Wikipedia talk:WikiProject Medicine/Archive 156
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What to do if a source is obviously wrong?
What is the policy if we are getting data from a WP:MEDRS source, and the source is obviously wrong?
In Pfizer–BioNTech COVID-19 vaccine, table called "Vaccine efficacy against confirmed symptomatic COVID‑19", the "Age ≥75" group, the 95% CI for efficacy includes negative numbers, which is impossible. This is what the source (Table 10) is showing: a number that cannot be negative, whose CI includes negative values. Isabela31 (talk) 20:06, 19 November 2021 (UTC)
- In the general case, if an otherwise solid source is "obviously" wrong for something, don't use it for that wrong thing. Alexbrn (talk) 21:15, 19 November 2021 (UTC)
- Good. Will you please edit the table to remove the wrong information? Isabela31 (talk) 21:16, 19 November 2021 (UTC)
- I know nothing about the particular case and its obviousness. If there's an obvious fix to make, you know what to do. I would however, caution any Wikipedia editor from adjudging a reputable source as "obviously wrong" without first ruling out the "I don't understand it" option. Obviously wrong has to mean obviously wrong. Alexbrn (talk) 21:21, 19 November 2021 (UTC)
- Good. Will you please edit the table to remove the wrong information? Isabela31 (talk) 21:16, 19 November 2021 (UTC)
- I remember seeing this when Pfizer first published their data. I assumed it was a Wikipedia editor's mistake but as you noted, it's in the source data. In fact, the negative numbers appear throughout the report. It's not an error. Rather just the result of their calculation methodology left unadjusted. - Wikmoz (talk) 21:41, 19 November 2021 (UTC)
- How certain are we that 1 minus an odds ratio cannot be a negative number?
- What would you expect this number to be, if someone who got the vaccine paradoxically had a higher risk of hospitalization than someone who did not? WhatamIdoing (talk) 06:53, 21 November 2021 (UTC)
- Wouldn't it be consistent with the observation that extremely frail people right on the cusp of "natural" death are quite likely to be pushed over the edge by the adverse effects of a vaccine? Alexbrn (talk) 08:37, 21 November 2021 (UTC)
- There is nothing wrong with these numbers from statistical point of view. Such negative numbers are frequently reported in clinical trials. Ruslik_Zero 20:39, 21 November 2021 (UTC)
- (edit conflict) That's not what's being reported here. What's being reported is the "vaccine effectiveness" in terms of (for the specific 95% confidence interval that includes the negative number) people being hospitalized with COVID-19. This particular range says if you are infected specifically with SARS-CoV-2-gamma, the vaccine effectiveness is somewhere between 82% and –9% (i.e., somewhere from likely to help a lot to likely to be slightly harmful). The "vaccine effectiveness" is calculated from an odds ratio, not a relative risk. The only think I can tell you with certainty about an odds ratio is that "25% relative risk" means you are a quarter as likely to get the specified result, and that "25% odds ratio" does not mean this.
- On the immunology side, it is possible for a (bad) vaccine to make you more prone to side effects or more prone to infection. I don't think there's any evidence of this happening with any of the COVID-19 vaccines, but with other viruses/vaccines, Antibody-dependent enhancement is a thing. This has been a failure path for HIV vaccines in the past. WhatamIdoing (talk) 20:52, 21 November 2021 (UTC)
- If you want to use numbers that humans can understand, it would be worth looking for sources that discuss the Number needed to treat. This is the metric that lets you say useful things, like how many people hospitalized with COVID-19 need to take dexamethasone to prevent one death (answer: about 36). People can understand this even if they don't have graduate degrees in statistics. WhatamIdoing (talk) 20:58, 21 November 2021 (UTC)
- A confidence interval can easily include "impossible" values, because it's mathematically derived from a statistical model, and models often include assumptions. And assumptions are there to make the model simple enough that it's useful.
