Talk:Anthroposophic medicine/Archive 3
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Category
There are several references that support AM being a Whole medical system[1] [2] [3] I'd like to suggest that it should be categorized as such.
References
- ^ Jeschke, Elke (Mar/Apr 2011). "Anthroposophic Medicine in Pediatric Primary Care: A Prospective, Multicenter Observational Study on Prescribing Patterns". Alternative Therapies. 17 (2): 18–28.
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suggested) (help) - ^ Tabali, Manuela (2009). "Educational intervention to improve physician reporting of adverse drug reactions (ADRs) in a primary care setting in complementary and alternative medicine". BMC Public Health. 9 (274). doi:10.1186/1471-2458-9-274.
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hgilbert (talk) 02:40, 31 August 2012 (UTC)
"Whole medical systems" is a controversial category to start with, and the leading source of the definition (NCCAM) does not include anthroposophy. The sources you cite appear to be anthroposophical sources, so have a vested interest in promoting this particular form of magick. They also appear to be primary sources. It is a term not much used outside the field of quackery promotion, and even within that small ambit does nto appear to be much used in respect of anthroposophy, which is in any case pretty insignificant in terms of reach. Guy (Help!) 19:03, 2 September 2012 (UTC)
- They are peer reviewed sources. Are you suggesting that, by analogy, no material written by Jews, even if in peer-reviewed journals, are competent sources for articles on Judaism? hgilbert (talk) 19:24, 2 September 2012 (UTC)
- I'll suggest that 1 and 3 are not WP:MEDRS and 2 refers to it only generically as a type of complementary medicine.a13ean (talk) 19:41, 2 September 2012 (UTC)
- This is not about whether anthros are a reliable source about anthroposophy (though that is a difficult one since they believe so we have to weigh their opinion against reality); it's about whether their claims to be a thing of class X are acceptable when independent sources, including the canonical source, NCCAM, do not appear to support the claim. Guy (Help!) 15:34, 3 September 2012 (UTC)
- First of all, it is not the case that all the many authors of these articles/books are "anthros". Second of all, it doesn't matter who authors are so long as their works are published in peer-reviewed sources (something well established in the arbitration proceedings over this and related articles). Finally, scientific work is not the Catholic Church; NCCAM is not a canonical source (!!!), whatever that would be, and its statement did not pretend to be a complete list of WMSs. The sources are not in conflict, they are various descriptions of a phenomenon.
- When my Audobon guide does not include certain birds listed in other bird guides, I do not therefore conclude that the latter are spurious. hgilbert (talk) 12:00, 4 September 2012 (UTC)
- You are missing the point. The sources are not reliable, independent sources. The canonical source for the term is NCCAM and they do not include this. The term itself is in any case a simple case of new names for old bullshit. Guy (Help!) 21:36, 4 September 2012 (UTC)
pov?
Two recent contributions appear to display undue pov, with intent, which detracts from whatever value could otherwise be attached to the comments being made:
- 1_"the idea that this twaddle is 'an extension to conventional medicine' is distinctly controversial" ( JzG's Revision 23:09, 30 August 2012)
- 2_"this particular form of magick" (Guy 19:03, 2 September 2012)
Qexigator (talk) 22:16, 2 September 2012 (UTC)
- There are no edits which violate WP:NPOV as that applies only in article space. To describe anthropsophical "medicine" in such terms in discussions is entirely reasonable and in line with the scientific consensus. It is pseudoscience, as I am sure you are well aware. Which reminds me, someone seems to have removed Category:Pseudoscience from the article, naughty naughty. Guy (Help!) 14:39, 3 September 2012 (UTC)
--Thank you, Guy, for making a response. Perhaps it will help if I add that the above two comments quoted (at 22:16, 2 September 2012) belong to a type of discourse which is anti-scientific, and possibly could be categorized as a branch of pseudo-science, lacking the exactitude and rigour of thought which is normally accepted as one of the characteristics of scientific enquiry. They are not expressed in terms which can be regarded as of the quality suited to a worthwhile discussion regarding the "scientific" status of, say, mathematics, epistemology, quantum physics, gravitation, biology or any kind of scientific method or practice as an intellectual pursuit or discipline. They seem to be aimed at winning an argument merely by using a pejorative label. That is not a scientific way of evaluating a bona fide method of practising medicine of any kind. The authors of the comments may be aware that whether or not either violates WP:NPOV is beside the point.Qexigator (talk) 15:28, 3 September 2012 (UTC)
- That may be your assertion, but it is an established fact that anthroposophic medicine is characterised as pseudoscience by reliable independent sources, and there is absolutely no objectively verifiable support for its distinct features such as "karmic destiny". Anthroposophy does not work within the scientific method. It does not make objectively rtestable claims, and its investigations, like those of homeopathy, are framed in terms designed to confirm, not test, belief. All this is very well documented. Wikipedia, being a reality-based project, will of course reflect these facts. Guy (Help!) 15:48, 3 September 2012 (UTC)
- I suggest you become familiar with WP:FRINGE. We don't present pseudoscience as legitimate. Doing so would unduly legitimize it. Edit summaries are just that, edit summaries, NPOV need not apply as they aren't in the article. IRWolfie- (talk) 15:54, 3 September 2012 (UTC)
Briefly, WP:FRINGE and WP:NPOV amount to exhorting fair reporting in articles about all topics, including those about science or medicine. This can be especially relevant when giving an account of matters rooted in belief systems of all kinds, with names such as theism, atheism, scienticism, rationalism and so on. It is not the purpose of such reporting to support or attack, to trivialise or persuade. The general purpose is to inform, not instruct. Qexigator (talk) 20:10, 3 September 2012 (UTC)
- I suggest reading WP:FRINGE thoroughly. We keep the mainstream position in perspective at all times; even in these articles dedicated to a fringe subject. IRWolfie- (talk) 22:35, 3 September 2012 (UTC)
Not quite spot on maybe (IRWolfie 22:35, 3 September 2012), but still a good cue for reviewing topics such as Mainstream in science and Philosophy of science in connection with John Milton's Areopagitica and Isaac Newton's General Scholium. Certainly "pseudoscience" needs to be carefully reconsidered and its abuse as a pejorative resulting in or from what could be called rigor orthodoxa. And what does "We" denote in "We keep..."? Qexigator (talk) 11:38, 4 September 2012 (UTC)
- "We" as in wikipedia. I'm not sure why you are mentioning Milton or Newton. On wikipedia we characterize pseudoscience as pseudoscience. This has been through the Arbitration committee already, see the top of WT:FRINGE for the highlights:
- Serious encyclopedias: Serious and respected encyclopedias and reference works are generally expected to provide overviews of scientific topics that are in line with respected scientific thought. Wikipedia aspires to be such a respected work.
- Obvious pseudoscience: Theories which, while purporting to be scientific, are obviously bogus may be so labeled and categorized as such without more.
- Generally considered pseudoscience: Theories which have a following, such as astrology, but which are generally considered pseudoscience by the scientific community may properly contain that information and may be categorized as pseudoscience.
Thanks, IRWolfie, for that clarification. Milton was mentioned only as author of Areopagitica and Newton as author of General Scholium; both works were by established authors whose propositions were contorversial in their own time (and to some extent are today), works which are well known to scholars and the subjects of readily accessible Wikipedia articles; and maybe some will comprehend their relevance to the present discussion. Qexigator (talk) 12:05, 4 September 2012 (UTC)
- If you are hinting that one day all pseudoscience will be vindicated and that wikipedia should hold out for that eventuality, sorry but that isn't how wikipedia operates. We report what the reliable sources say; with the mainstream sourcing getting the most weight. If the mainstream sources disparage or dismiss something, we take that into account in the article. IRWolfie- (talk) 13:07, 4 September 2012 (UTC)
Does IRWolfie's reply of 13:07 4 September 2012 make it look as though s/he is looking for a fight, perhaps in the interest of the pov's displayed at User:IRWolfie- ? Thus:
- 1_Attributing opinions with no justification, as in "If you are hinting that one day all pseudoscience will be vindicated and that wikipedia should hold out for that eventuality..."
- 2_...to make a Straw man to be knocked down, as in "... sorry but that isn't how wikipedia operates."
- 3_Empty attempt at point scoring or self-justification (perhaps injured innocence) under the protective "we" by diverting discussion from what is being proposed or developed, as in "We report what the reliable sources say; with the mainstream sourcing getting the most weight. If the mainstream sources disparage or dismiss something, we take that into account in the article." Qexigator (talk) 13:46, 4 September 2012 (UTC)
- I'm not looking for a fight, assume good faith. You've brought in examples without clarifying when asked. IRWolfie- (talk) 16:13, 4 September 2012 (UTC)
Re: IRWolfie- 16:13, 4 September 2012
- 1_"I'm not looking for a fight..". Thanks again for this clarification.
- 2_"... assume good faith." Quite so.
- 3_ "You've brought in examples without clarifying when asked." I am of the opinion (rightly or wrongly) that no party should be making use of the pseudoscience label for whom the two examples are not self-explanatory, either as soon as mentioned or after careful consideration (but I readily acknowledge that a party who does so is not necessarily of bad faith). Further, I object to what looks to me as an attempt to avoid the issue initially raised expressing concern at contributions which appear to display undue pov, with intent. Qexigator (talk) 17:28, 4 September 2012 (UTC)
- It is self-explanatory. See if you can find the scientific definition of karmic destiny. Guy (Help!) 20:33, 4 September 2012 (UTC)
- My guess would be the gradient of the karmic field although I may be off by a constant =) a13ean (talk) 22:02, 4 September 2012 (UTC)
- Hey, that's pretty good. hgilbert (talk) 23:33, 4 September 2012 (UTC)
- My guess would be the gradient of the karmic field although I may be off by a constant =) a13ean (talk) 22:02, 4 September 2012 (UTC)
What is It... which is self-explanatory? (in Guy's of 20:33, 4 September 2012). Qexigator (talk) 21:28, 4 September 2012 (UTC)
- You have already been pointed towards the guidelines. IRWolfie- (talk) 21:32, 4 September 2012 (UTC)
Yes, Wolfie, let the guidelines be, but I note again what looks to me like an attempt to avoid the issue initially raised expressing concern at contributions which appear to display undue pov, with intent. Perhaps we can leave it there? Qexigator (talk) 21:42, 4 September 2012 (UTC)
- The "it" which is self-explanatory is that a field that contains homeopathy, karmic fields and the like is pseudoscientific. The thing that makes anthroposophic "medicine" distinct from medicine is the integration of pseudoscientific concepts. Since its separate identity relies on the use of pseudoscientific concepts, it is characterised as pseudoscientific by reliable independent sources. Wikipedia is well aware that advocates of pseudoscience dislike the term, I am afraid this is a case of "reality being at fault" as Douglas Adams had it. Guy (Help!) 11:23, 5 September 2012 (UTC)
Thank you Guy for explaining what was meant in an intelligible and unemotive way. I happen to hold Douglas Adams's work in some esteem, but may be the shoe is on another foot than the one you have proposed (guidelines apart). Perhaps that is enough said, and we can now let it go at that?Qexigator (talk) 12:34, 5 September 2012 (UTC)
_Meantime, Revision Scientists, mainstream medical doctors, and other skeptics... (13:12, 10 September IRWolfie) (without discussing in greater detail the merits of their belief systems or of the citations) looks about OK to...Qexigator (talk) 14:18, 10 September 2012 (UTC)
Pseudoscience
A previous discussion agreed that this should not be categorized as pseudoscience (see high bar for such categorization in WP:Categories) but that the sources for such a description should be documented in the article. hgilbert (talk) 17:33, 3 September 2012 (UTC)
- Agreement three years ago between 3 editors isn't binding in any way. You've also removed the wording that Homoeopathy and naturopathy are pseudoscience. Your wording in the lead seeks to legitimize Anthroposophical medicine. This is contrary to WP:FRINGE. There is no "western medicine", there is only medicine. If you wish, I can get as many sources as required to say that Homeopathy and naturopathy are pseudoscience; choose how many high quality sources you wish. How many sources do you want that state medicine is called medicine. ("Western medicine" is called medicine, it's why the it redirects to medicine) IRWolfie- (talk) 22:33, 3 September 2012 (UTC)
- I suggest an RfC, on each of the wording, and on the category. IRWolfie- (talk) 22:36, 3 September 2012 (UTC)
- Unnecessary, there is a well referenced discussion of why anthroposophical "medicine" is a pseudoscience in List of topics characterized as pseudoscience. An RfC would mainly serve as an invitation to offsite solicitation. Guy (Help!) 00:00, 4 September 2012 (UTC)
- There have been substantial discussions about the criteria for inclusion in List of topics characterized as pseudoscience. Anything that anyone has ever characterized as PS, whether the characterization is true or not, is presently listed there. Did you really not know that?
