunnell et al. (2015) use Robin Williams's suicide as a very disturbing example. He did not actually use asphyxiation, but for 1 hour the suicide bag article said he did and the visits to that page increased astronomically, as did suicides completed by asphyxiation with gas. Look at Suicide_bag - what links there, literally any article about bags (purses, backpacks, etc.) links to suicide bag. PermStrump(talk) 15:33, 15 April 2016 (UTC)

That was a navigation template at work, I've changed it pending discussion. Certainly wp:NOTHOWTO, but the topic is clearly notable. It is also very current event driven. The Canadian parliament is (unwillingly) grappling with medically assisted suicide issues at present, as no doubt are others. The hard part will be finding NPOV sources without legitimizing self help approaches. LeadSongDog come howl! 18:17, 15 April 2016 (UTC)

I haven't spent much time thinking about medically assisted suicide, but I do sometimes wonder why even a few people bother with it. In comparison to the unregulated "homemade" methods – which are often so simple that even a brief explanation is "detailing all the information someone would need" – it seems like a lot of work for no benefit, except maybe the emotional comfort of having your decision "approved" by some medical or government authority (think "certified proof for my loved ones that I'm not mentally ill").

I'm not sure that every single article about suicide should have a "right to respond" section. If an article is about a particular method, then it makes sense for the information to be restricted to that particular method. For example, in the suicide bag article, editors could reasonably include information about, say, the ethics of this choice vs others (e.g., it's probably more ethical than jumping off a bridge and thereby triggering a search and rescue mission that could endanger emergency response workers). But I don't see room in an article like that for something on the ethics of committing suicide at all; it's off-topic. WhatamIdoing (talk) 03:29, 16 April 2016 (UTC)

Some of the sources I've linked above talk specifically about the suicide bag and ethics of suicide, so it wouldn't be off topic. I have it on my to-do list. I'm not really concerned about medically assisted suicide for people with terminal illnesses. The problem is that that's not who these prosuicide sites are usually aimed at/who they hurt. PermStrump(talk) 10:42, 16 April 2016 (UTC)

Oh dear, this issue again. Suicide bags exist. They have for decades. As an encyclopedia, WP covers them. The article describes them, what they look like, their history, what people have said about them, etc. There are no step by step instructions (such instructions are readily available elsewhere [11] [12] [13] etc etc). As for the panic about increasing numbers of people using this method, it should also be noted that total numbers of suicides have not risen (indeed, suicide rates are stable or falling in most countries)

The fact that a slightly increasing percentage of suicides (the numbers are tiny) are choosing this method (for euthanasia as well as suicide) is to be expected, since it is painless, non-toxic, aesthetically acceptable and easily obtained (until recently), compared, for instance, to carbon monoxide poisoning, hanging and other brutal and distressing methods (some of which are also extremely dangerous to bystanders and medical response personnel, e.g. CO poisoning). Those who would bury the suicide bag article probably have good motives (nobody wants to see depressed youngsters making this error), and are not on a religiously-motivated campaign, but the outcome, if we suppress it, is unlikely to be good. People who are absolutely determined to kill themselves will find a way, and that way will generally be much more distressing and dangerous for all concerned. In addition, helium canisters these days are "cut" with 20% oxygen (due to a global shortage of helium) [14], so the method does not work for many who try it. To make it effective, you have to get argon or nitrogen, and these are simply NOT casually available. Buying these gasses is not something most people are equipped to do. Ratel (talk) 21:50, 17 April 2016 (UTC)

From [15]:

“ Balloon Time, a major supplier, has issued a statement to say that in the future all of their “balloon gas” will be diluted with 20 per cent air. “Our helium is rated from 98-99.99 percent pure. However, due to global helium supply issues, we are now mixing helium with air. All tanks will have 80 percent or more helium. This allows us to deliver a quality product at an affordable price.” ” — Exit International

Without balloon helium tanks, potential suicides have to order very large canisters from gas suppliers. They are heavy, come delivered by a truck, and are expensive. This whole topic is becoming moot ... Ratel (talk) 22:22, 17 April 2016 (UTC)

Interesting. Diluting 99.x% helium with 20% air will give a hypoxic mixture (roughly 4% oxygen), which should be quite effective at asphyxiating a human at normal atmospheric pressure. However, I was under the impression that balloon helium has 20% oxygen added, specifically to avoid accidents with people breathing it from balloons to produce squeaky voice effects. Maybe this varies between countries. • • • Peter (Southwood) ^(talk): 09:44, 20 April 2016 (UTC)

resonant frequencies are many times higher in a human vocal tract that has helium in contrast to one that just has "air"--Ozzie10aaaa (talk) 10:41, 30 April 2016 (UTC)

Suicide bags result in quick and painless death — MEDRS or not?

Discussion currently ongoing at: Talk:Suicide_bag#Removed_swaths_of_original_research_and_primary_sourced

• Should we allow primary sources?
• Should we allow images without references on controversial issues?
• Are case reports WP:DUE?

Please comment. Carl Fredik 💌 📧 21:30, 9 May 2016 (UTC) 

Who is this "We" you refer to, and where do they get the authority to make this decision? • • • Peter (Southwood) ^(talk): 13:45, 10 May 2016 (UTC)

• 'Please note, the suicide bag article is right now undergoing what appears to be a concerted tag team attack to destroy the content. Is this what wikipedia is coming to, a censored portal? All editors need to examine their consciences here, and decide if we are going to reflect what's going on in the world, or play a more paternalistic role. Ratel (talk) 22:19, 9 May 2016 (UTC)

Having multiple editors disagree with your position is not the same as a tag team. Carl Fredik 💌 📧 22:50, 9 May 2016 (UTC) 

A sudden, concerted mass deletion of material, by several editors, on a longstanding article, is most definitely a tag team effort. Ratel (talk) 06:26, 10 May 2016 (UTC)

Actually you need to read WP:TAGTEAM and be careful about levelling false accusations of it because it's not WP:CIVIL and can lead to you being sanctioned. If you have grounds for your accusation you need to take them to WP:AN/I. Alexbrn (talk) 12:23, 10 May 2016 (UTC)

How else explain an article (that has been more or less ignored for years) getting 3 or 4 new editors, all with the same agenda (mass removal of text to the point of aggressive edit-warring), in the space of a week? If it looks like a duck, walks like a duck etc. But I may be wrong. Incredible coincidences can happen, perhaps this is just a chance occurrence. Ratel (talk) 12:38, 10 May 2016 (UTC)

Take it to WP:AN/I then, with your evidence. Here is not the place. It is very common for poor articles build with a spurious WP:LOCALCON to get heavily edited when they receive fresh eyes and a widened consensus, for example as a result of their being raised at a Noticeboard. Alexbrn (talk) 12:43, 10 May 2016 (UTC)

Real life precludes ANI action. But I'd welcome an admin freezing the article as it was so that all the reverting can stop and things can get sorted on Talk Ratel (talk) 12:56, 10 May 2016 (UTC)

As an uninvolved editor with a small amount of experience in editing medical articles related to diving, the editing interventions based on claimed biomedical information do seem rather over the top.• • • Peter (Southwood) ^(talk): 13:37, 10 May 2016 (UTC)

Diving and suicide methods have quite different implications do they not? Controversy dictates how important it is to adhere to quality sources, this is a principles of WP:RS. Carl Fredik 💌 📧 14:44, 10 May 2016 (UTC)

Not really. Divers accidentally die through the same biological mechanisms that kill the users of suicide bags. The fact that one death makes some people more queasy than the other doesn't really change the biomedical facts about what happens if you get your Nitrogen/Oxygen balance wrong (or Helium/Oxygen, for really deep dives). They both need good-enough sources, and neither absolutely requires gold-plated-only sources. "Controversial" only applies to BLPs. What you're probably thinking of is the "extraordinary claims" idea, and the biochemistry here isn't the least bit extraordinary. WhatamIdoing (talk) 02:51, 11 May 2016 (UTC)

As far as I can tell, no-one on Wikipedia is prescribing suicide bags as a medical intervention, or claiming that this would be an acceptable medical practice. Therefore why should the article on suicide bags be considered within the scope of MEDRS? A more appropriate standard for reliability should be applied to the sources used.• • • Peter (Southwood) ^(talk): 07:51, 11 May 2016 (UTC)

• we need more opinions at Talk:Suicide_bag--Ozzie10aaaa (talk) 18:08, 10 May 2016 (UTC)

It is well-known that breathing a severely oxygen-deficient atmosphere (4 to 6%) results in unconsciousness after a few breaths, and that the exposed person has no warning and cannot sense that the oxygen level is too low (http://www.csb.gov/assets/1/19/SB-Nitrogen-6-11-031.pdf). No warning would imply no pain, but I don't expect to find peer reviewed studies or Cochrane reviews confirming or disproving that assumption.

Maybe it's time to clearly define the limits of MEDRS, and ban "off-label use". Prevalence 21:32, 10 May 2016 (UTC)

Changing MEDRS won't stop POV pushing.

Speaking of which: I suspect that part of the public health concern about this uncommon method stems from the population that chooses it, and I wonder whether that's addressed. It's not the method of choice by sympathetic old cancer patients; instead, it's largely used by men with traditional risk factors for suicide (e.g., impulsive, young, white, recreational drug users). So I'm wondering whether there is real-world POV pushing at play here, too: parts of society have decided that this is a 'bad suicide' (a young person acting independently, if probably stupidly) rather than a 'good suicide' (a terminally ill elderly person ending up equally dead, but with the explicit blessing of a government bureaucracy and the medical establishment). Because, you know, if you truly wanted to stop suicides, you'd stop worrying about this method, and this article, and instead make it illegal for my local (American) pharmacy to sell an unlimited number of bottles containing 375 extra-strength pills of liver failure each to any kid who can use a credit card. WhatamIdoing (talk) 02:54, 11 May 2016 (UTC)

Changing (or more precisely, specifying the limits of) MEDRS will not stop POV pushing, but it would make using MEDRS as an excuse/ weapon by the POV pushers easier to refute/dismiss, hence a good thing. • • • Peter (Southwood) ^(talk): 07:37, 11 May 2016 (UTC)

I agree, of course, but I don't think that we'll get there until WP:MEDDUE exists. People cite MEDRS because it's a good hammer, even when the tool they really need is a screwdriver. WhatamIdoing (talk) 13:23, 12 May 2016 (UTC)

I surprised there seems little pushback at this article to what seems very dubious proposals. The latest is to source a description of how "peaceful" death-by-helium is, to eyewitness accounts. Alexbrn (talk) 12:54, 12 May 2016 (UTC)