- A very common example would be when we model a variable such as age, which can only be positive, as a normal distribution, which goes from -oo to +oo. We do that because it makes the model very simple, and very useful. Of course, there is no free lunch: in doing so, we end up with a model where there is a small (but non-zero) probability that the variable that models age is negative. It's the price we pay.
- The way we calculate confidence intervals entails inverting a normal distribution or any of a number of related distributions with similar assumptions.
- As George Box said, all models are wrong, but some are useful :) Dr. Vogel (talk) 21:04, 21 November 2021 (UTC)
- Wouldn't it be consistent with the observation that extremely frail people right on the cusp of "natural" death are quite likely to be pushed over the edge by the adverse effects of a vaccine? Alexbrn (talk) 08:37, 21 November 2021 (UTC)
- I would like to confirm that we are looking at this line:-
- Age ≥75, n1b 0, surveillance time 0.102 (774), n1b 5, surveillance time 0.106 (785), VE 100.0, 95% CI (-13.1, 100.0)
- from page 87 of the pdf? Axl ¤ [Talk] 21:54, 24 November 2021 (UTC)
- For that paper, "VE is defined as 100% × (1 – IRR), where illness rate ratio (IRR) is calculated as the ratio of first confirmed COVID-19 illness rate in the vaccine group to the corresponding illness rate in the placebo group". WhatamIdoing (talk) 23:34, 24 November 2021 (UTC)
- I was hoping that Isabela31 would answer my question. Anyway, just as you say, WAID, VE is defined like that on page 73. Axl ¤ [Talk] 00:07, 25 November 2021 (UTC)
- For the time being, I shall assume that the answer to my question is "yes".
- Firstly, I draw attention to Alexbrn's comment: "I would however, caution any Wikipedia editor from adjudging a reputable source as "obviously wrong" without first ruling out the "I don't understand it" option."
- The authors derived the confidence interval using the Clopper and Pearson method. I am not familiar with this method, but I can give some basic information about the confidence interval.
- The top end of the VE confidence interval corresponds to an illness rate ratio of 0. This makes sense because no people in the vaccinated group acquired the disease during the surveillance period.
- The bottom end of the interval corresponds to an IRR of 1.131 . This value would represent vaccinated people being more likely to acquire the disease than unvaccinated people.
- This confidence interval is large, and includes the null hypothesis (i.e. vaccination has no effect). The reason for this large CI is because of the small number of cases. Only five people in the group of 1,559 acquired the disease. This means that we should not have much confidence with pinpointing any effect from the vaccine.
- If we look at the rest of the table, we see that five other subgroups also had negative values in their confidence intervals. The most extreme value is "American Indian or Alaska Native", with a bottom value of -3429 . This corresponds to an IRR of 35.29 . If this value was the actual IRR, it would mean that vaccination would increase the illness rate in these people by a factor of 35. (This value is not the actual IRR). However we should note that in all five of these subgroups, the number of cases was five or fewer in each. This explains the enormous sizes of the confidence intervals.
- There is no limit to the extremity of a negative bottom end of the confidence interval.
- The top end of the CI should not exceed 100%, because such a value would correspond to a negative number of people acquiring the disease. (Such a value would be "obviously wrong".)
