Wikipedia talk:WikiProject Medicine/Archive 109

This news article:

Gellman, Lindsay (2018-03-22). "The Last Resort: Private clinics in Germany sell cancer patients hope — and mixed results — at exorbitant prices". Longreads. Retrieved 2018-03-24.

might be interesting to some editors here. WhatamIdoing (talk) 04:12, 24 March 2018 (UTC)

Interesting. Especially the last 5 paragraphs. Raymond3023 (talk) 04:51, 24 March 2018 (UTC)

See also here. I wonder whether this clinic is notable enough for an article. Alexbrn (talk) 06:38, 24 March 2018 (UTC)

probably is notable--Ozzie10aaaa (talk) 09:25, 24 March 2018 (UTC)

What may also be notable is the phenomenon of private (oncology) clinics doing this — because the Hallwang clinic is far from the only. It also reminds me of a case where a woman had travelled to Germany for SLE treatment for a full bone-marrow transplant, an experimental and highly dangerous procedure. Fortunately for her it went well, but the marketing and atmosphere is remarkably similar to that in the article. I don't know where we could place such an article, but I think focusing too much on the single actor is only marginally useful.

In fact we have no article on Financial toxicity, which has been lifted to the forefront the past few years as a major negative effect of cancer treatment (then often focusing on the US). The current redirect is to Cancer#Economic_effect and only reads:

In 2007, the overall costs of cancer in the US—including treatment and indirect mortality expenses (such as lost productivity in the workplace)—was estimated to be $226.8 billion. In 2009, 32% of Hispanics and 10% of children 17 years old or younger lacked health insurance; "uninsured patients and those from ethnic minorities are substantially more likely to be diagnosed with cancer at a later stage, when treatment can be more extensive and more costly."^[1]

There is a whole lot more we could write about here. RationalWiki has an article on the Hallwang Clinic https://rationalwiki.org/wiki/Hallwang_Clinic (which is CC-BY-SA, but does not adhere to our sourcing standards). Carl Fredrik ^talk 12:28, 24 March 2018 (UTC)

We have articles on the Oasis of Hope Hospital and (indirectly) the Burzynski clinic; it might be good to find a way to group all this stuff together rather than have one article per dodgy clinic - we could end up with quite a lot! Alexbrn (talk) 13:00, 24 March 2018 (UTC)

If for no other reason, writing ledes with "The xx clinic is a private oncology clinic alleged to engage in profiteering off terminal cancer patients, contributing greatly to financial toxicity of terminal cancer". That way we don't need to go into the details on each article, but can direct to a broader article. Carl Fredrik ^talk 13:20, 24 March 2018 (UTC)

I agree with Alex: I would rather not see articles on individual clinics.

In addition to the financial problem, we should probably expand our content on the "problem" of hope. WhatamIdoing (talk) 06:29, 26 March 2018 (UTC)

• Resolvin (edit | visual edit | history) · Article talk (edit | history) · Watch

I've tried to remove the primary clinical studies (and been reverted) - but more generally the entire article is heavily based based on primary sources. There appears to be a dearth of secondary literature discussing resolvins in a therapeutic context, but there is some discussing it pharmacologically e.g. PMID 29352860. Could use eyes. Alexbrn (talk) 17:03, 15 March 2018 (UTC)

Have left some feedback for the user in question. Doc James (talk · contribs · email) 17:31, 15 March 2018 (UTC)

What template is that you used? Alexbrn (talk) 18:46, 15 March 2018 (UTC)

{{Reliable sources please}} but I think handwritten messages are better for this job since they don't look thoughtless (the editor was welcomed to Wikipedia years ago). Jo-Jo Eumerus (talk, contributions) 19:40, 15 March 2018 (UTC)

• god that is unreadable. somebody has mistaken WP for a journal or something. Jytdog (talk) 19:47, 15 March 2018 (UTC)
  • When I notice content like that I think it could be a copyvio. QuackGuru (talk) 21:23, 15 March 2018 (UTC)
  • Well, the editor who largely wrote it, Joflaher is active and appears to be creating quite a lot of article content which is similar in nature. Alexbrn (talk) 21:31, 15 March 2018 (UTC)
    • Well some of their contributions are a little overly complicated, a good faith editor. Doc James (talk · contribs · email) 00:07, 16 March 2018 (UTC)
      • Yes, good faith I'm sure but the writing is way too technical. Alexbrn (talk) 16:55, 16 March 2018 (UTC)

My editing on Resolvin viewed it as a biochemistry article in WikiProject Chemicals category rather than a medical or clinical article. Many articles on other bioactive fatty acid metabolites (e.g. see LTB4) are classified as such and focus on the biochemistry, biology, and preclinical aspects of the metabolites. While the Resolvin article is actually classified in the WikiProject Molecular and Cell Biology category, it always focused on Resolvin biochemistry, biology, and pre-clinical studies that allow that Resolvins may someday become relevant to Medicine. Are you judging Resolvin from a overly medical viewpoint? Should the Resolvin article be re-categorized as WikiProject Chemicals? And, is there anything editorially that I can do to maintain Resolvin's biochemical, biological, and preclinical emphases? As always, I follow your judgements. joflaher talk(please sign your post..--Ozzie10aaaa (talk) 12:03, 26 March 2018 (UTC))

The Sugar article currently contains the statement "From systematic reviews published in 2016, there is no evidence that sugar intake at normal levels increases the risk of cardiovascular diseases.^[1][2]". Both those refs are from a "supplement sponsored by Rippe Health". I'm not sure what that means. Is it a reliable medrs source, or a vanity publication?

Rippe Health is in turn sponsored by producers of sugary foods, among others, like the Corn Refiners Association (sic).^[3] The lead author of the second paper is James M. Rippe, the founder and director of Rippe Health.^[4][5] The other is written by John Sievenpiper [edit:name made into wikilink] and his postdoc. Dr. Sievenpiper has received media attention for the support he has received from the sugar industry.^[6]

There is a better source. A Cochrane review found insufficient evidence to make any recommendations about low-glycemic index diets for cardiovascular health, because all the evidence was poor-quality.^[7] But I'd like to know if the supplement should be used as a source at all, as it is also cited on sugar addiction (this paper^[8]). The entire Rippe supplement seems to be open access, which is nice, but I can't see a copyleft.

