Wikipedia talk:Manual of Style/Medicine-related articles

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Not writing for patients or professionals[edit]

WP:MEDMOS#Writing for the wrong audience is one of my favorite sections, because I think it's very useful for many editors, without creating "rules". We don't write for (other) professionals and we don't write for (other) patients. This particular line:

  • You use a writing style appropriate only for graduate-level courses, because that's what you see in peer-reviewed journal articles and professional reference works.

was previously balanced by a line that said:

This seems to have disappeared sometime in the last couple of years, and I think it should be restored. Does anyone object? WhatamIdoing (talk) 21:53, 29 May 2018 (UTC)

  • Not from me. Didn't we (generally) use to have a recommended native-speaker reading age target of 18, or am I imagining that? We don't seem to have one now. Johnbod (talk) 01:16, 30 May 2018 (UTC)
    • I don't think it was ever in the guideline, although that specific age has been discussed repeatedly in the past. For a longer article, I think the actual goal is to be a bit less uniform. It's often desirable to write (very approximately) the first bit of the lead and important sections at a level that could be understood by a typical 12 year old. But from there, the ideal diverges: You might write a history section at a level that is best suited to 15 year olds, the main bulk of a technical section at a level that's only easy for graduate students, the diagnostic section at the level you would expect for a first-year university student, and so forth.
      (For reference: the first paragraph of Aspirin is written for 18 year olds, and the lead for Hypertension is more complex than that. The lead for Alcohol intoxication was recently cleaned up and sourced for translation. It was previously written at a post-graduate level, and now it is written at a level that will be understandable to 17 year olds. http://hemingwayapp.com/ will estimate a reading level if you paste content into the middle (over-writing the directions), but to get an accurate score, you have to manually remove the "[1]" refs.) WhatamIdoing (talk) 05:46, 31 May 2018 (UTC)
      • I certainly agree about a "rising" level through the course of the article, which has been generally accepted by the wikiproject in the past, though actually achieving a 12-yo level per the Kincaid etc tests is near-impossible, even in the lead, as any word over 8? letters costs you points. I put a lot of emphasis on this when I was at CRUK in 2014 - they were horrified at typical WP reading levels. We also have a large non-native-speaker readership, whose issues are somewhat different. This is especially the case for medical articles; in my research some non-native readers said they mostly used their native language WP, but used the English one for medical matters, in which they had greater trust. They often find long Latinate terms relatively easy, as they know them from their own language, but can be thrown by informal language. I don't know any tests for that. Johnbod (talk) 14:11, 31 May 2018 (UTC)
  • I think an 18-year old reading level would be a good suggestion. Some technical language should be ok when appropriate. Wikipedia is an encyclopedia, and shouldn't try to be a patient information repository, although that doesn't seem to be the opinion of some WPMED regulars. Per WP:ONEDOWN, the standard should vary based on the topic. An 18-year old reading level seems appropriate for aspirin, but should be more technical in an article on a specific type of cancer. One of my biggest pet peeves about this is that there is one person who insists that in all articles, "vertigo" needs to be replaced with "feeling like the world is spinning" and has reverted many, many editors who have changed it. Natureium (talk) 13:54, 31 May 2018 (UTC)
Medical issues are not generally "homework" ones, so I don't think WP:ONEDOWN is so relevant, though "The lead section should be particularly understandable" most certainly applies - myself I think a "rising" level through the course of the article is the way to treat virtually all technical subjects. I have some sympathy with the "vertigo" guy, not least because (thanks to Hitchcock?) I suspect a rather high % of people think it means "fear of heights". I might be inclined to use "vertigo (feeling like the world is spinning)" or something. Johnbod (talk) 15:27, 31 May 2018 (UTC)
Didn't you ever have to write papers on health topics when you were in school? I did, and it seems to be a pretty common thing (typical among the 10-to-12-year-old kids seem to be "Don't do drugs" and "Wear a bike helmet").
The point here isn't to recommend a particular reading level. The point is to say that you're probably doing it wrong if you're insisting upon a standard designed for a different type of publication (regardless of whether your preferred type is "peer-reviewed journal articles" or "patient information leaflets"). WhatamIdoing (talk) 16:31, 31 May 2018 (UTC)
Then why don't we take those 2 lines out altogether, since we all seem to be in agreement that the writing style will vary? Natureium (talk) 17:06, 31 May 2018 (UTC)
  • I don't think it appropriate for an internet encyclopedia to aim for a 12-year-old level. If folks are looking for simple, they can go to NIH or any number of websites that really dumb down the medical text to a less than high school level. I hope Wikipedia aims higher; not graduate level, but something like 18-ish at least. There are so many simple websites that dumb down the topics to a grammar school level already out there, and Wikipedia can aim for something different. SandyGeorgia (Talk) 03:09, 2 June 2018 (UTC)
Completely agree with SandyGeorgia. The English language is richly expressive. By all means clarify content (making use of the English language) and this really does not need to involve dumbing down. Particularly when there is such an abundance of links to make use of. A "sore thumb" example of this is the use of the word 'smaller' to describe a seriously muscle-wasted leg on a polio sufferer - this use is on a featured article, Poliomyelitis. Attempts to change this have always been reverted. Where is the sense in this type of dumbing down? (Or any type) --Iztwoz (talk) 09:35, 2 June 2018 (UTC)
