This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 |
It would be helpful if the article said which bogus points were used: i.e. where were they on the body with respect to the affected area, other acupuncture points, or other acupuncture meridians. For example, if the knee pain study used non-acupoints at or very near the knee, that would mean that the control could have been active according to TCM theory. (TCM suggests needling points close to a painful area even if those points are not traditional acupounts, especially if those same points are painful or ashi points.)
Needling shallowly at a verum point is also active.
Overall, it would be good to note that both controls, though less active than the treatment, are still potentially or actually active according to TCM theory. Ideally, we could use a source saying this in context of GERAC, to avoid coming even close to WP:SYN. But it could still be mentioned in a brief background section without violating SYN as long as we avoided putting a big "however" qualifier in the conclusion.
Some editors may say that the above sounds like special pleading, but the reasoning comes straight from the IOM [1]. They say that the study of traditional medicines must take into account the traditional context of its practice: i.e., how treatments are formulated (which goes to theory) and delivered. The fact that the IOM makes this point establishes it as a well-weighted, mainstream scientific approach to acupuncture. This is obvious on the merits: It's very hard to see how anyone would argue that the possible use of active control group should be ignored unless that person were scientifically illiterate or disingenuous. -- Middle 8 ( talk) 22:53, 28 May 2012 (UTC)
I found a good secondary source and just added it to the references... Don't have time to go through it right now and it's all in German, but this source should be able to cover most citations in this article. Will come back to it. -- Mallexikon ( talk) 03:02, 5 November 2013 (UTC)
Is the Federal Joint Committee (Germany) article notable. Does it meet Wikipedia notability guidelines? Hmm. QuackGuru ( talk) 05:08, 20 November 2013 (UTC)
In 2006, Edzard Ernst noted that the German Acupuncture Trials (GERAC) had attracted criticism for not controlling the risk of patient de-blinding, and said that they "[failed] to conclusively answer the question whether acupuncture helps patients through a specific or a nonspecific effect".<ref>{{cite journal|doi=10.1111/j.1365-2796.2005.01584.x|title=Acupuncture - a critical analysis|year=2006|last1=Ernst|first1=E.|journal=Journal of Internal Medicine|volume=259|issue=2|pages=125–37|pmid=16420542}}</ref>
I propose we add this text to Acupuncture#Modern era after the article has been deleted or redirected.
This is the one of the few references I could find in the article that discusses the trials. The Federal Joint Committee (Germany) is not reliable. It is an organization comprising of the Central Federal Association of Health Insurance Funds, among others. The dated RCTs are the trials. We don't have enough secondary sources or reliable sources on the trials for a separate article. QuackGuru ( talk) 04:46, 20 November 2013 (UTC)
I have executed a WP:NUKEANDPAVE, which has resolved the problems noted. Alexbrn talk| contribs| COI 06:25, 20 November 2013 (UTC)
I notice A1candidate has re-added a large quantity of poorly-sourced health information to the article that fails WP:MEDRS (specifically for being either a primary source, a non-medical source for health information, or for failing WP:MEDDATE). Conversely Howick, one of only two genuine secondary sourced has been removed (N.B. Howick gives a "negative" assessment of the worth of these trials). This edit appears to be non-neutral. Alexbrn talk| contribs| COI 08:07, 20 November 2013 (UTC)
Sources seem reliable to me (academic journals). The references are messy (cite journal template should be used), but overall I cannot support removal of that information. -- Piotr Konieczny aka Prokonsul Piotrus| reply here 08:35, 20 November 2013 (UTC)
Mallexikon wrote: "GERAC is notable because of its impact on health care in Germany". Any sources for this (not contemporary news items or primary sources)? Alexbrn talk| contribs| COI 05:18, 24 November 2013 (UTC)
According to WP:MEDRS in opening paragraph, "it is vital that the biomedical information in all types of articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge". The overview section is a massive WP:WEIGHT violation because it contains low level details and coat rack information. The article is about the event. It is not about the trials itself. So, I made this change. QuackGuru ( talk) 19:43, 27 November 2013 (UTC)
