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Pathomechanism, risk factors and diagnosis

As I have been suggested here and here, you have to discuss in the English Wikipedia whether you are allowed to expand an article or not. Hence the question whether the pathomechanism, some of the risk factors or the diagnosis may be mentioned in the article or not. Opinions? -- Brackenheim ( talk) 22:41, 14 August 2021 (UTC) reply

Note: In Germany we have an ICD-10 classification for MCS as well as a large medical association that is constantly researching the disease. Both the disease and the orthomolecular therapy have also received multiple legal recognition. Therefore, one can say that the pathomechanism relates to the situation in Germany. Perhaps the mechanism is different in other countries - then I would be very interested in the sources ... -- Brackenheim ( talk) 09:44, 15 August 2021 (UTC) reply
At this time, as only sources for Germany have been produced we can only say this is true in Germany. Slatersteven ( talk) 12:51, 15 August 2021 (UTC) reply
What is the name of this "large medical association"? It wouldn't happen to be Deutsche Gesellschaft für Orthomolekular-Medizin (German Society for Orthomolecular Medicine), would it?
Regardless of this, the changes you have made are not acceptable without discussion. You should not have edit warred, but sought a consensus. Currently, the article presents the condition as if it's uncontroversial ("is a chronic acquired illness"), by contrast to the long-standing consensus version ("is an unrecognized and controversial diagnosis"). The article needs to be reverted back to the March 29 version (right before an IP radically changed things, without anyone noticing the change). Some good edits after that might deserve restoration, but the current presentation of a fringe subject as if it's a mainstream subject is not acceptable.
It appears that this article hasn't been monitored, so fringe advocates have run wild here. Bbb23, we need to get this done so we can then discuss the future development of the article, but currently the article is a literal danger to public health (some treatment options for MCS are dangerous). Any mainstream recognition of the condition since that time can then be used to update the article.
BTW, the ICD-11 has no listing for MCS. -- Valjean ( talk) 15:44, 15 August 2021 (UTC) reply
It looks like the March 29th version is the long standing at this point. From what I can tell, as an outside observer that just saw the WP:AN3 posting, it looks like Brackenheim was restoring the status quo. Given that fact, BRD should of been followed by Slatersteven & ScienceFlyer who failed to start any discussion on the topic. PackMecEng ( talk) 16:00, 15 August 2021 (UTC) reply
Errr, that was the version we reverted to. This is Brackenheim's first edit [ [1]], it is an addition, not a restoration. Made after the 29th of March. Slatersteven ( talk) 16:08, 15 August 2021 (UTC) reply
Exactly. Brackenheim added huge amounts of content without any discussion. So that's a BOLD series of edits. If they had met no resistance, that would have been okay, but they did meet resistance. Then they edit warred repeatedly and their version is now frozen by the protection. Disputed BOLD edits must be reverted and then discussed. -- Valjean ( talk) 16:12, 15 August 2021 (UTC) reply
So as it is accepted the 29th of march version is the long-standing version, the article should be reset to that point. Slatersteven ( talk) 16:30, 15 August 2021 (UTC) reply