- In summary, I see nothing wrong with the statistical method used, the presence of negative values in the confidence intervals, or the way that the results are presented. Axl ¤ [Talk] 09:50, 25 November 2021 (UTC)
- I was hoping that Isabela31 would answer my question. Anyway, just as you say, WAID, VE is defined like that on page 73. Axl ¤ [Talk] 00:07, 25 November 2021 (UTC)
- For that paper, "VE is defined as 100% × (1 – IRR), where illness rate ratio (IRR) is calculated as the ratio of first confirmed COVID-19 illness rate in the vaccine group to the corresponding illness rate in the placebo group". WhatamIdoing (talk) 23:34, 24 November 2021 (UTC)
"Formaldehyde poisoning" listed at Redirects for discussion

A discussion is taking place to address the redirect Formaldehyde poisoning to the article Formaldehyde. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 November 21#Formaldehyde poisoning until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Comments from those with subject knowledge would be particularly useful to the discussion. Thryduulf (talk) 01:58, 21 November 2021 (UTC)
- give opinion(gave mine)--Ozzie10aaaa (talk) 13:48, 25 November 2021 (UTC)
Cuirass ventilators
An issue has arisen over at the Wikipedia:Reference desk/Science where it has been noticed that Biphasic Cuirass Ventilation redirects to Mechanical ventilation, while Biphasic cuirass ventilation is redirected to iron lung. Some informed help would be greatly appreciated. Alansplodge (talk) 09:35, 21 November 2021 (UTC)
- thanks for posting--Ozzie10aaaa (talk) 13:50, 25 November 2021 (UTC)
Dubious redirect from Non-freezing cold injury to Trench foot
The content of Trench foot makes no specific reference to 'non-freezing cold injury', which as far as I am aware is a real medical condition, albeit one of which I have little knowledge. I am concerned that the redirect is misleading, as well as failing to inform the reader. I plan to have a go at a stub if I can find suitable sources, but if there is anyone here who wants to pitch in, please go ahead, even if just to link some good sources from the talk page. Cheers, · · · Peter Southwood (talk): 05:29, 28 November 2021 (UTC)
- Partially fixed. New article on NFCI about start class but could benefit from some help from experts.· · · Peter Southwood (talk): 17:42, 28 November 2021 (UTC)
Effects of pornography
Could someone remove all the WP:MEDRS-dodging trash from Effects of pornography? Myself I'm fed up with being the party pooper at sexuality articles. So, I invite someone else to do it. tgeorgescu (talk) 14:27, 20 November 2021 (UTC)
- That subject is not exclusively about Wikipedia:Biomedical information (e.g., relationship satisfaction), so it probably should cite some sources that aren't MEDRS's ideal. WhatamIdoing (talk) 06:31, 21 November 2021 (UTC)
- True, but in its current form Effects of pornography covers a large amount of medical claims and AFAIK it's the medical claims that are the most commonly discussed ones. Jo-Jo Eumerus (talk) 21:22, 21 November 2021 (UTC)
- I'm not a medical professional, so it feels like too much for me to handle. tgeorgescu (talk) 13:02, 26 November 2021 (UTC)
- True, but in its current form Effects of pornography covers a large amount of medical claims and AFAIK it's the medical claims that are the most commonly discussed ones. Jo-Jo Eumerus (talk) 21:22, 21 November 2021 (UTC)
@WhatamIdoing and Jo-Jo Eumerus: I have advocated for WP:TNT at Wikipedia:Articles for deletion/Log/2021 November 29. tgeorgescu (talk) 02:42, 29 November 2021 (UTC)
Requested move at Talk:Tricuspid insufficiency#Requested move 19 November 2021

There is a requested move discussion at Talk:Tricuspid insufficiency#Requested move 19 November 2021 that may be of interest to members of this WikiProject. — Shibbolethink (♔ ♕) 14:05, 27 November 2021 (UTC)
- please give opinion(gave mine)--Ozzie10aaaa (talk) 13:31, 29 November 2021 (UTC)
PANDAS advocacy
As mentioned in secondary reviews (as well as countless media sources), PANDAS advocacy is widespread on the internet and social media, with hundreds of advocacy sites and groups, including multiple Facebook pages. Misinformation in the PANS/PANDAS realm has a considerable impact on the well-being of vulnerable children.
Ajpolino recently had to re-semi-protect the article because of advocacy IP edits and vandalism, and today, talk page posts were removed. See this post at Help desk.
More eyes on the article are needed; it is not an easy topic, and editing is made harder by recruiting.
This British Paediatric Neurology Associates consensus statement is a very readable primer on the topic:
- "Consensus statement on childhood neuropsychiatric presentations, with a focus on PANDAS/PANS" (PDF). British Paediatric Neurology Association. April 2021. Retrieved November 24, 2021. See summary here.