There have been some edits to the article recently that appear to misrepresent the sources and have the unfortunate effect of skewing POV. For example just now, Mallexikon has removed [2] the words "The trials found no significant differences between acupuncture and sham acupuncture" with the comment "deleting material not supported by the source given ...". Yet the source states: "the difference between real and sham acupuncture in the GERAC trial was not statistically significant". Mallexikon - have you got an explanation? Alexbrn talk| contribs| COI 07:07, 24 November 2013 (UTC)
That's not a "paraphrase" of the deleted content. Alexbrn talk| contribs| COI 05:47, 25 November 2013 (UTC)
I've left primary source citations next to secondary source citations at quite a few places now... The reason for this is that the primary source citations are more reader-friendly (English translation given), while their data is the same. One could argue, however, that the primary sources should generally eliminated. Comments? -- Mallexikon ( talk) 08:33, 25 November 2013 (UTC)
According to Schweizer Fernsehen, the total cost of the trials amounted to 7.5 million Euros.[6]
The low level details using unreliable sources are used everywhere in this article. QuackGuru ( talk) 19:35, 26 November 2013 (UTC)
This is a violation and WP:WEIGHT and WP:LEAD. Is there a reason to keep the low level details. QuackGuru ( talk) 17:50, 27 November 2013 (UTC)
The trials received coverage from most of the major media outlets in Germany.[65][not in citation given][unreliable source?] This article is very poorly written. The source an editor added failed verification. QuackGuru ( talk) 19:38, 26 November 2013 (UTC)
I removed the unreliable sources. The unreliable sources are not needed in the reference section. They were not used to verify the text. QuackGuru ( talk) 19:42, 26 November 2013 (UTC)
The unused primary sources have been restored inside the reference section. QuackGuru ( talk) 01:42, 27 November 2013 (UTC)
The trials were published in 2006. How could a dated 2005 source be reliable? This seems too old when there are newer sources. QuackGuru ( talk) 20:24, 26 November 2013 (UTC)
There are two sources but I think only one is used to verify the text. QuackGuru ( talk) 20:43, 26 November 2013 (UTC)
News magazine Der Spiegel pointed out that the results of GERAC couldn't be brushed aside by the Federal Joint Committee anymore. [6] The words pointed out is not neutral. QuackGuru ( talk) 01:57, 27 November 2013 (UTC)
"Pointed out" is neutral. - A1candidate ( talk) 14:17, 27 November 2013 (UTC)
The BBC pointed out that the study "echoes the findings of two studies published last year in the British Medical Journal, which found a short course of acupuncture could benefit patients with low back pain".[74] "Pointed out" is not neutral. QuackGuru ( talk) 18:19, 27 November 2013 (UTC)
Please stop tagging everything in this article. If you have serious issues with a particular source, there's already an ongoing discussion at Wikipedia:Reliable_sources, so why not wait and listen to the opinions of other editors first, before mass tagging? - A1candidate ( talk) 14:26, 27 November 2013 (UTC)
"This trial was one of the first large-scale controlled clinical trials of acupuncture in the world. The results suggested that there was no difference between acupoints and non-acupoints, and some insurance companies in Germany stopped reimbursement for acupuncture treatment. The trial's conclusion has had a negative impact on acupuncture and moxibustion in the international community." [8]
The abstract of the 2013 source. QuackGuru ( talk) 02:30, 28 November 2013 (UTC)
The references include extensive notes/quotes. These should be broken out into a notes section. The general references should be broken out into a bibliography section (preferably with anchors). Once the editing disputes have settled down some I will perform these edits unless there is objection. Once that is done it will probably be appropriate to edit down the notes. We don't need to quote extensively from sourcesĕ those interested can refer to the sources, again this needs to wait until contention has subsided. The quoting is support for various arguments about the article but does not belong in an encyclopedic article. - - MrBill3 ( talk) 11:39, 28 November 2013 (UTC)
I cleaned out some of the more obvious fluff. aprock ( talk) 04:18, 30 November 2013 (UTC)
My opinion is not that strong either, only three remain and they are pretty decent. My support is based on a preference for a clean tight article, concise. Also anything worth saying should go into the text unless it is needed for explanation of a brief statement. To play the devil's advocate I would say: encyclopedic, due and OR. Again not a major bone of contention for me (the previous quoted content was excessive, now reasonable). Willing to bend to consensus, see what others have to say.
