Wikipedia talk:WikiProject Medicine/Archive 79

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MEDRS required to support claim that something is placebo?

I thought this has might have been discussed by this project before and maybe there's a precedent someone could point me to... Does repeating a claim that something, like CAM, is a placebo require MEDRS? I know that in general FRINGE does not, but there's a debate about using the word placebo without MEDRS at Talk:Deepak Chopra#Treatment of controversy in lead. Permstrump (talk) 21:15, 9 March 2016 (UTC)

yes. any specific statement about health very much should be supported by an ideal source per MEDRS. we want high quality content, and that means well-supported. Following this consistently allows us to keep all kinds of low-quality content out - whether it is added by a shill for X or a "believer" in Y. Jytdog (talk) 21:21, 9 March 2016 (UTC)
Something to consider: if you 'gold-plated MEDRS' sources don't address a point, then trying using the best you can realistically get. If "the best" is not a very good source, then the it's possible that a statement is WP:UNDUE or that a different description would better comply with NPOV. WhatamIdoing (talk) 21:30, 9 March 2016 (UTC)
If "the best" is not a very good source, then the it's possible that a statement is WP:UNDUE or that a different description would better comply with NPOV-- Good point, WhatamIdoing. I don't know when or who added it, but the source was definitely an odd choice. It's a literary magazine called The Antioch Review published by Antioch College, neither of which mean anything to me. The author is a medical doctor and professor at University of Louisville Medical School though, FWIW. I haven't looked for an alternate, so I honestly have no idea if that's the only or best source. A few editors thought there was basically a blanket rule that FRINGE never requires MEDRS and others thought the reference to placebo made it a different story. But I think the bottom line is, like you said, if it's DUE there should be a couple of options for sources to choose from, which would apply regardless of MEDRS. Permstrump (talk) 22:35, 9 March 2016 (UTC)

Definition of CAM

The question misrepresents the situation. We're dealing with CAM, which by it's very nature is nothing better than placebo. A claim that CAM has effects other than placebo requires exceptionally high quality MEDRS sources per FRINGE. The reverse, that CAM as no effects beyond placebo, is exactly what it means to be CAM. --Ronz (talk) 17:27, 10 March 2016 (UTC)
We are dealing with a BLP article and charges related to the medical competence of the subject of the article. This at the least requires that the source be verifiable and reliable for those charges and that the charges are repeated in multiple sources indicating mainstream acceptance. Suggestion that this is entirely a CAM situation, that all of CAM is placebo, is not correct and further suggests that we have the right to judge a entire and complex field in view of our own opinions, and that we can extend that position to a man's life whoever he may be. This is a BLP we must treat it as such exercising the kind judgement in editing that does not damage whatever our opinions might be.
While the credentials of the writer of this piece might be what we could consider reliable the publication is not, especially in a BLP where extra care must be taken.(Littleolive oil (talk) 17:52, 10 March 2016 (UTC))
It is entirely a CAM situation. All of CAM is no better than placebo by definition. These aren't simply opinions, nor are they opinions that require balancing. Rather, they are viewpoints that get special prominence so we can create a respected encyclopedia when it comes to scientific thought. --Ronz (talk) 23:53, 10 March 2016 (UTC)
I've never yet seen a definition of CAM that says "CAM is stuff that's no better than placebo" – not even from the most strident critics. For one thing, that definition of CAM would have to include things like arthroscopic knee surgery, which is "mainstream", and exclude chiropractors treating a subluxated elbow. It also wouldn't be possible for something to stop being CAM and start being mainstream, which is exactly what happened to the Lamaze technique.
Additionally, BLP covers every living human, including criminals and "SCAM artists". When the article has a living human's name at the top, you must respect BLP throughout the page. You can't declare any part of a biography of a living person to be exempt from the policy about biographies of living persons. If the information isn't about that person, then it shouldn't be on that page. If it is about that person, then it must comply with BLP. WhatamIdoing (talk) 08:07, 11 March 2016 (UTC)
ack, Ronz. While i hear you, you are going a step too far when you say "all CAM is placebo". It is just too broad a brush and too definitive a statement. I agree with everything else you wrote; the same is true to say "medical device X is safe and effective to treat Y" - we also get people like company reps who want to over-emphasize how good their products are; but we do have to be extra careful to raise source quality with CAM stuff because we run into so much diffuse advocacy and so often there is no known biological mechanism by which the intervention could work. yes. Jytdog (talk) 14:25, 11 March 2016 (UTC)
I'm not saying all CAM is a placebo. I'm saying by definition it's no better than placebo.[citation needed] That's the defining point between evidence-based medicine and everything else. If it is found to be better than placebo, it's no longer CAM. Maybe I'm wrong. If editors disagree, we can look at sources. This is a topic where expertise is required, and we should not be making decisions without the necessary expertise guiding us. --Ronz (talk) 17:02, 11 March 2016 (UTC)
@Ronz: I'm on the same page, but WhatamIdoing still made a good in one of the first responses that if it's DUE, it should be available in other sources, so I decided to drop the MEDRS part of the debate for now. At one point I was hoping to squash it once and for all, but then I snapped out of it. That was silly of me. I found a couple of sources that say something similar even if they don't use the word placebo. I'll post on Talk:Deepak Chopra later today as soon as I have a chance. PermStrump(talk) 17:24, 11 March 2016 (UTC)
In the case of Chopra, the article - PMID 12846118 - by Hans Baer (a medical anthropologist) which is already used in the article refers to Chopra as "a multi-millionaire thoroughly seduced by the placebo effect". That would seem pertinent to this discussion. Edit: Sorry this is in the Gamel piece the article cites, and not the Baer one. Alexbrn (talk) 17:35, 11 March 2016 (UTC); amended 03:31, 12 March 2016 (UTC)
Ronz, do you have a source for this alleged definition, or are you just repeating your personal POV? I'd love to be able to edit the lead for arthroscopic knee surgery (Arthroscopy#Knee) to say that it's "alternative medicine" rather than conventional Western surgery, and I'm sure that there are people who would like to say that Cansema is "evidence-based medicine" according to your definition – because, you know, it does actually work "better than placebo" for superficial skin cancers ...just, unfortunately, at about one-tenth the rate of modern medicine, and with about ten times the side effects. You'd be better off wielding a kitchen knife than with herbal escharotics, but you're better off with Cansema than with a placebo. The reason that it's alternative is because there are options that are much, much, much better than placebo, not because it is no more effective than placebo. As for the knee surgery, you would probably be better off with a charismatic faith healer than with the surgery; both have been studied and neither are better than placebo – but the risks of sitting through a faith healing session are lower than the risks of anesthesia, infection, etc.
The precise antonym of "alternative" is "conventional". Words that contrast with "evidence-based" include "experimental", "unproven", and "disproven". WhatamIdoing (talk) 07:02, 12 March 2016 (UTC)
The words on the Alternative medicine side ("alternative", "complementary", "integrative", "holistic", etc) are all simply marketing to make it seem something other than quackery, snake oil, etc. Evidence-based medicine is not marketing. Read the articles. As I said, expertise is needed. --Ronz (talk) 17:25, 12 March 2016 (UTC)
I've already read multiple sources, all of which have the advantage of not being skewed by the POV of Wikipedia editors who are out to right great wrongs (on both sides), and none of which claim that "stuff that works no better than placebo" is an adequate or even relevant definition of altmed. There's quite a lot of marketing behind arthroscopic knee surgery for osteoarthritis, which is (a) no better than placebo, (b) not altmed, and (c) not evidence-based medicine. There's also some marketing (far, far less than for knee surgery!) for Cansema, which is (a) better than placebo, (b) much, much worse than conventional treatment, (c) very much altmed. Evidence-based medicine is (unfortunately) heavily affected by marketing – because marketing determines what gets researched and what gets reported – although not necessarily as much as, say, direct-to-consumer advertisements of those knee surgeries.
I believe that it is important as Wikipedia editors to be very precise. When something is known to be no better than placebo, we should say exactly that. We should not say "it's altmed" to mean "no more effective than placebo", and we should certainly not delude ourselves into thinking that conventional medical treatments are better than placebo – or even that "better than placebo" means "better than the other options". WhatamIdoing (talk) 04:26, 13 March 2016 (UTC)
See Bland, J (2008). "Does complementary and alternative medicine represent only placebo therapies?" (PDF). Alternative therapies in health and medicine. 14 (2): 16–8. PMID 18383985. .BlueStove (talk) 17:10, 13 March 2016 (UTC)
WhatamIdoing, I'm afraid I don't see any relevant arguments in your comments. My concerns are on the nature of CAM, evidence-based medicine, the relationship between the two, and how our policies and guidelines are relevant to them. You appear to be arguing a false equivalence of some sort: that because evidence-based medicine includes some treatments of poor effectiveness that this somehow reflects on something relevant somehow. It's not clear what point you're trying to make in all of it.
I am trying to be precise in my wording, without going into irrelevant detail. CAM is by definition no better than placebo.
Re Bland 2008: What's the point of the in-world editorial, other than pointing out how CAM practitioners promote their viewpoint? --Ronz (talk) 17:36, 13 March 2016 (UTC)

───────────────────────── Once again, Ronz: Citation needed. Seriously. There are some excellent definitions of altmed available in reliable sources, and I've never yet seen one that says "CAM is whatever's no better than placebo". I've seen quite a few skeptics say that CAM is a socially constructed category that ought to be ignored by scientists (i.e., "There is no alternative medicine. There is only medicine that works [e.g., Cansema, labeled "alternative" but scientifically proven to permanently cure some superficial skin cancers and possessed of a very plausible scientific rationale] and medicine that doesn't work [e.g., knee arthroscopy, "mainstream" but proven to be exactly "no better than placebo]"), but I've never yet seen one that says if it's "no better than placebo" is a complete, or even accurate, definition of CAM.

So here's the challenge: Quit simply repeating your personal POV as if it were The Truth™, and start providing reliable sources. Can you produce even one proper reliable source (not an opinion piece or a website) that defines CAM as "anything that's no better than placebo", with no further qualifiers? Can you find any expert who would seriously accept black salve as "modern, evidence-based medicine", and reject knee arthroscopy as "alternative"? WhatamIdoing (talk) 03:11, 14 March 2016 (UTC)

Again, you're asserting a false balance, not making yourself any clearer, and straying from the topic. Is this intentional?
You appear to be familiar with the pov, "There is no alternative medicine. There is only medicine that works". Good enough for me. --Ronz (talk) 15:37, 14 March 2016 (UTC)
That POV means that the socially constructed distinction should be ignored. It does not mean that 100% of treatments that are usually labeled as "alternative medicine" work no better than placebo. It also doesn't mean that 100% of treatments that are labeled as "not alternative" do work better than placebo. WhatamIdoing (talk) 17:31, 14 March 2016 (UTC)
You'll note I repeatedly pointed out a false balance in my previous comments. "It also doesn't mean that 100% of treatments that are labeled as "not alternative" do work better than placebo." I'm not arguing this and it's irrelevant. --Ronz (talk) 17:27, 15 March 2016 (UTC)
It's not irrelevant if you say that "no better than placebo" is the definition of altmed. If that were actually the definition, then knee arthroscopy would be pure altmed. WhatamIdoing (talk) 15:23, 16 March 2016 (UTC)

The claim is "His treatments rely on the placebo effect.[8]" There is no reviews for treatments Deepak Chopra uses that mention him. I don't think MEDRS covers BLP issues about claims referring to people. QuackGuru (talk) 17:32, 11 March 2016 (UTC)

Huh? You appear to just be repeating the initial concerns. --Ronz (talk) 17:41, 11 March 2016 (UTC)
It appears both sides of the above discussion seem to have fallen for the idea that better-than-placebo is good enough. If that was the case, willow bark could be the gold standard analgesic. We have to instead ask what works best: to identify the most efficacious option that is safe to use, with sufficiently trivial side-effects. It doesn't help that the FDA still plays along with patent "evergreening": new variants on old drugs should have to be shown as significantly better than the old ones (at least for some indications) in order to gain a new drug approval, not just better than placebo. It's far too low a bar to set. LeadSongDog come howl! 17:00, 14 March 2016 (UTC)
^ This. "Better than placebo" is not the same thing as "best" or "conventional" or any number of other desirable things. WhatamIdoing (talk) 17:31, 14 March 2016 (UTC)
Another irrelevant comparison.
@LeadSongDog: "Better than placebo" demonstrates that it's worth scientific investigation. (Perhaps you're pointing out that CAM would simply sit with willow bark and not bother to investigate what is effective about it?) Yes, there's the whole safety issue that I'm ignoring. Probably better had I said "Better than placebo, or safe", but the focus here is on placebo effects. Meanwhile, I think editors have moved on from the relevant dispute. --Ronz (talk) 17:43, 15 March 2016 (UTC)
No, "better than placebo" does not demonstrate that it's worth scientific investigation, including for black salve and willow root, which (a) have already been investigated, (b) proven to work better than placebo, and (c) proven to be much less effective than conventional treatment.
The problem I have is that you keep saying that the "altmed == no better than placebo by definition", which is simply not true. There is no such definition. It's true that altmed treatments are frequently no better than placebo, but that category also includes a non-trivial number of treatments that are "better than placebo but worse than (excellent) conventional care" and even a few that are "better than placebo and about as good as our current (largely ineffective) conventional care". If you'd stop repeating this canard about the definition being that they're no better than placebo, then I'd be satisfied. WhatamIdoing (talk) 15:23, 16 March 2016 (UTC)