The name of the medical association is "Deutscher Berufsverband Klinischer Umweltmediziner". As you can read in the article ( Multiple_chemical_sensitivity#International_Statistical_Classification_of_Diseases), "the public health service in Germany permits healthcare providers to bill for MCS-related medical services under the ICD-10 code T78.4".
I’m sorry I included the section without discussion. I have always found Wikipedia to be a free encyclopedia in which everyone can share their knowledge with others. So it was alien to me so far to ask first and then expand an article. Although I was warned by a number of Wikipedians that the corresponding regulations in the English Wikipedia are totally different, I simply could not imagine this until now. -- Brackenheim ( talk) 19:32, 15 August 2021 (UTC) reply
ICD-11 (WHO): 4A8Z (see: Transition from ICD-10-GM to ICD-11 -- Brackenheim ( talk) 22:14, 15 August 2021 (UTC) reply
There is no problem in principle with including something without discussion. See WP:BRD. -- Hob Gadling ( talk) 06:37, 16 August 2021 (UTC) reply
Yes, BRD starts with WP:BOLD, but that stops applying when the edit meets objections (the "R" in BRD). Then the previously existing status quo version should be restored while ongoing "D"iscussion determines what to do. -- Valjean ( talk) 15:51, 16 August 2021 (UTC) reply
I had tried to leave that part as an exercise to Brackenheim, but you are probably right to spell it out. -- Hob Gadling ( talk) 20:49, 17 August 2021 (UTC) reply
Apologies for the delay in commenting. I support reverting to the state of the article as it was on March 29. It is premature to discuss the pathogenesis of a condition that hasn't been found to exist. This was extensively discussed in 2019, when a consensus was reached. The presence of an ICD code does not mean that a condition is common or even that it exists. Medical professionals often joke about the absurdity of some ICD codes, and there are some ICD codes for pseudoscientific diagnoses such as "Liver qi stagnation pattern" and "Bladder meridian pattern". Additionally, WHO ICD10 codes ( J68.9, T78.4 ) do not seem to mention MCS. ScienceFlyer ( talk) 17:09, 17 August 2021 (UTC) reply
I am following up on this and again propose to revert to the article state as of March 29. ScienceFlyer ( talk) 11:43, 26 August 2021 (UTC) reply
If there is no further objection, I will revert the article to the state as of March 29. ScienceFlyer ( talk) 07:46, 30 August 2021 (UTC) reply
I am still in favor of at least leaving the explanations of the pathomechanism in the article. There are many diseases with unknown cause or with only little known facts (e.g. idiopathic Parkinson's syndrome). Such diseases do not have a simple mechanism as there is with a cold, so Wikipedia should rather reflect the current state of research. -- Brackenheim ( talk) 11:48, 30 August 2021 (UTC) reply
My apologies for lacking mastery of Wikipedia notifications. If I had known this discussion was taking place last month, I would have objected to reverting the article to its March 29 state. It is my belief that that state, and the state of at least a decade preceding, contains a mix of facts (that's what Wikipedia should report) and opinions which both serve special interests and contradict my lived experience of the last 25 years with MCS. That is, the article of that date used classic propaganda techniques to convey a belief not based in fact. Fstevenchalmers ( talk) 23:50, 17 September 2021 (UTC) reply