Finally, should I take Ozzie10aaaa's advice and request a GA reassessment for the whole article? I don't think I can bring, or keep, the medical section up to standard by my own efforts.

HLHJ (talk) 18:01, 21 March 2018 (UTC)

The Khan and Sievenpiper source has a very clear and broad COI, but that doesn't disqualify it immidately. The presence of other sources, and the fact that the systematic reviews and meta-analyses are not plagued with COI is a good reason to avoid it. It also doesn't really support the above statement, saying:

In fact, the harmful effect of SSBs is likely driven by a collinearity with an unhealthy lifestyle as SSB drinkers consume more calories, exercise less, smoke more and have a poor dietary pattern.

So I'm not going to say it has to be purged, but it should be given less weight, and maybe one could push the unhealthy lifestyle connection more, with the caveat that this is speculation.

The Rippe and Angeloupoulos source falls below this level of evidence, and is pretty much a narrative review of RCTs, which when we have meta-analysis and systematic reviews of the same topic — should not be included. It mentions systemic reviews in its summary, but the focus is squarely on RCTs. There is quite significant COI here as well, which further weighs it down. It also cites a systemtic review, focusing on a point that is omitted from the sentence above:

his caused these investigators to conclude “the most obvious mechanism by which increased sugars might promote weight gain is by increasing energy consumption to an extent that exceeds energy output and restores energy balance… we observed that isoenergetic replacement of dietary sugars with other macronutrients resulted in no change in weight. This finding strongly suggested that energy balance is a major determinant of the potential for dietary sugars to influence measures of body fatness… the data suggests that the change in body fatness that occurs from modifying intake of sugars results from in alteration in energy balance rather than physiologic or metabolic consequence of monosaccharides or disaccharides.”

So what I can infer here is that they both hypothesize that sugar consumption leads to weight gain, because(?) it causes increased caloric intake. This confounder is side-stepped by the authors focusing on the one systematic review on restricted diets, rather than the "ad libitum" or "at will" diets of the two available systematic reviews.

Point being, I Support removing that sentence, because it is not reasonably supported by the sources. They miss too many points, and the major findings are ignored. They could be used to support other statements in the Sugar-article, but I'm pretty sure there are better sources, with less COI-issues to be found. Carl Fredrik ^talk 19:25, 21 March 2018 (UTC)

Also why was this removed in April/May of 2017:

Studies in animals have suggested that chronic consumption of refined sugars can contribute to metabolic and cardiovascular dysfunction. Some experts have suggested that refined fructose is more damaging than refined glucose in terms of cardiovascular risk.^[1] Cardiac performance has been shown to be impaired by switching from a carbohydrate diet including fiber to a high-carbohydrate diet.^[2]

Switching from saturated fatty acids to carbohydrates with high glycemic index values shows a statistically-significant increase in the risk of myocardial infarction.^[3] Other studies have shown that the risk of developing coronary heart disease is decreased by adopting a diet high in polyunsaturated fatty acids but low in sugar, whereas a low-fat, high-carbohydrate diet brings no reduction. This suggests that consuming a diet with a high glycemic load typical of the "junk food" diet is strongly associated with an increased risk of developing coronary heart disease.^[4]

The consumption of added sugars has been positively associated with multiple measures known to increase cardiovascular disease risk amongst adolescents as well as adults.^[5]

Studies are suggesting that the impact of refined carbohydrates or high glycemic load carbohydrates are more significant than the impact of saturated fatty acids on cardiovascular disease.^[6][7]

A high dietary intake of sugar (in this case, sucrose or disaccharide) can substantially increase the risk of heart and vascular diseases. According to a Swedish study of 4301 people undertaken by Lund University and Malmö University College, sugar was associated with higher levels of bad blood lipids, causing a high level of small and medium low-density lipoprotein (LDL) and reduced high-density lipoprotein (HDL). In contrast, the amount of fat eaten did not affect the level of blood fats. Incidentally quantities of alcohol and protein were linked to an increase in the good HDL blood fat.^[8]

Carl Fredrik ^talk 19:35, 21 March 2018 (UTC) [edited by HLHJ to put the entire quote in quote format]

Some of the section you quote was removed by Jytdog on grounds, mostly, that the sources were terrible or primary (details in his edit summaries). The section as edited by Jytdog still contained the bit about animal studies, but the section was entirely replaced by Zefr just after Jytdog cleaned up the section. Zefr's version is still current and cites only the Rippe Supplement refs I am worried about (I've told Zefr I was worried and would look into them).

Does anyone know what the European Journal of Nutrition (not to be confused with the European Journal of Clinical Nutrition, or other similarly-named journals) means when it describes a publication as being a sponsored supplement? HLHJ (talk) 22:44, 21 March 2018 (UTC)

Thanks for bringing this. yes we should be careful with regard to James Rippe and his practice, Rippe Health. See this 2014 NYT piece and this WaPo piece from the same time. Jytdog (talk) 23:40, 21 March 2018 (UTC)

not good--Ozzie10aaaa (talk) 00:34, 22 March 2018 (UTC)

Thank you for the references, Jytdog. I've added them to my increasingly lengthy history of notgoodness at User:HLHJ/sandbox/Sugar industry funding and health information. HLHJ (talk) 00:49, 22 March 2018 (UTC)

Is there any generally-recognized database of the conflicts of interests of journals? Not Beall's list of predatory publishers, but a list of journals' funding, grants, reprint orders, etc.? Whether they print paid supplements, and on what terms? Or even just more basic stuff? In this case, I can't find a way to be sure who had editorial control of a sponsored supplement.