───────────────────────── @ Commenters above Ronz, WhatamIdoing, LeadSongDog, BlueStove, Littleolive oil, Jytdog, Permstrump, Alexbrn -- Late to the party but I think this is important: The simple fact is that there is no single accepted definition of alternative medicine, nor one that clearly outweighs the others. See the article's well-referenced first sentence. There are multiple definitions from excellent MEDRS -- Harrison's, IOM, NSF, Angell in NEJM, WebMD, NCCIH at NIH -- some of which overlap, and a couple of which are mutually exclusive (Harrison's rebuts NSF's & Angell's). While some weigh more than others (IOM's the biggest), choosing just one of them would violate NPOV, VER and OR all at the same time. Since there is no single accepted definition, perhaps best to wikilink to the article and where necessary quote or summarize its first sentence. --Middle 8 (tc | privacyCOI) 06:01, 25 March 2016 (UTC)

  • I am uninterested in discussing the "definition of CAM" here and find this discussion to be unproductive. This thread started with an answerable question, and I have given my thoughts on that. Jytdog (talk) 15:02, 25 March 2016 (UTC)
Agreed. We don't need more examples of why ArbCom enforcement is so important for alt med articles. --Ronz (talk) 16:32, 25 March 2016 (UTC)
Sorry if this is the wrong place, but the definition question has come up before, many times, and will again. --Middle 8 (tc | privacyCOI) 01:16, 26 March 2016 (UTC)
Attempting to nail down a complex idea, or term with one-overarching definition will never work. What does work is if and when we respect BLP as policy and guide respecting and protecting anyone we are writing about. We don't have the dubious luxury of inserting or using our opinions on anyone no matter who they are to color the articles or their content. I believe this discussion comes up because there is a tendency to get side-tracked into opinion land without realizing that opinion is driving the content selection.(Littleolive oil (talk) 12:05, 3 April 2016 (UTC))
@ Littleolive oil, Agreed. That's why we should stick close to our best sources for definitions, noting if necessary where they differ. (This is meant as a general suggestion; I have no knowledge of or interest in the Chopra debate.) --Middle 8 (tc | privacyCOI) 23:26, 4 April 2016 (UTC)

Fire needle acupuncture

There are several claims being thrown around Wikipedia:Articles for deletion/Fire needle acupuncture with regard to WP:MEDRS's application to that article. Regardless of the fate of the article, the sourcing for the article would probably benefit from some clarification from WPM folks. — Rhododendrites talk \\ 01:34, 24 March 2016 (UTC)

(The AfD has closed as a keep.) It's pretty straightforward. The 3rd para of WP:MEDRS indicates that biomedical content (in any article, medical or not) must meet MEDRS, but that non-medical content (even in medical articles) must meet only RS standards. Articles about traditional/alt-meds by definition will include much non-medical content. Some editors at the AfD mentioned above argued that all material in a traditional/alt-med article must meet MEDRS standards, and (per MEDRS's lede) they were mistaken. --Middle 8 (tc | privacyCOI) 12:49, 24 March 2016 (UTC)
And no, pace Rhododendrites's comments in that AfD, we don't need a medical textbook (MEDRS) to describe e.g. an ayurveda practice. We'd need something like a legitimate, traditional ayurvedic text, which would rock for ayurveda but suck as a MEDRS. MEDRS comes in for anything presented as biomedical info, e.g. efficacy claims. --Middle 8 (tc | privacyCOI) 13:04, 24 March 2016 (UTC)
WP:Biomedical information is quite broad, and of course for this topic WP:FRIND would also be a consideration. Alexbrn (talk) 13:16, 24 March 2016 (UTC)
WP:Biomedical information isn't PAG, but it does (properly imo) disclude beliefs. We do need to make sure (per WP:WEIGHT) that the reader understands the context: i.e. what the traditional practice is (which requires a topic-specific RS), vs. e.g. its validity (MEDRS). --Middle 8 (tc | privacyCOI) 16:56, 24 March 2016 (UTC)
So long as the "topic-specific" sources are WP:FRIND sure, but if the only sources are "in universe" ones then their content has no place on Wikipedia. Alexbrn (talk) 17:19, 24 March 2016 (UTC)
FRIND says nothing about "in-universe", nor does INDY or RS or MEDRS. What do mean by that? --Middle 8 (tc | privacyCOI) 18:15, 24 March 2016 (UTC)
WP:FRIND has: "Points that are not discussed in independent sources should not be given any space in articles". I meant that. If fringe points are not discussed in non-fringe publications Wikipedia should not be the first publication on the planet to attempt to describe them from a mainstream POV (which is our necessary POV), as that would entail significant WP:OR. Alexbrn (talk) 18:29, 24 March 2016 (UTC)
"Independent" and "holds a mainstream scientific view" are completely unrelated concepts. A local newspaper is independent of any medical or pseudomedical idea, even if it promotes the stupidest of anti-scientific beliefs. WhatamIdoing (talk) 20:29, 24 March 2016 (UTC)
WhatamIdoing Moreover, "independent" has to do with vested interest, not specialty or ideological alignment (cf. the lede of WP:INDY, to which WP:FRIND links). Even if one accepts that a Traditional Chinese Medical textbook or journal has a vested interest in promoting TCM (which I'd dispute; the target audience is primarily the already-converted), it doesn't have a vested interest with regard to describing TCM beliefs. --Middle 8 (tc | privacyCOI) 00:43, 25 March 2016 (UTC)
Alexbrn I see your point regarding mainstream coverage and OR, but we already have sources describing TCM from the mainstream POV; there is no reason to demand such sources for every notable aspect of TCM. We've followed that same principle in e.g. astrology topics. --Middle 8 (tc | privacyCOI) 00:45, 25 March 2016 (UTC)
If there are mainstream sources then there's no problem. If any aspect has never been touched by a mainstream source I don't see how you could call it a "notable aspect" - that would require an insider's perspective and WP:OR to judge how to present such information to the world at large. Alexbrn (talk) 06:43, 25 March 2016 (UTC)
Notability is not the same as mainstream acceptance, as WP:FRINGE indicates. What matters is that the topic at hand has been touched by RS for TCM theory. The RS in the article are enough for a topic-literate person to write from. Translating terms of art into good prose is not OR; it's what topic-literate editors do. --Middle 8 (tc | privacyCOI) 08:28, 25 March 2016 (UTC)
Nothing to do with "acceptance", but coverage. There is loads of fringe "topic-specific" literature going into (e.g) the typology of grey aliens, the precise purpose of the chemtrail conspiracy theory, and various rituals of woo in acupuncture, homeopathy, crystal healing and other magicks. If this stuff is just "in-universe" we don't bother with it. Otherwse the floodgates would be open to a world of UFO, altmed and conspiracy theory rubbish from the ever-active POV-pushers in these areas. Alexbrn (talk) 08:41, 25 March 2016 (UTC)
What part of "Notability is not the same as mainstream acceptance" is not clear? Specifically which PAG re "in-universe" pertain? It's WP:N that governs inclusion, not how "woo" something is. --Middle 8 (tc | privacyCOI) 09:43, 25 March 2016 (UTC)


WP:N applies to whether an article should exist or not, the issues here fall under our need for neutrality when writing the article. WP:NPOV and WP:FRINGE are the on-point PAGs. To quote from the former:

Conspiracy theories, pseudoscience, speculative history, or plausible but currently unaccepted theories should not be legitimized through comparison to accepted academic scholarship. We do not take a stand on these issues as encyclopedia writers, for or against; we merely omit this information where including it would unduly legitimize it, and otherwise include and describe these ideas in their proper context with respect to established scholarship and the beliefs of the wider world. [my bold]

If the only sources that exist are "in-universe" ones it would be impossible to present fringe ideas within "proper context with respect to established scholarship", so we omit it. We need mainstream sources for that. That is policy and not negotiable. Otherwise we'd be having to use ufologist texts for describing what might have happened at Roswell, TCM texts for altmed woo, psychic texts for outlining psychic abilities and so on. If some particular aspect of TCM is really weighty, it should be possible to find some decent text which has commented on it. That's certainly possible for homeopathy. Alexbrn (talk) 13:24, 25 March 2016 (UTC)

"Neutral" is defined as[1] fairly and proportionately representing what the published reliable sources say. If absolutely all of the published reliable sources represent the "in-universe POV", then the "neutral POV" is the "in-universe POV". From your POV, this definition works brilliantly when all the reliable sources are mainstream scientific sources, and it works abysmally when all the reliable sources are from altmed proponents – but the definition of NPOV doesn't change with the subject. The proposal to have a WP:Scientific point of view was rejected years ago.
WP:Notability is the on-point "PAG" for deciding whether there's going to be a separate article about this subject, and the ability to find sources that represent "mainstream POV" or "scientific POV" is not one of its requirements.[2] The NPOV policy does not tell editors whether or not a subject has received enough attention to qualify for a separate article. It only tells you what to write if you've decided to have one. And it's probably important to note here that, for better or worse, NPOV says to write what's actually in the sources, not what skeptical editors believe to be The Scientific Truth about the subject. WhatamIdoing (talk) 16:05, 25 March 2016 (UTC)
  1. ^ "All encyclopedic content on Wikipedia must be written from a neutral point of view (NPOV), which means representing fairly, proportionately, and, as far as possible, without editorial bias, all of the significant views that have been published by reliable sources on a topic."
  2. ^ I have tried to change this, with very little success, but we're still working on even more basic things, such as "if your neighbor writes two articles about your little gas station in his small-town newspaper, you still don't get a Wikipedia article".
If all the treatment of a topic is "in-universe" then it doesn't have "significant" coverage in my view since it's not broken out from its information ghetto. That is why NPOV requires us to contextualize fringe views within the view of the "wider world". If we don't have sources to do that, we cannot be neutral. Alexbrn (talk) 16:49, 25 March 2016 (UTC)
  • SIGCOV is all about the number of facts supported by any independent reliable source, including "in-universe" or "drank the Kool-aid" ones. If you've got multiple independent sources that list enough facts to write ten or more decent sentences, then you've got "significant coverage".
  • NPOV problems aren't a reason for deletion; that's a reason for editing.
  • Your best bet is a straight-up WP:Notability argument based on the nutshell's wording of "attention from the world at large". It's (unfortunately) not a very popular hook to hang deletion on, but it's an accurate description of what your complaint is. WhatamIdoing (talk) 23:07, 25 March 2016 (UTC)
There seems to be some idea that I've been arguing for deletion (I didn't vote to delete). What I am addressing is the application of NPOV policy to sourcing when writing the article. What we've had going on is editors removing definitions from Cochrane sources and using TCM sources instead. Alexbrn (talk) 04:27, 26 March 2016 (UTC)

