Talk:Maharishi Vedic Approach to Health

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removing POV tag with no active discussion per Template:POV[edit]

I've removed an old neutrality tag from this page that appears to have no active discussion per the instructions at Template:POV:

This template is not meant to be a permanent resident on any article. Remove this template whenever:
  1. There is consensus on the talkpage or the NPOV Noticeboard that the issue has been resolved
  2. It is not clear what the neutrality issue is, and no satisfactory explanation has been given
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Since there's no evidence of ongoing discussion, I'm removing the tag for now. If discussion is continuing and I've failed to see it, however, please feel free to restore the template and continue to address the issues. Thanks to everybody working on this one! -- Khazar2 (talk) 14:16, 17 July 2013 (UTC)

Aug 10 edits[edit]

@IRWolfie: you have deleted content here [1] that is supported by impeccable MEDRS sources: a book by Micozzi included in the MEDRS-suggested Brandon/Hill list, and a review paper by Mashour et al from the AMA's Archives of Internal Medicine. Also, shortly after, in the same set of edits [2], you have deleted content supported by a 2nd ref to Micozzi and a review by Nobili et al from Pharmacological Research. Would you like to restore these? EMP (talk 19:35, 15 August 2013 (UTC)

I suggest you familiarise yourself with what WP:MEDRS sources actually say about antioxidants rather than the nonsense that was in this article (i.e look at the article I linked to). Micozzi's 2007 "Ayurveda Medicine," is not on the brandon/hill list. Mashour's paper is from 1998. Nobilli do not say "studies using human cancer cells have found that Amrit Kalash may help to prevent formation of cancer cells and transform cancer cells to normal cells", rather they say it has a "claimed potential to significantly inhibit the in vitro growth of cancer cells from human tumour. Although these compounds were also able to inhibit the tumour progression in animal models[126], no reports of trials on these two herbal remedies in cancer patients are available at present." That was 4 years ago. Also [3], pubmed: http://www.ncbi.nlm.nih.gov/pubmed/?term=Amrit+Kalash+AND+Review[ptyp]+AND+%22last+5+years%22[PDat] . Do I need to comment further? IRWolfie- (talk) 19:57, 15 August 2013 (UTC)
  • Antioxidants -- we go with what sources say; we don't delete content because of something a Wikipedia article says.
  • MEDRS doesn't disallow a research review from 1998 if it hasn't been superseded by a subsequent review.
  • If you feel that Nobili wasn't accurately summarized, you're free to revise, but no policy supports deletion. The information from Nobili was clearly qualified by the sentence that followed the deleted summary, which said: "However, no clinical trials have been done, and it is unknown whether these test-tube results would translate to an effective cancer therapy."
  • In addition, you removed content sourced to the Journal of Complementary and Alternative Medicine, which is on the Brandon/Hill list. It's the very same journal that published the AHRQ/Ospina review.
  • And you have removed a 2003 scientific text (Nezu, et al) published by Wiley, and content related to it.
This peremptory deletion of reliable sources, without discussion, is a violation of the guidelines Arbcom has given for TM-related articles. EMP (talk 21:17, 16 August 2013 (UTC)
It is in violation of no ARBCOM decisions. I suggest you ask ARBCOM yourself. 1. The antioxidant articles highlights that the source is way out of date. Me pointing at that article was meant to be a subtle clue for you to check the medical sources on that article which demonstrate the out of dateness. 2. yes there are limits, preferably 2-3, 5 years stretching it. 3. With regards to Nobili, it's a brief sentence in the source and is speculative. 4. As I already pointed out, you are confusing the different Micozzi books. 5. 2003, is 10 years old. IRWolfie- (talk) 21:52, 16 August 2013 (UTC)
EMP, you're confused on multiple levels about the sources. As IRWolife mentioned, you're confusing two different books by Micozzi. You're also wrong about the Journal of Complementary and Alternative Medicine; the Ospina/AHRQ review was not published there, but rather in Evidence Reports/Technology Assessments (PMID 17764203). As a baseline for a productive discussion, can we make an effort to cite sources accurately? MastCell Talk 05:26, 18 August 2013 (UTC)
See "Clinical Trials of Meditation Practices in Health Care: Characteristics and Quality," Maria B. Ospina, Kenneth Bond, Mohammad Karkhaneh, Nina Buscemi, Donna M. Dryden, Vernon Barnes, Linda E. Carlson, Jeffery A. Dusek, and David Shannahoff-Khalsa. The Journal of Alternative and Complementary Medicine. December 2008, 14(10): 1199-1213. doi:10.1089/acm.2008.0307. EMP (talk 14:54, 19 August 2013 (UTC)
By the way, IRWolfie did in fact remove content sourced to Micozzi, Fundamentals of Complementary and Alternative Medicine, which is on the Brandon/Hill list that MEDRS recommends. [4] EMP (talk 19:10, 21 August 2013 (UTC)
I'm sorry for the delay in getting back to you; apparently I'd forgotten to watchlist this page. You are mixing up two review articles by Ospina. As I said, the AHRQ report was published in Evidence Reports/Technology Assessments as PMID 17764203. Subsequently, Ospina et al. expanded on their findings from the AHRQ analysis in a separate article in J. Alternative and Complementary Medicine (PMID 19123875). These are two separate articles. Both may be useful here, but they should not be conflated. I recognize that these sources are a bit confusing, but all the more reason to strive for more precision in discussing them. MastCell Talk 09:13, 22 August 2013 (UTC)
My turn to apologize for delay. Re: your point: Note that my reference was to the review article published in a journal, which is why I specifically used the word "journal." EMP (talk 04:23, 15 September 2013 (UTC)
The material sourced to the Miccozi book was a pseudoscientific perspective from a MVAH researcher. I have removed the material as being inherently non-neutral. Why would you presume a medical book is reliable for statements about quantum mechanics? IRWolfie- (talk) 09:21, 22 August 2013 (UTC)

