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I'm staying out of substantive editing of this article based on past experience with obvious partisans (being one is not necessarily a bad thing - I am one on other biographies) involved in biographical entries. However, I am mystified at the amount of effort expended regarding the citations about Barnes' work since this is a biographical article and not an article about hypothyroidism. When I actually visit Wikipedia's hypothyroidism entry I find no mention of Barnes' work. I would suggest that efforts towards presenting his theories are better suited to inclusion in the appropriate wikipedia entry on the malady where those who understand such things can weigh in on them (and I am not such a person). I construe the investment of effort in bolstering Barnes' theories in this article as a stealth mechanism to insert them in wikipedia if they can't stand up to communal editor scrutiny in the appropriate entry. I have no problems with them being listed bibliographically in an article about the man, but the effort to expand, bolster, and defend them in detail seems to be not only a misplaced effort, but also an inadvertent barrier to others who may wish to edit the article as stated in arguments above. It's almost impossible for all but an experienced editor to wade through the wiki-code. My observation, not my fight. -- Quartermaster ( talk) 14:48, 7 May 2009 (UTC)
Solved: The Riddle of Illness ; 4th edition McGraw-Hill (July 20, 2006) [1] Page 4: "I am thankful that I stumbled across the monumental research in this area of Broda O. Barnes, MD, PhD, one of the world's foremost authorities on the thyroid gland."
I've reverted a series of edits which (I believe) another editor (Verbal) had also taken issue with. There are multiple issues here; I'll hit a few for discussion here, and maybe we can make some progress along the lines of WP:BRD.
I think we can make the point that Barnes published in the mainstream medical literature and held a position at a major university without descending into the tone of a late-night infomercial. Part of it depends on using good sources, and part depends on our willingness to see this as an encyclopedia article rather than a chance to burnish Barnes' image. MastCell Talk 22:12, 12 May 2009 (UTC)
WP:PEACOCK#Do not hide the important facts: "In some contexts, the fame or reputation of a subject may be an objective and relevant question, better supported by a direct source than by drawing inferences indirectly based on other facts (which would constitute original research or synthesis). A sourced statement that the subject is "famous", "well known", "important", "influential", or the like may be appropriate, particularly to establish a subject's notability in an introductory sentence or paragraph."
WP:PEACOCK#Exception for quotations: "Do not impose Wikipedia style guidelines on sources that we cite or quote. It is proper to say, "Music critic Ann Bond wrote that Mozart was a great composer," or "Smith said, 'Senator Jones's acceptance of this contribution is a major scandal.'" Such indirect or direct quotations may be useful in presenting important perspectives, especially on contentious subjects,..."[emphasis mine]
To be clear, I have no problem with saying that "Several authors of alternative-medicine books have described Barnes as a major authority on the thyroid gland." That would be accurate and reasonably encyclopedic (if you leave out the more egregious self-published and unreliable sources that keep finding their way into the article). MastCell Talk 06:10, 13 May 2009 (UTC)
Tim hit the nail on the head: if Barnes is as notable, famous, influential, etc as you repeatedly insist, then let's produce the objective evidence of that notability - maintream awards,recognition, obits, etc. On the other hand, if Barnes is chiefly notable as the inspiration for an alternative medicine cottage industry - as the currently available sources indicate - then we should reflect that.
As a separate issue, please be clear: WP:NPOV specifically prohibits using "minority-view" articles to rewrite content from a minoritarian perspective. Whether the article is hypothyroidism or Broda Otto Barnes, the mainstream scientific view is the mainstream scientific view. We of course go into greater depth about Barnes' claims in his article, but we don't "limit" the voice of modern scientific knowledge to a few brief words - after all, our goal is not to promote Broda Barnes, but to provide a useful overview of the current state of human knowledge. MastCell Talk 18:41, 13 May 2009 (UTC)
←For easy reference here is WP:NPOV#Undue weight:
WP:NPOV/WP:UNDUE: "In articles specifically on the minority viewpoint, the views are allowed to receive more attention and space; however, on such pages, though the minority view may (and usually should) be described, possibly at length, the article should make appropriate reference to the majority viewpoint wherever relevant, and must not reflect an attempt to rewrite majority-view content strictly from the perspective of the minority view. Specifically, it should always be clear which parts of the text describe the minority view (and that it is, in fact the minority view). The majority view should be explained in sufficient detail so the reader understands how the minority view differs from the widely-accepted one, and controversies regarding parts of the minority view should clearly be identified and explained." [emphasis added]
I read the underlined section as meaning the majority viewpoint is to be clear, but limited and brief compared to the minority viewpoint. Otherwise, it would just be another majority article.
Also, you seem to have ignored my request for sources on your "alternative medicine" claims. Maybe you haven't had time to do that research, so I'll give you a few days to do that.
However, the impasse created by unrepentant reversions of specific good and unchallenged edits makes it impossible to proceed further with editing. Without the ability to make good edits, progress is impossible. Discussion is moot since it is going around in circles, and nothing else can be settled by the accumulation of good edits. See that behavioral meta issue below. Milo 23:31, 13 May 2009 (UTC)
As to supporting Langer's book as "alternative medicine", I'm pretty sure that any reasonable, objective person looking at the book description, blurbs, and content matter will place it squarely under the aegis of alt-med. But fine: Langer is president of the American Nutritional Medical Association ( [4]), a distinctly non-mainstream organization ( [5]). He is mentioned and promoted solely on alternative medicine websites ( representative example). He's mentioned in "Alternative Medicine: The Definitive Guide". In fact, I'm feeling much less comfortable using Langer's book as an encyclopedic source at all; there appears to be a small walled garden of a handful of people promoting Barnes' claims at present, and we give them far more weight than is appropriate given this site's goals and policies. MastCell Talk 04:04, 14 May 2009 (UTC)
As to linking Langer to the organization described by Quackwatch, I have no idea how many organizations share this name. It would be uncommon, but not impossible, for someone to take on an organizational name without checking into its history. It is possible that Langer is the president of a different "American Nutritional Medical Foundation", but if multiple low-profile organizations share this same name, then it only serves to underscore the position of this material outside the realm of sources on which this encyclopedia should depend. I don't see a BLP issue here; rather, I think it's an essential part of evaluating sources, and one which you have repeatedly demanded. You are of course welcome to solicit outside opinions at the BLP noticeboard. MastCell Talk 17:53, 14 May 2009 (UTC)
Both Verbal and then MastCell have reverted sizable swaths of both newly written and other large blocks of content under color of
WP:BRD. But
WP:Vandalism policy trumps WP:BRD.
The problem is not a reverting of those specific items they objected to for explainable guiderule reasons. The problem is that everything I (and another editor) wrote was reverted. If one can't cite explainable guiderule reasons for each item reverted, it's
WP:IDONTLIKEIT which is not an acceptable reason for making any contentious edit, such as, during any revert.
Verbal noted in edit summary that some of my edits were good edits. Ok, one can't revert good edits, because it disrupts progress of the project. The first time it's probably a misunderstanding. But it's vandalism to do it again after that point has been explained.
It's also not possible to explain at talk why one wrote a 3.5K intro, when both good and objectionable portions were wholesale reverted.
The reason some editors thoughtlessly engage in wholesale reversion is because it's work to go through and pick out only the edits with guiderule-citable reasons for reverting them. Yeah, well, it was a lot more work to do all that writing. If you think it's 'too much work' to save the good edits, then don't do a revert.
So here's what's could happen if non-selective content removal happens again: Next time, with both parties having been warned, it's probably going to be clear-cut content removal vandalism, and I will have these options:
Milo 11:54, 13 May 2009 (UTC)
Wikipedia talk:Vandalism/Archive 6#blatant POV warriors who delete large portions of text:
..."Message from village pump:
Wikipedia:Vandalism#Types of vandalism
"Blanking
"Removing all or significant parts of a page's content without any reason, or replacing entire pages with nonsense. Sometimes referenced information or important verifiable references are deleted with no valid reason(s) given in the summary. However, significant content removals are usually not considered to be vandalism where the reason for the removal of the content is readily apparent by examination of the content itself, or where a non-frivolous explanation for the removal of apparently legitimate content is provided, linked to, or referenced in an edit summary." [emphasis added]
Removing good edits knowingly is vandalism. Removing them for WP:IDONTLIKEIT is frivolous. Verbal admitted to removing good edits. MastCell (above section, 22:12) apparently removed good edits by a vague claim of "overall" which violates "readily apparent by examination of the content itself". Use of "overall" is indistinguishable from a cover up of frivolous WP:IDONTLIKEIT. If permitted, claims of "overall" would excuse both frivolity and complex vandalism.
WP:Vandalism is policy. Reversions claimed by WP:BRD must still be specifically identifiable and nonfrivolously justified at talk. Milo 21:19, 13 May 2009 (UTC)
←I have real world to do, so I'm giving both of you a few days to cool off and rest up from tiredness. When I work on this again, edit by the rules and this issue won't be a problem.