@Alexbrn Per Whatamidoing, there's no reason to delete an article just because it might be controversial. There's been plenty of sci commentary on acupuncture and no good reason to think scientists would think any differently about fire needling. Any attempt to argue otherwise, and slant the article, would be cut off pretty quickly. --Middle 8 (tc | privacyCOI) 04:06, 26 March 2016 (UTC)
"Whatamidoing" is not a policy, you may be surprised to learn. I wasn't talking about "deleting the article". In the past however I have seen AfD's pass because the nature of the existing sourcing meant it would be impossible to construct a neutral article. Alexbrn (talk) 04:23, 26 March 2016 (UTC)
Don't be disingenuous about my reference to Whatamidoing's arguments from PAG. My point is that existing sci commentary of acu allows us to address its child topics neutrally. If an editor made a "pro-woo" argument that, based on NOR, we can't generalize scientific skepticism about acupuncture to fire needle acupuncture, I would reply that such a narrow reading of OR is fatuous, and I suspect you'd agree with me.
Additionally, it's mistaken to base coverage on degree of "woo-ness". Some "woo's" have been around a very long time and are widely known. If we have adequate mainstream perspective on the mother topic, then we should usually be able to cover child topics neutrally. --Middle 8 (tc | privacyCOI) 06:20, 26 March 2016 (UTC)
Yes, so long as we have mainstream sources for the fringe topic, whether it's a "child topic" of another fringe topic, or not. If your favoured woo is really "widely known" then it should be easy to find a source from the "wider world" discussing it. But we no more rely on manuals of fringe medical practices for descriptions of those practices, than we do on UFO books for accounts of aliens abuductions, or on esoteric texts for an account of what is located on the astral plane. Basically, Wikipedia is not a venue for the exposition of bollocks. Alexbrn (talk) 06:38, 26 March 2016 (UTC)
No, you're wrong. The threshold for WP:N is not a "mainstream" source. And we don't need sci commentary on every aspect of (e.g.) acupuncture to portray its child topics in a balanced way. --Middle 8 (tc | privacyCOI) 07:18, 26 March 2016 (UTC)
I don't disagree, but I was never talking about WP:N so how is that relevant? I am talking about what it is the article (per WP:NPOV) once it exists. "Child topics" is your novel concept. Alexbrn (talk) 07:37, 26 March 2016 (UTC)
Re NPOV, if you agree that "we don't need sci commentary on every aspect of (e.g.) acupuncture to portray its child topics in a balanced way" then aren't we done? See perpetual motion machine example at WP:FRINGE/PS -- that's I mean re parent/child topics. Maybe time to fork to Talk:Fire_needle_acupuncture#Sourcing since discussion is getting duplicative --Middle 8 (tc | privacyCOI) 08:26, 26 March 2016 (UTC)
I have never used the words "sci commentary". I am just pointing out that NPOV requires us to use non-fringe sources to give a mainstream context, and that if that can't be done for any particular idea, then it is so fringe it needs to be omitted. Alexbrn (talk) 08:59, 26 March 2016 (UTC)
Several points
  • We have scientific commentary and other mainstream context coming out of our ears for acupuncture and TCM, as evidenced in those articles. We don't need to recap that in every child article. Sci skepticism on fringe X extrapolates to variations on X (WP:FRINGE/PS).
  • There is no basis in PAG for the assertion that we need "mainstream commentary" on each and every such topic, as opposed to on a mother topic. You've hung your argument on WP:GEVAL, from NPOV, but you're taking it out of context. (Referring to your post at 13:24, 25 March 2016.) GEVAL says not to present fringe ideas as if on par with mainstream scholarship. It's silent on what you are arguing re articles specifically about fringe topics.
  • You also misread WP:FRIND above (18:29, 24 March 2016), as WhatamIdoing pointed out. TCM textbooks are INDY sources, and while fringe and non-RS for biomedicine they are fine RS for TCM principles & practices.
Your argument seems, in effect, like an attempted end run around WP:N to omit topics you dislike. All based on your misreading of FRIND and GEVAL. I'm feeling more like Gevalt. --Middle 8 (tc | privacyCOI) 14:35, 26 March 2016 (UTC) add clarification 20:46, 26 March 2016 (UTC)
the article Fire_needle_acupuncture should be expanded[1]...IMO--Ozzie10aaaa (talk) 09:20, 5 April 2016 (UTC)

Hospital computer security

Is hospital computer security an important topic for Wikipedia?

My Web search for "hospital computer security" reported thousands of search results.
Wavelength (talk) 23:37, 2 April 2016 (UTC)

interesting article, perhaps place new section at Electronic health record or Health information management...IMO--Ozzie10aaaa (talk) 10:07, 3 April 2016 (UTC)
I believe this is definitely an important-enough topic, I find it very interesting and would like to help you if you want to start drafting and article. CFCF 💌 📧 14:15, 3 April 2016 (UTC)
CFCF, your indentation indicates that you are replying to Ozzie10aaaa when you say "would like to help you", but I have seen so many discussions where editors have not followed WP:INDENT and WP:THREAD that I am not sure whether you are actually replying to me.
Wavelength (talk) 17:53, 3 April 2016 (UTC)
CFCF,in regards to Wavelenght's question?--Ozzie10aaaa (talk) 20:16, 3 April 2016 (UTC)
I don't think hospital systems are unique when you compare it with other sensitive databases held by financial institutions, government agencies etc. Rather than starting a new article I think this is better covered in the articles that Ozzie10aaa mentions.
In the UK (and probably elsewhere) this is referred to as information governance, yet another related subject. JFW | T@lk 16:19, 3 April 2016 (UTC)
Agreed. Another related page is Protected health information (PHI, particularly focused on US policy stemming from HIPAA). Hospitals and other large healthcare organizations are the de facto hubs of information governance that manage all sorts of health data, much of it coming from primary care sites. This is a very big topic dominated by policy and law, so it may be best to generate and then organize coverage that is somewhat location/law-specific. — soupvector (talk) 18:30, 3 April 2016 (UTC)
The subject area is rather more worrisome than just information privacy or even integrity. It includes attacks on such things as dispensing systems, robotic pharmacies, pain pumps, programmable implants, and in the near-future, deep brain stimulators.LeadSongDog come howl! 23:04, 3 April 2016 (UTC)
Yes, implanted and other medical device security is another big topic. While it's addressed a bit here, our related articles (Implant_(medicine), category Category:Implants_(medicine)) need expansion and updating to reflect current knowledge and consensus about risks. — soupvector (talk) 12:12, 4 April 2016 (UTC)


This is ostensibly a fashion article, but it has medical implications (or does it?). Indeed the long history of the article appears to include a small number of pro- and anit- editors, which means we cannot really judge from the article.

I would appreciate medical, or just common-sense, revision of this article, which seems to me just a little too enthusiastic about the practice.

All the best: Rich Farmbrough, 22:43, 5 April 2016 (UTC).

it may be best to shorten the Effects section as it has a link to Effects of tightlacing on the body(though this article needs work as well)...IMO--Ozzie10aaaa (talk) 12:41, 6 April 2016 (UTC)

Mucoid cap

More eyes here would be helpful. This is a new article that appears to be a neologism; the sources appear to be basically copied from a google book search for the phrase "mucoid cap" strung together, from old sources or from sources that don't even use the phrase. None of the individual sources appear to suggest this is a distinct structure that would deserve its own article. Is AFD the right place for this? The editor seems to have moved mucoid plaque to mucoid plaque (alternative medicine) to make room for a disambig page for this. Yobol (talk) 23:03, 25 March 2016 (UTC)

i just speedied it for being a POV fork. Jytdog (talk) 23:09, 25 March 2016 (UTC)
Redirected back to the main topic. Doc James (talk · contribs · email) 01:38, 26 March 2016 (UTC)

We now have a disambiguation page with two items, both of which direct to the same alt med article. JFW | T@lk 08:41, 31 March 2016 (UTC)

  • This looks OK now. Jfdwolff, Jytdog, Yobol is this clean up now or is there still an unresolved problem? Zad68 13:55, 6 April 2016 (UTC)
Zad68, I think the original (and more appropriate) title is "Mucoid plaque"; the "cap" article was the POV fork. The article probably needs to be moved to "mucoid plaque". Thanks for the assistance/attention. Yobol (talk) 14:43, 6 April 2016 (UTC)
  • Looks like Guy got it... Zad68 11:58, 7 April 2016 (UTC)

Free access to 940 SAGE journals and 1.5 million articles throughout April!

I received this through the European Association of Science Editors. Might be useful. juanTamad (talk) 08:48, 8 April 2016 (UTC)

it does, thank you--Ozzie10aaaa (talk) 10:16, 8 April 2016 (UTC)

Book excerpt request

It's for this book:

I'm looking for the Nelson, Sass, and Parnas article on page 158 so I can update the self-disorder article.--Beneficii (talk) 00:25, 8 April 2016 (UTC)

MEDRS for "controversy" articles?

I found myself reading ADHD controversies earlier today. It's a mess and I've been trying to clean it up, but I'm getting a little stuck on what statements require MEDRS since it's a "controversy" article, for example, this statement: "Some believe that many of the traits of those diagnosed with ADHD are personality traits and are not indicative of a disorder. These traits may be undesirable in modern society, leading to difficulty functioning in society, and thus have been labeled as a disorder."[2] Is this a medical claim? The author is disagreeing the medical establishment's view of ADHD. Almost the whole article would be deleted if I removed every instance of non-MEDRS sources disagreeing with the medical establishment and that doesn't feel quite "right." There probably is notable controversy that exists, but I don't know that it's supported by MEDRS. According to this source, the debate is mainly coming from parents and educators. So how should I address non-medical professionals notably shooting from the hip and criticizing medical recommendations? It doesn't seem right to only include times doctors disagree with other doctors. PermStrump(talk) 04:21, 8 April 2016 (UTC)

Your instincts are exactly right. Perhaps the most pointful reply is this: That is not a biomedical claim. Therefore, it is not subject to WP:MEDRS.
It should be relatively easy to find a much better source for this view than one doctor's self-published website. A book from a generally reputable (including non-medical/non-scientific) publishing house should do nicely. (Also, we probably shouldn't assume that these opinions are either hastily formed or actually criticizing medical recommendations [as opposed to attitudes held by typical practitioners].) WhatamIdoing (talk) 05:50, 8 April 2016 (UTC)
Good point. I actually stumbled on some better sources by accident. Which is a little disappointing because now it's more work. :-P PermStrump(talk) 13:18, 8 April 2016 (UTC)
If care and good maintenance are absent, "controversy" articles can become dumping grounds for stuff not fit for the main article. "Controversy" articles are really about social phenomena, and less so the best-quality accepted evidence. However it takes work to avoid having them degrade into a collection of "Some say..." statements, which fail WP:WEASEL and often WP:GEVAL. Individual self-published websites may be perfectly valid sources for the opinions cited but often yield WP:UNDUE content. Independent high-quality secondary sourcing is needed to identify the highest-impact outside opinions and voices. Zad68 13:24, 8 April 2016 (UTC)

Please comment on my Individual Engagement Grant talk page about my proposal for Guided Checklist for Health Topic Experts

Hello everyone,

I created a new Individual Engagement grant to try and fix a problem. m:Grants:IdeaLab/Effective Engagement with Health Topic Experts using Guided Checklists

From my work with Cochrane as a Wikipedian in Residence and my observations of other attempts to engage health topic experts in editing, I've come to the conclusion that the quality of the contributions of new health topic expert recruits does not match their level of expertise and effort the we as Wikipedians put into training new medical editors. So, I decided to create a new project to develop a Guided Checklist that would assist a health topic expert in assessing the quality of a health articles on Wikipedia, and then guide their contributions toward making edits to correct the lack of quality.

My individual engagement grant would involve interviewing health topic experts and active medical editors, as well as a community consultation on Wikipedia English WikiProject Med. Please add yourself as a volunteer if you would like to participate. Or leave suggestions on the talk page. Or endorse if you support the idea. Sydney Poore/FloNight♥♥♥♥ 00:06, 9 April 2016 (UTC)

To new title:Peripheral nervous system

A new article has shown up, with a move request to overwrite Peripheral nervous system, for the discussion see talk:To new title:Peripheral nervous system -- (talk) 03:54, 10 April 2016 (UTC)

thanks, that is a student over-reaching. i moved it back into their userspace: User:Jungi0714/Peripheral nervous system Jytdog (talk) 04:01, 10 April 2016 (UTC)
Needs inline references.
Lots of caps need fixing.
Why did the student not work to fix the main PNS article? Doc James (talk · contribs · email) 08:51, 10 April 2016 (UTC)
Indeed. SandyGeorgia is missing silly season. :) Jytdog (talk) 08:55, 10 April 2016 (UTC)
Students do definitely love capital letters. Hopefully we will see her back. Doc James (talk · contribs · email) 09:08, 10 April 2016 (UTC)

Blog post on translation efforts

Here Doc James (talk · contribs · email) 13:46, 1 April 2016 (UTC)

That is such great and important work. Thank you, and all the folks working on that. Jytdog (talk) 20:54, 1 April 2016 (UTC)
agree--Ozzie10aaaa (talk) 11:12, 10 April 2016 (UTC)

User:Suhasini66/Parkinson's Disease Biomarkers

hat tip to User:Bradv who pointed out a new article Parkinson's Disease Biomarkers at the Talk page of the PD article. I userified it to the subject location. Is by a student. Maybe should exist; not clear. Jytdog (talk) 23:29, 11 April 2016 (UTC)

seems important per[3]--Ozzie10aaaa (talk) 23:43, 11 April 2016 (UTC)

Topiramate could use some eyes

I came across the topiramate article while going through the cluster fuck that is Addiction#Medication (still working on it - haven't committed my edits) and noticed the article claimed it was an effective treatment for methamphetamine addiction. For context, as of right now, there is no effective treatment for a psychostimulant addiction - the relapse rate following conventional behavioral therapy is around 90% for an addiction to methamphetamine. So when I saw this and looked at the ref - - I was a bit disturbed to find that not only is topiramate NOT effective, it EXACERBATES methamphetamine addiction by enhancing the drug's rewarding effects. The same is true with nicotine per the same review, but the article still said it was used as an "effective treatment" for smoking cessation, citing a clinical trial.