- I agree with IRWolfie's proposal for an RfC. I recognize that there is a risk that one of you will attempt offsite solicitation, but am willing to incur the risk. hgilbert (talk) 12:05, 4 September 2012 (UTC)
- Please retract the specific bad faith assumptions you have made about me possibly canvassing offwiki. I will prepare text for the RfC with the adequate sourcing etc; if an RfC does occur. Before any RfC we need to discuss all the details; can you please highlight why you don't wish Homeopathy and Naturopathy to be described as pseudoscience. Also highlight what you would require for something to be described as pseudoscience. IRWolfie- (talk) 13:02, 4 September 2012 (UTC)
- Guy: I agree with IRWolfie that we need a retraction here. It was an uncalled for comment. hgilbert (talk) 23:36, 4 September 2012 (UTC)
- You are of course wrong: I said that an RfC would be an invitation for offsite canvassing, that is a known risk with RfCs on subjects where people have deep personal beliefs that are at odds with objective reality (for example anything to do with creationism). I did not imply that either side would be more or less guilty of this. You then turned that into an accusation directly against those supporting the scientific consensus, i.e. you turned a generic warning into an accusation against people who do not share your POV. If you can't see the difference then you probably have no business here. Guy (Help!) 11:17, 5 September 2012 (UTC)
- Guy: I agree with IRWolfie that we need a retraction here. It was an uncalled for comment. hgilbert (talk) 23:36, 4 September 2012 (UTC)
- Please retract the specific bad faith assumptions you have made about me possibly canvassing offwiki. I will prepare text for the RfC with the adequate sourcing etc; if an RfC does occur. Before any RfC we need to discuss all the details; can you please highlight why you don't wish Homeopathy and Naturopathy to be described as pseudoscience. Also highlight what you would require for something to be described as pseudoscience. IRWolfie- (talk) 13:02, 4 September 2012 (UTC)
- Hgilbert, You know I was talking to you. Don't do that. IRWolfie- (talk) 19:29, 5 September 2012 (UTC)
- Pardon?? It was Guy who made the bad faith assumption, not me. I responded to him that I'd be willing to take the chance. hgilbert (talk) 19:45, 5 September 2012 (UTC)
- Hgilbert, you are aware that Guy's comment was not directed at you. Your comment was directed at me and Guy. IRWolfie- (talk) 19:52, 5 September 2012 (UTC)
- Pardon?? It was Guy who made the bad faith assumption, not me. I responded to him that I'd be willing to take the chance. hgilbert (talk) 19:45, 5 September 2012 (UTC)
- Hgilbert, You know I was talking to you. Don't do that. IRWolfie- (talk) 19:29, 5 September 2012 (UTC)
- As I said, the references for this being considered pseudoscience are sound. Anthroposophical "medicine" distinguishes itself from medicine solely by the inclusion of pseudoscience. It is a pretty unambiguous one. Guy (Help!) 14:55, 4 September 2012 (UTC)
Criteria
The recently removed information about AM's approach to vaccination comes from a peer-reviewed text, a more Reliable source than an editor's personal taste or judgment. I have restored the information. (See WP:Truth for clarity about whether you personally think something is true or not outweighs a reliable source) hgilbert (talk) 00:51, 8 September 2012 (UTC)
- Making that revision of 23:45, 7 September 2012 IRWolfie said "That sounds a lot like some bizarre weasely justification for not taking vaccines." But to a reader not wishing to be influenced by partisan polemic either way it sounds like common sense and practical ethics in applied medicine.Qexigator (talk) 07:37, 8 September 2012 (UTC)
- The version which I restored states "anthroposophical doctors try to minimize the use of ... vaccinations" which is both more clear and very mild. The AM community also broadly presents itself in these terms: 1 2 3 etc... a13ean (talk) 21:11, 8 September 2012 (UTC)
- As I read the 3 links helpfully given by a13ean (21:11, 8 September 2012 (UTC) ), they seem to support the words omitted, viz: while supporting a differentiated individual approach to vaccinations. Would not the article be more usefully informative if those words were included and the links added? Qexigator (talk) 22:03, 8 September 2012 (UTC)
- Indeed, two of these sources clearly suggest a differentiated approach. Now there are a total of three.
- 1 "This article does not suggest that one choice is better than another. It does, however, encourage parents to become well informed on the risks and benefits of both the diseases and the vaccines and consult their medical provider to arrive at the best decision for their child and their family."
- 3 Not a very good source -- more of a blog. Nevertheless, "vaccinations / immunizations [must be] used only after an in depth education regarding the safety and risks, and then only with great care and discernment about the potential impact." hgilbert (talk) 01:06, 9 September 2012 (UTC)
- AnthroMed Library publishes the following, as well: "The Medical Group for Differentiated MMR Immunization and the Groupe Medical de Reflexion sur le Vaccin ROR are not against immunization as such. They do, however, advocate a cautious approach, taking account of the individual situation and of the specific problems of each of the three childhood diseases, avoiding fundamental changes to their epidemiology and respecting parents' freedom of decision. " : Hans-Ulrich Albonico, "Swiss Campaign for Measles, Mumps and Rubella Immunization" hgilbert (talk) 01:19, 9 September 2012 (UTC)
- These are non-MEDRS compliant sources and amounts to a "teach the controversy" style approach to vaccines. IRWolfie- (talk) 17:15, 9 September 2012 (UTC)
- Indeed, two of these sources clearly suggest a differentiated approach. Now there are a total of three.
- As I read the 3 links helpfully given by a13ean (21:11, 8 September 2012 (UTC) ), they seem to support the words omitted, viz: while supporting a differentiated individual approach to vaccinations. Would not the article be more usefully informative if those words were included and the links added? Qexigator (talk) 22:03, 8 September 2012 (UTC)
- The version which I restored states "anthroposophical doctors try to minimize the use of ... vaccinations" which is both more clear and very mild. The AM community also broadly presents itself in these terms: 1 2 3 etc... a13ean (talk) 21:11, 8 September 2012 (UTC)
- You are adding non-MEDRS compliant sources to justify a fringe position on vaccines. Please don't do that. IRWolfie- (talk) 17:10, 9 September 2012 (UTC)
Typos or what?
- Pertussis spells "whooping".
- The link spelt "innoculation" gives redirect to Inoculation. --Qexigator (talk) 18:45, 9 September 2012 (UTC)
- "Whooping" and "inoculation" are the correct spellings. Dominus Vobisdu (talk) 19:17, 9 September 2012 (UTC)
Scientists and skeptics
This is an article about a certain type of medical practice. Its practitioners are medical doctors who, like other medical practitioners, have qualified in scientific subjects. They too may be "sceptics". It is not helpful to compose an article such as this with presuppositions about science or scepticism which articles on those topics more honestly show to be unresolved or inconclusive or open to differing positions -- such as Science and Skepticism. The term "scientist" is too often used as if there were something like a magisterium exclusively able to declare what is within the tenets valid for the use of the denomination and what is not. The article Scientist, and the accompanying discussions on Talk:Scientist show that the term is too variously applied to be used with precision, and more often than not its use may be ill-advised. Most informative articles will be clearer if comment, or what is being reported, is expressed in some other way. Qexigator (talk) 22:43, 9 September 2012 (UTC)
- And your concrete proposal based on WP policies and guidelines and reliable sources would be... Dominus Vobisdu (talk) 22:48, 9 September 2012 (UTC)
- Again I suggest you read WP:FRINGE and see exactly what it states. We do not give fringe topics extra validity than they have in terms of the mainstream sourcing. IRWolfie- (talk) 22:54, 9 September 2012 (UTC)
My comment is simply as an ordinary reader looking for a quality of writing which is genuinely npov and not larded with what can be seen as tendentious statements under cover of this or that policy. Such writing looks like an abuse of guidelines and timewasting. I do not propose to make revisions (even in respect of the typos noted above). My expectation is that those responsible for their own edits will correct them, or that others who evidently are more conversant with the finer points of the topic will do. I notice that the rapid responses above (22:48 and 22:54 UTC) fail to answer the concerns raised. Qexigator (talk) 23:10, 9 September 2012 (UTC)
- If you read the article you will find that the thing that distinguishes anthroposophical "medicine" from medicine is the integration of pseudoscientific concepts including homeopathy, karma and the various occult beliefs of the Steinerist sect. There are things on which reasonable people may disagree (how large is the placebo effect, are purified versions of naturally occurring substances inherently better or worse than the "wild" version and so on) but virtually everything that distinguishes anthroposophical "medicine" from medicine is pseudoscience or simply not scientific at all. A neutral review of anthroposophical "medicine" will be very much like a neutral review of a patisserie that adds cow pie to its apple pie. Adding cow pie to apple pie does not improve the apple pie, unless you are a dung beetle (and even they would probably prefer the native ingredient). I will remind you of the words of Tim Minchin: the name for alternative medicine that can be shown to work, is medicine. Anthroposophical "medicine" is distinguished solely by the inclusion of things that fail - usually spectacularly - to meet the standards of evidence-based medicine. Some of us have spent a lot of time looking at this exact problem, you on the other hand appear to be advocating a particularly naive form of the false balance fallacy. Guy (Help!) 00:14, 10 September 2012 (UTC)
Again, I note a piece of polemic which reveals no answer to the concerns raised. "Steinerist sect" looks like a neologismic implying bad faith. Time would be better used improving the written quality of the article as a source of npov information. Qexigator (talk) 07:12, 10 September 2012 (UTC)
- If you are unable to recognise that your questions have been answered I question your ability to edit here in a productive way. IRWolfie- (talk) 09:27, 10 September 2012 (UTC)
Thank you, Wolfie, for your intervention (09:27, 10 September 2012 (UTC)). What has been answered is seen very clearly, but "no answer to the concerns raised". Is it being said that expressing such concerns is not acceptable to those who claim to be authoritative spokespersons for "scientists"? Is the use of such terms in the course of discussion as "Steinerist sect" considered constructive? Qexigator (talk) 10:26, 10 September 2012 (UTC)
lead
The lead now makes little sense: AM "combines elements of medicine, homeopathy, and naturopathy". Homeopathy and naturopathy are medical approaches (whether successful or not is not the point). It would make sense to stay with the cited sources, which explicitly use the term "Western medicine". hgilbert (talk) 00:41, 10 September 2012 (UTC)
- The term is only ever used when we need to distinguish it from non-scientific medicine. That being said, I suppose you're right that there might be confusion. Please see my edit summary. :-) Arc de Ciel (talk) 02:26, 10 September 2012 (UTC)
- "conventional" works. hgilbert (talk) 03:01, 10 September 2012 (UTC)
"Scientists"
To call this group "scientists and other skeptics" is simply misleading. Michael Shermer is a historian of science, Robert Carroll is a philosopher, Atwood is an anesthesiologist.