Perceived peacefulness is not WP:Biomedical information. Therefore, plain WP:IRS guidelines apply, and that guideline probably requires nothing more than a newspaper article and WP:INTEXT attribution. WhatamIdoing (talk) 13:23, 12 May 2016 (UTC)

How the human body reacts physically to a substance / the nature of the death that subsequently occurs is biomedical information. The proposed source is the book Final Exit. Alexbrn (talk) 13:56, 12 May 2016 (UTC)

"Causes myoclonus" is biomedical information. "Seemed subjectively peaceful to bystanders" is not. WhatamIdoing (talk) 14:09, 12 May 2016 (UTC)

Possibly, but that's not the proposed wording and not the intended meaning of the edit, which is justified by the proposer thus: "We have ample evidence from numerous sources that this is a quick and easy way to die, and deleting that simple fact from the page by impugning the source is POV". The "evidence" being proposed for this "simple fact" is somebody saying "When I witnessed the helium death of a friend of mine it could not have been more peaceful". This seems to be way worse than using a well-published case report even: it falls off the bottom of WP:MEDASSESS. Alexbrn (talk) 15:52, 12 May 2016 (UTC)

Um no. That was not the evidence proposed, that was merely an example. There are different sources for the fact that the death is quick and peaceful. You can also go to the WP article Inert gas asphyxiation for data such as

According to the U.S. Chemical Safety and Hazard Investigation Board, in humans, "breathing an oxygen deficient atmosphere can have serious and immediate effects, including unconsciousness after only one or two breaths. The exposed person has no warning and cannot sense that the oxygen level is too low."

and

suddenly breathing pure inert gas causes oxygen levels in the blood to fall precipitously, and may lead to unconsciousness in only a few breaths, with no symptoms at all

And of course Ogden's studies draw on a large number of eyewitness accounts. And backing this up, autopsy does usually not show any notable findings, (lots of RS for this) suggesting an absence of unconscious death struggle. Ratel (talk) 22:29, 12 May 2016 (UTC)

The CSB.gov source that Ratel and Prevalence are referring to has nothing to do with suicide bags. It’s about accidental, gradual exposure to nitrogen in the workplace in a contained environment like a small room. I’m going to quote few sources that talk about death by nitrogen asphyxiation to illustrate how irrelevant the CSB source is. But I want to clarify something first... There are 2 different statements by 2 separate people about the physical reaction (or lack there of) to the inhalation of inert gas using a suicide bag. One is a primary source in a low-impact, peer-reviewed journal written by Ogden, a right-to-die advocate and criminologist, that talks about how quick, painless and peaceful death is with helium and a suicide bag. The other statement is from a self-published newsletter written by Nitschke in which Nitschke says that helium has a risk of adverse effects, but nitrogen is much better in comparison. I’m NOT suggesting that the sources quoted below that talk about nitrogen should be used in the article since they’re about nitrogen asphyxiation using masks or in a contained environment in the workplace, not suicide bags.

1) This CNN article from 2015 is about Oklahoma looking for humane alternatives if the Supreme Court ruled that lethal injections were inhumane: While the Supreme Court case was pending, Gov. Mary Fallin signed a bill that would allow the state to perform executions with nitrogen gas if lethal injection is ruled unconstitutional or becomes unavailable. While the medical community has voiced concerns about the method, at least one group thinks the Sooner State might be onto something. Philip Nitschke, director of the right-to-die group Exit International, said the increasing difficulty in obtaining pentobarbital has prompted him to consider gas as an alternative...”

Perfect illustration of how Nitschke doesn't represent the mainstream, medical view. By the way, Nitschke already sells suicide kits with pure nitrogen for $690, so I wonder if that has anything to do with why he claims there are zero adverse effects compared helium, the product gas of choice promoted by his right-to-die competitors, who have essentially rejected Nitschke and his methods. Not to mention the Medical Board of Australia suspended his medical registration, to which Nitschke replied, ‘Oh yeah? Well I was going to break up with you first. So there.’

2) This Time article is about the same debate in OK: Changing the context could prove problematic. Administrating the gas within a prison is much different than the instances in which pilots and divers have slowly and accidentally experienced a lack of oxygen. Dr. Michael Weiden, a pulmonary expert at NYU School of Medicine, says that while nitrogen could be administered without medical professionals, using it for capital punishment could create an ironic consequence: the need for sedation… somebody who thinks that an individual who’s asphyxiating will not freak out without sedation is foolish.”

3) This peer-reviewed case study (PMID 23899346) from 2015 about a suicide by nitrogen asphyxiation with a scuba mask, says, “Deliberate nitrogen asphyxiation is also viewed by some as a more humane way to end human life. Nevertheless, execution by nitrogen asphyxiation is not used by any nation in the world.”

In 2010, Ogden had a case study (PMID 20211999) published in a low-impact, peer-reviewed journal where he talks about 4 assisted-suicides he observed that involved helium asphyxiation using face masks. This is the primary source cited to support the claims that suicide with helium and a suicide bag is quick and painless.

4) In contrast, this peer-reviewed study from 2013, which is unlisted by PMID (see WP:PARITY), says that one of the two cases they studied had "bilateral eyelid petechiae and large amounts of gastric content in the airways. These findings challenge the assumption that death by this method is painless and without air hunger, as asserted in Final Exit." They also found that the time to death varied from 5-10 minutes to up to 40 minutes.

This is exact situation is why WP:MEDRS exists! I shouldn’t need to create an argument for using MEDRS from scratch just for this specific article. PermStrump(talk) 03:58, 13 May 2016 (UTC)

• Permstrump, you're confused by the fact that there are several ways to die from inert gas exposure, some much more efficacious than others. If you'd read Final Exit and The Peaceful Pill Handbook you'd know that there are very specific instructions to follow for using a suicide bag. Those instructions are not on WP because of WP:NOTHOWTO. The chapter from the latter book on how to use the suicide bag correctly runs to ~50 pages of instructions and videos, about all manner of aspects that must be done correctly. But in summary of the basic process, one has to put a completely flattened bag at the top of the head above the ears with collar loosely on head, turn on nitrogen to fill the bag like a tent with pure nitrogen/inert gas (takes ~2 minutes) and wait till nitrogen is escaping from the bottom of the bag, take rapid deep breaths (hyperventilate), then exhale completely (expel all air from lungs), then lower bag over head and take a deep breath, with cord and toggle snug against neck. This is a very precise sequence of events; if it is not done right, if there is insufficient nitrogen flow, or if the bag is not fully compressed and empty of air when the process begins, then failure to die quickly and peacefully can ensue, and this would be why we see some (a few) autopsies that show petechiae and aspiration of vomitus. If there is still air in the bag, that can delay the onset of unconsciousness and death. As Ogden says, "done correctly" the method is just about foolproof. I'd hazard a guess that most people who get a bag and a canister of helium don't know what to do, and there is a real chance they'll fuck it up. Sorry to have to be brutally specific, but these are the facts. Now perhaps you can think of a way to incorporate this information into the article as a warning? Ratel (talk) 04:25, 13 May 2016 (UTC)

• Ratel, no, I cannot think of a way to incorporate that into the article without original research or synthesizing multiple sources. That's one of several reasons why the current version isn't WP:NPOV. There are virtually no actual experts in the field who share the same view and had their work on the topic published in a solidly reliable, independent source that we could cite in lieu of Nitschke and Ogden's weak sources. There aren't even enough other people giving it the consideration to publish statements contesting their claims, making it next to impossible to appropriately contextualize. WP:FRIND says, "Points that are not discussed in independent sources should not be given any space in articles. Independent sources are also necessary to determine the relationship of a fringe theory to mainstream scholarly discourse." The current wording, despite attribution, still sounds like there's general consensus in the medical field that these 2 methods are quick and painless and all you need is a plastic bag and inert gas. Even if we take for granted that their statements are true (which in my opinion is dubious given the sources in my previous comment), even then their statements would only be true if the method is used properly, which the article technically says, but doesn't adequately emphasize, and likely can't without SYNTH due to the dearth of coverage on the topic outside of a small, radical group. PermStrump(talk) 05:43, 13 May 2016 (UTC)

@Ratel: I also think you should strikeout/delete the extraneous details from your last comment unless you're deliberately trying to scare other editors away from contributing to this discussion/article. I didn't need to understand the any of the details you gave about how to use the method properly in order to comprehend that there are more likely to be adverse reactions when you do it wrong. PermStrump(talk) 05:52, 13 May 2016 (UTC)

Permstrump:

1. I maintain that Ogden and Nitschke are not "weak sources". I think you need to RfC that.
2. I don't see the current page as not NPOV. It has a nice balance when I read it. I don't get a sense of slant at all.
3. FRINGE does not apply. Nitschke is discussed in thousands of sources, and his views on suicide with nitrogen published widely. One of numerous examples [16]:

   Nitrogen can provide people quite a quick, peaceful, totally legal and totally undetectable death.

   If he were clearly wrong, we'd have seen heavy pushback to the numerous such statements he has made in press worldwide; we'd have most definitely heard about it by now. And Ogden? Well, he is in Scientific American! Fringe 😂 ?
4. I could insert something about proper procedure being imperative, and cite it to Nitschke's book. Unfortunately it is behind a paywall.
5. No, no dearth of coverage of this topic, thousands of news articles, but no mainstream coverage of the warnings.
6. Me trying to scare off other editors? Sorry, I don't understand your meaning. Ratel (talk) 07:36, 13 May 2016 (UTC)

At this moment, I'm only saying Ogden and Nitschke are weak sources for the statements about how quick and painless nitrogen/helium+suicide bag are and that there aren't adverse effects. They're weak because there isn't a single independent reliable source that can be used in addition or in place of Ogden and Nitschke. The sources you just liked are blog/newspaper articles by journalists who were quoting/paraphrasing Nitschke's beliefs. The fact that Nitschke said those things doesn't need more sources. I've explained multiple times in various threads on Talk:Suicide bag how their views qualify as fringe on wikiepdia. It's a slam dunk. There's really no doubt about it. The argument of editors who disagree with me has basically boiled down to, "Nuh huh. Their views aren't fringe," but no one has been able to provide a single independent reliable source to show that other SCHOLARS agree with them. It doesn't matter how many people "in-universe" hold the same view. That's how WP:FRINGE works. "Statements about the truth of a theory must be based upon independent reliable sources... Points that are not discussed in independent sources should not be given any space in articles. Independent sources are also necessary to determine the relationship of a fringe theory to mainstream scholarly discourse." The editors claiming something isn't fringe are the ones who have to prove that support from mainstream scholars in the field exists. Until proven otherwise the WP:ONUS is on the editors who want to include the disputed content to find the better sources. It really should be removed until then. PermStrump(talk) 08:44, 13 May 2016 (UTC)

Permstrump said: Ogden and Nitschke are weak sources for the statements about how quick and painless nitrogen/helium+suicide bag are and that there aren't adverse effects. They're weak because there isn't a single independent reliable source that can be used in addition or in place of Ogden and Nitschke.