The entire Topiramate#Medical uses section needs to be combed through to remove the primary studies and ensure the cited reviews actually support the claim being made. Seppi333 (Insert ) 19:02, 11 April 2016 (UTC)

adverse effects has some citation issues as well--Ozzie10aaaa (talk) 23:58, 11 April 2016 (UTC)

Found an orphan article


I found Fungal sinusitis, a brief article that looks like it could do with some help from a topic specialist. I cleaned up the referencing but the subject is way outside my comfort zone. Roger (Dodger67) (talk) 07:25, 23 March 2016 (UTC)

Great find. Important topic with plenty of MEDRS. If no one points to an overlapping article that would obviate the effort, I'll give it some attention this weekend. — soupvector (talk) 09:58, 23 March 2016 (UTC)
organized it further per MEDMOS--Ozzie10aaaa (talk) 10:23, 2 April 2016 (UTC)


"it is most classically associated with aerospace manufacturing, microwave semiconductor electronics, beryllium mining or manufacturing of fluorescent light bulbs (which once contained beryllium compounds in their internal phosphor coating).[4][5][6][7][unreliable medical source?]" See Berylliosis#Classification. There appears to be MEDRS violations. QuackGuru (talk) 23:07, 31 March 2016 (UTC)

Can you please clarify what the problem is? Andy Dingley (talk) 23:25, 31 March 2016 (UTC)
QuackGuru hasn't commented there. Andy Dingley (talk) 00:20, 1 April 2016 (UTC)
I've reverted the MEDRS tag - the content there isn't health related and what Andy is upset has nothing to do with the medical condition nor any health-related content, but rather my conduct over sourcing for content that needs only RS. Jytdog (talk) 01:08, 1 April 2016 (UTC)

We need to use high quality secondary sources. For example, sources that are over 50 years old are too old. QuackGuru (talk) 01:18, 1 April 2016 (UTC)

Why? It's describing a contemporary event. Where is the policy in WP:RS that states sources "wear out"? Andy Dingley (talk) 01:37, 1 April 2016 (UTC)
Well, sources can "wear out"; the essay at WP:HISTRS might give you some ideas about when and how that happens.
This may be a good time as any other to remember that WP:BURDEN requires the original editor to provide one (1) source that the original editor (=not everyone else) believes is (at least barely) adequate. If you want a {{better source}}, then it's your job to replace it. There are no "I get to twiddle my thumbs while demanding that someone else improve the sourcing" policies. WhatamIdoing (talk) 01:14, 2 April 2016 (UTC)
See WP:OVERCITE. Three sources are plenty. QuackGuru (talk) 01:16, 2 April 2016 (UTC)
agree (3 sources are enough)--Ozzie10aaaa (talk) 10:03, 12 April 2016 (UTC)

Need some review at Flail chest

Pulmonary contusion (Flail chest)

This article needs help with repetitive text anyway, but there is a significant discrepancy between the mortality figure reported in the lead and that reported later on. Mangoe (talk) 15:48, 8 April 2016 (UTC)

believe it needs a diagnosis section[4]--Ozzie10aaaa (talk) 17:46, 8 April 2016 (UTC)

First sentence of MDMA

Being discussed here in a RfC Doc James (talk · contribs · email) 13:34, 2 April 2016 (UTC)

give opinion(gave mine)--Ozzie10aaaa (talk) 18:44, 2 April 2016 (UTC)

Move MDMA to Methylenedioxymethamphetamine?

Discuss/!vote here, at talk. --Middle 8 (tc | privacyCOI) 23:56, 11 April 2016 (UTC) sp., wl 12:11, 12 April 2016 (UTC)

Proposed move of Anterior cochlear nucleusVentral cochlear nucleus

Hi all

There is a currently a proposal to make the move above, which has not had a large number of responses so far. Please go to Talk:Anterior cochlear nucleus if you have any opinion on this matter. Thanks  — Amakuru (talk) 14:30, 12 April 2016 (UTC)

need opinions(gave mine)--Ozzie10aaaa (talk) 16:59, 12 April 2016 (UTC)

Stamina therapy

Article about the italian stem cell scam from a couple years ago. Which seems mostly over. Not sure this article should exist but it appears to have been written by a native Italian speaker and could use copyeding and some more English sources. such a story. Jytdog (talk) 12:58, 12 April 2016 (UTC)

best to merge to stem cells or Stem-cell_therapy (a small section)...IMO--Ozzie10aaaa (talk) 17:23, 12 April 2016 (UTC)

BallenaBlanca‎ and some gluten POV-pushing, in my view

Gluten Sources

In my view User:BallenaBlanca‎ is steadily pushing content about gluten into articles across the medical space. There is a lot of faddishness around gluten these days, and I am concerned that BallenaBlanca's gluten-related editing is skewing our articles.

Here are the top articles from BallenaBlanca's edit count:

There are also gluten-related edits to the following that would appear to be reasonably possibly related..

That is what it is and I am not going to wade into those for fear of what I will find. What is bringing me here is BallenaBlanca's editing in other articles, where this editor is consistently making claims that gluten sensitivity may be co-occurring or "may be" causative and so a gluten-elimination diet may be helpful in all kinds of other conditions.

Some of it is kind of digestive/metabolic which one can kind of see how a digestive disorder like celiac could be related maybe... like :

or clear immmune reaction like

but a whole bunch of tooth stuff (?)

But there is a whole slew of stuff that is really pushing it, in my view, like

fertility stuff:

These are the ones that are really bothering me, however:

To me this last set is really reaching into advocacy and POV pushing.

There is other stuff BallenaBlanca does like all these on Varicocele which are great and fighting off crazy people like this reversion of content that claimed that circumcision causes autism (lord knows those people never stop pushing).

But the whole "may or may not be co-morbid and a gluten-free diet may treat it" stuff should stop already, in my view. Maybe folks here find the above to be just fine. If so I will back off. Jytdog (talk) 00:16, 7 April 2016 (UTC)

First, I want to say that almost all information included in the articles mentioned by Jytdog have prepared by me and reviewed by Doc James. Most of the texts are the results of his corrections. I have worked with him in several pages, as for example on coeliac disease page see all this sections and I let myself always guided by his experience in Wikipedia. I am very happy to work with him and grateful for his help and kindness.
As I explained to Jytdog, I'm trying to improve and update Medicine articles. I edit on issues in which I can be useful and in which I have knowledge. Regarding gluten intolerance, they were very outdated. The information I include is supported by current scientific evidence, is not a gluten hypotheses nor "my point of view". I am not trying to give it prominence far beyond its place in the literature, I'm adjusting to the current knowledge. But it's not all I do. Currently I have 175 pages on my watchlist and I patrol them undoing vandalism, etc. Nevertheless, language limits me to do more work. Each of us contribute within our means. It is not incorrect.
I do not know how to say this without sounding bad. I apologize if it does not fit, I do not have enough level of English to express correctly that I want to say. People are surprised and shocked when we talk about the multiple affectations of CD, but it is only a problem of lack of information.
Some of these ones that are "really bothering" Jytdog (epilepsy, schizophrenia, anorexia nervosa, ADHD...) have been under discussion on the talk pages and reviewed by Doc James and other users. For example, schizophrenia: The gut–brain axis
Jytdog is insistently saying to me things as "imposing your view", "promoting a minority view in the field", "enthusiasm for the gluten hypotheses", "advocacy", " pet theories" etc. [5] [6] and when I tried to be nice to him thanking one edition, this was his reaction: I stopped watching the ADHD article because I find your POV-pushing to be reprehensible and I do not want to edit anywhere near you in Wikipedia. In my view you are harming Wikipedia with your advocacy but I am not going to waste my time arguing with you. Your "thanks" was very unwelcome. Jytdog (talk) 22:37, 27 March 2016 (UTC), and after, he removed this message [7]
But this is not a "minority view", nor a "gluten hypothesis" nor "my view", nor a "pet theory"... Is the current knwoledge about gluten-related disorders:
ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (Jan 2012). "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease" (PDF). J Pediatr Gastroenterol Nutr (Practice Guideline) 54 (1): 136–60. doi:10.1097/MPG.0b013e31821a23d0. PMID 22197856

ESPGHAN guidelines for the diagnosis of CD were last published in 1990 (1) and at that time represented a significant improvement in both the diagnosis and management of CD. Since 1990, the understanding of the pathological processes of CD has increased enormously, leading to a change in the clinical paradigm of CD from a chronic, gluten-dependent enteropathy of childhood to a systemic disease with chronic immune features affecting different organ systems.

Surprised by relation with dental enamel defects, arthritis, impairment of fertility...??? I am surprised of your surprise. For example, in undiagnosed children and adolescents (adults develop more and more complications):
ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (Jan 2012). "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease" (PDF). J Pediatr Gastroenterol Nutr (Practice Guideline) 54 (1): 136–60. doi:10.1097/MPG.0b013e31821a23d0. PMID 22197856

Extraintestinal: Failure-to-thrive, stunted growth, delayed puberty, chronic anaemia, decreased bone mineralisation (osteopenia/osteoporosis), dental enamel defects, irritability, chronic fatigue, neuropathy, arthritis/arthralgia,amenorrhea, increased levels of liver enzymes

Gastroenterol Hepatol Bed Bench. 2011 Summer;4(3):102-8. Subclinical celiac disease and gluten sensitivity. Rostami Nejad M, Hogg-Kollars S, Ishaq S, Rostami K (Review) PMID: 24834166 PMC: 4017418

Atypical presentation is the most common form of celiac disease (CD). (atypical --> non-classical symptoms)

CD is a common disorder in children as well as in adults. The spectrum of clinical presentations is wide, and currently extraintestinal manifestations (eg, anemia or short stature) are more common than the classic malabsorption symptoms. A high degree of awareness among health care professionals and a liberal use of serologic CD tests can help to identify many of the nonclassic cases. (..) Associated Conditions. An increasing number of studies have shown that many CD-associated problems, which originally were described mostly in adults, can indeed be observed in children or adolescents.[1]

Nat Rev Gastroenterol Hepatol. 2015 Sep;12(9):507-15. doi: 10.1038/nrgastro.2015.136. Epub 2015 Aug 25. Coeliac disease and autoimmune disease-genetic overlap and screening. Lundin KE, Wijmenga C2. PMID 26303674

Associated autoimmune diseases. The abnormal immunological response elicited by gluten-derived proteins can lead to the production of several different autoantibodies, which affect different systems. The most prominent autoantibodies target members of the TG family, notably IgA-class antibodies against TG2 in coeliac disease,29 TG2 and TG3 in dermatitis herpetiformis and TG6 in gluten ataxia.29–31 The levels of these antibodies are influenced by the gluten intake of patients with coeliac disease.32,33 Antibodies against coagulation factor XIII, another member of the TG family, have also been described.34 Whether this finding implicates an underlying autoimmune aspect of bleeding disorders is unclear. Antibodies to a range of other autoantigens have been reported, particularly actin, calreticulin, gangliosides, collagens, synapsin, zonulin, cardiolipin, ATP synthase subunit β and enolase.35 Interestingly, autoantibodies typically seen in general autoimmune diseases such as rheumatoid arthritis or systemic lupus erythematous are rarely seen in coeliac disease.35 A number of organ-specific autoimmune disorders and conditions are influenced by and associated with coeliac disease (Figure 1), but only a selection is discussed in this Review.3,36,37 Moreover, accurate, unbiased population-based data on disease prevalence are generally lacking and the published results are mainly derived from studies performed on patients who have been referred to secondary or tertiary care.