Upon again reviewing this section, it is obvious that the first paragraph is completely erroneous in saying MCS is unrecognized, as it is recognized legally and medically in several jurisdictions, as pointed out by Brackenheim (Germany) and myself (Canada as well as Germany, Luxembourg, Austria, Japan, Australia, new Mexico, and the USA department of education). If you disagree with me, then please provide contradiction to its recognition at the Federal level in Canada by the Canadian Human Rights Commission. However, as long as a single governing entity in the world (such as the CHRC where I live) officially recognizes it, then it is not unrecognized.

Therefore, in order to repair this mistake, I suggest we replace recognized with one of the following 3 changes:

1) Remove the word unrecognized completely.

2) Replace unrecognized with "formerly unrecognized"

3) Replace unrecognized with "unrecognized by (list bodies that do not recognize MCS, with citations on their official stance) and recognized by (list bodies that recognize MCS, with citations on their official stance)

If there are no opinions within say, 1 week, I can just go ahead and fix this error, likely with option 1.

Silliestchris ( talk) 23:26, 17 September 2021 (UTC) reply

Concur that the word "unrecognized" conveys an opinion, not fact. I believe this word is in the article to color the reader's perception based on an author's opinion and not based on fact. The fact is MCS is recognized by some and recognition is vehemently opposed by others. I think the simplest correction to opinion having crept into this article which is supposed to be fact based is Silliestchris's option 1 above. Fstevenchalmers ( talk) 23:50, 17 September 2021 (UTC) reply

References

  1. ^ "Policy on Environmental Sensitivities" (PDF). https://www.chrc-ccdp.gc.ca/en. Canadian Human Rights Commission. Retrieved 17 September 2021. {{ cite web}}: External link in |website= ( help)
  2. ^ Wilkie, Cara. "Accommodation for Environmental Sensitivities: Legal Perspective" (PDF). https://www.chrc-ccdp.gc.ca/. Canadian Human Rights Commission. Retrieved 17 September 2021. {{ cite web}}: External link in |website= ( help)

I agree with removing the word "unrecognized". In addition to the bodies mentioned earlier, there are also state agencies in the USA that recognize MCS. Janraison ( talk) 04:29, 18 September 2021 (UTC) reply

→Janraison, you would be doing non-partisanism a great service if you listed here the state agencies in the USA that recognize MCS, and for bonus points you could provide links to where this is stated.

Silliestchris ( talk) 04:48, 18 September 2021 (UTC) reply

I concur that the word unrecognized should be removed, as it conveys an opinion! Other editors have pointed out numerous institutions that recognize it. Sciencebuilder ( talk) 01:44, 27 September 2021 (UTC) reply

I believe the word unrecognized should be removed from the first sentence.
I would also appreciate it if people would quit claiming that permission to get paid when someone shows up in your clinic means that it's a recognized disease entity.
Although I'm pretty sure that it won't do any good, let me once again say that to be a recognized disease entity, it has to be a single condition with a predictable pattern. Every single person who has the thing has to have the same thing. Every person who shows up with the predictable pattern has to have that thing. This is probably not true with MCS. The science isn't there yet. We're still at a point when five licensed physicians could look at the same patient, and one could say "must be MCS", one could say "it's obviously Chronic Lyme disease", a third could say "Looks like Chronic fatigue syndrome with anxiety to me", the fourth could say "You're all wrong, because it's Traumatic brain injury", and the fifth could say " Post-traumatic stress disorder, with traumatic coupling to strong scents".
"Recognized" does not mean that sick people get disability benefits. "Recognized" means that we know enough that mainstream medicine has enough information that they can expect doctors to recognize when the patient has it, and when the patient doesn't. WhatamIdoing ( talk) 02:23, 30 October 2021 (UTC) reply
WhatamIdoing is correct here. The condition is unrecognized by the scientific community. Chamaemelum ( talk) 22:07, 9 July 2023 (UTC) reply

Remove pdate template?

Is there reall major, actual, research such as meta-studies on this that warrant the update-template? Looking at the article as well as the Talk page it looks obvious that the crrent article ver ell represent the current state of research. Is it fair to remove the "update" template? Leord Redhammer ( talk) 12:25, 4 March 2022 (UTC) reply

Possibly Relevant

I have no idea whether this is worth putting in the article, but it looks like there may be some relationship between this and mast cell disorders like Mast Cell Activation Syndrome. https://enveurope.springeropen.com/articles/10.1186/s12302-021-00570-3

Possibly also relevant, not that it's worth citing: https://www.hsph.harvard.edu/hoffman-program/resources/chemicals-in-your-life/what-is-mcstilt/ 173.66.202.193 ( talk) 03:12, 30 July 2023 (UTC) reply

The list of differential diagnoses is long. That's one of the challenges with having (or trying to diagnose a patient who has) non-specific symptoms. WhatamIdoing ( talk) 03:45, 30 July 2023 (UTC) reply

New in depth peer reviewed survey paper / not sure journal is credible enough

Just ran across a heavily sourced August 2023 review paper on MCS, from a peer reviewed journal, but pay-to-published on Elsevier. I thought the content was thorough and timely. The authors in their conclusions do, citing the role of TRPV1 and TRPA1 receptors, come down strongly on a physical origin.

