Wikipedia talk:WikiProject Medicine/Archive 67

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Archive 60

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Archive 65

Input requested at Kombucha

Hi there, we're having some difficulty seeing eye to eye on a claim about deaths-by-Kombucha.

The source being used for the claim is from an American Cancer Society piece, where they reference this 20 year old case.

"No studies have been done on humans to support any of the claims made for Kombucha tea. There have, however, been reports of some serious complications associated with the tea. In April 1995, two women who had been consuming the tea daily for two months were hospitalized with severe acidosis--an abnormal increase of the acid levels in body fluids. Both had high levels of lactic acid upon hospitalization. One woman died of cardiac arrest two days after admission. The second woman’s heart also stopped, but she was stabilized and recovered. The mushrooms used by both women came from the same "parent" mushroom. While no direct link to Kombucha tea was proven in this case, the FDA has warned consumers to use caution when making and drinking the tea."

Alexbrn has summarized it thusly:

"Drinking kombucha has been linked, in rare cases, to serious side effects and deaths".

Since the ACS specifically says "no direct link", it seems "has been linked" is misleading. Any clarity on the application of MEDRS and how this is best summarized would be appreciated. Here is the related talk page section. petrarchan47 คุ ก 07:13, 8 June 2015 (UTC)

This is a misrepresentation. I am not summarizing the quoted text but instead following the "Overview" of the ACS piece which states: "Available scientific evidence does not support claims that Kombucha tea promotes good health, prevents any ailments, or works to treat cancer or any other disease. Serious side effects and occasional deaths have been linked with drinking Kombucha tea." The "no direct link" wording used by the ACS is in respect of one case and is not an overall summary of the state of knowledge on this topic. Alexbrn (talk) 07:19, 8 June 2015 (UTC)

What is the evidence? There is no scientific evidence to support any of the claims made for Kombucha tea. There have been reports of some serious complications associated with the tea.3 In April 1995, two women who had been consuming the tea daily for two months, were hospitalized with severe acidosis--an abnormal increase in the acidity in the body fluids. Both had high levels of lactic acid upon hospitalization. One woman died of cardiac arrest two days after admission. The second woman also suffered a heart attack but was stabilized and eventually released. The mushrooms used by both women came from the same "parent" mushroom. While no direct link to Kombucha tea was proven in this case, the FDA has warned consumers to use caution when making and drinking the tea 4....i (have answered both here and at the link, since there is discussion at both places), this seems to indicated what your referring to petrarchan47 I happen to agree with you (BTW this source is non-MEDRS compliant, not too different from a 20 year old statement... for a compliant MEDRS source see below) --Ozzie10aaaa (talk) 10:48, 8 June 2015 (UTC)

(add) on the ability of KT to protect against a vast number of metabolic and infectious diseases, but very little scientific evidence is available that validates the beneficial effects of KT. The aim of this review is to give an overview of the recent studies in search of experimental confirmation of the numerous KT health-promoting aspects cited previously. Analysis of the literature data is carried out in correspondence to the recent concepts of health protection's requirements. Attention is given to the active compounds in KT, responsible for the particular effect, and to the mechanisms of their actions. It is shown that KT can efficiently act in health prophylaxis and recovery due to four main properties: detoxification, antioxidation, energizing potencies, and promotion of depressed immunity. The recent experimental studies on the consumption of KT suggest that it is suitable for prevention against broad-spectrum metabolic and infective disorders. This makes KT attractive as a fermented functional beverage for health prophylaxis. review 2014--Ozzie10aaaa (talk) 11:53, 8 June 2015 (UTC)

Are you seriously proposing we use happyherbalist.com to sink the view of the American Cancer Society!? Alexbrn (talk) 11:14, 8 June 2015 (UTC)

no...im looking for further information of this and have posted a review 2014 PubMed index as well--Ozzie10aaaa (talk) 11:21, 8 June 2015 (UTC)

Our article already cites that, alongside another 2014 review. Alexbrn (talk) 12:51, 8 June 2015 (UTC)

Since the ACS piece seems no longer to appear, and the site now apparently doesn't mention KT at all, I think we should drop that source. Johnbod (talk) 15:26, 8 June 2015 (UTC)

It was there yesterday. An amazing coincidence that the very time the site changes the source gets challenged! I wonder whether the ACS are doing a site reorg or if they've decided to drop this topic for good. Alexbrn (talk) 17:46, 8 June 2015 (UTC)

Weird conspiratorial meandering aside, the source was dead when I came across it on the 6th. petrarchan47 คุ ก 18:19, 8 June 2015 (UTC)

Thanks for the responses! I've added sources that do not seem to support the death-by-Kombucha claim here, whilst overnight the claim in the article has lept from "linked" to "causes". petrarchan47 คุ ก 19:59, 8 June 2015 (UTC)

After researching sources to confirm Wikipedia:Verifiable but not false, and in following MEDRS guidelines which tell us case reports regardless of whether they are in a scientific journal or popular media are below miniumum requirements as RS, there is no doubt the material should be removed. Core policy WP:V tells us extraordinary claims require extraordinary (multiple) sources, so inclusion of death and toxicity claims as causality fail on multiple counts. Put simply, the anecdotal material is noncompliant with PAGs. Considering the article is also subject to DS I don't think it is advisable to insist on keeping poorly sourced extraordinary claims in the article that are fundamentally noncompliant with core policy, WP:V. Also, the journal review indicates that the case reports involved a small number of individuals, there was no scientific evidence to confirm causality. It is believed the problems arose not from the inherent factors of kombucha but primarily through contamination or lead seepage from the ceramic containers during fermentation. If the journal review and common sense isn't convincing enough to justify removal of the anecdotal passages (extraordinary claims), then the dates should be considering the majority of the case reports date back to the 90s with only a few (rare cases) reported 6 or so years ago. Moreover, some of the books that were written citing those same case reports are not RS, two of which were cited for the death claims in the article and are factually inaccurate. At best, we could include highlights with intext attribution citing the conclusion of the 2014 review. --Atsme^📞📧 17:44, 11 June 2015 (UTC)

That comment makes little sense. We should simply summarize good secondary sources, rather than misreading and inventing policy to try and swerve around them. Alexbrn (talk) 18:15, 11 June 2015 (UTC)

"After researching sources..."? Looks like WP:OR to me. And what's with the 'extraordinary claims'? There is nothing extraordinary in a claim that fermentation under uncontrolled conditions can produce toxic substances. AndyTheGrump (talk) 18:25, 11 June 2015 (UTC)

Doc James I know WP doesn't give medical advice but I find the condescension ad nauseum. Would you be so kind as to read my post regarding "verifiable but false" information as it relates to RS that do not pass MEDRS guidelines and explain how it applies to case reports? It will be very helpful particularly with regards to editing other articles, like atrazine, and the like. Thank you in advance. Atsme^📞📧 19:54, 11 June 2015 (UTC)

Reading through a couple of comments:

I would disagree that 5 major newspapers are reliable sources when it comes to medical content. Sources / evidence are like school children. 5 first graders do not equal one 5 grade in ability.
I like the "true to presentation" bit.
I also like that extreme ideas require extreme sources. One would need amazing sources to support the idea that TMers can actually fly

Doc James (talk · contribs · email) 22:10, 11 June 2015 (UTC)

When we are dealing with major topics like diabetes, we never have to use less than idea sources and there are lots of ideal sources out there. When it comes to obscure topics like Kombucha there are few great sources and we must thus be careful and try to use the best available sources. Doc James (talk · contribs · email) 22:14, 11 June 2015 (UTC)

My response below isn't a response to you, Doc, just wanted to make that clear. petrarchan47 คุ ก 03:43, 12 June 2015 (UTC)

When the American Cancer Society hosted a webpage citing a link to deaths in 1997, that source was considered the top quality source, and its contents copied to the Lede almost verbatim. However, when that source disappeared, similar sources were suddenly considered not ideal, and 2 obscure sources were used instead, one of them 10 years old.

The Mayo Clinic and the Swedish Medical Center, both on par with the ACS source, cover the adverse effects of Kombucha - neither mention death. They go into (rather encyclopedic) detail about the ways in which people have become sickened by drinking Kombucha, as well as contributing factors that may have played a role.

The Lede now says: "...and the drinking of kombucha has been linked to illness, and the death of at least one person."

The 2 blurbs that were found and used for the above say:

"Kombucha tea; a general cure-all; can cause acidosis and death" -- 2005

"Kombucha has been associated with illnesses and death. A tea made from Kombucha is said to be a tonic, but several people have been hospitalised and at least one woman died after taking this product"

Because of MEDRS, the first source is unusable. The second source is not a strong enough claim to add it, without more details, to the Lede in this fashion. IMO, the readers should know how very loose the "link" really is -- not because I am part of a Kombucha Cabal, but simply because the truth is what we're here for. Other sources that have covered this topic go into a bit of detail behind that various serious side effects that have been reported. When the entire story is told, the picture that emerges is very different from Wikipedia's entry.

Those supporting this single source and claims of deadly Kombucha need to reconcile why the Mayo Clinic and Swedish source don't mention death in their list of negative effects.

It is obvious that POV is playing a role in the sudden flip flop on what is considered the best source. If we can quote the ACS verbatim, we should be able to quote the Mayo clinic in exactly the same way. Suggesting a 10 year old source to counter this is not good form, not after all the haughty lectures I've received on MEDRS. The single book that cites a death is a fringe claim, and we can't give a platform to fringe claims without really going into what the majority of high quality sources say. But you all know this already. petrarchan47 คุ ก 01:38, 12 June 2015 (UTC)

Petrarchan47 Are you aware that what you are calling "Mayo clinic" is in fact something in their "expert answers" series and is written by one individual doctor (Brent A. Bauer, M.D.)? Even then Dr Bauer writes that "several cases of harm have been reported" which in no way undercuts the stronger sources' listing of adverse effects associated with consuming this stuff. What you are calling "Swedish medical center" is 2013 syndicated content from the EBSCO CAM Review Board which appears on multiple web sites. It also does not contradict the strong sources we use. Perhaps you might like to consider the relative strength and relevance of the sources you're championing. Alexbrn (talk) 08:18, 12 June 2015 (UTC)

Doc James agreed that extraordinary claims require extraordinary sources (mulitple) per WP:V. I'd hate to think people are going into Walmart to buy kombucha tea or derivative health drinks if there's a risk it could have toxic effects or cause death. We have the 2014 Journal review which is extraordinarily reliable because it not only meets MEDRS requirements, it also passes the acid test for WP:V. I don't see why Mayo and a NYTimes article couldn't be used to cite kombucha products, either. I think we're good to go in that regard. --Atsme^📞📧 04:04, 12 June 2015 (UTC)

Either you have not read WP:V or you have not understood it. The principle of verifiability means that text on Wikipedia must be verifiable. To quote: "all quotations and any material challenged or likely to be challenged must be attributed to a reliable, published source using an inline citation". It does not mean that you have the job of personally "verifying" for yourself the work in secondary sources. For the avoidance of doubt, WP:MEDRS makes this explicit: "Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions." Talking of a source itself as "passing the acid test for WP:V" makes no sense. Alexbrn (talk) 10:42, 12 June 2015 (UTC)

Making broad "death" claims inst in the source either. It mentions "of at least one woman". Using just plain death can lead people to believe it is widespread. But you have decided to eliminate the quantitative facts in the source from the article in some strange sync claim. First you add your prefered claim to the body then you change the lede when it should just have been copied from the lede. AlbinoFerret 13:49, 12 June 2015 (UTC)

im going to have to concur with AlbunoFerret, (further logic dictates this line of "reasoning" has no objective bases , as indicated very early on the ref originally in question was quite dated, even further it does not come up on Google anymore??) --Ozzie10aaaa (talk) 14:17, 12 June 2015 (UTC)

@Ozzie10aaaa: per comments here, that ACS source has been removed and newer ones used. AlbinoFerret's edit that gives us "linked to ... the death of at least one person" is fine and supported by the sources currently used. Alexbrn (talk) 14:23, 12 June 2015 (UTC)

No, Alex, it is not fine for the reasons mentioned above which were further validated by Doc James in response to my questions. The claims you want included are unacceptable for the following the reasons:

outdated or involve such a small group of people (1 rare case) that inclusion of such information is not only UNDUE, it is FRINGE. MEDRS works both ways.
not one of the case reports is supported by scientific evidence that confirm causality,
the claims involve anecdotal case studies which is a flat no-no per MEDRS, and
the sources you cited contradict a more recent 2014 journal review wherein the conclusion statement is based in part on the same case reports cited in all other RS. There are no other reported cases of toxicity or death except for that same handful that is mirrored in all the sources.