More subtle versions of the shill publication Australasian Journal of Bone & Joint Medicine might declare their funding and cite one another like mad. Has anyone heard of other sponsored journal-like things, or how to spot them? HLHJ (talk) 02:58, 24 March 2018 (UTC)

Paging User:DGG... WhatamIdoing (talk) 04:05, 24 March 2018 (UTC)

Found it! Linked from the European Journal of Nutrition homepage (which I had looked for before, but absurdly, hadn't found). It turns out that the entire supplement was under the editorial control of James Rippe.

I am unconvinced that this form of publication funding serves the public good. Also, being the editor of a supplement containing a paper on which one is the lead author seems unusual.

I was curious to know who funded and edited the journal's other supplements; they publish a lot of them (23 of them, in fact, starting abruptly in 2002, after forty-odd years of the journal's existence). The resulting list was long, so I've posted it in my draftspace. In summary; I don't think I, personally, would cite anything from the European Journal of Nutrition. There are just too many conflicts of interest for my taste. I would heavily scrutinize any statement backed up by a paper they had published. They may well have published some respectable research; I didn't actually read the articles, although some of the stuff I skimmed I found worrying (the idea of supporting nutrition trends, for instance, and stuff that I would template as too advertising-like if I found it on Wikipedia).

Does anyone know anything about the history of this publication? It would be nice to be able to add something to the European Journal of Nutrition article. HLHJ (talk) 20:19, 24 March 2018 (UTC)

Eur J Nutrition was by no means the only publisher to issue such sponsored supplements. A number of otherwise very high quality journals did, and they represent a disgraceful cheapening of the medical literature. I do not consider any such publication to be truly peer-reviewed--it has the same status as any other conference papers in a commercially sponsored conference. In many cases these supplements were included only in the issues sent to individual subscribers, not to libraries. Essentially, they were advertisements.

I am amazed and horrified to learn that they are still being published. I do not know how fair it is to stigmatize this particular journal. I know where to ask, and I shall inquire further.

What I am fairly sure about, is that ewe cannot use the material as a RS even in our usual meaning of RS, and certainly not a MEDRS. DGG ( talk ) 03:48, 25 March 2018 (UTC)

Thank you, DGG. There are "European+Journal+of+Nutrition"+&title=Special:Search&fulltext=1 39 other articles that mention the European Journal of Nutrition, and from a quick scan, some of them are from other sponsored supplements whose conflicts of interest I listed. Some references, like the one in the Vitamin A or Lactulose articles, are obvious because part of the citation mentions that they are from a supplement; you can see it from the search page. I'll replace them with {{citation needed}} and a suitable edit comment, unless there's a better route. But the formatting of the supplements was not very consistent, so if we are going to keep the non-paid-supplement articles from the European Journal of Nutrition, I'll go through and check them individually.

Should non-paid-supplement articles from the European Journal of Nutrition count as WP:RS or WP:MEDRS?

HLHJ (talk) 20:35, 25 March 2018 (UTC)

I needd to revise my comment: On my talk page, you pointed out" this supplement article, cited in Venous stasis, from 2012. It includes a very precise breakdown of what the supplement sponsor is not allowed to do. HLHJ (talk) 20:28, 25 March 2018 (UTC) "

and indeed, this may be a different type than the earlier pseuo-peer-revieweed articles I remember. I will need to check further, but my feeling is that we should not necessarily ban all such references, but they do need a comment. DGG ( talk ) 22:56, 25 March 2018 (UTC)[edit:indent by HLHJ]

Fair. I should say that some Eur. J. Nutr. articles, even at least one in the Rippe supplement, appear not to have major authorial COIs. If they aren't properly peer-reviewed, though, I don't think they should be cited for anything important. The attitude of the EJN editorial board to peer review is a concern to me, based on the limited information I have. The stated policy of the EJN on supplements is available from the EJN homepage as a pop-up from the sidebar link "Aims and Scope":

Supplements: Symposia or workshop articles may be published as supplements in the EJN and are funded by their sponsors at a special rate. The EJN welcomes queries about the publication of supplements.

I think auto-commenting on reference COIs is a good idea in principle, and I'd be very glad of DGG's comments on the suggestions for that below. HLHJ (talk) 19:05, 26 March 2018 (UTC)

NAC:Article accepted after edits. Robert McClenon (talk) 03:17, 29 March 2018 (UTC) A review will be appreciated. Should this draft be accepted into article space? Robert McClenon (talk) 17:58, 27 March 2018 (UTC)

• This is a good topic for an article, but it needs more MEDRS sources and grammar editing. Natureium (talk) 18:21, 27 March 2018 (UTC)

agree(has only one good ref)..could also use a diagnosis section--Ozzie10aaaa (talk) 18:24, 27 March 2018 (UTC)

I've copy-edited the draft for idiom – the drafter gives the impression that English is not their first language – and tidied up the refs as examples for them. But the sources are almost all dire. There seem to be a lot of good possible sources available, so do we have an expert here who can point GentianB to the best ones, please? Thank you for the point about diagnosis, Ozzie10aaaa, I've left a comment on the draft including that. --RexxS (talk) 22:36, 27 March 2018 (UTC)

Thank you for your advises. Yes, English is obviously not my first language, so I am really sorry about the mistakes I made. If it is okay to you, I would redo the whole article the following days with the sources you gave me. Thanks for your patience. Since I'm new to Wikipedia, sometimes it is still confusing to me.--GentianB (talk) 23:40, 27 March 2018 (UTC)-

You're most welcome, GentianB. Please don't apologise: everybody makes mistakes and one of the advantages of working on a collaborative project like Wikipedia is that other editors can help and fix problems. Posting here will usually produce help with difficulties you encounter. Let us all know when your draft is ready and we can do another review for you. Cheers --RexxS (talk) 23:47, 27 March 2018 (UTC)

I have to thank you again. I hope to improve the draft and will let you know. Cheers. --GentianB (talk) 23:52, 27 March 2018 (UTC)

In general, if the directions for reviewing AFC submissions are being followed, then this should be accepted already. Yes, it could be improved. But it's in no danger of getting deleted, and therefore the AFC submission should have been accepted and the page moved to the mainspace. WhatamIdoing (talk) 05:17, 28 March 2018 (UTC)

