Talk:Osteoarthritis/Archive 2

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Reverted edits[edit]

This edit removed a bunch a reviews including a Cochrane review from 2009.[1] Thus I reverted. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:47, 7 April 2013 (UTC)

Doc James, that is a heavy handed revert that removed tons of abbreviations and other edits. To simply restore the Cochrane review, let's do it more surgically. Let me look closely at this single edit that you are trying to revert and see why I removed that info.Sthubbar (talk) 19:55, 7 April 2013 (UTC)
Doc James, this was near the start of my editing and I think I see the issue. My disagreement with that content is that as I mentioned in the edit comments, it violated NPOV to start listing every medication that has been shown to be ineffective for a particular disease. Unless we also include a complete list of Western medications that have been shown to be ineffective for OA, then why include ineffective "Alt Med" treatments. It appears clear that ineffective "Western" meds are ignored and only effective treatments are listed, so for "Alt Med" I would expect the same treatment. If there is some controversy or extensive debate, like glucosamine, I'll let that slide for now, but from the mention of Vitamin C and stuff, I see no reason to include them. Leave that out.Sthubbar (talk)
Doc James, that was in poor form. I put a comment in my I did the revert and further came here to explain. You didn't even leave a comment when do did the revert a second time, or try to come to the talk page. You are undoing tons of work, with no justification.Sthubbar (talk) 20:04, 7 April 2013 (UTC)
Justification was provided. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:19, 7 April 2013 (UTC)

Doc James, you provided some interesting input about glucosamine. I can't find that any of your data conflicts the statement that "1500mg cyrstalline glucosamine sulfate is effective" as stated by the 2012 review. Even the Cochrane mete-analysis can't rule out glucosamine sulfate, which supports the 2012 study. All other negative studies include glucosmaine HCL or heterogenous preperations of glucosamine.

Furthermore, as you made a mistake about the removal of the pmid:20847017 Cochrane review, I am reverting to where I left off. I appreciate your editing of the content and improving the quality.

You have removed a number of review articles again including: PMID:21220090 and this Cochrane review PMID:19821296. You have replaced the Cochrane review with an older non systematic review. You have removed the comments on there being a lack of good evidence which was supported by a 2010 review. I disagree with all these changes. The PMID to which you link is the BMJ article. The 2012 review is indeed contradicted by the other review you removed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:28, 7 April 2013 (UTC)

Doc James, I'm going to assume good faith, so let me clear up what appears to be your confusion. Here is the situation:

1) I made several changes to OA 2) You mistakenly assume I removed pmid:20847017 so you reverted most all of my changes 3) You added additional content, including PMID:21220090 that I wasn't aware of until just now 4) I reverted to #1 to fix your mistake

The implication I hear in your comment is that I intentionally removed pmid:20847017 and PMID:21220090. We have already agreed that the former you were mistaken and the later, I wasn't aware because it was an addition after you made the massive revert.

As to PMID:19821296, this is for an di proven treatment. The implication is I removed a study disproving this treatment in order to support it. Instead I have completely removed the treatment because the treatment section is not to include every dis proven treatment. If a treatment doesn't work then completely remove it, or put it in the history section if you really want to have that in there.

Please stop the reverting. If you want to redo your edit, or I can even redo it for you of PMID:21220090, that's perfectly fine.Sthubbar (talk) 00:27, 8 April 2013 (UTC)

No that is not at all the case. But let see what a third opinion has to say. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:30, 8 April 2013 (UTC)

I reverted the latest change because generally the sourcing has been made worse in both recency and authority of works cited. Please discuss and get consensus for these proposed changes one at a time before replacing. Zad68 01:25, 8 April 2013 (UTC)

Adding - I understand some other good changes were in there like formatting or abbreviations. But the most important thing is the sourcing. Feel free to fix the small things while we discuss the sourcing changes. Zad68 01:33, 8 April 2013 (UTC)

I think most of the formatting changes he made are still there. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:42, 8 April 2013 (UTC)

I restored another removal of well-sourced and correctly-located content, including a 2010 Cochrane review. What could be the justification for the removal of such relevant, well-sourced content? Zad68 03:51, 8 April 2013 (UTC)

And he keeps removing what the refs say as in this edit [2] Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:02, 8 April 2013 (UTC)
Restored "many" after I confirmed that is what the source says. Zad68 15:23, 8 April 2013 (UTC)

Zad one more edit[edit]

Zad, for consistency, I suggest we remove curcumin from the second sentence of possible treatments and it conflicts with the stronger later study that says there is unclear evidence. OK?Sthubbar (talk) 17:40, 9 April 2013 (UTC)