It's time to drop the stick, Alex, and stop being condescending. Spend some time reviewing MEDRS which clearly states and accurately reflect current medical knowledge. and WP:MEDASSESS: Knowing the quality of the evidence helps editors distinguish between minority and majority viewpoints, determine due weight, and identify information that will be accepted as evidence-based medicine.' Not all papers in even reputable medical journals can be treated as equivalent. Studies can be categorized into a number of levels, and in general, editors should rely upon high-quality evidence, such as systematic reviews, rather than lower-quality evidence, such as case reports, or non-evidence, such as anecdotes or conventional wisdom. The medical guidelines or position statements produced by nationally or internationally recognised expert bodies often contain an assessment of the evidence as part of the report. Contradictory to the allegations made against me, we actually are obliged to verify the sources and make sure they are verifiable but not false as further defined in far more detail by guideline essays and MEDRS. If your intent is to get the article right then by all means join as a GF collaborator, but if your only purpose is to assault kombucha products with scientifically unsupported death claims based on inaccuracies in RS that fail MEDRS and V, then you are not being helpful. Oh, and I highly recommend a trip over to Red Bull where your collaboration may prove beneficial. There are plenty of sources you can cite linking Red Bull to deaths including the death of a prime athlete who according to RS dropped dead shortly after drinking 4 cans of the stuff. There is no mention of death whatsoever in the lead despite the case studies and academic papers. In fact the lead gives the drink a clean bill of health. The circumstances surrounding that "energy" drink are far more profound than the antecdotal case reports linking kombucha tea. You might also take a look at Gatorade. It may turn out to be a great way to help Doc James sniff out COIs. Happy editing! Atsme^📞📧 15:40, 12 June 2015 (UTC)

Lots of confusion and original research there. Best if we WP:STICKTOSOURCE for the pharmacology textbook we cite (to quote it: "Kombucha has been associated with illnesses and death"), rather than adopt editors' personal views. Alexbrn (talk) 15:51, 12 June 2015 (UTC)

Sorry, but your position is neither supported by PAGs nor consensus. Also, please be mindful of the DS notice attached to the article. Have you received a DS CAM/PS notice this year? I believe you brought the DS to our attention on the article TP so you are aware it exists. Thank you and happy editing, Alex!!! Atsme^📞📧 15:58, 12 June 2015 (UTC)

Wikipedia:Articles for deletion/Differential DVH

Members of this project are invited to comment. --Kudpung กุดผึ้ง (talk) 01:58, 10 June 2015 (UTC)

Thanks User:Kudpung. Commented Doc James (talk · contribs · email) 02:33, 10 June 2015 (UTC)

And what about Cumulative DVH? Either article should be renamed if they are not merged.96.52.0.249 (talk) 18:14, 12 June 2015 (UTC)

2015 bee venom therapy systematic review

https://www.ncbi.nlm.nih.gov/pubmed/25996493 This source might be useful. QuackGuru (talk) 07:09, 11 June 2015 (UTC)

ok, are you referring to Acupuncture you didn't indicate the article (I surmised from your editing history)--Ozzie10aaaa (talk) 10:35, 11 June 2015 (UTC)

If anywhere, this probably belongs at apitherapy, which needs some attention from this WikiProject. Everymorning talk 22:14, 11 June 2015 (UTC)

concur...but poster never indicated originally intended article--Ozzie10aaaa (talk) 22:17, 11 June 2015 (UTC)

User:Everymorning. User:Ozzie10aaaa. Apitherapy for this ref and Acupuncture#Related practices (and possibly apitherapy) for these two refs. QuackGuru (talk) 18:18, 12 June 2015 (UTC)

Request page move

Ruyan changed its company name to Dragonite International Limited. QuackGuru (talk) 18:24, 12 June 2015 (UTC)

if you have consensus then Help:How_to_move_a_page--Ozzie10aaaa (talk) 18:31, 12 June 2015 (UTC)

Meningeal lymphatic vessels

A fascinating paper at http://www.nature.com/nature/journal/vaop/ncurrent/fig_tab/nature14432_F3.html (Louveau, A.; Smirnov, I.; Keyes, T. J.; Eccles, J. D.; Rouhani, S. J.; Peske, J. D.; Derecki, N. C.; Castle, D.; Mandell, J. W.; Lee, K. S.; Harris, T. H.; Kipnis, J. (2015). "Structural and functional features of central nervous system lymphatic vessels". Nature. doi:10.1038/nature14432.) seems to be getting a lot of press attention. As this is primary research, I presume WP:MEDRS precludes the creation of an article on this at the moment, but how might it be possible to report interesting research which meets WP:RS but not WP:MEDRS? -- Impsswoon (talk) 18:55, 2 June 2015 (UTC)

a) one species (mice) b) one single paper. this is not encyclopedia worthy. (but wow!) Jytdog (talk) 20:01, 2 June 2015 (UTC)

agree with Jtydog--Ozzie10aaaa (talk) 22:52, 2 June 2015 (UTC)

If confirmed, a Nobel Prize worthy discovery. Wow indeed! Boghog (talk) 20:56, 3 June 2015 (UTC)

in regards to the original question by the poster... The unique location of these vessels may have impeded their discovery to date, thereby contributing to the long-held concept of the absence of lymphatic vasculature... the discovery of the central nervous system lymphatic system may call for a reassessment of basic assumptions in neuroimmunology and sheds new light on the aetiology of neuroinflammatory and neurodegenerative diseases associated with immune system dysfunction. again impressive, but still primary , however due to... Articles should be based on reliable, third-party, published sources with a reputation for fact-checking and accuracy. This means that we publish the opinions only of reliable authors, and not the opinions of Wikipedians who have read and interpreted primary source material for themselves. The following examples cover only some of the possible types of reliable sources and source reliability issues, and are not intended to be exhaustive. Proper sourcing always depends on context; common sense and editorial judgment are an indispensable part of the process you "could" mention it in Lymphatic_vessel having said that get concensus first...IMO --Ozzie10aaaa (talk) 12:41, 6 June 2015 (UTC)

I third the "neat finding" sentiment. :P Seppi333 (Insert 2¢) 23:09, 12 June 2015 (UTC)

Summary of review

There is discussion of how we should summarize a cannabis review here and . Further input requested. Doc James (talk · contribs · email) 01:56, 13 June 2015 (UTC)

give opinion (I gave mine)--Ozzie10aaaa (talk) 09:36, 13 June 2015 (UTC)

Wikipedia:WikiProject Medicine/App

Hey All

We have just had a WikiMed App launch for android here . It is basically all our medical articles in a Kiwix automatically downloading format.

I have just updated the intro page which will soon be this Wikipedia:WikiProject_Medicine/Open_Textbook_of_Medicine and appreciate feedback.

Hope to have it translated into Chinese, Persian, and Oriya soon for launches into those languages.

Doc James (talk · contribs · email) 00:22, 12 June 2015 (UTC)

very well written and informative(looks good)--Ozzie10aaaa (talk) 00:52, 12 June 2015 (UTC)

This is 466mb. My guess is that the average app size is less than 10mb, and a big app would be 50mb. This is a big application. That matters a bit now, but will matter less in the future.

This is an extremely cool idea.

Is there any project page for this on English Wikipedia? Should I start one? Blue Rasberry (talk) 14:11, 12 June 2015 (UTC)

This is sort of the project page Wikipedia:WikiProject_Medicine/Open_Textbook_of_Medicine

We are looking at creating a version without pictures. Doc James (talk · contribs · email) 22:59, 12 June 2015 (UTC)

Just for a reference (no pun intended) I use an app called "WikiEM" which serves as a basic reference of notes and lab values - and this takes up about 200MB I believe on my phone. It might be a bit large, but as I do not have any way to guarantee that I will always have internet access I find it acceptable. I imagine this also would be perfect for residents and other hospital staff who often use Wikipedia at their workplace. I have two questions about it. i) is there an iOS app planned, and ii) do we have the approval we need to make the statement "Welcome to the Offline Medical Encyclopedia by Wikipedia" in the app description? Peter.C • talk • contribs 15:06, 12 June 2015 (UTC)

Yes to all of those. Doc James (talk · contribs · email) 22:59, 12 June 2015 (UTC)

Have created a page to coordinate the building of the app here Wikipedia:WikiProject Medicine/App Doc James (talk · contribs · email) 12:37, 13 June 2015 (UTC)

Cochrane protocals as refs

What do people think of these as refs . They provide an overview, have a DOI, but are not pubmed indexed. They are protocals for a systematic review that is planned. Doc James (talk · contribs · email) 05:06, 28 May 2015 (UTC)

they look informative, (in terms of non-PubMed indexed, perhaps we could make an exception in this case?)--Ozzie10aaaa (talk) 10:48, 28 May 2015 (UTC)

It depends on how the paper is used. A lot of this paper has more to do with the culture of research in a field and a summary of what research is routinely conducted. I am not seeing a lot of health claims, so WP:MEDRS would not apply to most of it anyway.

This is a statement by professionals. A large amount of health information is not PubMed indexed, particularly in areas like this where the health information is what professionals in the field take for granted that everyone knows. It is a good paper for what it is. Blue Rasberry (talk) 13:48, 28 May 2015 (UTC)

So what I've used these protocols for is not any kind of claims to the effectiveness of the intervention, but simply the background information in the article. I've read a ton of Cochrane reviews and the background seems to be on par in quality with other reviews - so I think it's worthy of exception provided it's only being used for background. Emily Temple-Wood (NIOSH) (talk) 21:21, 28 May 2015 (UTC)

Okay. I am happy than. Doc James (talk · contribs · email) 12:23, 30 May 2015 (UTC)

Yay, thanks for getting this all clarified! :) Emily Temple-Wood (NIOSH) (talk) 02:15, 4 June 2015 (UTC)

This issue has come up once before. The concern was that no-one was sure if the protocol has yet undergone a peer review. Matthew Ferguson (talk) 13:16, 13 June 2015 (UTC)

Discussion notification: Gender identity disorder article

Notification to LGBT and Medicine wikiprojects of discussion at Talk:Gender identity disorder#Gender dysphoria as commonly recognisable and less judgemental name.

Greg Kaye 22:57, 13 June 2015 (UTC)

Note: I altered the heading of this section by adding ": Gender identity disorder article" to it so that it is specific as to what the section is about and will be easier to locate once archived. Flyer22 (talk) 23:21, 13 June 2015 (UTC)

please give opinion, (I did)--Ozzie10aaaa (talk) 00:18, 14 June 2015 (UTC)

Definition of a Gene

As the Gene article is about to be GA reviewed, it might be useful to check that there is consensus on the definitions (Talk:Gene#Definitions). T.Shafee(Evo﹠Evo)^talk 01:15, 14 June 2015 (UTC)

Wikipedia:Good_article_criteria--Ozzie10aaaa (talk) 10:47, 14 June 2015 (UTC)

Discussion notification Sex article

Notification to LGBT and Medicine wikiprojects of discussion at Talk:Sex#Sex, facing ambiguity relating to a potential move/renaming of this article. Greg Kaye 13:50, 14 June 2015 (UTC)

WikiProject Anatomy should be informed as they have an interest in the article as well--Ozzie10aaaa (talk) 15:44, 14 June 2015 (UTC)

Making Sense of Allergies

Fyi, Making Sense of Allergies (published last week)

In my view at least, public information documents like this worked up by scientifically/medically reputable charities such as Sense about Science (similarly, say, to Cancer Research UK) can provide valid reliable sources conceived for the general public that is our primary readership. Cheers, 109.155.60.103 (talk) 09:33, 15 June 2015 (UTC)

For example for the fiscal year ending 5 April 2008, the trust received £145,902 in donations. Disclosed corporate donations comprised £88,000 with pharmaceutical company Astra Zeneca donating £35,000 ..? --Ozzie10aaaa (talk) 09:50, 15 June 2015 (UTC)

(...fwiw, that's quoted somewhat out of context.) 109.155.60.103 (talk) 11:07, 15 June 2015 (UTC)

Sense about Science is far from similar to Cancer Research UK. -Roxy the black and white dog™ (resonate) 11:17, 15 June 2015 (UTC)

There are some good reviews that cover this information. "The prevalence of reported penicillin allergy is 10% in the general population. However, more than 90% of these patients are found not to be allergic to penicillin after skin testing."