This journal is not seen as credible under Wikipedia standards, correct? I'd love to give it a citation in the article, but only if appropriate

https://www.sciencedirect.com/science/article/pii/S0149763423001963 Fstevenchalmers ( talk) 09:16, 26 February 2024 (UTC) reply

What gives the impression that Neuroscience and Biobehavioral Reviews isn't credible? Recon rabbit 16:08, 26 February 2024 (UTC) reply
Neuroscience & Biobehavioral Reviews is one of the top journals in their field. [2] Whatever one thinks of Elsevier's profitability, it is still considered reputable.
The main challenge with this paper will be determining what is WP:DUE. Is this more of a "one source thinks this" situation, or more of a "most researchers think this"? We can't look into a WP:CRYSTALBALL to figure out what will be accepted in the future.
This reminds me of a debate about Polycystic ovary syndrome about 20 years ago, in which one researcher proposed that women who didn't have a particular indicator (something about insulin resistance, I think) didn't really have PCOS, even if they had the traditional symptoms. This line of research could have a similar effect: if you think you have MCS, but you don't have this biological marker – well, you don't actually have MCS after all. This transition happens a lot in some fields (e.g., various subtypes of cancer get lumped and re-divided all the time), and sometimes it's quite easy to handle in an article (you add some variant on "In 2012, the Medical Authority changed the diagnostic criteria to require a minimum of four French hens and three calling birds"), but I'm not sure that it will be so easy in this case. WhatamIdoing ( talk) 23:00, 26 February 2024 (UTC) reply
If someone wanted to do something useful to help people understand this paper, then an article on a cough challenge study might be useful (just a generic "what is it?" article, not mentioning MCS). Look at Bronchial challenge test for a basic model. Both capsaicin and citric acid have commonly been used in these studies, though I didn't see anything about citric acid in this particular paper. WhatamIdoing ( talk) 23:17, 26 February 2024 (UTC) reply
Retrieved from " https://en.wikipedia.org/?title=Talk:Multiple_chemical_sensitivity&oldid=1210773158"
From Wikipedia, the free encyclopedia

Pathomechanism, risk factors and diagnosis

As I have been suggested here and here, you have to discuss in the English Wikipedia whether you are allowed to expand an article or not. Hence the question whether the pathomechanism, some of the risk factors or the diagnosis may be mentioned in the article or not. Opinions? -- Brackenheim ( talk) 22:41, 14 August 2021 (UTC) reply