Milo 08:18, 14 May 2009 (UTC)
All editors of this page should be aware that this article comes under the set that are covered by Wikipedia:Requests_for_arbitration/Pseudoscience#Discretionary_sanctions. Please read and familiarise yourself with this document. Tim Vickers ( talk) 16:18, 14 May 2009 (UTC)
I've (again) removed this material as poorly sourced. I disagree with both of the cited rationales for restoring it: letters to the editor of a medium-sized newspaper are not a reliable source of fact (perhaps, at most, of opinion, but even then they are far weaker than even an op-ed). And it would most certainly be a medical breakthrough if Barnes had discovered a "simple test that could detect iodine deficiency" through the skin. However, since this supposed breakthrough is utterly unsourced (so far as I can see) beyond this letter to the editor, it fails WP:REDFLAG. Basically, as with many of the issues with the article, it comes down to a lack of suitable, encyclopedic reliable sources.
I'd like to solicit some additional input. Am I mistaken in describing this as a letter to the editor? I can view only part of the text online. Assuming that it is a letter, do other editors believe this is suitable sourcing for a) a matter of fact and b) a fairly remarkable and exceptional claim? MastCell Talk 03:16, 19 May 2009 (UTC)
In a letter to the editor of The Charlotte Observer in 2005 a member of the public called XX stated that Barnes had used a test that he believed could detect iodine deficiency, which involved testing iodine being absorbed through the skin.
To some degree the slimming down that MastCell has done to the topic has improved readability, however, I think the pendulum may have swung too far the other way now. Specifically I think it is a mistake to have taken out the previously existing section on Heart Disease. Research on heart disease comprised arguably the biggest part of Barnes' research. He published 2 books specifically on the topic, plus the largest section of his New York Times best selling book "Hypothyroidism: the unsuspected illness"--as well as several peer reviewed papers on heart disease. In his lectures(available at the foundation) he also spends significant time on the topic. So to have a section on his pregnancy urine testing (though reported in TIME, it was a minor footnote in his career) but not have a section on Heart Disease seems an unbalanced view of his research. So what I'm proposing is bringing back the old section (which the wiki admin said was ok), and then opening it up for further edits and improvements. Does this sound reasonable? Mkronber ( talk) 18:42, 1 June 2009 (UTC)
I don't see a consensus to restore this section, so I have removed it pending further discussion. Verbal chat 07:34, 3 June 2009 (UTC)
In the sandbox section below I have posted Mkronber's 02:22, 3 June 2009 proposal edit to the article in the left column (don't edit) with an editable draft in the right column (do edit). Milo 18:03, 3 June 2009 (UTC)
Barnes devoted a significant part of his life's research into the cause of heart disease, and differed from the mainstream view on the etiology of it. [1] For many years he spent as much as 1 month per year in Graz, Austria, reviewing and researching autopsy reports in the city hospital, widely considered to be the oldest and most complete in the world. His study of over 70,000 of these autopsy reports spanning the war years of 1939-1945, lead Barnes to suggest that [[atherosclerosis] was not caused by diet and cholesterol as is widely believed, but instead by hypothyroidism. [1]
The widely accepted cholesterol theory of heart disease credits the drop in consumption of fatty foods during the war years for the drop in heart attacks, and the increase of heart attacks after the wars end with the resumed availability of fatty foods. [1] Barnes’ disputed this, claiming to show that in the war years when the rate of deaths from heart attacks dropped, the patients who were dying—-largely due to Tuberculosis--had in fact greatly accelerated rates of atherosclerosis. [1]
Barnes reasoned that the hypothyroid patient is both susceptible to infection and atherosclerosis, and it is a question of circumstances that will determine which will be fatal first. He claimed therefore that drop and rebound of heart attacks during and after WWII can be attributed to an increased rate of infectious disease during the war, and a sharp decrease after the war due to the availability of antibiotics, which simply modulated the timing of impending coronary events. [1]
Barnes also conducted a multi-decade study of his own patients, that claimed to show a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study. Barnes asserted that this was due to the thorough screening and effective treatment of hypothyroidism among his patients, which largely prevented the development of atherosclerosis. [1]
Mkronber ( talk) 13:59, 3 June 2009 (UTC)
To change the draft, click on the edit button at the top of the right column (not the header above). Strikes for deletions and underlines for inserts are suggested, or use anything else understandable such as square brackets or colors. Please add your signature to the list below the bottom line after each draft edit.
Heart Disease Perspective The widely accepted cholesterol theory of heart disease credits the drop in consumption of fatty foods during the war years for the drop in heart attacks, and the increase of heart attacks after the wars end with the resumed availability of fatty foods. [1] Barnes' disputed this, claiming to show that in the war years when the rate of deaths from heart attacks dropped, the patients who were dying—-largely due to Tuberculosis--had in fact greatly accelerated rates of atherosclerosis. [1] Barnes reasoned that the hypothyroid patient is both susceptible to infection and atherosclerosis, and it is a question of circumstances that will determine which will be fatal first. He claimed therefore that drop and rebound of heart attacks during and after WWII can be attributed to an increased rate of infectious disease during the war, and a sharp decrease after the war due to the availability of antibiotics, which simply modulated the timing of impending coronary events. [1] Barnes also conducted a multi-decade study of his own patients, that claimed to show a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study. Barnes asserted that this was due to the thorough screening and effective treatment of hypothyroidism among his patients, which largely prevented the development of atherosclerosis. [1] ______________________________
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Heart Disease Perspective {edit this draft}Barnes devoted a significant part of his life's research into the cause of heart disease, and differed from the mainstream view on the etiology of it. [1] For many years he spent as much as 1 month per year in Graz, Austria, reviewing and researching autopsy reports in the city hospital, widely considered to be the oldest and most complete in the world. His study of over 70,000 of these autopsy reports spanning the war years of 1939-1945, lead Barnes to suggest that [[atherosclerosis] was not caused by diet and cholesterol as is widely believed, but instead by hypothyroidism. [1] The widely accepted cholesterol theory of heart disease credits the drop in consumption of fatty foods during the war years for the drop in heart attacks, and the increase of heart attacks after the wars end with the resumed availability of fatty foods. [1] Barnes' disputed this, claiming to show that in the war years when the rate of deaths from heart attacks dropped, the patients who were dying—-largely due to Tuberculosis--had in fact greatly accelerated rates of atherosclerosis. [1] Barnes reasoned that the hypothyroid patient is both susceptible to infection and atherosclerosis, and it is a question of circumstances that will determine which will be fatal first. He claimed therefore that drop and rebound of heart attacks during and after WWII can be attributed to an increased rate of infectious disease during the war, and a sharp decrease after the war due to the availability of antibiotics, which simply modulated the timing of impending coronary events. [1] Barnes also conducted a multi-decade study of his own patients, that claimed to show a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study. Barnes asserted that this was due to the thorough screening and effective treatment of hypothyroidism among his patients, which largely prevented the development of atherosclerosis. [1] ______________________________
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Note: Ignore references which the sandbox reference section picks up from other sections of the talk page.
Signatures added horizontally will reduce the need for vertical scrolling: Milo 18:03, 3 June 2009, 03:20, 4 June 2009 (UTC) ;
I think a reasonable amount of time has passed to allow editing and modifications to this Heart Disease section. I propose we now move the edited section to the topic. Are there any objections to proceeding with that?--
Mkronber (
talk) 00:24, 25 September 2009 (UTC)
I'm not sure I understand the rationale for this revert by Milomedes ( talk · contribs). The edit summary asserts that "Harper-Collins is a respectable publishing house." I have no argument with that statement. However, the source I removed was not published by Harper-Collins; it was published by New Voice Publishing, an obscure, apparently one-person operation, and does not meet reliable-sourcing criteria. I just wanted to clarify whether this was a simple misunderstanding about the actual publisher. MastCell Talk 18:06, 29 June 2009 (UTC)
</ref><ref name="hypotype2">{{cite book |last=Starr |first=Mark |authorlink= |coauthors= |title=Hypothyroidism Type 2 |year=2005 |publisher=New Voice Publications |pages=174 | url=http://books.google.com/books?id=NbFzAAAACAAJ&dq |isbn=0975262408 }}</ref>
I don't know how many Ph.D.'s you know, but publishing a thesis does not give you automatic experience in editing others' work, making a legal assessment for defamation, understanding copyright law, or even being able to spot obvious errors outside of one's immediate area of expertise.
That said, we can of course solicit additional opinions here, from the Medicine wikiproject, or from the reliable sources noticeboard. MastCell Talk 23:57, 29 June 2009 (UTC)
←"...book by an unknown physician..." I don't think he's unknown. His name has about 2,000 hits on Google web combined with "hypothyroidism". His book, "Hypothyroidism Type 2: The Epidemic" has Amazon.com sales rank #11,010 in books. (By comparison, Barnes and Galton's "Hypothyroidism: The Unsuspected Illness" has Amazon.com sales rank #20,212 in books.) His blurb describes him as listed in a 1999 Who's Who – a paid entry perhaps, but purchased name recognition counts.
"essentially vanity press" ... "publish few or no other books" Those two things are mutually exclusive. An author pays a vanity press for printed copies of books, which the author owns outright and sells without the press getting a further cut. Since a vanity press makes its money from authors, the press doesn't put much if any effort into promoting or selling books. (I've seen a vanity press on the web with a long list of titles only.) Since a vanity press continuously needs a lot of new authors, the fact that NVP has a relatively small catalog suggests that they lack the volume to be a vanity press. Also, the Amazon.com sales rank suggests they are making some money from Starr's book.