Your suggestion is probably good. What's the later study's PMID? Zad68 17:54, 9 April 2013 (UTC)
The ref is already there talking about turmeric which curcumin is the active ingredient of turmeric.[1]Sthubbar (talk) 18:03, 9 April 2013 (UTC)

Changes for 9 April[edit]

  • "Cat's claw" is a "practical treatment" - overstates what the source says. Source states "Three studies support cat's claw alone or in combination for OA" (Rosenbaum 2010). Suggestion is to restore previous article content "Three studies support the use of cat's claw."
  • capsaicin and SAMe - study found them "effective in the management", but don't agree "practical" is a good paraphrase, suggest something like 'capsaicin and SAMe are effective in managing OA'.
  • vitamins and ginger, turmeric, omega-3, glucosamie: I'm OK with "There is insufficient evidence", I think it's an improvement.
  • chondroitin - "is not recommended", source says "discouraged", maybe we could make our statement a little stronger against

Zad68 17:51, 9 April 2013 (UTC)

The remove of "three studies" is because this is a direct quote and as I've been told, plagiarism and copyright infringement. Also, I read the rules about using studies and if it is a single study then the language is "A 2010 study says X is a fact.", if it is a review article then it is "X is fact". DJ already reverted when I used the word "effective" and wrote on my talk page that I must paraphrase so I used thesaurus.com and practical is a synonym. I don't see the problem with practical also for Cat's claw. The review article supports the use, period. You can make the chondroitin stronger.Sthubbar (talk) 18:01, 9 April 2013 (UTC)
I never said it didn't support, we just need to hammer out the wording. "Practical" is not a good synonym. How about "There is evidence that cat's claw is effective in managing OA"? Zad68 18:18, 9 April 2013 (UTC)
Zad, that's fine. Feel free to edit at your leisure, I'm going to bed.  :)Sthubbar (talk) 18:20, 9 April 2013 (UTC)
Great! Have a good one. Zad68 18:25, 9 April 2013 (UTC)

So reverted back the edit that put cat's claw in the "effective" category... again, the review that covered it didn't go as far as to say 'effective', just that there's some evidence (three studies) to support. Zad68 01:58, 10 April 2013 (UTC)

Why single out cat's claw?[edit]

Zad, why do you want to single out cat's claw? The organization of the section I see is:

Treatments that are the most likely
Treatments that show some evidence and require more evidence

I am following the criteria "‘Weak evidence’ describes herbs with a single RCT with significant results; ‘promising evidence’ describes herbs with two trials that produced favourable outcomes; ‘moderately strong evidence’ describes herbs with three or more favourable trials." as specified here http://rheumatology.oxfordjournals.org/content/40/7/779.long, which is PMID:11477283, included in the article. We only use 2 categories instead of 3. Category 1 is 3 or more RCT. Category 2 is less than 3 RCT. Cat's claw has 3 RCT so that is why I include it in the first sentence with Capcaicin. Does that make sense?Sthubbar (talk) 02:00, 10 April 2013 (UTC)

How supportive evidence is of a treatment does not depend just on the number of RCTs done. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:31, 10 April 2013 (UTC)
Why is cat's claw being kept out of the first sentence? The abstract says clearly that it is supported as a treatment for OA, so I suggest it be added with the other treatments in the first sentence. The abstract also says nothing about anti-inflammatory properties of cat's claw. I though anti-inflammatory properties was generally associated with RA not OA. Anyway, can we please change the first sentence to include cat's claw and remove the special clause? — Preceding unsigned comment added by Sthubbar (talkcontribs) 03:49, 11 April 2013 (UTC)
Because De Silva didn't study cat's claw, and Rosenbaum only says "Three clinical trials support the use of cat's claw as an anti-oxidant/antiinflammatory agent". This is stopping short of saying there's enough evidence that it's hands-down effective. I think the current article content reflects the source accurately, don't see a need to change it. Zad68 02:46, 12 April 2013 (UTC)
Zad68, where does Rosenbaum say "cat's claw as an anti-oxidant/antiinflammatory agent"? Do you have access to the complete document?Sthubbar (talk) 03:03, 12 April 2013 (UTC)
Yes sir, it is here. Whenever you find a document on PubMed, always search on the document title, you can often find an (illegal) copy of it somewhere to download. Zad68 03:07, 12 April 2013 (UTC)

Zad68, <sarcasm>how dare you suggest I do anything illegal! I would never!!</sarcasm>. I will agree to disagree. According to the reports: Phytodolor provides "significant improvement in grip strength", SAMe is "equal to or more effective and better tolerated than the NSAIDs" and SKI 306X provides "significantly lower levels of pain and better function".