I am probably going to boldly edit the format of the refs. I wish the page numbers hadn't been removed from several refs.
Any comments on breaking out multiply cited refs into a bibliography section? I don't know if its needed or appropriate. - - MrBill3 ( talk) 08:06, 2 December 2013 (UTC)
The excessive details and other nonsense was restored. It was a cut and paste copy that was part of an old version of the article. QuackGuru ( talk) 04:21, 1 December 2013 (UTC)
The nonsense had been restored again. QuackGuru ( talk) 04:38, 1 December 2013 (UTC)
The trial results should not be detailed as that violated WP:MEDRS. Even detailing the trial setup strikes me as a little undue, but heh ... I'll not argue over that. What you really need here is to use a secondary source that gives a historical perspective and a mainstream, current view. Alexbrn talk| contribs| COI 07:01, 1 December 2013 (UTC)
Before deciding what information should go in the article perhaps we should consider what sources ought to be cited. Could we decide which sources are primary and which are secondary? Here are some sources for consideration. Please add others, and most importantly, let's identify secondary sources. Here are some sources that seem significant, but which may be primary. Is there anyone here who thinks that these sources should form the base of the article?
He, W.; Tong, Y.; Zhao, Y.; Zhang, L.; Ben, H.; Qin, Q.; Huang, F.; Rong, P. (2013). "Review of controlled clinical trials on acupuncture versus sham acupuncture in Germany". Journal of traditional Chinese medicine. 33 (3): 403–7.
PMID
24024341. {{
cite journal}}
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suggested) (
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a fringe journal)
What are some better sources? Has discussion centered around individual sources already happened? Blue Rasberry (talk) 13:01, 1 December 2013 (UTC)
Rates of improvement among patients treated with acupuncture, sham acupuncture, and standard therapy | |||||
---|---|---|---|---|---|
Treatment | Low back pain | Knee osteoarthritis | Migraine | Tension headache | |
Acupuncture | 47.6% [1] | 53.1% [2] | 47% [3] | 33% [4] | |
Sham acupuncture | 44.2% [1] | 51.0% [2] | 39% [5] | 27% [4] | |
Standard therapy | 27.4% [1] | 29.1% [2] | 40% [3] | N.A. [6] | |
Note: The treatment outcome of standard therapy for tension headache could not be determined because a large number of patients who were prescribed with Amitriptyline did not comply to take it. [6] |
- A1candidate ( talk) 13:31, 1 December 2013 (UTC)
References
shenker
was invoked but never defined (see the
help page).The GERAC trials were being conducted to compare acupuncture to sham acupuncture and guideline-oriented standard therapy. Unlike ARTs though, GERAC found very little difference between acupuncture and sham acupuncture. In results published by Scharf et al. in 2006, the success rates (defined as a 36% improvement in WOMAC scores at 13 and 26 weeks) were 53.1% for acupuncture, 51.0% for sham acupuncture, and 29.1% for standard therapy. Both acupuncture and sham acupuncture were significantly better than standard therapy.
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The proportion of responders, defined as patients with a reduction of migraine days by at least 50%, 26 weeks after randomization, was 47% in the verum group, 39% in the sham acupuncture group, and 40% in the standard group (P= .133).
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The meta-analyses on response, headache days per 4 weeks and intensity are heavily influenced by the large, rigorous trial by Endres 2007. For headache frequency (response and headache days per 4 weeks), this trial found statistically significant benefits over sham acupuncture. Interestingly, for the predefined outcome measure of this trial, the difference was not statistically significant (P = 0.18). The predefined outcome measure was the proportion of patients with at least 50% reduction at 6 months, but patients with protocol violations were counted as non-responders. For example, patients who changed from one analgesic to another were reclassified as non-responders. Thus, only 33% in the true acupuncture and 27% in the sham group were counted as responders, while the commonly used response criterion without reclassification yielded responder proportions of 66% and 55%, respectively.
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The researchers then returned to the patients between 23 and 26 weeks later and checked on whether they had been "migraine free" for 50% of days. It was found 47% of those receiving traditional acupuncture, 39% of those given sham acupuncture and 40% of those in the drug treatment group had been migraine-free for at least 50% of the time.