So if we ignore two of the experts who have made this their life's work, we have no sources? Perm, that's only true if you ignore the great sources I gave above showing almost immediate unconsciousness ("one or two breaths"), and the existence of studies featuring inert gas asphyxia autopsies without petechiae or inhalations (therefore without what is called in veterinary science an "unconscious death struggle" example). Do you need links to the U.S. Chemical Safety and Hazard Investigation Board document and more studies showing unremarkable autopsies? For FRINGE to come into play, Nitschke and Ogden and Humphry and Dr Bruce Dunn and etc would all have to be claiming something that flies in the face of the wording of FRINGE, namely: an idea that departs significantly from the prevailing views or mainstream views in its particular field. For example, fringe theories in science depart significantly from mainstream science and have little or no scientific support. Ratel (talk) 09:48, 13 May 2016 (UTC)

Like I already said above, the CSB source has nothing to do with suicide bags. The Auwaerter et al. source doesn't support Nitschke and Ogden's statements; it repeats them, but doesn't support them. Auwaerter: "In the last years, right-to-die activists promoted suicide methods by asphyxiation with use of gases as being relatively quick and painless." WP:FRINGE says, "Statements about the truth of a theory must be based upon independent reliable sources." Auwaerter et al. did not attest to the truth of that theory. None of the names you mentioned are independent of the topic. They're part of the small, radical group, so no, the fact that they agree with each other doesn't make it mainstream. PermStrump(talk) 10:02, 13 May 2016 (UTC)

* Permstrump, we're going round in circles

CSB source has nothing to do with suicide bags — of course not, but CSB source is about breathing a pure inert gas in an enclosed space, which completely agrees with the statements of Nitschke, Ogden et al, so let's not play semantics, it just wastes everyone's time.

Statements about the truth of a theory — it's not a theory. Plenty of people have died like this, some filmed by Dignitas, some observed directly & reported to researchers like Ogden, some scuba divers by mistake, some workers around inert gases. Where's the theory? Where's the fringe claim? If you do it properly then just a couple of breaths and you're out, 10 mins later (or longer if there is a vestige of oxygen) you're dead. If you don't do it properly you can take ~10-50 seconds to lose consciousness and up to 50 mins to die, with some twitching and movements, and possibly some signs at autopsy (inhalations, heart congestion, a few other signs I forget now, but none of which would have been felt consciously by the unconscious suiciding person, so relevance is moot). This is not controversial, nobody has contested it except the one source you have who looked at only 2 deaths by inert gas asphyxia and based his doubts on the one case with petechiae and inhaled vomitus, but this case also took a known emetic before breathing nitrogen, and in any case there is no proof that case experienced any pain, so the author's questioning of the painlessness of the method is strange. You can complain all you like about lack of numerous independent verifiable sources that echo these details, but you're never going to get a lot of researchers doing this kind of research when you see what happened to Ogden, who got himself unavoidably into a legal minefield that hobbled his career, so bleating about lack of verification from other sources gets us nowhere. And then you have the latest review study in this field that calls bag+inert gas an "easily understood and generally effective suicide method". Want to quote that? Ratel (talk) 11:30, 13 May 2016 (UTC)

Quoted above too... Changing the context could prove problematic. Administrating the gas within a prison is much different than the instances in which pilots and divers have slowly and accidentally experienced a lack of oxygen. Dr. Michael Weiden, a pulmonary expert at NYU School of Medicine, says that while nitrogen could be administered without medical professionals, using it for capital punishment could create an ironic consequence: the need for sedation… somebody who thinks that an individual who’s asphyxiating will not freak out without sedation is foolish.” Time. PermStrump(talk) 13:35, 13 May 2016 (UTC)

The Howard source doesn't support "quick and painless" or "peaceful" or "without adverse reactions." It would be much better in place of those 2 citations. The "easy to understand and effective" comment was also specifically about a plastic bag alone, not with gas, BTW. If you include all 3, it severely lacks NPOV. PermStrump(talk) 13:40, 13 May 2016 (UTC)

Mainstream?

• Ogden is WP:INDY according to Wikipedia's standards. He gets nothing from his papers except what any other academic gets from their papers. If we start declaring that experts aren't independent, then we will never be able to cite any journal article – no surgeons on surgical methods, no drug manufacturers on drugs, no pesticide researchers on pesticides, etc. Ogden actually is that "single independent reliable source" that you're looking for.
• When you have one reliable source saying X, and no reliable sources saying anything about it, then saying X (perhaps with WP:INTEXT attribution) is DUE. For example, we don't reject LD50 numbers when there is only one source for that number.
• Here's how we know that "other SCHOLARS" accept Ogden: Multiple other scholars cited his paper.
• Permstrump, you're saying in your comments here that government sources about the proven effects of occupational exposure to Nitrogen is irrelevant, but that vague speculation in a newspaper about using it for lethal execution is just fine. This sounds like cherry-picking sources based upon their POV to me, and that won't produce an acceptable article. WhatamIdoing (talk) 13:53, 13 May 2016 (UTC)
• Permstrump:

1. Capital punishment: Using nitrogen for capital punishment would be difficult to impossible without sedation because to make it work properly you need complete co-operation (see instructions above). Some condemned prisoners will co-operate, most will not.
2. Without adverse reactions : The ultimate adverse reaction is death. And since the autopsy-discovered sequelae, which are rare, occur after loss if consciousnesses, they are moot. So why are you making an issue of them? To the user, the process is still painless, otherwise we'd have seen people interrupt it (note the eyewitness accounts and films by Dignitas showing some involuntary movements but no attempt to remove bag or mask).
3. BTW did you get access to the full text of the Kleespies paper? That paper seems to be more about a "debreather" than a suicide bag. Ratel (talk) 20:24, 13 May 2016 (UTC)

• Ratel, Yes, capital punishment is different from suicide, but so are the situations CSB was referring to that involved people who were unaware of accidentally and gradually being exposed to nitrogen while in a small room. Obviously that would be different than what if feels like when you have a plastic bag over your head. My point was essentially that the policies and guidelines exist for a reason. It's so easy to draw false conclusions with honest intentions, but WP:SYNTH and WP:COATRACK prohibit us from drawing conclusions from 2 separate works and from citing sources that aren't directly relevant to the topic at hand. It makes it really straight forward: CSB isn't talking about suicide bags, so it's irrelevant to this article. That should save us from wasting time arguing about sources that are unlikely to be useful for anything other than POV pushing. Yes, I have access to the full text of Kleespies (and pretty much any academic journal) through the library at work. I'll respond to your comment on Talk:Suicide bag after this and C&P some quotes from Kleespies.

WhatamIdoing: "Mr. Ogden is director of the Farewell Foundation, which advocates for assisted suicide." Source. PermStrump(talk) 00:30, 14 May 2016 (UTC)

So? Being employed in your field of expertise is not a conflict of interest for that scientific field. If it were, then we'd have to stop citing prominent world experts in nearly every subject. No more citing Peter Piot on infectious diseases, for example, because he's running a non-profit organization that relates to to his scientific expertise. WhatamIdoing (talk) 04:11, 14 May 2016 (UTC)

I don't know if Peter Piot is, but I assume you mentioned him because he's well accepted an expert in his field by other exerts in his field, which is not true of Ogden. He's one of few adherents to a view well outside of the mainstream in his field (aka WP:FRINGE) that he has some financial and much personal investment in. I didn't say he can't be cited in that article or any other article, but when it comes to this topic, it needs to be properly contextualized and his statements can't be given false weight. PermStrump(talk) 15:22, 14 May 2016 (UTC)

You keep saying that, but the reliable sources keep saying things like "internationally known assisted-suicide expert"[17], "a world-leading researcher"[18], "a respected social scientist doing research on illegal behavior"[19], "one of the world’s foremost experts on assisted suicide"[20] who "altered fundamentally the way the situation is looked at"[21]. So unless we're redefining this to mean "the mainstream of the field, counting only people who agree with the One True POV™", then I think we're going to have to give up on calling him FRINGEy or "outside the mainstream". He is definitely too accepting of suicide to please the pro-life people, and he is reportedly too restrictive to please the right-to-die people, but I checked about a dozens news sources, and I didn't find a single one that said he was anything other than a prominent researcher doing fairly good work in the legally fraught field of (sometimes) watching people commit crimes (i.e., watching people assist in a suicide attempt, when their assistance is illegal in that jurisdiction).

My mind is open on the point, but if you want me to change my mind, then you need to come up with some reliable sources (=not merely a repetition of this unverifiable assertion) that say he's not an expert. You might start with Canadian political sources; since he and his research has influenced every piece of Canadian legislation about assisted suicide for years, you might be able to find a political hatchet job in any magazine that opposed the legislation. If it's not there, it's probably not going to be in any standard news source. WhatamIdoing (talk) 04:19, 15 May 2016 (UTC)

I'm not sure what the question is anymore. He's "in-universe" as evidenced by the fact that he founded Farewell Foundation. No other scholars call him an expert. The only people who call him an expert are a few journalists, and even then they're calling him an expert in "assisted suicide", which isn't even a field of anything. (notability vs acceptance). There's also his legal conflict of interest:

Vancouver-based Ogden has been researching assisted death as a criminologist since 1991 and began pushing for legal reform with the birth of his Farewell Foundation last year. Behind the political advocacy, he’s also quietly performed the far more ethically thorny work of supporting those who can’t wait for the legal and political debate to play out.... Ogden’s work as a death facilitator has led to police questioning on seven occasions, he says. He was subpoenaed three times to court (in 1994, 2003 and 2004)." (source)

—PermStrump(talk) 09:39, 15 May 2016 (UTC)

This is a a silly, fatuous, vexatious charge. Russel Ogden IS an expert in the field of assisted suicide and voluntary euthanasia, as his long list of Pubmed indexed studies into this field show objectively. Not only is he called an expert in the field of assisted suicide by numerous major news sources, but his list of published studies into the topic, more than any other researcher AFAIK, speaks volumes. Let's stop this pointless discussion now please. Ratel (talk) 11:16, 15 May 2016 (UTC)

It doesn't matter if the "pro-life" people say that he's "in-universe" with the "pro-suicide" people. Ben Goldacre is "in-universe" with the evidence-based medicine people, and we don't say that he's FRINGEy or not an expert. Having a firm opinion on a socially controversial subject doesn't change anyone's status as an expert on assisted suicide.

