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Here is a draft replacement for the sections WP:MEDRS #Periodicals, WP:MEDRS #Books, and WP:MEDRS #Online. It attempts to take all the above discussion into account. It's a bit rushed and wordy, and could stand some improvement, but I thought I'd get it out the door sooner rather than later. Comments are welcome in #Comments on Draft replacement for Periodicals, Books, Online below. Eubulides ( talk) 00:59, 21 October 2008 (UTC)
Each of the sections of the draft replacement are intended to be top-level sections in WP:MEDRS. They are 3rd-level sections here, so that it's nested properly in the talk page. Eubulides ( talk) 00:59, 21 October 2008 (UTC)
(start of draft replacement)'
Search engines are commonly used to find biomedical sources. Each engine has quirks, advantages, and disadvantages, and may not return the results that you need unless used carefully. It typically takes experience and practice to recognize when a search has not been effective; even if you find useful sources, you may have missed other sources that would have been more useful, or you may generate pages and pages of less-than-useful material. A good strategy for avoiding sole reliance on search engines is to find a few recent high-quality sources and follow their citations to see what your search engine missed. It can also be helpful to perform a plain web search rather than one of scholarly articles only.
Pubmed is an excellent starting point for locating peer-reviewed medical sources. It offers a free search engine for accessing the MEDLINE database of biomedical research articles offered by the National Library of Medicine at the U.S. National Institutes of Health. Although PubMed is a comprehensive database, many of its indexed journals restrict online access; an additional site, PubMed Central, provides free access to full text. There are basic and advanced options for searching PubMed. Clicking on the "Review" tab will help you narrow your search to reviews. The "Limits" tab can let you further limit your search, for example, to meta-analyses or to freely-readable sources.
Other useful search engines include:
A Wikipedia article should cite the best and most-reliable sources regardless of whether they require a fee or a subscription. When all else is equal, it is better to cite a source whose full text is freely readable, so that your readers can follow the link to the source. Some high-quality journals, such as JAMA, publish a few freely-readable articles even though most are not free. A few high-quality journals, such as PLoS Medicine, publish only freely-readable sources. Also, a few sources are in the public domain; these include many U.S. government publications, such as the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention.
When searching for sources, it is wise to skim-read everything available, including abstracts of papers you can't fully access, and use that to get a feel for what reliable sources are saying. However, when it comes to actually writing a Wikipedia article, it is generally not a good idea to cite a source after reading only its abstract, as the abstract necessarily presents a stripped-down version of the conclusions and omits the background that can be crucial for understanding exactly what the source says. You may need to visit a medical library to access the full text, or ask somebody at the WikiProject Resource Exchange to either provide you with a copy or read the source for you and summarize what it says; if neither is possible, you may need to settle for using a lower-impact source or even just an abstract.
Citations should document precisely how to access sources. Normally, medical citations should contain a Pubmed identifier (PMID). It is good practice to also supply a digital object identifier (DOI) if available. A common practice is to supply a uniform resource locator (URL) to a source if and only if its full text is freely readable. If the {{ Cite journal}} template is used, all this information can be supplied with the "pmid=", "doi=", and "url=" parameters, respectively. It is also helpful to mention whether a source is also available on Pubmed Central; with {{ Cite journal}} this can be done with the "pmc=" parameter. For example:
produces this:
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)If a source is available in both HTML and some other form, normally the HTML form should be cited, as it is the most likely to work on a wide variety of browers.
As mentioned above, the biomedical literature contains two major types of sources: primary publications describe novel research for the first time, and review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments; secondary sources include meta-analyses that bring together the results from many clinical trials and attempt to arrive at an overall view of how well a treatment works. It is usually best to use reviews and meta-analyses where possible, as these give a balanced and general perspective of a topic, and are usually easier to understand!
Peer-reviewed medical journals are a natural choice as a source for up-to-date information for medical articles. They contain a mixture of primary and secondary sources, as well as less technical material such as biographies. Although almost all such material will count as a reliable source, not all the material is equally useful. Journal articles come in many types: original research, reviews, editorials, book reviews, correspondence, biographies and eulogies. Research papers are primary sources; although they normally contain previous-work sections that are secondary sources, these sections are typically less reliable than reviews. A general narrative review of a subject by an expert in the field makes a good secondary source that can be used to cover various aspects of a subject within a Wikipedia article. Such reviews typically contain no original research but can make interpretations and draw conclusions from primary sources that no Wikipedia editor would be allowed to do. A systematic review uses a reproducible methodology to select primary studies meeting an explicit criteria in order to answer a specific question. Such reviews should be more reliable, accurate and less prone to bias than a narrative review. [1] However, a systematic review's focus on answering one question limits its usage as a source on Wikipedia.
The 2003 Brandon/Hill selected list includes 141 journals suitable for a small medical library. [2] Although this list is no longer maintained, the listed journals are of high quality. The core general medical journals include the New England Journal of Medicine, The Lancet, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, British Medical Journal (BMJ), and Canadian Medical Association Journal. Core basic science and biology journals include Science, Cell, and Nature.
Medical textbooks published by the academic press are excellent secondary sources. Ensure the book is up-to-date, unless a historical perspective is required. Doody's maintains a list of core health sciences books, which is available only to subscribers. [3]
The popular press is generally not a reliable source for science and medicine information in articles. Most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits. [4] Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease, or an every-day substance as the "cause" of some dreaded disease. Newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. Such articles may be based uncritically on a press release, which can be a biased source. They also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms.
A news article should not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source, for example with the "laysummary=" parameter of {{ Cite journal}}.
On the other hand, the high-quality popular press can be a good source for social, biographical, current-affairs and historical information in a medical article. For example, popular science magazines such as New Scientist and Scientific American are not peer reviewed but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, common sense and the general guidelines presented in the verifiability policy and general reliable sources guideline should be considered in determining whether a popular press source is suitable for these purposes.
Popular science and medicine books are usually tertiary sources, but there are exceptions. Self-published or books published by vanity presses are generally not subject to any form of independent fact-checking or peer review and may not be reliable sources.
(end of draft replacement) Eubulides ( talk) 00:59, 21 October 2008 (UTC)
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cite web}}
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link)
{{
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: Unknown parameter |lay-date=
ignored (
help); Unknown parameter |lay-source=
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help); Unknown parameter |laysummary=
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help)
(Please put comments here.) Eubulides ( talk) 00:59, 21 October 2008 (UTC)
@WLU: Making improvements to a page is a good thing. Just edit the page like normal. :-) That's the whole point of wikipedia, and it's what we've been working towards. If anything happens (I hope it won't, but it might), drop me a line and I'll help sort it out. -- Kim Bruning ( talk) 17:49, 21 October 2008 (UTC) The rule on wikipedia is: someone has to do the consensus homework, else you may have ...some... trouble finding consensus at times. ;-) And I'll admit I'm rebelling a little: why should it always be the (informal) mediator who gets to do all the work? People should learn to do the homework themselves for a change! That way the workload is spread out over several people, and the mediators job is a lot lighter. In fact, why need a mediator at all? A stitch in time saves nine: If you try to understand the current consensus _before_ you get into an edit war, rather than after, well sure, it might cost you a couple of hours (only at first, with practice you can get it down to a couple of minutes), but it will save you a month of torture at the hands of an evil mediator! O:-)
Above suggested wording states PubMed Central as an "alternative" of PubMed - but in reality both hosted by NLM. They each provide a different webpage to search the database and whilst one shows PMID abstracts (which will mention any PMC links if available), the other only shows archived copies of articles. "additional" resource tool rather than "alternative" might be a better choice of wording ? David Ruben Talk 00:13, 22 October 2008 (UTC)
Consider the following citation:
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)This uses the "pmc=" parameter of {{ Cite journal}}, so that if you click on the article title, you visit the PubMed Central manuscript for that article. This manuscript, though, presumably differs in minor ways from the final version of the article (which is viewable only with a subscription).
So, my question is: is such a citation a reasonable one? Or should it be altered to make it clear to the reader that the URL is to something other than the final version of the paper? There is an argument for convenience and for encouraging people to read freely-available versions of papers; but there is also an argument for making it clear which is the final (and presumably best) version of the paper.
Should WP:MEDRS have some guidance about this issue?
Eubulides ( talk) 20:45, 23 October 2008 (UTC)
PMC is not necessarily manuscripts; a number of publishers deposit full versions, formatted in PMC's special XML. And when PMC has manuscripts they have invariably undergone full peer review--the difference is the lack of publishers' copyediting. There is consensus, though, in the academic community that the published version is the one for official citation--and consensus on WP that we always also give a convenience citation to the free version if available. Incidentally, as for the differences see my "Open access and accuracy: author-archived manuscripts vs. published articles " in Learned Publishing, 20:3, July 2007 , pp. 203-215 open access.and the refs listed therein. They are very rare--nobody has every demonstrated anything substantial. DGG ( talk) 01:05, 24 October 2008 (UTC)
Thanks, I made this change to cover the topic and cite DGG's paper. But there's a tasty irony here. As far as I can tell, Ingentaconnect, the publisher of DGG's paper, does not provide a stable URL to the full final version of the paper. Instead, one must go through a couple of levels of indirection, and that gives you a URL with session info in it, compromising both portability and privacy (so much for "open access"). My edit therefore contains this citation:
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)Here the DOI is to the final version, but the URL http://dlist.sir.arizona.edu/1968/01/OAandA%5FGDY.pdf points instead to the authors' preliminary manuscript. I sure hope that the paper's results apply to the paper itself! Eubulides ( talk) 08:59, 24 October 2008 (UTC)
It seems unfortunate/unbalanced for Wikipedia that there isn't actually a central guideline covering the various journal database and access issues above (unless I've missed it). To cover all the main databases, for different editors and points of view (pubmed of course is misleadingly titled/described 'cos it includes a large number of non-medical journals). Which could then split off into specific databases/topics if length dictated it. Avoiding cart before horse or tail wagging dog. EverSince ( talk) 11:27, 24 October 2008 (UTC)
I don't think we should restrict references to particular databases, but I personally would strongly object to the citation of articles from journals not indexed on Medline. I have a preference for freely accessible sources, but if there is a better source that is not freely accessible then the second one still wins... JFW | T@lk 18:58, 25 October 2008 (UTC)
(watches the tumbleweeds go by)...I guess the above issues about the lack of a neutral cross-disciplinary guideline on finding/assessing articles, and the illegitimacy of this guideline being founded on a priori privileging of reliable medical sources over reliable non-medical sources, can be added to the list of critical issues that remain unaddressed/ignored. Another one is that a sourced critique of press sources is included in this guideline - tendencies, things they miss out, exaggerate etc - but not a similar critique of medical sources. Here's a long list of the sorts of points that might be relevant, not saying these specific sources are necessarily ideal but they seem to support the presence of widespread issues & tendencies equivalent to those covered for press articles:
In the 150 years since Virchow produced his principles, medicine has strayed from this vision [20]. Despite television images of trapped hurricane survivors searching for food and the knowledge that 44 million Americans (most of them working) do not have health insurance, medical research continues its biomedical trajectory in search of expensive “magic bullets” and more sophisticated interventional technologies, rather than understanding the social determinants of health...Why then is social science often excluded? For one, academic medicine has been preempted by the glamour of technology and by the rewards it brings to those who discover and employ it [22]. For another, social scientists are unwelcome when they discover unpleasant facts, such as life circumstances trumping medical care in determining the health status of populations and that disparities in health care are part of the system rather than oversights [1]. These discoveries not only threaten medical hegemony, but they challenge the larger social order [4]
If structural violence is often a major determinant of the distribution and outcome of disease, why is it or a similar concept not in wider circulation in medicine and public health, especially now that our interventions can radically alter clinical outcomes? One reason is that medical professionals are not trained to make structural interventions. Physicians can rightly note that structural interventions are “not our job.” Yet, since structural interventions might arguably have a greater impact on disease control than do conventional clinical interventions, we would do well to pay heed to them. [5]
When 'medical facts' must be derived from 'magical beliefs' in the centres of biomedical science, the state often intervenes to criminalize practitioners of alternative medicine. But, when profits are to be made on the fact that 'the magical' sells in alternative medicine, the state also makes it possible to shift ownership of medical knowledge, sometimes by way of the randomized controlled trial and the pursuit of active ingredients. The possibility of relocating the label of 'crime' is explored in this paper by way of an inquiry into processes that enable this shift in ownership, and a relocation of what constitutes medical 'fact' versus 'belief'. [6]
studies have found high error rates in references in biomedical journals [7]
Selective reporting of trial results exists for commonly marketed drugs [8]
[Medical anthropology] use[s] the voices and stories of the poor to explain the impact of structural adjustments...I argue that [this] masks the real absence of the voices of the poor and their suffering on the world stage. There is no international public sphere within which these voices might be heard; rather, there is a set of claims about justice and human rights. [9]
[in] contested areas of science-society discourse...militaristic metaphors are still part of a pervasive, but by no means inevitable, mode of science and policy communication. [10]
disease in the Western world has been primarily constituted by the imagery of war...it derives its immediate nourishment and historical root from a corresponding language of war within medicine itself [11]
Medical journals are an extension of the marketing arm of drug companies [12]
The eight questions that I pose in the opening paragraph – having to do with blindness and deafness, mild depression and slow running, black racial features and plain facial features, obesity and anorexia – have become, even in today’s world of limited resources and imperfect technology, principal lightning rods for debate over the final limits to medicine ... treatments for conditions such as deafness, obesity, or anorexia may actually be a form of cultural genocide [13]
Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives. [14]
Three decades ago, Ivan Illich argued polemically that the medical establishment was “medicalising” life itself [8], and in the 1990s Lynn Payer described widening the boundaries of illness as “disease mongering” [3], highlighting the role of pharmaceutical companies. Today's debate about this phenomenon, while still maturing, both acknowledges the axiomatic interest of corporations and professionals in maximizing turnover and appreciates that well-informed citizens may choose to embrace the medicalisation of health problems previously regarded as troublesome inconveniences. [15]
The unequal distribution of power in contemporary society is reflected and reproduced in medical ideology. The present article analyses some articles from Israeli medical journals in order to show the ways in which biomedicine—the dominant medical ideology—is reinforced through hegemonic discourse. The central ways by which this is achieved are medicalization—which includes the desocialization of disease and the explanation of social phenomena in medical terms—and the affirmation by the Israeli medical literature of national, ethnic, class and gender relationships of domination. Analysis of the Israeli example provides useful insights about biomedicine's desocializing role, as the disregard for the social dimension of disease is particularly telling in a society characterized by several cleavages which determine a clearly unequal distribution of power and resources. [16]
"Social conditions such as poverty and crime have all too often been attributed to mental illness, biology, and genetics. This has created a kind of nihilism on the part of mental health professionals, which has proven to be an impediment both to research and health care delivery. These deterministic views of race-based psychology have continued to appear in the literature and continue to exert a pernicious influence." [17]
the dominance of biomedicine is delegated rather than absolute, these processes reflect the growing accommodation on the part of alternative practitioners to the reductionist disease theory which is compatible with capitalist ideology. [18]
The "Medical-Industrial complex" has led to the commercialization of health care well beyond what traditional practitioners would consider ideal. Medicine is being treated as a business, with cost curtailment measures and profit margins often dictating physicians' choices [19]
the transformation of continuing medical education into an enterprise for drug marketing. The chore of teaching doctors how to practice medicine has been handed to the pharmaceutical industry. [20]
By accepting only advertisements for drugs and medical devices, medical journals have accepted an exclusive and dependent relationship with corporations... Advertisements and other financial arrangements with pharmaceutical companies compromise the objectivity of journals. [21]
pharmaceutical industry organizations often front for sections of the pharmaceutical industry by retaining public relations consultants and sometimes by coordinating the funding of psychiatric research. An important line of agenda setting communication is via a two-way exchange between PR/advertising and the psychiatric profession/researchers. Public relations firms are often used to disguise the sources of drug company funding for psychiatric research and there is also a constant barrage of drug company advertising in psychiatric journals aimed at persuading psychiatrists to use specific drugs. The reverse flow, from psychiatry to PR, involves the utilization of psychiatric research, and psychiatric expertise, in public relations campaigning. [22]
the erosion of professional values and medical education by commerce shows no sign of slowing. The latest scandals involve Medscape [23]
One of the nation’s most influential psychiatrists earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules, according to documents provided to Congressional investigators. [24]
Leading medical journals seem to be having a difficult time disentangling themselves from the pharmaceutical and medical device industries. If they cannot stop printing articles by scientists with close ties to these businesses, they should at least force the authors to disclose their conflicts of interest publicly so that doctors and patients are forewarned that the interpretations may be biased. [25]
residents indicate that they do not have the time nor the mentors to deliver effective cross-cultural care, and are not evaluated on their ability to do so [26]
both EBM [Evidence-Based Medicine] and CCM [cultural competence in medicine] have been accused of fostering stereotypes and have therefore suffered some degree of backlash. EBM experienced a backlash over fears of “cookbook medicine,” or clinical stereotyping, while CCM experienced a backlash over fears of cultural stereotyping. [27]
the issue about the predominance of the neurosciences has less to do with truth than with the current economical and legal climate and hence it is imperative that other approaches to mental illness are allowed to participate in the process of understanding..." "Indeed, it could even be said that it would be unethical not to allow other approaches to participate in the common epistemological enterprise. Without such wider conceptual participation, the haematoma auris or the drapetomania stories will happen again." [28]
EverSince ( talk) 21:34, 23 November 2008 (UTC)
The Aspartame controversy article has some pretty lousy self-published or non-PubMed sources. It needs a good thinning. The whole controversy was started by one woman, and she's the one who keeps it alive, but she's not a reliable source in any sense, and her supporters (a few radical fringe MDs) aren't good sources either. -- Fyslee / talk 02:19, 1 November 2008 (UTC)
Wondering what others think about the Therapeutics Initiative as a reference source for medical articles. Another editor disagrees with its use. I presume this would be classified as a secondary source.