"...claims ... at odds with current ... scientific understanding,.." I'm not aware of any claim at odds with scientific understanding. You raised this issue in the AfD concerning the nature of "type 2 hypothyroidism". I did the research you requested, explained in the AfD that it is Starr's popularized name for thyroid receptor resistance, and described Starr's origin for the "type 2" name in consultation with a medical professional who had the condition. I also found at PubMed and posted in the AfD, a scientific reference to support the existence of thyroid receptor resistance.
"...claims ... at odds with current medical ... understanding..." The core of this controversy is a medical practice dispute about methods and test parameters of hypothyroidism diagnosis, as well as sources and mixture ratios of replacement hormones. Barnes' research was on the leading edge, but the dispute has persisted long beyond Barnes' lifetime, because both patients' clinical experience (that I've read) and scientific research (that I've read) support the minority view.
"dramatically" The source of the drama is hundreds or more of activist patients and their doctors demanding reform of hypothyroidism diagnosis and treatment standards. This activism exists elsewhere in the world, but in the UK it's an issue embarrassing to the government National Health Service and supportive UK medical societies being criticized by private doctors. Activist complaints about heavy-handed disciplining of private doctors on an unscientific basis is reportedly reaching members of Parliament.
"...can you image Encyclopedia Britannica, for instance, citing such a source?" I follow your intended point, but you're using that invalid cliché on the wrong editor. I may have been the first WP editor to declare that the Britannica model for Wikipedia was dead. I've strongly argued WP:NOTBRITANNICA since the symbolic date of March 22, 2007 when Wikipedia was banned as a primary source by professors at several US universities. (Here's the story I broke on Wikinews 2007-03-22 NBC Nightly News - Wikipedia charged with "bad information".)
"...how many Ph.D.'s you know..." Ever, too many to count.
"... publishing a thesis does not give you automatic experience in ... making a legal assessment for defamation, understanding copyright law..." You've heard the phrase publish or perish. PhDs are educated to become writers of original thought and research. Of necessity such education includes training in attribution to prevent career loss due to plagiarism, and the basic law of copyright and defamation to prevent lawsuits. No research university would risk embarrassing itself by excluding the opportunity for such education from its curriculum. No proficient advisor or experienced mentor would fail to mention the need for such learning, formal or informal, at some point in the thesis process. I'm not familiar with small institutions granting reputable humanities doctorates, but it's hard for me to believe that they wouldn't have the same attribution, copyright, and defamation learning standards as a world class university.
"editing others' work" I agree that isn't automatic in the PhD process; some PhDs write and therefore edit poorly. PhDs in English can certainly edit others' work, but editing is a business skill that many non-PhDs successfully master with practice. That is NVP's business, and one can examine the book to see if they did it professionally.
"...spot obvious errors outside of one's immediate area of expertise..." Straw man. I just wrote unqualified "obvious errors", which are of course, obvious.
"I don't see how ... can be considered a useful encyclopedic source." Lacking a major publisher, Starr/Type 2 is not the strongest source, but nothing I've seen in policy declares it unreliable. WP:V#Reliable sources: "The appropriateness of any source always depends on the context." Starr's book is in the context of a minority view, and one of the few contemporary medical professional sources that discusses Barnes' clinical methods in some detail.
The mainstream medical practice controversy is real, the minority practice view is significant, so WP:NPOV policy requires accurately describing the controversy. That is better done with two third-party sources that seem to agree with each other, for independent factual verification of the results of methods described by Barnes' own works. Milo 09:23, 30 June 2009 (UTC)
←The Barnes article objective here is to determine if Hypothyroidism Type 2 (Starr, 2005) meets the following publishing standards of WP:RS that you quoted:
MastCell (08:57): ""WP:RS: Articles should rely on ... sources with a reputation for fact-checking and accuracy"" The publisher's portion of this requirement is initially met by definition. By default, NVP PhDs have an academically-certified reputation for fact-checking and accuracy until proven otherwise.
A publisher's fact-checking and accuracy reputation is limited to checking verifiable statements about third parties, the rationality of conclusions drawn by the author as based on third parties, and the plausibility of conclusions drawn by the author based on his own data collection. A publisher's fact-checking and accuracy reputation does not depend on mainstreaming of their author's significant minority view, if it's based on a possible interpretation of the available facts (typically facts unknown to the majority view).
MastCell (08:57): "...promoting entities which do not exist in the scholarly medical literature ("type 2 hypothyroidism")..." I've already briefly summarized this issue in Milo (09:23) and referenced details posted in the AfD. For the convenience of all readers, here is my AfD post with referenced evidence on the origin of "type 2 hypothyroidism":
(Copied from Wikipedia:Articles for deletion/Broda Otto Barnes)
As sourced above, the exact phrase "type 2 hypothyroidism" originated with Dr. Starr and Dr. Boc as a popularization of the clinical and scientific entities variously known as "Peripheral Resistance Syndrome", "Thyroid hormone resistance syndromes", and "Selective peripheral resistance to thyroid hormone". In other words, there is no obvious scientific or clinical consensus term for the entity that Starr wanted to discuss, much less a simple popular term that patients would find easy to read.
Simple opposition to a doctor writing a popular medical book through the device of coining well-defined popular terminology is elitist or anti-educational. A demand that a secondary-source popular term with a scientifically-defined meaning, must first appear in primary peer-reviewed literature in order to be described in a Wikipedia article, is
wikilawyering (the attempt to defeat principles by the application of technical rules).
"Not too much to ask..." Yes, it's too much to ask. Starr, 2005, was published only 4 years ago. It may be a long time (if ever) before the popular term "type 2 hypothyroidism" is adapted in medical practice literature (perhaps due to frequent usage by patients). It could be sooner marginalized by a consensus term with the same meaning.
"...novel editorial syntheses of various primary papers..." As sourced above in the AfD quote, the synthesis is that of Broda Barnes MD, PhD, and Lawrence S. Sonkin, MD, PhD. Therein, I've supplied primary sources to verify the clinical and scientific basis for Barnes' and Sonkin's belief that this entity is responsible for the vast majority of hypothyroidism, as well as to verify Dr. Starr's (and Dr. Boc's) credibility in citing Barnes and Sonkin as the basis for popularly naming the entity "type 2 hypothyroidism".
"I would prefer to simply see ... scholarly source mentioning and describing "type 2 hypothyroidism"." I would prefer that also, but it's not necessary since a list of references has been cited for the equivalent entities named in the peer-reviewed literature. For article purposes, the scientific meaning of the popular term "type 2 hypothyroidism" is verifiable through Starr's attribution of it to Barnes and Sonkin.
MastCell (08:57): ""WP:RS: Reliable sources ... with a reliable publication process;"" We are agreed that New Voice Publishing is not a major publisher, but there is no guiderule or policy prohibiting publishers from being RS merely because they are small. Since NVP could not be a vanity press, you haven't been able to prove that NVP lacks some kind of reliable publication process for error checking.
A major publisher is usually an automatic RS because of its standard commercial error-checking process: a number of staff, each with a narrow expertise (such as a lawyer-paralegal team to check for defamation). But that's not the only way to reliably check for errors. For example, a web site which states that they correct errors, and requests readers to inform them of errors – this can be an RS process. WP:V/WP:RS doesn't require proof of an RS process actually being used, only that some RS process appears to be available.
An unusual available error-checking process is the apparent presence of generalists and experts who have the capability of doing many tasks that normally require a number of staff. This process couldn't be used at a major publisher due to the volume of work, but it's easily achieved with a small publishing volume. Small generalist and expert publishers also can hire contract staff by the job, and professionally review all aspects of their work.
So, what RS process does NVP appear to have available and be motivated to use for error checking?
NVP does have the capability of an RS error-checking process for cited reporting, logic, and plausibility through in-house research expertise in the field of hormone replacement.
In a list of errors to be checked, even a major journal publisher would be unlikely to ask to check Dr. Starr's proprietary data against his clinical research conclusions. That leaves a journal, and NVP, the purview to check for errors in reporting cited research, and errors of logic or plausibility in an author's synthesis of conclusions based on all forms of research.
I've already covered attribution, copyright, and defamation error-checking (Milo 20:16 & 09:23) through the universal expertise of PhDs like Marcus Plourde, the commercial publisher of NVP. Plus, I think one can presume obvious error editing by most commercial publishers (spelling, grammar, paragraphs out of order, etc.).
Discerning NVP's motivation for RS process, PhDs are certified-intelligent people who understand knowledge authority. NVP would not risk smudging their reputations (and two expensive educations) by failing to research the facts underlying a heated medical practice dispute. Such research is also routine for anyone with a statistical research education (which all PhDs have), and at least some knowledge of medicine and biochemistry.
New Voice Publishing is apparently co-owned by Marcus Plourde, PhD, publisher, and Elizabeth Plourde, PhD, author of Your Guide To Hysterectomy, Ovary Removal & Hormone Replacement, 2002. As it turns out, NVP greatly exceeds 'at least some' knowledge of medicine and biochemistry:
"ELIZABETH PLOURDE, Ph.D., C.L.S. ¶ Dr. Plourde is a licensed Clinical Laboratory Scientist with a Ph.D. in Psychology. This training in the fields of both medicine and psychology is augmented by invaluable experience gained while working with cutting-edge medical research laboratories. The author's well-rounded education and professional expertise provided the background necessary to research the 100-year history of medical literature encompassing hysterectomies and compile the information into an easily understandable format. ¶ Dr. Plourde's 20-years of research and expertise in the field of women's health have resulted in her appearances on ABC's 20/20, Berman & Berman: For Women Only, Good Morning America, The Gary Null Show, and numerous network news programs and radio shows across the country." [6]
Note that E. Plourde's research includes hormone replacement, and a review of 100 years of medical literature on hysterectomies. The historically large extent of hypothyroidism among women, and the profound cross-association between hypothyroidism and gynecological disorders is unmistakable in any competent professional review of medical literature. It's further possible-to-likely that E. Plourde read Barnes' peer-reviewed paper listed in the article: "The treatment of menstrual disorders in general practice." Barnes BO. Ariz Med. 1949 Jan;6(1):33.