The trial by Endres 2007 was originally designed to include a third arm of patients randomized to amitriptyline, the currently most widely accepted therapy (Diener 2004). However, as patients were unwilling to participate in a trial with the possibility of being randomized to amitriptyline, this arm was dropped after 1 year of very poor accrual.
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Results from these studies should not be included in the article as they are medical claims. A statement that the studies showed positive results but have since been discredited is appropriate. We can't have old, discredited medical claims presented. Details of the studies methodology are undue (especially since the studies have been discredited superseded). This article is not the place for a discussion of research methodology, particularly flawed methodology. Essentially what we have is that these studies were conducted, they were fairly large, they had an impact, they were discussed in popular, political and scientific publications, they have been largely discredited widely criticized, some of the legal/financial impacts have been revised. That is the subject of this article. The specifics details of the studies are undue and not MEDRS. Detail on the impact of the studies, the depth and nature of discussion of the studies and changes that resulted from the discussions are what belong in this article. - -
MrBill3 (
talk)
00:43, 2 December 2013 (UTC)
The specific results should be deleted. QuackGuru ( talk) 20:46, 12 December 2013 (UTC)
More nonsense deleted. QuackGuru ( talk) 19:02, 14 December 2013 (UTC)
There is OR in the lead. I propose the OR should be removed. QuackGuru ( talk) 05:14, 15 December 2013 (UTC)
Enough. I filed a complaint at Wikipedia:Administrators' noticeboard/IncidentArchive822#Disruptive editing by User:QuackGuru. -- Mallexikon ( talk) 09:39, 15 December 2013 (UTC)
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help) ... but they included an English summary on page 2.Mallexikon, but would you be kind enough to split this information for me? Pull out 1-2 contentious statements with their sources, replicate them here, and then let me comment. Otherwise confirm that you like the statement that I pulled and the way I am framing this. I am looking at what you and QuackGuru have done and I expect that I have a third opinion different from what either of you are doing. I think it would be more useful to talk about 1-2 items initially to see if we can work together rather than for me to try to comment on those 5 points you made all together. Let me start with something -
Here are the items requested:
(1) I like the idea of giving the number of test subjects because it is a fundamental question for any clinical trial. I recognize that this information is coming from a primary source, but I that since it is a defining characteristic of a trial, if a trial is worth describing the the number of participants is worth mentioning. Is there opposition to including this number whenever a trial is mentioned? Is there opposition to mentioning the names of trials which constitute the "German acupuncture trials"?
(2) If the design of the sham treatment and the training of the acupuncturist are mentioned, then that should go into a critical response section and be tied to a source which is not a paper published by the study coordinators. Right now I see
The acupuncture point selection was partially predetermined.<ref name="da1"/> Needles were to be manipulated until arrival of [[Acupuncture#De-qi sensation|''de-qi'']] sensation.<ref name="da1"/> For sham acupuncture, needles were inserted only superficially (3 mm at most), and at bogus points; there also was no subsequent manipulation.<ref name="da1"/> Thus, only the patients (not the performing acupuncturists) could be [[Blind experiment#Single-blind trials|blinded]].<ref name="da1"/> Assessment regarding the therapy's efficacy was undertaken by blinded interviewers.<ref name="da1"/>
which is all taken from a primary source, right? Why can all of this not be summarized simply by saying "sham acupuncture was used"? If no secondary source is identified to cite for this information and interpret it, then why include it at all? Is it correct to say that Mallexikon, you feel this information must be included? If so, is it correct that there is no secondary source and that you would like this referenced to a primary source? Why should there be an exception to the general rule in this case? Blue Rasberry (talk) 04:23, 19 December 2013 (UTC)
Control group setup *De-qi = positive *location = incorrect *Insertion = 3mm
Control group evaluation *Coordinating scientists = valid *government = valid *critics = invalid
"the results suggested that there was no difference between acupoints and non-acupoints, and some insurance companies in Germany stopped reimbursement for acupuncture treatment." [15] QuackGuru ( talk) 06:23, 18 December 2013 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 |
It would be helpful if the article said which bogus points were used: i.e. where were they on the body with respect to the affected area, other acupuncture points, or other acupuncture meridians. For example, if the knee pain study used non-acupoints at or very near the knee, that would mean that the control could have been active according to TCM theory. (TCM suggests needling points close to a painful area even if those points are not traditional acupounts, especially if those same points are painful or ashi points.)