Worst of all: how does Roger Rawling qualify as a verifiable source for anything whatsover? He has no qualifications whatsoever; at least the others are qualified to speak about science, even if they are not scientists themselves. hgilbert (talk) 10:17, 10 September 2012 (UTC)
- Both the Skeptic's Dictionary and Quackwatch are reliable sources for scientific consensus on fringe science and medicine, and Michael Shermer is one of the world's leading experts on pseudoscience. All of these sources clearly meet WP:PARITY. Dominus Vobisdu (talk) 10:58, 10 September 2012 (UTC)
- Out of curiosity, are you challenging the sentence because you think it is not true? If you really think it's not reliable take the issue to WP:RSN. IRWolfie- (talk) 13:08, 10 September 2012 (UTC)
Unreliable sources?
Greetings! There has been some discussion recently over on the Talk page for Waldorf education about what qualifies as a reliable source, especially in the light of an ArbCom ruling that stated "Waldorf education, Rudolf Steiner, Anthroposophy and the extended family of related articles such as Social Threefolding are placed on article probation" and that "material published in Anthroposophy related publications, especially by persons deeply involved in the movement such as teachers or theoreticians, are considered self published and thus not reliable sources". I don't believe this article is on probation, but nevertheless on coming here the first note I read (current No. 14) is a reference to work by Matthias Girke, who is president of the Gesellschaft Anthroposophischer Ärzte in Deutschland e. V., which appears to be an advocacy organization for anthroposophic medicine. Is that a reliable source for this article? particularly for a position stated as fact? Alexbrn (talk) 10:55, 7 December 2012 (UTC)
- Hi Alexbrn. That source was published by a non-anthroposophical journal, Komplementäre und Integrative Medizin, and thus falls under the stipulations from the ArbCom, that reliably sourced material even by anthroposophical authors can be used if they appear in a non-anthroposophical publications. This is also consistent with the general rule from WP:RS that the reliability can go with an expert author (even in a non-reliable publication) or with the questionable author if in a reliable publication. "Reliable sources may be published materials with a reliable publication process, authors who are regarded as authoritative in relation to the subject, or both." In this case, the publication is reliable and so this source is reliable. --EPadmirateur (talk) 21:44, 7 December 2012 (UTC)
The Heart
I wonder if the bit about the heart not being a pump should just be deleted. I noticed that someone has botched it up a bit, and started to fix it, but wondered if it was worth it. Clearly, the heart IS a pump and any contention that it is not would need to have dramatic scientific justification. Hey hgilbert--do you have a blurb about why Steiner thought the heart was not a pump? The way it is described (Steiner's thoughts) in the article suggested that he thought that it also regulates flow, which, of course, it does but many pumps also regulate flow so it is not an either/or phenomenon.Desoto10 (talk) 04:27, 30 December 2012 (UTC)
- I agree the section could be struck without loss here.
- In answer to your question: as far as I can tell, Steiner never quite came out and says that it is not a pump, just that this is a bad characterization (which is reasonable -- if we had, outside the body, a hunk of muscle not connected to any conventional power source that healed itself from small injuries and kept going for 100 years without maintenance, and that depended on an active circulation system to complete its work, we would probably not just call it a pump either). Here are relevant passages (in German) from two lectures where he goes into this. hgilbert (talk) 12:24, 30 December 2012 (UTC)
- I don't think that anyone in medicine considers the heart "just a pump". That is just its main function. The heart is not only a pump, but a pump that adapts to changes in blood flow and pressure on its own as well as via input from the autonomic nervous system. My take is that Steiner felt that the blood, itself had some kind of magical forces of propulsion that were intimately involved in the heart's action.
- I removed a large amount of text that someone obviously spent some effort on. I apologize for that, but without more background on exactly what Steiner thought and how he thought about these things made the deleted text uninterpretable. The text was also attributed to a single source from a fringe journal.Desoto10 (talk) 03:46, 4 February 2013 (UTC)
Requested move
{{subst:Anthroposophical medicine|Anthroposophic medicine}} The Medical Section of the Geotheanum and the IVAA have agreed that the official international name for this form of medicine is Anthroposophic medicine (without "al").
- Support: This seems inevitable given the above, subject to usual redirect to allow for continuing current use of "Anthroposophical", and in published works, articles etc. Qexigator (talk) 16:38, 24 January 2013 (UTC)
- Support. hgilbert (talk) 17:06, 24 January 2013 (UTC)
- Support Volker Siegel (talk) 01:06, 9 March 2014 (UTC)
- Fixed. HGilbert (talk) 11:57, 9 March 2014 (UTC)
ANI
FYI, I opened a thread at ANI with regards to my concerns about POV pushing on this page and related ones. a13ean (talk) 23:30, 31 January 2013 (UTC)
Problematic sourcing
The article leans quite heavily (with 11 citations) on this book, whose authors are:
- Gunver Sophia Kienle ("Working to develop the scientific basis for a permanent regulatory framework for anthroposophic medicinal products in Europe")
- Helmut Kiene (spouse? at the same institute)
- Hans Ulrich Albonico ("Homöopath und Vertreter der Anthroposophischen Medizi") ... you'll need to google for this as WP has blacklisted the site it's from
Although this book might be usable to describe how anthroposophical medics think about themselves, it should not be used for independent statements about the topic; its use really needs to be reduced. Alexbrn talk|contribs|COI 10:56, 29 October 2013 (UTC)
(add) Rather confirming the problem, I found Ernst had reviewed this book. He says: "The authors are convinced believers in AM, with a long history of defending its principles. Those expecting to find a strong element of critical assessment in this book will be disappointed. The little critical thought that can be identified is unrelated to AM, but is aimed at EBM or any publication that does not praise AM unreservedly. If you asked the Vatican to produce an account of Catholicism, or the pharmaeutical industry of drug treatment, you might get a similarly fair evaluation.". Alexbrn talk|contribs|COI 05:33, 30 October 2013 (UTC)
Update
Okay, after ... some editing we're down to 4 uses of this iffy source. Could it be eradicated entirely? The remaining uses are:
- To source "In 2006, there were anthroposophic practices in 80 countries." in the lede (shouldn't be there; is this even notable?)
- To source "According to its proponents, anthroposophic medicine uses a holistic approach ("salutogenesis") that seeks to support the preconditions for health by strengthening the patient's physiology and individuality, as well as addressing the specific factors that cause disease. They say that self-determination, autonomy and dignity of patients is a central theme." in the Methods section.
- To comment (of mistletoe) "it is now probably the best-known anthroposophic medicine."
- To say "There are also phytotherapeutic preparations using non-homeopathic doses of mistletoe; these should not be confused with the anthroposophic preparations". A burning issue I am sure for our readers (humour!)
Do any of these uses deserve to be kept? Are there better sources for these things? Alexbrn talk|contribs|COI 14:35, 30 October 2013 (UTC)
More Problematic sourcing
I have just tried to remove some poorly sourced material. User:Hgilbert has restored some. I am worried about this claim:
Anthroposophic medicine seeks to extend, not replace, mainstream Western medicine, and its practitioners do not regard it as an "alternative", but as an extension, to conventional science-based medicine
which is sourced to four things (already a warning flag, as that signals likely synthesis, or overcitation for special pleading). This would seem to be a fringe claim since (unless we can source it otherwise) the view that AM is an "extension" is something held by AM itself, and would not be entertained my mainstream medicine. Anyway this claim is sourced to:
- The Kiene et al book mentioned above, an anthroposophical source.
- A report on alternative medicine originating from a 1992 workshop
- Something from the fringe journal Komplementäre und Integrative Medizin by Matthias Girke, an anthroposophist
- Something that looks like a illicit book chapter on the web[1].
Since (2) is the only barely usable source I have re-cast the sentence around that, for now - but would appreciate more input. I have also made Ernst and Singh's views more prominent as they are independent commentators. Alexbrn talk|contribs|COI 13:00, 29 October 2013 (UTC)
- Hilarious argument: that because multiple citations can be provided in support of a statement, the statement is therefore suspicious. Usually a well-cited argument is regarded as better founded!
- The Kiene book is published by a mainstream academic press, which satisfies the requirements both of WP:RS and of the arbitration proceedings for this group of articles.
- The report was commissioned by the National Institutes of Health
- The journal is hardly fringe.
- The "illicit book chapter" is actually available through the author's page on his university website, and this is common practice for professors. HGilbert (talk) 16:16, 29 October 2013 (UTC)
- Reports about a pseudoscience published in a journal devoted to pseudoscience are obviously not a valid source for scientific claims. That being said, if such a source is being used to demonstrate what those practitioners believe, I think that's fine. JoelWhy?(talk) 16:20, 29 October 2013 (UTC)
- The point about WP:CITEKILLs is that they impact the readability of the article and make it appear the information is shaky. It is better to have one, or maybe two, strong sources that a string of weak ones. I agree these sources may be RS for what anthroposophists say but the problem is that by using them, rather than independent sources, we are giving a WP:PROFRINGE account. I doubt very much that "conventional science-based medicine" regards AM as some kind of "extension" to it. Ideally we need some independent source that comments on the relationship between AM and mainstream medicine. (As to the book chapter, if it is one we need to cite the book and not point to a bare URL). Alexbrn talk|contribs|COI 16:36, 29 October 2013 (UTC)
- I think you misunderstand the term "extension" in this regard. The point is that mainstream medicine is accepted and used by anthroposophic doctors (thus the requirement from the very beginning that these be conventionally trained as well), and that the AM is then a further set of resources. Mainstream sources regard it as an extension in this sense, without implying that it is a valid extension. HGilbert (talk) 16:43, 29 October 2013 (UTC)
- Well, proponents will promote the view of course that AM is "compatible" with the mainstream (especially since, as we see above, some here are engaged in advocating for a regulatory framework). But what we we need is an independent/mainstream non-fringe commentator giving a view on the relationship. Do you know of any source that gives that? Alexbrn talk|contribs|COI 17:03, 29 October 2013 (UTC)
Many other sources could be found to support the original wording, for example: HGilbert (talk) 16:27, 29 October 2013 (UTC)
- Gudrun Bornhöft and Peter F. Matthiessen, "Anthroposophische Medizin", in K. Kraft and R. Stange, Lehrbuch Naturheilverfahren Georg Thieme Verlag. p. 754.