-- Doc James ( talk) 22:10, 31 October 2008 (UTC)
I have found sources that are only available through paid subscriptions. When one does a google search no other mention of the article can be found beyond the links to subscription service. Is that an acceptable source?-- scuro ( talk) 05:45, 11 November 2008 (UTC)
I've been corresponding with a researcher about the topic of reviews. I've collected her thoughts and organized them, taking ideas from different e-mails and stringing them together. Hopefully I have done her justice. She has broadened my knowledge about quality of sources and I thought some may find what she has to say of interest.
Review articles just review the literature, so they are not better sources than research reports; they are just a good place to get a general overview of what's new (when they are good). Research findings are primary sources, so they are always superior. If you can read the report, you can evaluate the validity of the finding first-hand. Reviews are hearsay. Reviews are excellent sources - when they are published in peer-reviewed academic journals. In my field, for example, there are entire journals devoted to this kind of work. They have names like "Current Directions in..." and "Annals of..." and are published by organizations like the American Psychological Association and the Association for Psychological Science. Any literature is static, too, and reviews are meant to summarize the recent literature.
The problem is that the term "review" could be used to describe any piece of crap. Anyone can WRITE a review. Not just anyone can get a literature review PUBLISHED (at least in a "real" journal). Everybody does literature reviews as part of graduate education, but published review articles are written by individuals that have published several important findings in the field, especially recent ones. The quality of a review varies just like studies, but they are usually good when published in appropriate journals. There are journals that will publish any article if you pay them. They are academic & sometimes peer-reviewed, but not of high quality. There are journals created by activist groups. They are not academic, not peer-reviewed (by the usual definition of "peer"), and usually qualify as propaganda. NOBODY uses these in science.
Websites are never appropriate in my opinion, unless it's a government organization like NIMH or NSF. Anybody can say whatever they want on a website. Statements and summaries by the NIMH and NSF are some of the best information available with the most thorough and strongest citations. They are not technically the kind of literature review that I described above, but they are reviews in a loose sense.
She would most likely speak to this if there is enough interest.-- scuro ( talk) 21:58, 29 November 2008 (UTC)
I think you misunderstand the reason why we place so much emphasis on reviews. You are quite wrong that reviews "must be hearsay". Quite the opposite, reviews filter out the "noise" (especially in heavily researched areas, where lots of research leads to dead-ends or is of questionable quality). We cannot allow discussions to get bogged down by claims of one study vs the next - contradictory results are obtained all the time, and reviews are exactly the tool to deal with such phenomena.
I agree that sources need to support their statements, but a corollary of this is that if there is no reliable source (i.e. a review) we must be prepared to drop a certain subject, however much it tickles our collective fascination.
You have very few article edits, but you seem to be fishing in the same pond as Scuro. Could you clarify what the disagreement is about, and how any of us could assist in dealing with this disagreement? JFW | T@lk 20:07, 30 November 2008 (UTC)
Scuro, could you have a stab at generating a list of useful discriminators that will help editors distinguish between a sterling and a faecal review? JFW | T@lk 22:24, 30 November 2008 (UTC)
So there is broad consensus that reviews are not a "widget" of uniform quality?..and that wikipedia needs to address this issue?-- scuro ( talk) 12:52, 1 December 2008 (UTC)
All sources vary in quality. These guidelines already prefer reviews from reputable medical journals, which should filter out the "crap" reviews. But really this is not WP's most pressing problem. An analogy: "Eat in a restaurant rather than from a burger van, if you want quality food, safely prepared". We're getting comments above along the lines of "Well I've seen some really dodgy restaurants, and food inspectors often find poor hygiene when they inspect them." Totally ignoring the burger van is using week-old fat and has no running water or toilet facilities for staff. It is easy to find bad WP articles that cite primary sources that superficially appear to support the text. In my experience here, I've yet to see the same problem with reviews being widely misused. I agree with almost nothing in II's first paragraph above, and don't even understand the "An inflexible..." sentence. Academic practice to sourcing isn't relevant on WP and thinking our papers should be researched and sourced the same way as an academic review shows a big misunderstanding over WP fundamentals. II once again claims reviews add "bias", as though the primary research paper contained virgin facts, unsullied by another's opinion. Primary sources are widely misused on WP for at least three reasons:
ICBSeverywhere, your lack of edits doesn't devalue your opinions but does cast doubt over your experience of applying existing WP guidelines and policy when writing articles. Remember that only a tiny proportion of topics on WP are controversial. Writing an article sourced to reviews is much easier than trying to do so from primary research papers. Most folk disputing WP guidelines have an issue with a controversial aspect of a topic. What is often forgotten is that it is practically impossible to source an entire topic to primary research. WP:NOR does not allow you to fill in the blanks. Colin° Talk 20:31, 1 December 2008 (UTC)
Okay, on the premise that reviews which are seen as an ideal source and have limitations. These limitations get short shrift on the guideline page. I will attempt to find examples of:
If other contributors can easily find examples of such reviews, it would be appreciated if you shared that with us. :)-- scuro ( talk) 12:03, 3 December 2008 (UTC)
Then we are agreed that the limitations of outdated reviews should be spelt out more clearly on the med. reliable source page. Following wiki processes, old reviews can be removed but this can be time consuming and frustrating. It has been a source of conflict in the past. A contributor will find a review and argue that the informtation on the review is relevant, when in reality it clearly no longer is. Clearer guidelines may nip these sort of problems in the bud.-- scuro ( talk) 20:16, 3 December 2008 (UTC)
These things should not be phrased in terms of rules. This is a guideline. There's going to be wikilawyering when they're phrased as hard rules. Just yesterday I ran into Mattisse saying that a 2002 American Journal of Nutrition review is unciteable because it is not within the 5 year date. [30] Yet this particular 2002 review has free full-text. A 2005 review ( PMID 16021987) has essentially the same conclusions, but it lacks full-text. II | ( t - c) 20:13, 4 December 2008 (UTC)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link) A freely readable but older review supporting the same claim is: Mischoulon D, Fava M (2002).
"Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence". Am J Clin Nutr. 76 (5): 1158S–61S.
doi:
10.1093/ajcn/76/5.1158S (inactive 2023-12-13).
PMID
12420702.{{
cite journal}}
: CS1 maint: DOI inactive as of December 2023 (
link){{
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: CS1 maint: multiple names: authors list (
link)Here is the passage that Scuro want to remove from the ADHD "The controversies have involved clinicians, teachers, policymakers, parents, and the media with opinions regarding ADHD that range from those who do not believe it exists at all to those who believe that there is genetic and physiological basis for the condition, and also include disagreement about use of stimulant medications in treatment." It is in the past tense and is not a review per say.
Here is the reference. http://www.ahrq.gov/clinic/epcsums/adhdsum.htm
The reference from the therapeutics initiative is there aswell that is contested. Doc James ( talk) 03:39, 5 December 2008 (UTC)
(Undent) Scuro, this guideline already says that recent reviews are preferable. Now why are you insisting that this guideline doesn't say that recent reviews are preferable? WhatamIdoing ( talk) 19:16, 5 December 2008 (UTC)
Reviews also have degrees of quality. A systematic review for example is often better then a literature review. The Cochrane collaboration being one of the most famous sources of these.
Systematic reviews that are recent are preferable to a single research article. As would large reviews from groups such as the NHS. I have seen research articles selective pick from the available research only that that supports the conclusions of their study.
If a review or primary research article is wrong /dated then it should be easy to find other sources that refute its conclusions. And this should be the discussion that takes place on the talk page of the article. WRT the review which showed ECT caused brain damage one could easily word things: "a review from 1975 indicted that ECT might cause brain damage, further research however showed that this was not the case" etc. This type of info might be interesting under the history section of an article. One acknowleges the review and then refutes its conclusions.-- Doc James ( talk) 14:23, 7 December 2008 (UTC)
Colin° Talk 19:10, 7 December 2008 (UTC)
(Undent) Scuro, I numbered your suggestions for convenience. Here are my comments on each individual item:
1. Peer review is an issue of quality, however, many documents, such as consensus statements by major organizations or government guidelines, are not generally considered peer reviewed and are still great sources. Thus this proposed bit of advice would mislead editors into incorrectly rejecting high-quality sources.
2. Per
WP:V, unpublished documents cannot be used anywhere on Wikipedia for any purpose. Presumably this is meant to read "self-published". However, consensus statements by major organizations or government guidelines are generally considered to be self-published and are still great sources. Thus this proposed bit of advice would mislead editors into incorrectly rejecting high-quality sources.
3. I'm not entirely sure what this means, but academic sources are not necessarily the best. I would not necessarily elevate the work of a university-based researcher over the work of an intramural NIH researcher simply because the one holds a post at a university and the other holds a post with the US federal government. Thus this proposed bit of advice would mislead editors into incorrectly rejecting high-quality sources.
4. Age is not a matter of quality. (Age dramatically limits how you can appropriately use a source of scientific information, but an amazingly well-conducted review doesn't become a bad one in fifty years; it just becomes an outdated source.)
5. Focus is not a matter of quality.
6. The effectiveness of an author's publicity and self-promotion efforts is not a matter of quality. They are often used as proxies for quality, but famous researchers make mistakes, and unknown people publish brilliant work.
Importantly, not a single one of these proposed items is specific to medical reviews, which is what I thought you set out to do. You could have written exactly the same thing about primary research papers, or about Egyptian archaeology, or about computer architecture. Those areas, too, benefit from peer reviewed papers, published in reputable media, by knowledgeable researchers. It is not appropriate for MEDRS to tread so heavily on the territory of WP:RS and WP:V as to provide advice that applies to nearly every one of Wikipedia's two and a half million articles. WhatamIdoing ( talk) 21:05, 10 December 2008 (UTC)
The issue is, are there reviews which are not ideal..or are all reviews which don't fit the parameters on MEDRS not ideal? Also, how do you determine if a review is a poor review, or are all reviews that are not ideal, poor reviews.-- scuro ( talk) 16:53, 12 December 2008 (UTC)
Consensus statement by well respected authorities in the field are great sources for Wikipedia. Wikipedia is not a review itself but an encyclopedia. If we were trying to write a review then yes one should quote the primary research however we are not. I think a good example of what sort of references we should use in the medical parts of articles is Uptodate. For those who have access if you look at the references they use they often reference sources such as the WHO, the FDA, the AAP, etc..
Science is about ideas not people. Just because you are famous does not make you right or your ideas unapproachable. It is the quality of the work that matters period. For the none medical parts of the articles such as the section on history, cultural significance, social implications, references requirements are less stringent.-- Doc James ( talk) 19:10, 13 December 2008 (UTC)
So what I understand you saying is that one should go directly to the primary research? Unfortunately there are lots of problems with that. SSRIs in depression is a perfect example. You have something called publication bias were the company funding the research only publishes results that are in their favor. So that if 16 trial are done 10 are not published and show negative results, 6 are published of which 5 show positive results and one shows negative results. Those doing a review are much better then you and I at finding all the trial that have been done. In this example the meta analysis of all trials found no clinical benefit for SSRIs in mild / mod / and severe depression.
In most areas of research there are trials that show both positive and negative result. A review analysis the over all picture to get useful clinical answer. If you were to ask clinicians weather they would prefer to base their treatments on reviews or primary research virtually all would go for the reviews. Doc James ( talk) 17:39, 14 December 2008 (UTC)
Which question? Do you mean should we have specific guidelines outlining how to determine if a review is good or not? Doc James ( talk) 18:56, 14 December 2008 (UTC)
Yes but it all comes back to determining what a "lesser review, questionable review, and biased review" is. These are all subjective terms. You cannot say that any review you do not like the conclusion of is biased. Or just because you do not like other work the reviewer might have published it is biased.
Now it was mentioned that the importance of the researcher should be used as a criteria. This is not verifiable. Therefore it cannot be used as a criteria.
There are entire classes in University on assessing the quality of a review or a primary research paper. This is a complicated process. Will see if I can find a paper on it.-- Doc James ( talk) 22:04, 14 December 2008 (UTC)
Webster's on,
Collin, are we not to focus on content and not the contributor? By focusing on the contributor are we not in danger of imparting bias?-- scuro ( talk) 05:41, 15 December 2008 (UTC)
The point I have been making is that all evidence interpreted is hearsay. Interpretation always creates the possibility of bias, either intentional or unintentional. I fail to see how these concepts are controversial, they are just fact. If you want to infer meaning and judgement into these concepts, the fault is not mine. I totally agree that there are many more problems with primary sources and that the vast majority of reviews do not have a significant bias problem. Even if you consider this a small problem though, it is still a problem, and wikipedia will be a lesser source as long it remains as is. There are many guidelines about what makes a poor primary sources and how they shouldn't be used. On those grounds it is much easier to challenge a primary source. A review is much harder to challenge. Yes, you can challenge any review in wikipedia but consider this, a review is considered an ideal source. What will you base your challenge on, your own personal expertise? Some fault in the review?...well unless the review is blatantly biased this will be difficult. What are the criteria that would allow you to find fault in a review? If the review did not meet the criteria of what wikipedia sees as a good review? Answer that question and we are half way home. Reviews are different from other sources and there are criteria that can be used to judge reviews. I've posted ideas, others are now posting further citations. A few obvious and general guidelines should not be that difficult to agree too. MEDRS tells us what makes a good review, but tells us little about what to watch out for.-- scuro ( talk) 12:13, 15 December 2008 (UTC)
I am having a hard time understanding what exactly you mean in the above paragraph? You want to remove "crap reviews"? How do you know that the reviews are poor? Some of the rating criteria that have been proposed are not significant. Like who the author is or the focus of the question. The date I would agree has some importance. Peer reviewed is of course important. There are rating scales for review quality but they can be difficult to carry our. Here is one for example for a systematic review http://www.uwo.ca/cns/ebn/Scales/metaanalysis.pdf
These are subjective questions and no review is going to be perfect. If you are wanting a unanimous rule I do not think you will find one. What one does is compare what research is out there and discuss which is the best. There are no cut and dried answer in medicine. Information should be provided so that people can assess the risks and benefits. That is what it means to provide a NPOV. Doc James ( talk) 23:13, 15 December 2008 (UTC)
I think it is time we wrapped up this discussion. It is going around in circles, it discusses issues well beyond the scope of this guideline alone, and seems to revolve about one editor sowing seeds of confusion. Can we move on please? JFW | T@lk 22:21, 16 December 2008 (UTC)
A few of us are wondering if Bestbets are sufficient to be used as references for Wikipedia? They often ask questions that are not looked at elsewhere in the literature. If better sources can be found I think they should be. But I think that this is a reasonable source to add to pages that might have few or no references. see http://www.bestbets.org/home/bets-introduction.php Would like to get others comments. -- Doc James ( talk) 13:37, 21 December 2008 (UTC)
The November issue of Epilepsia had a 133-page supplement on the Ketogenic diet. It contains nearly 40 short review papers. The introduction states:
Are such papers given the same editorial / peer-review scrutiny as reviews appearing in the main journal? I should very much like to use some of these as sources. They are up-to-date and together form a comprehensive resource. Any concerns? Colin° Talk 21:45, 22 December 2008 (UTC)
I've posted a question at RSN that relates to this guideline. It's here, and involves a patient's personal website about iguanas and chronic fatigue syndrome. Those that are familiar with Wikipedia's standards for medicine-related articles are invited (begged) to respond. WhatamIdoing ( talk) 02:21, 26 January 2009 (UTC)
About recent changes that I've just reverted: Editors may not cite sources that they have not read. This guideline must not provide advice that directly contradicts the main page on citing sources. WhatamIdoing ( talk) 02:54, 24 February 2009 (UTC)
User:WhatamIdoing doesn't seem to understand Wikipedia:SAYWHEREYOUGOTIT. It puts the burden on the editor to verify that the original source gives that information, but it certainly does not preclude you from citing it after checking that it really gives that information.
“ | It is improper to obtain a citation from an intermediate source without making clear that you saw only that intermediate source. For example, you might find some information on a Web page that is attributed to a certain book. Unless you look at the book yourself to check that the information is there, your source is really the Web page, which is what you must cite. The credibility of your article rests on the credibility of the Web page, as well as the book, and your article must make that clear. | ” |
Therefore, I'm going to revert that removal, and add a link to the Wikipedia:SAYWHEREYOUGOTIT making clear the onus for verifying that the original source concurs with the review rests with the editor making that change. Xasodfuih ( talk) 04:16, 24 February 2009 (UTC)
When a statement taken from a narrative review is supported there by only one or two original research articles, it's recommended to cite both the original work(s) and the narrative review, especially if the original articles were published in higher impact venues than the narrative review. Citing the original article(s) is a convenience for the reader, and avoids diminishing the importance of the results; citing the review gives the result some additional credibility beyond that conferred by the (often anonymous) reviewers of the original work.