Some people love saying they are allergic to stuff. Doc James (talk · contribs · email) 11:20, 15 June 2015 (UTC)

Smallpox was / is an infectious disease

Discussion is occurring here Doc James (talk · contribs · email) 10:47, 15 June 2015 (UTC)

give opinion (I did)--Ozzie10aaaa (talk) 14:11, 15 June 2015 (UTC)

Route of administration articles + template

Route of administration and {{Routes of administration}} aren't harmonized; I figured I should mention it here in the event anyone wants to take a stab at making the template and article consistent/complete. Some of the links in {{Routes of administration}} are directed to an article on an anatomical region instead of an article on the route of administration associated with that region. Some routes of administration also lack an associated article on the topic or an article exists but ambiguously refers to the route of administration (e.g., title+lead vs scope mismatch, as in the epidural example below).

As an example, for the articles involving drug administration into the spine, there's spinal anaesthesia which covers spinal administration of anesthetics (into subarachnoid spaces), "intrathecal (administration)" (into subarachnoid spaces; the scope of intrathecal appears to be redundant with spinal anaesthesia), and epidural administration (into epidural spaces). I already moved the epidural article to epidural administration and copyedited it and the epidural (disambiguation) page accordingly to address this particular case. I wouldn't mind creating, moving, or redirecting the remaining articles myself; however, I'd need a comprehensive reference on medical/recreational routes of administration to do so since I've never formally studied topic.

So... anyone interested in tackling this issue or linking/emailing me such a reference? Seppi333 (Insert 2¢) 19:28, 12 June 2015 (UTC)

Well, I found a comprehensive list at the FDA's website. It doesn't have a lot of information about each one, but my quick count indicates 111 different routes (who knew that there were so many?), not including "unknown" and "unassigned" (which are relevant for their paperwork, but not actual routes). WhatamIdoing (talk) 03:11, 13 June 2015 (UTC)

That's really all I needed - I can just look up specific routes based upon that. Thanks!

Seppi333 (Insert 2¢) 16:40, 14 June 2015 (UTC)

First of all, if dosage form and route of administration are actually the same, as the links say, then merge them or otherwise make their diff clear. For example to me as a Reader.-DePiep (talk) 20:33, 13 June 2015 (UTC)
I'm interested from another angle. I edit the {{Drugbox}} infobox, which of course has parameter | routes_of_administration= (RoA). I'd like to introduce a code-list for this RoA, so that easy input produces a correct and well-linked infobox test. (for example: |routes_of_administration=iv does show: Intravenous injection). So I'd like to know if there is a set of top options, we can abbreviate into code. WhatamIdoing counted 111 options, that's too much. But we can make a shortlist of ~20 obvious/common options, that would be nice. An example set is the pregnancy category options. -DePiep (talk) 20:49, 13 June 2015 (UTC)

Routes of administration are determined by the dosage form of a drug; e.g., a tablet can't utilize nasal administration (assuming it isn't powderized and insufflated), but it could be taken via the oral route or rectal route. Some dosage forms are typically associated with specific routes of administration; e.g., a suppository typically involves a rectal/vaginal route.

Based upon all the medical papers I've read, I'd say the most common general routes of administration used in preclinical research or in humans are oral administration, intraperitoneal administration (i.p.), intravenous administration (i.v.), intramuscular administration (i.m.), subcutaneous administration (s.c.), nasal administration (this includes insufflation (medicine), which involves a specific dosage form, but insufflation is commonly used in drugboxes), inhalation (this includes recreational routes like smoking), topical administration, and rectal administration, assuming I haven't forgotten any. In preclinical research, injections into specific brain structures or regions (e.g., intra-accumbal or intra-striatal) is a very common route of administration, but I don't know of a catch-all term for this type of administration.

Buccal administration and sublingual administration aren't utilized medically anywhere near as much as the oral route in humans, but certain drugs like nicotine polacrilex utilize these as a primary route due to oral bioavailability issues. Intrathecal and epidural administration are notable routes, but they're also comparatively less common to those listed above, as they're applied by doctors/clinicians in hospitals/clinics instead of for use by the general populous.

Assuming I haven't forgotten any notable/major drug routes, the remainder are typically associated with very particular drugs/agents or are simply uncommonly used as a medical route in humans due to the feasibility of using a more standard drug route, like oral intake. Intravaginal administration is a notable medical route for particular drugs/devices and a somewhat less common recreational route; e.g., see History and culture of substituted amphetamines#Recreational routes of administration.

It's probably worth coding an abbreviated input for all of the above routes (excluding the preclinical one I noted). Seppi333 (Insert 2¢) 16:40, 14 June 2015 (UTC)

Seppi333 thanks. Working on this sidenote of template shortcuts, when there is news I'll be back here. Leave it to you for the OP merge issue. -DePiep (talk) 20:59, 14 June 2015 (UTC)

No problem. :) Seppi333 (Insert 2¢) 21:30, 14 June 2015 (UTC)

What about transdermal administration? It isnt a terribly common method but it is the way nicotine patches are administered and I would think it would be of interest to the general reader. Ca2james (talk) 18:52, 15 June 2015 (UTC)

We should be very careful here, as there are still, I expect, strong national preferences. Doctors on the old big ocean liners used to keep common drugs in 3 forms: injectable for the Americans and Germans, pills for the British, and suppositories for the French. Johnbod (talk) 14:29, 15 June 2015 (UTC)

Are you sure those were the doctors and not the bartenders? ;-) LeadSongDog come howl! 15:08, 15 June 2015 (UTC)

Johnbod that is so, so interesting. Thanks for sharing that. I had no idea administration practices were that variable. Jytdog (talk) 15:12, 15 June 2015 (UTC)

I like the comprehensive list provided by WhatamIdoing. I like DePiep's ideas of considering a merge between dosage form and route of administration, and of prioritizing about 20 main options over the list of 100+ options. The anatomical listings in the current version of the template seem more organized than the system being used in the current version of the article. I think right now, the article is sorted by a mix of anatomical and technique sortings. It would be ideal to derive the sorting system from an existing published source. I have not looked for one, but I see no obvious candidate at a glance. Blue Rasberry (talk) 17:39, 15 June 2015 (UTC)

Concerning refs

Some questionable refs are being used per this discussion here Talk:Phimosis#Content. Others thoughts? Doc James (talk · contribs · email) 22:45, 15 June 2015 (UTC)

please give opinion--Ozzie10aaaa (talk) 09:56, 16 June 2015 (UTC)

diabetic microvascular complications/review

recently published, I deem this a good read, enjoy.--Ozzie10aaaa (talk) 18:45, 16 June 2015 (UTC)

Seeking comment on a new kind of drug infoboxes

Quick facts Clinical data, Trade names ...

Lorcaserin
Clinical data

Trade names	Belviq
Other names	APD-356
AHFS/Drugs.com	Monograph
MedlinePlus	a613014
License data	US FDA: Lorcaserin
Routes of administration	Oral
ATC code	A08AA11 (WHO)
Legal status
Legal status	US: Schedule IV
Pharmacokinetic data
Protein binding	70%^[1]
Metabolism	Hepatic (extensive)^[1]
Elimination half-life	11 hours^[1]
Excretion	Renal (92.3%), Faecal (2.2%)^[1]
Identifiers
IUPAC name (1R)-8-chloro-1-methyl-2,3,4,5-tetrahydro-1H-3-benzazepine
CAS Number	616202-92-7^N
PubChem CID	11658860
IUPHAR/BPS	2941
ChemSpider	9833595^Y
UNII	637E494O0Z
ChEMBL	ChEMBL360328^Y
Chemical and physical data
Formula	C₁₁H₁₄ClN
Molar mass	195.688 g/mol g·mol⁻¹
3D model (JSmol)	Interactive image
SMILES Clc1cc2c(cc1)CCNC[C@@H]2C
InChI InChI=1S/C11H14ClN/c1-8-7-13-5-4-9-2-3-10(12)6-11(8)9/h2-3,6,8,13H,4-5,7H2,1H3/t8-/m0/s1^Y Key:XTTZERNUQAFMOF-QMMMGPOBSA-N^Y
^NY (what is this?) (verify)

Close

Please see the example drug infobox to the right. This is in the lead of Lorcaserin, and similar boxes are in most drug articles.

In my opinion drug infoboxes currently are not human readable. They present information which is useful to librarians and chemists and not for general readers. I like the information they present, but I think it should not be put at the top of the article because the top of the article is reserved for priority content. A few months ago I made the same comments at Infobox medical condition, where I said I would like those boxes to similarly become human readable.

The resolution to that discussion was that I proposed to make about 10 new infoboxes as a demo and trial them. I also said that I would look into keeping the data in Wikidata, so that short text descriptions could be developed and translated into more languages. I have been unable to find good sources for making infoboxes for diseases, but I recently found out that I have content for drug infoboxes. See the top of this PDF.

I have some mockups here -

I was thinking of putting any one of these in the Lorcaserin article, and moving the current drug infobox from the lead to somewhere lower in the page. Does anyone have any comment on this information or this plan? Blue Rasberry (talk) 22:22, 11 June 2015 (UTC)

I think you make a very valid point, in terms of the drug infoboxes and the "general reader"...which is useful to librarians and chemists and not for general readers...my comment would be- I support such a move in regard to the Lorcaserin article--Ozzie10aaaa (talk) 22:33, 11 June 2015 (UTC)

I am not a fan. These are blocks of text that do not work well in infoboxes. This is content that belongs in the article proper

Other issues 1) you are using brand names rather than generic names 2) you refer to US data like it is global "When was the drug approved? June 2012" 3) it is writing in a how to format "If you don't lose at least 5% of your body weight after 3 months, stop taking the drug, because it is unlikely to work" 4) You have even written the brand name in all caps BELVIQ

Stuff like route of administration, key trade names, and pregnancy category work in infoboxes. I agree that the identifiers are chemist centric.

Putting massive lists of uses or side effects in infoboxes is not a good idea IMO. We could make it more general public centric by adding stuff like a) onset of action b) duration of action c) some measure of price Doc James (talk · contribs · email) 22:49, 11 June 2015 (UTC)

Would support splitting the box into two and moving identifiers and chemical / physical data to a box lower in the article. The drug infoboxes in the lead would do well with shortening. So I support User:Bluerasberry ideals behind his suggestions. Doc James (talk · contribs · email) 22:54, 11 June 2015 (UTC)

James' point 2 is not really exclusively related to these mock ups, the current infobox is also like this.

My concern about this is that it looks too much like a patient information leaflet. I feel the current one looks more professional and encyclopedic. Matthew Ferguson (talk) 07:02, 12 June 2015 (UTC)

We state US for some data that is US specific. Doc James (talk · contribs · email) 10:07, 12 June 2015 (UTC)

First of all, this is not the proper forum to be having this discussion. This discussion should be happening at WP:PHARMA, not here. I also agree with Matthew that the current format looks much more professional and encyclopedic. Wikidata, especially in its current form, is not a substitute for displaying the data. This data needs to be displayed in an organized format in an infobox. I would also strongly oppose removing the chemical structure. Drugs are chemicals and our audience includes chemists, pharmacologists, and students who are interested in chemistry. Boghog (talk) 10:32, 12 June 2015 (UTC) The chemical structure and IUPAC name is priority content and it is essential that this is displayed at the top of the article. The "Clinical data" section also contains essential information. The other information is less critical and appropriately it is displayed later in the infobox and therefore by definition is no longer at the top of the article. Boghog (talk) 10:58, 12 June 2015 (UTC)

FWIW, I think pharmacists are the correct people to decide how to display information about medication. I think the information is informative and is important for the primary users of the information - who are likely to be chemists and pharmacists - and the medical and/or human readable version is likely best left in the text. Clearly not all information is applicable to a general reader, but I don't think we can assume that medics are the primary users of such information. Not that anyone should care what I think as a non-medic, non-pharmacist, of course. JMWt (talk) 10:41, 12 June 2015 (UTC)

Revisions

Quick facts Systematic (IUPAC) name, Clinical data ...