PMID
18106263
MastCell (08:57): "I am unaware of any indication that Starr is considered an authority by experts in the field of thyroid disease." I'm sure you can provide a good source for stating the majority view in the article, but the majority view is not relevant here. I agree that they would not consider Starr a mainstream expert thyroidologist. If they did, there would be no medical practice dispute to describe in the article. The relevant issue:
—»Is Mark Starr, MD, a trustworthy source for clinical practice experience with the significant minority view?«—
WP:RS:"their authors are generally regarded as trustworthy or authoritative in relation to the subject at hand."[emphasis added]
The "subject at hand" ( WP:RS) is the current "significant-minority view" ( WP:UNDUE) of:
—the clinical medical practice as pioneered by Dr. Barnes, including: methods and test parameters of hypothyroidism diagnosis – and – sources and mixture ratios of replacement hormone treatments—
Starr is a licensed medical doctor with significant name recognition, by the public through his book: (14,200 Google hits today searching: { "Mark Starr" hypothyroidism }), and his peers through his professional associations:
"American Academy of Physical Medicine Rehabilitation and a Diplomate of the American Board of Pain Medicine. He has studied with President Kennedy's famous pain specialist, Hans Kraus, M.D., and Lawrence S. Sonkin, Ph.D., renowned endocrinologist at the New York Hospital-Cornell Medical Center." [7]
MastCell (08:57): ""WP:RS: Reliable sources are credible published materials...""
M-W.com "credible": "1 : offering reasonable grounds for being believed <a credible account of an accident> <credible witnesses>" ....
Starr as a credible source, for clinical practice experience with the significant minority view, is reinforced by his theory, diagnostic, and treatment methods consensus with:
The latter is not only a consensus, it is the primary theme of Starr's book. Starr states that "type 2 hypothyroidism" is equivalent to "Peripheral Resistance Syndrome", for which I have provided equivalent-term scientific references to the peer-reviewed primary literature.
This New Voice Publishing book was considered in detail above by WP:RS standards. In summary it has:
Hypothyroidism Type 2: The epidemic, by Mark Starr, MD, is a reliable source with unusual but validly-available error checking qualifications. Accordingly, it is adequate to co-source the minority medical practice view of hypothyroidism pioneered by Dr. Broda Otto Barnes. Milo 10:10, 6 July 2009 (UTC)
As to the larger point, we are still left with an obscure two-person publishing house, which publishes a small number of low-profile books (2?) by authors without recognized expertise in the field, making claims at odds with common understanding. Nothing you've written convinces me that this constitutes a useful encyclopedic source. MastCell Talk 19:52, 6 July 2009 (UTC)
←
• MastCell (19:52): "publishing house, which publishes a small number ... (2?)" There are three books on NVP's
"Our authors" page. Two of NVP's books can be reasonably termed "low-profile":
But sales of their third book may pay for the Plourde's utility bills every month.
MastCell (19:52): "of low-profile books" NVP's third book, Starr, 2005, is not low-profile, and is a book with apparently unique Barnes resources for this article.
Compare to Barnes, 1976, which has a 7/10 Amazon.com Sales Rank of #25,422. [10] (These unaveraged numbers sharply rise or fall daily depending on Amazon's other daily sales).
Starr, 2005, sells persuasively because it has 5-star reviews. Its sales have been boosted by being promoted as "Frequently Bought Together" with Barnes, 1976, and, importantly, with an Amazon.com best-seller at #429: "Adrenal Fatigue: The 21st Century Stress Syndrome". Not surprising that the latter is frequently bought together with Starr, since this is a pair of books which mirrors Barnes' invention of the "combination treatment" of thyroid and daily 5mg physiological-dose adrenal-substitute prednisone (Barnes, 1976, p.208).
Starr also got an undeniably helpful Amazon.com top review from James T. Webber, MD, of San Diego, California (diabetes, metabolism & endocrinology, family practice – 30 years experience):
(excerpt) "Skepticism helped medicine leap forward centuries ago. Dr. Starr's excellent book brings it on. After reading this book, you will know, you, or someone dear to you, will have some expression of hypothyroidism type 2 (thyroid hormone resistance syndrome). His book will empower you to seek, no, insist, on getting the proper treatment. Dr. Starr's assessment that this is an epidemic is true. This is a must-read for all healthcare professionals." [author misspelling corrected] [11]
• MastCell (19:52): "authors without recognized expertise in the field" I previous discussed that issue in Milo (10:10 -3-) above, but here's a summary plus new evidence.
• MastCell (19:52): "Nothing you've written convinces me..." Since you were disappointed that this article wasn't AfD'd, neutral observers wouldn't necessarily expect you to be convinced by any source available for this significant minority view article.
MastCell (19:52): "...that this constitutes a useful encyclopedic source useful encyclopedic source." For just one example of the usefulness of this source, Starr provides an apparently unique report of the Barnes and Sonkin view; that the missing ~33% of hidden hypothyroidism is caused by "Peripheral Resistance Syndrome", as they and science understood it, circa 1988.
Milo 04:31, 12 July 2009 (UTC)
• MastCell (19:52): "...literature for "thyroid resistance syndromes..." .... "...points up the flaws in Starr's book." No source I've read has found the clinical or scientific evidence to prove Starr (or Barnes) are scientifically or clinically wrong. I've evaluated your Chatterjee citation as follows, and you haven't found it either. (We have both emphasized the distinction between hypo- (too little thyroid) and hyper- (too much thyroid) for the convenience of other editors in following this discussion.)
MastCell (19:52): "...according to
PMID
9350446, thyroid hormone resistance .... can be detected by blood tests..." Congratulations, you have evidenced Barnes' case against thyroid hormone blood tests in the inverse.
Chatterjee does describe GRTH and PRTH as associated with "elevated free thyroid hormones in the serum". Both of these are hyperthyroid conditions by blood tests, but since only PRTH patients are thyrotoxic, the blood tests for GRTH are diagnostically inaccurate for symptomatic hyperthyroidism. Why should the exact same tests be inerrantly trusted for hypothyroidism diagnosis?
MastCell (19:52): "unfounded ... to try to link ... to this particular rare medically recognized syndrome" Agreed, since Chatterjee, 1997, is describing a different thyroid resistance syndrome.
Read more carefully
PMID 9350446, abstract of Chatterjee VK, (Horm Res. 1997;48 Suppl 4:43-6),: "...patients with thyrotoxic features, suggesting predominant pituitary resistance (PRTH). Molecular genetic analyses indicate that both GRTH and PRTH are associated with diverse mutations in the thyroid hormone receptor beta gene..." [emphasis added]
Now reread L Wikström, et al, (EMBO J. 1998 January 15; 17(2): 455–461.
Abstract) "developed mice lacking the thyroid hormone receptor TR alpha 1." In addition to abnormal hearts, "The mice have a body temperature 0.5 degrees C [about 1ºF] lower than normal and exhibit a mild hypothyroidism, whereas their overall behavior and reproduction are normal." [emphasis added]
By matched description of symptoms, mice missing TR alpha 1 receptors have the same entity that Barnes observed clinically, that Barnes and Sonkin described as due to "Peripheral Resistance Syndrome", and which Starr and Boc popularly named "Type 2 hypothyroidism" [Starr capitalizes the "T"].
• MastCell (19:52): "I don't think it's a good idea to go down the road of mining the literature for "thyroid resistance syndromes"" This seems to be necessary, because an NPOV requirement is triggered by the article statement: "Barnes' views on the prevalence of hypothyroidism ... run counter to the current medical understanding of thyroid function..." The medical practice community bases this understanding on controversial blood testing which ignores thyroid resistance syndromes. Barnes generally refutes the diagnostic accuracy of blood tests of thyroid hormone supply (Barnes, 1976, p.41-42), Starr and Langer confirm Barnes, and among some non-Barnes sources, David Derry MD, PhD, questions the accuracy of TSH [12]. Furthermore, non-Barnes primary source McDermott, 1993, published research which scientifically supports Barnes' position:
"Thyroid hormone resistance syndromes" (McDermott MT, Am J Med. 1993 Apr;94(4):424-32. Abstract), "Selective peripheral resistance to thyroid hormone (PerRTH)..." [had been identified in one patient with] "...normal serum thyroid hormone and TSH levels but was clinically hypothyroid and improved with thyroid hormone administration. All of these disorders are probably more common than is generally recognized and are often misdiagnosed and inappropriately treated." [emphasis added]
A citation to McDermott also supports various positions of Sonkin, Starr, and Langer.