Some journals specialize in the publication of third-party summaries of reviews published elsewhere, in particular summaries of systematic reviews, often accompanied by a short commentary. Unless such summaries/commentaries add significant additional insight, citing them instead of the original review must be avoided because this practice can confuse the reader as to the actual review authors. If these summaries/commentaries are cited along the original review, label them clearly as summary/commentary in the footnote.
Have had a lot of issue lately with editors using case reports for justification of just about everything. IMO these should not be allowed as evidence. I think this should be make perfectly clear.-- Doc James ( talk · contribs · email) 04:02, 24 February 2009 (UTC)
I don't see anything written about these or medical sites in general. Should we added them as reliable sources? Xasodfuih ( talk) 05:37, 24 February 2009 (UTC)
Sounds good overall, although whether a specialized encyclopedia entry cites reviews or original research articles depends on the amount of literature available on the topic. Look at the free sample pages here: " Josephine domain" cites two primary sources, whereas "Jews and Genetic Diseases" cites at least one review. (By the way, there's no concise article about this on the wiki. Ashkenazi Jews#Specific diseases and disorders covers a narrower topic, but for the other populations, I don't see anything.) The same choice of sources is also true for most medical textbooks. Surely this book is much better source for writing about Machado-Joseph disease/ Spinocerebellar Ataxia Type-3, but that distinction has nothing to with whether one of these books is a "secondary" source and the other "tertiary". I suspect the same observation holds about the choice of sources in WebMD and uptodate.com, although these two sites have different target audiences.
So, all of the above go together as tertiary sources if you insist on that classification, which I don't find very helpful: "The term tertiary source[1][2] is a relative term. What is considered tertiary depends on what is considered primary and secondary. A tertiary source may thus be understood as a selection, distillation, summary or compilation of primary sources, secondary sources, or both.[3][4][5]" (and the rest is unsourced) If a review cites another review it's automatically tertiary? In that line of reasoning the NHMRC report in water fluoridation is tertiary source, because it explicitly cites the York report in support of its conclusions (and for efficacy they explicitly say they've looked only one newer primary study). I would not bother drawing a line between secondary and tertiary sources for medical articles; it will lead to more artificial distinctions instead of considering the quality and level of coverage of source. In the case of third-party summaries of reviews published elsewhere it is easy enough to give a general recommendation, but we should do the same for uptodate.com/WebMd based on how good they are (and easy to cite), as opposed to WP:ARTIFICIALDISTINCTION between secondary and tertiary. Xasodfuih ( talk) 05:24, 25 February 2009 (UTC)
Another observation is that some specialized encyclopedias may have a beefy overview section that are quite suitable as review source. Look at this one (using Amazon's look inside). Xasodfuih ( talk) 08:23, 25 February 2009 (UTC)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link) Summary: Yeung CA (2007). "Fluoride prevents caries among adults of all ages". Evid Based Dent. 8 (3): 72–3.
doi:
10.1038/sj.ebd.6400506.
PMID
17891121.I have removed the following, which appears to be the personal opinion of Xasodfuih.
WhatamIdoing has already removed an earlier version of this text. It has not been discussed by the community and is likely to be contentious. There has never been any requirement on WP to cite two sources when one alone is a reliable source. We are not an academic journal and have no obligation to cite the original research out of courtesy/acknowledgement to the original researchers, nor do we have the same issue with regarding the citation of a review as "lazy research". The middle paragraph seems to come from a recent issue at Water fluoridation and I don't think it is a common problem. We must avoid knee-jerk updates to guidelines based on current events. I encourage Xasodfuih to patiently wait further discussion on this text and avoid restoring the contested text (even with minor changes). Colin° Talk 08:57, 24 February 2009 (UTC)
When a reviewer is citing many sources to make a point, it's indeed his WP:SYNT, so attributable mostly him, and it may also be impractical to cite all of his primary sources. However, when single statements are extracted from narrative reviews where they are supported by a single source, it sometimes makes sense to cite the original article along with the review, especially when:
Finally, this is merely a suggestion in a guideline. Nobody will make a big fuss if this isn't always followed; 90% of the time reviewers at FA/GA do not read the sources (which is why we have FAs like anabolic steroids or paleolithic diet, but I'm digressing), so we're not going to see articles failing from standards in any numbers because of this recommendation. Xasodfuih ( talk) 13:36, 24 February 2009 (UTC)
Note that in standard style guidelines, it's often encouraged to cite the original source while also noting "as cited in ..." -- this could be easily done on Wikipedia, where the primary source is cited, but the footnote also contains: "As cited in: [review]". I don't see why not. People often assume that everyone has great access to medical journals, and it's just not so. Hiding a weak source behind a review is not necessarily a good thing. II | ( t - c) 00:21, 11 March 2009 (UTC)
We give all sorts of advice on which sources to use and which not. I don't see why we should say something about this type of journals. If you feel that that something needs to be something else, please formulate an alternative. The fact that the issue doesn't come up very often means that it shouldn't be discussed at length, but since it has come up in a FAC, it means it's not negligible either. Xasodfuih ( talk) 11:14, 24 February 2009 (UTC)
{{
cite journal}}
: Unknown parameter |lay-date=
ignored (
help); Unknown parameter |lay-source=
ignored (
help); Unknown parameter |laysummary=
ignored (
help)An interesting and relevant article from the New England Journal of Medicine on the difficulties and pitfalls inherent in popular-press coverage of science and medicine is here. I thought it might be relevant, and perhaps even useful as a source. MastCell Talk 20:34, 8 January 2009 (UTC)
(Undent) Nbauman, you write professionally. Think about the last few science-related pieces you've done. About how often did you, in your professional writing, rely entirely on what some other journalist wrote for a scientific/medical fact, without bothering to check it against a journal article, textbook, or other source? Never? Always? Something in between? WhatamIdoing ( talk) 22:30, 24 February 2009 (UTC)
Some science journalism is accurate some is not. Before adding info to wikipedia one should verify the accuracy to a peer reviewed source. Up in the cold cold north we play a game were you site in a circle and whisper from one person to next to see what comes back to you. This recreates the accuracy of moving farther from the source.-- Doc James ( talk · contribs · email) 20:29, 26 February 2009 (UTC)
Eubulides ( talk) 17:55, 25 March 2009 (UTC)
(Undent) Nbauman, you've just gone circular on us. How do you tell if the newspaper story is accurate? By determining whether or not the journalist "writes an accurate story". That's not helpful. (Are you aware that this section already says that the coverage ranges "from excellent to irresponsible"? Perhaps you forgot that we already acknowledge the existence of excellent work -- while still recommending a solid scientific source for any scientific fact.) WhatamIdoing ( talk) 17:56, 26 March 2009 (UTC)
And others read the synopsis provided by the likes of Uptodate which reference the original research. We should be trying to create a open source Uptodate and to do this we need to primarily reference the literature much like they do.-- Doc James ( talk · contribs · email) 23:26, 27 March 2009 (UTC)
In my book, "reliable" does not include sources that are "all too frequently...wrong or misleading". Nbauman continues to argue that because newspapers can sometimes be accurate, we should regard them as reliable. In addition, he continues to avoid the "suitability" argument that even if they were reliable sources of medical information, they aren't suitable as sources for such in an encyclopaedia (see archive, for example, the "Bell curve" discussion). As DGG says below "No responsible encyclopedia could admit non medical sources to the discussion, except to discuss the ethical or political implication of the data. Lay sources testify to the lay understanding of science, not to science." I find this determination to "not get the point" after nearly two years of discussion on these talk pages to be quite extraordinary, verging on disruptive. Colin° Talk 22:54, 25 March 2009 (UTC)
Oh for heaven's sake, do you ever see a newspaper or TV show publishing corrections? In both your examples, the journals made a point to publish large corrections. With the popular press you'd never know. Simply a ridiculous analogy. Also, when the medical journals mess up this is not due to inaccuracy but due to errors in judgement (Lancet) or misrepresentation by the original authors (NEJM). JFW | T@lk 23:56, 25 March 2009 (UTC)
I just now
reverted a
change of wording "the worst news articles too often convey wrong or misleading information about health care". This change is definitely not supported by the cited source, Dentzer 2009 (
PMID
19118299), who says that wrong or misleading information is conveyed "all too frequently", and who does not confine her criticism to the "worst" articles (she does writes that lack of context in medical news is a "worsening" problem, but that's quite a different matter).
Regardless of our personal opinions on this topic, we do have an obligation to summarize our sources as accurately as possible within the space constraints here, and conjuring up a "worst" here does not fulfill that obligation.
For more on this topic please see # Popular press accuracy below. Eubulides ( talk) 18:47, 27 March 2009 (UTC)
I am tagging NPOV because this essay conflicts with our policies on reliable sources and neutrality. It was recently used in an attempt at removing a reliable source about a social issue [32]. From the start, this essay was an attempt by pov pushers with a conflict of interest to use an essay to further their pov pushing and silence the other side. Among the supporters, Jfdwolff, MastCell, Cyclonenim, Casliber, Mattisse and probably others admitted a conflict of interest. I was lied to when I was assured that this essay would not be used for removing information about social issues. -- Mihai cartoaje ( talk) 09:02, 10 March 2009 (UTC)
I don't see anything in the above discussion that suggests that WP:MEDRS is in conflict with Wikipedia policy, that it is particularly relevant to social issues, or that it has been used to "removing a reliable source about a social issue". Surely this thread belongs on Talk:Schizophrenia, not here. Eubulides ( talk) 16:46, 10 March 2009 (UTC)
As I commented on the talk page, the question of efficacy or safety is not in any sense asocial issue. No responsible encyclopedia could admit non medical sources to the discussion, except to discuss the ethical or political implication of the data. Lay sources testify to the lay understanding of science, not to science. DGG ( talk) 02:28, 11 March 2009 (UTC)
In this section of the article, there is a confusing use of sources. This situation has occurred because of the edits made by science-based editors on one side, and a board member of the ICAK on the other side. He has attempted to present this pseudoscience as a scientifically legitimate discipline. The best research has consistenly shown it to be hogwash. Please take a look and you'll be rewarded with a fascinating glimpse into the 10th most used chiropractic technique. -- Fyslee ( talk) 05:30, 17 March 2009 (UTC)
A user has requested mediation on this issue. Jmh649 is here to help resolve your dispute. The case page for this mediation is located here.
Above, TimVickers suggested inserting this text somewhere:
I have a few ideas for making the proposal more concrete and better-supported by the cited source, Dentzer 2009 (
PMID
19118299). I just now reread the above thread and Dentzer, and with all this in mind, I suggest that in
WP:MEDRS #Popular press, we make the following change (deletions struck out, insertions italicized, and changing the preceding comma to a period):
This captures Dentzer's thrust more accurately (albeit at more length), and mentions a positive thing she has to say about the news, which seems to be the main point of contention here. Eubulides ( talk) 18:47, 27 March 2009 (UTC)
A recent change gave reporter inexperience as the reason for poor medical stories, claiming the cited article excluded "seasoned reporters". It does nothing of the sort. That is a logical error like saying that "weekdays are dry" based on a source that says "often weekends are ruined by rain". Colin° Talk 21:18, 27 March 2009 (UTC)
Nbauman - stop edit warring. You were bold. It got reverted. Now discuss. Your reinsertion of text which is neither supported by the cited article nor supported by consensus of WP editors is extremely bad form. I strongly encourage you to have the decently to self-revert and engage in consensus seeking here before making contentious changes. Colin° Talk 21:37, 27 March 2009 (UTC) WP:RS does not apply outside of article space, and you yourself regard it merely as an "opnion piece, not supported by data or research". Colin° Talk 21:39, 27 March 2009 (UTC)
That's followed by a fairly detailed breakdown of recent studies on the subject. So I think the Times piece is actually an example of responsible mainstream-media reporting, which is one reason I cited it. Another reason is that the citation occurred in orthomolecular medicine, which specifically involves very large doses of vitamins and where the potential harms of such megadoses are relevant.Recent studies have even suggested that at the high doses many people consume, vitamin E could be hazardous. In November 2004, the American Heart Association warned that while the small amounts of vitamin E found in multivitamins and foods were not harmful, taking 400 International Units a day or more could increase the risk of death. ( [37])
I can't fault the Times for "excluding" a non-significant finding - I'd be more inclined to praise them for doing so. And the Times piece reaches the same conclusion as Gann's (excellent) editorial: Vitamin E pills aren't a magic bullet. MastCell Talk 00:40, 28 March 2009 (UTC)
WhatamIdoing, you've got it exactly backwards. I have always been a strong critic of medical journalism, and I agree with most of Schwitzer's work because Schwitzer is based on evidence. Much medical reporting is terrible. I don't know if "most" of it is terrible, but I'll go with the evidence.
I'm flattered when I see articles like Dentzer's, because I'm one of those experienced journalists she talks about. I write for doctors, my work is edited and reviewed by doctors, and if I didn't get the story right in every respect, my work would be tossed out pretty fast.
My difference with you and the other editors here is that I believe that evaluations and criticisms of medical journalism should be based on the same kind of scientific evidence that we use in medicine and elsewhere in science. That's what I'm offended at -- your abuse of science and contempt for scientific method. You're not using high-quality secondary scientific sources at all.
You're making wild claims about journalism based not on scientific evidence, like Schwitzer's work, but on your own personal prejudices. I won't speculate on the psychological roots of those prejudices, but you can't support your broad overstatements with facts.
You cherry-pick articles like Dentzer's to find excerpts that you think support your position, and quote them selectively and misleadingly, even though you misunderstand the whole essay.
I've seen something similar, where alternative medicine advocates will pick out excerpts of medical articles to support their argument that all doctors and all drug companies are harming people.
Your basic fallacy is to condemn all journalism in the popular press, when the scientific data displays a much more interesting pattern: some of the popular press is accurate and some is not. So you're really missing the point.