Lorcaserin
Systematic (IUPAC) name
(1R)-8-chloro-1-methyl-2,3,4,5-tetrahydro-1H-3-benzazepine
Clinical data
Trade names	Belviq
License data	US FDA
Pregnancy category	contraindicated (US)
Legal status	Schedule IV (US)
Route of administration	Oral
Onset of action	30-60 minutes (guess!!!!)
Duration of action	48-72 hours (guess!!!!)
List price for month supply	US$300 (US)
Medical uses
Weight loss along with diet and exercise.^[2]
Who is it for
Overweight adults (body mass index of 27-29.9) who have a weight-related health problem; obese adults (BMI of 30 or higher)^[2]
Interactions
Drugs which affect serotonin levels. This includes antidepressants, anti-anxiety drugs, triptans for headache, and dextromethorphan^[2]
Other options
Diet and exercise programs, other medications approved for weight loss, and weight loss surgery for people with severe obesity (BMI greater than 40)^[2]
v t e

Close

Please see THIS REVISION in context with a second chemical infobox. Visit on a mobile device for maximum effect. I would appreciate more comments about splitting the current infobox into two, one for consumers and in the lead and one for chemists and further down the page. The consumer box is here, and see it in context in THIS REVISION.

In response to the comments above -

@Doc James: - You said you were not a fan, then you gave a lot of constructive criticism. I retained what you said should be kept and mock-added some more. Referencing needs to be sorted for some of this. The US-centricity is not just in my proposal, but deeply built into the current system. I removed what US-centric content I had added and retained what was already there. I greatly shortened the text descriptions. I might like to shorten them more so that whenever possible they can eventually be reduced to terms which can be translated in Wikidata, but this is what I have now. I would like more feedback on the extent to which you think this could be developed further.
@Matthew Ferguson: What is the problem with Wikipedia articles looking like a patient information leaflet? Patients use them for information, right? I am trying to emulate Google's Knowledge Graph. They have these well developed for medical conditions (Google search hepatitis, for example) and will start doing drugs soon enough. I copied a patient information leaflet to make this.
Patients are not the (only) audience. It is not the encyclopedia's role to provide patient advice. Matthew Ferguson (talk) 19:43, 12 June 2015 (UTC)
Although the more recent offer above does look better. Matthew Ferguson (talk) 19:49, 12 June 2015 (UTC)
None of that is patient "advice", and it actually is an encyclopedia's role to provide patient "information". WhatamIdoing (talk) 03:21, 13 June 2015 (UTC)
We should provide encyclopedic coverage for general readers. It is outside of this remit to pander to a particular kind of reader such as someone wanting to make health decision or who wants to compare prices of various meds. Matthew Ferguson (talk) 13:12, 13 June 2015 (UTC)
I don't think that we necessarily should exclude "non-general" readers. To the extent that it's feasible, we should provide encyclopedic coverage for all the readers, including not only people who are reading for entertainment and unfocused knowledge acquisition ("the general reader"), but also readers who are affected by a health condition, readers that know someone affected by health conditions, students writing papers for school about the cost of drugs, and more – even for professionals, to the extent that professionals want encyclopedic information rather than review articles. We should always write encyclopedia articles, and we should never write for one group to the exclusion of the others (especially not to the exclusion of general readers), but I don't believe that I can agree that the general reader is, or should be, the sole audience.

Also, what you deride as "pandering to someone wanting to make a health decision" sounds an awful lot like what general readers keep asking for. Infobox and bullet-point summaries are handy for people who don't have college-level educations. And the general reader might, of course, be interested in things like how much of his tax dollars are being used to buy which drugs, why some drug was in the news recently with complaints about overuse, or which drug's revenue or patent expiration dates suggest that it would be a better investment target. I don't see anything in this list that wouldn't interest some general readers. WhatamIdoing (talk) 16:02, 13 June 2015 (UTC)
It is a matter of presentation. The current infobox looks more professional and deserving of an encyclopedia. Matthew Ferguson (talk) 09:05, 14 June 2015 (UTC)
If your concern is appearance, then there is no need to change appearance just to add information that non-professionals can understand. WhatamIdoing (talk) 04:30, 15 June 2015 (UTC)
@Boghog: If this proposal progresses then it will travel to other forums, with WP:PHARM being the next stop. Wikidata is not a substitute for displaying data but when single words and items need to be repeatedly translated into 100+ languages, like "contraindication - pregnancy", I think it is nice to start looking at how Wikidata might someday get safety alerts to a lot of languages which are not presenting them. I want to serve chemists, and I want this information in an "infobox", but right now "infobox" usually means "box in the lead". Go to Lorcaserin on your phone and you will see that this chemistry information comes up first. I do not want this information there - I want consumer and patient information first. Please see this revision I just presented. I preserved all the information you wanted kept, but I put it further down the page. I opted to put the chemical structure in the lower box even though you said it was priority content, and I repeated the IUPAC name. Things can be moved, but please comment for now if you think this is a disruption to chemists to have this content moved into a different box further down the page.

OK, I do see your point concerning the mobile version. But I think the problem is not specific to the drugbox but equally applies to all articles. What really is needed is the WP:ALT equivalent of a lead tailored for mobile devices (e.g., the display should start with lead sentence accompanied by a condensed graphic). The graphic for drug articles should be the chemical structure rather than the IUPAC chemical name. Boghog (talk) 20:04, 12 June 2015 (UTC)

Boghog, when you say that the chemical structure should be prioritized, you're assuming small molecules, right? And why should the chemical structure be prioritized over what the drug looks like to the average person (e.g., everyone from pharmacy techs to patients to caregivers to hospital cleaning staff)? WhatamIdoing (talk) 03:21, 13 June 2015 (UTC)

WAID, yes, I was meant small molecules and not biopharmaceuticals. Concerning your second question, we previously had an extensive discussion and the consensus at that time was to generally keep using chemical structures in the drug box rather than pill images. I really think the problem is not with the infobox per se but how it is displayed on the desktop vs. mobile view. IMHO, the current version of {{infobox drug}} is appropriate for the desktop. One solution is to make all the sections except for the chemical structure collapsable and set the initial state to "uncollapsed" in the desktop view and "collapsed" in the mobile view. However there does not currently appear to be a way to do this. Boghog (talk) 08:02, 13 June 2015 (UTC)

I'm not surprised that a discussion involving mostly people with advanced degrees in health and chemistry concluded that chemical structures were appropriate. Are you?

I don't think that our actual "general readers" (invoked to justify several answers) would agree with them, though. The typical general reader can't make heads or tails of a chemical structure.

I agree about the mobile vs desktop problem. Infoboxes (and much of our article layout) was designed on the assumption that everyone would have a desktop computer with a fairly large screen. (Collapsing causes WP:ACCESS problems.) WhatamIdoing (talk) 16:12, 13 June 2015 (UTC)

Even if the chemical structure cannot be understood by everyone, it still defines what the drug is, hence it is essential that a picture of it be included. Our audience is broader than the general reader, it also includes more technically inclined readers. If the structure is not included at the top of the article, one may lose the attention of later which would be a disaster since these types of readers are the most likely to contribute content to drug articles. Concerning collapsing content, it should be noted that all content except the lead is collapsed in the mobile version. My suggestion mentioned above is to collapse the more detailed parts of the drug infoboxes only when displayed in the mobile view. The desktop view would remain unchanged. Currently this suggestion cannot be implemented because there does not seem to be any support for detection of what view is being used and conditional collapsing based on that view. Boghog (talk) 08:29, 14 June 2015 (UTC)

I read and edit using the mobile version and I wanted to clarify how things are displayed. In the mobile version, top-level sections are collapsed. Thus the mobile reader can click on and read each section independently, the display is scaled for the device, and the whole page need not be loaded. (Note that project- and user-space pages using a tabbed display, like WP:GA, don't display things this way and are unreadable on mobile devices).

However, anything collapsed with a show/hide link doesn't show up at all on the mobile version. The only way a mobile reader can see those links to click them is if they load the desktop version of the page. This loads the whole page in tiny font, which kind of defeats the purpose of a mobile view. Collapsed content is better avoided until or unless it displays properly on mobile devices.

Another reason collapsed content should be avoided is that it doesn't play nice with accessibility devices. Ca2james (talk) 18:36, 15 June 2015 (UTC)

At least with iOS, the exact opposite is true. Content in infoboxes that is collapsed in the desktop view is not collapsed in the mobile view. This is the main reason that I always use the desktop view, even when viewing on my smart phone. What I was suggesting above is that detailed sections of infoboxes should be treated exactly like sections in the mobile view (collapsed by default but definitely viewable if uncollapsed). Boghog (talk) 19:56, 15 June 2015 (UTC)

JMWt You said, "Not that anyone should care what I think as a non-medic, non-pharmacist, of course." Yes, everyone here should care. Almost every health decision is made by non-medic, non-pharmacists. Even people under intense medical guidance make many medical decisions with their friends and family, and non-medic opinions are very important here. There are other ways to cut this, like for example, everything under "what is this drug for" could be cut. However, the facts under that are all in different places in the article, and I would like for those questions to be answered immediately first thing in the article. Further comments are welcome, even if it is to confirm what you said before.

Well, I prefer this version than the others, but I still think the proper place to discuss this is with the pharmacists. For me, the danger with elevating even general medical advice to the top of the page is that potential patients take this to be prescriptive advice for their own condition - having a box which is focussed on the pharma is much less likely to do that, and I believe will barely be noticed by non-pharma visitors to the page. For me, the issue here comes down to who it is that will a) use the page and b) which wikiproject will manage the template. Most of the time, I'd suggest that accuracy and precision on the chemical basis of the medication is a top priority and should be at the top of the page - in an emergency, pharmacists may turn to wikipedia for information about a medication and that, for me, trumps information supplied to potential patients. They need to know what it is, what the chemical structure is, what the brand names are and so on. In the general way, I'd say medics are the proper people to edit pages on conditions and diagnosis, I believe pharmacists are the proper people to make major decisions about the layout of pages on medication. I therefore do not support the layout suggested in the templates offered above, although I do like the way they display on mobiles. JMWt (talk) 11:07, 13 June 2015 (UTC)

Ozzie10aaaa Thanks, acknowledged.

Thanks everyone. Blue Rasberry (talk) 19:05, 12 June 2015 (UTC)or

I think that we need to accommodate the chemist / pharmacist / medic, reader and the health patient / non-medic reader in the infobox since infoboxes are so prominent in mobile and also in other new devices like Google Glass. It would also be helpful to have research to better understand who the prominent audience of health / medical articles are: health professionals or the general public? I would assume the latter, but no reader should be preferenced as far as Infobox information in my opinion. It seems to me that it would be especially nice if each of these new proposed sections like “Medical uses” were a WikiData item. Otherwise, I also support the idea of also raising this as a discussion point in WP:PHARMA.OR drohowa (talk) 19:00, 15 June 2015 (UTC)

Prices

I like the addition of onset of action, duration of action, and price. Hope to be adding price info to Wikidata and than we could have a drop down menu for different countries. I am not sure if we are allowed to us IP addresses to geo locate people.

Medical uses for this new medication with a single use is easy as is the patient population. Try this for cephalexin or metoprolol and things will get way more complicated. Other options is basically asking to but the treatment of all diseases in which the medication is used in an infobox.