Has anyone ever actually accused WP medical articles of being written at a 12-yo level? I doubt it. Almost all of them, when tested, give graduate++ levels. The struggle is to get them, or the leads at least, to a level where you don't need (according to to the tests) a science degree to understand them. Has everyone grasped that the quotes at the top are about what NOT to do? Johnbod (talk) 14:09, 2 June 2018 (UTC)
Agree. Cancer.gov has some great basic information about many facets of cancer. Wikipedia does not need to duplicate these efforts. Natureium (talk) 18:48, 2 June 2018 (UTC)
  • IMO different parts of the article should be written at different reading levels. Using technical language so we sound erudite is a much greater issues than using language that is overly simple. There is nothing wrong with Wikipedia using high quality secondary sources such as cancer.gov among others. The language used is very different from whether or not we are writing for patients, which of course we are not. Do we have any leads of medical articles written at a "6 or 7th grade level"? Doc James (talk · contribs · email) 19:44, 2 June 2018 (UTC)
  • I don't have an opinion about the exact age level of the readers (which is pointless because education levels vary between countries) but I do have an opinion about readability. Many, many Wikipedia articles have very low readability which makes them difficult to understand for laypersons and for people whose native language is not English (and makes them difficult to translate!). There is a great website with which you can easily check the readability score of any Wikipedia article: http://www.readabilityofwikipedia.com/ I know it is difficult to assess an article with such tools only but it gives a good general indication. A score of higher than 50 or 60 would be good. Many of the important WikiProject medicine articles have very low readability. E.g. the one on diarrhea: 38, the one on gastroenteritis: 36. This website is very helpful in improving readability scores: http://www.hemingwayapp.com/ - So could the Manual of Style say something about aiming for fairly high readability scores? In the WikiProject Sanitation we have explained it like this: https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Sanitation#Improve_readability EMsmile (talk) 12:28, 3 June 2018 (UTC)
    • I get 54 for just the lead of the EN article on diarrhea. One does not need to remove the references like with the other tool which is nice. Doc James (talk · contribs · email) 19:42, 3 June 2018 (UTC)
  • Keep 6th grade reading level / 12 educated years of age Wikipedia needs to be accessible to its target audience and match the standards of what other similar publications do. NIH and CDC publish many of their consumer guides targeting a 4th grade reading level, which is more simplistic than anyone has proposed for Wikipedia. Voice of America publishes using a 6th grade reading level with restricted vocabulary which is good for non-native English speakers but not what we are doing here. In English Wikipedia we should use a mix of high freedom to drop technical terms in wikilinks with a goal of otherwise making text, even technical text, highly readable to a general audience.
I cannot speak for the entire publishing industry but at Consumer Reports I worked on a project called Choosing Wisely which published educational materials for doctors and patients. After doing audience testing the team found that even physicians more frequently choose to read texts with more plain language and shorter sentences when the goal is to introduce and summarize a topic. In recent years various universities in the United States have begun hosting plain language medical writing conferences, but so far as I know, this profession and field is not well established.
I feel that this is a controversial topic and that it is difficult to get good information. Simple English Wikipedia has faltered in part because of great difference of opinion about what constitutes "Simple English", which is a more standardized concept. There is even less formalization in what English Wikipedia does. 6th grade English is a familiar reading level which all sorts of people enjoy. The Harry Potter book series targets 12-year old readers by telling stories of protagonists from age 12. Various readability rankings put Harry Potter books at 6th grade reading level. Although it is hard to define exactly how English Wikipedia can achieve this, I want Wikipedia's medical content to be accessible to anyone who might read a Harry Potter book. Blue Rasberry (talk) 14:13, 3 June 2018 (UTC)
And we have this article here which states "Wikipedia was used by 341 students (94%) while studying medicine. The most common reasons reported for using Wikipedia were ease of access (98%) and ease of understanding (95%)."[1]
The fact that we are often easier to understand is why many medical students turn to use. Doc James (talk · contribs · email) 19:31, 3 June 2018 (UTC)
Lane, there's nothing to "keep" here, because MEDMOS has never recommended that articles be written for 12-year-old children. I'm not sure that everyone really understands what this reading level means. Your most recent mainspace contribution was "A 2018 study examined the way that Wikipedia integrates new scientific information." That sentence scores at age 18. Your most recent new article scores at end-of-university reading level (~age 22). There isn't a single sentence in that article that scores below age 15. These aren't even technical subjects. If someone who is fully convinced of the value of simpler writing styles isn't managing to get anywhere near his goal on non-technical subjects, then I really don't think that we're going to get technical pages written in a way that typical 12 year olds can read fluently. WhatamIdoing (talk) 22:23, 9 June 2018 (UTC)
@WhatamIdoing: You are completely correct that we have no wiki community labor to copyedit to a professional standard. Editors are awesome and they easily do amazing things with text that non-professionals cannot. While I aspire for simpler text, I would not want anyone to use the wish for readability to impair anyone's attempt to edit articles as best they can. Readers are important but at this stage being welcoming to editors is our priority and I do not want anyone deterred.