Also, there are healthcare professionals right here on Wikipedia who have "been subpoenaed". That's what happens to the victims and witnesses of a crime, not to the alleged criminals. "Pushing for legal reform" (according to one source, his goals are to reduce the number of painfully botched suicides and suicide attempts that turn into murder, and to make it clear in Canadian law that merely sitting in the same room as a suicide attempt, especially in the capacity of a journalist or scholar, without physically trying to stop it, is not itself a crime) is not a "legal conflict of interest". Conflicts of interest are spelled out pretty clearly in law, and they involve tangible benefits (money, goods, or services).

All you've proven is that he's WP:BIASED. It would hardly be surprising if a scholar in the social sciences hadn't formed a strong opinion about his subject area. WhatamIdoing (talk) 16:33, 15 May 2016 (UTC)

"Assisted suicide" isn't a field of study so one can't be an expert in it. WP:INDEPENDENT says, "A third-party source is not affiliated with the event, not paid by the people who are involved, and not otherwise likely to have a conflict of interest or significant bias related to the material." See also WP:Third-party sources#Conflicts of interest. Clearly not independent on multiple fronts. —PermStrump(talk) 05:30, 17 May 2016 (UTC)

References

Repeatedly adding a primary source

Which has an author who has the same name as their user name.[22] Thoughts? Doc James (talk · contribs · email) 16:07, 10 May 2016 (UTC)

COI[23](and MEDRS)...also marks all edirs minor?[24]--Ozzie10aaaa (talk) 16:59, 10 May 2016 (UTC)

There's quite a pattern of the same behavior at contributions. AFAICT every contrib is the insertion of a wp:SELFCITE to a primary source, and all the edits are marked as minor. Also rather troubling are earlier IP edits such as this, presumably from the same named author, at a now-blocked IPEdu. LeadSongDog come howl! 18:45, 10 May 2016 (UTC)

I have reverted all of their self-cites and left the editor a clear warning that WP is not a vehicle for promotion. I suggest a block the next time they self-cite. Jytdog (talk) 19:21, 10 May 2016 (UTC)

Berkson's paradox.

Berkson's paradox may be within the scope of this project. The current article doesn't explain or even state the actual paradox, and seems based on a flawed interpretation of Berkson's paper. See Talk:Berkson's_paradox. Prevalence 18:16, 10 May 2016 (UTC)

• may help[25][26]--Ozzie10aaaa (talk) 10:34, 11 May 2016 (UTC)

Merger discussion for Decubitus

An article that you have been involved in editing—Decubitus—has been proposed for merging with another article. If you are interested, please follow the (Discuss) link at the top of the article to participate in the merger discussion. Thank you. Aucassin (talk) 12:25, 11 May 2016 (UTC)

• give opinion(gave mine)--Ozzie10aaaa (talk) 15:18, 11 May 2016 (UTC)

Can freely licensed videos from institutions include copyrighted logos in end credits?

see the five seconds of logo animation at the end of the 4-minute video

• File:American Chemical Society - What Chemists Do - Nathan Allen.ogg

The American Chemical Society has applied a free license to a video. I expect that in the future more organizations will consider sharing videos. It is fairly common for videos to include credits somewhere. It is also common for online video for the credit to be in the form of a logo, and perhaps a copyrighted logo.

As the Wikipedia community negotiates these kinds of institutional partnerships and gets video donations, are credits acceptable in videos? What about the inclusion of copyrighted logos? I started a discussion on Commons. Anyone may comment either here or there.

• Commons:Commons:Village_pump/Copyright#Advice_on_noting_non-free_logo_animations_in_freely_licensed_videos

I am presenting this to WikiProject Medicine because this particular video talks about a partnership between science organizations and another website called Reddit. A collaborator and I (Peter.C) have noted this science outreach project here several times in the past -

• archive 56
• archive 63
• archive 68

I continue to be impressed by that reddit project's ability to recruit leading health thinkers to have discussions with the general public.

• Francis Collins, director of NIH, in discussion on April 25, 2016

In general, I wish Wikipedia could be more clear on the boundaries for how organizations can share content on Wikipedia. Sorting out allowance for credits is a basic issue on which we ought to be clear. Blue Rasberry (talk) 16:58, 11 May 2016 (UTC)

there is certainly a lot to gain, however its important not to allow too much time for "logos"...IMO--Ozzie10aaaa (talk) 10:53, 12 May 2016 (UTC)

If they are released under an open license, they can be re edited to remove parts of the logo if the logo is too long. Hopefully most will be reasonable if it is simply discussed. Doc James (talk · contribs · email) 20:19, 13 May 2016 (UTC)

Obesity-associated morbidity

I've been bold, but it needs some more attention and updates from pros. LeadSongDog come howl! 21:19, 12 May 2016 (UTC)

most of it is covered at Obesity subsection morbidity, which is GA (though not in detail)?--Ozzie10aaaa (talk) 10:52, 13 May 2016 (UTC)

Yes this is a subpage of the obesity article. Doc James (talk · contribs · email) 20:00, 13 May 2016 (UTC)

Ah, James, it was you who copied Obesity#Morbidity to the Obesity-associated morbidity subpage back on 14 Jan 2009, but then you left the table in place at Obesity#Morbidity. Perhaps that was an oversight, or you were interrupted? Anyhow, it seems a bit excessive to leave in place, and many of the refs in that section are getting stale (2006-7 time frame). Time to trim the now-redundant original back? LeadSongDog come howl! 20:43, 13 May 2016 (UTC)

The table sort of gives an overview. I have no strong feeling whether or not it should be moved to the subpage aswell. Doc James (talk · contribs · email) 20:46, 13 May 2016 (UTC)

Perhaps we could just trim it to identify 8-10 affected major systems and leave the details to the subpage.LeadSongDog come howl! 21:12, 13 May 2016 (UTC)

Fetal tissue implant and Fetal Tissue Transplantation

I am way out of my depth on this one. Could some subject-matter experts please evaluate the two articles Fetal tissue implant and Fetal Tissue Transplantation, with respect to the proper name for the concept, duplication of content, and style? I am a new editor and in no way knowledgeable about this area, and I just thought some extra eyes would help the project. MisterRandomized (talk) 06:25, 13 May 2016 (UTC)

there same, best to merge--Ozzie10aaaa (talk) 10:33, 13 May 2016 (UTC)

Redirect one to the other. And moved the new content to the persons talk page as it needs more work. Doc James (talk · contribs · email) 19:45, 13 May 2016 (UTC)

NAC of Wikipedia:Articles for deletion/Diagnostic test

I notice that Wikipedia:Articles for deletion/Diagnostic test was never delsorted. Yesterday it was NACed as Merge to Medical test, despite some good Keep arguments made by Mark viking, Bearian, DeVerm, and Zefr. Sam Sailor ^Talk! 10:42, 13 May 2016 (UTC)

Thanks for the alert. Bearian (talk) 17:52, 13 May 2016 (UTC)

Thanks, Sam Sailor. I thought it was my Keep vote that triggered the deletion! --Zefr (talk) 22:00, 13 May 2016 (UTC)

New account

This user is making strange edits. They keep adding a category to this article as seen here and adding caps [27] which are not needed. Thoughts? Doc James (talk · contribs · email) 19:48, 13 May 2016 (UTC)

Spam account trying to get auto-confirmed? Sizeofint (talk) 20:08, 13 May 2016 (UTC)

Appears to be dealt with. Not a spam account. I am not sure. Doc James (talk · contribs · email) 20:16, 13 May 2016 (UTC)

Advice to students

I have put together a welcome template specifically for advice for those who appear to be new student edits here Template:Student Doc James (talk · contribs · email) 03:19, 14 May 2016 (UTC)

A few comments. Most significantly, it needs to be clearer early-on that this is targetted to students working in a certain topic-area. It's not a general welcome to student editors, though such a separate template might be useful. Relatedly, you might want to organize the list either in order of significance, or chunked according to content vs sourcing vs formatting. Finally, it should be titled something like {{Welcome student med-article}} or somesuch, to help it correlate with the family of Template:Welcome... templates and clarify/self-document its use. DMacks (talk) 04:17, 14 May 2016 (UTC)

Reading more closely, most most significantly, it doesn't sound very friendly. While it doesn't violate AGF, it doesn't really welcome them, rather just instructs. Please coordinate with Wikipedia:Welcoming committee/Welcome templates, who have a well-vetted set of templates already. Maybe you could just write a wrapper/clone that enhances a standard one with the WPMED aspects. DMacks (talk) 04:21, 14 May 2016 (UTC)

[28]looks good...IMO--Ozzie10aaaa (talk) 10:11, 14 May 2016 (UTC)

I agree with DMacks. #2 gets cleaned up by bot, #3 is a minor problem, #4 is technically wrong, etc. I'm especially unhappy with #11, which will be understood as telling new editors not to significantly expand stubs or add missing sections. And the overall feel is "you're going to screw up, and 'The Team at Wikipedia:WikiProject Medicine' (complete with the capital letters) is in charge here". I recommend not using it. WhatamIdoing (talk) 13:30, 14 May 2016 (UTC)

I sort of see the logic Doc James, but I think it is just too long. Nobody is going to be able to digest that lot. Maybe it might be better to write a shorter welcome with a link to some abbreviated version of the WP:MEDMOS for new users. In my experience almost everyone makes mistakes at the beginning, and whilst it is annoying for everyone else to keep correcting the same mistakes, it isn't always altogether obvious what the problem is with any given newbie edit. There must be new user guides for students, presumably a medical version of this would be a better way forward? JMWt (talk) 15:04, 14 May 2016 (UTC)

Please see WT:ENV#Wiki Education Foundation looking for input on Environmental Science student guidebook (permanent link) for a discussion about a guide for students of environmental science. You might wish to adapt some features of that guide to the guide for medical students.

—Wavelength (talk) 15:27, 14 May 2016 (UTC)

Because the content of Template:Student is for medical students specifically, I propose that the page be moved to (renamed as) something specifically referring to medical students in its title.