I like the "interactions" bit and would be supportive of adding it. A few others are working on this. Doc James (talk · contribs · email) 22:50, 12 June 2015 (UTC)

Should still have a picture. Doc James (talk · contribs · email) 23:01, 12 June 2015 (UTC)

There's some geolocation ability in banners, but I understand that it's a bit 'expensive', so it probably isn't going to be something that can run on every page view (especially for logged-out readers, because they all see cached versions). WhatamIdoing (talk) 03:21, 13 June 2015 (UTC)

：Great, thanks for putting this together BlueRaspberry, here are some thoughts:

I like the general direction you're going, especially with a preference towards patient information
Could 'identifiers' be moved ultimately to a form of Authority Control template, like we do for biographies?
It's a pity to see some of the pharmacokinetic data go, that's very useful from my point of view and something that is eminently 'Infobox-able'
Am a general fan of your template except for these two fields: alternatives and price.
Alternatives -- I think these are better covered in the parent articles for the topics. I shudder to think about the large amount of editing (and potential edit wars) for any drug related to an even moderately controversial topic -- I'm thinking weight loss, depression, pain control drugs here, in which there are simply too many and too nuanced treatments to summarize accurately on an 'alternatives' field in the infobox in every single drug article
Price -- pregnancy data and contraindications are fairly similar everywhere, but not price. As a non-US editor and reader I'm not a big fan of things where are explictly US and not very translatable to my own country (keep in mind that this is not just an issue of exchange rates, but how health systems are structured). Also surely the price a person is charged varies greatly between venue and circumstance?

Overall I think you're doing something very useful! --Tom (LT) (talk) 07:41, 13 June 2015 (UTC)

LT910001

2 and 3 - I also do not want identifiers and pharmacokinetic data removed, but instead, I just want this information out of the lead and put anywhere else. Did you see the revised mockup? The information is still there, just split into two infoboxes. Yes, one model could be to turn part of an infobox into an authority control navbox. First I wanted to check consensus on having a split from consumer info and catalog info, then after that, if people wanted the split then each box could be designed to match its purpose.

4 - I do not feel strongly about the fields to include. My position is that the infobox should be for health care consumers and my supporting argument is that the majority audience for this content is that audience. The fields you criticize are consumer fields, and I think they are candidates for inclusion, but I recognize that because of limited space and quality concerns only the best options should be included. Right now I do not even know what all the consumer information options are. I might suggest that we identify all options then choose the best five or so.

You raise good points. I do not have thoughtful responses, but other people here do. Blue Rasberry (talk) 17:23, 15 June 2015 (UTC)

With drug prices my hope would be to have them added to Wikidata and than allow people to set what country they are in to view their specific countries data. The initial displace will show the range from Wikidata of the lowest and highest prices. Still a lot of work before that is ready to role out. Doc James (talk · contribs · email) 09:35, 13 June 2015 (UTC)

I struggle with "price" too, not just for the differences between jurisdictions but the differences even within the US. Different insurance companies get different actual prices after discounts based on their negotiating power, and different consumers pay very differently based on their specific insurance plan. (our article on Prescription drug prices in the United States is woeful btw and something i have had on my to-do list forever) What price would be put there? Jytdog (talk) 11:13, 13 June 2015 (UTC)

This contains a bunch of pricing info plus I have all the pricing info from Doctors Without Borders that they update yearly. But as I said this is a long way from being ready to be rolled out. Doc James (talk · contribs · email) 12:35, 13 June 2015 (UTC)

I'd assumed that "price" would either be an average actual cost (not the out of pocket expense for an individual consumer) or a general category (think "$$$$" on a restaurant review). For the average actual cost, there are several data sources available per country. WhatamIdoing (talk) 16:34, 13 June 2015 (UTC)

{{u|Doc James]] that drugs.com page says: "This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2014. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays." Seems random to me. I don't understand what a single number in that field would mean. Jytdog (talk) 16:57, 13 June 2015 (UTC)

an approximation as to cost (would be its meaning)--Ozzie10aaaa (talk) 17:06, 13 June 2015 (UTC)

I know I'm not part of this project but it's on my watchlist. I strongly disagree that a price for drugs should be included in an infobox for several reasons. First, drug prices are not static and they aren't the same around the world, let alone in the US. This means that any value will be inaccurate for some - perhaps many - readers and therefore meaningless to them. An approximation that isn't accurate is not useful. Second, an infobox is supposed to summarise the article information and the cost of drug production along with how the price is determined isn't a part of these articles. Finally, broad categories (like restaurant costs) aren't much better than a specific value. Since the approximations are not accurate, comparing them isn't meaningful. Even if they could be compared, the range of drug costs is so great that there is no good, easily understandable value scale. For example, aspirin costs pennies per dose while chemotherapy drugs can cost thousands of dollars. I guess you could use a logarithmic scale but that's not easy for most people to understand. Ca2james (talk) 20:00, 13 June 2015 (UTC)

Agree pricing info is completely unsuitable for an infox. I'm dubious about the general approach adopted in this draft, as infoboxes are only suitable for clear, uncomplicated information without caveats or conditions. Johnbod (talk) 20:16, 13 June 2015 (UTC)

Ca2james, your statement comparing aspirin to the most expensive drugs is exactly what I believe our articles should contain. If a drug is cheap, like aspirin, then we ought to say so. Prices That's proper encyclopedic information. Similarly, if it's astonishingly expensive, like Eculizumab, then we ought to say so, too. We don't need to provide exact prices, but a range from "inexpensive" through "pricey" and to (or beyond) "mortgage your house" would be appropriate encyclopedic information.

Furthermore, if information about the costs of these manufactured goods aren't present in the article, then we're violating WP:NPOV with our healthcare (or anti-business) bias and need to change that. Drugs are things – things that get made by businesses and sold for money to people who use them. An encyclopedia article about things should say what they are, how they're made, who makes them, and how they're sold, marketed, distributed, used, and disposed of. Maybe we need to update MEDMOS#Drugs to explicitly recommend content about manufacturing and selling these things that do, in fact, get manufactured and sold. WhatamIdoing (talk) 01:13, 15 June 2015 (UTC)

No other kind of article in WP regularly discusses the prices at a per-purchase level. Our article on Meat doesn't give the price/lb of chicken breasts; our article on chickens doesn't give the price slaughterhouses pay for birds; our article on milk doesn't give the price of a gallon of 2%; our article on the Chevrolet Camaro doesn't give the MSRP much less what you get at a dealer; the T-mobile article doesn't tell me how much an iphone costs me nor a cell phone plan. This proposal is deeply awry from my perspective. Something like annual worldwide sales of a drug (or maybe even broken down country by country but that is hard info to find) would be maybe more workable and more encyclopedic. I am not understanding this at all. Jytdog (talk) 02:18, 15 June 2015 (UTC)

(edit conflict) I'd have thought that it would be well-nigh impossible to find sourcing for drug prices beyond "recouping r&d and clinical trials costs". Pharmacy companies keep their drug costing formulae secret. More important than the exact price is whether or not a drug is patented or available in generic form. Drugs under patent always cost more than generics, after all, and the difference between those prices is significant.

Drug prices change, and they're different from country to country and even within the US, which makes the information unsuitable for a global encyclopaedia, as I've outlined above. Even if you could find a reliable source for worldwide drug pricing that could be automatically updated (because otherwise price information will be time-consuming to maintain), Wikipedia articles don't typically include the price of the widgets in the articles on those widgets. If a drug is just another kind of widget, then its price doesn't belong in the its article. Ca2james (talk) 02:27, 15 June 2015 (UTC) (updated 04:59, 15 June 2015 (UTC))

Jytdog, why would you expect an article about a telecommunications carrier to tell you what the price of a particular telephone is? If you want to know the price of an iPhone, don't look at T-Mobile. Look at iPhone, where you will find quite extensive information about the prices of various models over time. You will also find that the very broad article Personal computer#Average selling price has a solid paragraph about the average cost of computers sold with Microsoft Windows installed. Kindle Fire covers pricing in significant detail in the lead. IPad#iPad series has the launch price for every single iPad listed in the table. We even have extensive information on how much electricity costs around the world. There are hundreds, if not many thousands, of similar examples in articles. I had no trouble finding these at all.

Wikipedia clearly does list prices at the per-purchase level, and I really see no reason why we shouldn't give some indication of per-purchase costs for some drugs (when we have decent sources, and some are listed above). I have not yet heard a single good reason for us to withhold the fact that aspirin and ibuprofen are cheaper NSAIDs than celecoxib. It's true everywhere in the world, and it's relevant to a wide variety of users, including healthcare professionals, patients, economists, policymakers, students, and potential investors. The exact prices change over time and may vary by country, but aspirin is never more expensive than any COX-2 inhibitor. So why should we omit that information? WhatamIdoing (talk) 06:26, 15 June 2015 (UTC)

WAID makes a very good point, even further, readers would (logic dictates) be more interested in their health than other things (cars, phones, etc) with regards to pricing, in this case medication--Ozzie10aaaa (talk) 09:39, 15 June 2015 (UTC)

Yes when it comes to pricing one needs to state the 1) year 2) company selling it 3) country in which it is sold 4) dose / amount. But this is no different than other consumer products. The price of milk in different parts of the world is exceedingly interesting and definitely deserves mention (we in Canada have some of the highest prices as we have three companies that have formed a monopoly and are protected by government tariffs of 300%). The US has much less expensive dairy.

For the iPhone we state "The two initial models, a 4 GB model priced at US$499 and an 8 GB model at US$599 (both requiring a 2-year contract), went on sale in the United States on June 29, 2007" When people are reading about hep C treatments the fact that costs vary from $20,000 to $100,000 depending on which option is chosen and were in the world is important. It is important for policy makers as well as people paying for it themselves. Those who have coverage / government supplied medical should know just how much money is being paid on their behalf.

Initially we need to more consistently have a section under society and culture that discusses cost. I would like this sort of data on Wikidata. There would be a drop down menu to select the country by flag. With respect to others paying a part of the price, this does not mean that a price is not being paid in the end. Doc James (talk · contribs · email) 11:01, 15 June 2015 (UTC)

Doc James and WAID first i hear you - I do - on the "this is very expensive" vs "this is very cheap" thing, as well as the importance of economics to everything. There is a lot of important and hard-to-sort out "stuff" about drug pricing - like why the generics market in the US remains so broken even though it is meant to be as raw competition-based as you can get in such a regulated field. Why are there ever shortages for generic drugs with strong demand and why would the price of generic drugs increase faster than inflation? Not to mention issues that happen with proprietary drugs like the the avastin vs lucentis debate in the UK.

i could live with nuanced/exact content like Doc James suggests, but even with that, there is still tons of meaningful variation -- see this report from the NYC govt on prices for common drugs at pharmacies in NYC - p iii in the printed number, p 7 of the pdf has a summary chart. Example for those who don't want to click: "The Bronx: the highest cash price obtained for a month’s supply of Celebrex was $102.00, while the lowest was $60.19 — resulting in a $41.81 difference." The data is very heterogenous.

And in any case, what you are describing Doc James, is very far from slap-a-number-on-it "infobox" kind of content. Actual drug prices for payors and the final price for patients in the US are very hard to sort out; I believe (but am not sure) that countries with universal health care are much, much easier and you can say more meaningful high level things. To get that kind of data and keep it up to date we would need some kind of data feed. I don't know where we could get that. IMS Health is a famous source of that kind of data but I don't imagine they would donate it. Worth asking?

in general our content on the nuts and bolts of providing health care is pretty weak, as we have discussed before. I recently met a young woman who just got her PhD in Medical anthropology, a discipline I didn't even know existed. I wonder how we could attract more of them and more experts in Health economics... Jytdog (talk) 14:18, 15 June 2015 (UTC)

I completely agree that information regarding drug pricing must be included in the body of the article and that drug pricing isn't something that can be completely and accurately summarized with a single number in an infobox. If it isn't possible to find one single price for a drug within one small region (the Bronx, in the example above), how can including one single price in an infobox be anything but misleading? The same problem exists even if ranges are used: if, say, the range break is $100, would Celebrex fall into the $100+ range or the <$100 range? No matter which range it was given the article, the information will be misleading. Including misleading information is worse than including no information. Instead of trying to put this information into an infobox, why not focus on adding costing and pricing information to the article body? Ca2james (talk) 15:34, 15 June 2015 (UTC)

There's no need to provide retail prices for every neighborhood, and it wouldn't be encyclopedic even if it were easy to do. For the US, we should use something like Medicaid's National Average Drug Acquisition Cost (which is updated weekly and monthly) to find average costs on a national scale, produced by experts in the subject. Go download the latest data set from Medicaid and look at it: In the US, the average cost of celecoxib (generic) last week was 57¢ for 50 mg, $1.10 each for 100 mg, $1.77 each for 200 mg, and $2.69 each for 400 mg. The brand name was more expensive than the generic. And look again: Standard 325 mg aspirin pills cost about 1.0 to 1.5¢ each last week, and what used to be called "baby aspirin" cost 2.7¢ each. There are several ways to present that information; one is a table for each dose, showing prices for multiple countries. Another is a statement of the range ("from 57¢ to $2.69 per pill, depending on dose"). We could provide a general summary ("usually about a dollar or so, depending upon dose") or a comparison ("A celecoxib pill is approximately 100 times more expensive than an aspirin").

