Wikipedia talk:Identifying reliable sources (medicine)

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Frequently Asked Questions (FAQ)

These are some Frequently Asked Questions about Wikipedia's guidelines on sourcing for medical content, manual of style for medicine-related articles, and how the guidelines and policies apply to biomedical content.

General
Why do you have special rules for medical information?
Different types of sources have different strengths and weaknesses. A type of source that is good for scientific information is not usually as reliable for political information, and vice versa. Since Wikipedia's readers may make medical decisions based on information found in our articles,[1] we want to use high-quality sources when writing about biomedical information. Many sources that are acceptable for other types of information under Wikipedia's general sourcing guideline, such as the popular press, are not suitable sources for reliable medical information.[2][3] (See also: WP:MEDPOP and WP:WHYMEDRS)
When do I need to follow MEDRS?
MEDRS-compliant sources are required for biomedical information. Like the policy on the biographies of living people ("BLP"), MEDRS applies to statements and not to articles: biomedical statements in non-medical articles need to comply with MEDRS, while non-medical statements in medical articles (such as in a History section) do not need to follow MEDRS. Also like BLP, the spirit of MEDRS is to err on the side of caution when making biomedical statements. Content about human biochemistry or about medical research in animals is also subject to MEDRS if it is relevant to human health.
Sourcing
I used a peer-reviewed source, but it was reverted, and the editor said I needed to use a review. I did, didn't I?
Probably not. Most peer-reviewed articles are not review articles. The very similar names are easily confused. For most (not all) purposes, the ideal source is a peer-reviewed review article.
Why can't I use primary sources?

Primary sources aren't completely banned, but they should only be used in rare situations. Whenever possible, you should cite a secondary source such as:

So if primary sources can be used in rare cases, what are those rare cases?

Primary sources might be useful in these common situations:

  • when writing about a rare disease, uncommon procedure, etc., for which no high-quality secondary literature is available, or for which the available secondary sources do not cover all of the information normally included in an encyclopedia article.
  • when mentioning a famous paper or clinical trial that made a recognized substantial impact, as part of a purely historical treatment of a topic.
  • when describing major research that has made a significant impact (i.e., continued and substantial coverage). While recent research results are normally omitted, it is sometimes necessary to include it for WP:DUE weight. In this case, it is usually preferable to read and cite the primary scientific literature in preference to WP:PRIMARYNEWS sources. Later, these primary sources can be replaced or supplemented with citations to high-quality secondary sources.
Can I use websites like Quackwatch?
Quackwatch is a self-published website by an author who is an expert in problems with complementary and alternative medicine. Whenever possible, you should use a scholarly source instead of Quackwatch. However, if no scholarly sources are available, and the subject is still notable, then it might be reasonable to cite Quackwatch with WP:INTEXT attribution to the POV.
Can I cite Chinese studies about Traditional Chinese Medicine?
Yes, but be careful that you give them only WP:DUE weight. As of 2014, there are concerns regarding positive bias in publications from China on Traditional Chinese Medicine.[4][5] Such sources should be used with caution. The problem also includes issues with the academic system in China.[6]
Can I cite NCCAM (now NCCIH)?
Yes, but again only with WP:DUE weight. Unlike other branches of the National Institutes of Health, which are generally accepted as authoritative in their fields, NCCAM has been the focus of significant criticism from within the scientific community.[7] Whenever possible, you should cite the established literature directly.
What if I can’t find any MEDRS-compliant sources on a subject?
MEDRS contains a section about finding sources which may be helpful. Alternatively, a more experienced editor may be able to help you find them (or to confirm that they do not exist).
Neutrality
What is a fringe medical claim?
How should fringe medical claims be described?
When fringe claims have been widely reported in the press, have a large popular following, and/or have a long history, it may be appropriate to describe them in terms of that reporting, popularity, or history. However, weight should be determined by MEDRS-compliant sources, and the context (or lack thereof) should not make implications about medical statements that are not supported by such sources. Guidance on the additional considerations relevant to fringe subjects can be found at WP:FRINGE, as well as at other places such as WP:WEIGHT and WP:EXCEPTIONAL.
In the case of alternative medicine, medical statements are often derived from an underlying belief system, which will include many propositions that are not subject to MEDRS. These propositions are subject to the usual sourcing requirements and the usual requirements for determining fringe status.
If a treatment hasn't been shown to work, can we say it doesn't work?

There are three possible situations:

  • no evidence exists (i.e., studies for the treatment have not been published, or the evidence base is too small or weak to draw any conclusions);
  • evidence exists, and it shows no effect;
  • evidence exists, and it shows an effect.

In the first case, we cannot say that it does not work, but we can say that there is no evidence to determine whether it works. In the second, we can say that there is no evidence that it works. In the last, we should say that there is evidence that it has an effect.

After multiple, high-quality independent studies have been published, it is reasonable to understand "no evidence that it works" as "some evidence that it does not work". You should follow the lead of review articles and other secondary sources for determining when this threshold has been crossed.

Reports may conflict with each other. For example, a clinical trial may produce no evidence of an effect, but the treatment's manufacturer might produce testimonials claiming a positive effect. You should follow the lead of review articles and other secondary sources for determining how to balance these claims.