Good point but I expect Robert was just checking to make sure the article doesn’t already exist under another name or significantly overlap with another article like Osteoarthritis (risk factors) for example.CV9933 (talk) 08:34, 28 March 2018 (UTC)

User:CV9933 - No. I wasn't just checking whether it already exists. I was asking whether the article was up to the standards of this project. Robert McClenon (talk) 15:27, 28 March 2018 (UTC)

@WhatamIdoing: On the other hand, there is little point in moving an article into mainspace when the drafter knows it requires a complete re-write to include good quality sources. Frankly, if the only sources available were the ones used in the article, it should be deleted because it would have no content supported by reliable secondary sources, which - as you know - is a prerequisite for a Wikipedia article. No, it's far better to give drafters the encouragement to find the good sources and use them at this early stage (the draft is only a day old!). Nobody is more critical than I am of overly strict AfC reviewers who decline perfectly notable topics for spurious reasons, but this draft has not been declined, and I believe it would benefit both the drafter and the encyclopedia to give them the chance to do more research on the topic. Others can add to it later once it's been published, but there's value in spending a little more time now in learning how to use MEDRS. --RexxS (talk) 13:27, 28 March 2018 (UTC)

RexxS, I'd say that the main point in moving the article to mainspace is that the research shows that articles get improved faster there. WhatamIdoing (talk) 06:41, 29 March 2018 (UTC)

User:WhatamIdoing, User:RexxS - I am aware that this project has higher standards than most of the rest of the English Wikipedia. I would have accepted an article of this quality on a nineteenth-century person. I routinely accept articles on nineteenth-century people. To get to an area a little closer to medicine but not medicine, I routinely accept stubs on animal and plant species. I neither accepted nor declined this article because I know that this project has (and should have) high standards. Thank you for commenting. Robert McClenon (talk) 15:27, 28 March 2018 (UTC)

Robert, WPMED doesn't "own" any articles. We don't get to say whether an article is "good enough" to be in the mainspace. We don't have "higher standards" for anything that relates to AFC. The AFC reviewer rules are that all articles that are unlikely to get deleted should be accepted and moved to the mainspace. You just need to follow those rules, even on medicine-related articles. If you're genuinely unsure whether a subject is notable, then please do come ask. We're pretty good about answering those questions. But otherwise, if you think that the article is likely to survive AFD, you should treat it like any other subject. WhatamIdoing (talk) 06:47, 29 March 2018 (UTC)

Hello. Even if it is definetly not finished, I have done some rework of the draft and I would be pleased if an experienced user could give me some feedback and improvements. Thanks. — Preceding unsigned comment added by GentianB (talk • contribs) 17:36, 28 March 2018 (UTC)

I think in it's current state it is ready to be published. There are improvements needed, but ongoing work can be done in main space. Natureium (talk) 19:25, 28 March 2018 (UTC)

moved--Ozzie10aaaa (talk) 19:31, 28 March 2018 (UTC)

I am giving a talk to a bunch of librarians from the National Network of Libraries of Medicine tomorrow about editing Wikipedia per here.

If you see new editors working on rare diseases and using sources like this https://rarediseases.info.nih.gov/diseases Please welcome them. Best Doc James (talk · contribs · email) 04:27, 29 March 2018 (UTC)

a very good effort--Ozzie10aaaa (talk) 12:17, 29 March 2018 (UTC)

I use the NIH resources in the article on Kallmann syndrome, they are of high quality and very helpful. I try to keep the Wikipedia article as updated as possible but hopefully still accessible to patients. Wikipedia articles can be very helpful to patients and families with rare conditions where there might a lack of good quality information on the internet. A very worthwhile project I think.

Neilsmith38 (talk) 20:31, 29 March 2018 (UTC)

The following RfC was moved, Please do not comment here:

@CFCF:, thanks for the move. But should you have put that at Wikipedia:WikiProject Medicine/Osmosis RfC instead of at Wikipedia talk:WikiProject Medicine/Osmosis RfC? Because you put it at the talk page, I cannot ask this question ... on the talk page. SandyGeorgia (Talk) 14:19, 30 March 2018 (UTC)

Feel free to move it again, the links should still work. Carl Fredrik ^talk 14:20, 30 March 2018 (UTC)

Not for me to do. The links at CENT will need to be fixed, so this should get sorted. SandyGeorgia (Talk) 14:21, 30 March 2018 (UTC)

Thank you, Carl, for moving that to a dedicated sub-page. WhatamIdoing (talk) 15:02, 30 March 2018 (UTC)

The Signpost has now been published after a long delay. There are some articles in it that may be of interest to Wikiproject Medicine contributors. Don't hesitate to contribute to the comments sections. All Wikipedia editors are welcome to submit articles on any topic for consideration by the editorial board for the next issue.Kudpung กุดผึ้ง (talk) 06:23, 30 March 2018 (UTC)

thanks for posting--Ozzie10aaaa (talk) 00:04, 1 April 2018 (UTC)

Resolved

• Module:Infobox gene (edit | talk | history | links | watch | logs)

Hello,

I have noted that practically every gene I look up on Wikipedia shows a human and mouse gene in the panel on the right. The chromosome number given for the mouse ortholog position is always incorrect. Instead of the correct chromosome location, it always gives the human chromosome location in the place of the mouse chromosome location. I cannot figure out how to change this and is likely in error in the lookup code that populates that chromosome field for the mice.

For an example, look at this gene and view the summary data panel on the right: CRHR1

Eakhiro (talk) 06:54, 26 March 2018 (UTC)

Seems like a problem with Module:Infobox gene but I don't know how to fix that. Jo-Jo Eumerus (talk, contributions) 08:35, 26 March 2018 (UTC)

From a quick look at the infobox of CRHR1 I can't tell which data item is supposed to be wrong. The CRHR1 gene is said to be on Chromosome 17 (human) and on Chromosome 11 of the mouse. These locations agree with the references. EdJohnston (talk) 16:47, 26 March 2018 (UTC)

Look further below, in the "summary data panel", there it says:

Location (UCSC) | Chr 17: 45.78 – 45.84 Mb | Chr 17: 104.13 – 104.18 Mb

I think this is what user:Eakhiro means; the right-most value is for mouse and says "Chr 17" incorrectly. --Treetear (talk) 20:41, 26 March 2018 (UTC)

Yes, I am talking about the box on the right of the screen, where at the bottom it list the chromosomes for human and mouse orthologs. user:Treetear is exactly right. I noticed that the mouse gene summaries are now missing from the box. I assume this means that someone is trying to fix this.