But my point is that high-quality and very detailed information really does exist about prices for drugs, no matter what you read in magazines about it all being very hush-hush. There are 23,000 lines in that spreadsheet, so I expect that it covers more than one thousand different drugs. The US is not the only country on Earth that produces that information. We should be including that information.

(Doc James, if you want a data feed, I'd start with Medicaid's dataset. It appears to be set up for automated processing.) WhatamIdoing (talk) 01:49, 16 June 2015 (UTC)

Nice find WAID; I didn't know that existed. Much better than IMF. Jytdog (talk) 11:39, 16 June 2015 (UTC)

If, as with some cancer drugs, the cost is exceptionally high, placing them out of reach of many patients even in the West, and that has been the subject of RS (it need not always be MEDRS-compliant) coverage, then certainly that should be added, in a section in the text. In England these matters are done in public in the National Institute for Health and Care Excellence approval process, generating lots of RS coverage in some cases. Equally that aspirin is dirt cheap can easily be referenced. But I think we should avoid saying much about the mass of mid-price drugs, for the reasons set out above, plus the need (which we may not be able to cope with) to update when they come off-patent etc. We should just cover the extremes. Johnbod (talk) 15:51, 15 June 2015 (UTC)

I agree with John's earlier point that information in infoboxes needs to be clear-cut and free from nuances. From that perspective drug prices simply aren't suitable for inclusion in an infobox. It would be possible to write something about them in the body of an article, where variations between and within countries could be discussed, but I would urge caution in terms of quoting values because of the potential for such information to go out-of-date. At present we only have agreement to use Wikidata values in infoboxes on the English Wikipedia, and Wikidata does not yet allow the storage of data that has units (which obviously includes cost). At some point in the future, we may be able to have automatically updating price information in the body of an article, but I'm afraid we're still quite some way short of that ambition right now. --RexxS (talk) 17:31, 15 June 2015 (UTC)

The idea of having an up-to-date dataset of prices by location / currency / dose / amount as a Wikidata item that then could be loaded into a dropdown menu in an infobox is very appealing, but it doesn’t make sense to have a price header before we have that Wikidata aspect completed, as the prices would be widely off for the many reasons stated above. If people are interested in pursuing the discussion of price data on Wikidata in the context of this infobox or health, I would be interested in participating in that discussion, but it might be more useful to branch that off into WikiData Talk page or a separate section of this page or perhaps other WikiProjects (?) OR drohowa (talk) 18:53, 15 June 2015 (UTC)

References

[1]
[2]
Informulary (2013). "Drug Facts: BELVIQ (lorcaserin) for weight loss in adults who are overweight" (PDF). Consumer Reports. Consumer Reports. Retrieved 8 June 2015.

Source request (Wiley online library)

Most active content project

Someone just pointed out this page which shows we are the most active content project by number of edits excluding bots. Great being able to come here for a second or third opinion. Doc James (talk · contribs · email) 12:55, 16 June 2015 (UTC)

Another perspective is at Wikipedia:WikiProject Directory/All. From the first link (the "database report" WikiProject Medicine is the most popular after deletion sorting in terms of number of edits in articles within its scope. From the WikiProject Directory in the link I just shared, WikiProjects for AfC and AfD have more participants, then Military History and Medicine both have 130 active partcipants, but Military History has 145,000 articles and 3200 editors of articles to medicine's 27000 articles and 900 editors. Football, film, and video games also have close numbers to medicine and military history.

Considering the numbers there are different ways to interpret the meaning of this. I think it is fair for anyone to say "WikiProject Medicine is the most popular and active WikiProject on English Wikipedia". In a different sense it would be fair to say the same about those other four but it would not be reasonable to say that about any other WikiProjects. The functionary Wikiprojects probably should not be compared to the subject matter ones. They are support important but participation in those kinds of projects is very different from subject area participation. Blue Rasberry (talk) 14:06, 16 June 2015 (UTC)

lets keep it going!--Ozzie10aaaa (talk) 14:28, 16 June 2015 (UTC)

Thanks Blue had not seen that data. It just came out. Doc James (talk · contribs · email) 15:41, 16 June 2015 (UTC)

Wikipedia:WikiProject Directory/All tells you how many pages we've tagged, how many people have made at least two edits to a "WPMED" page (like this one, including all subpages) during the last 90 days, and how many people are editing the articles that we've tagged (at least five edits during the last 30 days). That last column lists people we interact with, but not necessarily participants in the project itself. And for those that didn't notice, if you click on the numbers, you get a list of the individual editors' names. WhatamIdoing (talk) 23:22, 16 June 2015 (UTC)

Related to this, I noticed that the other recently revived WikiProjects database report, Wikipedia:Database reports/WikiProject watchers does not list WikiProject Medicine at all. How curious that it could be the most active content project yet have fewer than 30 watchers! :) I suspect this is because WP:MED is not in Category:Active WikiProjects, but I'm not certain. I left a message to that effect at the report talk page. --Ryan (Wiki Ed) (talk) 16:40, 16 June 2015 (UTC)

There are 790 watchers per Doc James (talk · contribs · email) 00:01, 17 June 2015 (UTC)

Wikipedia to promote stock health photography

File:Mooddisorder.jpg

a person sitting at the beach

Just today DIS Magazine documented the reuse of a particular image submitted to Wikipedia to encourage its reuse.

In this case the person is not identifiable. I continue to wonder what it would mean for Wikipedia to have stock photos with identifiable models which could be used to illustrate health articles. The issue is described at meta:Grants:IdeaLab/Stock photos for health organizations. Blue Rasberry (talk) 15:12, 15 June 2015 (UTC)

Interesting, but I'm not sure what to make of it. Generally I don't approve of stock images, and find our use of art as in Gout, Suicide, etc. far more appealing. Something similar wouldn't be hard to find for mood disorder.

But that might just be a general aversion, not specifically on Wikipedia. I like the quote by Clive Thompson in Wired last year:

Stock photography needs to die. In his 1946 essay “Politics and the English Language,” George Orwell argued that clichéd language produces clichéd thinking. Using a stale image, as he’d put it, “makes it easier for us to have foolish thoughts.” Stock photography imprisons us in the same cognitive jail. Its intentionally bland images are designed to be usable in many vaguely defined situations

-- CFCF 🍌 (email) 17:54, 15 June 2015 (UTC)

Sorry, I should have read you proposal first, and I realize you're tackling some of the major issues with stock art: trying to promote diversity and realism. I like your idea as long as you keep that focus. -- CFCF 🍌 (email) 18:08, 15 June 2015 (UTC)

I like the idea period,good proposal--Ozzie10aaaa (talk) 18:13, 15 June 2015 (UTC)

There are several major issues with this particular image. First is BLP in assigning a living person as having a mood disorder. Second is the WP:OR in attributing a "mood disorder" to someone in this pose. Third this particular "artist" has caused major disruption previously through his spamming of images throughout the project for use in an "art project" consisting of the use of his pics in Wikipedia. I am not sure which is the most troubling, but they all need to be addressed. -- TRPoD aka The Red Pen of Doom 18:42, 15 June 2015 (UTC)

I am not a stock photo fan. They are not terribly educational. If someone wishes to take this on I do not have a problem with it. Even happy to bring some scrubs. I do not see it as important enough to need funding. Doc James (talk · contribs · email) 22:49, 15 June 2015 (UTC)

This proposal is worth trying to see if something useful occurred, but under no circumstances should pictures like "a person sitting at the beach" be used to illustrate a medical condition, and any stock health image project must not involve the photographer of the above picture due to his misuse of Wikipedia for self-promotion. The outline at the grants page would need a lot of work to produce a worthwhile result because merely arranging people pretending to be patients and doctors is very unlikely to produce helpful images—the caption would have to say "this is a fake photo showing someone pretending to have malaria" (or whatever the condition is)—not very helpful. Johnuniq (talk) 23:46, 15 June 2015 (UTC)

Technically, that's a real photo of a real person expressing a human emotion. It's not necessarily useful for Wikipedia (it's a bit on the "decorative" side), but if you used it, then you'd give it a caption like "Mood disorders can cause intense emotions", or something verifiable like that. WhatamIdoing (talk) 21:39, 16 June 2015 (UTC)

This type of image use has been addressed at this project before; see Wikipedia talk:WikiProject Medicine/Archive 40#Image of narcolepsy? See the Narcolepsy article and Wikipedia talk:WikiProject Medicine/Archive 40#Alleged leprosy image. In that former discussion, which I started, Lesion, Johnuniq, Anthonyhcole, Hordaland and WhatamIdoing all weighed in. WhatamIdoing cited WP:Pertinence, stating, "The image need not be verifiably a person with the exact condition. Indeed, it need not even be a photo of an actual human. It only needs to be an image that looks like what we're trying to illustrate." Flyer22 (talk) 23:57, 15 June 2015 (UTC)

I also meant to WP:Ping Axl and TenOfAllTrades as editors who weighed in. Flyer22 (talk) 01:55, 16 June 2015 (UTC)

I dont think it "looks like what we're trying to illustrate" - it looks like a man sitting on a beach. And we should definitely not be promoting bad pop psychology that sitting on a beach is a mood disorder. -- TRPoD aka The Red Pen of Doom 12:58, 16 June 2015 (UTC)

I think that the point of the image is that a person with their head down and hands in their hair is a common expression of frustration and/or despair. That stated, I'm know that the image can be interpreted differently by different people, and I'm not arguing for it to stay. Flyer22 (talk) 05:11, 17 June 2015 (UTC)

To reiterate what James said previously: if you plan to do this at Wikimania I could bring a decent camera, a tripod and some scrubs as well. As for props, I think it may be hard to pull off at Wikimania regardless of budget, but we could always try to get in touch with some Mexican Wikipedians. I know for one that Wiki Borregos had a partnership with a medical school, we could maybe message Thelmadatter? (Images donated: commons:Category:Photos_donated_by_Spring_2013_Medical_English_class_ITESM_CCM-- CFCF 🍌 (email) 06:12, 16 June 2015 (UTC)

Call me paranoid, but what's the plan for making sure people understand the implications of the license terms? (Being realistic, hardly anyone here really deeply understands the licenses they're contributing under.) Seems easy for people to volunteer to take pictures because hey, cool, props! without really thinking about what it means to irrevocably license identifiable photographs for reuse with modification. I'd be concerned that some good-faith participants might be setting themselves up for trolling. Opabinia regalis (talk) 06:40, 16 June 2015 (UTC)

I find that extremely unlikely as Wikimania attendees in general are quite well-versed with the licensing terms. -- CFCF 🍌 (email) 08:23, 16 June 2015 (UTC)

Opabinia regalis is right to worry. CFCF, I have never been able to find a position or consensus in the Wikimedia community on personality rights. When models are featured in a way that makes their personal lives the subject of the work then their personality rights must be considered. So far as I can tell, no open knowledge or free culture organization has produced a waiver for models to release personality rights. there are lots of sample waivers available online from many photography studies and I could adapt one. In my opinion personality rights need to be released when an image is used on Wikipedia in a way that can be disparaging. In this case, there can be social stigma about having a mood disorder, so this image has worked because the model is not personally identifiable.