The list of possible extra-intestinal manifestations of untreated CD is immense. For example National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. Celiac Disease:
What are the signs and symptoms of celiac disease?
A person may experience digestive signs and symptoms, or symptoms in other parts of the body. Digestive signs and symptoms are more common in children and can include
• abdominal bloating
• chronic diarrhea
• constipation
• gas
• pale, foul-smelling, or fatty stool
• stomach pain
• nausea
• vomiting
Being unable to absorb nutrients during the years when nutrition is critical to a child's normal growth and development can lead to other health problems, such as
• failure to thrive in infants
• slowed growth and short stature
• weight loss
• irritability or change in mood
• delayed puberty
• dental enamel defects of permanent teeth
Adults are less likely to have digestive signs and symptoms and may instead have one or more of the following:
• anemia
• bone or joint pain
• canker sores inside the mouth
• depression or anxiety
• dermatitis herpetiformis, an itchy, blistering skin rash
• fatigue, or feeling tired
• infertility or recurrent miscarriage
• missed menstrual periods
• seizures
• tingling numbness in the hands and feet
• weak and brittle bones, or osteoporosis
• headaches
Intestinal inflammation can cause other symptoms, such as
• feeling tired for long periods of time
• abdominal pain and bloating
• ulcers
• blockages in the intestine
Celiac disease can produce an autoimmune reaction, or a self-directed immune reaction, in which a person's immune system attacks healthy cells in the body. This reaction can spread outside of the gastrointestinal tract to affect other areas of the body, including the
• spleen
• skin
• nervous system
• bones
• joints
Recognizing celiac disease can be difficult because some of its symptoms are similar to those of other diseases and conditions. :Celiac disease can be confused with
• irritable bowel syndrome (IBS)
• iron-deficiency anemia caused by menstrual blood loss
• lactose intolerance
• inflammatory bowel disease
• diverticulitis
• intestinal infections
• chronic fatigue syndrome
As a result, celiac disease has long been underdiagnosed or misdiagnosed. As health care providers become more aware of the many varied symptoms of the disease and reliable blood tests become more available, diagnosis rates are increasing, particularly for adults.

  • Relatives of first and second degree.
  • Down's Syndrome.
  • Williams syndrome.
  • Turner syndrome.
  • Autoimmune diseases and other immunopathies, sucha as selective IgA Deficiency, inflammatory bowel disease, systemic lupus erythematosus, IgA nephropathy.
  • Endocrine diseases, such as diabetes mellitus type I, hypothyroidism, hyperthyroidism, autoimmune thyroiditis, Addison's disease. :*Neurological and psychiatric disorders, such as cerebellar ataxia, epilepsy with or without cerebral calcifications, polyneuropathy, multiple sclerosis, progressive encephalopathy, cerebellar syndromes, dementia with brain atrophy, leukoencephalopathy, schizophrenia, depression, anxiety.
  • Liver diseases, such as primary biliary cirrhosis, autoimmune hepatitis, autoimmune cholangitis, idiopathic chronic hypertransaminasemia.
  • Rheumatic diseases, such as Sjögren's syndrome, ankylosing spondylitis, rheumatoid arthritis, other arthritis.
  • Heart diseases, such as dilated cardiomyopathy, recurring myocarditis, autoimmune pericarditis.
  • Skin diseases, such as dermatitis herpetiformis, psoriasis, vitiligo, alopecia areata.
  • Other associations: iron deficiency anemia, osteoporosis/osteopenia, Hartnup's disease, cystinuria, microscopic colitis, cardiomyopathy, fibromyalgia, chronic fatigue syndrome, scleroderma.
  • Certain cancers, such as non-Hodgkin’s lymphoma, small intestinal adenocarcinoma, squamous cell carcinoma of the pharynx and mouth .
  • etc...
Gastroenterol Hepatol Bed Bench. 2011 Summer;4(3):102-8. Subclinical celiac disease and gluten sensitivity. Rostami Nejad M, Hogg-Kollars S, Ishaq S, Rostami K (Review) PMID: 24834166 PMC: 4017418

More and more diseases are proven to be associated with CD. In these conditions, screening is strongly recommended.

In fact, celiac disease is known as the "great imitator":
Duggan JM (May 17, 2004). "Coeliac disease: the great imitator" (PDF). Med J Aust (Review) 180 (10): 524–6. PMID 15139831
Eur Ann Allergy Clin Immunol. 2004 Mar;36(3):96-100. A great imitator for the allergologist: intolerance to gluten. Article in French. Rousset H. PMID 15137480
And since 2010, non-celiac gluten sensitivity has been included in the spectrum of gluten-related disorders. The definition and diagnostic criteria of non-celiac gluten sensitivity was debated and established by three consensus conferences.
The Oslo definitions for coeliac disease and related terms Gut (Impact factor: 14.66) 2013 Jan;62(1):43-52. doi: 10.1136/gutjnl-2011-301346. Epub 2012 Feb 16. PMID 22345659

As understanding of CD has advanced, new disease associations have been regularly found and populations tested for CD have changed in response.(...) This review was based on PubMed literature searches and expert meetings. We aimed to define key concepts relevant to CD and related disorders. The character of the current paper implies that we did not pool any data or use any statistical tools. Instead, we assembled an international team of recognised experts in CD research, discussed definitions and tried to reach a consensus. This approach is similar to that of previous papers on definitions of CD.2e4 As opposed to previous studies,2e4 however, we did not limit ourselves to ‘CD only’ but defined a large number of concepts. In addition, we provide guidance to the scientific and clinical community as to which terms should be used and which should be abandoned. Overall, we evaluated more than 300 papers in detail and all authors participated in the discussion leading to consensus definitions. (...) Our research team was multidisciplinary and was composed of specialists from gastroenterology, pathology, paediatrics, neurology and dermatology. (...) Gluten-related disorders. Gluten-related disorders is a term used to describe all conditions related to gluten. We recommend that this term is used to describe all conditions related to gluten. This may include disorders such as gluten ataxia, DH, non-coeliac gluten sensitivity (NCGS) and CD (...) Non-coeliac gluten sensitivity. The term NCGS relates to one or more of a variety of immunological, morphological or symptomatic manifestations that are precipitated by the ingestion of gluten in people in whom CD has been excluded. NCGS is a condition in which gluten ingestion leads to morphological or symptomatic manifestations despite the absence of CD.172e176 As opposed to CD, NCGS may show signs of an activated innate immune response but without the enteropathy, elevations in tTG, EMA or DGP antibodies, and increased mucosal permeability characteristic of CD.173 Recently, in a double-blind randomised trial, Biesiekierski et al showed that patients with NCGS truly develop symptoms when eating gluten.156 It is unclear at this time what components of grains trigger symptoms in people with NCGS and whether some populations of patients with NCGS have subtle small intestinal morphological changes. While there is currently no standard diagnostic approach to NCGS, systematic evaluation should be conducted, including exclusion of CD and other inflammatory disorders.

There are hundreds and hundreds of articles...


  1. ^ Fasano A (Apr 2005). "Clinical presentation of celiac disease in the pediatric population". Gastroenterology (Review). 128 (4 Suppl 1): S68–73. doi:10.1053/j.gastro.2005.02.015. PMID 15825129.
Best regards. --BallenaBlanca (talk) 01:42, 7 April 2016 (UTC)
yep, another impenetrable wall of text complete with colors and bolding and underlining. Unreadable. And these will come over and over. Paradigmatic WP:Civil POV pushing. -- Jytdog (talk) 01:54, 7 April 2016 (UTC)
It is impossible simplifying celiac disease. >20 years ago it was believed that was simple... but the reality is just the opposite. There is no comparable disease. How can someone learn if does not read? It is good to read, there is much to read about celiac to understand the disease and update knowledge.
Best regards. --BallenaBlanca (talk) 02:06, 7 April 2016 (UTC)
This came up before here and as I wrote then: "By my understanding NGCS is something of a controversial condition the classification, diagnosis and treatment of which is rather up in the air. By contrast it seems to me Wikipedia is now rather certain on the topic". This is a concern. Alexbrn (talk) 05:45, 7 April 2016 (UTC)
Actually, from the lists above, it looks like celiac disease can be simplified quite dramatically. The lists of "signs and symptoms" appears to be nothing more than a typical list of the manifestations of malnutrition.
My concern isn't whether this is The Truth™. My concern with this is that it's not WP:DUE. For example, I've finally remembered to go back to inflammatory bowel disease and remove the instructions on how to diagnose irritable bowel syndrome as well as celiac disease. It might be true, but the fact is that it's irrelevant to that page. If you want to know about how to diagnose IBS or CD, then you should not be reading the page about IBD. WhatamIdoing (talk) 06:16, 7 April 2016 (UTC)
I suppose my worry is that while, say, the NHS says (this year) that apart from for people with coeliac disease, there is no evidence a gluten-free diet has any benefit and that it may cause harm,[8] Wikipiedia is, in contrast, and for a range of medical conditions, now saying that gluten might be a root cause. Alexbrn (talk) 06:44, 7 April 2016 (UTC)
WAID yes I am saying that BB is consistently giving UNDUE weight to this stuff. Let's see what happens as others weigh in (heh). My hope in posting this is that a clear enough consensus will emerge one way or the other and I will shut up and apologize (I owe BB an apology anyway for being too harsh) or BB will reel back what she has been doing. Jytdog (talk) 06:50, 7 April 2016 (UTC)

───────────────────────── I have helped edit details on coeliac disease and some of the other gluten-related issues. I may be considered an expert on this in real life so I am careful not to push my POV. Coeliac disease is still 70-80% unrecognised (the "iceberg") because symptoms often are mild. BallenaBlanca has brought a new enthusiasm to update these pages and should be congratulated for her efforts. NCGS (and other related problems) is clearly recognised condition by experts as BB in her characteristic style points out yet again above. However, like IBS or fibromyalgia, there are many other factors contributing to this picture and it is crucial to have WP:balance and to adhere to WP:MEDRS and not have WP:UNDUE weight. BB needs to be more careful how she expresses this balance (I guess English may not be her first language). I think only excellent sources such as Systematic review and Guidelines in high impact journals should be cited and that we need to be careful not to pull out isolated quotations from parts of the text that have some balance elsewhere and to overload the article with multiple citations. This is particularly important in the articles that are more remote from the core issues of gluten-sensitivity and a gluten-free diet such as epilepsy, schizophrenia, anorexia nervosa, ADHD etc which UK NICE did not include (mostly) in their recent 2015 review [9]. This should be the standard of "accepted knowledge" at present. Some sharp and incisive editing, as jytdog is so expert at, will help! Jrfw51 (talk)