It's paricularly ironic that you claim to be supporting "high-quality secondary scientific sources", when you're doing exactly the opposite. Except for Schwitzer, your entire guideline is based on personal opinion and personal prejudice and ignores those sources. Nbauman ( talk) 23:45, 27 March 2009 (UTC)
Here is a dilema that I have noticed particularly with books. Whilst it is for obvious reasons preferable to use secondary sources wherever possible, is this always the case? One scenario I saw was when reading a high quality secondary source in a book which is widely used especially by medical students where it stated that benzodiazepines are GABA reuptake inhibitors or increase GABA levels for their therapeutic effects which is clearly false as they work at benzodiazepine receptors enhancing the effect of GABA at the GABAa receptor via benzodiazepine receptors. This scenario didn't happen on wikipedia but using it as an example of inaccurate info in books, but something similar happened in the past few days where on the surface seemingly high quality books on psychiatry and psychopharmacology were cited but on closer inspection the authors were employed by literally over 20 pharmaceutical companies and they had cherry picked 2 or 3 primary sources and then distorted the results of the primary sources and reinterpreted them and falsely represented the primary sources without any evidence but their opinion. So what would happen in that scenario? To be clearer though the sections of the books were not doing an extensive review of the literature but were basically touching a little on every aspect of psychiatry and psychopharmacology. So that brings up another question what happens if the secondary source is not doing a meta-analsysis or extensive review of the literature but are simply touching on one aspect of a condition or drug or syndrome etc? Also is a peer reviewed meta-analysis or review superior to a non-peer reviewed book? Is a peer reviewed secondary source published by people with ties to a drug company or some other conflict of interest equal to an independent peer reviewed secondary source? I guess my point and dilema is this. The use of secondary sources are viewed higher on wikipedia because they are seen as being an independent outside opinion but what if the author(s) are not independent and/or they can be shown to be distorting data? My main concern is secondary sources which are not peer reviewed as this area seems to be most open to abuse by those with a conflict of interest. Currently the recommendations is books which are not necessarily peer reviewed and open to abuse, opinion, synthesis, reinterpreting results, distorting facts are declared as "excellent" (secondary) sources. I disagree and think that the problems of books needs to be addressed. There are some good medical books which are high quality don't get me wrong but you see the dilema that I see and problem for misinformation getting inserted into articles. I think peer reviewed secondary sources trump non peer reviewed secondary sources and that many (but not all) books in general are not excellent sources of reliable citeable data. Infact I think primary sources are quite often superior to many books depending on the subject matter being quoted for reasons that I have just explained.--
Literaturegeek |
T@1k? 23:32, 1 April 2009 (UTC)
I have striked out some of my text as on closer inspection I see that you differentiate between non-reliable medical books and reliable trusted publications, but still have some concerns mentioned above.-- Literaturegeek | T@1k? 15:54, 2 April 2009 (UTC)
[Edit conflict with Colin, posting at same time] Sorry for length of questions. This was the book that I was talking about. Would this book be considered superior to an FDA review or Committee on Safety of Medicines review? This book is cited in an article and I have no intention of deleting it so I am not in a conflict with anyone per se. It was just when reading the book and comparing it to their sources I noted how they had distorted or even falsified the conclusions of the sources they were citing. Also they appeared to be giving best practice guidelines based on taking one or two primary sources out of context and also synthesising without any evidence in conflict. I guess I noticed a potential occasional serious problem with using books over more reliable peer reviewed secondary sources. Then of course the above example I mentioned where a trusted book source got the mechanism of benzodiazepines completely wrong is another example. I am not against using books and more often than not they do make good sources to quote and infact I used one today myself. I guess I am asking does a secondary peer reviewed meta-analysis or review source trump this example of a book? Or does FDA review or CSM review or department of health guidelines trump it?-- Literaturegeek | T@1k? 17:56, 2 April 2009 (UTC)
Colin, I think perhaps you misinterpreted me or perhaps it is my fault in how I worded the issue. I was not in anyway shape or form saying that primary sources are superior to secondary sources. I was raising an occasional isolated problem of what happens basically if a secondary source says something which is nonsense. For example should we change the mechanism of action of benzos to say they are reuptake inhibitors because a good quality book made a mistake? Or in such a scenario would a peer reviewed secondary source trump it so we can add accurate data? What happens if the book is demonstratly misrepresenting their sources etc. I was talking about isolated examples. These examples didn't happen in real life on wikipedia but I just noticed a potential from spotting several inaccuracies and thought that I would raise it. I have noticed this is less problematic in the peer reviewed literature especially secondary sources which have been published in medical journals. The inaccuracies I have spotted in sources (particularly books which often briefly skim a topic) are not necessarily POV issues but just a matter of an inaccurate factoids. Another one I have noticed is flunitrazepam is short acting when it is long acting.-- Literaturegeek | T@1k? 18:03, 2 April 2009 (UTC)
Speaking of misrepresenting primary sources, you appear again to be misrepresented me. I never said nor implied that I should resynthesise an authors opinion. I was asking what do we do in that scenario? Do we accept the demonstrately intentional or unintentional inaccurate factoids or opinions of a book which often briefly touched on one aspect of medicine,,, or does a peer reviewed secondary source such as a meta-anaylis or review or FDA, department of health etc etc trump it? I came here just to ask for guidance on what to do. Initially I misread the book guidelines on this project and striked out my text above but still wanted some guidance or discussion on what to do in these isolated scenarios I have mentioned. Instead I appear to be getting responses trivialising and mocking me as an idiot by distorting what I was saying and asking.-- Literaturegeek | T@1k? 19:28, 2 April 2009 (UTC)
Thank you Tim this is what I was asking for, some guidance. Could you also give me your opinion on whether official national reviews by say the FDA or Department of Health, meta-analyis or review in a journal would be superior to a book? What happens if a book says for example SSRIs work by stimulating the release of serotonin when the truth is they block its reuptake or something like that? Do we delete the book ref and replace it with a more accurate secondary source? Or do we leave the mistake of the book in even though we know that it is false? I guess I would like this project to state whether reviews or meta-analysises (secondary sources) in medical journals are superior to a (secondary source) book if content is in dispute.-- Literaturegeek | T@1k? 19:28, 2 April 2009 (UTC)
Okie dokie Tim, problems with specific sources, try and sort out on article talk page or else if that fails go to RS noticeboard is what you are saying I believe. So no need to alter guidance. You have answered my question, thank you.-- Literaturegeek | T@1k? 19:47, 2 April 2009 (UTC)
Ok thank you Colin for your reply and good advice, makes sense.-- Literaturegeek | T@1k? 20:00, 2 April 2009 (UTC)
Just to clarify it wasn't a "benzo book", but a clinical psychopharmacology text book (see above) and also another medical text book. Anyway like I said the inaccurate data wasn't cited on wiki so I was raising a potential issue I had noted with isolated books saying inaccurate things eg benzos are reuptake inhibitors or distorting sources. Anyway like Tim said discuss on article talk page to reach consensus, use better secondary sources or as a last resort go to RS noticeboard in such a scenario.-- Literaturegeek | T@1k? 21:52, 2 April 2009 (UTC)
This has been bugging me and I would like to end this by saying that I apologise for the confusion generated by myself initially misreading (due to skim reading when half asleep) the policy regarding books and I now know why Colin reacted the way he did. He is only trying to defend wikipedia. Ironically I was trying to do the same in my posting and had nothng to gain and the policy actually reads the way I thought it should read but I misread it initially. Anyway I got my questions answered in the end so all is good. :) I would like to just end this conversation here by saying I support Colin's efforts in defending this project and wikipedia and I am glad we now understand each other's misinterpretation of each other. No need for anyone to reply.-- Literaturegeek | T@1k? 02:15, 6 April 2009 (UTC)
I hope I can raise a query here without offending! But regarding the determination of 'review ' status for a paper, does listing as a review by the NIH generally differentiate it. To fit the criteria, Ideal sources for these articles include general or systematic reviews in reputable medical journals, Given A secondary source in medicine summarizes one or more primary or secondary sources and that not all reviews particularily narrative type necessarily label themselves as reviews, but the NIH might list them as such? Leaving aside of course arguments about various journals. Peerev ( talk) 22:37, 20 May 2009 (UTC)
Is it worth mentioning the {dangerous|idiotic|POV-pushing|your favorite adjective here} practice of citing popular media reports on studies that have not (yet) been published? This practice isn't very common, but it seems to be most common in things that turn out to be lucrative for the scientist but false later, i.e., Andrew Wakefield's long-delayed publications in the MMR hoax.
While I think relying on a news article instead of the proper paper is undesirable (and common), "science by unsubstantiated press release" is dramatically worse. WhatamIdoing ( talk) 17:59, 23 May 2009 (UTC)
If anyone wants to comment or has some insight, I've a question about the Journal of Mental Health over at RSN. WLU (t) (c) Wikipedia's rules: simple/ complex 14:33, 26 May 2009 (UTC)
I have posted this at the RS/N, but want to make sure the medical matters contained are addressed by readers here. I have concerns about the way a source is being used. The way it is being used is consistent with the way it has been used in internet conspiracy theories regarding the supposed myriad dangers of aspartame, but I believe it grossly misrepresents the nature of the original source. I would appreciate more eyes on the matter. This is a medical and scientific matter, so to some degree WP:MEDRS would apply to any interpretation of the scientific matters discussed in the source. The original source seems to bear evidence of being influenced by the fringe conspiracy theories, while fortunately noting the mainstream POV from governmental and medical sources. -- Brangifer ( talk) 04:27, 28 May 2009 (UTC)
The very new Medicinal clay article is in need of a thorough checking. Lots of undoumented claims are made. -- Brangifer ( talk) 04:47, 1 June 2009 (UTC)
Under WP:MEDRS#Websites, could we mention some of the major government websites, like the CDC? We have ongoing problems (e.g., this) with people insisting that only peer-reviewed journals are acceptable. Perhaps a mention of major (international?) charities would also be appropriate: they often have decent statistics and can be accurate sources for statements about whether a treatment is common or only used for refractory cases, etc. WhatamIdoing ( talk) 15:49, 4 June 2009 (UTC)
Sadly, there is no language that will completely prevent some of our fellow editors from trying to sneak www.associationforsnakeoilstudies.com or rife.org into the encyclopedia under the same aegis as the CDC. I would suggest wording along the lines of "information from reputable major medical and scientific organizations may be a valuable encyclopedic source." If we reach the point where the words "reputable major scientific organization" have lost their meaning, then it's time to abandon this ship anyway. MastCell Talk 22:55, 4 June 2009 (UTC)
Looking at it another way, the word "Websites" in the section header WP:MEDRS #Websites is problematic. Whether info is on a website is reasonably independent of how reliable it is. After all, JAMA is a website, and it's generally reliable. Even medical books are now commonly accessed via websites. So I propose the following change, along the lines suggested above (and with some wording shamelessly stolen from MastCell's comments):
Eubulides ( talk) 07:25, 12 June 2009 (UTC)
Seems a very good change.-- Garrondo ( talk) 07:15, 16 June 2009 (UTC)
How about this change to Books, to mention online books and The Merck Manuals?
While we're at it, Formatting citations should probably give an example of a book. Something like this, perhaps?
{{
cite book}}
: CS1 maint: multiple names: authors list (
link)"Eubulides ( talk) 21:02, 16 June 2009 (UTC)
No further comment, so I installed the proposed changes. Eubulides ( talk) 19:09, 22 June 2009 (UTC)
When considering studies for inclusion in clinical articles, I have usually kept a rule of thumb that phase II trials need to be absolutely earth-shattering to deserve inclusion. Even phase III trials need to be included with caution, because their findings don't necessarily mean that a procedure or substance will ever be used in a widespread fashion.
I was wondering if there was any scope for anchoring this rule of thumb into this guideline. After all, this applies to all medicine articles. JFW | T@lk 18:35, 21 June 2009 (UTC)
I think ImperfectlyInformed's reaction illustrates the need for guidance on the inclusion of phase I/II trials. This is not a current major issue but it happens constantly in numerous articles, sometimes driven by media reports and sometimes driven by editors who have read something in a journal and find it highly fascinating and surely worth including. More is not always better; this applies to huge topics such as Alzheimer's but I can't see why pancreatic cancer (which receives a fair bit of research attention) doesn't fall under such guidance. Again, just because a very small trial has found some marginally interesting results for "some scary illness" doesn't automatically mean we are including it, because in the larger subsequent studies such effects may well regress to the mean or shown to be marred by toxicity. I can say with confidence that many of the drugs in Alzheimer's disease clinical research will never hit the shelves. What was then the purpose of giving them so much airtime? JFW | T@lk 14:15, 22 June 2009 (UTC)
On the other hand, the evidence base for specific medical practices varies widely. In some areas (pancreatic cancer being an example), interventions are often adopted wholesale on the basis of very limited data, and Phase III trials may or may not ever be done (certainly the impetus for a drug company to fund such a trial evaporates rather quickly once their drug becomes de facto standard-of-care).
Basically, our articles should be in line with respected, expert medical thought and opinion, since our goal is to produce a serious and respectable reference work. If such opinion is based on Phase II trials, then it would be OK to cite them (hence I can't really get behind a cast-in-stone prohibition). On the other hand, we shouldn't be emphasizing the latest, greatest preliminary result at the expense of a balanced treatment of a topic. It might be OK to have a section in an article like pancreatic cancer where we discuss areas of active investigation - preclinical work and early Phase I/II results - with the clarity that this is the cutting edge and may or may not pan out. That would probably do readers a service - by informing them of current avenues of research - without misleading them into thinking that a single-institution, uncontrolled Phase II abstract definitively represents the wave of the future. MastCell Talk 18:31, 22 June 2009 (UTC)
Absolutely. My main point was with regards to discussing treatments in clinical articles. I think we need to think really carefully about whether we go along with the mindless hype of newspapers to write hysterically about every in vitro study (in the UK, the Daily Mail is especially good at this) or try to educate by providing balanced high-quality context-driven content. JFW | T@lk 07:24, 28 June 2009 (UTC)
Summarize relevant, currently accepted knowledge
Research is underway in nearly all areas of medicine. Although the results of a recent study might interest many people, from patients to investors, Wikipedia is not a newspaper and includes only encyclopedic information, in due proportion to its long-term importance. Medicine-related articles should present the current state of medical knowledge. Editors should normally not include speculative proposals and should avoid presenting early-stage research in ways that suggest it is widely accepted.
For example, the results of an early-stage clinical trial are unlikely to be appropriate for inclusion in the "Treatment" section of an article about a disease, because a possible future treatment has no bearing on current treatment practices. However, the results might, in some cases, be appropriate for inclusion in an article dedicated to the drug or treatment in question, or to the researchers or businesses involved in it. Such information might also be appropriate for a well-documented section on "Research directions" in an article about a disease. If including this information in this situation, it is frequently helpful to the reader to clearly identify the level of research (e.g., "first-in-human safety testing," " Phase II clinical trial") to prevent misunderstandings.
I'd like some clarification on an issue that I'm not entirely sure is addressed by the main page (or perhaps I just didn't understand it). Let's say Dr. Watson writes an article in a highly-reliable source like The Lancet, and this article is cited in a Wikipedia article. His peer, Dr. Seuss, later writes a critical response to the original article, which also gets published in The Lancet. The response is, presumably, considered editorial in nature being only one person's opinion. Is it appropriate and/or desirable to include that response within the body of an article, assuming it's relevant? Something along the lines of "In an article in The Lancet, Dr. Watson wrote that all bunnies are fluffy, but this claim was countered by Dr. Seuss who dismissed Dr. Watson's claims." This is basically the point of peer review is it not?
Just as a point of note, I'm not a doctor, researcher, or anything else of that nature, so I don't have a good understanding of the amount/quality of review that would go into any given article or response in order for it to actually be published in a reliable source like The Lancet. Us computer nerds tend to just blog everything. :) Thanks in advance for any clarification on this question. -- RobinHood70 ( talk) 21:03, 12 July 2009 (UTC)
Question about when MEDRS is not MEDRS. I have interest in conditions with medically unexplained symptoms, i edit articles on Morgellons, chronic Lyme, Fibromyalgia, Chronic fatigue syndrome. The reviews on CFS and FM say, the cause is not known, but i use the phrase "medically unexplained symptoms" and other editors do not like. I think some editors think MUS is the same as "functional somatic syndrome" so they do not like that, but i do not think it is, it means medically unexplained.
Editors say I need to proove MUS is used in the fibromyalgia literature, i am ok with it, and they say no article on fibromyalgia uses MUS, i am not ok with that! A week now, i am giving reference and more reference like at my sandbox User:RetroS1mone/MUSreferences and the articles Talk:Fibromyalgia#Primary_sources, Talk:Fibromyalgia#MUPS and user talks, also with quotes, many from the reviews and articles I am giving have "medically unexplained" in abstract or title. Reviews on FM and articles use MUS or MUPS, reviews in the MUPS literature say FM and CFS, textbooks also. Reviews in the psych literature say MUPS and FSS and CFS and FM. There is more support for CFS and FM "medically unexplained" then most of the things in these articles. The editors are saying, these MEDRS are not good enough bc the articles they find in there searches have only a few citations. but the articles i am giving, some have in hundreds of citations, i do not know why they do not look at those.
The question, is there a total citation number before a MEDRS can be used, and how many MEDRS reviews does it take, for supporting a statement in article?? Thx RetroS1mone talk 11:53, 20 July 2009 (UTC)
See Linksearch: [42]. Should these links be removed as not up to WP:MEDRS? Seems all very worthy in intention, but it's ultimately a celebrity doctor site. Gordonofcartoon ( talk) 20:49, 21 July 2009 (UTC)
Here is the first cut at a replacement for the Assess evidence quality section, for discussion. It's too long and wordy, but I thought I'd get it out the door now and we can trim it later. The basic idea is to incorporate some of the discussion mentioned above, and to trim away some of the unnecessary detail that's in the section now.
Several systems exist for assessing the quality of available evidence on medical subjects, and these should be kept in mind while assessing whether a particular viewpoint is a majority or minority one, and in deciding what constitutes evidence-based medicine. [1] [2] The best evidence comes from meta-analyses of randomised controlled trials (RCTs), and from systematic reviews of bodies of literature of overall good quality and consistency addressing the specific recommendation. Narrative reviews can help establish the context of evidence quality. Roughly in descending order of quality, lower-quality evidence in medical research comes from individual RCTs, other controlled studies, quasi-experimental studies, and non-experimental studies such as comparative, correlation, and case control studies. Although expert committee reports or opinions, along with clinical experience of respected authorities, are weaker evidence than the scientific studies themselves, they often provide helpful overviews of evidence quality. Case reports, whether in the popular press or a peer-reviewed medical journal, are a form of anecdote and generally fall below the minimum requirements of reliable medical sources.
If an notable important scientific result is so new that no reliable reviews have been published on it, it may be helpful to cite the primary source that reported the result. Although popular-press news articles and press releases often tout the latest
phase II clinical trial, such trials are rarely notable important enough to mention in an encyclopedia. Any such results should be described as being from a single study, for example:
After enough time has passed for a review to be published in the area, the review should be cited in preference to the primary study. If no review is published in a reasonable amount of time, the primary source should be removed as not reporting an notable important result. When in doubt, omit mention of the primary study, as per
WP:RECENTISM.
Speculative proposals and early-stage research should not be cited in ways that suggest wide acceptance. For example, the results of an early-stage clinical trial are unlikely to be appropriate for inclusion in the Treatment section of an article about a disease, because a possible future treatment has little bearing on current treatment practice. However, the results might, in some cases, be appropriate for inclusion in an article dedicated to the treatment in question, or to the researchers or businesses involved in it. Such information, particularly if citing a secondary source, might also be appropriate for a well-documented section on "Research directions" in an article about a disease. To prevent misunderstandings, the text should clearly identify the level of research cited, e.g., "first-in-human safety testing".