Eakhiro (talk) 23:36, 27 March 2018 (UTC)

Hello Eakhiro. I fixed the error. Now, mouse links work well.  Done --Was a bee (talk) 18:08, 1 April 2018 (UTC)

Thank you, Was a bee! --Treetear (talk) 19:09, 1 April 2018 (UTC)

I am currently writing an article on the electric bath (Franklinization). I can't get a handle on whether or not modern use is considered fringe. I started off with the premise that this was an archaic technique no longer used. However Tribology and Biophysics of Artificial Joints gives a definition of it as if it is a thing. There is also "The Clinical Observation of the Acupuncture Supplemented by Franklinism Treating Insomnia" and some other papers. Can someone suggest how I should treat modern uses in the article? SpinningSpark 21:20, 1 April 2018 (UTC)

With the exception of the Chinese source you cite, every recent article that uses the term deals with it in a purely historical way. Looie496 (talk)

Still a bit unsure, but I've posted the article anyway at Electric bath (electrotherapy). If anyone has anything further to say, please post on the talk page there. SpinningSpark 15:20, 2 April 2018 (UTC)

A discussion is taking place that may be of interest to some members of this project at Talk:Hepatitis_D#Merger_proposal. — soupvector (talk) 13:45, 2 April 2018 (UTC)

• give opinion(gave mine)--Ozzie10aaaa (talk) 16:43, 2 April 2018 (UTC)

I'm keen to get opinions from contributors to this group about the controversy described by the article 2017–18 Philippine dengue vaccination controversy and the one-line mention it receives in the article section Sanofi Pasteur#Philippine Dengue Vaccination Controversy. I am no a medical expert, but I have been asked by Sanofi Pasteur (on a paid basis via their PR firm, Purple Strategies, so I am mindful of my COI) to look into what should happen here. Naturally, I figured WP:MED should be my first stop.

The full article is not a bad summary of the situation as I've come to understand it: the Philippine government suspended a dengue vaccination program after Sanofi Pasteur said their vaccine poses higher risks for those who have not previously had the virus, and could worsen the disease in some cases; an investigation is pending. It also contains some potential WP:NOTNEWS reports of politicians weighing in; I wonder if others find this tick-tock excessive, or appropriate in the circumstances. It's complicated by the fact the principal writer (here pinged, in case they choose to weigh in) has a less-than-professional command of English.

Also, both articles contain similarly-worded statements that strike me as prejudicial, and WP:SYNTHESIS: Since the announcement by Sanofi, at least 20 children were killed, allegedly after being received a vaccination. The victims' parents blamed the dengue vaccine for the deaths of their children. As the cited source indicates, it is true that a few parents have made the claim; as other sources indicate, no public official has said anything like it. My question, then: should this sentence be included as-is, stricken, or rewritten? I'm prepared to help with article cleanup in both cases, if it will be of help to volunteers—however, I won't directly edit these pages. Best, WWB Too (Talk · COI) 16:30, 28 March 2018 (UTC)

please indicate on article/talk how (w/ references) and what improvement you think the article might need, thank you--Ozzie10aaaa (talk) 20:48, 28 March 2018 (UTC)

OK, thanks for the reply and suggestion. I'll do so tomorrow. WWB Too (Talk · COI) 00:57, 29 March 2018 (UTC)

thank you--Ozzie10aaaa (talk) 02:22, 29 March 2018 (UTC)

A quick update for today, so Ozzie10aaaa doesn't think I've abandoned this: First, thank you, WhatamIdoing, for modifying the language in both articles—certainly better than before. As I'm researching the topic to come up with proposed edits, I'm finding a lot of confusing and seemingly contradictory media reports, so I'll need some additional time to make sure I have the full picture. More soon. WWB Too (Talk · COI) 21:09, 29 March 2018 (UTC)

I assume that the person who wrote "allegedly after being received a vaccination" is not a native English speaker. There was no need to keep the strange wording. WhatamIdoing (talk) 01:33, 30 March 2018 (UTC)

After reading 2017–18 Philippine dengue vaccination controversy, which needs translating into idiomatic English, and reading the references that I could access, I've added a summary to Sanofi Pasteur #Philippine Dengue Vaccination Controversy. At least that section now has some context for the reader. I've done my best to summarise the two sources I chose as neutrally and concisely as I could, but no doubt it can be improved on. The talk pages of the articles are in need of some debate there.

[Update:] I've now tried to correct the unidiomatic English in the main article, as well as attempting to clarify the narrative. I think that WWB Too should take their remaining concerns to the article talk pages now. My advice is to concentrate on (1) suggesting missing sources; (2) criticising inappropriate sources (if any); (3) suggesting better wording if the current wording is an inaccurate or undue summary of sources. Beyond that, I doubt that there's anything more we can do. --RexxS (talk) 22:51, 2 April 2018 (UTC)

Hi all,

The last sentence in the lead section for Mini-Mental State Examination mentions examples of other tools used for evaluating mental status in geriatric patients. One is the Geriatric Mental State Examination (GMS). Several days ago I had cited a source for the GMS that I'm not sure is an acceptable source even after reading through WP:Medrs guidelines. I have an alternate source that I'm not sure is better. N. Jain ^{(talk to me)} 23:55, 1 April 2018 (UTC)

That's kind of on the old side. Have you considered a book such as https://books.google.com/books?id=6RQoBgAAQBAJ&pg=PA62&q="Geriatric Mental State Examination" (ISBN 9780191006753, page 62)? This mention of the test also compares it against another, which is useful if you want to write something more than a passing mention. WhatamIdoing (talk) 03:46, 2 April 2018 (UTC)