If "current medical understanding" in the article is allowed to claim or imply that Barnes, (and Sonkin, Starr, and Langer) are wrong, then "current scientific evidence" (per McDermott, 1993, etc.) is allowed to claim or imply that Barnes, et al are correct. Milo 04:40, 12 July 2009 (UTC)
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I'm staying out of substantive editing of this article based on past experience with obvious partisans (being one is not necessarily a bad thing - I am one on other biographies) involved in biographical entries. However, I am mystified at the amount of effort expended regarding the citations about Barnes' work since this is a biographical article and not an article about hypothyroidism. When I actually visit Wikipedia's hypothyroidism entry I find no mention of Barnes' work. I would suggest that efforts towards presenting his theories are better suited to inclusion in the appropriate wikipedia entry on the malady where those who understand such things can weigh in on them (and I am not such a person). I construe the investment of effort in bolstering Barnes' theories in this article as a stealth mechanism to insert them in wikipedia if they can't stand up to communal editor scrutiny in the appropriate entry. I have no problems with them being listed bibliographically in an article about the man, but the effort to expand, bolster, and defend them in detail seems to be not only a misplaced effort, but also an inadvertent barrier to others who may wish to edit the article as stated in arguments above. It's almost impossible for all but an experienced editor to wade through the wiki-code. My observation, not my fight. -- Quartermaster ( talk) 14:48, 7 May 2009 (UTC)
Solved: The Riddle of Illness ; 4th edition McGraw-Hill (July 20, 2006) [1] Page 4: "I am thankful that I stumbled across the monumental research in this area of Broda O. Barnes, MD, PhD, one of the world's foremost authorities on the thyroid gland."
I've reverted a series of edits which (I believe) another editor (Verbal) had also taken issue with. There are multiple issues here; I'll hit a few for discussion here, and maybe we can make some progress along the lines of WP:BRD.
I think we can make the point that Barnes published in the mainstream medical literature and held a position at a major university without descending into the tone of a late-night infomercial. Part of it depends on using good sources, and part depends on our willingness to see this as an encyclopedia article rather than a chance to burnish Barnes' image. MastCell Talk 22:12, 12 May 2009 (UTC)
WP:PEACOCK#Do not hide the important facts: "In some contexts, the fame or reputation of a subject may be an objective and relevant question, better supported by a direct source than by drawing inferences indirectly based on other facts (which would constitute original research or synthesis). A sourced statement that the subject is "famous", "well known", "important", "influential", or the like may be appropriate, particularly to establish a subject's notability in an introductory sentence or paragraph."
WP:PEACOCK#Exception for quotations: "Do not impose Wikipedia style guidelines on sources that we cite or quote. It is proper to say, "Music critic Ann Bond wrote that Mozart was a great composer," or "Smith said, 'Senator Jones's acceptance of this contribution is a major scandal.'" Such indirect or direct quotations may be useful in presenting important perspectives, especially on contentious subjects,..."[emphasis mine]
To be clear, I have no problem with saying that "Several authors of alternative-medicine books have described Barnes as a major authority on the thyroid gland." That would be accurate and reasonably encyclopedic (if you leave out the more egregious self-published and unreliable sources that keep finding their way into the article). MastCell Talk 06:10, 13 May 2009 (UTC)
Tim hit the nail on the head: if Barnes is as notable, famous, influential, etc as you repeatedly insist, then let's produce the objective evidence of that notability - maintream awards,recognition, obits, etc. On the other hand, if Barnes is chiefly notable as the inspiration for an alternative medicine cottage industry - as the currently available sources indicate - then we should reflect that.
As a separate issue, please be clear: WP:NPOV specifically prohibits using "minority-view" articles to rewrite content from a minoritarian perspective. Whether the article is hypothyroidism or Broda Otto Barnes, the mainstream scientific view is the mainstream scientific view. We of course go into greater depth about Barnes' claims in his article, but we don't "limit" the voice of modern scientific knowledge to a few brief words - after all, our goal is not to promote Broda Barnes, but to provide a useful overview of the current state of human knowledge. MastCell Talk 18:41, 13 May 2009 (UTC)
←For easy reference here is WP:NPOV#Undue weight:
WP:NPOV/WP:UNDUE: "In articles specifically on the minority viewpoint, the views are allowed to receive more attention and space; however, on such pages, though the minority view may (and usually should) be described, possibly at length, the article should make appropriate reference to the majority viewpoint wherever relevant, and must not reflect an attempt to rewrite majority-view content strictly from the perspective of the minority view. Specifically, it should always be clear which parts of the text describe the minority view (and that it is, in fact the minority view). The majority view should be explained in sufficient detail so the reader understands how the minority view differs from the widely-accepted one, and controversies regarding parts of the minority view should clearly be identified and explained." [emphasis added]
I read the underlined section as meaning the majority viewpoint is to be clear, but limited and brief compared to the minority viewpoint. Otherwise, it would just be another majority article.
Also, you seem to have ignored my request for sources on your "alternative medicine" claims. Maybe you haven't had time to do that research, so I'll give you a few days to do that.
However, the impasse created by unrepentant reversions of specific good and unchallenged edits makes it impossible to proceed further with editing. Without the ability to make good edits, progress is impossible. Discussion is moot since it is going around in circles, and nothing else can be settled by the accumulation of good edits. See that behavioral meta issue below. Milo 23:31, 13 May 2009 (UTC)
As to supporting Langer's book as "alternative medicine", I'm pretty sure that any reasonable, objective person looking at the book description, blurbs, and content matter will place it squarely under the aegis of alt-med. But fine: Langer is president of the American Nutritional Medical Association ( [4]), a distinctly non-mainstream organization ( [5]). He is mentioned and promoted solely on alternative medicine websites ( representative example). He's mentioned in "Alternative Medicine: The Definitive Guide". In fact, I'm feeling much less comfortable using Langer's book as an encyclopedic source at all; there appears to be a small walled garden of a handful of people promoting Barnes' claims at present, and we give them far more weight than is appropriate given this site's goals and policies. MastCell Talk 04:04, 14 May 2009 (UTC)
As to linking Langer to the organization described by Quackwatch, I have no idea how many organizations share this name. It would be uncommon, but not impossible, for someone to take on an organizational name without checking into its history. It is possible that Langer is the president of a different "American Nutritional Medical Foundation", but if multiple low-profile organizations share this same name, then it only serves to underscore the position of this material outside the realm of sources on which this encyclopedia should depend. I don't see a BLP issue here; rather, I think it's an essential part of evaluating sources, and one which you have repeatedly demanded. You are of course welcome to solicit outside opinions at the BLP noticeboard. MastCell Talk 17:53, 14 May 2009 (UTC)
Both Verbal and then MastCell have reverted sizable swaths of both newly written and other large blocks of content under color of
WP:BRD. But
WP:Vandalism policy trumps WP:BRD.
The problem is not a reverting of those specific items they objected to for explainable guiderule reasons. The problem is that everything I (and another editor) wrote was reverted. If one can't cite explainable guiderule reasons for each item reverted, it's
WP:IDONTLIKEIT which is not an acceptable reason for making any contentious edit, such as, during any revert.
Verbal noted in edit summary that some of my edits were good edits. Ok, one can't revert good edits, because it disrupts progress of the project. The first time it's probably a misunderstanding. But it's vandalism to do it again after that point has been explained.
It's also not possible to explain at talk why one wrote a 3.5K intro, when both good and objectionable portions were wholesale reverted.
The reason some editors thoughtlessly engage in wholesale reversion is because it's work to go through and pick out only the edits with guiderule-citable reasons for reverting them. Yeah, well, it was a lot more work to do all that writing. If you think it's 'too much work' to save the good edits, then don't do a revert.
So here's what's could happen if non-selective content removal happens again: Next time, with both parties having been warned, it's probably going to be clear-cut content removal vandalism, and I will have these options:
Milo 11:54, 13 May 2009 (UTC)
Wikipedia talk:Vandalism/Archive 6#blatant POV warriors who delete large portions of text:
..."Message from village pump:
Wikipedia:Vandalism#Types of vandalism
"Blanking
"Removing all or significant parts of a page's content without any reason, or replacing entire pages with nonsense. Sometimes referenced information or important verifiable references are deleted with no valid reason(s) given in the summary. However, significant content removals are usually not considered to be vandalism where the reason for the removal of the content is readily apparent by examination of the content itself, or where a non-frivolous explanation for the removal of apparently legitimate content is provided, linked to, or referenced in an edit summary." [emphasis added]
Removing good edits knowingly is vandalism. Removing them for WP:IDONTLIKEIT is frivolous. Verbal admitted to removing good edits. MastCell (above section, 22:12) apparently removed good edits by a vague claim of "overall" which violates "readily apparent by examination of the content itself". Use of "overall" is indistinguishable from a cover up of frivolous WP:IDONTLIKEIT. If permitted, claims of "overall" would excuse both frivolity and complex vandalism.
WP:Vandalism is policy. Reversions claimed by WP:BRD must still be specifically identifiable and nonfrivolously justified at talk. Milo 21:19, 13 May 2009 (UTC)
←I have real world to do, so I'm giving both of you a few days to cool off and rest up from tiredness. When I work on this again, edit by the rules and this issue won't be a problem.
Milo 08:18, 14 May 2009 (UTC)
All editors of this page should be aware that this article comes under the set that are covered by Wikipedia:Requests_for_arbitration/Pseudoscience#Discretionary_sanctions. Please read and familiarise yourself with this document. Tim Vickers ( talk) 16:18, 14 May 2009 (UTC)
I've (again) removed this material as poorly sourced. I disagree with both of the cited rationales for restoring it: letters to the editor of a medium-sized newspaper are not a reliable source of fact (perhaps, at most, of opinion, but even then they are far weaker than even an op-ed). And it would most certainly be a medical breakthrough if Barnes had discovered a "simple test that could detect iodine deficiency" through the skin. However, since this supposed breakthrough is utterly unsourced (so far as I can see) beyond this letter to the editor, it fails WP:REDFLAG. Basically, as with many of the issues with the article, it comes down to a lack of suitable, encyclopedic reliable sources.