Here are the most recent secondary reviews:
- Wilbur C, Bitnun A, Kronenberg S, Laxer RM, Levy DM, Logan WJ, Shouldice M, Yeh EA (May 2019). "PANDAS/PANS in childhood: Controversies and evidence". Paediatr Child Health. 24 (2): 85–91. doi:10.1093/pch/pxy145. PMC 6462125. PMID 30996598.
- Sigra S, Hesselmark E, Bejerot S (March 2018). "Treatment of PANDAS and PANS: a systematic review". Neurosci Biobehav Rev. 86: 51–65. doi:10.1016/j.neubiorev.2018.01.001. PMID 29309797.
- Chiarello F, Spitoni S, Hollander E, Matucci Cerinic M, Pallanti S (June 2017). "An expert opinion on PANDAS/PANS: highlights and controversies". Int J Psychiatry Clin Pract. 21 (2): 91–98. doi:10.1080/13651501.2017.1285941. PMID 28498087.
SandyGeorgia (Talk) 22:12, 29 November 2021 (UTC)
Writing internationally

A common problem I have when editing pages is that I know that something is common practice in a couple of countries (and can find sources), but often can't find a paper that discusses practices internationally. What are good approaches here? I am sort of reduced just to listing the policies in countries that are "important" (though I imagine for the people living there their country's policies are important... but a list of 200 countries might be unhelpful). An approach I've seen is that you have a summary in one page and then link to another page which is effectively a list of policies in as many countries as people care to find.
On this topic, does anyone happen to know the equivalent of UK's GMC (general medical council) in the US and, say, Germany or France? What about the NICE (national institute of clinical excellence). What I really want is a kind of "rosetta stone" of medical bodies in different countries.
I'm a little afraid that in federal countries like the US and Germany you will have a proliferation of bodies for each separate state - one nice think about the UK is that they often have a single national body solely governing policy for 60 million people or so.
Talpedia (talk) 13:49, 27 November 2021 (UTC)
- List of national public health agencies?--Ozzie10aaaa (talk) 02:27, 30 November 2021 (UTC)
Epidemiology course
Hi, I noticed an epidemiology course that may benefit from a warm welcome and a reminder about secondary sources. I reviewed the Heat stroke contribution. There is a very big edit in Tetralogy of Fallot that may benefit from another set of eyes if anyone has time. Other articles are listed here: https://en.wikipedia.org/wiki/Wikipedia:Wiki_Ed/University_of_Wisconsin-Eau_Claire/Epidemiology_ENPH_450_(Fall_2021) JenOttawa (talk) 17:45, 1 December 2021 (UTC)
- Bad edits at Multiple sclerosis, lot was reverted (with good reason), have not had time address this, but ALL of this course's edits need scrutiny. The instructor, Maxel Ruptor has never edited Wikipedia. This course should not be editing mainspace. @Ian (Wiki Ed): SandyGeorgia (Talk) 18:33, 1 December 2021 (UTC)
- PS, most of their edits will come in this week, resulting in lots of work for us, and many will likely end up reverted next week. I find it less stressful to just wait for the course to end before removing the poor work, unless it is info that is really going to jeapordize someone's health. @Lukelahood: SandyGeorgia (Talk) 18:35, 1 December 2021 (UTC)
- @Ian (Wiki Ed):Concussions in sports student editor really really needs some extra guidance. This looks like it is from a different course and not the same instructor as above. I am sorry to revert like this on a well-intentioned student but these edits are actually the complete opposite of current best practice. I do not have time to provide guidance myself on this but I did indicate a starting place secondary source for the individual in my revert edit summary. https://en.wikipedia.org/w/index.php?title=Concussions_in_sport&type=revision&diff=1058149885&oldid=1058148801&diffmode=source. This second class also just made a large contribution to Language disorder that should be looked at as well if anyone has extra time. Thank you for your support Ian @Wiki Ed. JenOttawa (talk) 19:57, 1 December 2021 (UTC)
- @JenOttawa: This is a writing class that shouldn't be editing medical topics at all. Thanks for the ping. Also thanks for the note SandyGeorgia - I'll try to keep this class's edits on my radar this week. Ian (Wiki Ed) (talk) 20:01, 1 December 2021 (UTC)