To be fair I suggest these two choice:

  1. Put these statements along with each of the treatments to make them similar to the clarification for cat's claw.
  2. Leave out this clarification for all items, including cat's claw.

Which seems more reasonable to you?Sthubbar (talk) 03:57, 12 April 2013 (UTC)

Added treatments are from full articles not from abstract[edit]

Before reverting the added treatments under dietary supplements, please review the complete articles and discuss here. There are 2 new references from Ernst in 2001 and 2011. This is where much of this info, though not all is coming from.

I realize there is still conflicting information to be clarified, for example stinging nettle is both listed as promising and not able to be recommended in the first and last paragraph of the section. I think there are other review articles for some of these conflict treatments that we can review.

I will also alphabatize these treatments when I have a mild confidence that these edits aren't just going to be blanket reverted.Sthubbar (talk) 02:27, 10 April 2013 (UTC)

We typically do not use reviews older than 10 years when newer stuff is available. Thus we should remove the 2001 review.Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:33, 10 April 2013 (UTC)
Doc James, thank you for educating me about that rule. There is much overlap between the two studies, so I will remove anything that is only in the 2001 study and take the results from the 2011 study.Sthubbar (talk) 05:25, 10 April 2013 (UTC)
Have removed the 2001 ref. Not sure if there is still content there support by it though. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:30, 10 April 2013 (UTC)

Why a special page for knee osteoarthrits?[edit]

Doc James, I see you have created a special page for osteoarthritis of the knee. I'm curious why a special page. It seems like it will make it more difficult to maintain a consistent information if there is significant overlap with osteoarthritis. This page would make sense to me if on the osteoarthritis page there is a section "osteoarthritis of the knee" and with a link to the new page. Then this new page would only include additional clarification of this particular manifestation of OA and not include duplicate from OA. So, the general question is, why the special page and how to keep both pages in sync?Sthubbar (talk) 12:22, 13 April 2013 (UTC)

If mean this page knee osteoarthritis it was created by someone else in 2010 Jan [3]. In fact in May of 2010 I tried to redirect it to the main page here [4] and would still be supportive of this option with incorporation of the bit of good content into the main article. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:48, 14 April 2013 (UTC)
Doc James, I think I was looking at the history of the talk page that led me to believe you created the page. OK, so you have the same idea I have of putting in the redirect. I guess next is to take it up on the talk page there. Thanks.Sthubbar (talk) 11:36, 14 April 2013 (UTC)
I notice that there seems to be no activity on the talk page, so probably won't be helpful to start a discuss there. Do you recommend trying to put back in the redirect?Sthubbar (talk) 11:38, 14 April 2013 (UTC)
Best to mention it on the talk page first. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:56, 14 April 2013 (UTC)

OA vs. RA?[edit]

Shouldn't the article, including the introduction, define the difference between osteoarthritis and rheumatoid arthritis? (The link to Dorland's is dead.) --Nbauman (talk) 18:57, 22 April 2013 (UTC)

Yes they stopped offering a free copy of Dorlands a while ago. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:41, 23 April 2013 (UTC)
The simple explanation is that OA is a disease of mechanical wear, while RA is an autoimmune disease. That's arguably an oversimplification, but I think it's acceptable for the introduction. --Nbauman (talk) 17:10, 24 April 2013 (UTC)
I agree with the RA autoimmune bit. Do we have a ref for the mechanical wear? Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:04, 25 April 2013 (UTC)

Added massage therapy[edit]

I also reorganized under Alternative Medicine so the headings there are now: Dietary supplements, Manual therapies, Acupuncture, Electrical stimulation

I moved the content that was under Manual therapies into the two new headings (Acupuncture and E-stim), two sentences on the first and one on the other.

TBH this is the first time I've used journal citations, so please let me know if I did a poor job.

Derekawesome (talk) 20:25, 6 May 2013 (UTC)

Per WP:MEDRS we try to use secondary sources rather than primary sources. Thus reverted additions. Will look for secondary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:11, 7 May 2013 (UTC)
Dillard, JN (2011 Sep). "Use of complementary therapies to treat the pain of osteoarthritis". The Journal of family practice. 60 (9 Suppl): S43–9. PMID 22442759.  Check date values in: |date= (help)
. PMID 22632691.  Missing or empty |title= (help)
The last one is a review of massage. As soon as I have internet that works I will look at it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:46, 7 May 2013 (UTC)
Okay added summary. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:54, 7 May 2013 (UTC)