- [2]
- [3]
- what does this apply to? I see the source here is calling AM "a whole system of medicine". Alexbrn talk|contribs|COI 16:47, 29 October 2013 (UTC)
- As a layman to medical science or practice of any kind (but one, like so many others today having some critically sceptical responsibility for the medical care of family members) I read the present version of 1 Conceptual basis as, in the main, a fair report about the topic, given the context. For example, this seems to say no more than might be expected of any type of medical practice: According to its proponents, anthroposophic medicine uses a holistic approach that seeks to support the preconditions for health by strengthening the patient's physiology and individuality, as well as addressing the specific factors that cause disease. They say that self-determination, autonomy and dignity of patients is a central theme. In other words, as practitioners who have qualified in "conventional" medicine, their intention is to practice with a view of medicine "that encompasses standard treatment" but takes a larger view than the unduly narrow one which may influence exclusively "mainstream" medical practitioners. This is explained by Ernst and Singh reporting that anthroposophical medicine is an "entirely new school of medicine" based on Steiner's beliefs in which "imagination, inspiration and intuition" play a part (etc). The article also quotes Carroll as an outright opponent from what he claims to be a "science based" standpoint. But the passage from "Steiner believed that vaccination" to "medical property to be discovered" is too feeble for an article such as this. 1_The bald statement "When this was put into practice, it caused a pertussis outbreak in a waldorf school due to a lack of inoculation, causing the school to be temporarily closed" is insufficiently fact based (and the citation is not linked for a reader to check it out as good science, bad science, anecdotal hearsay, misreporting on basis of pov, or what). 2_I have tweaked some of the wording about "character" to let the phrase" is considered" extend more explicitly over the next two sentences. The source could then be as reliable as the text, if the link could be repaired. Qexigator (talk) 16:52, 29 October 2013 (UTC)
"unconventional" or "alternative"
The terminology "unconventional" medicine is itself rather unconventional, and the citation provided for the term is to a German author who may not know the usual terminology in English. There are a vast array of English-language sources that use either the term "alternative" or "extended". HGilbert (talk) 16:02, 29 October 2013 (UTC)
- I thought alternative was what it didn't want to call itself. But yes the sources do use either that, "complementary" (or not), or "entirely new". I thought "unconventional" was a neutral umbrella term (RS and true) that didn't come down any way, but might be persuaded no adjective at all is better still ... Alexbrn talk|contribs|COI 16:07, 29 October 2013 (UTC)
- "unconventional medicine" is inapposite for the reason given by Hgilbert; "complementary medicine" (as it was in earlier versions) is redirected to Alternative medicine, where "complementary medicine" is defined as 'alternative medicine used together with conventional medical treatment in a belief, not proven by using scientific methods, that it "complements" the treatment', while AM is defined as 'any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method'. In the ordinary use of the English language, 'extended' fits the facts reported in this article about anthropsophical medical practice better than the other terms. The practices listed as 'alternative' neither propose themselves nor are regarded by 'conventionally' qualified physicians as having arisen as an extension of conventional medicine, in the way 'conventional' is used in the AM article. Qexigator (talk) 17:47, 29 October 2013 (UTC)
- Evidently, different sources say different things about how to categorize AM. So picking just one is a kind of misrepresentation and synthesis. Either we need to go with some more abstract umbrella term, find a devastatingly definitive source, or have no adjective. Alexbrn talk|contribs|COI 19:39, 29 October 2013 (UTC)
- "unconventional medicine" is inapposite for the reason given by Hgilbert; "complementary medicine" (as it was in earlier versions) is redirected to Alternative medicine, where "complementary medicine" is defined as 'alternative medicine used together with conventional medical treatment in a belief, not proven by using scientific methods, that it "complements" the treatment', while AM is defined as 'any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method'. In the ordinary use of the English language, 'extended' fits the facts reported in this article about anthropsophical medical practice better than the other terms. The practices listed as 'alternative' neither propose themselves nor are regarded by 'conventionally' qualified physicians as having arisen as an extension of conventional medicine, in the way 'conventional' is used in the AM article. Qexigator (talk) 17:47, 29 October 2013 (UTC)
- There seems to be no such "abstract umbrella term" currently in general use, so, lacking a definitive source, we default to "no adjective". But looking at the given source, NIH, maybe "augment" could be used, as well as "extend". Given the first two paragraphs of the NIH "Overview" (p.85-6) and the rest of that article, it is difficult to see why anthroposohpic(al) medicine is said to "build on" three pre-existing foundations, namely, naturopathy, homeopathy and Western medical training for MD qualification. It looks as though the basis is modern scientific medicine (as taught in mainstream medical schools) "augmented" (per NIH p.86, col.2 )[4] by the principles expressed in the work Steiner co-authored with (med,) Dr Wegman (published 1925). Qexigator (talk) 23:12, 29 October 2013 (UTC)
- That is what this source said practitioners did, not what the basis is (the source says modern medicine is the "third foundation" of AM). According to Ernst, the idea that AM "extends" conventional medicine is used for its promotion. Alexbrn talk|contribs|COI 04:29, 30 October 2013 (UTC)
- As I read the present version, it has certainly been improved by some of the recent revisions (sources, copyedit, etc), but the question whether "unconventional" is apt is still unresolved. Qexigator (talk) 08:57, 30 October 2013 (UTC)
- That is what this source said practitioners did, not what the basis is (the source says modern medicine is the "third foundation" of AM). According to Ernst, the idea that AM "extends" conventional medicine is used for its promotion. Alexbrn talk|contribs|COI 04:29, 30 October 2013 (UTC)
The trouble with the terms "alternative" or "complementary" is that they've both been disputed, while the discourse of "extension" and "augmentation" has been identified by RS as a promotional strategy - and we're not having Wikipedia join in that game! The word "unconventional" has been used by a RS and has been described as a neutral alternative to "complementary" by homeopath P. Fisher here: ("Even the term complementary medicine is not entirely satisfactory, lumping together as it does a wide range of methods with little in common except that they are outside the mainstream of medicine. The most accurate term is perhaps "unconventional therapeutic methods."). The term also has the advantage of being kind-of obvious.
Another option, which is warranted by the fringe nature of this topic, is to term AM a "collection of pseudoscientific ideas" or somesuch. We have RS for that. Alexbrn talk|contribs|COI 09:12, 30 October 2013 (UTC)
- Well, a principal criterion for an article is readablity rather than promoting any point of view such as in the game you mention (and seem to engage in, per the last sentence). The main point to report seems to be that it takes a non-standard view of the human body and its anatomy. It is believed that a patient's past lives may influence their illness and that its progress is subject to karmic destiny. That alone is enough to let a reader know that this something "out of the ordinary", without any prompting fom "Skeptics". In fact, and in view of above discussion, the lead would be clearer, "game"-free, and more concise for a reader if some surplus wording were omitted there (which could be in the body), thus:
- "Anthroposophical medicine (or anthroposophic medicine) is a form of
unconventionalmedicine that draws on a spiritual philosophy called anthroposophy devised by Rudolf Steiner (1861–1925).It builds on naturopathy, homeopathy and conventional medicine.Anthroposophical medicine was founded in the 1920s by Steiner in conjunction with Ita Wegman (1876–1943).Anthroposophical medicineIt takes a non-standard view of the human body and its anatomy. It is believed that a patient's past lives may influence their illness and that its progress is subject to karmic destiny. Some anthroposophical physicians maintain an anti-immunization stance.
- "Anthroposophical medicine (or anthroposophic medicine) is a form of
- "Certification as an anthroposophical physician is gained...etc." "Skeptics, including many scientists and mainstream medical doctors...etc".
- Qexigator (talk) 09:40, 30 October 2013 (UTC)
- We are required by policy to keep the mainstream scientific view to the fore, for the sake of neutrality, so removing "unconventional" would be very naughty (and calling it pseudoscientific prominently is okay). The stuff about naturopathy is sourced, in the body, and is long-standing article content. Have you any reason to believe it is incorrect? (Also starting two sentences with "Anthroposophical medicine ..." and the next one with "It ..." is inelegant; better to have the "It" sentence in the middle). Alexbrn talk|contribs|COI 09:57, 30 October 2013 (UTC)
- Yes, but those comments sidestep what was being proposed in the above draft, which is for improving the lead. 1_It is not acceptable encyclopedically to distort what a reader needs to know by undue emphasis and repetitive comments under the general banner "pseudoscientific". 2_ Naturopathy can properly be mentioned per source in body, but it is not an essential or main feature of anthroposophical medical practice, so far as can be seen, even if it, and homeopathy, can be regarded as part of the historic emergence from "quack" medicine (leeches and the like) from which scientific and anthroposophical medicine emerged. Anthroposophical medicine was introduced when scientific medicine had become established, both in Europe and USA, and as I understand it, was not properly described as having the other two as a first and second foundation. Is that backed up by any other source? It looks like
a well-meant misdescription, butinexact writing nonetheless according to the rest of the cited context. 3_Of course, the draft would need tweaking "It"-wise before use. Qexigator (talk) 11:08, 30 October 2013 (UTC)
- Yes, but those comments sidestep what was being proposed in the above draft, which is for improving the lead. 1_It is not acceptable encyclopedically to distort what a reader needs to know by undue emphasis and repetitive comments under the general banner "pseudoscientific". 2_ Naturopathy can properly be mentioned per source in body, but it is not an essential or main feature of anthroposophical medical practice, so far as can be seen, even if it, and homeopathy, can be regarded as part of the historic emergence from "quack" medicine (leeches and the like) from which scientific and anthroposophical medicine emerged. Anthroposophical medicine was introduced when scientific medicine had become established, both in Europe and USA, and as I understand it, was not properly described as having the other two as a first and second foundation. Is that backed up by any other source? It looks like
- "it looks like a well-meant misdescription" is not really an argument is it? Alexbrn talk|contribs|COI 11:12, 30 October 2013 (UTC)
- Another sidestep is neither a reason nor argument nor discussion, but posibly game-play. If it pleases you, let the words be struck. Qexigator (talk) 11:38, 30 October 2013 (UTC)
The most frequent terminology across all sources is "complementary" or "extended", followed by "alternative" and "whole. As far as I can see only one source, written by a non-English speaker, uses the term unconventional. It would make sense to use the most familiar terminology.
Homeopathy is clearly a strong basis. I would put naturopathy as a definite third runner, and also question its appropriateness for the lede, which should focus on what all (or most) sources agree on, except perhaps for a closing paragraph on the controversial nature of the medicine. HGilbert (talk) 12:15, 30 October 2013 (UTC)
Sourcing
I have tried to track down the most common characterizations of AM in mainstream journals. I have removed the controversial adjective from the lede (as per the suggestion above), and it is surprising how (to my eye, at least) little it matters, as long as there is description, which may still need tweaking.
In the characterization section, I have tried to order these according to frequency of use. Ernst's pejorative comment seems unnecessary, as the term "extension" is found throughout the literature, not only in proponents' writings, and it is clear even from the training process that doctors have to first learn conventional medicine, and then add on a training in AM on top of this. This is so radically different from how homeopaths, naturopaths, chiropractors, etc. are trained, that it can hardly be ignored. (I would hope that anyone who knows what a full medical training involves must recognize that.) HGilbert (talk) 12:43, 30 October 2013 (UTC)
- By removing a number of independent views from the lede, you've made it rather skewed in its POV. And - a bit too short, really. Alexbrn talk|contribs|COI 12:58, 30 October 2013 (UTC)
Over use of primary sources
Primary fringe sources should not be relied upon to establish due weight, per WP:FRINGE: "The best sources to use when describing fringe theories, and in determining their notability and prominence, are independent reliable sources. In particular, the relative space that an article devotes to different aspects of a fringe theory should follow from consideration primarily of the independent sources. Points that are not discussed in independent sources should not be given any space in articles." IRWolfie- (talk) 12:51, 30 October 2013 (UTC)
- I have attempted to reduce this, but there's still a way to go. I note you removed the certification and prevalence figures from the anthro. medical bodies, which I had at least sourced - but I'll not argue with this removal. Alexbrn talk|contribs|COI 12:55, 30 October 2013 (UTC)
- Points should be established by independent sourcing of which there is plenty, IRWolfie- (talk) 12:58, 30 October 2013 (UTC)
Lancet source
This content
Most children under the care of anthroposophic physicians are vaccinated only against tetanus and polio, and most vaccinations are given later than recommended by conventional medicine.