Thank you very much, Jrfw51, you are very kind and balanced. Yes, I have started editing to update Wikipedia articles, because there was information as "wonderful" as this: In modern times to meet the demands of coeliac sufferers and similar diets, the use of rice, maize and whole durum wheat has become commercially significant. It was present without anyone touching it from 24 March 2012 until may revision on 14 December 2015. This is only a little example of harmful and/or outdated information on Wikipedia.
WhatamIdoing, you said: The lists of "signs and symptoms" appears to be nothing more than a typical list of the manifestations of malnutrition. mmmm... I think clearer I can not write. Possibly you have not read this written above:
Nat Rev Gastroenterol Hepatol. 2015 Sep;12(9):507-15. doi: 10.1038/nrgastro.2015.136. Epub 2015 Aug 25. Coeliac disease and autoimmune disease-genetic overlap and screening. Lundin KE, Wijmenga C2. PMID 26303674 "The abnormal immunological response elicited by gluten-derived proteins can lead to the production of several different autoantibodies, which affect different systems..... A number of organ-specific autoimmune disorders and conditions are influenced by and associated with coeliac disease"
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. Celiac Disease: "Celiac disease can produce an autoimmune reaction, or a self-directed immune reaction, in which a person's immune system attacks healthy cells in the body. This reaction can spread outside of the gastrointestinal tract to affect other areas of the body, including the • spleen • skin • nervous system • bones • joints"
European Society for Pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the Diagnosis of Coeliac Disease: "ESPGHAN guidelines for the diagnosis of CD were last published in 1990 (1) and at that time represented a significant improvement in both the diagnosis and management of CD. Since 1990, the understanding of the pathological processes of CD has increased enormously, leading to a change in the clinical paradigm of CD from a chronic, gluten-dependent enteropathy of childhood to a systemic disease with chronic immune features affecting different organ systems"
Another source, American Gastroenterological Association (AGA) Institute Technical Review on the Diagnosis and Management of Celiac Disease: "Celiac disease appears to be more prevalent in several autoimmune disorders than in the general population. Additionally, some evidence suggests that the longer the exposure to gluten, the higher the risk of autoimmune disorders in patients with celiac disease."
(and there is a long list of autoimmune diseases caused by and/or associated with celiac disease, which may affect any organ or tissue of the body, many of them I was written above...)
Alexbrn, NCGS is recognized since 2010 (Oslo definitions). For example, it is included on differential diagnosis of CD on Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology (table 2, page 4) Doubts about NCGS are not if it exists or not exists, are its pathophysiology: if is caused by gluten or also other proteins (ATIs, amylase trypsin inhibitors) and FODMAPS present in gluten-containing cereals. And because there is no diagnostic tests for the moment. Anyway, this situation does not differ much from that of many other diseases, as for example IBS.
The systemic nature of CD, which can affect any organ or tissue of the body, is the most important issue on which progress has been made,(e.g. ESPGHAN guidelines) after years of hard work of worldwide specialists in the field. It should not be allowed losing on what has been achieved, it's too important! It is very difficult to move forward and expand knowledge. If you look at the dates of the guidelines mentioned above, you'll see that they are published for many years and nevertheless, currently the lack of knowledge has not been corrected. We should not put us even more barriers.
Best regards. --BallenaBlanca (talk) 10:41, 7 April 2016 (UTC)
I agree w/ WAID on "signs and symptoms" appears to be nothing more than a typical list of the manifestations of malnutrition , as the section seems to reflect that--Ozzie10aaaa (talk) 11:05, 7 April 2016 (UTC)
BB, I realize that "true" celiac is an autoimmune disease, and that any autoimmune disease can have secondary effects (AFAICT, all of them do, in at least some patients). I'm looking at this list:
  • failure to thrive in infants – The first question there is whether the baby is being fed enough calories, not whether the baby is being exposed to gluten through breastmilk or (gluten-free) infant formula.
  • slowed growth and short stature – Classic sign of under-nutrition, seen among poor families over the world
  • weight loss – Classic sign of recent-onset under-nutrition
  • irritability or change in mood – Such a non-specific symptom that it's worthless. It appears in all forms of malnutrition. Poor sleep, intestinal parasites, and abuse are (many times) more likely than celiac disease.
  • delayed puberty – Classic sign of under-nutrition
  • dental enamel defects of permanent teeth – Classic sign of under-nutrition. Also acid reflux.
The adult list is similar:
  • anemia – Dietary deficiency of iron, vitamins, and/or protein.
  • bone or joint pain – Another non-specific symptom that appears in every type of malnutrition (even over-nutrition, as any obese person with bad knees can tell you).
  • canker sores inside the mouth – Classic sign of scurvy; can be caused by malnutrition that results in anemia.
  • depression or anxiety – Another non-specific symptom that appears in under-nutrition (even temporary: think about how many grumpy dieters you know).
  • dermatitis herpetiformis, an itchy, blistering skin rash –
  • fatigue, or feeling tired –Another non-specific symptom that appears in under-nutrition; typical result of anemia (regardless of the cause of the anemia).
  • infertility or recurrent miscarriage – Classic (and evolutionarily sound) sign of under-nutrition.
  • missed menstrual periods – Classic sign of under-nutrition, e.g., due to anorexia nervosa.
  • seizures – Known to be caused by severe general malnutrition, especially if it results in low levels of Magnesium; a poorly planned gluten-free/corn-based diet increases the risk of seizures (PMID 8641237).
  • tingling numbness in the hands and feet – Typical of B12 deficiency (also poorly controlled diabetes)
  • weak and brittle bones, or osteoporosis – Long-term result of under-nutrition, especially malabsorption of vitamins and minerals.
  • headaches – Common result of anemia.
And as you can see, every single one of them is associated with malnutrition, and in no case is celiac disease the most likely cause of that malnutrition. This is why I say that it's quite simple: If you have untreated celiac disease (=not "a predisposition to" or "a subclinical, symptom-free case of"), then you will have symptoms of malnutrition. WhatamIdoing (talk) 15:28, 7 April 2016 (UTC)
  • I looked through a bunch of the CD-related edits and followed them through to the sourcing. And in pretty much the order Jytdog presented them, my concern moves from low to high. Many edits adding CD-related content seem fine, citing sources that look good and authoritative and not adding undue weight--many of those edits are just adding one more item to an existing list, or adding one content sentence. The list Jyt provides at the bottom do look more concerning. Is this POV pushing or simply enthusiasm, not sure/probably not important to determine, but it would be great to get more independent eyes at those articles. Zad68 12:16, 7 April 2016 (UTC)
I'm hoping the problems are just the typical ones we have when an editor wants to push articles toward the latest research rather than accepting that as an encyclopedia we have to give more weight to the most prominent medical viewpoints, even if they lag the research. --Ronz (talk) 15:26, 7 April 2016 (UTC)
Please review the international systematic reviews that have been cited and incorporate these findings in a way that shows we still have unconvinced opinions. Non-celiac gluten sensitivity, gluten ataxia and a whole slew of symptomatic presentations are now current recognised terms. See The Oslo definitions for coeliac disease and related terms Interpreting how often a gluten-free diet is effective is different. Jrfw51 (talk) 18:59, 7 April 2016 (UTC)
Thank you very much for your extensive explanation, WhatamIdoing, now I understand your confusion!
No, no, it is not as easy, not explained by simple malabsorption. This is the main problem in understanding CD: still in the minds of most people that the cause of the symptoms is malabsorption, but malabsorption occurs only in a minority of patients. Also, when we talk about symptoms, we must be clear that not all occur in all patients, the range is very wide. Not all children have growth delayed or short stature, it occurs only in a minority of them (and it is not only caused by malabsorption), not all have anaemia (nor anaemia is only explained by malabsorPtion), etc. For example, dental enamel defects might be the only clinical manifestation of coeliac disease, in absence of any other symptom. Defects in dental enamel occur when coeliac disease affects children during dental development; generally before they are 7 years of age. The aetiology is multifactorial owing to immune mediated damage and nutritional disturbances. Recently, some authors suggest the existence of an autoimmune process, with antiesmalte antibodies.
As we see in the WGO guidelines World Gastroenterology Organisation Global Guidelines on Celiac Disease "Many patients with CD have few symptoms or present atypically, whereas a minority of patients have malabsorption (classical CD)." "Atypically" means with mild or absent gastrointestinal symptoms and extraintestinal manifestations unrelated to malabsorption but mainly with autoimmune or inflammatory processes.
Let's take a look at this table, which contains the main extraintestinal manifestations of CD and their pathophysiology (Nature Reviews Gastroenterology & Hepatology , 2015), without forget that there are also a large number of associated autoimmune diseases and other complications resulting from lack of treatment, such as cancers of various types (intestinal and extraintestinal):
Leffler DA, Green PH, Fasano A (Oct 2015). "Extraintestinal manifestations of coeliac disease". Nat Rev Gastroenterol Hepatol (Review) 12 (10): 561–71. doi:10.1038/nrgastro.2015.131. PMID 26260366.
Anaemia Nutritional deficiencies: iron most frequently followed by folate and vitamin B12. Chronic inflammation
Reduced bone density Nutritional, inflammatory, autoimmune
Arthritis Inflammatory and/or autoinmune
Peripheral neuropathy Autoimmune, inflammatory
Short stature Nutritional, hormonal, Inflammatory
Hepatitis Inflammatory, autoimmune
Dermatitis herpetiformis Autoimmune: crossreaction of TG2 antibodies with TG3 in skin
Eczema or psoriasis Inflammatory
Gluten ataxia Autoimmmune
Autism Unknown
Schizophrenia Unknown
Delayed puberty Nutritional, hormonal, Inflammatory
Hepatitis Inflammatory, autoimmune
Cardiovascular manifestations Nutritional, inflammatory
Splenic manifestations Autoimmune, inflammatory, haemodynamic
Pulmonary manifestations Autoimmune
Renal manifestations Autoimmune
Pancreatic manifestations Obstructive, inflammatory
Reproductive manifestations including impaired fertility Nutritional, inflammatory, autoimmune
Dental Nutritional, inflammatory
About your concerns of Sjögren's syndrome and other CD associated diseases ("The list Jyt provides at the bottom do look more concerning"): let's take a look for example at this source of The Lancet, already present on coeliac disease page before my first edits: Di Sabatino A, Corazza GR (April 2009). "Coeliac disease". Lancet 373 (9673): 1480–93. doi:10.1016/S0140-6736(09)60254-3. PMID 19394538 We can read: Autoimmune and immune-mediated diseases often reported in association with coeliac disease are type 1 diabetes, autoimmune hyroiditis, autoimmune myocarditis, idiopathic dilated cardiomyopathy, Sjogren’s syndrome, systemic lupus erythematosus, autoimmune hepatitis, autoimmune cholangitis, primary biliary cirrhosis, IgA deficiency, Addison’s disease, IgA mesangial nephropathy, alopecia areata, neurological abnormalities, atopy, inflammatory bowel disease, systemic and cutaneous vasculitis, psoriasis, juvenile idiopathic arthritis, and polymyositis. A wide range of neurological and psychiatric disorders such as ataxia, peripheral neuropathy, epilepsy (mainly with occipital calcifi cations), headache, dementia, depression, autism, and schizophrenia has been reported in association with coeliac disease.82 However, pathology studies and diet trials have not confirmed the existence of a link between autism and schizophrenia and coeliac disease. Furthermore, women with coeliac disease more frequently experience recurrent spontaneous miscarriage, delayed menarche, early menopause, and amenorrhoea. Fertility problems and loss of libido can also be present in male patients.83
About Schizophrenia, this is the current text present on Schizopherina page, after working with Doc James and Literaturegeek on talk page: "It has been hypothesised that in some people, development of schizophrenia is related to intestinal tract dysfunction such as seen with non-celiac gluten sensitivity or abnormalities in the intestinal flora.[57] A subgroup of persons with schizophrenia present an immune response to gluten, different from that found in people with celiac, with elevated levels of certain serum biomarkers of gluten sensitivity such as anti-gliadin IgG or anti-gliadin IgA antibodies.[58]"
Edits on Epilepsy: mine [10] and reviewed by Doc James Revision as of 09:13, 22 October 2015 Doc James (link seem controversial by the sources provided) Revision as of 23:14, 22 October 2015 Doc James (→‎Acquired: added) Mine: Revision as of 17:30, 27 January 2016 BallenaBlanca (→‎Management: Dietetic) and reviewed by Doc James Revision as of 16:06, 28 January 2016 Doc James (small number of people and therefore the results are tentative at best)
Edits on Anorexia nervosa: mine [11] and reviewed by Doc James Revision as of 02:11, 1 March 2016 (wording)
Edits on ADHD: mine [12] and reviewed by Doc James: Revision as of 11:10, 28 March 2016 Doc James (simplified aqnd added quote, we already state food intolerances above)
I worry that you keep saying things as that it's "my" POV or that it is not the "most prominent medical viewpoint"...
Best regars. --BallenaBlanca (talk) 19:25, 7 April 2016 (UTC)
The fact that these symptoms could be explained by other causes does not automatically mean that they cannot all be explained through malnutrition (=a bigger subject than malabsorption, by the way).
Furthermore, I think you are tending to somewhat over-state and over-emphasize the current state of evidence regarding the "associated" autoimmune diseases. The fact that two autoimmune diseases co-occur does not mean that celiac caused the other one, or that treating celiac will solve the other.
For that matter, if someone goes on a gluten-free diet and feels better, that doesn't mean that avoiding gluten had anything to do with it. Quite a few people go from a diet of gluten-filled beer and junk food to a carefully planned, vegetable-oriented, gluten-free diet. If you feel better on a diet that has more vegetables and lean protein, and no cakes or deep-fried foods, then that could mean that your blood sugar is happier with the removal of sugary food, or that your liver and gall bladder are happier with the removal of fatty foods, or that your intestines like the fiber – or even that the placebo effect, or regression to the mean, or the desire to find some benefit that justified all of that effort, is keeping you from discovering whether you are actually sensitive to gluten. These effects probably explain why various studies show that 65% to 85% of people who claim to have gluten problems have no problems when they start eating gluten or wheat again. WhatamIdoing (talk) 01:45, 8 April 2016 (UTC)

arbitrary break

I cited this above but again see this edit and edit note which really encapsulates what I see as your intent here BB; you are abusing WP as a vehicle for raising awareness of gluten. Is the fact that people with celiac can eat Torta caprese really so important that it is the 2nd sentence in the article? And the content at Schizophrenia is not good: "Some evidence links epilepsy and coeliac disease and non-celiac gluten sensitivity, while other evidence does not." We only end up with that kind of bad content in an article where we have some POV-pusher demanding that there be some discussion of something where there is really nothing meaningful to say about it. We all get it that this is the focus of your work in the RW; that you see medicine through lens of gluten. Please take off your gluten-glasses when you edit WP and follow the heart of the literature and please do not keep emphasizing gluten everywhere, no matter how marginal it is to the topic. Jytdog (talk) 20:14, 7 April 2016 (UTC)