MC’s revert[edit]

I would like to note here my objection to MC’s reversion of reliably sourced content added to the article on Sept 15. I have other things pressing at the moment, but give will a fuller explanation here as soon possible. EMP (talk 19:20, 16 September 2013 (UTC)

Appropriate sourcing is necessary, but not sufficient, for inclusion. Material must also be presented neutrally and without without undue weight. Per WP:MEDRS, it is especially important to avoid juxtaposing lower-quality sources to editorially "debunk" the conclusions of higher-quality sources. MastCell Talk 19:39, 16 September 2013 (UTC)
I fully agree with that reasoning. Lower quality sources by their very nature have much less weight to try and be used to attack higher quality sources, IRWolfie- (talk) 22:45, 16 September 2013 (UTC)

@Mastcell: You have reverted criticism of quality assessment methods used in the 2007 AHRQ-funded review by Ospina et al, with three supporting references. You have said that these references are low quality and are being given undue weight. But this is not the case. The references cited, and others that I will add here, are of excellent quality, and in addition much more up-to-date:

1) The 2012 protocol for the new AHRQ-funded review of meditation and health takes issue with the 2007 AHRQ-Ospina review’s insistence on double-blinding in quality assessment: “Double-blinding, a major component of the report’s evaluation criteria, is not an appropriate control for placebo in meditation research . . . . Several reviewers have objected to the use of double-blinding in meditation research.”

2) A 2012 systematic review and meta-analysis by Chen, published in the journal, Depression and Anxiety, explicitly criticizes the quality assessment criteria of the Ospina review.

3) Orme-Johnson, in the Journal of Alternative and Complementary Medicine, which is on the Brandon/Hill list [5] that MEDRS recommends as core, also critiques Ospina’s approach to quality assessment. His commentary appeared alongside the journal-published version of Ospina’s review. The reliability of this source is also evidenced by Orme-Johnson’s comments being cited in the 2012 AHRQ protocol mentioned in 1) above.

Here are two more:

4) The extensive 2013 American Heart Association review of meditation and health notes Ospina 2007 has been criticized on methodological grounds, citing two meta-analyses.

5) A 2010 systematic review and meta-analysis authored by Chiesa and Serretti, published in Psychiatry Research, points out Ospina’s outdated quality assessment, and acknowledges Orme-Johnson's contribution in identifying this as a problem.

Note also that the AHRQ has archived Ospina 2007 as no longer current.