Should medical content be attributed?
Why not say there is a call for more research?
How can Quackwatch be considered a reliable source?
Finding and using sources
How can I find good sources using PubMed?
Are there ways to find good sources other than PubMed?
Besides being a secondary source, what else indicates a source is of high quality?
I found what looks like a good source, but can't access the full text – what next?

Most scholarly journals are behind paywalls. Some options to access these articles include visiting a local university library, visiting The Wikipedia Library, and WikiProject Resource Requests.

Note that paywalled articles are frequently pirated and made available on the open web. When linking to a journal article, care must be taken not to link to such a pirate copy, as such a link would be a copyright violating link in contravention of Wikipedia's policy. In general if you find such a copy and it is not accompanied by text explicitly stating that it is made available with the permission of the copyright holder, assume that it is potentially infringing, and do not link to it. This holds for all edits in Wikipedia, not just in article space.

How do I reference a medical article?

Almost all medical articles medical articles are indexed by the PubMed search engine and have a Digital object identifier (DOI) assigned to them. All articles included in PubMed are assigned an eight-digit PubMed identifier (PMID). These identifiers can be used to refer to articles, which is preferred to URLs as it makes a reliable link which is resilient to changes beyond our control – i.e. the publisher being acquired by another publisher and it's "normal" web URLs changing as a consequence.

Once you have the PMID, there are a number of tools such as this one which you can use to generate a full citation automatically.

In article references, the "doi" and "pmid" parameters are preferred to the "url" parameter for such reasons.

On Talk pages, when referring to journal articles, is it good practice to make any link using these types of identifer also:

  • Typing "PMID", a space, and the 8-digit PubMed identifier will be automagically turned into a link by the Wikipedia software (e.g. PMID 21148220).
  • Any DOI can be turned into a resolvable web address by prepending "http://dx.doi.org/" to it (e.g. http://dx.doi.org/10.1136/bmj.c6801).
Conflict of interest
Are there special rules on conflicts of interest for health content?
What if I am being paid to edit medical content?
References

References

  1. ^ Laurent, MR; Vickers, TJ (2009). "Seeking health information online: does Wikipedia matter?". J Am Med Inform Assoc 16 (4): 471–9. doi:10.1197/jamia.M3059. PMC 2705249. PMID 19390105. 
  2. ^ Schwitzer G (2008). "How do US journalists cover treatments, tests, products, and procedures? an evaluation of 500 stories". PLoS Med 5 (5): e95. doi:10.1371/journal.pmed.0050095. PMC 2689661. PMID 18507496. Lay summaryGuardian (2008-06-21). 
  3. ^ Dentzer S (2009). "Communicating medical news—pitfalls of health care journalism". N Engl J Med 360 (1): 1–3. doi:10.1056/NEJMp0805753. PMID 19118299. 
  4. ^ Li J, et al The quality of reports of randomized clinical trials on traditional Chinese medicine treatments: a systematic review of articles indexed in the China National Knowledge Infrastructure database from 2005 to 2012. BMC Complement Altern Med. 2014 Sep 26;14:362. PMID 25256890
  5. ^ Further information:
  6. ^ Qiu, Jane (January 12, 2010), Publish or perish in China, Nature 
  7. ^ Some examples:
    • Nature Reviews Cancer: "the subject of rancorous scientific and political debate over its mission and even continued existence"
    • Clinical Rheumatology: "The criticism repeatedly aimed at NCCAM seems justified, as far as their RCTs of chiropractic is concerned. It seems questionable whether such research is worthwhile."
    • Nature News: "still draws fire from traditional scientists", "Many US researchers still say such funding is a waste of time and money."
    • Science News: "[NCCAM] is a political creation"; "This kind of science isn't worth any time or money" (quoting Wallace Sampson)
    • Science Policy Forum: "[NCCAM] was created by pressure from a few advocates in Congress"; "NCCAM funds proposals of dubious merit; its research agenda is shaped more by politics than by science; and it is structured by its charter in a manner that precludes an independent review of its performance"; "NCCAM is unable to implement a research agenda that addresses legitimate scientific opportunities or health-care needs"
Other helpful resources
          This page is of interest to the following WikiProjects:
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WikiProject icon This page is within the scope of WikiProject Psychoactive and Recreational Drugs, a collaborative effort to improve the coverage of psychoactive and recreational drugs on Wikipedia. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.
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Proposal: Strengthen wording of "in a nutshell" at beginning[edit]

Right now, the "nutshell" version of this guideline begins with:

"Ideal sources for biomedical material include... <description of some high-quality medical sources>"

As a relatively new editor, this seems somewhat misleading as a summary of the guide (and associated documents, like this talk page's FAQ). "Ideal" and "include" are very weak wording. An "ideal" Wikipedia article is one that meets the Featured criteria, but there's no realistic expectation that more than a few percent of articles will get there anytime soon. The "meat" of the guide seems to be much stronger than this; saying, if I understand correctly, that most biomedical material should be based on these sources most of the time. IE, there may be exceptions, but the intent is that the sources described should be the "default" for most Wikipedia medical content.

Therefore, I'd suggest amending this introduction to something like:

"Biomedical material in Wikipedia should primarily be based on... <description of some high-quality medical sources>"

Maybe not those exact words, but I think something like this would better represent the fundamental principles and intention of this guide. NeatGrey (talk) 00:07, 13 April 2016 (UTC)