Needling shallowly at a verum point is also active.
Overall, it would be good to note that both controls, though less active than the treatment, are still potentially or actually active according to TCM theory. Ideally, we could use a source saying this in context of GERAC, to avoid coming even close to WP:SYN. But it could still be mentioned in a brief background section without violating SYN as long as we avoided putting a big "however" qualifier in the conclusion.
Some editors may say that the above sounds like special pleading, but the reasoning comes straight from the IOM [1]. They say that the study of traditional medicines must take into account the traditional context of its practice: i.e., how treatments are formulated (which goes to theory) and delivered. The fact that the IOM makes this point establishes it as a well-weighted, mainstream scientific approach to acupuncture. This is obvious on the merits: It's very hard to see how anyone would argue that the possible use of active control group should be ignored unless that person were scientifically illiterate or disingenuous. -- Middle 8 ( talk) 22:53, 28 May 2012 (UTC)
I found a good secondary source and just added it to the references... Don't have time to go through it right now and it's all in German, but this source should be able to cover most citations in this article. Will come back to it. -- Mallexikon ( talk) 03:02, 5 November 2013 (UTC)
Is the Federal Joint Committee (Germany) article notable. Does it meet Wikipedia notability guidelines? Hmm. QuackGuru ( talk) 05:08, 20 November 2013 (UTC)
In 2006, Edzard Ernst noted that the German Acupuncture Trials (GERAC) had attracted criticism for not controlling the risk of patient de-blinding, and said that they "[failed] to conclusively answer the question whether acupuncture helps patients through a specific or a nonspecific effect".<ref>{{cite journal|doi=10.1111/j.1365-2796.2005.01584.x|title=Acupuncture - a critical analysis|year=2006|last1=Ernst|first1=E.|journal=Journal of Internal Medicine|volume=259|issue=2|pages=125–37|pmid=16420542}}</ref>
I propose we add this text to Acupuncture#Modern era after the article has been deleted or redirected.
This is the one of the few references I could find in the article that discusses the trials. The Federal Joint Committee (Germany) is not reliable. It is an organization comprising of the Central Federal Association of Health Insurance Funds, among others. The dated RCTs are the trials. We don't have enough secondary sources or reliable sources on the trials for a separate article. QuackGuru ( talk) 04:46, 20 November 2013 (UTC)
I have executed a WP:NUKEANDPAVE, which has resolved the problems noted. Alexbrn talk| contribs| COI 06:25, 20 November 2013 (UTC)
I notice A1candidate has re-added a large quantity of poorly-sourced health information to the article that fails WP:MEDRS (specifically for being either a primary source, a non-medical source for health information, or for failing WP:MEDDATE). Conversely Howick, one of only two genuine secondary sourced has been removed (N.B. Howick gives a "negative" assessment of the worth of these trials). This edit appears to be non-neutral. Alexbrn talk| contribs| COI 08:07, 20 November 2013 (UTC)
Sources seem reliable to me (academic journals). The references are messy (cite journal template should be used), but overall I cannot support removal of that information. -- Piotr Konieczny aka Prokonsul Piotrus| reply here 08:35, 20 November 2013 (UTC)
Mallexikon wrote: "GERAC is notable because of its impact on health care in Germany". Any sources for this (not contemporary news items or primary sources)? Alexbrn talk| contribs| COI 05:18, 24 November 2013 (UTC)
According to WP:MEDRS in opening paragraph, "it is vital that the biomedical information in all types of articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge". The overview section is a massive WP:WEIGHT violation because it contains low level details and coat rack information. The article is about the event. It is not about the trials itself. So, I made this change. QuackGuru ( talk) 19:43, 27 November 2013 (UTC)
There have been some edits to the article recently that appear to misrepresent the sources and have the unfortunate effect of skewing POV. For example just now, Mallexikon has removed [2] the words "The trials found no significant differences between acupuncture and sham acupuncture" with the comment "deleting material not supported by the source given ...". Yet the source states: "the difference between real and sham acupuncture in the GERAC trial was not statistically significant". Mallexikon - have you got an explanation? Alexbrn talk| contribs| COI 07:07, 24 November 2013 (UTC)