—Wavelength (talk) 15:37, 14 May 2016 (UTC)

• It is indeed correct that one cannot see the inside net of most universities libraries so #4 is indeed correct
• 2 and 3 while minor issues are commonly not done. Bots are not that fast in cleaning these up.
• Yes this template is to provide instructions and I am using it in people who are having some of these issues
• Want to keep the name short as it takes less time for me to type it.
• Agree about 11 not being the best and adjusted

Doc James (talk · contribs · email) 16:03, 14 May 2016 (UTC)

• • 4 is wrong because Wikipedia:Convenience links are permitted.
  • 2 and 3 may be common, but they are unimportant and easily fixed. The template is already so much WP:TLDR.
  • The effect of this long list of instructions is anti-welcoming. It's undeniably true that if everyone else quit (or didn't even start), then I'd spend much less time resolving disputes and cleaning up other people's messes, but I know that's not the result you want. WhatamIdoing (talk) 04:31, 15 May 2016 (UTC)
    • Interested. Convenience links is an essay. And is not what I am referencing. I am referring to a bar url to the inside next of a person's library. Basically the only way you can figure out what the ref is, is if you have a user name and password for that library.
    • With respect to the rest we simply disagree. Doc James (talk · contribs · email) 21:49, 15 May 2016 (UTC)
      • • Yes, that is what you're referencing; you just didn't know it. Including a URL to your university library is simply not prohibited anywhere. It's not the single most useful thing someone could add, but there is no prohibition against it, and it is occasionally better than nothing. (Also, see WP:PGE: it doesn't matter if accurate information is written in an essay. WP:Five pillars is "an essay", too.) WhatamIdoing (talk) 00:13, 16 May 2016 (UTC)
    • WhatamIdoing, point 4 is referring to links like this: http://web.b.ebscohost.com.proxy.library.adelaide.edu.au/ehost/pdfviewer/pdfviewer?sid=df69463c-4b0b-4154-bbe1-f3e06748e906%40sessionmgr105&vid=1&hid=128 That link takes me to a non-free peer-reviewed article. But it's useless for you or anyone else who's not a Uni of Adelaide student or staff member, as it requires Uni of Adelaide authentication; note the "proxy" and "adelaide.edu.au" in the url. Students often use these kinds of links in references, unaware of the authentication step that is automatically bypassed from university computers. The explanation in the template probably needs clarification. Adrian J. Hunter^{(talk•contribs)} 09:40, 15 May 2016 (UTC)
      • I know what it is. I'm telling you that, contrary to your expectations, including this kind of URL in a citation is not prohibited. I don't believe that WP:CITE even formally discourages it. WhatamIdoing (talk) 00:13, 16 May 2016 (UTC)
• this is not just for med students. it is for any student who wants to work on articles about health - the things in the list are common mistakes that people in these classes make. It would save us a ton of effort if students took them on board. Doc James drafted this because there are actual problems that we deal with over and over. Jytdog (talk) 22:17, 14 May 2016 (UTC)

On the former item #11 which I added. It was

• Please try to avoid generating a large of block of text to insert in the article. You are used to creating essays for school, but working in Wikipedia is not essay writing. Look at the whole article in terms of the quality of sourcing (how recent, how strong) and in terms of WP:WEIGHT (are all the sections described in WP:MEDMOS present and complete, and is space allocated to each part reasonably?); those are the two key ways most articles need improving.

In my view this is the biggest problem with student work. Students (and teachers) spend their entire academic careers (years and years of training/habituation) working in a model where a student gets an assignment to create some block of writing - an essay, a research paper, whatever - that the student submits under his or her own name and that the teacher grades the student on as the student's own work. That paradigm is completely foreign to what we do here in Wikipedia. Yet every semester we get classes that deluge our articles with these big blocks of content, written with no regard whatsoever for WEIGHT, the existing sources used in the article, etc etc. I wish the Education Program would spend a bit more effort in the training to get teachers and students alike to see that the "essay" paradigm doesn't work well in WP. These students could be adding a ton more value to articles, (and could be learning a lot more about the topic and - with respect to the goal of attracting new editors who stay - getting a much better grasp of how real editing occurs in WP) if they approached the article as a whole and really analyzed them per NPOV and the sourcing guidelines, and work to improve actual flaws in articles (of which there are often many, many), instead of trying to find some little issue to blow up into an essay which almost always gives UNDUE weight to whatever it is about and introduces a host of other problems with content, sourcing etc.

I write this as someone who has dealt with a boatload of student editing, not from an "armchair" as it were. Jytdog (talk) 22:29, 14 May 2016 (UTC)

Yes, it's a problem. No, this isn't going to solve that problem. (I exclude 'scare away the students' as a solution.)

My personal wish for the Edu programs might be the opposite of yours: Find a disease that doesn't have a ==Prognosis== section, and add a big block of well-sourced text. We've got copyeditors; we don't have very many people who are expanding stubs with important, sourced material. WhatamIdoing (talk) 04:31, 15 May 2016 (UTC)

This is the second time in a short time that you have come at me with this kind of bad faith approach. My goal is not to scare away students. Jytdog (talk) 06:14, 15 May 2016 (UTC)

I'm sorry; I don't intend to imply that you want to scare away students. There are two ways to reduce the burden of class-based editing: make their product better (hard) or make them go away (easier). I'm excluding the latter entirely from the definition of success.

This TLDR template might make some of them go away, but there is no realistic chance that it will actually improve their product. If we want to get them to stop creating enormous, isolated, useless blocks of text, then we need to educate their instructors, not give them a warning against doing something that their instructor rewards. Also, that particular line warned them equally against an activity that is sometimes useful (adding a missing section) and sometimes not (adding two thousands words on a minor detail without noticing that the subject was already covered elsewhere in the article), and there is no chance that they will be able to figure out what was intended. WhatamIdoing (talk) 00:22, 16 May 2016 (UTC)

Wikipedia:WikiProject Medicine/Student guide can have the shortcut WP:MED/SG.

—Wavelength (talk) 22:51, 14 May 2016 (UTC)

Basically I have seen 100s of student edits. They are typically obvious as they contain a certain repeated set of errors. Each batch of students making similar errors as the last bunch.

When I submit a paper for publication I get a much longer list of things to fix than these 11 (the lists typically run to 25 or 50 pages). And yet if you want to publish in PLOS or JMIR you persist. I do not think we should have way lower standards / expectations. Doc James (talk · contribs · email) 23:11, 15 May 2016 (UTC)

Proactive training

Some of our NIOSH researchers are actively working with university courses that are interested in improving Wikipedia on health topics. I know in my trainings I put a strong emphasis on medical reliable sources. I cannot say for certain that others do as well (I'm not directly involved). To the extent I can make sure our university partners are following best practices, is there anything I should be sure to remind our partners? Thanks, James Hare (NIOSH) (talk) 12:38, 16 May 2016 (UTC)

I give advice about formatting of references so they match those already in the article. I also tell them of the cool tools to auto format references based on the ISBN and page number or the PMID. Doc James (talk · contribs · email) 18:41, 16 May 2016 (UTC)

Draft:Cardiac Research Institute at Masonic Medical Research Laboratory - ready for mainspace?

A few months ago I brought this draft to the attention of the editors here, and WhatamIdoing and Blueboar responded that the draft was about a notable topic but needed better sources. I have added some news reports and other items that I found on the web, changed the "Education" section to paragraph form, rewritten some of the point form into sentences, and changed the title to Masonic Medical Research Laboratory since this seems to be what it is commonly called. The "Scientific achievements" was sourced back to articles by the lab's research staff, so I moved these to a "Selected publications" section. This leaves the section mostly unsourced, but I don't have the medical knowledge to add sources. I did find [Inborn Genetic Diseases: Advances in Research and Treatment: 2011 Edition. ScholarlyEditions. 9 January 2012. pp. 1–. ISBN 978-1-4649-2829-1. this].

I propose to move the article to mainspace, while tagging that section with "refimprove", and let the medical research community add supporting citations. Was I right to change the title? "Cardiac Research Institute at Masonic Medical Research Laboratory" can always be a redirect title.—Anne Delong (talk) 17:20, 15 May 2016 (UTC)

I don't disagree with such a move, but (perhaps "because", given your rationale) sourcing of key sections like "Scientific achievemnents" is notably sparse. I've started a discussion over there. — soupvector (talk) 18:48, 15 May 2016 (UTC)

Brand names at Metoclopramide article

Input would be helpful at Talk:Metoclopramide#Brand_names. Thanks. Jytdog (talk) 20:46, 15 May 2016 (UTC)

give opinion(gave mine)--Ozzie10aaaa (talk) 22:03, 15 May 2016 (UTC)

I have questions about brand names being deleted from any/ and ALL prescription drug articles, not just this one. Thank-you for any help making this clear. I'm having trouble understanding why brand names should be deleted from these highly-regulated products, or if there is a reason why they should be. TeeVeeed (talk) 22:57, 15 May 2016 (UTC)

Might be good to have a rfc around this issue. My position is that one or two brandnames should be in the lead. Maybe three in the infobox and others can go in the society and culture section if people so choose to put them there and reference it. Doc James (talk · contribs · email) 23:04, 15 May 2016 (UTC)

I don't see any need for an RFC. MEDMOS and PHARMOS both say that brand names ought to be included in the article, ideally as a ===Brand names=== subsection under ==Society and culture== when there are more than a couple. Also, they say that the original brand name ought to be in bold-face type in the lead, along with the name of the original manufacturer. We just need more people to be aware of the existing advice (and also to be aware that the advice isn't an absolute requirement. There are some good reasons to vary the standard approach on occasion [e.g., when different forms have different trade names, then you might as well give the brand names with the forms, for concision; also, there's no need for a whole section on brand names if there's only a couple of brand names], and some GA articles on drugs are sensibly adjusting the suggested sections to better fit each case). WhatamIdoing (talk) 05:06, 16 May 2016 (UTC)

No the two MOS are not in sync. WP:PHARM says list them all but MEDMOS advises away where it explicitly says' "Try to avoid cloning drug formularies such as the BNF and online resources like RxList and Drugs.com.". There is no encyclopedic value to a CATALOG of drug names that you can find at dozens of sites. I generally list the originator name and then "there are many brands available worldwide" and cite the laundry list at drugs.com. I often do that in the context of writing a history section that talks about who discovered it when and where, and the series of relationships that were struck to bring the drug to market, and when it went generic. I most recently did that a couple of days ago when i completely revised the Trospium chloride article; the history took a few hours to work out and I am still not clear on the relationship between the 2 German companies. There was also some interesting litigation around trademarks on names that I added content on here: Trospium_chloride#Society_and_culture. There is no encyclopedic value to a LAUNDRYLIST of names. I am baffled that people are claiming there is and no one has articulated any encyclopedic value, nor why we should contravene the policy, WP:NOTCATALOG. Jytdog (talk) 06:25, 16 May 2016 (UTC)

That's not what we actually meant when we said to avoid cloning drug formularies.  :-/ A drug formulary tells you chemical and clinical information about the drug, e.g., side effects and contraindications. It does not (traditionally) tell you business information, such as the variety of trademarks or manufacturers (although online ones probably do, to help with search engine optimization).