is sourced to this article. Some serious problems:
- It's a primary medical source
- It's 14 years old
- The use isn't relaying the study's principal conclusion, but drawing a conclusion based on its raw data
- The claims that this proves something about "most children" cannot be drawn from a study of 295 children in Stockholm. Alexbrn talk|contribs|COI 13:29, 30 October 2013 (UTC)
- It's unneeded. I've swapped it with another source, IRWolfie- (talk) 14:13, 30 October 2013 (UTC)
"at odds"
Neutrality of "is at odds with medical science" disputed tag-- The respects in which it is said to be "at odds" are there stated or cited: of the heart, of mistletoe, of past lives and karmic destiny; but otherwise physician practitioners are qualified in and use 'conventional' medicine. In other words, it is more accurate to put 'in some respects'. And, as mentioned above, that is enough said to show anyone that, in simple everyday terms, it is 'out of the ordinary'. There is room in the body for more if that is so, but without needless repetition or undue generalities. Qexigator (talk) 20:35, 30 October 2013 (UTC)
- The problem is the evasive "in some respects". The mainstream views we have say that AM it utter bollocks with no basis in science. We need to state that to be neutral, and not pussyfoot around. Alexbrn talk|contribs|COI 21:18, 30 October 2013 (UTC)
- That seems to have it back to front, and is not much help in resolving questions about the encyclopedic presentation of information for this particular article. No one claiming to speak for "basis in science" should be unaware of fundamental uncertainty, which is actually the source of scientific enquiry, perhaps more in modern scientific theory and practice than ever before; but that is rather remote from what an article such as this is reporting to readers. Given that anthroposophic physicians are qualified and practice "conventional" medicine it would be purblind nonsense to describe that as if it were wholly at odds with scienctific mainstream medical practice: that would be evasion. Qexigator (talk) 22:04, 30 October 2013 (UTC)
- There is uncertainty about some things and then there is ignoring the evidence and stupidity. Denying the heart pumps blood is stupidity and the article should make that very clear; the heart pumps blood. Those who don't believe that based on any philosophy or "spirituality" are wrong and their beliefs are wrong. There are things we don't know, and then there are things we do know. The main function of the heart is one of the known quantities. There are qualified doctors who are also homoeopaths and plenty of doctors that believe in lots of nonsense. Just because they can make that work without their mind turning into putty does not mean it is not contradictory or that it somehow makes sense. IRWolfie- (talk) 23:15, 30 October 2013 (UTC)
- Absolutely, the idea that anthroposhophic medicine "extends and embraces" mainstream medicine is an arrogant nonsense promoted only by fringe sources; the idea that when an anthroposophic doctor prescribes (say) antibiotics they are engaging in "anthroposophic medicine" is not something that mainstream sources say. Ernst pointed this out somewhere, but strangely this seems to have been removed from the article ... Alexbrn talk|contribs|COI 05:51, 31 October 2013 (UTC)
- Let's not be non-specific here. Anthroposophy claims that the blood is moved by its own inherent momentum. This contradicts basic physics and basic biology. There is no ambiguity. IRWolfie- (talk) 23:06, 30 October 2013 (UTC)
Thank you, both, for those responses, so frankly exposing (in good faith) the flawed apriority sometimes operating here, as well as for the edits which have helped improve the article. Qexigator (talk) 08:52, 31 October 2013 (UTC)
So what actually goes on in AM?
Apart from selling ineffective drugs and promoting vaccination aversion?
I've found it hard to locate sources, which should meet WP:MEDRS and be independent. What for example is "anthroposophic nursing"? Anyone got any pointers? Alexbrn talk|contribs|COI 20:38, 1 November 2013 (UTC)
- There are a lot of internal sources for background on this, primarily in German: [5],[6]. For academic sources, see
- Pflege als Gestaltungsaufgab: Anregungen aus der Anthroposophie für die Praxis R Heine, F Bay - 1995 - Hippokrates
- "Notizen aus der anthroposophisch erweiterten Pflege" H Glaser - PFLEGEZEITSCHRIFT, 1995
- this.
- There are a lot of internal sources for background on this, primarily in German: [5],[6]. For academic sources, see
- You're right, we need more concrete description of what it is and does. Probably the best source published by an academic press is Anthroposophic Medicine: Effectiveness, Utility, Costs, Safety, by Gunver Sophia Kienle, Helmut Kiene, Hans Ulrich Albonico. This is an excellent source, certainly for non-controversial questions, such as many aspects of the actual practice are likely to be.
- One minor aspect worthy of note: AM tries to use antibiotics only when really necessary. (Incidentally, mainstream medicine considered this as foolish as reducing vaccine use to a minimum until quite recently...but now considers it best practice.) HGilbert (talk) 20:48, 1 November 2013 (UTC)
- That book is not usable: it's the one Ernst likened to an account of Catholicism written by the Vatican (and judging by the stuff used from it in the article previously, he's got a point). We really need something independent of anthroposophists. Surely there must be something? Or is this something that is an entirely closed world? ... Alexbrn talk|contribs|COI 21:01, 1 November 2013 (UTC)
- Actually, accounts of Catholicism written by the people at the Vatican are very usable if published by academic presses. Remember, NPOV consists of a balance of sources, not the selection of any one of these (everyone has a position). HGilbert (talk) 12:09, 9 March 2014 (UTC)
- For fringe subjects we require independence: WP:FRIND. Second Quantization (talk) 13:15, 9 March 2014 (UTC)
- WP:Fringe##Reliable_sources only specifies that the material be published by peer-reviewed presses/journals: "Reliable sources on Wikipedia include peer-reviewed journals; books published by university presses; university-level textbooks; magazines, journals, and books published by respected publishing houses; and mainstream newspapers. Academic and peer-reviewed publications are usually the most reliable sources in areas where they are available, but material from reliable non-academic sources may also be used in these areas." Perhaps we could say that if the material is published in peer-reviewed, mainstream journals, as the above is, it is by definition not fringe. HGilbert (talk) 15:29, 9 March 2014 (UTC)
- For fringe subjects we require independence: WP:FRIND. Second Quantization (talk) 13:15, 9 March 2014 (UTC)
- Actually, accounts of Catholicism written by the people at the Vatican are very usable if published by academic presses. Remember, NPOV consists of a balance of sources, not the selection of any one of these (everyone has a position). HGilbert (talk) 12:09, 9 March 2014 (UTC)
Accreditation & training
Again, we need some secondary & independent sourcing for this. Pointers? Alexbrn talk|contribs|COI 21:43, 1 November 2013 (UTC)
Accuracy
This article text should stay true to the cited sources. Someone's been playing fast and loose with these. HGilbert (talk) 02:53, 12 February 2014 (UTC)
Quality of life
The same cited source says
- "Two scientifically sound clinical trials of mistletoe suggested that mistletoe might improve quality of life among people with cancer." Further statements in this paragraph discount other studies, but not these "scientifically sound" trials.
- "Available evidence from well-designed clinical trials does not support claims that mistletoe can improve length or quality of life."
These are difficult to reconcile.HGilbert (talk) 16:48, 18 October 2014 (UTC)
- No difficulty at all. We should quote from the conclusion (or "Overview" as ACS call it). Sure, it seems a couple of studies have "suggested" misteltoe "might" do something, but overall that kind of vague suggestion does not constitute evidence that it can; hence ACS's conclusion (in accord with our other strong sources). Alexbrn talk|contribs|COI 17:00, 18 October 2014 (UTC)
Concerning important distinction in lead sentence
@Alexbrn: With respect, I don't think it's remotely well sourced. The current reading suggests some sort of endorsement of the notion that these practices are in some way meaningful replacements for mainstream medicine. We shouldn't be speaking to that at all (nor using wording where it might reasonably be interpreted as such). Especially for practices that are fringe even by alternative medicine standards. We can speak as to what the proponents say it accomplishes or what they utilize it for, but neutral voice demands that we not even slightly appear to be saying that, in any meaningful way, is or is not valid as a replacement for other, more conventional treatments. If you don't like my wording, I don't have any bones with that, but we certainly need to change it to something less ambiguous with regard to the above. Snow talk 07:46, 27 January 2015 (UTC)
- But this isn't just what proponents say, it's what Ernst identifies as an accurate statement of what AM is, and is well-published (I recall he repeated this formulation in a BMJ piece if you want me to look it up). Since this is one of the few points where mainstream/skeptical categorisation and an anthroposophical text align, I think we'd need a strong source to overturn it. In practice AM does of course in part "replace" conventional medicine - that's one of its chief problems as the article sets out more fully. Alexbrn talk|contribs|COI 07:59, 27 January 2015 (UTC)
- (Add) That other Ernst piece is PMC 1761165 (which we cite). I've tweaked the Article text to use Ernst's translation ("substitute") rather then "replace". Do you think this eliminates any whiff of NNPOV (I'm guessing you thought the word "replace" had an untoward connotation of "update"?) Alexbrn talk|contribs|COI 08:30, 27 January 2015 (UTC)
- Well, your change-out does make for an improvement, but I'm still concerned we're giving a sense of certitude. What do you think about: "..is a form of alternative medicine that is meant to partly complement, and partly substitute for, mainstream medicine."? Does that seem like it meets the middle ground between avoiding implied support while also not dismissing the perspective of the source? Snow talk 08:49, 27 January 2015 (UTC)
- I don't think that's better. AM does complement/substitute conventional medicine (when it's used). If it didn't do that nobody would worry about it. If anything saying it only "means" to do that plays down its problematic nature? Alexbrn talk|contribs|COI 09:14, 27 January 2015 (UTC)
- I agree that the current wording represents well the usual emic and etic descriptions of AM, and that the alternative suggested here is excessively cumbersome for an opening sentence. The lead goes on to make abundantly clear that there are concerns with the results of this substitution and extension. HGilbert (talk) 10:32, 27 January 2015 (UTC)
- I don't think that's better. AM does complement/substitute conventional medicine (when it's used). If it didn't do that nobody would worry about it. If anything saying it only "means" to do that plays down its problematic nature? Alexbrn talk|contribs|COI 09:14, 27 January 2015 (UTC)
- Well, your change-out does make for an improvement, but I'm still concerned we're giving a sense of certitude. What do you think about: "..is a form of alternative medicine that is meant to partly complement, and partly substitute for, mainstream medicine."? Does that seem like it meets the middle ground between avoiding implied support while also not dismissing the perspective of the source? Snow talk 08:49, 27 January 2015 (UTC)
Fairness
I was very astonished to find the following sentence in this Wiki article: “In the 1990s the Witten/Herdecke University in Germany established a chair in anthroposophical medicine. The press described the appointment as a "death sentence" and the perception that pseudoscience was being taught damaged the university's reputation, bringing it close to financial collapse. It was ultimately saved by a cash injection from Software AG, a technology corporation with a history of funding anthroposophic projects.[8] In 2006, anthroposophical medicine was practised in 80 countries.[16][unreliable source?]
I have several remarks to make about these sentences:
1) Why is Reference [8], a mere journalist essay with no reliable sources, not questioned as to its reliability when reference [16], the result of a Swiss Health Technology Assessment based on over 1000 publications, is quesioned?
2) The Gerhard Kienle Chair at Witten/Herdecke University (UWH) was established in 1993 for Professor Peter Matthiessen, who was previously commissioned by the German Government to undertake the first academic inventory of complementary medicine in Germany, which he then continued. Prof. Matthiessen was also one of the founders of UWH and the Pluralism in Medicine Forum now located at the Bundesärztekammer.
In 2009 he retired and Prof. Peter Heusser became his successor to the chair, after successfully establishing and holding the Department for Anthroposophic Medicine at the Institute of Complementary Medicine (KIKOM) at the University of Bern, which he held for 14 years.
For this reason, the UWH Chair was renamed in 2009: "The Gerhard Kienle Chair of Medical Theory and Complementary Medicine" became "The Gerhard Kienle Chair of Medical Theory, Integrative Medicine and Anthroposophic Medicine". Meanwhile, the successor of Prof. Heusser in Bern also bekam Professor of Anthroposophic Medicine.
Already in Bern every study on anthroposophic medicine was conducted in cooperation with senior consultants and professors of the University of Bern, as well as with one of the two Heads of the Department of Clinical Research. The studies well all state-of-the-art and satisfied scientific rigor criteria. The results have been, and will continue to be, published in peer review journals.
Prof. Heusser was also Co-chairman (along with one of the two Heads of Oncology at Bern University Hospital) of a large National Science Foundation (equivalent to the DFG, Deutsche Forschungsgemeinschaft) project for the critical examination of the contribution of anthroposophic cancer treatment to quality of life in non-curable cancer. The results were positive.
Prof. Heusser was also, for many years, consulted as an expert in the evaluation of Complementary Medicine for the Swiss Federal Ministries (federal agencies) for Social Security and Health, and is still a member of the Swissmedic Medicines Expert Committee as an expert on Anthroposophic Medicine.