The modest criticism of Ospina 2007 that was reverted Sept 15 is substantiated by several high-quality and up-to-date sources. It is clearly a significant viewpoint and deserves appropriate mention in this article, as per WP:MEDRS, WP:WEIGHT and WP:NPOV. EMP (talk 22:15, 19 September 2013 (UTC)

It's a misuse to quote the 2012 AHRQ protocol document as a criticism or refutation of the 2007 review. The protocol doesn't dismiss the 2007 document, but rather seeks to update and improve it. We'll replace the 2007 review as soon as the update is published. Incidentally, I think that you'll find the updated analysis to be, if anything, more negative about the evidence for health benefits from TM than was the 2007 Ospina analysis. But we'll see.

Chen 2012 analyzed meditation approaches in general. Of the 40 trials included in their meta-analysis, only 3 dealt with TM. It's a real stretch to use that paper to say anything specific about TM. If you're citing it because one sentence in the middle of the 5,000-word paper supports your effort to dismiss the 2007 Ospina paper, then, well, I'm not sure what to tell you. (The paper is PMID 22700446 for anyone curious).

Orme-Johnson is a TM advocate and an employee of Maharishi University. An opinion piece from a TM employee, published in a relatively obscure journal, cannot be presented as a refutation of a definitive AHRQ systematic review. A more fundamental violation of WP:WEIGHT and WP:MEDRS would be difficult to imagine.

Let's say a large, high-quality meta-analysis by AHRQ finds that Merck's new antidepressant is ineffective. Then, an employee of Merck writes an opinion piece in a low-profile, non-mainstream journal disputing the AHRQ findings. Do we present the Merck employee's opinion as the last word on the subject, without even mentioning that he works for Merck? That's exactly what you're proposing.

The bottom line is that there's a well-established hierarchy of reliable and credible clinical evidence. AHRQ reviews and Cochrane Library reviews are near the top of that hierarchy. If you're unhappy with the 2007 AHRQ findings, you're in luck; they're being updated as we speak. There is no deadline, and we'll get the updated findings into the article once they're finalized. Until then, please respect distinctions in source quality. MastCell Talk 23:31, 19 September 2013 (UTC)


I’d like to backtrack slightly, for the sake of any who may just be coming to this discussion. Here is how we got to where we are: On July 17, IRWolfie deleted content that critcized the approach to assessing experimental quality used in the 2007 AHRQ-Ospina review of meditation and health. He used the following edit summary:

“rm clear pseudoscience and pseudoscientific claims” [6] (he removed several items under this one edit summary).

The content deleted:

TM researcher and former Maharishi University of Management professor David Orme-Johnson said that the review's use of double blinding, which is required by the Jadad scale, is not appropriate to meditation research and that the review failed to assess more relevant determinants of research quality. (Ref: 2008 commentary by Orme-Johnson published in the Brandon/Hill-listed Journal of Alternative and Complementary Medicine).

which had come after the sentences,

A 2007 review of meditative practices that included Transcendental Meditation concluded that the definitive health effects of meditation cannot be determined as the scientific evidence was of poor quality. The review found that meditation has no advantage over health education to improve blood pressure, body weight, heart rate, stress, anger, self-efficacy, cholesterol, dietary intake, or level of physical activity in hypertensive patients” (ref: 2007 AHRQ-funded systematic review by Ospina et al.).

On Sept 16, I added to the article a much briefer statement of criticism of quality assessment methodology in Ospina 2007 (I simply followed the first sentence in the quotation immediately above [ending in "was of poor quality"] with “though the review has been criticized for using an inappropriate method for assessing quality”), and included references to two additional sources [7].

This was reverted by MastCell, with the edit summary,

"appropriate sourcing is necessary, but not sufficient, for inclusion; material also needs to respect WP:WEIGHT and editors should avoid juxtaposing low-quality sources to editorially "debunk" higher-quality sources." [8]

On Sept 19, I explained on this page that the three sources I had cited, plus two more, are not only reliable, but of high quality. Let me further elaborate: In WP:MEDRS, systematic reviews, meta-analyses, and official position papers of major scientific bodies are considered ideal evidence. My five sources included two systematic reviews, the published 2012 research protocol for a new federally-funded review of meditation and health, and an extensive 2013 review by the American Heart Association, which cited two meta-analyses.