I'd like to solicit some additional input. Am I mistaken in describing this as a letter to the editor? I can view only part of the text online. Assuming that it is a letter, do other editors believe this is suitable sourcing for a) a matter of fact and b) a fairly remarkable and exceptional claim? MastCell Talk 03:16, 19 May 2009 (UTC)
In a letter to the editor of The Charlotte Observer in 2005 a member of the public called XX stated that Barnes had used a test that he believed could detect iodine deficiency, which involved testing iodine being absorbed through the skin.
To some degree the slimming down that MastCell has done to the topic has improved readability, however, I think the pendulum may have swung too far the other way now. Specifically I think it is a mistake to have taken out the previously existing section on Heart Disease. Research on heart disease comprised arguably the biggest part of Barnes' research. He published 2 books specifically on the topic, plus the largest section of his New York Times best selling book "Hypothyroidism: the unsuspected illness"--as well as several peer reviewed papers on heart disease. In his lectures(available at the foundation) he also spends significant time on the topic. So to have a section on his pregnancy urine testing (though reported in TIME, it was a minor footnote in his career) but not have a section on Heart Disease seems an unbalanced view of his research. So what I'm proposing is bringing back the old section (which the wiki admin said was ok), and then opening it up for further edits and improvements. Does this sound reasonable? Mkronber ( talk) 18:42, 1 June 2009 (UTC)
I don't see a consensus to restore this section, so I have removed it pending further discussion. Verbal chat 07:34, 3 June 2009 (UTC)
In the sandbox section below I have posted Mkronber's 02:22, 3 June 2009 proposal edit to the article in the left column (don't edit) with an editable draft in the right column (do edit). Milo 18:03, 3 June 2009 (UTC)
Barnes devoted a significant part of his life's research into the cause of heart disease, and differed from the mainstream view on the etiology of it. [1] For many years he spent as much as 1 month per year in Graz, Austria, reviewing and researching autopsy reports in the city hospital, widely considered to be the oldest and most complete in the world. His study of over 70,000 of these autopsy reports spanning the war years of 1939-1945, lead Barnes to suggest that [[atherosclerosis] was not caused by diet and cholesterol as is widely believed, but instead by hypothyroidism. [1]
The widely accepted cholesterol theory of heart disease credits the drop in consumption of fatty foods during the war years for the drop in heart attacks, and the increase of heart attacks after the wars end with the resumed availability of fatty foods. [1] Barnes’ disputed this, claiming to show that in the war years when the rate of deaths from heart attacks dropped, the patients who were dying—-largely due to Tuberculosis--had in fact greatly accelerated rates of atherosclerosis. [1]
Barnes reasoned that the hypothyroid patient is both susceptible to infection and atherosclerosis, and it is a question of circumstances that will determine which will be fatal first. He claimed therefore that drop and rebound of heart attacks during and after WWII can be attributed to an increased rate of infectious disease during the war, and a sharp decrease after the war due to the availability of antibiotics, which simply modulated the timing of impending coronary events. [1]
Barnes also conducted a multi-decade study of his own patients, that claimed to show a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study. Barnes asserted that this was due to the thorough screening and effective treatment of hypothyroidism among his patients, which largely prevented the development of atherosclerosis. [1]
Mkronber ( talk) 13:59, 3 June 2009 (UTC)
To change the draft, click on the edit button at the top of the right column (not the header above). Strikes for deletions and underlines for inserts are suggested, or use anything else understandable such as square brackets or colors. Please add your signature to the list below the bottom line after each draft edit.
Heart Disease Perspective The widely accepted cholesterol theory of heart disease credits the drop in consumption of fatty foods during the war years for the drop in heart attacks, and the increase of heart attacks after the wars end with the resumed availability of fatty foods. [1] Barnes' disputed this, claiming to show that in the war years when the rate of deaths from heart attacks dropped, the patients who were dying—-largely due to Tuberculosis--had in fact greatly accelerated rates of atherosclerosis. [1] Barnes reasoned that the hypothyroid patient is both susceptible to infection and atherosclerosis, and it is a question of circumstances that will determine which will be fatal first. He claimed therefore that drop and rebound of heart attacks during and after WWII can be attributed to an increased rate of infectious disease during the war, and a sharp decrease after the war due to the availability of antibiotics, which simply modulated the timing of impending coronary events. [1] Barnes also conducted a multi-decade study of his own patients, that claimed to show a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study. Barnes asserted that this was due to the thorough screening and effective treatment of hypothyroidism among his patients, which largely prevented the development of atherosclerosis. [1] ______________________________
|
Heart Disease Perspective {edit this draft}Barnes devoted a significant part of his life's research into the cause of heart disease, and differed from the mainstream view on the etiology of it. [1] For many years he spent as much as 1 month per year in Graz, Austria, reviewing and researching autopsy reports in the city hospital, widely considered to be the oldest and most complete in the world. His study of over 70,000 of these autopsy reports spanning the war years of 1939-1945, lead Barnes to suggest that [[atherosclerosis] was not caused by diet and cholesterol as is widely believed, but instead by hypothyroidism. [1] The widely accepted cholesterol theory of heart disease credits the drop in consumption of fatty foods during the war years for the drop in heart attacks, and the increase of heart attacks after the wars end with the resumed availability of fatty foods. [1] Barnes' disputed this, claiming to show that in the war years when the rate of deaths from heart attacks dropped, the patients who were dying—-largely due to Tuberculosis--had in fact greatly accelerated rates of atherosclerosis. [1] Barnes reasoned that the hypothyroid patient is both susceptible to infection and atherosclerosis, and it is a question of circumstances that will determine which will be fatal first. He claimed therefore that drop and rebound of heart attacks during and after WWII can be attributed to an increased rate of infectious disease during the war, and a sharp decrease after the war due to the availability of antibiotics, which simply modulated the timing of impending coronary events. [1] Barnes also conducted a multi-decade study of his own patients, that claimed to show a 94% reduction in the rate of heart attacks as compared to the Framingham Heart Study. Barnes asserted that this was due to the thorough screening and effective treatment of hypothyroidism among his patients, which largely prevented the development of atherosclerosis. [1] ______________________________
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Note: Ignore references which the sandbox reference section picks up from other sections of the talk page.
Signatures added horizontally will reduce the need for vertical scrolling: Milo 18:03, 3 June 2009, 03:20, 4 June 2009 (UTC) ;
I think a reasonable amount of time has passed to allow editing and modifications to this Heart Disease section. I propose we now move the edited section to the topic. Are there any objections to proceeding with that?--
Mkronber (
talk) 00:24, 25 September 2009 (UTC)
I'm not sure I understand the rationale for this revert by Milomedes ( talk · contribs). The edit summary asserts that "Harper-Collins is a respectable publishing house." I have no argument with that statement. However, the source I removed was not published by Harper-Collins; it was published by New Voice Publishing, an obscure, apparently one-person operation, and does not meet reliable-sourcing criteria. I just wanted to clarify whether this was a simple misunderstanding about the actual publisher. MastCell Talk 18:06, 29 June 2009 (UTC)
</ref><ref name="hypotype2">{{cite book |last=Starr |first=Mark |authorlink= |coauthors= |title=Hypothyroidism Type 2 |year=2005 |publisher=New Voice Publications |pages=174 | url=http://books.google.com/books?id=NbFzAAAACAAJ&dq |isbn=0975262408 }}</ref>
I don't know how many Ph.D.'s you know, but publishing a thesis does not give you automatic experience in editing others' work, making a legal assessment for defamation, understanding copyright law, or even being able to spot obvious errors outside of one's immediate area of expertise.
That said, we can of course solicit additional opinions here, from the Medicine wikiproject, or from the reliable sources noticeboard. MastCell Talk 23:57, 29 June 2009 (UTC)
←"...book by an unknown physician..." I don't think he's unknown. His name has about 2,000 hits on Google web combined with "hypothyroidism". His book, "Hypothyroidism Type 2: The Epidemic" has Amazon.com sales rank #11,010 in books. (By comparison, Barnes and Galton's "Hypothyroidism: The Unsuspected Illness" has Amazon.com sales rank #20,212 in books.) His blurb describes him as listed in a 1999 Who's Who – a paid entry perhaps, but purchased name recognition counts.
"essentially vanity press" ... "publish few or no other books" Those two things are mutually exclusive. An author pays a vanity press for printed copies of books, which the author owns outright and sells without the press getting a further cut. Since a vanity press makes its money from authors, the press doesn't put much if any effort into promoting or selling books. (I've seen a vanity press on the web with a long list of titles only.) Since a vanity press continuously needs a lot of new authors, the fact that NVP has a relatively small catalog suggests that they lack the volume to be a vanity press. Also, the Amazon.com sales rank suggests they are making some money from Starr's book.