Note: In Germany we have an ICD-10 classification for MCS as well as a large medical association that is constantly researching the disease. Both the disease and the orthomolecular therapy have also received multiple legal recognition. Therefore, one can say that the pathomechanism relates to the situation in Germany. Perhaps the mechanism is different in other countries - then I would be very interested in the sources ... -- Brackenheim ( talk) 09:44, 15 August 2021 (UTC) reply
At this time, as only sources for Germany have been produced we can only say this is true in Germany. Slatersteven ( talk) 12:51, 15 August 2021 (UTC) reply
What is the name of this "large medical association"? It wouldn't happen to be Deutsche Gesellschaft für Orthomolekular-Medizin (German Society for Orthomolecular Medicine), would it?
Regardless of this, the changes you have made are not acceptable without discussion. You should not have edit warred, but sought a consensus. Currently, the article presents the condition as if it's uncontroversial ("is a chronic acquired illness"), by contrast to the long-standing consensus version ("is an unrecognized and controversial diagnosis"). The article needs to be reverted back to the March 29 version (right before an IP radically changed things, without anyone noticing the change). Some good edits after that might deserve restoration, but the current presentation of a fringe subject as if it's a mainstream subject is not acceptable.
It appears that this article hasn't been monitored, so fringe advocates have run wild here. Bbb23, we need to get this done so we can then discuss the future development of the article, but currently the article is a literal danger to public health (some treatment options for MCS are dangerous). Any mainstream recognition of the condition since that time can then be used to update the article.
BTW, the ICD-11 has no listing for MCS. -- Valjean ( talk) 15:44, 15 August 2021 (UTC) reply
It looks like the March 29th version is the long standing at this point. From what I can tell, as an outside observer that just saw the WP:AN3 posting, it looks like Brackenheim was restoring the status quo. Given that fact, BRD should of been followed by Slatersteven & ScienceFlyer who failed to start any discussion on the topic. PackMecEng ( talk) 16:00, 15 August 2021 (UTC) reply
Errr, that was the version we reverted to. This is Brackenheim's first edit [ [1]], it is an addition, not a restoration. Made after the 29th of March. Slatersteven ( talk) 16:08, 15 August 2021 (UTC) reply
Exactly. Brackenheim added huge amounts of content without any discussion. So that's a BOLD series of edits. If they had met no resistance, that would have been okay, but they did meet resistance. Then they edit warred repeatedly and their version is now frozen by the protection. Disputed BOLD edits must be reverted and then discussed. -- Valjean ( talk) 16:12, 15 August 2021 (UTC) reply
So as it is accepted the 29th of march version is the long-standing version, the article should be reset to that point. Slatersteven ( talk) 16:30, 15 August 2021 (UTC) reply
The name of the medical association is "Deutscher Berufsverband Klinischer Umweltmediziner". As you can read in the article ( Multiple_chemical_sensitivity#International_Statistical_Classification_of_Diseases), "the public health service in Germany permits healthcare providers to bill for MCS-related medical services under the ICD-10 code T78.4".
I’m sorry I included the section without discussion. I have always found Wikipedia to be a free encyclopedia in which everyone can share their knowledge with others. So it was alien to me so far to ask first and then expand an article. Although I was warned by a number of Wikipedians that the corresponding regulations in the English Wikipedia are totally different, I simply could not imagine this until now. -- Brackenheim ( talk) 19:32, 15 August 2021 (UTC) reply
ICD-11 (WHO): 4A8Z (see: Transition from ICD-10-GM to ICD-11 -- Brackenheim ( talk) 22:14, 15 August 2021 (UTC) reply
There is no problem in principle with including something without discussion. See WP:BRD. -- Hob Gadling ( talk) 06:37, 16 August 2021 (UTC) reply
Yes, BRD starts with WP:BOLD, but that stops applying when the edit meets objections (the "R" in BRD). Then the previously existing status quo version should be restored while ongoing "D"iscussion determines what to do. -- Valjean ( talk) 15:51, 16 August 2021 (UTC) reply
I had tried to leave that part as an exercise to Brackenheim, but you are probably right to spell it out. -- Hob Gadling ( talk) 20:49, 17 August 2021 (UTC) reply
Apologies for the delay in commenting. I support reverting to the state of the article as it was on March 29. It is premature to discuss the pathogenesis of a condition that hasn't been found to exist. This was extensively discussed in 2019, when a consensus was reached. The presence of an ICD code does not mean that a condition is common or even that it exists. Medical professionals often joke about the absurdity of some ICD codes, and there are some ICD codes for pseudoscientific diagnoses such as "Liver qi stagnation pattern" and "Bladder meridian pattern". Additionally, WHO ICD10 codes ( J68.9, T78.4 ) do not seem to mention MCS. ScienceFlyer ( talk) 17:09, 17 August 2021 (UTC) reply
I am following up on this and again propose to revert to the article state as of March 29. ScienceFlyer ( talk) 11:43, 26 August 2021 (UTC) reply
If there is no further objection, I will revert the article to the state as of March 29. ScienceFlyer ( talk) 07:46, 30 August 2021 (UTC) reply
I am still in favor of at least leaving the explanations of the pathomechanism in the article. There are many diseases with unknown cause or with only little known facts (e.g. idiopathic Parkinson's syndrome). Such diseases do not have a simple mechanism as there is with a cold, so Wikipedia should rather reflect the current state of research. -- Brackenheim ( talk) 11:48, 30 August 2021 (UTC) reply
My apologies for lacking mastery of Wikipedia notifications. If I had known this discussion was taking place last month, I would have objected to reverting the article to its March 29 state. It is my belief that that state, and the state of at least a decade preceding, contains a mix of facts (that's what Wikipedia should report) and opinions which both serve special interests and contradict my lived experience of the last 25 years with MCS. That is, the article of that date used classic propaganda techniques to convey a belief not based in fact. Fstevenchalmers ( talk) 23:50, 17 September 2021 (UTC) reply