End of draft replacement. Eubulides ( talk) 16:57, 2 July 2009 (UTC)
No further comment, so I replaced the text in question with the above draft. I copied the previous version to #Previous version of "Address evidence quality" below, as it looks like it could well be useful in an article somewhere. Eubulides ( talk) 06:42, 23 July 2009 (UTC)
Several systems exist for assessing the quality of available evidence on medical subjects, and these should be kept in mind while assessing whether a particular viewpoint is a majority or minority one, and in deciding what constitutes evidence-based medicine. [1] [3]
Two of the most commonly used schemes are the US Agency for Healthcare Research and Quality one:
Class | Requirements |
Ia | Evidence from meta-analysis of randomised controlled trials (RCTs) |
Ib | Evidence from at least one RCT |
IIa | Evidence from at least one well-designed controlled study without randomisation |
IIb | Evidence from at least one other type of well-designed quasi-experimental study |
III | Evidence from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies, and case control studies |
IV | Evidence from expert committee reports or opinions and/or clinical experience of respected authorities |
And the slightly simpler NHS one:
Grade | Evidence | Description |
A | Ia, Ib | Requires at least one RCT as part of the body of literature of overall good quality and consistency addressing the specific recommendation |
B | IIa, IIb, III | Requires availability of well-conducted clinical studies but no RCTs on the topic of recommendation |
C | IV | Requires evidence from expert committee reports or opinions and/or clinical experience of respected authorities. Indicates absence of directly applicable studies of good quality. |
Case reports, whether in the popular press or a peer-reviewed medical journal, are a form of anecdote and generally fall below the minimum requirements of either scheme.
Primary research often, if not usually, includes introduction and discussion sections which cite other sources. Can these be then considered as "secondary" sources? - Tekaphor ( TALK) 14:26, 20 July 2009 (UTC)
Hi everyone, i cannot believe, but Medical Hypotheses journal is discussed again as MEDRS Talk:Chronic_fatigue_syndrome#Herpes_and_CFS, a single purpose account editor thinks it has a MEDRS review about Herpes causes CFS. I tried explain them, it is not MEDRS, but editor has very good arguments for MEDRS by calling me uninformed and a conservative, ha ha if they knew!! I am sorry for bugging every body about it, pls can we say the journal is, is not MEDRS. Thx RetroS1mone talk 13:51, 30 July 2009 (UTC)
We need some wording to disambiguate between different sources regarding alternative medicine. I propose something like the following:
ScienceApologist ( talk) 19:14, 10 August 2009 (UTC)
@ScienceApologist, re above proposal for poorly sourced claims: that sounds fine to me as long as we're not construing it to say that
Quackwatch can be cited as fact rather than attributed with an inline citation, or that it supersedes other MEDRS's. Quackwatch is certainly fine to use, per
WP:PARITY, but you go too far with your argument
here when you hold Quackwatch as a superior source to the
Institute of Medicine, viz:
Quackwatch can be a valuable source, but it's not the best MEDRS out there, and certainly isn't as good as sources like the Cochrane Collaboration and other mainstream, peer-reviewed sources. I doubt that I'd put it in the same tier as sources mentioned under Wikipedia:MEDRS#Medical_and_scientific_organizations, either, because (its advisory board notwithstanding) there's no apparent mechanism of peer review.
When a topic is not discussed by superior MEDRS's, Quackwatch can be an ideal counter to self-published, WP:VANITY claims; but when a topic is discussed by superior MEDRS's, Quackwatch can still be cited, but with less weight. In that light, I agree with Eubulides' caveat above about throwing out the baby with the bathwater. My position is simply that we should give Quackwatch no more or less than its due weight per WP:PARITY, and always use inline attribution with a wikilink (which is the default, safe, wise approach on WP anyway). -- Middle 8 ( talk) 19:59, 11 August 2009 (UTC)
Okay. I have tried to take all the comments and considerations into play. Middle 8, we're going to have to agree to disagree about what this particular paragraph can be construed as -- but actually I think that's okay for now. ScienceApologist ( talk) 17:16, 14 August 2009 (UTC)
← I think there is a real need for language like this. If anyone doesn't believe this is a problem, I'll point them to a series of articles demonstrating the issue. Combine the following:
The result is a low-quality article which can never be anything other than a) credulous snake-oil promotion or b) original-synthesis deconstruction of the nonsensical claim. And with one dedicated single-purpose editor (and a few of the usual suspects to chime in) the article can never be deleted through AfD. This is a real barrier to the goal of creating a serious, respectable reference work, so I would support some language clarifying the ways in which Wikipedia's core principles apply to such situations. MastCell Talk 04:11, 15 August 2009 (UTC)
Broadly speaking, there seems to be agreement here that something along these lines is a positive addition to the guideline, yes? Does anyone mind if we go ahead and drop it in? - 2/0 ( cont.) 06:12, 18 August 2009 (UTC)
Hi, there is an ongoing discussion in the Wikipedia:Reliable sources/Noticeboard#Sources appropriate for medical and health-related articles about the use of an inconclusive commentary as a source for a medical and health-related article, that relates with WP:MEDRS. So your opinion is welcome.-- Nutriveg ( talk) 20:17, 16 August 2009 (UTC)
Most journals also publish pieces that are not scientific articles, such as editorials, op-ed pieces, commentaries, and letters to the editor. These sources may provide interesting ideas, but they are never peer-reviewed and are rarely even fact-checked, and therefore they should be treated with caution. In general, such pieces must comply with Wikipedia's standard rules for self-published works, including rejecting claims outside the author's expertise and requiring direct attribution of the claims to the source.
How about this?
Some reputable journals also publish pieces that are not strictly journal papers, such as editorials, op-ed pieces, commentaries, and letters to the editor. These sources may provide interesting ideas, but they should be treated with caution as the peer-review status and accuracy of the text can be nebulous. In general, such pieces must comply with Wikipedia's standard rules for self-published works, including rejecting claims outside the author's expertise and requiring direct attribution of the opinions of the author to the source.
ScienceApologist ( talk) 20:15, 17 August 2009 (UTC)
This edit inserted a paragraph saying that editorials etc. must have direct attribution of claims to the source. If I understand that correctly, it goes too far: if (say) a NEJM editorial says that the use of Lupron to treat autism is controversial, we need not have the article text say "Mr. Schmoe wrote that the use of Lupron to treat autism is controversial". Also, if a letter to the editor by an article's author corrects information in that article, surely a citation to the letter suffices; we don't need intext attribution. Furthermore, the change caused the project page to be incoherent: in one paragraph it says that editorials are articles, and in the next paragraph it says they aren't. I'm not sure what this change is motivated by, but I suggest that it be discussed here further before installing.
Eubulides (
talk) 16:47, 17 August 2009 (UTC)
(Unindenting, as the above is too hard to follow.) I have some concerns about ScienceApologist's above proposal (dated 20:15, 17 August 2009). I am mostly concerned about Letters to the Editor. Since these are the standard method by which errors in published work are discussed, I think it would be a mistake to craft a rule that permits an erroneous paper to be cited but not a Letter to the Editor describing the error. Consequently, I think care is needed. In particular, I don't think that we should classify this material as self-published. It's considerably more reliable than that. At the very least, it will have received the attention of the Editor, who will have made the decision to publish (based, presumably, on merit). And some journals (for example the International Journal of STD and AIDS) apply a full peer-review process for Letters to the Editor. I suggest simply stating that such material should be treated with caution, that it may be worth determining what review process (if any) applies, and that extra care should be taken to watch for dubious or surprising claims that may require stronger sourcing. Jakew ( talk) 13:55, 18 August 2009 (UTC)
Review in Nat Clin Pract Gastroenterol Hepatol. Free full text at Medscape, could be a useful source. Fvasconcellos ( t· c) 16:46, 22 August 2009 (UTC)
There are good reasons for the existence of specific medicine-related reliability criteria. But the guidelines fail to explain them with the result that its application is too wide.
Are there any essays, guidelines or policies that talk about pharmanoia, and the idea that sources shouldn't be trusted because of Big Pharma having sticky fingers in things? I've been treating such arguments as spurious without a specific source criticizing a specific paper. I'm also interested in whether there's something similar for when alt med advocates cite the pharmanoia argument to support the idea that vitamins are a panacea and preventive wonder for all things (also would be nice to have something to point to that states the alt med advocates often have their own conflict of interest, and are not immune merely because they aren't Pfizer). WLU (t) (c) Wikipedia's rules: simple/ complex 20:47, 3 September 2009 (UTC)
I am in doubt about a reference that has been added. To me it sounds like dubious woo-woo advice by pushers of dietary supplements that isn't backed up with good evidence. The ref is being used to justify mentioning that aspartame can produce migraines. While there is a subset of individuals that are sensitive to it, the ref is being used to imply that it causes migraines, without qualifying the subset it applies to:
The edit seems to be pushing an unjustified and POV use of the source. Brangifer ( talk) 04:43, 11 November 2009 (UTC)
An IP editor ( 131.215.40.141 and 131.215.6.110) seems to need advice regarding the importance of not depending on primary sources, on the difference between in vitro and in vivo, and on how the dose makes the poison. -- Brangifer ( talk) 04:51, 17 November 2009 (UTC)
This article needs to be gone through. I suspect there are many false claims backed up by sources that appear to be official medical journals, but are really fringe journals not even listed in PubMed. -- Brangifer ( talk) 15:23, 22 November 2009 (UTC)
This section seems to be one huge special pleading section with peacock language and undue weight given to alt med advocates like Haley and Blaxil from SafeMinds, and ancient claims made by Bowen. (Yes, believe it or not, Bowen does rant about Satan, Zionism, and the Illuminati, and in his letter to Martini explains why his medical license was revoked.) While the fringe position should be stated clearly, it shouldn't be allowed to deceive the public by making their claims seem plausible through a presentation marred by undue weight. -- Brangifer ( talk) 00:10, 23 November 2009 (UTC)
I've been looking through some conversations from earlier this year, and I have run across an area that WP:MEDRS#Assess_evidence_quality may need to provide a little more clarity. It seems that this section is being occasionally (mis)understood as requiring editors to decide whether a study (or review) has sufficient data to support the conclusions that it draws.
So what we mean -- and what I thought we said -- was that if you're faced with contradictory papers, or trying to decide whether something's important enough to include, then you prefer reviews and meta-analyses to original RCT reports, and that you prefer RCTs to case studies, and so forth.
I'm seeing this invoked as a justification for WP:OR: I didn't think that their data sample was big enough to justify that conclusion... and the review cites Smith's trial for this fact, so that's just a single original paper... and Smith's paper is a little old, anyway, even though the review is recent... and probably the reviewer is twisting Smith's conclusions... -- even though we're citing the review instead of Smith.
I think that the problem might actually be in the section's title. Could we consider renaming it to something less open-ended, like "Prefer well-designed studies"? WhatamIdoing ( talk) 19:58, 19 October 2009 (UTC)
Why not just rename the section to "Use high-quality sources"? That matches the section's contents better anyway, and would help avoid the possible misunderstandings noted above. Eubulides ( talk) 23:25, 19 October 2009 (UTC)
How about Consider study design? I think asking editors to conduct assessments of studies is wildly inappropriate, and maybe even insisting on "preferences" can be construed problematically, but exhorting people to consider the designs of studies when writing prose is okay in my book. ScienceApologist ( talk) 03:35, 20 October 2009 (UTC)
The new template is interesting, on the one hand, but based on its sole use to date, [50] I suspect that it may be no more useful than Template:Verify credibility, and may be misused. MEDRS doesn't presume to provide standards for strictly social facts, such as whether scientists "should" publicly oppose quackery, or whether a country devotes sufficient resources to health care for a given marginalized population, or what the polite term is for a given condition, or that sort of thing. Instead, it cares mostly about physical facts, of the type that you can determine with a well-designed trial or three. The other RS-related guidelines are quite sufficient for these non-scientific statements.
Does anyone else have any thoughts about this new template? WhatamIdoing ( talk) 02:52, 1 November 2009 (UTC)
This guideline implicitly defines its scope as all medical articles. While reasonable in principle this is probably not precisely what is intended, or at least should not be. I believe the situation is parallel to WP:BLP, which generally talks about biographic articles but really means biographic information in any article.
Here are two real examples of the problem.
The first problem is addressed by a paragraph in WP:MEDRS#Popular press. It makes clear that for non-medical sections in medical articles there is a relaxed standard. It does not try to define this standard; clearly such an attempt would be out of proportion in this guideline. It would be more efficient to delegate this to WP:RS.
I can't see that the more serious second problem is addressed anywhere: Medical information in List of common misconceptions seems to be outside the scope of this guideline! Therefore I propose adding a new section at the end of the lead:
Hans Adler 11:12, 2 November 2009 (UTC)
Hans, is there an active dispute that centers around this distinction, or is this purely hypothetical? WhatamIdoing ( talk) 03:27, 3 November 2009 (UTC)
I have started a thread and hope readers here will chime in there:
We need a parallel noticeboard to deal with medical sourcing: WP:MEDRS/N. Currently such matters end up at Wikipedia talk:Reliable sources (medicine-related articles) and Wikipedia talk:WikiProject Medicine, but that's unsatisfactory. We need a separate noticeboard which is watched by medical professionals who understand the complexities of medical matters and medical research, understand our RS policy, and understand the MEDRS guideline. What think ye?
Please discuss it there, not here. -- Brangifer ( talk) 00:50, 23 November 2009 (UTC)
Is there any guidance anywhere on the use of conference abstracts and symposia? My find function doesn't turn anything up, and who wants to read all that WLU (t) (c) Wikipedia's rules: simple/ complex 13:38, 3 December 2009 (UTC)
FWIW, I proposed a long time ago that conference proceedings and low-impact journals be considered primary source documents that have not undergone strict review for the intents and purposes of Wikipedia. My concern was outlined here: Wikipedia:Reliable_sources/Noticeboard/Archive_9#Low impact journals used to POV-push. ScienceApologist ( talk) 22:47, 3 December 2009 (UTC)
Sorry to raise this thread from its deathbed, but it might be worth looking at how the Center for Integrative Medicine at M.D. Anderson Cancer Center approaches conference abstracts:
The problem with these [conference] abstracts is that they do not contain all the available details of the study methodology and data, and are not reviewed by experts in the same field (peer-reviewed) for how well the data supports the conclusions. In fact, it is not uncommon for such abstracts to be subsequently published in greater detail in peer-reviewed scientific and clinical journals with modified conclusions from the original abstract, or to be rejected for publication because the methodology or data was judged to not support the conclusions. Because of this problem with abstracts, the CIMER Web site has a policy for its content of only drawing conclusions from the most carefully reviewed information available in complete articles published in peer-reviewed journals. [51]
This mirrors the approach (and reasoning) we should be using fairly closely, and might be a useful addition (or not). Anyhow... MastCell Talk 21:32, 15 January 2010 (UTC)
Would someone independent please have a look at [ this edit]? Prior discussion on the article's talk page pertains. Thank you, LeadSongDog come howl 20:08, 7 December 2009 (UTC)
Hello all,
I'm more and more convinced that the definitions used in MEDRS are unjustifiably limited to medical articles. The definitions found at WP:PSTS gives the impression that a peer-reviewed article on a scientific subject is a secondary source, when really if there is any debate the appropriate secondary source would be a review article. Is there any discussion elsewhere that points to this? For a celebutard's personal life, a news article is appropriate, but for a discussion of the impact of different drivers on human bipedalism, a review article would seem a better source than a journal article - where it is easy to cherry-pick sources to provide the illusion of being a respected hypothesis. Any wikilinks to policies or guidelines that would be helpful to me? WLU (t) (c) Wikipedia's rules: simple/ complex 13:14, 21 January 2010 (UTC)
This guideline appears to be about medical articles, but it's titled "medicine". A Quest For Knowledge ( talk) 17:05, 21 March 2010 (UTC)
We talked about this a while ago and never got very far. My bold change rearranges a bit, but it's the first and last paragraphs that are (mostly) new.
I didn't get very far with wordsmithing, so if you've got any ideas about how to improve it, please go ahead. WhatamIdoing ( talk) 00:32, 27 March 2010 (UTC)
There is currently an ongoing discussion about the future of this and others MoS naming style. Please consider the issues raised in the discussion and vote if you wish GnevinAWB ( talk) 21:00, 25 April 2010 (UTC)
BMJSystematicReviews
was invoked but never defined (see the
help page).{{
cite journal}}
: CS1 maint: date and year (
link)
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Here is a draft replacement for the sections WP:MEDRS #Periodicals, WP:MEDRS #Books, and WP:MEDRS #Online. It attempts to take all the above discussion into account. It's a bit rushed and wordy, and could stand some improvement, but I thought I'd get it out the door sooner rather than later. Comments are welcome in #Comments on Draft replacement for Periodicals, Books, Online below. Eubulides ( talk) 00:59, 21 October 2008 (UTC)
Each of the sections of the draft replacement are intended to be top-level sections in WP:MEDRS. They are 3rd-level sections here, so that it's nested properly in the talk page. Eubulides ( talk) 00:59, 21 October 2008 (UTC)
(start of draft replacement)'
Search engines are commonly used to find biomedical sources. Each engine has quirks, advantages, and disadvantages, and may not return the results that you need unless used carefully. It typically takes experience and practice to recognize when a search has not been effective; even if you find useful sources, you may have missed other sources that would have been more useful, or you may generate pages and pages of less-than-useful material. A good strategy for avoiding sole reliance on search engines is to find a few recent high-quality sources and follow their citations to see what your search engine missed. It can also be helpful to perform a plain web search rather than one of scholarly articles only.