IMO the main value in that "laundry list" of names is helping people figure out if they're at the right page. Every one of those names should have a redirect that points to the article, and it is standard practice to mention terms that redirect to a page (except for trivial variations). WhatamIdoing (talk) 13:22, 16 May 2016 (UTC)

The two sources cited in the MEDMOS, RxList and drugs.com both list all the tradenames, so I have no idea what you are talking about. People can figure out if they are at the right article but clicking on the link to a reference that has the laundry list. Now you seem to be saying that we should be in the business of SEO, and that Wikipedia editors should waste their time copying lists of drug brand names into Wikipedia and then maintaining those laundrylists when people spam unsourced trademark-sounding names into the list, which happens all the time. You are not dealing with that. You are just armchair quarterbacking and I have no idea what is at stake for you in this discussion. Jytdog (talk) 15:17, 16 May 2016 (UTC)

Varicocele

Peoples thoughts here [29]. Thanks Doc James (talk · contribs · email) 21:42, 15 May 2016 (UTC)

• more opinions(gave mine)--Ozzie10aaaa (talk) 11:07, 16 May 2016 (UTC)

Price of medications

I have been including pricing information in medication articles. We have a good source here that gives the price range found internationally and in a number of countries in the developing world. Often the variation between prices is less than 5 fold. I have also been providing the US price as presented in this book but there are other good options. The US is not only a large portion of the EN speaking population but a large percentage of our readership. Also most other countries are somewhere between the global price and the US price.

Previous discussions:

• [30]
• [31]
• [32]

Support including pricing details

• Support as proposer. Doc James (talk · contribs · email) 22:44, 15 May 2016 (UTC)
• Support Shelley V. Adams ‹blame
  credit› 03:30, 16 May 2016 (UTC)
• Support It is encyclopedic information, with decent sources available. With that said, ideally we could handle this with WikiData or something and pull it in, which would allow for things like automatic charting II | (t - c) 04:03, 16 May 2016 (UTC)
• Support inclusion of the wholesale prices when decent sources are available. Drugs are manufactured products produced by large corporations; the price that a product sells for on the market is relevant commercially, even when/if it is unimportant medically. WhatamIdoing (talk) 04:09, 16 May 2016 (UTC)
• Support. It would be good to be able to easily compare the average wholesale price of a drug in one market with the average in another/others. In one of the discussions he linked to above, James suggested a drop-down list of price x country in the infobox or sidebar, updated at Wikidata.

Knowing how slow Wikipedia and Wikidata can sometimes be in updating information, it might be prudent to always associate a price with its date: "The average 2015 wholesale price in the U.S. was x per standard dose. The average 2015 wholesale price in Australia was y per standard dose." --Anthonyhcole (talk · contribs · email) 04:14, 16 May 2016 (UTC)

• support when reliable sources are available--Ozzie10aaaa (talk) 10:14, 16 May 2016 (UTC)
• support only per my comment in the middle previous discussion, and not in infoboxes: "If, as with some cancer drugs, the cost is exceptionally high, placing them out of reach of many patients even in the West, and that has been the subject of RS (it need not always be MEDRS-compliant) coverage, then certainly that should be added, in a section in the text. In England these matters are done in public in the National Institute for Health and Care Excellence approval process, generating lots of RS coverage in some cases. Equally that aspirin is dirt cheap can easily be referenced. But I think we should avoid saying much about the mass of mid-price drugs, for the reasons set out above, plus the need (which we may not be able to cope with) to update when they come off-patent etc. We should just cover the extremes. Johnbod (talk) 15:51, 15 June 2015 (UTC)" Johnbod (talk) 14:51, 16 May 2016 (UTC)
• Support. I wish to respond to Kashmiri's opposition arguments below, because they are all excellent reasons which must be directly addressed.
  • Kashmiri refers to this English Wikipedia policy which historically says, "no prices". Wikipedia:What_Wikipedia_is_not#Wikipedia_is_not_a_directory. There is more discussion on this topic at WP:PRICES. I do not think the prohibition in the policy is on prices specifically, but instead, the prohibition is on primary data and information which is not backed by reliable sources. Prices often are those things, but not always. Sometimes reliable sources make price information available for consumer reference, and in that case, Wikipedia might include the information.
  • I agree that if price data is included then there has to be continual mindfulness about global markets. It is not acceptable to present only United States prices. I do not think Wikipedia has to be global, but there should be diversity in presenting data. If prices were presented, they could either be "international" somehow, or they could present more than one marketplace.
  • I disagree that price data is irrelevant in OECD countries. I work for a consumer organization, Consumer Reports, which does activism and lobbying that more medical pricing data be made more public. Consumer REports advocates for greater public awareness of how drugs are purchased, and what happens to the many people who for whatever reason seek to buy drugs on the open market without the support of other funding programs.
  • I am able to provide an organizational opinion that providing drug pricing information is not medical advice. Consumer Reports has published drug price information for decades and has done so in a way is not medical advice, and that establishes a precedent. Example publications presenting price information include the yearly Best Drugs for Less report, educational materials directing consumers to consider price, and consumer guides for ~50 classes of drugs (statins, for example) which compare "effectiveness, safety, and price". It often happens that there can be multiple drugs available to treat a medical condition and price is a major guiding factor in choosing which one is appropriate for the patient. It is politically difficult to acknowledge that people get different medical care depending on the money they have, but it is the reality, and having access to information on drug prices makes it easier for consumers have discussions with their health care providers about what sort of treatment matches their health care needs and the money they have.
  • I might agree that there is not consensus to add prices, but at the same time, I disagree that there is consensus to exclude them. I think it would be best to say that lots of people have varying opinions on the matter, and it is difficult to come to agreement on what is best. I do think there is consensus that without good sources to cite, Wikipedia definitely should not attempt to include price information.

Here are things that I would want to see if prices remained in Wikipedia articles:

1. Excellent sourcing. Right now International Drug Price Indicator Guide and the Tarascon Pharmacopoeia 2015 Professional Desk Reference Edition are proposed as sources. It might be worthwhile to critique these or any sources to confirm or deny that they are respected, reliable, and presenting the sort of information which meets Wikipedia goals to be international and meet general reader needs.
2. Discussion about what kinds of prices are acceptable, and what are not acceptable. For example, there might be consensus that Wikipedia only present prices at the consumer level, and exclude prices at the industry or wholesale level. Whatever the case, perhaps it would be helpful to discuss restrictions and limits in advance. Johnbod makes a sensible suggestion that only the best established prices be mentioned. In the case of drugs, it is easier to describe the cheapest off-patent drugs and the latest, most expensive and highly controlled drugs. Discussing the mid-level markets where the variation is greatest is most difficult. I am not sure what is possible.
3. There should be discussion about international relevance. I have a lot of sympathy for India, which Kashmiri mentioned. In India practically everyone buys out of pocket from local pharmacies. India is a major drug market and would be a great contrast to pricing information from OECD countries. Even if there is no ready solution to providing drug information relevant to Wikipedia readers in India, I think it would be helpful to state that it is a problem if Wikipedia were presenting price information for some places but was not providing a solution for price information in India. China would be another good market to address, but I think it would be easier to eventually get data relevant to India since India's drug market responds to international drug import and export markets more than China's more state controlled market.

Blue Rasberry (talk) 15:23, 16 May 2016 (UTC)

• Support — as long as we use international price points and not only US. Also preferable to solve this using Wikidata and including the information in the infobox. Carl Fredik 💌 📧 18:13, 16 May 2016 (UTC)

Thanks CFCF have been looking at importing prices by bot into Wikidata. Doc James (talk · contribs · email) 18:19, 16 May 2016 (UTC)

Oppose including pricing details

• Strongly oppose on various grounds, including WP policies:
  • WP:PRICE states clearly that Wikipedia is not a sales catalogue and item's current pricing is NOT encyclopaedic information.
  • Wikipedia articles are (mostly) about specific compounds used in pharmacology; WP even requires use of INN names. Whereas pricing can only be given for commercial products.
  • Per WP:GLOBAL, Wikipedia is a GLOBAL ENCYCLOPAEDIA and the majority of English Wikipedia readers are based outside of the US.[33]
  • US drug prices are among the highest in the world [34] [35]. Consequently, quoting US prices will be very misleading.
  • The majority of OECD countries offer public health insurance coverage to their populations, with many (or sometimes all) drugs paid for by the state. Prices found in US pharmacies are utterly irrelevant for those populations.
  • We run a real risk that if we advertise lower prices, patients might be discouraged from buying the medicines they need, instead hoping to find them somewhere cheaper; and thus harming their health. That's the reason Wikipedia is very clear that IT SHOULD NOT OFFER ADVICE.
  • From the links listed by OP, there seems to be a consensus on not adding retail pricing on Wikipedia at all.

— kashmiri ^TALK 09:25, 16 May 2016 (UTC)

You missed the qualifiers at WP:NOTDIRECTORY which is "unless there is an independent source and a justified reason for the mention"

It is not a medical product unless you can actually buy it.

43% of our readers are in the USA [36]

As mentioned we are providing a range of prices which applies to dozens if not more than a hundred countries. There is also a global market in medications.

US prices are among the highest in the world and therefore giving US prices typically provides an upper limit.

That the majority of OECD countries pays for medications for outpts will need a reference. It is not the case in Canada.

Doc James (talk · contribs · email) 15:30, 16 May 2016 (UTC)

• I don't really know what section to comment in. Is the question whether prices can sometimes be included, or that we should include prices routinely? I don't think anyone will argue that pricing information is never appropriate – but if the proposal is to include prices routinely, then the proposal appears to violate WP:NOT. From NOTDIRECTORY, the use of pricing information requires a "justified reason," and specifically excludes "passing mention." The prices here appear to be passing mentions; the source is a database page with no commentary or context. I don’t have access to the Tarascon Pharmacopoeia, but I infer from the description that it's similar.

The standard here is that inclusion should require a source that includes the price as part of a discussion; simply listing it should not be sufficient. This is also in accordance with the comments of several other editors, including a couple in the discussion section that I think are otherwise most easily categorized as Opposes. If e.g. a drug's price has been criticized in the media, that's important information and it should be sourced appropriately. But finding the price in a database, or in any other context where it is presented without commentary, does nothing to establish its relevance to the article.