Upon again reviewing this section, it is obvious that the first paragraph is completely erroneous in saying MCS is unrecognized, as it is recognized legally and medically in several jurisdictions, as pointed out by Brackenheim (Germany) and myself (Canada as well as Germany, Luxembourg, Austria, Japan, Australia, new Mexico, and the USA department of education). If you disagree with me, then please provide contradiction to its recognition at the Federal level in Canada by the Canadian Human Rights Commission. However, as long as a single governing entity in the world (such as the CHRC where I live) officially recognizes it, then it is not unrecognized.

Therefore, in order to repair this mistake, I suggest we replace recognized with one of the following 3 changes:

1) Remove the word unrecognized completely.

2) Replace unrecognized with "formerly unrecognized"

3) Replace unrecognized with "unrecognized by (list bodies that do not recognize MCS, with citations on their official stance) and recognized by (list bodies that recognize MCS, with citations on their official stance)

If there are no opinions within say, 1 week, I can just go ahead and fix this error, likely with option 1.

Silliestchris ( talk) 23:26, 17 September 2021 (UTC) reply

Concur that the word "unrecognized" conveys an opinion, not fact. I believe this word is in the article to color the reader's perception based on an author's opinion and not based on fact. The fact is MCS is recognized by some and recognition is vehemently opposed by others. I think the simplest correction to opinion having crept into this article which is supposed to be fact based is Silliestchris's option 1 above. Fstevenchalmers ( talk) 23:50, 17 September 2021 (UTC) reply

References

  1. ^ "Policy on Environmental Sensitivities" (PDF). https://www.chrc-ccdp.gc.ca/en. Canadian Human Rights Commission. Retrieved 17 September 2021. {{ cite web}}: External link in |website= ( help)
  2. ^ Wilkie, Cara. "Accommodation for Environmental Sensitivities: Legal Perspective" (PDF). https://www.chrc-ccdp.gc.ca/. Canadian Human Rights Commission. Retrieved 17 September 2021. {{ cite web}}: External link in |website= ( help)

I agree with removing the word "unrecognized". In addition to the bodies mentioned earlier, there are also state agencies in the USA that recognize MCS. Janraison ( talk) 04:29, 18 September 2021 (UTC) reply

→Janraison, you would be doing non-partisanism a great service if you listed here the state agencies in the USA that recognize MCS, and for bonus points you could provide links to where this is stated.

Silliestchris ( talk) 04:48, 18 September 2021 (UTC) reply

I concur that the word unrecognized should be removed, as it conveys an opinion! Other editors have pointed out numerous institutions that recognize it. Sciencebuilder ( talk) 01:44, 27 September 2021 (UTC) reply

I believe the word unrecognized should be removed from the first sentence.
I would also appreciate it if people would quit claiming that permission to get paid when someone shows up in your clinic means that it's a recognized disease entity.
Although I'm pretty sure that it won't do any good, let me once again say that to be a recognized disease entity, it has to be a single condition with a predictable pattern. Every single person who has the thing has to have the same thing. Every person who shows up with the predictable pattern has to have that thing. This is probably not true with MCS. The science isn't there yet. We're still at a point when five licensed physicians could look at the same patient, and one could say "must be MCS", one could say "it's obviously Chronic Lyme disease", a third could say "Looks like Chronic fatigue syndrome with anxiety to me", the fourth could say "You're all wrong, because it's Traumatic brain injury", and the fifth could say " Post-traumatic stress disorder, with traumatic coupling to strong scents".
"Recognized" does not mean that sick people get disability benefits. "Recognized" means that we know enough that mainstream medicine has enough information that they can expect doctors to recognize when the patient has it, and when the patient doesn't. WhatamIdoing ( talk) 02:23, 30 October 2021 (UTC) reply
WhatamIdoing is correct here. The condition is unrecognized by the scientific community. Chamaemelum ( talk) 22:07, 9 July 2023 (UTC) reply

Remove pdate template?