Jytdog, I did NOT add that sentence on Torta capresse, it was already present!! Please, be more cautious of your conclusions. It was added on Revision as of 17:21, 2 September 2011 Mindmatrix (expand). I agree with you, has no sense, why say in the lead "As it is made without flour, it may be eaten by individuals following a gluten-free diet, such as those with coeliac disease.[1]"?? But I wanted respect and not removed, and what I did was point out. But after one reversion, I did what it would have been more logical doing from the beginning: delete that mention, which did not make sense in the lead: Revision as of 06:36, 25 January 2016 BallenaBlanca ( then, we can't say that it may be eaten by individuals following a gluten-free diet) As it is made without flour, it may be eaten by individuals following a gluten-free diet, such as those with coeliac disease.
The text in schizophrenia is the result of teamwork on Talk page.
Best regards. --BallenaBlanca (talk) 20:42, 7 April 2016 (UTC)
yes, you actually 'expanded the original UNDUE content about the dessert. And yes we end up with crappy content like that at the Schizophrenia article trying like crazy to compromise with POV-pushers; that is exactly what i said. Jytdog (talk) 20:51, 7 April 2016 (UTC)
Jytdog, could you please stop referring to me as POV, and similar disrespectful expressions, and be more respectful WP:NPA, please? Thank you very much. --BallenaBlanca (talk) 21:01, 7 April 2016 (UTC)
The purpose of this thread it to help you see that you are POV-pushing on gluten. "POV-pushing" means that an editor consistently gives UNDUE weight to something; it is a description of a pattern of behavior we sometimes find in Wikipedia. So far no one has disagreed with me, that you are doing this. Please listen to what others are saying, not just me. Please actually read WP:Civil POV pushing , especially the section on behaviors - it is what you are doing. Thanks. Jytdog (talk) 21:08, 7 April 2016 (UTC)
"The purpose of this thread it to help you see that you are POV-pushing on gluten" Does this have to be the purpose?? You are very mistaken: the aim must be analyze this issue with neutrality, you, me and all of us. It seems that you already have a preconceived idea and that you don't want to reflect. All my work in Wikipedia is being made in collaboration with other users and reaching agreements. Please review all the provided information and misinterpretations that you're making.
Best regards. --BallenaBlanca (talk) 23:12, 7 April 2016 (UTC)
BellenaBlanca, the way Dispute resolution in Wikipedia works, is that if you have an issue with someone's behavior, you bring that to the person at their talk page. If that fails to resolve the issue, you bring it to the community. That is what I have done. My notion isn't "pre-conceived" - I looked at your editing before i came to the conclusion that you are POV-pushing, and only after that did i approach you on your talk page the first time. Anyway, If folks agree me here, you should listen to them. I am ready to hear if folks think your editing is just fine, but so far folks are seeing the same pattern I am seeing. Please listen to the community. I am going to stop responding to you, because my goal here was to get other people to weigh in, not for you and me to spat. Jytdog (talk) 00:29, 8 April 2016 (UTC)
Oh well, we've now got BallenaBlanca and Jrfw51, our two resident gluten POV-pushers, removing material sourced to NHS Choices from the Non-celiac gluten sensitivity article because apparently "NHS information is very poor and not adjusted to current knowledge". And apparently wheat sensitivity and gluten sensitivity are the same thing? (RS seems to say otherwise[13]). More eyes needed. Alexbrn (talk) 18:23, 8 April 2016 (UTC)
Wheat allergy (in your link) and wheat sensitivity are different. Please read carefully! Jrfw51 (talk) 18:31, 8 April 2016 (UTC)
You might wish to review [14] and compare with WP:MEDRS. Often these sources are very good but they are not infallible. I do not have a point of view either way but do know there are many primary studies, which we do not cite, regarding wheat, gluten and FODMAP sensitivity, and an increasing number of secondary review articles. Jrfw51 (talk) 18:40, 8 April 2016 (UTC)
It is the opinion of some authors (and NHS source is in the same line), because besides gluten, other components in wheat, rye, barley, and their derivatives, including amylasetrypsin inhibitors (ATIs) and FODMAPs, may cause symptoms. They suggest that "non-celiac wheat sensitivity" is a more appropriate term, without forgetting that other gluten-containing cereals are implicated in the development of symptoms: "One of the most controversial and highly debated discussions concerns the role of gluten in causing NCGS (...) there is growing evidence that other proteins that are unique to gluten-containing cereals can elicit an innate immune response that leads to NCGS, raising a nomenclature issue. For this reason, wheat sensitivity, rather than gluten sensitivity, seems to be a more appropriate term, keeping in mind that other gluten-containing grains such as barley and rye also can trigger the symptoms."[1][2]
NHS source are opinion articles, without references and unsigned.[3][4] IMO, it seems that they don't match with WP:MEDRS, but I will accept what is decided.
And please stop talking about us as POV-pusher. Avoid personal attacks and be neutral. WP:NPA WP:NPOV
Best regards. --BallenaBlanca (talk) 18:50, 8 April 2016 (UTC)

  • more opinions at the respective article(s)--Ozzie10aaaa (talk) 23:01, 7 April 2016 (UTC)

I've been watching BallenaBlanca's for awhile now without saying much, but that coupled with the comments above show textbook WP:ADVOCACY on the subject of gluten. At quick glance, it looks like we're dealing with an WP:SPA in that regard too as everything comes back to controversial topics on gluten or wheat. I think the writing has been on the wall for awhile that a topic-ban would likely be needed. The comments here seem to be indicate a lack of recognition of why their behavior (even if it's civil POV-pushing) is problematic and violating policy.

Editors at other venues typically don't have the background needed for ferreting out advocacy within subject matter. Probably best for this community to establish we've got an advocacy problem on this board first before ANI or considering how admin discretionary sanctions may apply. Kingofaces43 (talk) 18:40, 8 April 2016 (UTC)

Thanks, Kingofaces43. I work not only on this issue, I do what I can to contribute to general Wikipedia project, but language limits me. I always thought I was working well, because I do in collaboration with other users. Editing on gastroenterology issues, autoimmune disease and other ones related with gluten-related disorders is not like editing only on art, or literature, or cooking...? What is the difference? Each one of us work in what dominates. And I have no trouble following all these advices, I will consider what other users tell me, I've been doing it so far.
Sorry, but I do not understand what means ANI.
Best regards. --BallenaBlanca (talk) 19:13, 8 April 2016 (UTC)
  • Non-celiac gluten sensitivity does show the issues here pretty well. Our article treats this as a mostly very well-defined thing, despite a nod to some controversy in the lead. The diagnostic section is way too definitive in parts, as I noted on its talk page here and voices concerned about how this diagnosis is made and deployed are pretty much excluded, and there is no content about the hyping of this condition in the media. I would ask folks here to glance at the Talk page of that article, where you see the kinds of walls of text that I have been talking about. We keep ending up with flawed content about gluten like what is in this article, as a result of compromising with BB, who continues to advocate relentlessly (in a civil manner, but relentlessly).
In Gluten-free diet see here too. Jytdog (talk) 20:58, 8 April 2016 (UTC)


  1. ^ Fasano A, Sapone A, Zevallos V, Schuppan D (May 2015). "Nonceliac gluten sensitivity". Gastroenterology (Review). 148 (6): 1195–204. doi:10.1053/j.gastro.2014.12.049. PMID 25583468.
  2. ^ Schuppan D, Pickert G, Ashfaq-Khan M, Zevallos V (Jun 2015). "Non-celiac wheat sensitivity: differential diagnosis, triggers and implications". Best Pract Res Clin Gastroenterol (Review). 29 (3): 469–76. doi:10.1016/j.bpg.2015.04.002. PMID 26060111.
  3. ^ "Food allergy or food intolerance?". NHS Choices. 16 February 2016.
  4. ^ "Should you cut out bread to stop bloating?". NHS Choices. 8 April 2016.
  • Jytdog (talk · contribs), I looked at a few of your diffs at the top and didn't see the issues. Please be extremely specific and provide specific quotes of issues. I must say, however, that I find your (as well as Alexbrn (talk · contribs)) tone distressingly hostile at times. As you may be aware, the number of editors remains in a long-term decline and Wikipedia is infamous for its unpleasant vibes. It's also respectful to not speak in terms of black and white when you are talking about things that are rather gray, such as approaches to how detailed we can be in describing facts. In these cases, it seems mostly these facts are broadly covered in review articles.... II | (t - c) 05:28, 9 April 2016 (UTC)
"gray" is what is wanted: the problem is heavily leaning on sources with one kind of POV while dismissing other sources (or parts of the sources used) which complicate that. Alexbrn (talk) 06:07, 9 April 2016 (UTC)
Well, yes, but it's perhaps not very surprising that a gastroenterologist, who presumably deals with people who are truly sick (rather than friends or neighbors who decide to go gluten-free because of what they heard on the television last week), has more definite ideas about this subject than a couple of lay Wikipedia editors. For example, it's important for a specialist to know how fallible some medical tests are: a clean mammogram does not definitely rule out breast cancer, and a positive food allergy test result in adults probably doesn't indicate an actual food allergy. Most people in low-risk groups who test positive for HIV on a single test do not have HIV. Maybe instead of talking about POV pushing, we should start looking for information about the negative predictive value for gluten-related tests – or talking about whether something is too detailed for an encyclopedic summary. Whether it's WP:The Truth (at least in a minority of cases) might not be the most productive approach. WhatamIdoing (talk) 06:15, 10 April 2016 (UTC)

Specifying and my intentions

ImperfectlyInformed's comment made me reflect. I think I've had most of guilt of this situation with Jytdog. I'm afraid that I was on the defensive and I had a bad reaction, and he has reacted with hostility.[15] I apologize. I would leave this in the past and start again. I think that control in Wikipedia is very necessary, but truly I say that I am not, and I will not be, a problem.

I have no problem listening to other users. I have done so far and my intention is continuing to do. Really, I feel more comfortable if I can count on the advice and collaboration of other colleagues. One of the first things I did on Wikipedia was to contact for advice and help, after work with Doc James to block a user.

I ask you, please, read this conversations and reflect whether this is the position of a person who wants to impose his point of view or, conversely, want to find the balance and advice, in collaboration. I have no trouble recognizing my mistakes and correct them. As I said to Doc James, "I do not want any misunderstanding."

Talking with Doc James: Epilepsy (22 October 2015 to 24 October 2015 Coeliac disease 27 October 2015 to 30 October 2015 Schizophrenia 2 November 2015

Talking with Jfdwolff: Revision as of 23:14, 31 October 2015 (→‎Coeliac disease) (One intermediate revision by one other user not shown) Revision as of 12:56, 4 November 2015 BallenaBlanca (→‎Coeliac disease: Very thanks and one proposition.) (5 intermediate revisions by 2 users not shown) Revision as of 19:48, 9 March 2016 BallenaBlanca (→‎Coeliac disease review: Ok!) (3 intermediate revisions by 2 users not shown)

In addition, other users have thanked me my job, as CFCF Revision as of 15:50, 11 January 2016 CFCF and Flyer22 Reborn Revision as of 23:32, 26 February 2016 Flyer22 Reborn (→‎Welcome: Fine editor.)