Through his initiative the Gemeinschaftskrankenhaus Herdecke, has built a clinical research and teaching center (FLZ) within which GCP-compliant studies on AM and homeopathic methods will be carried out. The FLZ is part of the Center for Clinical Research at the UWH. The goal is to investigate AM according to the usual scientific standards.
3) The UWH’s financial crisis had absolutely nothing to do with the complementary and alternative medicine (CAM) or anthroposophic medicine (AM) at the UWH. This crisis was in 2008 and by 2009 was already resolved. Prof. Heussers appointment was as of July, 2009.
4) The SAGST was only one of several partners that helped overcome the UWH’s financial crisis, and they represented less than 50% of the former UWH sponsors. The SAGST is incidentally one of the most respected foundations in Germany for supporting positive cultural achievements. It is decidedly not an anthroposophic foundation, although it also supports anthroposophic cultural initiatives. There are a lot of positive anthroposophic cultural initiatives.
5) As a consequence of the 2005 National Science Council’s review, which was positive about their outstanding teaching, but saw the scientific research capacity of UWH very critically, much had changed by the new review in 2010. So much so that in 2011 their re-accreditation was granted for 7 instead of 5 years, and the UWH was, overall, highly praised by the press. — Preceding unsigned comment added by Divadnitram (talk • contribs) 22:02, 14 May 2015 (UTC)
- I wonder about the death sentence the guardian speaks about in 2012. I have not been successful finding the press writing about a death sentence (whatever language it may have originally been written in and whatever year. I only looked in english.) Maybe someone could point me to one article mentioning the death sentence that the guardian article speaks about. It's quite general to say that "the press said it was a death sentence" without reference to any article actually doing so. By the way: The university still exists and in the english article there's no mentioning of death sentence nor decease. --C holtermann (talk) 16:39, 1 July 2015 (UTC)
- @Alexbrn: Could you please explain, why you reverted my edit [7] ? You did not give an explanation in your edit comment. It seems rude to me to revert an edit that is based on a discussion on the talk page without explanation. --C holtermann (talk) 09:48, 19 May 2017 (UTC)
- The source does say "a death sentence", so the complaint here is just wrong. Alexbrn (talk) 11:36, 19 May 2017 (UTC)
- I never said that the source does not contain the words "a death sentence". I am well aware of that it does. Only does the source not present the source on which basis it makes this claim. It's the level of hearsay. That may be ok for a newspaper article. But it's not for an article in wikipedia. Wikipedia could say that there is an article which states that, 'The move was denounced in the press as "a death sentence"'. But if Wikipedia says that itself then it needs to source this specific claim, needs to tell specific names instead of "the press". For that one or more articles are needed that state, that 'The move is "a death sentence"'. I said that 2 years ago. No one has come up with the original source of that claim. Same goes for the poor image and other aspects as discussed further up in this thread. The article goes like this:
- "The private Witten-Herdecke University in Germany established a chair in anthroposophical medicine in the 1990s, also with support from Software AG. The move was denounced in the press as "a death sentence". The university has suffered from a poor image ever since and its medical school has been tarnished for indulging in "pseudo-science". In 2009, the university came close to financial collapse but was rescued by a cash injection provided by Software AG."[1]
- That's almost exactly what is written in this article. As so far that is correctly cited as you correctly state. But I find it really weird that an newspaper article paragraph has just been copied here. So I still see the necessity for my edit. This paragraph does not fulfill the quality criteria of wikipedia. -- C holtermann (talk) 13:34, 19 May 2017 (UTC)
- You put an "unreliable source?" tag. The source is reliable, and we go by sources not by the original research of editors, especially those pushing a fringe POV. The Guardian is a respectable source, especially (as here) for commentary on reporting in the media. Alexbrn (talk) 13:38, 19 May 2017 (UTC)
- I doubt the reliability in this specific case, not in general as I have discussed. Can't the tag be used in this way ? I will have a look into the uses of this tag. Which tag should I use ? -- C holtermann (talk) 13:47, 19 May 2017 (UTC)
- Having read through Template:Unreliable source? it seems formally adequate to be used here. It does not say that it voices a general doubt against the source. It says "This template is intended to be used when a statement is sourced but it is questionable whether the source used is reliable for supporting the statement." That's exactly what I intended. This source for this statement. No general doubt to be voiced against the guardian. @Alexbrn:, could you agree with that from a formal point of view ? In this question I'm not talking about if using this template is right from the perspective of the content. That aspect also needs to be discussed - but I want to seperate it for clarities sake. -- C holtermann (talk) 09:17, 20 May 2017 (UTC)
- There is no basis for a tag. The source is reputable and WP:V is met. You're just trying to bury criticism based on your own views of matter. Alexbrn (talk) 09:47, 20 May 2017 (UTC)
- Having read through Template:Unreliable source? it seems formally adequate to be used here. It does not say that it voices a general doubt against the source. It says "This template is intended to be used when a statement is sourced but it is questionable whether the source used is reliable for supporting the statement." That's exactly what I intended. This source for this statement. No general doubt to be voiced against the guardian. @Alexbrn:, could you agree with that from a formal point of view ? In this question I'm not talking about if using this template is right from the perspective of the content. That aspect also needs to be discussed - but I want to seperate it for clarities sake. -- C holtermann (talk) 09:17, 20 May 2017 (UTC)
- I doubt the reliability in this specific case, not in general as I have discussed. Can't the tag be used in this way ? I will have a look into the uses of this tag. Which tag should I use ? -- C holtermann (talk) 13:47, 19 May 2017 (UTC)
- You put an "unreliable source?" tag. The source is reliable, and we go by sources not by the original research of editors, especially those pushing a fringe POV. The Guardian is a respectable source, especially (as here) for commentary on reporting in the media. Alexbrn (talk) 13:38, 19 May 2017 (UTC)
- The source does say "a death sentence", so the complaint here is just wrong. Alexbrn (talk) 11:36, 19 May 2017 (UTC)
- @Alexbrn: Could you please explain, why you reverted my edit [7] ? You did not give an explanation in your edit comment. It seems rude to me to revert an edit that is based on a discussion on the talk page without explanation. --C holtermann (talk) 09:48, 19 May 2017 (UTC)
Heart
As far as I can see the source of the claim "This view of the heart is contradicted by the vast majority of mainstream medical physicians, and is not based on any scientific theory or evidence." doesn't say anything about the anthroposophic view of the heart or Marinelli or Fuersts works. The only thing about anthroposophic medicine I see in it is "If readers aren't familiar with “cranial adjusting,” “Nambudripad's allergy elimination techniques,” “anthroposophical medicine,” homeopathy, applied kinesiology, the ACAM (the major organization advocating EDTA “chelation therapy” for atherosclerosis), “the sanctity of blood” (a code for opposition to vaccinations) and the rest, they can find explanations at Quackwatch.org.". But that was only a quick glance. The source is Atwood, Kimball C. (March 2004). "Naturopathy, Pseudoscience, and Medicine: Myths and Fallacies vs Truth". Medscape General Medicine 6 (1 (33)): 33. PMC 1140750. PMID 15208545. --C holtermann (talk) 16:50, 1 July 2015 (UTC)
- I offered a quote in this respect. Tgeorgescu (talk) 18:57, 1 July 2015 (UTC)
- Thank you for your suggestion. Your source actually contains your cited text. But my formal question remains unanswered. I will remove the source Atwood at al from that point. It is a good source but it doesn't match here. Please prove me wrong. --C holtermann (talk) 11:35, 4 July 2015 (UTC)
- The citation given to substantiate the (probably accurate) statement that "This view of the heart is not based on any scientific theory and contradicted by all evidence" is to an article that does not even mention this view of the heart. I have tagged it accordingly. Either the citation should be changed or the text should be modified to reflect what the article does say. HGilbert (talk) 15:57, 4 July 2015 (UTC)
This text would seem to be open to revision. See the 2016 Global Cardiologists and Echocardiography Annual Meeting. The link shows an abstract of a paper presented by Branko Furst MD titled "Functional Morphology of the Heart Calls for a Revised Circulation Model", along with Furst's credentials. The Ernst document (heavily) quoted from is nearly 20 years out of date. I don't think "quacks" get invited to present papers at events such as this! — Preceding unsigned comment added by 93.107.82.232 (talk) 21:05, 8 June 2016 (UTC)
- We have fairly high standards for making medical claims inside Wikipedia, see WP:MEDRS. Anyway, the view that the heart is not a pump has to fulfill WP:EXTRAORDINARY, especially seen the uncontested fact about the man who has lived for 555 days without a heart in his body - and still plays basketball (his heart got replaced by a pump, or artificial heart). Tgeorgescu (talk) 22:34, 8 June 2016 (UTC)
- The text should not read "not based on any scientific theory" if there is a reputable scientist putting forward a scientific theory that would support this, with extensive evidence. See a review of Furst's book indicating that his work is being taken quite seriously. A milder wording would be in order. HGilbert (talk) 23:49, 8 June 2016 (UTC)
- Nevertheless, the review makes clear what is the common wisdom inside the academy and that Furst challenges the quasi-unanimous view of heart as a pump. So, WP:EXTRAORDINARY still applies. Also, upon the presumed future broad acceptance of Furst's idea see WP:BALL. Tgeorgescu (talk) 00:45, 9 June 2016 (UTC)
- There are reasons his challenge is respected. There are several contradictions inherent in the current theory. Why is blood flowing before the heart develops- even in quite isolated hemodynamic systems such as the chicken egg? Why in heart failure (pump failure?) do we typically have an increase in blood pressure- and not just pressure, cardiac output? What sort of pump when it fails increases its output? We have discovered that negative inotropes such as beta blockers provide a contradictory increase in survival in heart failure- after having been contraindicated in CHF for decades due to the theorized risk based on the current model of the heart. We used to give inotropes regularly until we realized they were killing patients- but it made sense based on the current heart model. Rarely we use inotropes like dobutamine or milrinone and both of these have a complementary vasodilating action. Why don't promising inventions such as the aortic balloon pump yield real results in mortality in cardiogenic shock- they should per the heart as pump model. There are current developments (not anthroposophic inspired per my knowledge) using enhanced external counterpulsation (EECP) to treat heart failure as well as studies showing better cerebral blood flow after cardiac arrest with EECP- basically a periphery driven pulsation mechanism on each limb). How does the blood move through miles of vessels merely on the impulse of such a relatively small muscle- especially after one takes into account the membrane deformation of RBCs in capillaries? Chickpecking (talk) 20:13, 4 December 2017 (UTC)
- God of the gaps or occultism of the gaps? Or maybe false dilemma. Tgeorgescu (talk) 20:33, 4 December 2017 (UTC)
- Also, O'Leary is Furst's co-worker on this subject, they published together an article on this subject, so the review hardly passes WP:FRIND. Tgeorgescu (talk) 01:05, 9 June 2016 (UTC)
- Another report of using a pump: [8] (in Dutch only, use Google Translate). Tgeorgescu (talk) 01:21, 9 June 2016 (UTC)
- I am not suggesting using this study to suggest that Steiner's idea has been confirmed, only that it is no longer possible to claim that the idea is completely devoid of any scientific basis or plausibility. Springer is an excellent academic publisher, and The Journal of Cardiothoracic and Vascular Anesthesia (that link points to an article by the same author) is a peer-reviewed journal.