That's not a "paraphrase" of the deleted content. Alexbrn talk| contribs| COI 05:47, 25 November 2013 (UTC)
I've left primary source citations next to secondary source citations at quite a few places now... The reason for this is that the primary source citations are more reader-friendly (English translation given), while their data is the same. One could argue, however, that the primary sources should generally eliminated. Comments? -- Mallexikon ( talk) 08:33, 25 November 2013 (UTC)
According to Schweizer Fernsehen, the total cost of the trials amounted to 7.5 million Euros.[6]
The low level details using unreliable sources are used everywhere in this article. QuackGuru ( talk) 19:35, 26 November 2013 (UTC)
This is a violation and WP:WEIGHT and WP:LEAD. Is there a reason to keep the low level details. QuackGuru ( talk) 17:50, 27 November 2013 (UTC)
The trials received coverage from most of the major media outlets in Germany.[65][not in citation given][unreliable source?] This article is very poorly written. The source an editor added failed verification. QuackGuru ( talk) 19:38, 26 November 2013 (UTC)
I removed the unreliable sources. The unreliable sources are not needed in the reference section. They were not used to verify the text. QuackGuru ( talk) 19:42, 26 November 2013 (UTC)
The unused primary sources have been restored inside the reference section. QuackGuru ( talk) 01:42, 27 November 2013 (UTC)
The trials were published in 2006. How could a dated 2005 source be reliable? This seems too old when there are newer sources. QuackGuru ( talk) 20:24, 26 November 2013 (UTC)
There are two sources but I think only one is used to verify the text. QuackGuru ( talk) 20:43, 26 November 2013 (UTC)
News magazine Der Spiegel pointed out that the results of GERAC couldn't be brushed aside by the Federal Joint Committee anymore. [6] The words pointed out is not neutral. QuackGuru ( talk) 01:57, 27 November 2013 (UTC)
"Pointed out" is neutral. - A1candidate ( talk) 14:17, 27 November 2013 (UTC)
The BBC pointed out that the study "echoes the findings of two studies published last year in the British Medical Journal, which found a short course of acupuncture could benefit patients with low back pain".[74] "Pointed out" is not neutral. QuackGuru ( talk) 18:19, 27 November 2013 (UTC)
Please stop tagging everything in this article. If you have serious issues with a particular source, there's already an ongoing discussion at Wikipedia:Reliable_sources, so why not wait and listen to the opinions of other editors first, before mass tagging? - A1candidate ( talk) 14:26, 27 November 2013 (UTC)
"This trial was one of the first large-scale controlled clinical trials of acupuncture in the world. The results suggested that there was no difference between acupoints and non-acupoints, and some insurance companies in Germany stopped reimbursement for acupuncture treatment. The trial's conclusion has had a negative impact on acupuncture and moxibustion in the international community." [8]
The abstract of the 2013 source. QuackGuru ( talk) 02:30, 28 November 2013 (UTC)
The references include extensive notes/quotes. These should be broken out into a notes section. The general references should be broken out into a bibliography section (preferably with anchors). Once the editing disputes have settled down some I will perform these edits unless there is objection. Once that is done it will probably be appropriate to edit down the notes. We don't need to quote extensively from sourcesĕ those interested can refer to the sources, again this needs to wait until contention has subsided. The quoting is support for various arguments about the article but does not belong in an encyclopedic article. - - MrBill3 ( talk) 11:39, 28 November 2013 (UTC)
I cleaned out some of the more obvious fluff. aprock ( talk) 04:18, 30 November 2013 (UTC)
My opinion is not that strong either, only three remain and they are pretty decent. My support is based on a preference for a clean tight article, concise. Also anything worth saying should go into the text unless it is needed for explanation of a brief statement. To play the devil's advocate I would say: encyclopedic, due and OR. Again not a major bone of contention for me (the previous quoted content was excessive, now reasonable). Willing to bend to consensus, see what others have to say.
I am probably going to boldly edit the format of the refs. I wish the page numbers hadn't been removed from several refs.