Is there reall major, actual, research such as meta-studies on this that warrant the update-template? Looking at the article as well as the Talk page it looks obvious that the crrent article ver ell represent the current state of research. Is it fair to remove the "update" template? Leord Redhammer ( talk) 12:25, 4 March 2022 (UTC) reply

Possibly Relevant

I have no idea whether this is worth putting in the article, but it looks like there may be some relationship between this and mast cell disorders like Mast Cell Activation Syndrome. https://enveurope.springeropen.com/articles/10.1186/s12302-021-00570-3

Possibly also relevant, not that it's worth citing: https://www.hsph.harvard.edu/hoffman-program/resources/chemicals-in-your-life/what-is-mcstilt/ 173.66.202.193 ( talk) 03:12, 30 July 2023 (UTC) reply

The list of differential diagnoses is long. That's one of the challenges with having (or trying to diagnose a patient who has) non-specific symptoms. WhatamIdoing ( talk) 03:45, 30 July 2023 (UTC) reply

New in depth peer reviewed survey paper / not sure journal is credible enough

Just ran across a heavily sourced August 2023 review paper on MCS, from a peer reviewed journal, but pay-to-published on Elsevier. I thought the content was thorough and timely. The authors in their conclusions do, citing the role of TRPV1 and TRPA1 receptors, come down strongly on a physical origin.

This journal is not seen as credible under Wikipedia standards, correct? I'd love to give it a citation in the article, but only if appropriate

https://www.sciencedirect.com/science/article/pii/S0149763423001963 Fstevenchalmers ( talk) 09:16, 26 February 2024 (UTC) reply

What gives the impression that Neuroscience and Biobehavioral Reviews isn't credible? Recon rabbit 16:08, 26 February 2024 (UTC) reply
Neuroscience & Biobehavioral Reviews is one of the top journals in their field. [2] Whatever one thinks of Elsevier's profitability, it is still considered reputable.
The main challenge with this paper will be determining what is WP:DUE. Is this more of a "one source thinks this" situation, or more of a "most researchers think this"? We can't look into a WP:CRYSTALBALL to figure out what will be accepted in the future.
This reminds me of a debate about Polycystic ovary syndrome about 20 years ago, in which one researcher proposed that women who didn't have a particular indicator (something about insulin resistance, I think) didn't really have PCOS, even if they had the traditional symptoms. This line of research could have a similar effect: if you think you have MCS, but you don't have this biological marker – well, you don't actually have MCS after all. This transition happens a lot in some fields (e.g., various subtypes of cancer get lumped and re-divided all the time), and sometimes it's quite easy to handle in an article (you add some variant on "In 2012, the Medical Authority changed the diagnostic criteria to require a minimum of four French hens and three calling birds"), but I'm not sure that it will be so easy in this case. WhatamIdoing ( talk) 23:00, 26 February 2024 (UTC) reply
If someone wanted to do something useful to help people understand this paper, then an article on a cough challenge study might be useful (just a generic "what is it?" article, not mentioning MCS). Look at Bronchial challenge test for a basic model. Both capsaicin and citric acid have commonly been used in these studies, though I didn't see anything about citric acid in this particular paper. WhatamIdoing ( talk) 23:17, 26 February 2024 (UTC) reply
Retrieved from " https://en.wikipedia.org/?title=Talk:Multiple_chemical_sensitivity&oldid=1210773158"

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