I like the source you suggested WhatamIdoing. I agree, my sources were quite dated. I did not think of doing a book search. By "more than a passing mention" are you suggesting perhaps including a section on the GMS within the article on the MMSE, or starting a brand new article on the GMS? If you're suggesting the latter, I'm just not sure there is a sufficient body of information out there on this subject. Also most of the sources relate directly to Copeland et al in some way or another, and I'd like to see some other perspectives as well. I'm open to suggestions from others as well. N. Jain ^{(talk to me)} 23:40, 2 April 2018 (UTC)

I'm a m:Mergist at heart, so I'd rather not create an article on GMS unless we had to. I think it's helpful to have a quick compare-and-contrast in articles like this: X is quicker than MMSE, Y is longer than both MMSE and Z but more sensitive; Z is better than X and Y for younger people (or whatever the real comparison is). That way, readers get more context instead of just the names of alternative tests. WhatamIdoing (talk) 21:39, 4 April 2018 (UTC)

April is cannabis month where at WP:420 WikiProject Cannabis organizes a drive to develop Wikimedia content about cannabis.

So far as I understand the world's most popular medical treatments are, in order:

1. Alcohol
2. Tobacco
3. Cannabis (13% of Americans over age 18,^[1] true number includes non-reporting and under 18s)
4. Aspirin (19% of Americans over age 18,^[2] plus probably ~0% non-reporting and under 18s)

Of course the US is not representative but this is the data I have. It is less uncertain what all these things treat or how they work, but users report a perception of positive outcomes.

If anyone here has something to contribute to any article in Category:Medicinal use of cannabis then please feel free and report your contribution at the 420 project. These articles get a lot of traffic so anyone with anything to share can get their audience by participating. Blue Rasberry (talk) 23:41, 1 April 2018 (UTC)

I think dronabinol should be listed in this category. But maybe we can try to get some consensus before I or someone else decides to add that category to the article. N. Jain ^{(talk to me)} 00:01, 2 April 2018 (UTC)

What are the indications for tobacco use? I've heard of physicians prescribing the other items on your list, but not tobacco (i.e., as a current practice). WhatamIdoing (talk) 03:40, 2 April 2018 (UTC)

What are the indications for alcohol use? Avoiding DTs? Does that count? Natureium (talk) 14:30, 4 April 2018 (UTC)

Primarily as a protective agent in methanol or ethylene glycol ingestion (to prevent conversion to toxic aldehyde, etc); historically, ethanol was also used as a tocolytic but that use has been debunked as ineffective. — soupvector (talk) 16:24, 4 April 2018 (UTC)

I remember learning about that, but as a thing of the past. Now we have fomepizole. Natureium (talk) 00:12, 5 April 2018 (UTC)

Fomepizole is expensive and not always readily avaliable and therefore ethanol is still used sometimes. Doc James (talk · contribs · email) 02:07, 5 April 2018 (UTC)

Out of curiosity, I checked if it's on our special list of high-cost medications. It's not, but I did learn that we currently have 113 drugs listed as shortage. Yikes. Natureium (talk) 02:40, 5 April 2018 (UTC)

Do people drink antifreeze so often that alcohol has become the number one prescribed medical treatment? If not, I think it is rather misleading to give a list of the "world's most popular medical treatments" when they are not actually treating anything. Here in the UK, I would expect the "most popular medical treatments" right now to be: (1) cough medicine; (2) throat lozenges; (3) Beechams hot lemon; and (4) aspirin. But the weather has been lousy lately. --RexxS (talk) 16:54, 4 April 2018 (UTC)

Your list also raises the question (perhaps definitively answered somewhere) about what defines a "medical treatment". I'd estimate that there's close to (not exactly) zero scientific evidence for the 4 things (especially the first 3) that you just listed having effectiveness greater than placebo for most indications for which they're used. Such lists are fraught, aren't they? — soupvector (talk) 21:37, 4 April 2018 (UTC)

I once chatted with a physician who told me that he'd prescribed whiskey sours as a muscle relaxant for a patient who refused to take pills, and it's probably more effective than nothing. I still wouldn't count a champagne toast as contributing towards alcohol's popularity as a "medical treatment", though. WhatamIdoing (talk) 21:54, 4 April 2018 (UTC)

Another use of ethanol is as a diagnosis and treatment for essential tremor. Ethanol can cause symptom resolution for affected patients, albeit episodically. However, as these things go, this is no longer a first-line treatment for ET. N. Jain ^{(talk to me)} 22:04, 4 April 2018 (UTC)

@Soupvector: Fraught indeed. But 'placebo' is a recognised treatment, and often surprisingly effective. Perhaps I should have put that at number one? --RexxS (talk) 16:36, 5 April 2018 (UTC)

Turns out there's an Alcohol (medicine) page. Not very useful though. Natureium (talk) 00:13, 5 April 2018 (UTC)

Interesting piece here. I'd love to see this extended to secondary articles. I wonder what proportion of material on Wikipedia is sourced to articles just based on a read of the abstract? Alexbrn (talk) 16:58, 4 April 2018 (UTC)

It's an interesting piece, but unfortunately its abstract is inconsistent with the full review . Moreover, why do folks make up their own metrics and then use a sample size that's smaller than the number of contributors cited on the paper? (maybe they gave out one sample each to work on.) It's also worth noting that that they excluded any study where "no data were reported on inconsistency between abstracts and full reports" – so we have no idea how many studies had no inconsistency, just the figures for those that had. Oh well. --RexxS (talk) 17:58, 4 April 2018 (UTC)

Like the rest of MEDRS, this is unnecessarily obstructionist. For example, I just violated this criterion in this edit, because all I needed to cite was a direct link between the "paper factor" being studied in the 1960s and the chemical formula for juvabione before it was given its own name. So I cited an old Science paper and no, I did not bother to read it. Wnt (talk) 12:14, 5 April 2018 (UTC)