Any comments on breaking out multiply cited refs into a bibliography section? I don't know if its needed or appropriate. - - MrBill3 ( talk) 08:06, 2 December 2013 (UTC)
The excessive details and other nonsense was restored. It was a cut and paste copy that was part of an old version of the article. QuackGuru ( talk) 04:21, 1 December 2013 (UTC)
The nonsense had been restored again. QuackGuru ( talk) 04:38, 1 December 2013 (UTC)
The trial results should not be detailed as that violated WP:MEDRS. Even detailing the trial setup strikes me as a little undue, but heh ... I'll not argue over that. What you really need here is to use a secondary source that gives a historical perspective and a mainstream, current view. Alexbrn talk| contribs| COI 07:01, 1 December 2013 (UTC)
Before deciding what information should go in the article perhaps we should consider what sources ought to be cited. Could we decide which sources are primary and which are secondary? Here are some sources for consideration. Please add others, and most importantly, let's identify secondary sources. Here are some sources that seem significant, but which may be primary. Is there anyone here who thinks that these sources should form the base of the article?
He, W.; Tong, Y.; Zhao, Y.; Zhang, L.; Ben, H.; Qin, Q.; Huang, F.; Rong, P. (2013). "Review of controlled clinical trials on acupuncture versus sham acupuncture in Germany". Journal of traditional Chinese medicine. 33 (3): 403–7.
PMID
24024341. {{
cite journal}}
: Unknown parameter |displayauthors=
ignored (|display-authors=
suggested) (
help) (
a fringe journal)
What are some better sources? Has discussion centered around individual sources already happened? Blue Rasberry (talk) 13:01, 1 December 2013 (UTC)
Rates of improvement among patients treated with acupuncture, sham acupuncture, and standard therapy | |||||
---|---|---|---|---|---|
Treatment | Low back pain | Knee osteoarthritis | Migraine | Tension headache | |
Acupuncture | 47.6% [1] | 53.1% [2] | 47% [3] | 33% [4] | |
Sham acupuncture | 44.2% [1] | 51.0% [2] | 39% [5] | 27% [4] | |
Standard therapy | 27.4% [1] | 29.1% [2] | 40% [3] | N.A. [6] | |
Note: The treatment outcome of standard therapy for tension headache could not be determined because a large number of patients who were prescribed with Amitriptyline did not comply to take it. [6] |
- A1candidate ( talk) 13:31, 1 December 2013 (UTC)
References
shenker
was invoked but never defined (see the
help page).The GERAC trials were being conducted to compare acupuncture to sham acupuncture and guideline-oriented standard therapy. Unlike ARTs though, GERAC found very little difference between acupuncture and sham acupuncture. In results published by Scharf et al. in 2006, the success rates (defined as a 36% improvement in WOMAC scores at 13 and 26 weeks) were 53.1% for acupuncture, 51.0% for sham acupuncture, and 29.1% for standard therapy. Both acupuncture and sham acupuncture were significantly better than standard therapy.
{{
cite journal}}
: Check date values in: |date=
(
help); Italic or bold markup not allowed in: |journal=
(
help); Unknown parameter |coauthors=
ignored (|author=
suggested) (
help); Unknown parameter |month=
ignored (
help)CS1 maint: date and year (
link)
The proportion of responders, defined as patients with a reduction of migraine days by at least 50%, 26 weeks after randomization, was 47% in the verum group, 39% in the sham acupuncture group, and 40% in the standard group (P= .133).
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The meta-analyses on response, headache days per 4 weeks and intensity are heavily influenced by the large, rigorous trial by Endres 2007. For headache frequency (response and headache days per 4 weeks), this trial found statistically significant benefits over sham acupuncture. Interestingly, for the predefined outcome measure of this trial, the difference was not statistically significant (P = 0.18). The predefined outcome measure was the proportion of patients with at least 50% reduction at 6 months, but patients with protocol violations were counted as non-responders. For example, patients who changed from one analgesic to another were reclassified as non-responders. Thus, only 33% in the true acupuncture and 27% in the sham group were counted as responders, while the commonly used response criterion without reclassification yielded responder proportions of 66% and 55%, respectively.