I think it would be an interesting precedent to have Wikimania participants sign a model release and append that to photos uploaded to Commons. Having a collection of diverse people modeling as doctors and patients would be a real help for small health organizations which do local publishing and have to pay for stock art. Google image search shows what it means to be a patient and I know a photo shoot at Wikimania would not be less weird but at least everyone would not be white. Blue Rasberry (talk) 14:28, 16 June 2015 (UTC)

Sorry for the delay in responding. We dont have a partnership per se... we've talked to the health sciences school on various occasions but nothing has developed as of yet. I taught a Medical English class in 2013 and I have a couple of biotechnology students with me doing community service hours with me right now. I can forward this discussion to them to see who might be interested in following up. BTW, for our major editathon last year some students on a different campus uploaded photos on social issues, some of which overlapped into health, for example https://commons.wikimedia.org/wiki/File:Depression_in_women.JPG (similar to the one here and was published in an issue of Science Times 3 days after being uploaded to Commons)Thelmadatter (talk) 21:37, 16 June 2015 (UTC)

(edit conflict) Images showing identifiable people get tagged with a warning about their personality rights, which they do not release or give up (and in some countries, may not be able to do so). End users of images, such as small health organizations, are required to use the images in ways that do not contravene the rights of the people depicted. I would encourage most models to retain their personality rights.

Adherence to personality rights rules may be somewhat imperfect, as with all things. For example, I'm aware of one person whose picture on Commons is used as an illustration for a page about how women of her ethnicity have a problem with eating disorders. But that seems to be a typical type of "misuse": an image placed on a page about a condition, but not text saying "here's a person with this condition" (unless the person really does have that condition). If she complained, they would probably take it down, and I suspect that people are familiar enough with the concept of stock art (and in her circles, with Commons) that they wouldn't necessarily attribute any meaning to it. WhatamIdoing (talk) 21:39, 16 June 2015 (UTC)

Regression Therapy draft (again) - healing modularities

As I expected, this has been resubmitted, and is now awaiting review for acceptance as an article at User:Andy Tomlinson/sandbox. It now does not appear to make claims about curing asthma or autoimmune disorder, although the titles of some of the sources still do.

If there is no possibility of this Draft ever meeting the requirements of Wikipedia:MEDRS or else ever moving into a subject area where it would not be required to meet MEDRS, perhaps we should nominate the Draft page itself at Wikipedia:MFD? Arthur goes shopping (talk) 14:17, 16 June 2015 (UTC)

this comment has already been left...It appears the previous reviewer is mistaken, this topic is not equivalent to Past life regression (to which "Regression therapy" now redirects). This topic is about a mainstream(?) psychology technique for exploring one's past, not a pseudoscience exploration of "past lives" in the sense of reincarnation and all that. Next reviewer to look at this please examine it in that light and ignore previous decline. MatthewVanitas (talk) 14:22, 16 June 2015(UTC) ...however we still at least need one reference that is MEDRS(Wikipedia:Identifying_reliable_sources_(medicine) )--Ozzie10aaaa (talk) 14:39, 16 June 2015 (UTC)

I would agree with Matthew, the comparison with the other topic is something of a red herring. However, would we really be happy with this article just by its having one single MEDRS compliant reference, while still having many many paragraphs of statements sourced by dozens of citations to the Heart Press? Arthur goes shopping (talk) 14:59, 16 June 2015 (UTC)

no...but the point is it does need one MEDRS ref (to begin and build on)I don't see any...I think it should be declined perhaps you should seek a second opinion? thank you--Ozzie10aaaa (talk) 15:13, 16 June 2015 (UTC)

@Ozzie10aaaa: Yes, that is why I have come here. Arthur goes shopping (talk) 10:10, 17 June 2015 (UTC)

It's a POV fork of repressed memory/recovered memory therapy. Wikiisawesome's comparison to past life regression wasn't inappropriate, either, because if you check the sources (the Earth Association of Regression Therapy or the Heart Press books), they do focus on past life regression. It should definitely be deleted. KateWishing (talk) 15:24, 16 June 2015 (UTC)

repressed memory/recovered memory therapy are just techniques. This article is about a therapy that uses many different types of techniques and is practiced by 500 to 600 therapists internationally. In the same way as hypnotherapy and psychotherapy have separate articles from the techniques they use the same should applies to this article. It not an article on medical practice so why is MRDRS needed? The only medical comment is " Psychiatrists and medical doctors have used regression therapy to resolve some medical conditions unresponsive to traditional medicine" and uses the reference of 6 medical doctors around the world who independently found this. The subject of past lives is misleading. Anything that looks like a past life is dealt with as a story. Also the article has 57 references from psychologists, psychiatrists and two secondary articles/books on regression therapy.--User:Andy Tomlinson (talk) 16:42, 16 June 2015 (UTC)Andy Tomlinson (talk) 16:08, 16 June 2015 (UTC)

The whole article falls under WP:MEDRS because psychotherapy is a form of medicine. KateWishing (talk) 16:14, 16 June 2015 (UTC)

The topic falls under WP:MEDRS as it stands. Even if the article were rewritten as a spiritual practice I doubt it would have the reliable sources. Stuartyeates (talk) 22:42, 16 June 2015 (UTC)

Need eyes on Masturbation - being reverted after deleting primary sources

Chocolate

Dr.Kent Brantly/AMA international award 2015

New Wikipedia Library donations

Autofil of refs

Emu oil

Can someone check an article for me?

Seeking comments on the placement of GMO safety consensus

Permit WP:Red links in WP:Navboxes?

Arteriosclerosis

De-wiki's in-house radiologist

More information Malfunctioning template ...

Malfunctioning template

The template Imagestack requires additional javascript-code. It doesn't work if javascript is switched off.

Esophageal web in barium swallow (scrollable)

Close

I came across Hellerhoff over at Commons, and found a treasure-trove of German-labeled radiographs. I found the scrollable images especially exiting. You can check out a really cool one at commons:User:Hellerhoff. -- CFCF 🍌 (email) 20:02, 18 June 2015 (UTC)

these images can be very useful in several articles (the one posted could be used at Upper_gastrointestinal_series )--Ozzie10aaaa (talk) 20:31, 18 June 2015 (UTC)

Cool. Needs a way to scroll through the images. That java is required is an issue. This needs to be fixed before we use them I think. Doc James (talk · contribs · email) 20:52, 18 June 2015 (UTC)

Came across some of these for a few articles, e.g. eagle syndrome. Generally advice is that sometimes good quality medical images can be found on commons, but difficult to navigate because the categorization is so chaotic. Matthew Ferguson (talk) 21:57, 18 June 2015 (UTC)

On the client side, JavaScript is available in almost every browser. To make it more usable the JavaScript for this widget makes use of the jQuery library and that's commonly available on our wikis. What is problematic is that using the mousewheel really requires an extra JavaScript library to make it compatible with all browsers and that's probably going to be a stumbling block if we want to use this in other language wikis. --RexxS (talk) 00:24, 19 June 2015 (UTC)

There are some kind admins at commons who helped me with the final JavaScript-code. I'm more a radiologist but a programmer even though I set up the basic version. You do not need the wheel, dragging with left is also possible.--Hellerhoff (talk) 07:32, 19 June 2015 (UTC)

Interesting, I imported the template to Template:Imagestack/Commons. As I'm not either a programmer I also ended up importing a number of multi-language modules. RexxS do you know if there is any way to get rid of the dependencies and to see if we can create something that is scrollable with the left mouse-button without taking this through the long process of importing that extension to en-Wiki? -- CFCF 🍌 (email) 11:12, 19 June 2015 (UTC)

Thanks for the help with the template Jackmcbarn! So, you can manually load the javascript by adding:

mw.loader.load('https://commons.wikimedia.org/w/index.php?title=MediaWiki:Gadget-ImageStack.js&action=raw&ctype=text/javascript');

to your common.js.

James do you know if you can install commons:MediaWiki:Gadget-ImageStack.js as an administrator, or would that need to go through a community discussion first? -- CFCF 🍌 (email) 16:07, 19 June 2015 (UTC)

Installing gadgets is accomplished via discussion at Wikipedia:Gadget/proposals - you need to read Wikipedia:Gadget first. But note that the gadget on Commons just loads the JavaScript into a page when required - you'll still need to get the full script installed somewhere and it's not generally done at mediawiki:Common.js for the English Wikipedia (unlike on Commons). I usually talk to Edokter for advice on where's best. I have a full copy of Hellerhoff's JavaScript in my User:RexxS/common.js and I'm trying to work around the problem of incompatibilities between the way browsers handle mouse scrolling. If I get a good solution, I'll ping you. --RexxS (talk) 17:16, 19 June 2015 (UTC)

Gadgets can be split into a loader and the full core script that is loaded on-demand, as we have done with a few gadgets already. So there is no need to stash the code in Common.js. Why hasn't Commons picked up on this technique yet? -- [[User:Edokter]] {{talk}} 19:04, 19 June 2015 (UTC)

Using epigenetics to completely remove memories of traumatic experiences

Nephritis

Liver disease /mechanism section

Toxic Joint Syndrome

Electronic cigarette

Drawing request

1st drawing:

Less serious adverse effects from e-cigarette use can include throat and mouth inflammation, vomiting, nausea, and cough.<ref name=Grana2014/> This text can be used for the drawing.

Possible 2nd drawing:

The most frequently reported benefits of e-cigarettes were reduced shortness of breath in comparison to traditional cigarettes, reduced cough, reduced spitting, and reduced sore throat.<ref name=Dagaonkar2014/> This text can be used for the drawing.

https://en.wikipedia.org/wiki/Tobacco_smoking#/media/File:Adverse_effects_of_tobacco_smoking.svg

Something like this above. This will be for the Safety of electronic cigarettes#Adverse effects section. QuackGuru (talk) 07:49, 26 May 2015 (UTC)

Who can create the drawings? A little help please. QuackGuru (talk) 19:44, 27 June 2015 (UTC)

QuackGuru might have more luck here Wikipedia:Graphics Lab/Illustration workshop. Matthew Ferguson (talk) 20:06, 27 June 2015 (UTC)

Thanks. QuackGuru (talk) 19:55, 29 June 2015 (UTC)

Image request

Hon Lik, the inventor of the modern electronic cigarette.<ref name=Demick2009/> This text can be used for the image or drawing.

http://www.gettyimages.com/detail/news-photo/the-inventor-of-the-electronic-cigarette-hon-lik-smokes-his-news-photo/87962255

I request an image of the inventor of the e-cigarette for the Electronic cigarette#History section. QuackGuru (talk) 07:49, 26 May 2015 (UTC)

I assume its this ...in regards to the drawing (drawing request in the first section) you might try User_talk:VHenryArt...this is the thread when they originally introduced themselves Wikipedia_talk:WikiProject_Medicine/Archive_58 (its almost at bottom of the page)--Ozzie10aaaa (talk) 10:42, 26 May 2015 (UTC)

See Wikipedia talk:WikiProject Medicine/Archive 58#Artist. It could be an image or a drawing for Hon Lik. User:VHenryArt, are you interested in making a drawing of Hon Lik? QuackGuru (talk) 07:02, 29 May 2015 (UTC)

Herbert A. Gilbert, inventor of the earliest electronic cigarette.<ref name=Bellis2015/> This text can be used for the drawing.

http://www.cleancigarette.com/what-is-the-ecigarette/electronic-cig-inventor.php

I request a drawing of Herbert A. Gilbert for the Electronic cigarette#History section. QuackGuru (talk) 08:53, 29 May 2015 (UTC)

I don't think you can get what you want. If someone looks at a photo and copies it by hand (e.g., makes an oil painting out of it), then it's a derivative and the original copyright still applies. And if the copy isn't close enough to the original for copyvio to apply, then it won't look like the person enough to be usable. WhatamIdoing (talk) 22:17, 29 May 2015 (UTC)

Someone can create new drawing at different angles. QuackGuru (talk) 21:04, 3 June 2015 (UTC)

yes, I think what Whatamidoing indicated still applies...it would be a copyvio...IMO--Ozzie10aaaa (talk) 21:13, 3 June 2015 (UTC)

Thanks for thinking of me, but I am not really a portrait artist. I do more medical, scientific, and technical work. To comment on the topic of copyvio, I agree with the others that it is a risky move, with regards to copywrite, to do a portrait from a copywrited photograph. An artist could produce a unique portrait using multiple references, though, without being in violation, so long as the finished piece is unique and not a copy of any of the references. To do this would probably take a considerable amount of time (especially from someone like myself who does not do portraits often). Plus, "uniqueness" is somewhat open to interpretation and that is where the risk comes in. Should the copywrite holder of any photograph deem the piece to be too much like his/her material, the artist is likely to have to prove in court that it is not. Regardless of the outcome, it would be costly to have to build a case and go to court. This case is a good example: Obama 'Hope' Poster. VHenryArt (talk) 00:17, 13 June 2015 (UTC)

If this had been a request that was actually announced where it should have been: One of the electronic cigarette pages, then I could have been helpful with such an image, since i was just at a conference where Hon Lik was a speaker. Why is this being discussed/requested/deciderd here? --Kim D. Petersen 22:12, 24 June 2015 (UTC)

Request Uploads

https://www.flickr.com/photos/skooksie/17199255616/

https://www.flickr.com/photos/lwr/16163676905/

https://www.flickr.com/photos/jeepersmedia/18748617245/

https://www.flickr.com/photos/23748404@N00/9491763732/

Thanks. QuackGuru (talk) 05:57, 16 June 2015 (UTC)

I believe this is the link --Ozzie10aaaa (talk) 09:30, 16 June 2015 (UTC)

No medical references in "addiction" articles listed in Category:Behavioral addiction

Resolved

- nothing sketchy or entirely unsourced remaining. Seppi333 (Insert 2¢) 10:40, 22 June 2015 (UTC)

I'm still working on addressing the ambiguity in a number of articles in which dependence and addiction are used interchangeably, so I don't really have the desire to salvage any article content which I find blatantly stupid and which lacks medical citations.