Apart from your first five words, I agree with you. However, it is a fallacious to argue that when one section among twenty is missing information, it follows that the entire guideline has the same problem. Your efforts would be better directed to proposing a change to Wikipedia:Identifying reliable sources (medicine) #Don't just cite the abstract to exclude cases where the information supported is straightforward, like a name, a date, a formula, etc. --RexxS (talk) 16:31, 5 April 2018 (UTC)

Like so many things on Wikipedia, and in life in general, most cases could be resolved by the application of a little thought and logic - what is sometimes referred to as common sense - but as we know it is not so common that one can rely on it. There is always a problem with people interpreting things to mean what they want them to mean, and since they know they are right, everyone else must be wrong. I agree with RexxS, but don't consider it an urgent matter. If someone references an abstract, it may be adequate for the purpose, but as it may sometimes not be good enough, how about putting (abstract) into the citation. That way those of us who only have access to the abstract can make use of it when it looks useful, and it serves as a notice to anyone who does have full access that it might be a good idea to check. If they do and it checks out good, then they can amend the citation by deleting (abstract). · · · Peter (Southwood) ^(talk): 18:43, 5 April 2018 (UTC)

Other than for mundane information, I think citing an article while only having read its abstract is dishonest editing. Having some means of citing an abstract may be a solution, but are abstracts even reliable sources (other than for mundane information)? Alexbrn (talk) 19:51, 5 April 2018 (UTC)

Thanks for bringing this, Alexbrn. I added this as a citation in MEDRS as all the more reason to not to be sloppy and just go by what the abstract says.Jytdog (talk) 21:13, 5 April 2018 (UTC)

I think it's more complicated than that. In the minority of articles whose abstract and paper disagree (in some material way, for the material you're actually supporting), if you don't "go by what the abstract says", then you will get people complaining that you've mis-interpreted the paper. WhatamIdoing (talk) 02:05, 6 April 2018 (UTC)

I cannot believe you are arguing for editing based on the abstract, on the grounds that other people can be lazy and sloppy sometimes. Jytdog (talk) 02:21, 6 April 2018 (UTC)

Why are people being characterised as "lazy and sloppy sometimes". Not everyone has access to a university library, and lots of people in good faith want to help wikipedia. We should help them do so honestly, rather than insult them. The title "Don't just cite the abstract" is wrong, in the absolute sense, and for non-controversial facts derived from the abstract, but the body text is right: "it is misleading to give a full citation for a source after reading only its abstract". Another thing I was taught, at uni, you should never do, is cite a paper based on reading the text in another paper that cites it. However, both might be permissible if done truthfully, if you word your citation correctly. You can say "(abstract only)" or "as cited by ...." in your own reference. It might be necessary in some articles if you wish to note a seminal paper, but since it is in Russian, and you can't read it, you cite it second hand. Those of you using templates may have more difficulty than those formatting by hand. Another example, might be if you want to say Dr XYZ published his paper on ABC in 1972, where the only evidence you need is that he did indeed publish the paper, and not even the abstract is necessary. It would be better to word MEDRS to encourage writers to make a truthful citation, and to encourage the reading of the full paper. -- Colin°^Talk 07:46, 6 April 2018 (UTC)

I should add, that DGG, many moons ago, also pointed out that there can be differences between the draft at PubMed Central, and the final edited paper on the publisher's website. This may range from formatting differences to the correction of mistakes or misleading words. So how far do you want to go? It is also worth noting that many secondary source articles have abstracts that give very little away "Here we review the literature on ..." or "We perform a systematic review of ..." and there's little to draw from them. The above article was quite concerned about conference abstracts of research in progress or that had not yet been published. Those again aren't our main concern if we mainly want secondary sources. So I'd be more interested in an analysis comparing the abstracts of review papers with their body, but it seems very hard to put a numerical figure on any discrepancy found. Ultimately I'm far more interested in editors citing truthfully, and we should certainly discourage dishonest citation of full papers (or papers by proxy). Btw, Timeline of tuberous sclerosis has lots of "as cited in ...." references, and there's nothing wrong with that. -- Colin°^Talk 08:34, 6 April 2018 (UTC)

First off, changes between an accepted manuscript and a final version are normally minor. When it comes to abstracts, the differences can be much more pronounced. Maybe you're right Colin that people aren't being lazy, but citing only the abstract is still bad practice and should be avoided. And at Wnt — I think it's a bad idea if you cited that statement only based on the abstract, but likely you came across the fact elsewhere, and then cited it to that article — so you're not really just citing the abstract, even if what you did isn't best practice.

We go as far as is possible, and helping those willing to engage to access papers is a large part of what this project does. I'd like for there to be more requests for sources on this website, but for some reason(?) those requests seem to have gone down lately. Another related bias is FUTON bias, and it is a major issue we should be trying to tackle, not resign to. Carl Fredrik ^talk 13:50, 6 April 2018 (UTC)

Wrt to your second sentence, and for secondary source papers, you have zero evidence for that assertion. The issue is that if this project makes the guideline stricter than allowed by policy, or keeps avoiding common sense when using this guideline, then people will start to remove bits of it, or challenge its status. There will be things for which citing just an abstract is likely to be OK, and it is better that editors are truthful about that. A heading "Don't just cite the abstract" is likely to discourage them from making an honest citation. A better heading is "Cite what you read", which is a basic scholarly requirement, along with advise on how to cite just the abstract, or cite a paper by proxy. Remember that your experience on Wikipedia is not the same as someone else, who may be working in historical articles or biographical articles, where the medical journals are old and not online, or not in English. I know many WP:MED folk are in constant battle against alternative medicine, and fake claims, etc, but many many article are not a battle, and the facts are rather boring and uncontested. As for open journal bias, no, actually as a Free Content project, and as a project where everything we write should, as much as possible, be verifiable by our readers, then a bias towards freely available papers is totally in keeping with that. Being able to access paywalled journals is not a privilege extended to our readers. -- Colin°^Talk 14:46, 6 April 2018 (UTC)

Jyt, I'm not arguing for or against editing based on the abstract. Imagine a paper whose structured abstract says "Conclusion: We demonstrated that the sky is pink" and whose body contains the sentence, "The sky can be any number of colors depending upon the weather conditions, including pink, blue, and green" and contains a graph showing that blue is the most common color.