Jytdog believes that advocates my own point of view. Well, let's take a look. I will specify the list of diseases provided by Jytdog, whom says that their relationship with celiac is my point of view. I will use some references, among the many that are [without colors or bold or underlined ;-) ] All I ask is neutral and objective judgment, without preconceived ideas nor aggressiveness towards me.

could be related maybe... like
clear immmune reaction like
a whole bunch of tooth stuff (?)
the ones that are really bothering me
  • Schizophrenia: Lachance LR, McKenzie K (Feb 2014). "Biomarkers of gluten sensitivity in patients with non-affective psychosis: a meta-analysis". Schizophr Res (Review) 152 (2–3): 521–7. doi:10.1016/j.schres.2013.12.001. PMID 24368154. - Nemani, K; Hosseini Ghomi, R; McCormick, B; Fan, X (2 January 2015). "Schizophrenia and the gut-brain axis.". Progress in neuro-psychopharmacology & biological psychiatry 56: 155–60. doi:10.1016/j.pnpbp.2014.08.018. PMID 25240858. - Talked on talk page: [17] after working with Doc James and Literaturegeek on talk page
  • Sjögren's syndrome: Di Sabatino A, Corazza GR (April 2009). "Coeliac disease". Lancet 373 (9673): 1480–93. doi:10.1016/S0140-6736(09)60254-3. PMID 19394538 - "The spectrum of celiac disease: epidemiology, clinical aspects and treatment" Nat Rev Gastroenterol Hepatol. 2010 Apr;7(4):204-13. doi: 10.1038/nrgastro.2010.23. PMID 20212505
  • Anorexia nervosa: Bern EM, O'Brien RF (Aug 2013). "Is it an eating disorder, gastrointestinal disorder, or both?". Curr Opin Pediatr (Review) 25 (4): 463–70. doi:10.1097/MOP.0b013e328362d1ad. PMID 23838835 - Quick VM, Byrd-Bredbenner C, Neumark-Sztainer D (May 1, 2013). "Chronic illness and disordered eating: a discussion of the literature". Adv Nutr (Review) 4 (3): 277–86. doi:10.3945/an.112.003608. PMC 3650496. PMID 23674793. - Edits on this page: mine [19] and reviewed by Doc James Revision as of 02:11, 1 March 2016 (wording)
  • Fibromyalgia: Aziz I, Hadjivassiliou M, Sanders DS (Sep 2015). "The spectrum of noncoeliac gluten sensitivity". Nat Rev Gastroenterol Hepatol (Review) 12 (9): 516–26. doi:10.1038/nrgastro.2015.107. PMID 26122473 Rossi A, Di Lollo AC, Guzzo MP, Giacomelli C, Atzeni F, Bazzichi L, Di Franco M (2015). "Fibromyalgia and nutrition: what news?". Clin Exp Rheumatol (Review) 33 (1 Suppl 88): S117–25. PMID 25786053. Discussion opened on Fibromyalgia talk page (and this conversation with Doc James Fibromyalgia)

Best regards. --BallenaBlanca (talk) 21:31, 9 April 2016 (UTC)

No one has said that you are adding unsourced content to Wikipedia. No one. It is the WEIGHT you are giving to gluten stuff. Belllena I appreciate the effort to reset but you still not addressing the things that I and others are actually saying. Do you understand what we are talking about when we talk about "WP:WEIGHT" and "WP:UNDUE"? (that is a real question) Jytdog (talk) 19:17, 11 April 2016 (UTC)
Yes, I understand. Do not worry, I'll keep that in mind. You will see. If I ever have made a mistake, was inadvertently. I will be more careful. Thank you very much. Best regards. --BallenaBlanca (talk) 20:04, 11 April 2016 (UTC)
BallenaBlanca, it seems to me you've done a great job finding sources on gluten's relation to X, Y, Z (etc.) conditions -- that's the first part. The second part, to address WP:WEIGHT issues, is this: find sources reviewing the factors involved in the etiology and pathology of X, Y and Z conditions and see to what degree those sources mention gluten as a factor. Then weight the discussion of gluten in X, Y & Z articles accordingly. Does that make sense? BTW, it's paradoxical but true that on WP noticeboards, the less one says (and the less one repeats one's self), the more persuasive one is. To communicate more effectively here, I suggest this: try to summarize as briefly as possible here, then wikilink to longer discussions on particular talk pages. Happy editing. --Middle 8 (tc | privacyCOI) 00:02, 12 April 2016 (UTC) revise to clarify 12:08, 12 April 2016 (UTC), tweak wording 13:15, 12 April 2016 (UTC)
Middle_8, thank you very much for your words. And your advices are very welcome! I'm going to apply (a short answer, I already started ;-) ). Best regards. --BallenaBlanca (talk) 20:43, 12 April 2016 (UTC)

Article about supplement company Onnit

I tried to trim this article down and was reverted. The "clinical studies" section is particularly relevant. KateWishing (talk) 20:59, 12 April 2016 (UTC)

I reached out to them on the COI stuff. Yes the article needs more eyes. Jytdog (talk) 23:55, 12 April 2016 (UTC)
Has been well dealt with. I'm curious to see what happens. -Roxy the dog™ woof 00:30, 13 April 2016 (UTC)

Spam creep at Influenza_vaccine#Universal_flu_vaccines

Can someone with a bit more time than I ever seem to have check out the spam-creep at Influenza_vaccine#Universal_flu_vaccines? This is an important article (approaches 200,000 page views a year) and this research section has been acquiring "breakthrough! (almost)" announcements sourced to company-published or otherwise connected sources. This could use a good cleanup and tightening down to just a paragraph or two sourced to indepenent authorities. DGG had declined a recent draft of a newly-added company by a self-declared COI editor, but they're still adding stuff. Jytdog this seems like right up your alley? Any help appreciated. Zad68 13:57, 12 April 2016 (UTC)

I saw a bunch of headlines about this recently. As with most things that are currently in the news, it'll probably be easier to clean up if we wait a couple of weeks. WhatamIdoing (talk) 18:12, 12 April 2016 (UTC)
cleaned. Jytdog (talk) 07:56, 13 April 2016 (UTC)


Further comments appreciated here Talk:Sudden_infant_death_syndrome#study_on_use_of_fans Doc James (talk · contribs · email) 17:36, 12 April 2016 (UTC)

give opinion(gave mine)--Ozzie10aaaa (talk) 10:31, 13 April 2016 (UTC)

Looking for experienced editors

mw:Design Research is looking for experienced editors (hundreds or thousands of edits, probably more than a year old) who haven't used WP:VisualEditor before (or at least not much/not recently). The usual setup is a scheduled video chat via Google Hangout on Air (or maybe Skype?) for 30 to 60 minutes, in English. To run the visual editor, you'll need to have a reasonably modern web browser (>95% of you already do) and to have Javascript turned on.

I think that they're hoping to find about a dozen editors for this. The responses from editors in small studies like these have a significant effect on the product direction. If anyone's interested, please let me know. Whatamidoing (WMF) (talk) 17:13, 12 April 2016 (UTC)

SPDT: Activated Cancer Therapy as an Alternative Cancer Treatment

What should be done with this new article? Aside from the obvious problems of unencyclopedic tone, etc., it seems to overlap in content with sonodynamic therapy and photodynamic therapy. Is there anything worth keeping and/or merging into one of those articles? Deli nk (talk) 14:43, 14 April 2016 (UTC)

Created by a conflicted editor per their username, unsourced, promo. I tagged it for speedy. Jytdog (talk) 14:48, 14 April 2016 (UTC)
Beat me to it. The Hospital had already removed it once. -Roxy the dog™ woof 14:50, 14 April 2016 (UTC)

Move: Artificial respiration → Mouth to mouth resuscitation

I made this request at Talk:Artificial respiration#Requested move 15 April 2016. Previously discussed here. Please have a look. Fountains of Bryn Mawr (talk) 18:43, 15 April 2016 (UTC)

Okay dealt with I think. Doc James (talk · contribs · email) 19:07, 15 April 2016 (UTC)

Intact penis advocates

Talk:Urinary tract infection Jytdog (talk) 18:35, 15 April 2016 (UTC)

give opinion(gave mine)--Ozzie10aaaa (talk) 19:10, 15 April 2016 (UTC)

Draft:Attachment and Health

Please evaluate this draft for acceptability. Roger (Dodger67) (talk) 06:35, 16 April 2016 (UTC)

  • should be declined per prior editor comment... whole sections of the draft are completely unsourced[21]--Ozzie10aaaa (talk) 09:18, 16 April 2016 (UTC)

Template:Eponymous medical signs for digestive system and general abdominal signs merger proposal

I don't see this showing up in the alerts but there's a proposal to merge Template:Eponymous medical signs for digestive system and general abdominal signs with Template:Digestive system and abdomen symptoms and signs at Wikipedia:Templates for discussion/Log/2016 April 15. It's been relisted twice with no comments so it would be helpful to know if this separation is wanted or not in use or whatever. -- Ricky81682 (talk) 22:32, 15 April 2016 (UTC)

  • more opinions please(relisted 2x)--Ozzie10aaaa (talk) 09:20, 16 April 2016 (UTC)

Koren Specific Technique

Mass MEDRS violations Primary sources and studies are not even RS. QuackGuru (talk) 19:05, 29 March 2016 (UTC)

give opinion(gave mine)--Ozzie10aaaa (talk) 19:06, 29 March 2016 (UTC)

It looks like some of the content has been blanked, and very little of what's left is actually WP:Biomedical information. MEDRS doesn't apply to non-biomedical information (e.g., the name of the guy who invented it, which is BLP; the various names it's been marketed under, which requires the same kinds of sources you'd use for any business product; etc.). WhatamIdoing (talk) 02:41, 30 March 2016 (UTC)

"Because of lack of evidence of efficacy,[not in citation given][unreliable medical source?] KST is considered experimental by insurers who cover other chiropractic techniques.[4][3][5]"

The part "Because of lack of evidence of efficacy,[unreliable medical source?] requires a MEDRS source. QuackGuru (talk) 17:11, 30 March 2016 (UTC)

No, it doesn't. First of all, if this is really WP:FRINGE, then any source that's equal or better than the promoters' website is good enough. Secondly, this isn't a biomedical statement (read the whole sentence); it's a business statement about which excuse the insurance companies are giving for refusing to pay for it. WhatamIdoing (talk) 03:36, 31 March 2016 (UTC)
WAID fwiw i kind of like the use of insurance company evaluations for alt med topics. insurance companies have a strong financial interest in only paying for stuff that works (their money is on the line) and they often review interventions where there are few or no reviews in the biomedical literature nor statements by major health authorities. So in the absence of those two kinds of high quality sources, insurance company evaluations are, in my view, useful for independent discussion of the intervention. The Aetna source has two separate statements. One is the overall evaluation: "Aetna considers the following chiropractic procedures experimental and investigational" and heads a list. The other is specific and provides an independent description (pretty neutral, as they have no desire to additionally upset people) and then their evaluation: "The Koren Specific Technique (KST) appears to be a new system of analysis in chiropractic. With the KST method, the adjustment is generally made with an instrument called the "Arthrostim" although finger pressure can also be used. The KST allegedly opens up a new horizon on the analysis and correction of health problems by accessing the binary information of the holographic body, which supposedly enables a trained practitioner to access information about a patient's physiology that otherwise would not be available. However, there is a lack of evidence regarding the effectiveness of this approach." I think that is a very useful source and as I said this is what I generally find, when there are not better independent sources. Jytdog (talk) 03:47, 31 March 2016 (UTC)
Within reasonable limits, I tend to agree with you. In particular, I think it's a reasonable source for "not covered, due to experimental status/no evidence". I doubt that I'd accept "this insurance company pays for it, so there must be good evidence". WhatamIdoing (talk) 19:10, 31 March 2016 (UTC)

The possible MEDRS violations and possible unreliable sources have been restored. QuackGuru (talk) 15:41, 6 April 2016 (UTC)

Wikipedia health talk on a local NPR affiliate

Yesterday this radio talk was presented through an NPR affiliate.

Listen if you like. If anyone wishes, share the link. Thanks. Blue Rasberry (talk) 20:28, 18 April 2016 (UTC)

RFC at Talk:Sudden_infant_death_syndrome

Hi folks, there's an RFC at Talk:Sudden_infant_death_syndrome#Should_the_wiki_article_cover_the_fact_that_one_limited_study_found_a_beneficial_effect_from_fan_use.3F, opinions and comments welcome. Zad68 21:26, 18 April 2016 (UTC)

more opinions(gave mine)--Ozzie10aaaa (talk) 10:05, 19 April 2016 (UTC)

Someone else busted for plagiarizing Wikipedia

See here. Hattip to User:TeeVeeed who posted at the relevant Talk page. Jytdog (talk) 00:17, 18 April 2016 (UTC)

[23],retracted!--Ozzie10aaaa (talk) 11:37, 18 April 2016 (UTC)
Unfortunate they could not figure it out. PLOS is open access. Doc James (talk · contribs · email) 16:43, 18 April 2016 (UTC)
Sadly PLOS can't use material from Wikipedia, ironically because they use a less restrictive licence (CC-BY) than we do (CC-BY-SA). I did some work with them when they set up a wiki and I ran into lots of problems when I couldn't import templates, etc. from here. At some point WPMED editors may want to consider retrospectively licensing all of our Wikipedia contributions under the least restrictive licence that's in common use, with the aim of making our medical content as freely available as possible. --RexxS (talk) 21:40, 18 April 2016 (UTC)
PLOS Medicine has indicated that they may be willing to go with CC BY SA on specific articles. But yes that is indeed one of the barriers. Doc James (talk · contribs · email) 10:53, 19 April 2016 (UTC)