Writing for 12 year olds is much harder than reading the same texts. Neither 12-year olds nor anyone without professional training can write at this level. If somehow WikiProject Medicine were able to standardize the reading level of articles, either by recruiting a professional-quality copyeditor or technological innovation, then 12-year old reading level is the mark I am choosing. I already mentioned Harry Potter. Here are more examples of the standard that I want. DK publishes for 8-12 year olds and is a model for Wikipedia style and scope. Check "first pages" to see actual text by clicking the amazon image.
The last one has more text but the writing style is still their own. DK translates their books so also they write anticipating that. Blue Rasberry (talk) 22:16, 10 June 2018 (UTC)
I typed the first paragraph of DK Eyewitness Medicine into these tools. Both agree: That's a college-level text, in terms of its readability. It averages 20 words per sentence and uses several complex sentence structures. The others you list are also not written for children. They are, in order, formally rated at a typical reading level for age 14, age 13, and age 15. According to this library-oriented website, that series of books isn't written for age 8 to 12; they're written for teenagers in grade 8 to 12. If your goal is to mimic the writing in those books, then your goal is not writing for 12 year olds.
I doubt that writing more simply actually requires professional training. Tech News (put out by one of my teammates) regularly scores around the US fourth grade level (10 year olds). Most of the announcements that I write with translation in mind score around age 13 to 15 (according to the Hemingway app, which I use to check long items before posting them for translation). I'm pretty sure that nobody on my team has had any special training. It requires some thought and effort, but anybody here could likely do the same with a little practice. WhatamIdoing (talk) 03:16, 11 June 2018 (UTC)
well that is at least about brain surgery. I wonder how technical our "rocket science" pages are :) Jytdog (talk) 18:12, 5 June 2018 (UTC)
"Rocket science" is a disambiguation page that leads to Aerospace engineering, which seems to score favorably. WhatamIdoing (talk) 22:30, 9 June 2018 (UTC)
Not quite the same. That's the basic overview of aerospace engineering. They looked at pages on neurosurgical topics, not neurosurgery. Natureium (talk) 11:46, 10 June 2018 (UTC)
  • The problem is more that when leads of articles are simplified down to a "16 to 18 year old level" some complain that Wikipedia is being "dumbed down" or that those who attempt to simplify to this level should leave English Wikipedia and go someplace else. Some appear to think that writing which is at a grade 12 level is at a grade 6 level. I get the impression that they feel all parts of English Wikipedia should be written at a post doc level.
  • Our article on WP:Audience says "Make your article accessible and understandable for as many readers as possible." Writing for a general audience is much harder than writing for a technical audience. We all need to work on our skills writing for the former rather than the latter. Doc James (talk · contribs · email) 19:26, 14 June 2018 (UTC)
  • The risk that we will write at too low a level is negligible, and I do not agree we should restore this sentence. On the other hand, writing in too complicated a fashion is very common. I have much more to say on this, but I tend to agree with Bluerasberry — and there is an important distinction between the lede and body of articles. Carl Fredrik talk 12:36, 17 June 2018 (UTC)
  • While I agree with Doc James's comments just above, I support restoring the balancing line about not writing WP as if for children. This is not simple.wikipedia.org. That's a separate project for a reason. I'm among the first to criticize writing in obtuse jargon when it can be avoided, specifically because millions of children and ESL leaners are among our audience. But WP isn't written specifically for them. Rather, we apply WP:JARGON, MOS:TONE, and various aspects of WP:NOT, among other guidance, to produce text that most of our readers can figure out, though sometimes this requires branching off to side articles. Hypertext also exists for a reason. A balance is required, and it's just a fact that the more technical the topic is the more technical our article's wording will be – to a constrained extent – otherwise we rapidly lose precision and accuracy. Go read some Simple English Wikipedia articles on technical topics and you'll see this effect in action. Such writing does in fact dumb down the content.  — SMcCandlish ¢ 😼  20:40, 17 June 2018 (UTC)
  • Support restoring the sentence per WAID. Not at all surprised at who was involved in removing/restoring/removing it. Let's write for grown-ups please. If you know anything about how children learn, or about how people with English as a second language learn, you know that text which is above the level they know already is a fantastic way to stretch their vocabulary. Children are quite capable of reading text written for adults, looking up words, asking questions, etc. If Doc James thinks the lead should be understandable by young children, then go make that proposal to the wider WP community and get the MOS changed. Most of the article titles in WP:MED's remit are words that themselves are above the level James thinks our leads should be dumbed down to. Influenza, Poliomyelitis, Tuberous sclerosis, ketogenic diet. Writing well involves meeting multiple goals, some of which conflict. It isn't possible to accurately define, describe and explain complex topics using baby words. -- Colin°Talk 10:45, 19 June 2018 (UTC)
    • I don't think that Doc James actually holds the POV that has been repeatedly attributed to him through the years. Even for the leads, which most editors agree should be somewhat more accessible than sections covering technical details, he seems to have been writing for older teenagers and young adults (age 16 to 18). WhatamIdoing (talk) 02:14, 20 June 2018 (UTC)