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The researchers then returned to the patients between 23 and 26 weeks later and checked on whether they had been "migraine free" for 50% of days. It was found 47% of those receiving traditional acupuncture, 39% of those given sham acupuncture and 40% of those in the drug treatment group had been migraine-free for at least 50% of the time.
The trial by Endres 2007 was originally designed to include a third arm of patients randomized to amitriptyline, the currently most widely accepted therapy (Diener 2004). However, as patients were unwilling to participate in a trial with the possibility of being randomized to amitriptyline, this arm was dropped after 1 year of very poor accrual.
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Results from these studies should not be included in the article as they are medical claims. A statement that the studies showed positive results but have since been discredited is appropriate. We can't have old, discredited medical claims presented. Details of the studies methodology are undue (especially since the studies have been discredited superseded). This article is not the place for a discussion of research methodology, particularly flawed methodology. Essentially what we have is that these studies were conducted, they were fairly large, they had an impact, they were discussed in popular, political and scientific publications, they have been largely discredited widely criticized, some of the legal/financial impacts have been revised. That is the subject of this article. The specifics details of the studies are undue and not MEDRS. Detail on the impact of the studies, the depth and nature of discussion of the studies and changes that resulted from the discussions are what belong in this article. - -
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The specific results should be deleted. QuackGuru ( talk) 20:46, 12 December 2013 (UTC)
More nonsense deleted. QuackGuru ( talk) 19:02, 14 December 2013 (UTC)
There is OR in the lead. I propose the OR should be removed. QuackGuru ( talk) 05:14, 15 December 2013 (UTC)
Enough. I filed a complaint at Wikipedia:Administrators' noticeboard/IncidentArchive822#Disruptive editing by User:QuackGuru. -- Mallexikon ( talk) 09:39, 15 December 2013 (UTC)
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help) ... but they included an English summary on page 2.Mallexikon, but would you be kind enough to split this information for me? Pull out 1-2 contentious statements with their sources, replicate them here, and then let me comment. Otherwise confirm that you like the statement that I pulled and the way I am framing this. I am looking at what you and QuackGuru have done and I expect that I have a third opinion different from what either of you are doing. I think it would be more useful to talk about 1-2 items initially to see if we can work together rather than for me to try to comment on those 5 points you made all together. Let me start with something -
Here are the items requested:
(1) I like the idea of giving the number of test subjects because it is a fundamental question for any clinical trial. I recognize that this information is coming from a primary source, but I that since it is a defining characteristic of a trial, if a trial is worth describing the the number of participants is worth mentioning. Is there opposition to including this number whenever a trial is mentioned? Is there opposition to mentioning the names of trials which constitute the "German acupuncture trials"?
(2) If the design of the sham treatment and the training of the acupuncturist are mentioned, then that should go into a critical response section and be tied to a source which is not a paper published by the study coordinators. Right now I see
The acupuncture point selection was partially predetermined.<ref name="da1"/> Needles were to be manipulated until arrival of [[Acupuncture#De-qi sensation|''de-qi'']] sensation.<ref name="da1"/> For sham acupuncture, needles were inserted only superficially (3 mm at most), and at bogus points; there also was no subsequent manipulation.<ref name="da1"/> Thus, only the patients (not the performing acupuncturists) could be [[Blind experiment#Single-blind trials|blinded]].<ref name="da1"/> Assessment regarding the therapy's efficacy was undertaken by blinded interviewers.<ref name="da1"/>
which is all taken from a primary source, right? Why can all of this not be summarized simply by saying "sham acupuncture was used"? If no secondary source is identified to cite for this information and interpret it, then why include it at all? Is it correct to say that Mallexikon, you feel this information must be included? If so, is it correct that there is no secondary source and that you would like this referenced to a primary source? Why should there be an exception to the general rule in this case? Blue Rasberry (talk) 04:23, 19 December 2013 (UTC)
Control group setup *De-qi = positive *location = incorrect *Insertion = 3mm
Control group evaluation *Coordinating scientists = valid *government = valid *critics = invalid
"the results suggested that there was no difference between acupoints and non-acupoints, and some insurance companies in Germany stopped reimbursement for acupuncture treatment." [15] QuackGuru ( talk) 06:23, 18 December 2013 (UTC)