- The fact that mechanical pumps are used in place of hearts and function does not have any relevance; it is OR to suggest otherwise. It is like arguing that as horses which pull carts can be replaced by steam engines, so horses are steam engines. HGilbert (talk) 02:06, 9 June 2016 (UTC)
- I don't know if two advocates of a fringe idea count as it having scientific basis. There are many fringe insights which pass peer-review, see Wikipedia:Why MEDRS?#Primary scientific literature is exceptionally unreliable in biology. The correct conclusion would not be "horses are steam engines" but "both horses and steam engines do work (physics)". I admit though that my examples are WP:OR. Tgeorgescu (talk) 14:37, 9 June 2016 (UTC)
- It is not yours or mine to judge whether an idea is fringe. If peer-reviewed scientific journals and academic publishers publish work, it is no longer fringe. It may still not be widely accepted, but it is a genuine scientific hypothesis under discussion. (See RS and V) HGilbert (talk) 14:58, 9 June 2016 (UTC)
- A Nobel prizewinner claims to be able to transmit the effectiveness of homeopathic medicines through the telephone or the sound card of a computer, but his idea is still a fringe idea. Homeopathy is WP:FRINGE/PS regardless of several peer-reviewed articles which support it. So a book and the peer-reviewed review of a book do not show that "heart is not a pump" isn't WP:FRINGE. The two authors represent at most a walled garden. You should not be clutching at straws, "heart is not a pump" is fringe and even the review you quoted admits there is nearly-universal agreement among experts that the heart is a pump. Tgeorgescu (talk) 19:05, 9 June 2016 (UTC)
- @Hgilbert:, you're fundamentally misunderstanding what Dr. Furst's theory is about. It does not, even taken at face value, validate Steiner's theory of the heart. Furst believes, as quoted directly from his theory, that "The heart thus functions as an impedance-pump generating pressure, but not the flow of blood." Steiner thought the heart didn't function as a pump at all, and created no pressure. He thought that the heart generated "spiraling motions" that created flow, and that capillaries were generating pressure. Furst's theory does not support Steiner's findings, not at all.--Shibbolethink (♔ ♕) 20:05, 9 June 2016 (UTC)
- A Nobel prizewinner claims to be able to transmit the effectiveness of homeopathic medicines through the telephone or the sound card of a computer, but his idea is still a fringe idea. Homeopathy is WP:FRINGE/PS regardless of several peer-reviewed articles which support it. So a book and the peer-reviewed review of a book do not show that "heart is not a pump" isn't WP:FRINGE. The two authors represent at most a walled garden. You should not be clutching at straws, "heart is not a pump" is fringe and even the review you quoted admits there is nearly-universal agreement among experts that the heart is a pump. Tgeorgescu (talk) 19:05, 9 June 2016 (UTC)
- Actually, Furst discusses the capillary circulation in detail from page 13 on. For example, he mentions that De Langen further suggested that “the capillary is like a tiny, incomplete heart, which exerts pressure on the blood passing through it, hereby propelling it and furthering and regulating the filtration,” and that the sum total of the placental capillaries act as a “peripheral heart” which drives the circulation (p. 28; cf. pp. 67ff). Chapter 15 includes a rich discussion of the history of theories of capillary pressure which makes it evident that the idea has been given empirical support by various researchers. On page 176, Furst proposes that the conflicting observation can be resolved only when the blood is assumed not to be an inert fluid “pumped” around the circuit by the heart but a “self-moving” agent with flow directly coupled to the metabolic needs of working muscles.
- Steiner, on the other hand, never suggested that the heart generates spiraling motions. You may have gotten this idea from your own or someone else's misreading of this article, which states that "In 1932, Bremer of Harvard filmed the blood in the very early embryo circulating in self-propelled mode in spiralling streams before the heart was functioning." In other words, what you put forward as a ridiculous, pseudo-scientific theory of Steiner is actually the observation of a notable scientist. HGilbert (talk) 03:09, 10 June 2016 (UTC)
Once again, I am not proposing that this be presented in the article as an accepted theory, merely that to say that it is "not based on any scientific theory" is in direct contradiction to the fact, demonstrated by Furst, that there is indeed an extensive body of scientific theory which supports this. HGilbert (talk) 03:09, 10 June 2016 (UTC)
- Is "theory" being used here in a lay sense rather than a scientific sense? It's best to avoid "theory" because of this ambiguity in usage, so how about deleting the phrase "is not based on any scientific theory"? Simply stating "This view of the heart has been characterized as 'crank science.'" is sufficient to make the point. Shock Brigade Harvester Boris (talk) 03:18, 10 June 2016 (UTC)
- I think this is the best outcome. --Shibbolethink (♔ ♕) 05:06, 10 June 2016 (UTC)
- Although, on second reading, I think "is not based on any mainstream scientific evidence or theory" would be the best change. Hgilbert is right, there are fringe sources here, and it's difficult to truly delineate what counts as science and what doesn't. I would say this doesn't count, as it has no falsifiable hypothesis driven research, but that's just my opinion. Many mainstream thinkers might disagree. Anyway we should just point out that there's a mainstream scientific consensus that this is bullshit.--Shibbolethink (♔ ♕) 14:34, 10 June 2016 (UTC)
- I've tried to merge all these viewpoints into what seems to me a neutral summary of the state of play. Incidentally, if anything, the bit about William T. Jarvis characterized it as "crank science" is the least reliable source; compare an author published in a major medical journal and by a major medical press (Furst) and a web page by an author of the National Council Against Health Fraud without any peer review. HGilbert (talk) 21:50, 10 June 2016 (UTC)
- Although, on second reading, I think "is not based on any mainstream scientific evidence or theory" would be the best change. Hgilbert is right, there are fringe sources here, and it's difficult to truly delineate what counts as science and what doesn't. I would say this doesn't count, as it has no falsifiable hypothesis driven research, but that's just my opinion. Many mainstream thinkers might disagree. Anyway we should just point out that there's a mainstream scientific consensus that this is bullshit.--Shibbolethink (♔ ♕) 14:34, 10 June 2016 (UTC)
- I think this is the best outcome. --Shibbolethink (♔ ♕) 05:06, 10 June 2016 (UTC)
- We have WP:PARITY for non-peer-reviewed sources, which nevertheless express the mainstream view upon fringe subjects. Furst is fringe, or, if you do not like that word, a marginal view or provisional research. That could change in time, but we have to wait till then in order to make that call. Tgeorgescu (talk) 23:43, 10 June 2016 (UTC)
- Fine as regards WP:PARITY. But I do rather object to using the term fringe for Furst's work. WP:RS urges us to look at the status of the publisher of works to determine their reliability. Furst's article and book have been accepted by mainstream presses and journals without critical comment. This implies that there is a degree of mainstream acceptance of his ideas; Springer Press does not publish works on fringe topics, nor do peer-reviewed journals. HGilbert (talk) 23:49, 10 June 2016 (UTC)
- HGilbert, you are saying that "Springer Press does not publish works on fringe topics, nor do peer-reviewed journals". You're joking right? Because a couple of very simple google searches would show you that it is clearly not true. --McSly (talk) 00:27, 11 June 2016 (UTC)
- Fine as regards WP:PARITY. But I do rather object to using the term fringe for Furst's work. WP:RS urges us to look at the status of the publisher of works to determine their reliability. Furst's article and book have been accepted by mainstream presses and journals without critical comment. This implies that there is a degree of mainstream acceptance of his ideas; Springer Press does not publish works on fringe topics, nor do peer-reviewed journals. HGilbert (talk) 23:49, 10 June 2016 (UTC)
- 'Reputability' of the publisher is not enough in scientific matters. Because of the nature of science, higher profile journals and respectable journals often publish research that is later disproven, or completely unfounded. The often lauded journal Nature published Andrew Wakefield's infamous vaccine-autism paper, and was later forced to retract it. In fact, there's a positive correlation between the "reputability" of the journal and the number of retractions. The fact that this reputable anesthesiology journal published Furst's work has very little relationship as to whether or not his work is "fringe." The scientific consensus, as shown by multiple reviews and textbooks, is good enough for that.--Shibbolethink (♔ ♕) 16:30, 11 June 2016 (UTC)
Johns Hopkins study
The following was removed in a blanket revert. What is the justification for excluding it?
- In 2015, Johns Hopkins University's Kimmel Cancer Center began a multiyear clinical trial of mistletoe's efficacy, motivated by individual cases in the United States in which sometimes dramatic improvement in patient condition was seen when mistletoe was used in conjunction with exercise and other non-intrusive therapies.[2] HGilbert (talk) 10:34, 17 October 2015 (UTC)
- Please see WP:MEDRS. Also note than MSKCC is not a good source when we have much stronger ones (see here). Alexbrn (talk) 11:26, 17 October 2015 (UTC)
Tendentious
The inclusion of "*Quackery" in the See Also list is highly tendentious.
So is the {{See also|List of ineffective cancer treatments}} template under mistletoe. The NIH sums up the state of the research as uncertain and mutually contradictory:
Quality of life was measured in a review that included 26 randomized clinical trials. Of these, 22 trials showed patients had improved quality of life. All 10 nonrandomized, controlled clinical trials reviewed also reported the same benefits. Chemotherapy-related fatigue, nausea and vomiting, depression, emotional well-being, and concentration improved. Some of the studies were well designed, while others had weaknesses.
Tumor response, quality of life, and psychological distress were measured in a review of 21 randomized clinical trials in patients with different types of cancer. A variety of mistletoe extracts were used either alone, with chemotherapy, or with radiation therapy. Most of the studies reported benefits for patients, although this review had weaknesses in design and size.
Quality of life and survival were measured in a review of 10 randomized clinical trials which used a variety of mistletoe extracts in patients with different types of cancer. There was no difference in survival or quality of life measures in patients who received mistletoe compared to those who did not.
[3] HGilbert (talk) 10:34, 17 October 2015 (UTC)
- Quackery is a useful tangent for this topic; as for Mistletoe we have very strong sources and nothing in the NIH stuff says it "treats" cancer, and even the more positive evidence is compromised by iffy research. More generally, we don't twistily use a magazine to undercut systematic reviews, that would be blatant POV-pushing. Alexbrn (talk) 11:17, 17 October 2015 (UTC)
None of the systematic reviews suggest the term quackery or any equivalent. They show mixed results, not proving that it is effective or ineffective. NPOV would represent this uncertainty honestly. HGilbert (talk) 11:30, 17 October 2015 (UTC)
- Anybody selling something that wasn't shown to be effective (to "treats" AIDS even) would be a quack. See also sections are for tangential topics; the only possible objection would be that quackery is not a tangent, but a direct classification! Alexbrn (talk) 11:37, 17 October 2015 (UTC)
- Agree that there is much tendentiousness. I attempted to change, and would suggest we do change, the mistletoe subheading to point to experimental cancer therapies. This is much less tendentious than "disproven cancer remedies". It suggests that the jury is still out, which it is, and the evidence that is so far gathered has been mixed but mostly positive. Ostermann et al. published a systematic review of mistletoe trials and cancer survival and found positive results[4]. There is a need for more clear studies, as in nearly any field, but it is important that we report results that are there, and our linking as an encyclopedia should reflect this, not a biased linking and use of sources. Throwing around a word like quack is derogatory and not helpful for discourse. For instance, there is considerable debate about the utility of pacemakers in certain indications as many older studies on pacers did not have a placebo arm and the indications certainly looked valid. However, calling a large group of cardiologists quacks is less than helpful even if the evidence has been brought into question.Chickpecking (talk) 18:38, 26 November 2015 (UTC)
- "However, the methodological quality of the studies was poor." Quoted from [9]. Tgeorgescu (talk) 12:05, 27 November 2015 (UTC)
- When I searched for this I found instead of poor, "quite heterogenous"- these were studies that were evaluated. In the discussion the authors mentioned that several studies on mistletoe are "far below the standard that is today regarded as optimal or necessary" but it is not clear on my reading of this paper that those studies were used in this meta-analysis. On reading this meta analysis I have the impression that it is clear there is not a perfect set of studies on mistletoe for many reasons discussed in the paper. There was evidence of some publication bias as well heterogeneity. The paper tries to do what it can with the data that are there and gives a thorough discussion of the data, the studies and the problems with it. There was also a critique of Ernst's methodology which seems to relate here. Typically, an encyclopedia would report objectively on all available studies, not just one. To me "objectively" means to state that positive findings were found, but heterogeneity and publication bias complicated the analysis. Other things could be said about Ernst's results from his critics. Chickpecking (talk) 16:22, 2 December 2015 (UTC)
It's also in the journal EBCAM, perhaps the most notorious fringe/junk journal there is.Sorry, I see now we're discussing another source here - commented below Alexbrn (talk) 12:29, 27 November 2015 (UTC) - amended 18:45, 2 December 2015 (UTC)- This particular study is published in BMC Cancer, SJR ranks it as a Q2[5]Chickpecking (talk) 16:22, 2 December 2015 (UTC)
- Which "study"? Link please. Alexbrn (talk) 16:44, 2 December 2015 (UTC)
- Presumably the one under discussion here: Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer. 2009;9:451. doi:10.1186/1471-2407-9-451. (See link above.)