Digression: simple.wikipedia.org[edit]

I think the first thing we need to get on board with, is to smash the notion that Simple Wikipedia has any usefulness or utility for anyone. It has roughly 1/500th the readership of en-wiki, and I've never met a single person outside Wikimania or Wiki-meetups that was even aware of it existing. I've also never met anyone who actually edits it.

The second point is that it is rediculously out of date, and poorly maintained — and has no community interested in working on its medical articles.

And for a third point — it doesn't even do what it's supposed to do. Just take a look at this:

It consistently scores horribly in readability — so even if the articles weren't horrible, they aren't much more readable. In fact the only article I found on some of our most important topics that was at all useful was:

But, on the other hand, it's so horrible and short that it's useless anyway. It defines "safe sex" as: "to have sex in a safe way." That article saw 55 views in the past month — while the en-wiki one saw 25,000.

I think any argument that builds on the existence of simple-wiki should be ignored on sight. (Not direct at you SMcCandlish, but I don't think people realize how useless and ignored simple-wiki is. It's worse than Wikipedia Zero, and I'm entirely convinced that the only reason it hasn't been closed down is because it has a handful of editors who would get very mad if it did, while Zero was run by foundation employees). Carl Fredrik talk 21:11, 17 June 2018 (UTC)

Since you say that you have never met anyone who edits at simple, then let me introduce you to some of your fellow enwiki admins: @Auntof6, Bsadowski1, Mentifisto, Only, and Djsasso:. And Doc James, of course, since he's made a few hundred edits there. You might also be interested in w:simple:User:Bluerasberry/WikiProject Medicine; WikiProjects are too bureaucratic for a small community, but editors who are interested tend to get in touch and sometimes set up a userpage to make themselves easier to find.
I agree that simplewiki isn't a substitute for clear writing here, but I don't agree with bashing of simplewiki. WhatamIdoing (talk) 03:31, 18 June 2018 (UTC)
Thank you, WhatamIdoing, but I am an admin at Simple, not here at en. --Auntof6 (talk) 03:38, 18 June 2018 (UTC)
I looked at and worked on simple.WP a while ago. It is trying to write in language simpler than I can manage or than I think is desirable here. Often it does not succeed in the goal it has set out for itself. Doc James (talk · contribs · email) 07:40, 18 June 2018 (UTC)
Whether simple.WP is failing its mission or not (I agree that it is) isn't very relevant to this conversation. My point in mentioning it at all was for people in this conversation to go have a look at the actual, palpable dumbing-down effect when highly technical topics are reduced to elementary-to-secondary-school English. I'm not at all suggesting any sort of "you should shut up and go write at simple.WP instead" fallacy.  :-)

If people want to save (and make "actually workable") the idea of applying some combination of the Simple English limited lexicons to WP topics, the eventual solution is probably integrating it into en.WP itself, as some kind of sidebar option. If the huge active editorial base of en.WP were also creating the simplified versions of articles, it would get done more often and better.  — SMcCandlish ¢ 😼  06:25, 18 June 2018 (UTC)

I've been staying out of the discussion because others have stated what I would state on the matter, which is that I don't think we should be unnecessarily dumbing down our articles or aiming for Simple English Wikipedia level. I agree that we should use clearer language when we can, especially for the lead, but even in those cases I consider pipelinking to the technical wording and/or putting the simpler wording in parentheses to briefly explain what the technical word is. We definitely shouldn't forgo wikilinks that will help explain matters, and all because those wikilinks are technical terms. A lot of technical articles, such as the Human brain article, can't help but use a lot of technical terminology. Same goes for a lot of our math articles. Often, in cases such as the Human brain article, there are no simpler words. Flyer22 Reborn (talk) 02:12, 20 June 2018 (UTC)