I also agree with the editors who oppose listing of prices in infoboxes; I see not listing prices in such a manner as one of the key qualitative differences that distinguish us from catalogues and other commercial websites. But inclusion in Wikidata is a different matter, and could be worth considering assuming that their policies allow it. Sunrise (talk) 19:53, 16 May 2016 (UTC)

The proposal is for whether prices can sometimes be included. Yes some are arguing that they should never be included it appears. Doc James (talk · contribs · email) 20:15, 16 May 2016 (UTC)

Oppose. Nothing good can come out of this - what seriously is it supposed to achieve? We know for a fact that the British NHS pays within a five-fold (what does that mean? 5 orders of magnitude? Five times?) difference of the wholesale price in India? I think, knowing how international products are traded, that's highly unlikely. And a conversion from USD to the local currency is going to mean almost nothing, as the wholesale price in any given market is going to vary enormously based on many different factors, so suggesting that it is "available" for this price means almost nothing outside of the USA. And the fact that 43% of readers are in the USA (which I doubt anyway) means that 57% are not. Why should the rest of us be fed information which is only relevant to a minority of readers in the USA? If you want USA-centric information, why don't you start your own digital encyclopedia. JMWt (talk) 17:03, 17 May 2016 (UTC)

5 fold means five times. What is being provided is both the US price and the global wholesale price. Doc James (talk · contribs · email) 21:02, 17 May 2016 (UTC)

And what do you think that's telling someone who isn't in the USA? You are presumably aware that a "global wholesale price" doesn't exist, right? JMWt (talk) 21:14, 17 May 2016 (UTC)

Did you look at http://erc.msh.org/dmpguide/ Doc James (talk · contribs · email) 22:31, 17 May 2016 (UTC)

Brilliant, although on quick search, "buyer prices" are only available for South Africa, Sudan and one or two developing countries. Still, hope you don't intend to duplicate this database on Wikipedia? — kashmiri ^TALK 22:39, 17 May 2016 (UTC)

Strong, strong oppose per Kashmiri who makes a number of very good points including about our global nature, national insurance schemes, not listing prices, and misleading readers. A global wholesale price doesn't reflect at all the large amount of other English-speaking countries who may subsidize or nationally or regionally negotiate or mandate prices. Some of these other large countries include the UK and India and as per JMWt 57% of our readers. As a non-US reader I am completely opposed to a misleading and potentially harmful effort that doesn't reflect the reality of sale prices for 57% of our readers, nor take into account insurance rebates etc. I don't think this issue can be dealt with in the same nuance that we'd expect of a WP article, and such a nuance certainly not in an infobox.--Tom (LT) (talk) 02:27, 18 May 2016 (UTC)

Discussion

• Cost benefit analyses are done in many areas of the world and these rely on the cost of medications.
• Cost is also taken into account by the World Health Organization when they put together their essential medicines list.
• In many areas of the world medications are purchased in the international market. Medicine San Frontier for example puts together a price list to help with their work. Thus the international price applies to around 100 countries. Doc James (talk · contribs · email) 22:48, 15 May 2016 (UTC)

I personally don't feel like we should include price information in an encyclopedia. Here's why:

• The price varies depending on country
  • In Canada, the end-user price varies depending on province/insurance. Wholesale prices are controlled to some extent by the government.
  • In the UK, the end-user price is a flat fee set by the NHS. Prices are controlled to some extent by the government.
  • In the US, the end-user price varies depending on insurance status (have insurance vs. paying cash) and insurance benefits (lots of different ways to handle drug coverage - percentage-based, flat copays, deductables, etc). Additionally:
    • It varies based on what pharmacy you go to (store X (e.g. CVS) vs. store Y (e.g. Walgreens), retail vs. discounted retail (e.g. Walmart) vs. mail-order)
    • It varies if you use discounts, which can be third party ("drug savings card"?), manufacturer coupons (usually time-limited), manufacturer-paid (low income programs), etc
    • It varies based on the pharmacy benefits manager used and the drug formulary.
    • It varies based on insurance plan

Another major point is that when a generic for a brand-name drug comes out, prices can change drastically overnight. Medication prices are always changing, and there's no way that we can keep up with prices, which will be completely inaccurate for anyone seeking pricing information anyways as we're generally listing wholesale prices, which do not factor in several additional layers of profit margins, and are utterly useless to the average person. Here's a personal example for a hypothetical drug (although this is actually based on a real medication I'm on). I pay a fixed copay for this drug of $A. The pharmacy claims the drug cost $B on the info accompanying the drug (and that my insurer saved me $(B - A)). My insurer's report says they paid the pharmacy $C for the drug. $B is much greater than $(A + C). The cash price that pharmacy would charge for the same drug is $D according to GoodRX, which is close to the pharmacy's official cash price of $B. If you use GoodRX's discount program, you would pay $E. Confusing, right? Garzfoth (talk) 23:55, 15 May 2016 (UTC)

• I don't much like the idea of simply including the price indiscriminately or as a matter of routine. And considering what Garzfoth said just above, it may be better to use wholesale than retail pricing, or to indicate a range of prices. But I think the decision about whether to include pricing at all depends upon context. As Doc James said, it becomes relevant in the context of cost-benefit analysis, etc. So if, for a particular drug, there is content about something significant concerning cost-benefit or other analyses or classifications, then specific pricing information can and probably should be stated explicitly in that content. On the other hand, simply saying routinely for each drug that its typical price is such-and-such strikes me as unencyclopedic, and I would not want to see prices in infoboxes. --Tryptofish (talk) 00:22, 16 May 2016 (UTC)
  • User:Tryptofish We are using the whole sale price and we are providing a range of prices. We are not writing for "patients". Someone pays. Many people care about the price and price often determined what meds are covered.
  • This is not typically true "Medication prices are always changing" Medication prices are typically more or less stable for years. For example:
    • Price for salbutamol in a bunch of countries in 2014 between 0.0056 and 0.0132 per dose[37]
    • 2006 0.0043 to 0.0145 per dose[38]
    • 1996 0.0055 to 0.0095 per dose[39]
  • 20 years and the lowest price per dose changed by only one hundredth of a cent
  • Yes when meds become generic the price decreases. It is notable not only when the med becomes generic but the new lower cost if any.
  • By the way we are talking about meds on the WHO essential medication list. All these meds have had cost benefit analysis done.
  • Doc James (talk · contribs · email) 02:36, 16 May 2016 (UTC)

Is that adjusted for inflation? Seppi333 (Insert 2¢) 05:26, 16 May 2016 (UTC)

Do not think so. So a slight decrease in price over the years than. Doc James (talk · contribs · email) 05:29, 16 May 2016 (UTC)

US cell-phone pricing—which depends on carrier, contract-length, special promotions, etc.—is almost as confusing as US drug pricing, but the iPhone article is full of prices. Complicated pricing schemes (and the resulting obfuscation) are all the more reason to include an approximate "market price" that might be difficult for the average reader to locate independently. —Shelley V. Adams ‹blame
credit› 03:30, 16 May 2016 (UTC)

Yep, they seem to be violating WP:PRICE in the iPhone article. But that article has been cared for by Apple fans, and here we are dealing with serious stuff, not tech gadgets :) — kashmiri ^TALK 09:29, 16 May 2016 (UTC)

The lone opponent has some interesting ideas, but I don't think that they hold up under scrutiny:

• "WP:PRICE states clearly that...current pricing is NOT encyclopaedic information."
  1. PRICE says that encyclopedic relevance can be established if the prices are discussed in good sources, and discussion of price is typical for generic drugs and universal for drugs still under (or recently released from) patent protection.
  2. Who said that it would only include "current pricing"? It'd be far more interesting to include information about how the price changed over time (e.g., once a decade for as far back as our sources go).
• "pricing can only be given for commercial products."
  • If it gets sold, then it's a commercial product, so this seems like a tautology. Perhaps you mean that prices can only be given for particular combinations of brand name/manufacturer/location/time? That wouldn't be factually true; we have good sources that give wholesale prices from around the world, based upon the compound itself.
• "quoting US prices will be very misleading....Prices found in US pharmacies are utterly irrelevant for those populations."
  • Who said that we'd be quoting only US prices? Who said that we'd be giving prices for any pharmacy? The goal is the wholesale price, not retail.
• "We run a real risk that if we advertise lower prices, patients might be discouraged from buying the medicines they need"
  • Wikipedia is WP:NOTCENSORED, even to protect people from their own ignorance about the difference between global wholesale prices and local retail prices. WhatamIdoing (talk) 13:34, 16 May 2016 (UTC)
• It strikes me that WP is the wrong place for such data to reside, though (depending on discussion results) it might be a good place for readers to find it. Price data is still data, and there's no real reason to bind it to an English language text format. It would be much more at home on Wikidata in a language-neutral form. Then insertions, revisions, national prices, currencies, and references inserted there once will be reflected on all using wikis simultaneously. We should avoid creating a local crapheap on w:en that just has to be cleaned up after the fact. LeadSongDog come howl! 16:12, 16 May 2016 (UTC)

Yes Wikidata has now been set up from what I understand to handle this data. I am not much of a Wikidata editor though.

I have just shown that the price of salbutamol internationally has not changed in 20 years User:LeadSongDog so not sure what "cleanup" you are referring to? Yes medications become generic once in their existence. We have a number of currencies that are used internationally with the USD and Euro being two of them. Many countries in the developing world either us USD or prefer it to their national currency.

Doc James (talk · contribs · email) 16:56, 16 May 2016 (UTC)

@Doc James:Every wp article that gets price info added into it would then need it removed once there's a way to use d: instead. It would seem simpler and better to just get the location right the first time. LeadSongDog come howl! 19:27, 16 May 2016 (UTC)

Hum okay thanks. Are we using d: for anything outside of the infobox at this point? I could look into doing that. Doc James (talk · contribs · email) 20:18, 16 May 2016 (UTC)

Doc James: For sure you mean Zimbabwe? [40] Neither China, nor India, nor Brazil, nor Russia (which combined account for more than 50% of world's population) do not "prefer USD" in drug pricing to the best of my knowledge. But ok, let's agree on USD or EUR, that still does not address the key questions raised above. And BTW even if price of salbutamol, a patent-free small molecule, has not changed in 20 years (I can't locate your proof, though), the most problematic and expensive drugs are those still covered by patents and/or in the marketing exclusivity period, and their prices can vary several orders of magnitude between countries. — kashmiri ^TALK 17:58, 16 May 2016 (UTC)

If you look at were I provide prices for salbutamol by year you will notice a link to the reference beside each.

With respect to countries that like USD I am thinking of Cuba, much of Central America, and much of Africa. In Tanzania they request payment of not only bribes but entry fees and hotel rooms in USD. Iran also requires payment of hotel fees and tour fees in either USD or Euro.