Pubmed is an excellent starting point for locating peer-reviewed medical sources. It offers a free search engine for accessing the MEDLINE database of biomedical research articles offered by the National Library of Medicine at the U.S. National Institutes of Health. Although PubMed is a comprehensive database, many of its indexed journals restrict online access; an additional site, PubMed Central, provides free access to full text. There are basic and advanced options for searching PubMed. Clicking on the "Review" tab will help you narrow your search to reviews. The "Limits" tab can let you further limit your search, for example, to meta-analyses or to freely-readable sources.
Other useful search engines include:
A Wikipedia article should cite the best and most-reliable sources regardless of whether they require a fee or a subscription. When all else is equal, it is better to cite a source whose full text is freely readable, so that your readers can follow the link to the source. Some high-quality journals, such as JAMA, publish a few freely-readable articles even though most are not free. A few high-quality journals, such as PLoS Medicine, publish only freely-readable sources. Also, a few sources are in the public domain; these include many U.S. government publications, such as the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention.
When searching for sources, it is wise to skim-read everything available, including abstracts of papers you can't fully access, and use that to get a feel for what reliable sources are saying. However, when it comes to actually writing a Wikipedia article, it is generally not a good idea to cite a source after reading only its abstract, as the abstract necessarily presents a stripped-down version of the conclusions and omits the background that can be crucial for understanding exactly what the source says. You may need to visit a medical library to access the full text, or ask somebody at the WikiProject Resource Exchange to either provide you with a copy or read the source for you and summarize what it says; if neither is possible, you may need to settle for using a lower-impact source or even just an abstract.
Citations should document precisely how to access sources. Normally, medical citations should contain a Pubmed identifier (PMID). It is good practice to also supply a digital object identifier (DOI) if available. A common practice is to supply a uniform resource locator (URL) to a source if and only if its full text is freely readable. If the {{ Cite journal}} template is used, all this information can be supplied with the "pmid=", "doi=", and "url=" parameters, respectively. It is also helpful to mention whether a source is also available on Pubmed Central; with {{ Cite journal}} this can be done with the "pmc=" parameter. For example:
produces this:
{{
cite journal}}
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link)If a source is available in both HTML and some other form, normally the HTML form should be cited, as it is the most likely to work on a wide variety of browers.
As mentioned above, the biomedical literature contains two major types of sources: primary publications describe novel research for the first time, and review articles summarize and integrate a topic of research into an overall view. In medicine, primary sources include clinical trials, which test new treatments; secondary sources include meta-analyses that bring together the results from many clinical trials and attempt to arrive at an overall view of how well a treatment works. It is usually best to use reviews and meta-analyses where possible, as these give a balanced and general perspective of a topic, and are usually easier to understand!
Peer-reviewed medical journals are a natural choice as a source for up-to-date information for medical articles. They contain a mixture of primary and secondary sources, as well as less technical material such as biographies. Although almost all such material will count as a reliable source, not all the material is equally useful. Journal articles come in many types: original research, reviews, editorials, book reviews, correspondence, biographies and eulogies. Research papers are primary sources; although they normally contain previous-work sections that are secondary sources, these sections are typically less reliable than reviews. A general narrative review of a subject by an expert in the field makes a good secondary source that can be used to cover various aspects of a subject within a Wikipedia article. Such reviews typically contain no original research but can make interpretations and draw conclusions from primary sources that no Wikipedia editor would be allowed to do. A systematic review uses a reproducible methodology to select primary studies meeting an explicit criteria in order to answer a specific question. Such reviews should be more reliable, accurate and less prone to bias than a narrative review. [1] However, a systematic review's focus on answering one question limits its usage as a source on Wikipedia.
The 2003 Brandon/Hill selected list includes 141 journals suitable for a small medical library. [2] Although this list is no longer maintained, the listed journals are of high quality. The core general medical journals include the New England Journal of Medicine, The Lancet, Journal of the American Medical Association (JAMA), Annals of Internal Medicine, British Medical Journal (BMJ), and Canadian Medical Association Journal. Core basic science and biology journals include Science, Cell, and Nature.
Medical textbooks published by the academic press are excellent secondary sources. Ensure the book is up-to-date, unless a historical perspective is required. Doody's maintains a list of core health sciences books, which is available only to subscribers. [3]
The popular press is generally not a reliable source for science and medicine information in articles. Most news articles fail to discuss important issues such as evidence quality, costs, and risks versus benefits. [4] Articles in newspapers and popular magazines generally lack the context to judge experimental results. They tend to overemphasize the certainty of any result, for instance presenting a new experimental medicine as the "discovery of the cure" of a disease, or an every-day substance as the "cause" of some dreaded disease. Newspapers and magazines frequently publish articles about scientific results before those results have been peer-reviewed or reproduced by other experimenters. Such articles may be based uncritically on a press release, which can be a biased source. They also tend neither to report adequately on the scientific methodology and the experimental error, nor to express risk in meaningful terms.
A news article should not be used as a sole source for a medical fact or figure. Editors are encouraged to seek out the scholarly research behind the news story. One possibility is to cite a higher-quality source along with a more-accessible popular source, for example with the "laysummary=" parameter of {{ Cite journal}}.
On the other hand, the high-quality popular press can be a good source for social, biographical, current-affairs and historical information in a medical article. For example, popular science magazines such as New Scientist and Scientific American are not peer reviewed but sometimes feature articles that explain medical subjects in plain English. As the quality of press coverage of medicine ranges from excellent to irresponsible, common sense and the general guidelines presented in the verifiability policy and general reliable sources guideline should be considered in determining whether a popular press source is suitable for these purposes.
Popular science and medicine books are usually tertiary sources, but there are exceptions. Self-published or books published by vanity presses are generally not subject to any form of independent fact-checking or peer review and may not be reliable sources.
(end of draft replacement) Eubulides ( talk) 00:59, 21 October 2008 (UTC)
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(Please put comments here.) Eubulides ( talk) 00:59, 21 October 2008 (UTC)
@WLU: Making improvements to a page is a good thing. Just edit the page like normal. :-) That's the whole point of wikipedia, and it's what we've been working towards. If anything happens (I hope it won't, but it might), drop me a line and I'll help sort it out. -- Kim Bruning ( talk) 17:49, 21 October 2008 (UTC) The rule on wikipedia is: someone has to do the consensus homework, else you may have ...some... trouble finding consensus at times. ;-) And I'll admit I'm rebelling a little: why should it always be the (informal) mediator who gets to do all the work? People should learn to do the homework themselves for a change! That way the workload is spread out over several people, and the mediators job is a lot lighter. In fact, why need a mediator at all? A stitch in time saves nine: If you try to understand the current consensus _before_ you get into an edit war, rather than after, well sure, it might cost you a couple of hours (only at first, with practice you can get it down to a couple of minutes), but it will save you a month of torture at the hands of an evil mediator! O:-)
Above suggested wording states PubMed Central as an "alternative" of PubMed - but in reality both hosted by NLM. They each provide a different webpage to search the database and whilst one shows PMID abstracts (which will mention any PMC links if available), the other only shows archived copies of articles. "additional" resource tool rather than "alternative" might be a better choice of wording ? David Ruben Talk 00:13, 22 October 2008 (UTC)
Consider the following citation:
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)This uses the "pmc=" parameter of {{ Cite journal}}, so that if you click on the article title, you visit the PubMed Central manuscript for that article. This manuscript, though, presumably differs in minor ways from the final version of the article (which is viewable only with a subscription).
So, my question is: is such a citation a reasonable one? Or should it be altered to make it clear to the reader that the URL is to something other than the final version of the paper? There is an argument for convenience and for encouraging people to read freely-available versions of papers; but there is also an argument for making it clear which is the final (and presumably best) version of the paper.
Should WP:MEDRS have some guidance about this issue?
Eubulides ( talk) 20:45, 23 October 2008 (UTC)
PMC is not necessarily manuscripts; a number of publishers deposit full versions, formatted in PMC's special XML. And when PMC has manuscripts they have invariably undergone full peer review--the difference is the lack of publishers' copyediting. There is consensus, though, in the academic community that the published version is the one for official citation--and consensus on WP that we always also give a convenience citation to the free version if available. Incidentally, as for the differences see my "Open access and accuracy: author-archived manuscripts vs. published articles " in Learned Publishing, 20:3, July 2007 , pp. 203-215 open access.and the refs listed therein. They are very rare--nobody has every demonstrated anything substantial. DGG ( talk) 01:05, 24 October 2008 (UTC)
Thanks, I made this change to cover the topic and cite DGG's paper. But there's a tasty irony here. As far as I can tell, Ingentaconnect, the publisher of DGG's paper, does not provide a stable URL to the full final version of the paper. Instead, one must go through a couple of levels of indirection, and that gives you a URL with session info in it, compromising both portability and privacy (so much for "open access"). My edit therefore contains this citation:
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link)Here the DOI is to the final version, but the URL http://dlist.sir.arizona.edu/1968/01/OAandA%5FGDY.pdf points instead to the authors' preliminary manuscript. I sure hope that the paper's results apply to the paper itself! Eubulides ( talk) 08:59, 24 October 2008 (UTC)
It seems unfortunate/unbalanced for Wikipedia that there isn't actually a central guideline covering the various journal database and access issues above (unless I've missed it). To cover all the main databases, for different editors and points of view (pubmed of course is misleadingly titled/described 'cos it includes a large number of non-medical journals). Which could then split off into specific databases/topics if length dictated it. Avoiding cart before horse or tail wagging dog. EverSince ( talk) 11:27, 24 October 2008 (UTC)
I don't think we should restrict references to particular databases, but I personally would strongly object to the citation of articles from journals not indexed on Medline. I have a preference for freely accessible sources, but if there is a better source that is not freely accessible then the second one still wins... JFW | T@lk 18:58, 25 October 2008 (UTC)
(watches the tumbleweeds go by)...I guess the above issues about the lack of a neutral cross-disciplinary guideline on finding/assessing articles, and the illegitimacy of this guideline being founded on a priori privileging of reliable medical sources over reliable non-medical sources, can be added to the list of critical issues that remain unaddressed/ignored. Another one is that a sourced critique of press sources is included in this guideline - tendencies, things they miss out, exaggerate etc - but not a similar critique of medical sources. Here's a long list of the sorts of points that might be relevant, not saying these specific sources are necessarily ideal but they seem to support the presence of widespread issues & tendencies equivalent to those covered for press articles:
In the 150 years since Virchow produced his principles, medicine has strayed from this vision [20]. Despite television images of trapped hurricane survivors searching for food and the knowledge that 44 million Americans (most of them working) do not have health insurance, medical research continues its biomedical trajectory in search of expensive “magic bullets” and more sophisticated interventional technologies, rather than understanding the social determinants of health...Why then is social science often excluded? For one, academic medicine has been preempted by the glamour of technology and by the rewards it brings to those who discover and employ it [22]. For another, social scientists are unwelcome when they discover unpleasant facts, such as life circumstances trumping medical care in determining the health status of populations and that disparities in health care are part of the system rather than oversights [1]. These discoveries not only threaten medical hegemony, but they challenge the larger social order [4]
If structural violence is often a major determinant of the distribution and outcome of disease, why is it or a similar concept not in wider circulation in medicine and public health, especially now that our interventions can radically alter clinical outcomes? One reason is that medical professionals are not trained to make structural interventions. Physicians can rightly note that structural interventions are “not our job.” Yet, since structural interventions might arguably have a greater impact on disease control than do conventional clinical interventions, we would do well to pay heed to them. [5]
When 'medical facts' must be derived from 'magical beliefs' in the centres of biomedical science, the state often intervenes to criminalize practitioners of alternative medicine. But, when profits are to be made on the fact that 'the magical' sells in alternative medicine, the state also makes it possible to shift ownership of medical knowledge, sometimes by way of the randomized controlled trial and the pursuit of active ingredients. The possibility of relocating the label of 'crime' is explored in this paper by way of an inquiry into processes that enable this shift in ownership, and a relocation of what constitutes medical 'fact' versus 'belief'. [6]
studies have found high error rates in references in biomedical journals [7]
Selective reporting of trial results exists for commonly marketed drugs [8]
[Medical anthropology] use[s] the voices and stories of the poor to explain the impact of structural adjustments...I argue that [this] masks the real absence of the voices of the poor and their suffering on the world stage. There is no international public sphere within which these voices might be heard; rather, there is a set of claims about justice and human rights. [9]
[in] contested areas of science-society discourse...militaristic metaphors are still part of a pervasive, but by no means inevitable, mode of science and policy communication. [10]
disease in the Western world has been primarily constituted by the imagery of war...it derives its immediate nourishment and historical root from a corresponding language of war within medicine itself [11]
Medical journals are an extension of the marketing arm of drug companies [12]
The eight questions that I pose in the opening paragraph – having to do with blindness and deafness, mild depression and slow running, black racial features and plain facial features, obesity and anorexia – have become, even in today’s world of limited resources and imperfect technology, principal lightning rods for debate over the final limits to medicine ... treatments for conditions such as deafness, obesity, or anorexia may actually be a form of cultural genocide [13]
Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives. [14]
Three decades ago, Ivan Illich argued polemically that the medical establishment was “medicalising” life itself [8], and in the 1990s Lynn Payer described widening the boundaries of illness as “disease mongering” [3], highlighting the role of pharmaceutical companies. Today's debate about this phenomenon, while still maturing, both acknowledges the axiomatic interest of corporations and professionals in maximizing turnover and appreciates that well-informed citizens may choose to embrace the medicalisation of health problems previously regarded as troublesome inconveniences. [15]
The unequal distribution of power in contemporary society is reflected and reproduced in medical ideology. The present article analyses some articles from Israeli medical journals in order to show the ways in which biomedicine—the dominant medical ideology—is reinforced through hegemonic discourse. The central ways by which this is achieved are medicalization—which includes the desocialization of disease and the explanation of social phenomena in medical terms—and the affirmation by the Israeli medical literature of national, ethnic, class and gender relationships of domination. Analysis of the Israeli example provides useful insights about biomedicine's desocializing role, as the disregard for the social dimension of disease is particularly telling in a society characterized by several cleavages which determine a clearly unequal distribution of power and resources. [16]
"Social conditions such as poverty and crime have all too often been attributed to mental illness, biology, and genetics. This has created a kind of nihilism on the part of mental health professionals, which has proven to be an impediment both to research and health care delivery. These deterministic views of race-based psychology have continued to appear in the literature and continue to exert a pernicious influence." [17]
the dominance of biomedicine is delegated rather than absolute, these processes reflect the growing accommodation on the part of alternative practitioners to the reductionist disease theory which is compatible with capitalist ideology. [18]
The "Medical-Industrial complex" has led to the commercialization of health care well beyond what traditional practitioners would consider ideal. Medicine is being treated as a business, with cost curtailment measures and profit margins often dictating physicians' choices [19]
the transformation of continuing medical education into an enterprise for drug marketing. The chore of teaching doctors how to practice medicine has been handed to the pharmaceutical industry. [20]
By accepting only advertisements for drugs and medical devices, medical journals have accepted an exclusive and dependent relationship with corporations... Advertisements and other financial arrangements with pharmaceutical companies compromise the objectivity of journals. [21]
pharmaceutical industry organizations often front for sections of the pharmaceutical industry by retaining public relations consultants and sometimes by coordinating the funding of psychiatric research. An important line of agenda setting communication is via a two-way exchange between PR/advertising and the psychiatric profession/researchers. Public relations firms are often used to disguise the sources of drug company funding for psychiatric research and there is also a constant barrage of drug company advertising in psychiatric journals aimed at persuading psychiatrists to use specific drugs. The reverse flow, from psychiatry to PR, involves the utilization of psychiatric research, and psychiatric expertise, in public relations campaigning. [22]
the erosion of professional values and medical education by commerce shows no sign of slowing. The latest scandals involve Medscape [23]
One of the nation’s most influential psychiatrists earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules, according to documents provided to Congressional investigators. [24]
Leading medical journals seem to be having a difficult time disentangling themselves from the pharmaceutical and medical device industries. If they cannot stop printing articles by scientists with close ties to these businesses, they should at least force the authors to disclose their conflicts of interest publicly so that doctors and patients are forewarned that the interpretations may be biased. [25]
residents indicate that they do not have the time nor the mentors to deliver effective cross-cultural care, and are not evaluated on their ability to do so [26]
both EBM [Evidence-Based Medicine] and CCM [cultural competence in medicine] have been accused of fostering stereotypes and have therefore suffered some degree of backlash. EBM experienced a backlash over fears of “cookbook medicine,” or clinical stereotyping, while CCM experienced a backlash over fears of cultural stereotyping. [27]
the issue about the predominance of the neurosciences has less to do with truth than with the current economical and legal climate and hence it is imperative that other approaches to mental illness are allowed to participate in the process of understanding..." "Indeed, it could even be said that it would be unethical not to allow other approaches to participate in the common epistemological enterprise. Without such wider conceptual participation, the haematoma auris or the drapetomania stories will happen again." [28]
EverSince ( talk) 21:34, 23 November 2008 (UTC)
The Aspartame controversy article has some pretty lousy self-published or non-PubMed sources. It needs a good thinning. The whole controversy was started by one woman, and she's the one who keeps it alive, but she's not a reliable source in any sense, and her supporters (a few radical fringe MDs) aren't good sources either. -- Fyslee / talk 02:19, 1 November 2008 (UTC)
Wondering what others think about the Therapeutics Initiative as a reference source for medical articles. Another editor disagrees with its use. I presume this would be classified as a secondary source.