- The following summary from this meta-analysis seems appropriate: "Pooled analysis of clinical studies suggests that adjuvant treatment of cancer patients with the mistletoe extract Iscador is associated with a better survival. Despite obvious limitations, and strong hints for a publication bias which limits the evidence found in this meta-analysis, one can not ignore the fact that studies with positive effects of VA-E on survival of cancer patients are accumulating." HGilbert (talk) 17:06, 2 December 2015 (UTC)
- Right, so the only suggestion of benefit is from weak sources (poorly designed & potentially biased). We say as much already from a much stronger source, the American Cancer Society. What is more the prediction of "accumulation" of positive results from 6 years ago has not been borne out in the literature. Alexbrn (talk) 17:21, 2 December 2015 (UTC)
- I'm not sure that's how I'd rephrase ""Pooled analysis of clinical studies suggests that adjuvant treatment of cancer patients with the mistletoe extract Iscador is associated with a better survival." HGilbert (talk) 21:08, 2 December 2015 (UTC)
- You don't need to rephrase it, but to understand it in context. Sure these studies do "suggest" this, but the studies cannot be trusted because they're either compromised by bias or weakly designed. Alexbrn (talk) 22:10, 2 December 2015 (UTC)
- I'm not sure that's how I'd rephrase ""Pooled analysis of clinical studies suggests that adjuvant treatment of cancer patients with the mistletoe extract Iscador is associated with a better survival." HGilbert (talk) 21:08, 2 December 2015 (UTC)
- Right, so the only suggestion of benefit is from weak sources (poorly designed & potentially biased). We say as much already from a much stronger source, the American Cancer Society. What is more the prediction of "accumulation" of positive results from 6 years ago has not been borne out in the literature. Alexbrn (talk) 17:21, 2 December 2015 (UTC)
- Which "study"? Link please. Alexbrn (talk) 16:44, 2 December 2015 (UTC)
- This particular study is published in BMC Cancer, SJR ranks it as a Q2[5]Chickpecking (talk) 16:22, 2 December 2015 (UTC)
- "However, the methodological quality of the studies was poor." Quoted from [9]. Tgeorgescu (talk) 12:05, 27 November 2015 (UTC)
These are clear statements that should be represented in the text. They do not say that the studies should not be trusted, but the opposite: despite the limitations...one can not ignore the accumulating evidence. HGilbert (talk) 22:47, 2 December 2015 (UTC)
- Yeah, one can't ignore the accumulation of bad evidence, but what does it prove? Nothing medical. It proves only that a lot of people are engaging in poor-quality research. We could say something I suppose about how research into AM is characterized by a mass of poor-quality research (e.g. Anthroposophists ignoring basic scientific practice), there's support in the BMJ editorial for that. But I think you're suggesting this state of affairs bolsters AM, when it fact it does quite the opposite. Alexbrn (talk) 07:30, 3 December 2015 (UTC)
- If we quote Ernst, for fairness we should quote this other high-quality source, which states: "Pooled analysis of clinical studies suggests that adjuvant treatment of cancer patients with the mistletoe extract Iscador is associated with a better survival. Despite obvious limitations, and strong hints for a publication bias which limits the evidence found in this meta-analysis, one can not ignore the fact that studies with positive effects of VA-E on survival of cancer patients are accumulating." I am not claiming that one or the other has the whole truth, only that we should present all sides fairly. We should also mention that there are ongoing studies of the question, which is true and should not be concealed. HGilbert (talk) 02:37, 4 December 2015 (UTC)
- Why would we quote a poor source? And it's simply not true that the effectiveness of this therapy is being seriously studied - Since the Cochrane review (2008) there have been ZERO high quality RCTs, and as of now apparently only one observational trial is in progress. Clinically, the area is moribund and the current science is settled that there is no evidence of efficacy (as our strong modern sources say, and as we faithfully relate). There may be some lab work going on but that can never show anything meaningful about efficacy. The real question is why people with cancer and being given unproven therapies. Alexbrn (talk) 03:56, 4 December 2015 (UTC)
- Again, reading from Wikipedia's policies on reliable sources, we can and should include these meta analysis. They are all reasonable candidates for inclusion, and I agree that a commentary may be necessary. Again, no evidence is not the same as weak evidence per cochrane, no matter how often this is repeated and emphasized. Why do physicians give mistletoe to cancer patients? (and many thousands do)- it does have clinically evident effects, with very low risk (as your strong modern sources say and we faithfully try to relate). Medicine is about weighing risk and benefit. I love my patients and want to give them the best care possible. That is my answer, since you asked.Chickpecking (talk) 04:58, 7 December 2015 (UTC)
- Oh so yet another editor in this space with a conflict of interest. We don't use poor-quality sources for biomedical information. If you want to convince yourself using them that's between your conscience and the people you "treat", but has no relevance to our article content. Alexbrn (talk) 06:40, 7 December 2015 (UTC)
- Look above, you posed a question. I answered this in good faith. Should I stop assuming that you have good faith, friend? You answer in thin veiled insults.Chickpecking (talk) 04:54, 9 December 2015 (UTC)
- @Alexbrn: The sources quoted above are conducted by independent researchers and published by mainstream journals. These should be allowed to speak for themselves, not reinterpreted, especially by editors with clearly biased POVs on either side. (It would be really good to have a genuinely neutral editor here!) HGilbert (talk) 13:13, 7 December 2015 (UTC)
- The sources are poor, and shouldn't be included per MEDRS and FRINGE. We don't waste our time with medical claims on treating unspecific cancers, as various cancers and their treatments vary so widely that what helps with one type of cancer harms with other types. --Ronz (talk) 00:12, 9 December 2015 (UTC)
- Ronz: can you explain why you see some meta analysis as a poor source? Which sources are poor, and which deal only with unspecified cancers? I admit I am new to wikipedia. But when I read MEDRS I am not reading anywhere that meta-analysis are poor sources. I do agree that each can be critiqued and they appear to critique eachother to some degree- (the cochrane critiques both Ernst and Kienle). Chickpecking (talk) 05:06, 9 December 2015 (UTC)
- I already did, and the issue is FRINGE: "We don't waste our time with medical claims on treating unspecific cancers, as various cancers and their treatments vary so widely that what helps with one type of cancer harms with other types." --Ronz (talk) 16:34, 9 December 2015 (UTC)
- I am not sure that is inconceivable. In allopathic medicine we will give neupogen for people with severely depressed immune systems to prevent infections, even though infections vary widely and an antibiotic that treats one (pneumonia) may make another worse (C diff diarrhea) or have no effect (viral infections). There are other such treatments.Chickpecking (talk) 01:15, 11 December 2015 (UTC)
- I already did, and the issue is FRINGE: "We don't waste our time with medical claims on treating unspecific cancers, as various cancers and their treatments vary so widely that what helps with one type of cancer harms with other types." --Ronz (talk) 16:34, 9 December 2015 (UTC)
- Ronz: can you explain why you see some meta analysis as a poor source? Which sources are poor, and which deal only with unspecified cancers? I admit I am new to wikipedia. But when I read MEDRS I am not reading anywhere that meta-analysis are poor sources. I do agree that each can be critiqued and they appear to critique eachother to some degree- (the cochrane critiques both Ernst and Kienle). Chickpecking (talk) 05:06, 9 December 2015 (UTC)
- The sources are poor, and shouldn't be included per MEDRS and FRINGE. We don't waste our time with medical claims on treating unspecific cancers, as various cancers and their treatments vary so widely that what helps with one type of cancer harms with other types. --Ronz (talk) 00:12, 9 December 2015 (UTC)
- @Alexbrn: The sources quoted above are conducted by independent researchers and published by mainstream journals. These should be allowed to speak for themselves, not reinterpreted, especially by editors with clearly biased POVs on either side. (It would be really good to have a genuinely neutral editor here!) HGilbert (talk) 13:13, 7 December 2015 (UTC)
- Again, reading from Wikipedia's policies on reliable sources, we can and should include these meta analysis. They are all reasonable candidates for inclusion, and I agree that a commentary may be necessary. Again, no evidence is not the same as weak evidence per cochrane, no matter how often this is repeated and emphasized. Why do physicians give mistletoe to cancer patients? (and many thousands do)- it does have clinically evident effects, with very low risk (as your strong modern sources say and we faithfully try to relate). Medicine is about weighing risk and benefit. I love my patients and want to give them the best care possible. That is my answer, since you asked.Chickpecking (talk) 04:58, 7 December 2015 (UTC)
- Why would we quote a poor source? And it's simply not true that the effectiveness of this therapy is being seriously studied - Since the Cochrane review (2008) there have been ZERO high quality RCTs, and as of now apparently only one observational trial is in progress. Clinically, the area is moribund and the current science is settled that there is no evidence of efficacy (as our strong modern sources say, and as we faithfully relate). There may be some lab work going on but that can never show anything meaningful about efficacy. The real question is why people with cancer and being given unproven therapies. Alexbrn (talk) 03:56, 4 December 2015 (UTC)
- If we quote Ernst, for fairness we should quote this other high-quality source, which states: "Pooled analysis of clinical studies suggests that adjuvant treatment of cancer patients with the mistletoe extract Iscador is associated with a better survival. Despite obvious limitations, and strong hints for a publication bias which limits the evidence found in this meta-analysis, one can not ignore the fact that studies with positive effects of VA-E on survival of cancer patients are accumulating." I am not claiming that one or the other has the whole truth, only that we should present all sides fairly. We should also mention that there are ongoing studies of the question, which is true and should not be concealed. HGilbert (talk) 02:37, 4 December 2015 (UTC)
break
PMID 20021637 is the one funded by the manufacturers of Iscador. Not surprisingly, it tries to eke some Iscador benefits out of the meagre evidence. It's poor work: for a critique see the UKMi source we cite:
The applicability of this review is limited by several flaws in the design of their study. The search strategy used is not clearly reported, and a language bias is present. The authors also suggest that there is a likelihood of publication bias in this area.
No need to scrape the barrel for sources like this when we have much stronger up-to-date ones from e.g. the ACS and NIH. Overall, it is fairly clear that (as we say) independent research in this area has converged on finding this therapy of little or no benefit, while efforts remain only the part of the faithful to try and promote this stuff. Wikipedia mustn't be part of that rearguard. Alexbrn (talk) 05:26, 9 December 2015 (UTC)
References
- ^ McKie, Robin; Hartmann, Laura (29 April 2012). "Holistic unit will 'tarnish' Aberdeen University reputation". The Observer.
- ^ Joe Sugarman, Are mistletoe extract injections the next big thing in cancer therapy? Johns Hopkins Magazine Spring 2014
- ^ NIH Mistletoe
- ^ Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer. 2009;9:451. doi:10.1186/1471-2407-9-451.
- ^ http://www.scimagojr.com/journalsearch.php?q=28747&tip=sid&clean=0