That said, I started to sifting through Category:Addiction and Category:Behavioral addiction to fix any incorrect categorization of dependence/addiction topics and noticed a number of unusual addiction entries involving various behaviors in the latter category. I've just started to work through these - the ~~three~~ 4 I've gone through so far had a complete lack of reliable medical references. In particular:

Articles with addressed issues

Virtual reality addiction (somewhat new) - I deleted all the text and redirected to video game addiction.
Love addiction - there's only one MEDRS-quality review on this topic on pubmed and it concluded that current evidence doesn't support this addiction model; I ended up deleting most of the article, as it contained a large number of medical claims without medical citations. Pubmed reviews containing that term
Sex and love addiction - I read a few sentences in this article, looked at the refs, and then deleted all the text + replaced it with a redirect to love addiction for the reasoning in my edit summary.
Information addiction - ~~WP:PRODed for reasons listed in the prod template~~ redirected to Internet addiction as suggestion in the discussion below
Television addiction - minor copyedits + added medical review. Should be ok now.
Hypermobility (travel) - deleted every medical claim/citation to it. Removed from category. No pubmed coverage
Compulsive talking - deleted relevant text associated with an addiction. Removed from category. Left {{MEDREF}} there. No pubmed coverage
Workaholic - deleted statements / citations relevant to addictions/medical claims. Removed from category. Left {{MEDREF}} there.

I could probably use some help sorting through these categories since I doubt the lack of medical referencing is confined to just these articles...

Articles that appear ok

Other articles in the category that aren't listed above may still have problems.

- Seppi333 (Insert 2¢) 20:48, 14 June 2015 (UTC)

- Updated Seppi333 (Insert 2¢) 05:20, 17 June 2015 (UTC)

- Updated Seppi333 (Insert 2¢) 08:28, 21 June 2015 (UTC)

the article Problem gambling is ICD-10/F63.0 ( will look at references)--Ozzie10aaaa (talk) 10:04, 15 June 2015 (UTC)

What about all the references that point to a biochemical cause in the brain? ...shoot, I just was reading about this. I'll take a time travel trip back through my editing history because I know I found it....OH! Its in the Sexual Intercourse article in some new content I added.

Bfpage |leave a message 19:19, 15 June 2015 (UTC)

Here are two sources I used:

<ref name="Probstvan Eimeren2013">{{cite journal|last1=Probst|first1=Catharina C.|last2=van Eimeren|first2=Thilo|title=The Functional Anatomy of Impulse Control Disorders|journal=Current Neurology and Neuroscience Reports|volume=13|issue=10|year=2013|issn=1528-4042|doi=10.1007/s11910-013-0386-8}}</ref>
<ref name="Natural and drug addictions">{{cite journal | author = Olsen CM | title = Natural rewards, neuroplasticity, and non-drug addictions | journal = Neuropharmacology | volume = 61 | issue = 7 | pages = 1109–1122 |date=December 2011 | pmid = 21459101 | pmc = 3139704 | doi = 10.1016/j.neuropharm.2011.03.010 | url = }}</ref>

Bfpage |leave a message 19:39, 15 June 2015 (UTC)

those are both very good reviews for the Problem gambling article,--Ozzie10aaaa (talk) 19:52, 15 June 2015 (UTC)

Thanks for the help! Seppi333 (Insert 2¢) 18:21, 17 June 2015 (UTC)

Information addiction seems to essentially describe internet addiction. Matthew Ferguson (talk) 20:56, 15 June 2015 (UTC)

Redirected it to that page. Seppi333 (Insert 2¢) 05:20, 17 June 2015 (UTC)

Kumdang-2

Sudden cardiac death

Historical content subject to MEDRS?

At Kombucha, it is being claimed that "[Kombucha] was prized 220 BC during the Tsin Dynasty for its detoxifying and energizing properties" is a biomedical claim and therefore subject to MEDRS. I was hoping to get some clarity on this. Thanks, petrarchan47 คุ ก 06:45, 21 June 2015 (UTC)

(Note: this has also been raised at WP:NPOV/N#History_of_Kombucha_.3D_POV.3F) From the opening of MEDRS: "it is vital that the biomedical information in all types of articles be based on reliable, third-party, published secondary sources and accurately reflect current medical knowledge" (my bold). So while of course it's fine to detail historical information according to our general WP:PAGs, care needs to taken to ensure anything which bears on current medical knowledge is properly sourced. Otherwise we have problems with statements of the type "in the 1950s, there were many successful reports of the use of rife machines to cure cancer", which from time to time have been attempted with the justification that historical observations don't need MEDRS. Alexbrn (talk) 06:59, 21 June 2015 (UTC)

Sticking to the matter at hand, "Kombucha was prized 220 BC during the Tsin Dynasty for its detoxifying and energizing properties" bears on 220 BC, nothing current about it. I'd be interested to hear from others, as I am pretty sure you are either not understanding this guideline, or are misusing it. petrarchan47 คุ ก 07:07, 21 June 2015 (UTC)

It's fine so long as it's clearly stated as being knowledge relevant to that time, i.e., "for its ... properties" is not acceptable. Instead, what would be is "for the detoxifying and energizing properties which it was thought to possess at that time" is. The former represents currency in the medical portion of that statement. The latter does not. Seppi333 (Insert 2¢) 07:19, 21 June 2015 (UTC)

We have WP:MEDDATE for this type of thing; but it can be a case-by-case basis. Flyer22 (talk) 07:22, 21 June 2015 (UTC)

If it is something people believed, it must be presented as a belief, not as a fact. Doc James (talk · contribs · email) 08:04, 21 June 2015 (UTC)

Why doesn't this edit solve the issue? By last count this very small wording issue is now being discussed at the article Talk page, NPOVN, and here. Why is this still being discussed? Zad68 15:03, 21 June 2015 (UTC)

The edit was reverted for being POV (that's why it went to the NPOV NB). It was claimed at that NB that the statement required MEDRS, so it seemed this project talk page would be the best place to get clarity on this. This thread isn't about solving the issue, it's about helping me to understand the MEDRS guideline. My question is specific: how does a statement about the beliefs of people in 220 BC - taken straight from the review - fall under the "biomedical information" category when it is clearly ancient history? This has nothing to do with POV, and it's doubtful people at the NPOV NB have a better understanding of MEDRS than the folks here. Does this make sense? If there is a better way to handle these separate concerns, let me know. MEDRS is not a very well understood or accessible guideline. In fact it has been suggested that a tutorial on MEDRS would be helpful, since it is causing a lot of confusion and making it difficult for non "medical editors" to participate in article building the way we did a few years ago. petrarchan47 คุ ก 15:58, 21 June 2015 (UTC)

I don't think that this falls under MEDRS at all. Alexbrn's edit (which is still in the article) makes it a little clearer (although it probably needs to lose the scare quotes), but "what people believed 2200 years ago" is not WP:Biomedical information. This kind of information should come from a history book. And before anyone asks, antique claims that something "rectifies the humours" also do not constitute biomedical information. WhatamIdoing (talk) 03:04, 22 June 2015 (UTC)

Requested move for "Substance dependence" → "Dependence"

Time to stop displaying each individual archive in Template:MedTalkheader ?

Template:PMID3

This is up for deletion in case anyone is interested. Discussion here. There's apparently a new template that's easier to type that offers the same external link, but no internal one. Sarah ^(talk) 19:32, 22 June 2015 (UTC)

Why do we not simply use cite journal templates? Having so little data in the ref is a problem IMO. Doc James (talk · contribs · email) 19:55, 22 June 2015 (UTC)

Ease of use is important for simply getting it introduced, but it should promptly be replaced by substituting a more substantial citation that provides robust redundancy against error, vandalism, etc. In most cases {{cite journal}} is the best answer for WPMED, though some editors would disagree. Even one other parameter, such as |title= vastly improves the robustness of the citation.LeadSongDog come howl! 21:01, 22 June 2015 (UTC)

this is a template for talk pages, not articles. Cite templates aren't even relevant to the discussion. Seppi333 (Insert 2¢) 01:00, 23 June 2015 (UTC)

Exactly. This template was never intended to be used in articles. Only on talk pages where a short link to a in-text citation is adequate to get the point across and where including a full citation might be overkill. Boghog (talk) 16:03, 23 June 2015 (UTC)

It is used in article space though. If there is a bot that would auto replace this template when used in mainspace I would support keeping it. Doc James (talk · contribs · email) 10:50, 24 June 2015 (UTC)

As far as I can tell, this template has only been used in a single article, Veganism compared to the dozens of uses on talk pages. It probably is not worth the effort to write a bot script to detect a highly unlikely occurrence. However it is straight forward to detect which name space this template is included (see for example {{Namespace detect}}), and if it is used in article space, it would display an error message (for example PMID3 error, this template should not be used in articles). Combined with the following caution on the {{PMID3}} template documentation page:

This template is only intended for use on talk pages. For articles, please use {{cite journal}} or equivalent instead.

should be enough to deter most editors from including this template in article space. Would this be sufficient? Boghog (talk) 12:09, 24 June 2015 (UTC)

Sure. We should add that to all three of the Template:PMIDs IMO Doc James (talk · contribs · email) 13:03, 24 June 2015 (UTC)

Well, sure, but why bother? This template has 50ish transclusions and was used in one article with otherwise manually formatted citations. The problem being solved here is....? The odd article or two might have citations in a slightly unusual format? This discussion plus the TfD must be more words than the collective set of talk page posts using this template. Yes, I know I'm making it worse... ;) Opabinia regalis (talk) 00:02, 25 June 2015 (UTC)

I think I will soon nominate this template for the Wikipedia:Lamest edit wars/Templates ;-) In any case, I have now added code to generate an error message if the template is used in an article. I have also added support for multiple PMIDs, something that the PMID magic word does not do. These changes should address the two major arguments that have been raised against the template, overlinking and that the template is redundant. Boghog (talk) 05:48, 25 June 2015 (UTC)

The multi-PMID function is a great idea. In a non-lame world I'd complain about generating unnecessary errors in mainspace, but I can live with a red bike shed. Opabinia regalis (talk) 09:07, 25 June 2015 (UTC)

(←) Almost everyone who'd supported deletion has now changed to neutral or keep, and keep has a truckload of support. I think a bold admin could close this. Adrian J. Hunter^{(talk•contribs)} 12:46, 25 June 2015 (UTC)

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