-- Doc James ( talk) 22:10, 31 October 2008 (UTC)
I have found sources that are only available through paid subscriptions. When one does a google search no other mention of the article can be found beyond the links to subscription service. Is that an acceptable source?-- scuro ( talk) 05:45, 11 November 2008 (UTC)
I've been corresponding with a researcher about the topic of reviews. I've collected her thoughts and organized them, taking ideas from different e-mails and stringing them together. Hopefully I have done her justice. She has broadened my knowledge about quality of sources and I thought some may find what she has to say of interest.
Review articles just review the literature, so they are not better sources than research reports; they are just a good place to get a general overview of what's new (when they are good). Research findings are primary sources, so they are always superior. If you can read the report, you can evaluate the validity of the finding first-hand. Reviews are hearsay. Reviews are excellent sources - when they are published in peer-reviewed academic journals. In my field, for example, there are entire journals devoted to this kind of work. They have names like "Current Directions in..." and "Annals of..." and are published by organizations like the American Psychological Association and the Association for Psychological Science. Any literature is static, too, and reviews are meant to summarize the recent literature.
The problem is that the term "review" could be used to describe any piece of crap. Anyone can WRITE a review. Not just anyone can get a literature review PUBLISHED (at least in a "real" journal). Everybody does literature reviews as part of graduate education, but published review articles are written by individuals that have published several important findings in the field, especially recent ones. The quality of a review varies just like studies, but they are usually good when published in appropriate journals. There are journals that will publish any article if you pay them. They are academic & sometimes peer-reviewed, but not of high quality. There are journals created by activist groups. They are not academic, not peer-reviewed (by the usual definition of "peer"), and usually qualify as propaganda. NOBODY uses these in science.
Websites are never appropriate in my opinion, unless it's a government organization like NIMH or NSF. Anybody can say whatever they want on a website. Statements and summaries by the NIMH and NSF are some of the best information available with the most thorough and strongest citations. They are not technically the kind of literature review that I described above, but they are reviews in a loose sense.
She would most likely speak to this if there is enough interest.-- scuro ( talk) 21:58, 29 November 2008 (UTC)
I think you misunderstand the reason why we place so much emphasis on reviews. You are quite wrong that reviews "must be hearsay". Quite the opposite, reviews filter out the "noise" (especially in heavily researched areas, where lots of research leads to dead-ends or is of questionable quality). We cannot allow discussions to get bogged down by claims of one study vs the next - contradictory results are obtained all the time, and reviews are exactly the tool to deal with such phenomena.
I agree that sources need to support their statements, but a corollary of this is that if there is no reliable source (i.e. a review) we must be prepared to drop a certain subject, however much it tickles our collective fascination.
You have very few article edits, but you seem to be fishing in the same pond as Scuro. Could you clarify what the disagreement is about, and how any of us could assist in dealing with this disagreement? JFW | T@lk 20:07, 30 November 2008 (UTC)
Scuro, could you have a stab at generating a list of useful discriminators that will help editors distinguish between a sterling and a faecal review? JFW | T@lk 22:24, 30 November 2008 (UTC)
So there is broad consensus that reviews are not a "widget" of uniform quality?..and that wikipedia needs to address this issue?-- scuro ( talk) 12:52, 1 December 2008 (UTC)
All sources vary in quality. These guidelines already prefer reviews from reputable medical journals, which should filter out the "crap" reviews. But really this is not WP's most pressing problem. An analogy: "Eat in a restaurant rather than from a burger van, if you want quality food, safely prepared". We're getting comments above along the lines of "Well I've seen some really dodgy restaurants, and food inspectors often find poor hygiene when they inspect them." Totally ignoring the burger van is using week-old fat and has no running water or toilet facilities for staff. It is easy to find bad WP articles that cite primary sources that superficially appear to support the text. In my experience here, I've yet to see the same problem with reviews being widely misused. I agree with almost nothing in II's first paragraph above, and don't even understand the "An inflexible..." sentence. Academic practice to sourcing isn't relevant on WP and thinking our papers should be researched and sourced the same way as an academic review shows a big misunderstanding over WP fundamentals. II once again claims reviews add "bias", as though the primary research paper contained virgin facts, unsullied by another's opinion. Primary sources are widely misused on WP for at least three reasons:
ICBSeverywhere, your lack of edits doesn't devalue your opinions but does cast doubt over your experience of applying existing WP guidelines and policy when writing articles. Remember that only a tiny proportion of topics on WP are controversial. Writing an article sourced to reviews is much easier than trying to do so from primary research papers. Most folk disputing WP guidelines have an issue with a controversial aspect of a topic. What is often forgotten is that it is practically impossible to source an entire topic to primary research. WP:NOR does not allow you to fill in the blanks. Colin° Talk 20:31, 1 December 2008 (UTC)
Okay, on the premise that reviews which are seen as an ideal source and have limitations. These limitations get short shrift on the guideline page. I will attempt to find examples of:
If other contributors can easily find examples of such reviews, it would be appreciated if you shared that with us. :)-- scuro ( talk) 12:03, 3 December 2008 (UTC)
Then we are agreed that the limitations of outdated reviews should be spelt out more clearly on the med. reliable source page. Following wiki processes, old reviews can be removed but this can be time consuming and frustrating. It has been a source of conflict in the past. A contributor will find a review and argue that the informtation on the review is relevant, when in reality it clearly no longer is. Clearer guidelines may nip these sort of problems in the bud.-- scuro ( talk) 20:16, 3 December 2008 (UTC)
These things should not be phrased in terms of rules. This is a guideline. There's going to be wikilawyering when they're phrased as hard rules. Just yesterday I ran into Mattisse saying that a 2002 American Journal of Nutrition review is unciteable because it is not within the 5 year date. [30] Yet this particular 2002 review has free full-text. A 2005 review ( PMID 16021987) has essentially the same conclusions, but it lacks full-text. II | ( t - c) 20:13, 4 December 2008 (UTC)
{{
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link) A freely readable but older review supporting the same claim is: Mischoulon D, Fava M (2002).
"Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence". Am J Clin Nutr. 76 (5): 1158S–61S.
doi:
10.1093/ajcn/76/5.1158S (inactive 2023-12-13).
PMID
12420702.{{
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link)Here is the passage that Scuro want to remove from the ADHD "The controversies have involved clinicians, teachers, policymakers, parents, and the media with opinions regarding ADHD that range from those who do not believe it exists at all to those who believe that there is genetic and physiological basis for the condition, and also include disagreement about use of stimulant medications in treatment." It is in the past tense and is not a review per say.
Here is the reference. http://www.ahrq.gov/clinic/epcsums/adhdsum.htm
The reference from the therapeutics initiative is there aswell that is contested. Doc James ( talk) 03:39, 5 December 2008 (UTC)
(Undent) Scuro, this guideline already says that recent reviews are preferable. Now why are you insisting that this guideline doesn't say that recent reviews are preferable? WhatamIdoing ( talk) 19:16, 5 December 2008 (UTC)
Reviews also have degrees of quality. A systematic review for example is often better then a literature review. The Cochrane collaboration being one of the most famous sources of these.
Systematic reviews that are recent are preferable to a single research article. As would large reviews from groups such as the NHS. I have seen research articles selective pick from the available research only that that supports the conclusions of their study.
If a review or primary research article is wrong /dated then it should be easy to find other sources that refute its conclusions. And this should be the discussion that takes place on the talk page of the article. WRT the review which showed ECT caused brain damage one could easily word things: "a review from 1975 indicted that ECT might cause brain damage, further research however showed that this was not the case" etc. This type of info might be interesting under the history section of an article. One acknowleges the review and then refutes its conclusions.-- Doc James ( talk) 14:23, 7 December 2008 (UTC)
Colin° Talk 19:10, 7 December 2008 (UTC)
(Undent) Scuro, I numbered your suggestions for convenience. Here are my comments on each individual item:
1. Peer review is an issue of quality, however, many documents, such as consensus statements by major organizations or government guidelines, are not generally considered peer reviewed and are still great sources. Thus this proposed bit of advice would mislead editors into incorrectly rejecting high-quality sources.
2. Per
WP:V, unpublished documents cannot be used anywhere on Wikipedia for any purpose. Presumably this is meant to read "self-published". However, consensus statements by major organizations or government guidelines are generally considered to be self-published and are still great sources. Thus this proposed bit of advice would mislead editors into incorrectly rejecting high-quality sources.
3. I'm not entirely sure what this means, but academic sources are not necessarily the best. I would not necessarily elevate the work of a university-based researcher over the work of an intramural NIH researcher simply because the one holds a post at a university and the other holds a post with the US federal government. Thus this proposed bit of advice would mislead editors into incorrectly rejecting high-quality sources.
4. Age is not a matter of quality. (Age dramatically limits how you can appropriately use a source of scientific information, but an amazingly well-conducted review doesn't become a bad one in fifty years; it just becomes an outdated source.)
5. Focus is not a matter of quality.
6. The effectiveness of an author's publicity and self-promotion efforts is not a matter of quality. They are often used as proxies for quality, but famous researchers make mistakes, and unknown people publish brilliant work.
Importantly, not a single one of these proposed items is specific to medical reviews, which is what I thought you set out to do. You could have written exactly the same thing about primary research papers, or about Egyptian archaeology, or about computer architecture. Those areas, too, benefit from peer reviewed papers, published in reputable media, by knowledgeable researchers. It is not appropriate for MEDRS to tread so heavily on the territory of WP:RS and WP:V as to provide advice that applies to nearly every one of Wikipedia's two and a half million articles. WhatamIdoing ( talk) 21:05, 10 December 2008 (UTC)
The issue is, are there reviews which are not ideal..or are all reviews which don't fit the parameters on MEDRS not ideal? Also, how do you determine if a review is a poor review, or are all reviews that are not ideal, poor reviews.-- scuro ( talk) 16:53, 12 December 2008 (UTC)
Consensus statement by well respected authorities in the field are great sources for Wikipedia. Wikipedia is not a review itself but an encyclopedia. If we were trying to write a review then yes one should quote the primary research however we are not. I think a good example of what sort of references we should use in the medical parts of articles is Uptodate. For those who have access if you look at the references they use they often reference sources such as the WHO, the FDA, the AAP, etc..
Science is about ideas not people. Just because you are famous does not make you right or your ideas unapproachable. It is the quality of the work that matters period. For the none medical parts of the articles such as the section on history, cultural significance, social implications, references requirements are less stringent.-- Doc James ( talk) 19:10, 13 December 2008 (UTC)
So what I understand you saying is that one should go directly to the primary research? Unfortunately there are lots of problems with that. SSRIs in depression is a perfect example. You have something called publication bias were the company funding the research only publishes results that are in their favor. So that if 16 trial are done 10 are not published and show negative results, 6 are published of which 5 show positive results and one shows negative results. Those doing a review are much better then you and I at finding all the trial that have been done. In this example the meta analysis of all trials found no clinical benefit for SSRIs in mild / mod / and severe depression.
In most areas of research there are trials that show both positive and negative result. A review analysis the over all picture to get useful clinical answer. If you were to ask clinicians weather they would prefer to base their treatments on reviews or primary research virtually all would go for the reviews. Doc James ( talk) 17:39, 14 December 2008 (UTC)
Which question? Do you mean should we have specific guidelines outlining how to determine if a review is good or not? Doc James ( talk) 18:56, 14 December 2008 (UTC)
Yes but it all comes back to determining what a "lesser review, questionable review, and biased review" is. These are all subjective terms. You cannot say that any review you do not like the conclusion of is biased. Or just because you do not like other work the reviewer might have published it is biased.
Now it was mentioned that the importance of the researcher should be used as a criteria. This is not verifiable. Therefore it cannot be used as a criteria.
There are entire classes in University on assessing the quality of a review or a primary research paper. This is a complicated process. Will see if I can find a paper on it.-- Doc James ( talk) 22:04, 14 December 2008 (UTC)
Webster's on,
Collin, are we not to focus on content and not the contributor? By focusing on the contributor are we not in danger of imparting bias?-- scuro ( talk) 05:41, 15 December 2008 (UTC)
The point I have been making is that all evidence interpreted is hearsay. Interpretation always creates the possibility of bias, either intentional or unintentional. I fail to see how these concepts are controversial, they are just fact. If you want to infer meaning and judgement into these concepts, the fault is not mine. I totally agree that there are many more problems with primary sources and that the vast majority of reviews do not have a significant bias problem. Even if you consider this a small problem though, it is still a problem, and wikipedia will be a lesser source as long it remains as is. There are many guidelines about what makes a poor primary sources and how they shouldn't be used. On those grounds it is much easier to challenge a primary source. A review is much harder to challenge. Yes, you can challenge any review in wikipedia but consider this, a review is considered an ideal source. What will you base your challenge on, your own personal expertise? Some fault in the review?...well unless the review is blatantly biased this will be difficult. What are the criteria that would allow you to find fault in a review? If the review did not meet the criteria of what wikipedia sees as a good review? Answer that question and we are half way home. Reviews are different from other sources and there are criteria that can be used to judge reviews. I've posted ideas, others are now posting further citations. A few obvious and general guidelines should not be that difficult to agree too. MEDRS tells us what makes a good review, but tells us little about what to watch out for.-- scuro ( talk) 12:13, 15 December 2008 (UTC)
I am having a hard time understanding what exactly you mean in the above paragraph? You want to remove "crap reviews"? How do you know that the reviews are poor? Some of the rating criteria that have been proposed are not significant. Like who the author is or the focus of the question. The date I would agree has some importance. Peer reviewed is of course important. There are rating scales for review quality but they can be difficult to carry our. Here is one for example for a systematic review http://www.uwo.ca/cns/ebn/Scales/metaanalysis.pdf
These are subjective questions and no review is going to be perfect. If you are wanting a unanimous rule I do not think you will find one. What one does is compare what research is out there and discuss which is the best. There are no cut and dried answer in medicine. Information should be provided so that people can assess the risks and benefits. That is what it means to provide a NPOV. Doc James ( talk) 23:13, 15 December 2008 (UTC)
I think it is time we wrapped up this discussion. It is going around in circles, it discusses issues well beyond the scope of this guideline alone, and seems to revolve about one editor sowing seeds of confusion. Can we move on please? JFW | T@lk 22:21, 16 December 2008 (UTC)
A few of us are wondering if Bestbets are sufficient to be used as references for Wikipedia? They often ask questions that are not looked at elsewhere in the literature. If better sources can be found I think they should be. But I think that this is a reasonable source to add to pages that might have few or no references. see http://www.bestbets.org/home/bets-introduction.php Would like to get others comments. -- Doc James ( talk) 13:37, 21 December 2008 (UTC)
The November issue of Epilepsia had a 133-page supplement on the Ketogenic diet. It contains nearly 40 short review papers. The introduction states:
Are such papers given the same editorial / peer-review scrutiny as reviews appearing in the main journal? I should very much like to use some of these as sources. They are up-to-date and together form a comprehensive resource. Any concerns? Colin° Talk 21:45, 22 December 2008 (UTC)
I've posted a question at RSN that relates to this guideline. It's here, and involves a patient's personal website about iguanas and chronic fatigue syndrome. Those that are familiar with Wikipedia's standards for medicine-related articles are invited (begged) to respond. WhatamIdoing ( talk) 02:21, 26 January 2009 (UTC)
About recent changes that I've just reverted: Editors may not cite sources that they have not read. This guideline must not provide advice that directly contradicts the main page on citing sources. WhatamIdoing ( talk) 02:54, 24 February 2009 (UTC)
User:WhatamIdoing doesn't seem to understand Wikipedia:SAYWHEREYOUGOTIT. It puts the burden on the editor to verify that the original source gives that information, but it certainly does not preclude you from citing it after checking that it really gives that information.
“ | It is improper to obtain a citation from an intermediate source without making clear that you saw only that intermediate source. For example, you might find some information on a Web page that is attributed to a certain book. Unless you look at the book yourself to check that the information is there, your source is really the Web page, which is what you must cite. The credibility of your article rests on the credibility of the Web page, as well as the book, and your article must make that clear. | ” |
Therefore, I'm going to revert that removal, and add a link to the Wikipedia:SAYWHEREYOUGOTIT making clear the onus for verifying that the original source concurs with the review rests with the editor making that change. Xasodfuih ( talk) 04:16, 24 February 2009 (UTC)
When a statement taken from a narrative review is supported there by only one or two original research articles, it's recommended to cite both the original work(s) and the narrative review, especially if the original articles were published in higher impact venues than the narrative review. Citing the original article(s) is a convenience for the reader, and avoids diminishing the importance of the results; citing the review gives the result some additional credibility beyond that conferred by the (often anonymous) reviewers of the original work.
Some journals specialize in the publication of third-party summaries of reviews published elsewhere, in particular summaries of systematic reviews, often accompanied by a short commentary. Unless such summaries/commentaries add significant additional insight, citing them instead of the original review must be avoided because this practice can confuse the reader as to the actual review authors. If these summaries/commentaries are cited along the original review, label them clearly as summary/commentary in the footnote.