You mention "vary several orders of magnitude between countries". Several orders of magnitude fold is very small. If they varied by 10 or 100 fold that would be a stronger argument.

We already give a price range of salbutamol of 1.12 to 50 USD. Doc James (talk · contribs · email) 18:15, 16 May 2016 (UTC)

It's probably worth pointing out here that one order of magnitude is 10 fold; two orders of magnitude equals 100 fold. In any event, I'm not entirely convinced that it is a good idea to quote an "international price" in USD due to currency inflation and changes in forex valuations. Seppi333 (Insert 2¢) 18:24, 16 May 2016 (UTC)

Yes thanks. I have not seen prices vary by several orders of magnitude (100 fold) among OECD countries (except for brief periods of time). Would be interested in seeing a reference for this if one can be found.

Our sources often quote the price in USD. I know the MSF uses Euros. Doc James (talk · contribs · email) 18:43, 16 May 2016 (UTC)

I'm not saying an international price shouldn't be quoted in USD; if one quoted at all, it should be in USD because that's easily the most actively traded/liquid currency in the world. I'm just not convinced that a USD quote would be particularly useful to someone who doesn't live in the US because they'd literally need to look up their exchange rate and convert it to their currency for context (i.e., to compare the price of the drug relative to the price of other things they buy in their currency). Seppi333 (Insert 2¢) 18:54, 16 May 2016 (UTC)

Many outside the US know the conversion between their own currency and USD. Otherwise it is fairly easy to look up. Would be interesting to build a tool that uses a readers IP add the local currency in brackets. Doc James (talk · contribs · email) 16:31, 17 May 2016 (UTC)

Many outside the US know the conversion between their own currency and USD. - you know that how? Seppi333 (Insert 2¢) 16:36, 17 May 2016 (UTC)

That's a bit of a red herring. Whether or not individuals know this, the USD is the reference currency for interbank transactions on the foreign exchange market.(see http://www.bis.org/press/p130905_fr.pdf) We already have guidance at wp:CURRENCY saying that country-non-specific articles should use United States dollars, euros, or pounds sterling. We also have templates that can do the conversion {{EUR}}, {{GBP}} and apply historic inflation {{inflation}} where needed, and even a navbox: {{Exchange Rate}}, which renders as, e.g.

Current EUR exchange rates
From Google Finance:	AUD CAD CHF CNY GBP HKD JPY USD RUB INR
From Yahoo! Finance:	AUD CAD CHF CNY GBP HKD JPY USD RUB INR
From XE.com:	AUD CAD CHF CNY GBP HKD JPY USD RUB INR
From OANDA:	AUD CAD CHF CNY GBP HKD JPY USD RUB INR

.LeadSongDog come howl! 18:49, 17 May 2016 (UTC)

ok, but that's quite misleading, because there are lots of reasons why products have different wholesale prices in different markets. An item might well be available for $x in the USA but be a completely different price elsewhere. Given that some medications are particularly sold in some jurisdictions at or below cost and some are vastly expensive in others, some spot wholesale price in one place is totally useless when one desires to know how much it would be to get a wholesale purchase where I am, Unless I happen to be in the USA. There is no "global wholesale" price of anything. How are you imagining this information would be informing the global WP reader? JMWt (talk) 21:25, 17 May 2016 (UTC)

@LeadSongDog: It's not a red herring at all. It's a real problem that is resolved by listing the US price with the price quoted in other major English speaking currencies; the converted price needs to be updated with the closing exchange rate from the preceding day in order to circumvent the issue. Seppi333 (Insert 2¢) 22:28, 17 May 2016 (UTC)

@Seppi333 not just a matter of exchange rates at all. You can look at how national pricing of the new Hepatitis drugs such as Sofosbuvir to gain some insight into the determinants of pricing in non-US countries. As you may have encountered there are legislative approaches to essential and nonessential drugs, pricing of generies, and national or regional negotiation strategies that countries employ -- not to mention that many of these costs are not passed on in many non-US countries to the end users, who may have national or private insurance policies that reduce or rebate the costs of the drugs. Not an issue that can be simply dealt with by exchange rates.--Tom (LT) (talk) 02:32, 18 May 2016 (UTC)

I realize this. There's 4 price issues that have been discussed in this section: whole price variability in USD over time, USD inflation, pricing USD in other currencies, and the additional cost of a drug above the wholesale price which is unique to each nation and varies by government subsidization and/or private insurance. I'm just talking about the forex issue here. Seppi333 (Insert 2¢) 02:42, 18 May 2016 (UTC)

category for early psychosis

I wonder if we can create a category for early psychosis, which would be a sub-category of psychosis, to organize at least 3 articles: at-risk mental state, early intervention in psychosis, and basic symptoms of schizophrenia. These articles all relate to the early detection of psychosis, so it may useful to have a category for them.--Beneficii (talk) 07:08, 16 May 2016 (UTC)

What would be the purpose? Carl Fredik 💌 📧 09:57, 16 May 2016 (UTC)

To create an organized category on early psychosis from which people can access the relevant articles.--Beneficii (talk) 18:06, 16 May 2016 (UTC)

I created the category, called Early psychosis.--Beneficii (talk) 18:28, 17 May 2016 (UTC)

Referencing popular culture in medical articles / Amyotrophic_lateral_sclerosis

This text was added

A storyline in the ''Incredible Hulk'' series in 2000 saw [[Hulk (comics)|Bruce Banner]] dealing with the revelation that he has ALS<ref>''The Incredible Hulk'' vol.2 #12</ref>[41]

Often people reference the comic itself or the tv show etc. IMO this is primary research? Wondering what others thoughts are? Doc James (talk · contribs · email) 15:37, 16 May 2016 (UTC)

agree this edit [42] does not enhance the Society and culture section of Amyotrophic_lateral_sclerosis...IMO(while the Research section could use help/edits)--Ozzie10aaaa (talk) 21:41, 16 May 2016 (UTC)

That edit is actually valid in terms of fiction and TV shows. MOS:PLOT says: The plot summary for a work, on a page about that work, does not need to be sourced with in-line citations, as it is generally assumed that the work itself is the primary source for the plot summary. However, editors are encouraged to add sourcing if possible. If a plot summary includes a direct quote from the work, this must be cited using inline citations per WP:QUOTE. Sometimes a work will be summarized by secondary sources, which can be used for sourcing. Otherwise, using brief quotation citations from the primary work can be helpful to source key or complex plot points. Presenting fictional material from the original work is allowed, provided passages are short, are given the proper context, and do not constitute the main portion of the article. If such passages stray into the realm of interpretation, per WP:PRIMARY, secondary sources must be provided to avoid original research. Plot summaries cannot engage in interpretation and should only present an obvious recap of the work.

Feels terribly like OR to me but that is how those people roll. There isn't a basis in policy/guideline to exclude it in the Society and culture section. Maybe split off in a subsection about popular culture/media or something. Jytdog (talk) 23:08, 16 May 2016 (UTC)

Jytdog makes a fair point about MOS:PLOT, but there is something that feels weird about it. I think it arguably goes against MOS:INUNIVERSE, unless there are independent sources saying the same thing. I'm not familiar with the comic, but if there aren't other sources saying the same thing, I wonder if the comic explicitly said he had ALS or if it was just heavily implied. Tagging Doc James since this thread is getting a little old. —PermStrump(talk) 17:06, 17 May 2016 (UTC)

Oh no, that happened. I remember buzz in ALS-land when that issue published. Jytdog (talk) 21:42, 17 May 2016 (UTC)

Hah, well then I would assume it could be backed up with a more reliable source. —PermStrump(talk) 02:42, 18 May 2016 (UTC)

RfC: Wikidata in infoboxes, opt-in or opt-out?

There is currently an RfC at Wikipedia:Village_pump_(policy)#RfC:_Wikidata_in_infoboxes.2C_opt-in_or_opt-out.3F which has the potential to have a major impact on how we use templates. The new Template:Infobox medical condition(new) is a ß-version displaying a number of great uses of Wikidata for diseases and medical conditions — see for example Gout. Changing policy of Wikidata items to opt-in would undermine the entire venture and lose a potential source of quality data for article infoboxes.

Please comment. Carl Fredik 💌 📧 18:05, 16 May 2016 (UTC) 

• give opinion(gave mine)--Ozzie10aaaa (talk) 19:00, 16 May 2016 (UTC)

CFCF I asked this over at the RfC but how would "opt-in" prevent using WikiData in infoboxes like you used it at gout? Jytdog (talk) 21:26, 16 May 2016 (UTC)

We are "opt-out" right now. I am not exactly sure what that means. What difference will opt-in make? Doc James (talk · contribs · email) 22:54, 16 May 2016 (UTC)

Am trying to figure that out. From what I can tell with "opt in" you would need to add some kind of flag to the infobox (or maybe to each field?) to allow WikiData in. I think that is better, based on the little I know. WikiData gets manipulated by SEO folks all the time (there are SEOs who market themselves as doing that for clients), there is all kinds of unsourced data in it from what I gather, and i have no idea how well or how carefully curated it is. Also changes it makes to the actual infobox should show up in the history and therefore in watchlists, and they don't now. Jytdog (talk) 23:03, 16 May 2016 (UTC)

Yes thanks, that makes sense.

At least for now I agree "opt in" makes sense. Doc James (talk · contribs · email) 23:08, 16 May 2016 (UTC)

External link being added to many bacteria articles

Hi folks, I was wondering about links to this database [43] being added to numerous articles about bacteria. Here's one example: [44]. The two editors adding the links, User:L.C.Reimer and User:AnnaVetci), appear to be authors of the paper describing the database: [45]. They seem to be promoting the website. So far, they've added these links to over a thousand Wikipedia articles. CatPath (talk) 16:55, 17 May 2016 (UTC)

Agree. There is a "mass rollback" ability but not sure how to get it to work. Doc James (talk · contribs · email) 20:34, 17 May 2016 (UTC)

User:CatPath have removed the links in question. Doc James (talk · contribs · email) 21:41, 17 May 2016 (UTC)

Would be good to check the value of this database. It is managed by DSMZ, and judging from their website they are a bona fide research institution in Germany.[46] [47]. Their data might actually be valuable enough to be included on Wikipedia, although I'd imagine Wikidata would be the place to go. — kashmiri ^TALK 21:43, 17 May 2016 (UTC)

(edit conflict) For what it's worth, there's still about 100 instances of this link on Wikipedia, many of them added by an IP editor a few weeks ago. - Aoidh (talk) 21:45, 17 May 2016 (UTC)

It is basically another database. Content belongs in wikidata. Import could be done. Doc James (talk · contribs · email) 22:00, 17 May 2016 (UTC)