"...claims ... at odds with current ... scientific understanding,.." I'm not aware of any claim at odds with scientific understanding. You raised this issue in the AfD concerning the nature of "type 2 hypothyroidism". I did the research you requested, explained in the AfD that it is Starr's popularized name for thyroid receptor resistance, and described Starr's origin for the "type 2" name in consultation with a medical professional who had the condition. I also found at PubMed and posted in the AfD, a scientific reference to support the existence of thyroid receptor resistance.
"...claims ... at odds with current medical ... understanding..." The core of this controversy is a medical practice dispute about methods and test parameters of hypothyroidism diagnosis, as well as sources and mixture ratios of replacement hormones. Barnes' research was on the leading edge, but the dispute has persisted long beyond Barnes' lifetime, because both patients' clinical experience (that I've read) and scientific research (that I've read) support the minority view.
"dramatically" The source of the drama is hundreds or more of activist patients and their doctors demanding reform of hypothyroidism diagnosis and treatment standards. This activism exists elsewhere in the world, but in the UK it's an issue embarrassing to the government National Health Service and supportive UK medical societies being criticized by private doctors. Activist complaints about heavy-handed disciplining of private doctors on an unscientific basis is reportedly reaching members of Parliament.
"...can you image Encyclopedia Britannica, for instance, citing such a source?" I follow your intended point, but you're using that invalid cliché on the wrong editor. I may have been the first WP editor to declare that the Britannica model for Wikipedia was dead. I've strongly argued WP:NOTBRITANNICA since the symbolic date of March 22, 2007 when Wikipedia was banned as a primary source by professors at several US universities. (Here's the story I broke on Wikinews 2007-03-22 NBC Nightly News - Wikipedia charged with "bad information".)
"...how many Ph.D.'s you know..." Ever, too many to count.
"... publishing a thesis does not give you automatic experience in ... making a legal assessment for defamation, understanding copyright law..." You've heard the phrase publish or perish. PhDs are educated to become writers of original thought and research. Of necessity such education includes training in attribution to prevent career loss due to plagiarism, and the basic law of copyright and defamation to prevent lawsuits. No research university would risk embarrassing itself by excluding the opportunity for such education from its curriculum. No proficient advisor or experienced mentor would fail to mention the need for such learning, formal or informal, at some point in the thesis process. I'm not familiar with small institutions granting reputable humanities doctorates, but it's hard for me to believe that they wouldn't have the same attribution, copyright, and defamation learning standards as a world class university.
"editing others' work" I agree that isn't automatic in the PhD process; some PhDs write and therefore edit poorly. PhDs in English can certainly edit others' work, but editing is a business skill that many non-PhDs successfully master with practice. That is NVP's business, and one can examine the book to see if they did it professionally.
"...spot obvious errors outside of one's immediate area of expertise..." Straw man. I just wrote unqualified "obvious errors", which are of course, obvious.
"I don't see how ... can be considered a useful encyclopedic source." Lacking a major publisher, Starr/Type 2 is not the strongest source, but nothing I've seen in policy declares it unreliable. WP:V#Reliable sources: "The appropriateness of any source always depends on the context." Starr's book is in the context of a minority view, and one of the few contemporary medical professional sources that discusses Barnes' clinical methods in some detail.
The mainstream medical practice controversy is real, the minority practice view is significant, so WP:NPOV policy requires accurately describing the controversy. That is better done with two third-party sources that seem to agree with each other, for independent factual verification of the results of methods described by Barnes' own works. Milo 09:23, 30 June 2009 (UTC)
←The Barnes article objective here is to determine if Hypothyroidism Type 2 (Starr, 2005) meets the following publishing standards of WP:RS that you quoted:
MastCell (08:57): ""WP:RS: Articles should rely on ... sources with a reputation for fact-checking and accuracy"" The publisher's portion of this requirement is initially met by definition. By default, NVP PhDs have an academically-certified reputation for fact-checking and accuracy until proven otherwise.
A publisher's fact-checking and accuracy reputation is limited to checking verifiable statements about third parties, the rationality of conclusions drawn by the author as based on third parties, and the plausibility of conclusions drawn by the author based on his own data collection. A publisher's fact-checking and accuracy reputation does not depend on mainstreaming of their author's significant minority view, if it's based on a possible interpretation of the available facts (typically facts unknown to the majority view).
MastCell (08:57): "...promoting entities which do not exist in the scholarly medical literature ("type 2 hypothyroidism")..." I've already briefly summarized this issue in Milo (09:23) and referenced details posted in the AfD. For the convenience of all readers, here is my AfD post with referenced evidence on the origin of "type 2 hypothyroidism":
(Copied from Wikipedia:Articles for deletion/Broda Otto Barnes)
As sourced above, the exact phrase "type 2 hypothyroidism" originated with Dr. Starr and Dr. Boc as a popularization of the clinical and scientific entities variously known as "Peripheral Resistance Syndrome", "Thyroid hormone resistance syndromes", and "Selective peripheral resistance to thyroid hormone". In other words, there is no obvious scientific or clinical consensus term for the entity that Starr wanted to discuss, much less a simple popular term that patients would find easy to read.
Simple opposition to a doctor writing a popular medical book through the device of coining well-defined popular terminology is elitist or anti-educational. A demand that a secondary-source popular term with a scientifically-defined meaning, must first appear in primary peer-reviewed literature in order to be described in a Wikipedia article, is
wikilawyering (the attempt to defeat principles by the application of technical rules).
"Not too much to ask..." Yes, it's too much to ask. Starr, 2005, was published only 4 years ago. It may be a long time (if ever) before the popular term "type 2 hypothyroidism" is adapted in medical practice literature (perhaps due to frequent usage by patients). It could be sooner marginalized by a consensus term with the same meaning.
"...novel editorial syntheses of various primary papers..." As sourced above in the AfD quote, the synthesis is that of Broda Barnes MD, PhD, and Lawrence S. Sonkin, MD, PhD. Therein, I've supplied primary sources to verify the clinical and scientific basis for Barnes' and Sonkin's belief that this entity is responsible for the vast majority of hypothyroidism, as well as to verify Dr. Starr's (and Dr. Boc's) credibility in citing Barnes and Sonkin as the basis for popularly naming the entity "type 2 hypothyroidism".
"I would prefer to simply see ... scholarly source mentioning and describing "type 2 hypothyroidism"." I would prefer that also, but it's not necessary since a list of references has been cited for the equivalent entities named in the peer-reviewed literature. For article purposes, the scientific meaning of the popular term "type 2 hypothyroidism" is verifiable through Starr's attribution of it to Barnes and Sonkin.
MastCell (08:57): ""WP:RS: Reliable sources ... with a reliable publication process;"" We are agreed that New Voice Publishing is not a major publisher, but there is no guiderule or policy prohibiting publishers from being RS merely because they are small. Since NVP could not be a vanity press, you haven't been able to prove that NVP lacks some kind of reliable publication process for error checking.
A major publisher is usually an automatic RS because of its standard commercial error-checking process: a number of staff, each with a narrow expertise (such as a lawyer-paralegal team to check for defamation). But that's not the only way to reliably check for errors. For example, a web site which states that they correct errors, and requests readers to inform them of errors – this can be an RS process. WP:V/WP:RS doesn't require proof of an RS process actually being used, only that some RS process appears to be available.
An unusual available error-checking process is the apparent presence of generalists and experts who have the capability of doing many tasks that normally require a number of staff. This process couldn't be used at a major publisher due to the volume of work, but it's easily achieved with a small publishing volume. Small generalist and expert publishers also can hire contract staff by the job, and professionally review all aspects of their work.
So, what RS process does NVP appear to have available and be motivated to use for error checking?
NVP does have the capability of an RS error-checking process for cited reporting, logic, and plausibility through in-house research expertise in the field of hormone replacement.
In a list of errors to be checked, even a major journal publisher would be unlikely to ask to check Dr. Starr's proprietary data against his clinical research conclusions. That leaves a journal, and NVP, the purview to check for errors in reporting cited research, and errors of logic or plausibility in an author's synthesis of conclusions based on all forms of research.
I've already covered attribution, copyright, and defamation error-checking (Milo 20:16 & 09:23) through the universal expertise of PhDs like Marcus Plourde, the commercial publisher of NVP. Plus, I think one can presume obvious error editing by most commercial publishers (spelling, grammar, paragraphs out of order, etc.).
Discerning NVP's motivation for RS process, PhDs are certified-intelligent people who understand knowledge authority. NVP would not risk smudging their reputations (and two expensive educations) by failing to research the facts underlying a heated medical practice dispute. Such research is also routine for anyone with a statistical research education (which all PhDs have), and at least some knowledge of medicine and biochemistry.
New Voice Publishing is apparently co-owned by Marcus Plourde, PhD, publisher, and Elizabeth Plourde, PhD, author of Your Guide To Hysterectomy, Ovary Removal & Hormone Replacement, 2002. As it turns out, NVP greatly exceeds 'at least some' knowledge of medicine and biochemistry:
"ELIZABETH PLOURDE, Ph.D., C.L.S. ¶ Dr. Plourde is a licensed Clinical Laboratory Scientist with a Ph.D. in Psychology. This training in the fields of both medicine and psychology is augmented by invaluable experience gained while working with cutting-edge medical research laboratories. The author's well-rounded education and professional expertise provided the background necessary to research the 100-year history of medical literature encompassing hysterectomies and compile the information into an easily understandable format. ¶ Dr. Plourde's 20-years of research and expertise in the field of women's health have resulted in her appearances on ABC's 20/20, Berman & Berman: For Women Only, Good Morning America, The Gary Null Show, and numerous network news programs and radio shows across the country." [6]
Note that E. Plourde's research includes hormone replacement, and a review of 100 years of medical literature on hysterectomies. The historically large extent of hypothyroidism among women, and the profound cross-association between hypothyroidism and gynecological disorders is unmistakable in any competent professional review of medical literature. It's further possible-to-likely that E. Plourde read Barnes' peer-reviewed paper listed in the article: "The treatment of menstrual disorders in general practice." Barnes BO. Ariz Med. 1949 Jan;6(1):33.