- Thanks, Ian (Wiki Ed); it is quite shocking to see this writing in a 400-level course. Very very busy, but I should point out to others here that Alzheimer's disease has had some really great student additions, in case anyone wants to look them over (I haven't seen the latest crop, but plan to barnstar them when I get a free moment). SandyGeorgia (Talk) 20:20, 1 December 2021 (UTC)
- @JenOttawa: This is a writing class that shouldn't be editing medical topics at all. Thanks for the ping. Also thanks for the note SandyGeorgia - I'll try to keep this class's edits on my radar this week. Ian (Wiki Ed) (talk) 20:01, 1 December 2021 (UTC)
- @Ian (Wiki Ed):Concussions in sports student editor really really needs some extra guidance. This looks like it is from a different course and not the same instructor as above. I am sorry to revert like this on a well-intentioned student but these edits are actually the complete opposite of current best practice. I do not have time to provide guidance myself on this but I did indicate a starting place secondary source for the individual in my revert edit summary. https://en.wikipedia.org/w/index.php?title=Concussions_in_sport&type=revision&diff=1058149885&oldid=1058148801&diffmode=source. This second class also just made a large contribution to Language disorder that should be looked at as well if anyone has extra time. Thank you for your support Ian @Wiki Ed. JenOttawa (talk) 19:57, 1 December 2021 (UTC)
Relevant RFC on the Medical Disclaimer page about adding a serious injury or death warning.
Wikipedia_talk:Medical_disclaimer#RFC_For_addition_of_a_serious_injury_or_death_warning. ☢️Plutonical☢️ᶜᵒᵐᵐᵘⁿᶦᶜᵃᵗᶦᵒⁿˢ 14:56, 2 December 2021 (UTC)
- See old proposal from 2014 at Wikipedia:WikiProject Medicine/RFC on medical disclaimer. SandyGeorgia (Talk) 15:45, 2 December 2021 (UTC)
Medical Editing Internship For ILAE Wikipedia Epilepsy Project
As the Editor in Chief of the ILAE Wikipedia Project, I from my organisation, Institute of NeuroDevelopment, have taken the liberty to announce an internship to contribute to health information on Wikipedia. Currently, we have above 40 applicants who have expressed interest and around 20 of them were present in the first meeting that we had, the recording of which can be found here. The participants are students from diverse health-related backgrounds and the roles are defined. We are going to track the contributions through Outreach dashboard from wmflabs which User:AminMDMA has created for us. User:Marium (ILAE-WiR) would be helping us through the process.
I call upon you all to help these newbies get a hold of Wikipedia. I seek your involvement and guidance for the matter. There are various roles that you could play. We are open to feedback. -Diptanshu 💬 04:06, 3 December 2021 (UTC)
Non-freezing cold injury
New article done for now. I would appreciate if someone would check whether I have appropriately filled in the infobox, and whether there are any categories to add. Other constructive comments also welcome. Cheers, · · · Peter Southwood (talk): 08:17, 1 December 2021 (UTC)
- did a couple of edits, article looks good--Ozzie10aaaa (talk) 14:43, 3 December 2021 (UTC)
creating a wiki page for medical education conferences and journals
Hello! I am working with physicians to create a wiki page with resources for specific medical education conferences and one for specific medical education journals to be in one spot for educators or students interested in this field. They start with general conferences and journals that take things from all fields then they go into specific specialties based on alphabetical order. They have been rejected and their recommendations were to use WikiProject Medicine as the platform instead of just the general wiki page. I was wondering if anyone can help me or guide me to create these resources for our students. Thank you — Preceding unsigned comment added by Mwarshel (talk • contribs) 21:27, 2 December 2021 (UTC)
- @Mwarshel, what's the goal? Is this supposed to be an encyclopedia article, or something else? WhatamIdoing (talk) 01:45, 4 December 2021 (UTC)