The anti-abstract position says that you should read the paper, cite the paper, and then accurately write that the sky is mostly blue. I'm saying that if you cite this source to support "The sky is usually blue, but can be other colors", then some good-faith, trying-to-be-helpful editor is going to come along, slap a {{failed verification}} tag on your source, and accuse you of violating WP:NOR. (And if it's a primary source, then you will have violated MEDRS's rules about only presenting the formally identified conclusions of the source, too.)

I also think there's too much either-or thinking about this. The best solution in such a situation is usually going to be looking for a different source. When the abstract and the body don't match in material ways, it's probably not a high-quality source.

I do agree with Colin about the misleading heading in MEDRS. We want you to cite (=put information between the ref tags) the abstract, if that's all you read. What we don't want you to do is to rely too much on the abstract. This is a "say where you got it" thing, not a "please cite the whole paper even if you only read the abstract" thing. The section heading is ambiguous. WhatamIdoing (talk) 15:12, 6 April 2018 (UTC)

I understood you well the first time; the well-intentioned person who didn't check what the article actually says is being lazy and sloppy.

For biomedical information I don't use primary sources (if the "you" is referring to me).

We do not want people to edit content based on abstracts only, generally speaking. Yes there are obvious-in-the-paper things as others have noted, but those are not interesting nor what we are really talking about here. As the paper cited mentions, when the abstract is misleading it is generally spinning how solid the conclusion actually is. That is the kind of stuff Alexbrn and I and others that deal with from fringey POV pushers all the time.

This is really a basic scholarship thing. People should read multiple MEDRS refs carefully, and should generate content carefully summarizing them; you cannot do that looking at abstracts only.Jytdog (talk) 15:24, 6 April 2018 (UTC)

Identifying a potential error in an article, based on the information and resources that you actually have, is not generally what I'd call "lazy and sloppy". WhatamIdoing (talk) 15:33, 6 April 2018 (UTC)

Jytdog, there is absolutely no justification for throwing insults around about people's motivation. MEDRS is not a weapon and if you spend all your time fighting people you call "fringey POV pushers" then you're going to develop some pretty bad faith opinions when you actually meet editors who are simply trying to improve the project, and who aren't nearly as privileged as you, or are working in areas that are poorly covered by online material. The paper, on abstracts, that started this discussion is useless to us. And I question how you know your "fringey POV pushers" only read the abstract anyway, or if you can find an example of a secondary source someone cited where they were relying on incorrect/misleading information in the abstract that is clearly correct/not misleading in the full text. Otherwise, this just seems like a bunch of privileged editors making rules to help them win wars, not write articles. -- Colin°^Talk 15:59, 6 April 2018 (UTC)

WAID, using the Template:Failed verification - which makes a definitive claim that the content fails verification -- if you haven't looked at the whole ref but the abstract only, is not good. (it also contradicts the instructions which say "use only if...you have checked the source"). It is easily resolvable on the talk page, but everybody would have saved time if the person would have checked the whole source. A better thing to do -- and entirely reasonable -- if a person only has access to the abstract and it seems to not support the content, would be to open a discussion at Talk and say "hey, i don't have access to the whole paper but X is not supported by the abstract of ref ZZ - can anybody verify this and reply here?" But whatever. This is a theoretical discussion -- I have never seen this happen in actual editing. Jytdog (talk) 18:11, 6 April 2018 (UTC)

A weapon is anything used as a weapon, whether it was originally intended as a weapon or not, so WP:MEDRS is a weapon, because it is sometimes used that way. This is not a moral deficiency of WP:MEDRS any more than it is a moral deficiency of the candlestick in the library. · · · Peter (Southwood) ^(talk): 19:32, 6 April 2018 (UTC)

I don't think you got the point. -- Colin°^Talk 21:14, 6 April 2018 (UTC)

I think it is absurd to equate abstract-reading with "laziness". Because Wikipedia isn't some ascetic pursuit of scholarship, but a hobby of finding information backed up by reliable sources. If I manage to find a 360-page review volume about hormones in Virchow's Archive of Pesticides, and I find a line in a table that says that "paper factor" is juvabione, does that make me less lazy than if I find the same line in an abstract? Am I supposed to read the entire irrelevant article in order to be a "scholar"? Under WP:NOR, am I even allowed to use the preceding four figures and GC-MS results in order to decide whether I think the paper factor really is juvabione??? Then why the hell are you expecting or demanding that I read them! Wikipedia has insisted that we rely on other sources to digest facts into simple, citable assertions. Abstracts are where they do much, though not all, of that. And we should cite an abstract whenever we would cite any other page -- when we think the source is reliable and has made a clear statement. It is not even formally our job to evaluate whether we think the statement is true. Wnt (talk) 23:43, 6 April 2018 (UTC)

Wnt as I noted above the issue is not about simple facts. I explicitly said that above. It is more about evaluative statements like evidence for whether X is effective to treat Y. I am done commenting here. Jytdog (talk) 23:51, 6 April 2018 (UTC)

I see no obvious boundary between "simple facts" and "evaluative statements". If an abstract says that drug X was no better than placebo, is that a fact or an evaluation? And if it's an evaluation, why would we ignore what the author says in the abstract and pull something rosier out of the conclusions section? And what other editor is going to stand for that? Wnt (talk) 00:21, 7 April 2018 (UTC)

Looking for anatomy experts here. Does this exist in humans? Is there another name for it? Does it only exist in rats? Natureium (talk) 03:50, 9 April 2018 (UTC)

It would seem to be a bit more widespread. https://onlinelibrary.wiley.com/doi/pdf/10.1002/cne.903180202 refers to presence in humans, and at least one ref in the article mentions rabbits. cheers · · · Peter (Southwood) ^(talk): 05:47, 9 April 2018 (UTC)