PMID
18106263
MastCell (08:57): "I am unaware of any indication that Starr is considered an authority by experts in the field of thyroid disease." I'm sure you can provide a good source for stating the majority view in the article, but the majority view is not relevant here. I agree that they would not consider Starr a mainstream expert thyroidologist. If they did, there would be no medical practice dispute to describe in the article. The relevant issue:
—»Is Mark Starr, MD, a trustworthy source for clinical practice experience with the significant minority view?«—
WP:RS:"their authors are generally regarded as trustworthy or authoritative in relation to the subject at hand."[emphasis added]
The "subject at hand" ( WP:RS) is the current "significant-minority view" ( WP:UNDUE) of:
—the clinical medical practice as pioneered by Dr. Barnes, including: methods and test parameters of hypothyroidism diagnosis – and – sources and mixture ratios of replacement hormone treatments—
Starr is a licensed medical doctor with significant name recognition, by the public through his book: (14,200 Google hits today searching: { "Mark Starr" hypothyroidism }), and his peers through his professional associations:
"American Academy of Physical Medicine Rehabilitation and a Diplomate of the American Board of Pain Medicine. He has studied with President Kennedy's famous pain specialist, Hans Kraus, M.D., and Lawrence S. Sonkin, Ph.D., renowned endocrinologist at the New York Hospital-Cornell Medical Center." [7]
MastCell (08:57): ""WP:RS: Reliable sources are credible published materials...""
M-W.com "credible": "1 : offering reasonable grounds for being believed <a credible account of an accident> <credible witnesses>" ....
Starr as a credible source, for clinical practice experience with the significant minority view, is reinforced by his theory, diagnostic, and treatment methods consensus with:
The latter is not only a consensus, it is the primary theme of Starr's book. Starr states that "type 2 hypothyroidism" is equivalent to "Peripheral Resistance Syndrome", for which I have provided equivalent-term scientific references to the peer-reviewed primary literature.
This New Voice Publishing book was considered in detail above by WP:RS standards. In summary it has:
Hypothyroidism Type 2: The epidemic, by Mark Starr, MD, is a reliable source with unusual but validly-available error checking qualifications. Accordingly, it is adequate to co-source the minority medical practice view of hypothyroidism pioneered by Dr. Broda Otto Barnes. Milo 10:10, 6 July 2009 (UTC)
As to the larger point, we are still left with an obscure two-person publishing house, which publishes a small number of low-profile books (2?) by authors without recognized expertise in the field, making claims at odds with common understanding. Nothing you've written convinces me that this constitutes a useful encyclopedic source. MastCell Talk 19:52, 6 July 2009 (UTC)
←
• MastCell (19:52): "publishing house, which publishes a small number ... (2?)" There are three books on NVP's
"Our authors" page. Two of NVP's books can be reasonably termed "low-profile":
But sales of their third book may pay for the Plourde's utility bills every month.
MastCell (19:52): "of low-profile books" NVP's third book, Starr, 2005, is not low-profile, and is a book with apparently unique Barnes resources for this article.
Compare to Barnes, 1976, which has a 7/10 Amazon.com Sales Rank of #25,422. [10] (These unaveraged numbers sharply rise or fall daily depending on Amazon's other daily sales).
Starr, 2005, sells persuasively because it has 5-star reviews. Its sales have been boosted by being promoted as "Frequently Bought Together" with Barnes, 1976, and, importantly, with an Amazon.com best-seller at #429: "Adrenal Fatigue: The 21st Century Stress Syndrome". Not surprising that the latter is frequently bought together with Starr, since this is a pair of books which mirrors Barnes' invention of the "combination treatment" of thyroid and daily 5mg physiological-dose adrenal-substitute prednisone (Barnes, 1976, p.208).
Starr also got an undeniably helpful Amazon.com top review from James T. Webber, MD, of San Diego, California (diabetes, metabolism & endocrinology, family practice – 30 years experience):
(excerpt) "Skepticism helped medicine leap forward centuries ago. Dr. Starr's excellent book brings it on. After reading this book, you will know, you, or someone dear to you, will have some expression of hypothyroidism type 2 (thyroid hormone resistance syndrome). His book will empower you to seek, no, insist, on getting the proper treatment. Dr. Starr's assessment that this is an epidemic is true. This is a must-read for all healthcare professionals." [author misspelling corrected] [11]
• MastCell (19:52): "authors without recognized expertise in the field" I previous discussed that issue in Milo (10:10 -3-) above, but here's a summary plus new evidence.
• MastCell (19:52): "Nothing you've written convinces me..." Since you were disappointed that this article wasn't AfD'd, neutral observers wouldn't necessarily expect you to be convinced by any source available for this significant minority view article.
MastCell (19:52): "...that this constitutes a useful encyclopedic source useful encyclopedic source." For just one example of the usefulness of this source, Starr provides an apparently unique report of the Barnes and Sonkin view; that the missing ~33% of hidden hypothyroidism is caused by "Peripheral Resistance Syndrome", as they and science understood it, circa 1988.
Milo 04:31, 12 July 2009 (UTC)
• MastCell (19:52): "...literature for "thyroid resistance syndromes..." .... "...points up the flaws in Starr's book." No source I've read has found the clinical or scientific evidence to prove Starr (or Barnes) are scientifically or clinically wrong. I've evaluated your Chatterjee citation as follows, and you haven't found it either. (We have both emphasized the distinction between hypo- (too little thyroid) and hyper- (too much thyroid) for the convenience of other editors in following this discussion.)
MastCell (19:52): "...according to
PMID
9350446, thyroid hormone resistance .... can be detected by blood tests..." Congratulations, you have evidenced Barnes' case against thyroid hormone blood tests in the inverse.
Chatterjee does describe GRTH and PRTH as associated with "elevated free thyroid hormones in the serum". Both of these are hyperthyroid conditions by blood tests, but since only PRTH patients are thyrotoxic, the blood tests for GRTH are diagnostically inaccurate for symptomatic hyperthyroidism. Why should the exact same tests be inerrantly trusted for hypothyroidism diagnosis?
MastCell (19:52): "unfounded ... to try to link ... to this particular rare medically recognized syndrome" Agreed, since Chatterjee, 1997, is describing a different thyroid resistance syndrome.
Read more carefully
PMID 9350446, abstract of Chatterjee VK, (Horm Res. 1997;48 Suppl 4:43-6),: "...patients with thyrotoxic features, suggesting predominant pituitary resistance (PRTH). Molecular genetic analyses indicate that both GRTH and PRTH are associated with diverse mutations in the thyroid hormone receptor beta gene..." [emphasis added]
Now reread L Wikström, et al, (EMBO J. 1998 January 15; 17(2): 455–461.
Abstract) "developed mice lacking the thyroid hormone receptor TR alpha 1." In addition to abnormal hearts, "The mice have a body temperature 0.5 degrees C [about 1ºF] lower than normal and exhibit a mild hypothyroidism, whereas their overall behavior and reproduction are normal." [emphasis added]
By matched description of symptoms, mice missing TR alpha 1 receptors have the same entity that Barnes observed clinically, that Barnes and Sonkin described as due to "Peripheral Resistance Syndrome", and which Starr and Boc popularly named "Type 2 hypothyroidism" [Starr capitalizes the "T"].
• MastCell (19:52): "I don't think it's a good idea to go down the road of mining the literature for "thyroid resistance syndromes"" This seems to be necessary, because an NPOV requirement is triggered by the article statement: "Barnes' views on the prevalence of hypothyroidism ... run counter to the current medical understanding of thyroid function..." The medical practice community bases this understanding on controversial blood testing which ignores thyroid resistance syndromes. Barnes generally refutes the diagnostic accuracy of blood tests of thyroid hormone supply (Barnes, 1976, p.41-42), Starr and Langer confirm Barnes, and among some non-Barnes sources, David Derry MD, PhD, questions the accuracy of TSH [12]. Furthermore, non-Barnes primary source McDermott, 1993, published research which scientifically supports Barnes' position:
"Thyroid hormone resistance syndromes" (McDermott MT, Am J Med. 1993 Apr;94(4):424-32. Abstract), "Selective peripheral resistance to thyroid hormone (PerRTH)..." [had been identified in one patient with] "...normal serum thyroid hormone and TSH levels but was clinically hypothyroid and improved with thyroid hormone administration. All of these disorders are probably more common than is generally recognized and are often misdiagnosed and inappropriately treated." [emphasis added]
A citation to McDermott also supports various positions of Sonkin, Starr, and Langer.
If "current medical understanding" in the article is allowed to claim or imply that Barnes, (and Sonkin, Starr, and Langer) are wrong, then "current scientific evidence" (per McDermott, 1993, etc.) is allowed to claim or imply that Barnes, et al are correct. Milo 04:40, 12 July 2009 (UTC)
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