Here are the five sources, this time also including their actual comment on Ospina 2007:

1) A 2012 systematic review and meta-analysis by Chen et al. [9]. Note that my purpose here is not to cite Chen’s findings on TM and anxiety, but rather their criticism of Ospina’s methodology:

Differing from the findings in previous reviews of meditation, we found that quality of the reviewed RCTs was improved, mostly acceptable, and some of them (40%) were of good quality. This different finding in study quality may be related to several factors. The first factor is the quality criteria used to assess the studies. Specifically, most previous reviews used a standard Jadad scale,[42] which emphasizes significance of blindness. Because blindness is hard to implement in a meditation study, we believe this is an overly strict criteria and therefore we used a more practical quality checklist (11 criteria instead of 5) that was designed for nonpharmaceutical trials. The second factor is the procedure of review. We tried to contact most authors for clarifications in detailed research design, treatment outcomes, and other quality issues while most previous reviews, including Ospina et al.[6], did not appear to apply this critical procedure.

2) The 2013 Scientific Statement from the American Heart Association on Alternative Approaches to Lowering Blood Pressure [10]:

Since the Healthcare Research and Quality report (referring to Ospina et al 2007), 2 additional meta-analyses evaluating the effects of TM on BP have been published.32,33 They criticized the Healthcare Research and Quality report on several methodological grounds.

3) A 2010 systematic review and meta-analysis by Chiesa and Serretti [11] The authors discuss limitations of their own review in the light of Ospina 2007:

The present review and meta-analysis has some relevant limitations. First of all, similarly to an early systematic review on meditation (Ospina et al., 2007), we assessed the quality of reviewed studies using a standardized scale (Jadad et al., 1996) that was not specifically designed to assess the quality of meditation and psychotherapy studies. As Orme-Johnson (2008) recently pointed out, the development of a new quality scale which includes factors such as therapist's experience and adherence to practice in the global evaluation of study's quality in meditation studies is needed.

4) The published 2012 protocol for the new AHRQ-funded review of meditation and health [12]. This protocol analyzes methodologies utilized in AHRQ-Ospina 2007 and other early reviews of meditation and health, and as such is an excellent source of authoritative commentary on this subject. My quotation of this source in this context is not a “misuse,” as alleged by Mastcell. Their comment:

. . . previous reviews have overemphasized certain bias measures, such as blinding of the intervention in the Jadad scale, that are more appropriate for pharmaceutical interventions and not possible in meditative studies.

@Mastcell: note that the forthcoming AHRQ review isn't an “update” of Ospina 2007. It has a different scope—it does not look at several of the main Ospina outcomes, such as blood pressure. Also, its inclusion criteria are much narrower.

5) A 2008 commentary by Orme-Johnson, published in the Journal of Complementary and Alternative Medicine. This is not an “obscure” journal, as evidenced by the fact that Ospina et al. sought it out to publish their major 2008 article [PMID: 19123875], in which they summarise much of their 2007 review. Significantly, Orme-Johnson’s commentary appeared adjacent to this article in the same issue. Clearly the journal editors felt the comments of this author to be worthy of note, notwithstanding he is a former professor at Maharishi University. Also, his commentary is cited by the 2012 AHRQ protocol and the 2010 Chiesa systematic review. As noted above, JACM is on the MEDRS-recommended Brandon/Hill list[13] of core medical publications.

Therefore I am not making “pseudoscientific claims,” or using low quality sources to debunk higher-quality ones.

Several MEDRS-compliant sources indicate that Ospina 2007 was flawed in its methods for assessing scientific quality. WP:NPOV says neutral editing means “representing fairly, proportionately, and, as far as possible, without bias, all of the significant views that have been published by reliable sources on a topic.” The common view of these five sources is significant and its complete exclusion is not justified by Wikipedia policy. EMP (talk) 20:34, 25 September 2013 (UTC)

The "Journal of Alternative and Complementary Medicine" is not a reliable source, whether its on some hallowed list or not. It makes statements that are clearly incompatible with more reliable sources such as [14]. The reliability of each article would need to be established on a case by case basis (in this case it is unreliable since the material is by a TM advocate) IRWolfie- (talk) 10:48, 28 September 2013 (UTC)

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