Have had a lot of issue lately with editors using case reports for justification of just about everything. IMO these should not be allowed as evidence. I think this should be make perfectly clear.-- Doc James ( talk · contribs · email) 04:02, 24 February 2009 (UTC)
I don't see anything written about these or medical sites in general. Should we added them as reliable sources? Xasodfuih ( talk) 05:37, 24 February 2009 (UTC)
Sounds good overall, although whether a specialized encyclopedia entry cites reviews or original research articles depends on the amount of literature available on the topic. Look at the free sample pages here: " Josephine domain" cites two primary sources, whereas "Jews and Genetic Diseases" cites at least one review. (By the way, there's no concise article about this on the wiki. Ashkenazi Jews#Specific diseases and disorders covers a narrower topic, but for the other populations, I don't see anything.) The same choice of sources is also true for most medical textbooks. Surely this book is much better source for writing about Machado-Joseph disease/ Spinocerebellar Ataxia Type-3, but that distinction has nothing to with whether one of these books is a "secondary" source and the other "tertiary". I suspect the same observation holds about the choice of sources in WebMD and uptodate.com, although these two sites have different target audiences.
So, all of the above go together as tertiary sources if you insist on that classification, which I don't find very helpful: "The term tertiary source[1][2] is a relative term. What is considered tertiary depends on what is considered primary and secondary. A tertiary source may thus be understood as a selection, distillation, summary or compilation of primary sources, secondary sources, or both.[3][4][5]" (and the rest is unsourced) If a review cites another review it's automatically tertiary? In that line of reasoning the NHMRC report in water fluoridation is tertiary source, because it explicitly cites the York report in support of its conclusions (and for efficacy they explicitly say they've looked only one newer primary study). I would not bother drawing a line between secondary and tertiary sources for medical articles; it will lead to more artificial distinctions instead of considering the quality and level of coverage of source. In the case of third-party summaries of reviews published elsewhere it is easy enough to give a general recommendation, but we should do the same for uptodate.com/WebMd based on how good they are (and easy to cite), as opposed to WP:ARTIFICIALDISTINCTION between secondary and tertiary. Xasodfuih ( talk) 05:24, 25 February 2009 (UTC)
Another observation is that some specialized encyclopedias may have a beefy overview section that are quite suitable as review source. Look at this one (using Amazon's look inside). Xasodfuih ( talk) 08:23, 25 February 2009 (UTC)
{{
cite journal}}
: CS1 maint: multiple names: authors list (
link) Summary: Yeung CA (2007). "Fluoride prevents caries among adults of all ages". Evid Based Dent. 8 (3): 72–3.
doi:
10.1038/sj.ebd.6400506.
PMID
17891121.I have removed the following, which appears to be the personal opinion of Xasodfuih.
WhatamIdoing has already removed an earlier version of this text. It has not been discussed by the community and is likely to be contentious. There has never been any requirement on WP to cite two sources when one alone is a reliable source. We are not an academic journal and have no obligation to cite the original research out of courtesy/acknowledgement to the original researchers, nor do we have the same issue with regarding the citation of a review as "lazy research". The middle paragraph seems to come from a recent issue at Water fluoridation and I don't think it is a common problem. We must avoid knee-jerk updates to guidelines based on current events. I encourage Xasodfuih to patiently wait further discussion on this text and avoid restoring the contested text (even with minor changes). Colin° Talk 08:57, 24 February 2009 (UTC)
When a reviewer is citing many sources to make a point, it's indeed his WP:SYNT, so attributable mostly him, and it may also be impractical to cite all of his primary sources. However, when single statements are extracted from narrative reviews where they are supported by a single source, it sometimes makes sense to cite the original article along with the review, especially when:
Finally, this is merely a suggestion in a guideline. Nobody will make a big fuss if this isn't always followed; 90% of the time reviewers at FA/GA do not read the sources (which is why we have FAs like anabolic steroids or paleolithic diet, but I'm digressing), so we're not going to see articles failing from standards in any numbers because of this recommendation. Xasodfuih ( talk) 13:36, 24 February 2009 (UTC)
Note that in standard style guidelines, it's often encouraged to cite the original source while also noting "as cited in ..." -- this could be easily done on Wikipedia, where the primary source is cited, but the footnote also contains: "As cited in: [review]". I don't see why not. People often assume that everyone has great access to medical journals, and it's just not so. Hiding a weak source behind a review is not necessarily a good thing. II | ( t - c) 00:21, 11 March 2009 (UTC)
We give all sorts of advice on which sources to use and which not. I don't see why we should say something about this type of journals. If you feel that that something needs to be something else, please formulate an alternative. The fact that the issue doesn't come up very often means that it shouldn't be discussed at length, but since it has come up in a FAC, it means it's not negligible either. Xasodfuih ( talk) 11:14, 24 February 2009 (UTC)
{{
cite journal}}
: Unknown parameter |lay-date=
ignored (
help); Unknown parameter |lay-source=
ignored (
help); Unknown parameter |laysummary=
ignored (
help)An interesting and relevant article from the New England Journal of Medicine on the difficulties and pitfalls inherent in popular-press coverage of science and medicine is here. I thought it might be relevant, and perhaps even useful as a source. MastCell Talk 20:34, 8 January 2009 (UTC)
(Undent) Nbauman, you write professionally. Think about the last few science-related pieces you've done. About how often did you, in your professional writing, rely entirely on what some other journalist wrote for a scientific/medical fact, without bothering to check it against a journal article, textbook, or other source? Never? Always? Something in between? WhatamIdoing ( talk) 22:30, 24 February 2009 (UTC)
Some science journalism is accurate some is not. Before adding info to wikipedia one should verify the accuracy to a peer reviewed source. Up in the cold cold north we play a game were you site in a circle and whisper from one person to next to see what comes back to you. This recreates the accuracy of moving farther from the source.-- Doc James ( talk · contribs · email) 20:29, 26 February 2009 (UTC)
Eubulides ( talk) 17:55, 25 March 2009 (UTC)
(Undent) Nbauman, you've just gone circular on us. How do you tell if the newspaper story is accurate? By determining whether or not the journalist "writes an accurate story". That's not helpful. (Are you aware that this section already says that the coverage ranges "from excellent to irresponsible"? Perhaps you forgot that we already acknowledge the existence of excellent work -- while still recommending a solid scientific source for any scientific fact.) WhatamIdoing ( talk) 17:56, 26 March 2009 (UTC)
And others read the synopsis provided by the likes of Uptodate which reference the original research. We should be trying to create a open source Uptodate and to do this we need to primarily reference the literature much like they do.-- Doc James ( talk · contribs · email) 23:26, 27 March 2009 (UTC)
In my book, "reliable" does not include sources that are "all too frequently...wrong or misleading". Nbauman continues to argue that because newspapers can sometimes be accurate, we should regard them as reliable. In addition, he continues to avoid the "suitability" argument that even if they were reliable sources of medical information, they aren't suitable as sources for such in an encyclopaedia (see archive, for example, the "Bell curve" discussion). As DGG says below "No responsible encyclopedia could admit non medical sources to the discussion, except to discuss the ethical or political implication of the data. Lay sources testify to the lay understanding of science, not to science." I find this determination to "not get the point" after nearly two years of discussion on these talk pages to be quite extraordinary, verging on disruptive. Colin° Talk 22:54, 25 March 2009 (UTC)
Oh for heaven's sake, do you ever see a newspaper or TV show publishing corrections? In both your examples, the journals made a point to publish large corrections. With the popular press you'd never know. Simply a ridiculous analogy. Also, when the medical journals mess up this is not due to inaccuracy but due to errors in judgement (Lancet) or misrepresentation by the original authors (NEJM). JFW | T@lk 23:56, 25 March 2009 (UTC)
I just now
reverted a
change of wording "the worst news articles too often convey wrong or misleading information about health care". This change is definitely not supported by the cited source, Dentzer 2009 (
PMID
19118299), who says that wrong or misleading information is conveyed "all too frequently", and who does not confine her criticism to the "worst" articles (she does writes that lack of context in medical news is a "worsening" problem, but that's quite a different matter).
Regardless of our personal opinions on this topic, we do have an obligation to summarize our sources as accurately as possible within the space constraints here, and conjuring up a "worst" here does not fulfill that obligation.
For more on this topic please see # Popular press accuracy below. Eubulides ( talk) 18:47, 27 March 2009 (UTC)
I am tagging NPOV because this essay conflicts with our policies on reliable sources and neutrality. It was recently used in an attempt at removing a reliable source about a social issue [32]. From the start, this essay was an attempt by pov pushers with a conflict of interest to use an essay to further their pov pushing and silence the other side. Among the supporters, Jfdwolff, MastCell, Cyclonenim, Casliber, Mattisse and probably others admitted a conflict of interest. I was lied to when I was assured that this essay would not be used for removing information about social issues. -- Mihai cartoaje ( talk) 09:02, 10 March 2009 (UTC)
I don't see anything in the above discussion that suggests that WP:MEDRS is in conflict with Wikipedia policy, that it is particularly relevant to social issues, or that it has been used to "removing a reliable source about a social issue". Surely this thread belongs on Talk:Schizophrenia, not here. Eubulides ( talk) 16:46, 10 March 2009 (UTC)
As I commented on the talk page, the question of efficacy or safety is not in any sense asocial issue. No responsible encyclopedia could admit non medical sources to the discussion, except to discuss the ethical or political implication of the data. Lay sources testify to the lay understanding of science, not to science. DGG ( talk) 02:28, 11 March 2009 (UTC)
In this section of the article, there is a confusing use of sources. This situation has occurred because of the edits made by science-based editors on one side, and a board member of the ICAK on the other side. He has attempted to present this pseudoscience as a scientifically legitimate discipline. The best research has consistenly shown it to be hogwash. Please take a look and you'll be rewarded with a fascinating glimpse into the 10th most used chiropractic technique. -- Fyslee ( talk) 05:30, 17 March 2009 (UTC)
A user has requested mediation on this issue. Jmh649 is here to help resolve your dispute. The case page for this mediation is located here.
Above, TimVickers suggested inserting this text somewhere:
I have a few ideas for making the proposal more concrete and better-supported by the cited source, Dentzer 2009 (
PMID
19118299). I just now reread the above thread and Dentzer, and with all this in mind, I suggest that in
WP:MEDRS #Popular press, we make the following change (deletions struck out, insertions italicized, and changing the preceding comma to a period):
This captures Dentzer's thrust more accurately (albeit at more length), and mentions a positive thing she has to say about the news, which seems to be the main point of contention here. Eubulides ( talk) 18:47, 27 March 2009 (UTC)
A recent change gave reporter inexperience as the reason for poor medical stories, claiming the cited article excluded "seasoned reporters". It does nothing of the sort. That is a logical error like saying that "weekdays are dry" based on a source that says "often weekends are ruined by rain". Colin° Talk 21:18, 27 March 2009 (UTC)
Nbauman - stop edit warring. You were bold. It got reverted. Now discuss. Your reinsertion of text which is neither supported by the cited article nor supported by consensus of WP editors is extremely bad form. I strongly encourage you to have the decently to self-revert and engage in consensus seeking here before making contentious changes. Colin° Talk 21:37, 27 March 2009 (UTC) WP:RS does not apply outside of article space, and you yourself regard it merely as an "opnion piece, not supported by data or research". Colin° Talk 21:39, 27 March 2009 (UTC)
That's followed by a fairly detailed breakdown of recent studies on the subject. So I think the Times piece is actually an example of responsible mainstream-media reporting, which is one reason I cited it. Another reason is that the citation occurred in orthomolecular medicine, which specifically involves very large doses of vitamins and where the potential harms of such megadoses are relevant.Recent studies have even suggested that at the high doses many people consume, vitamin E could be hazardous. In November 2004, the American Heart Association warned that while the small amounts of vitamin E found in multivitamins and foods were not harmful, taking 400 International Units a day or more could increase the risk of death. ( [37])
I can't fault the Times for "excluding" a non-significant finding - I'd be more inclined to praise them for doing so. And the Times piece reaches the same conclusion as Gann's (excellent) editorial: Vitamin E pills aren't a magic bullet. MastCell Talk 00:40, 28 March 2009 (UTC)
WhatamIdoing, you've got it exactly backwards. I have always been a strong critic of medical journalism, and I agree with most of Schwitzer's work because Schwitzer is based on evidence. Much medical reporting is terrible. I don't know if "most" of it is terrible, but I'll go with the evidence.
I'm flattered when I see articles like Dentzer's, because I'm one of those experienced journalists she talks about. I write for doctors, my work is edited and reviewed by doctors, and if I didn't get the story right in every respect, my work would be tossed out pretty fast.
My difference with you and the other editors here is that I believe that evaluations and criticisms of medical journalism should be based on the same kind of scientific evidence that we use in medicine and elsewhere in science. That's what I'm offended at -- your abuse of science and contempt for scientific method. You're not using high-quality secondary scientific sources at all.
You're making wild claims about journalism based not on scientific evidence, like Schwitzer's work, but on your own personal prejudices. I won't speculate on the psychological roots of those prejudices, but you can't support your broad overstatements with facts.
You cherry-pick articles like Dentzer's to find excerpts that you think support your position, and quote them selectively and misleadingly, even though you misunderstand the whole essay.
I've seen something similar, where alternative medicine advocates will pick out excerpts of medical articles to support their argument that all doctors and all drug companies are harming people.
Your basic fallacy is to condemn all journalism in the popular press, when the scientific data displays a much more interesting pattern: some of the popular press is accurate and some is not. So you're really missing the point.
It's paricularly ironic that you claim to be supporting "high-quality secondary scientific sources", when you're doing exactly the opposite. Except for Schwitzer, your entire guideline is based on personal opinion and personal prejudice and ignores those sources. Nbauman ( talk) 23:45, 27 March 2009 (UTC)
Here is a dilema that I have noticed particularly with books. Whilst it is for obvious reasons preferable to use secondary sources wherever possible, is this always the case? One scenario I saw was when reading a high quality secondary source in a book which is widely used especially by medical students where it stated that benzodiazepines are GABA reuptake inhibitors or increase GABA levels for their therapeutic effects which is clearly false as they work at benzodiazepine receptors enhancing the effect of GABA at the GABAa receptor via benzodiazepine receptors. This scenario didn't happen on wikipedia but using it as an example of inaccurate info in books, but something similar happened in the past few days where on the surface seemingly high quality books on psychiatry and psychopharmacology were cited but on closer inspection the authors were employed by literally over 20 pharmaceutical companies and they had cherry picked 2 or 3 primary sources and then distorted the results of the primary sources and reinterpreted them and falsely represented the primary sources without any evidence but their opinion. So what would happen in that scenario? To be clearer though the sections of the books were not doing an extensive review of the literature but were basically touching a little on every aspect of psychiatry and psychopharmacology. So that brings up another question what happens if the secondary source is not doing a meta-analsysis or extensive review of the literature but are simply touching on one aspect of a condition or drug or syndrome etc? Also is a peer reviewed meta-analysis or review superior to a non-peer reviewed book? Is a peer reviewed secondary source published by people with ties to a drug company or some other conflict of interest equal to an independent peer reviewed secondary source? I guess my point and dilema is this. The use of secondary sources are viewed higher on wikipedia because they are seen as being an independent outside opinion but what if the author(s) are not independent and/or they can be shown to be distorting data? My main concern is secondary sources which are not peer reviewed as this area seems to be most open to abuse by those with a conflict of interest. Currently the recommendations is books which are not necessarily peer reviewed and open to abuse, opinion, synthesis, reinterpreting results, distorting facts are declared as "excellent" (secondary) sources. I disagree and think that the problems of books needs to be addressed. There are some good medical books which are high quality don't get me wrong but you see the dilema that I see and problem for misinformation getting inserted into articles. I think peer reviewed secondary sources trump non peer reviewed secondary sources and that many (but not all) books in general are not excellent sources of reliable citeable data. Infact I think primary sources are quite often superior to many books depending on the subject matter being quoted for reasons that I have just explained.--
Literaturegeek |
T@1k? 23:32, 1 April 2009 (UTC)
I have striked out some of my text as on closer inspection I see that you differentiate between non-reliable medical books and reliable trusted publications, but still have some concerns mentioned above.-- Literaturegeek | T@1k? 15:54, 2 April 2009 (UTC)
[Edit conflict with Colin, posting at same time] Sorry for length of questions. This was the book that I was talking about. Would this book be considered superior to an FDA review or Committee on Safety of Medicines review? This book is cited in an article and I have no intention of deleting it so I am not in a conflict with anyone per se. It was just when reading the book and comparing it to their sources I noted how they had distorted or even falsified the conclusions of the sources they were citing. Also they appeared to be giving best practice guidelines based on taking one or two primary sources out of context and also synthesising without any evidence in conflict. I guess I noticed a potential occasional serious problem with using books over more reliable peer reviewed secondary sources. Then of course the above example I mentioned where a trusted book source got the mechanism of benzodiazepines completely wrong is another example. I am not against using books and more often than not they do make good sources to quote and infact I used one today myself. I guess I am asking does a secondary peer reviewed meta-analysis or review source trump this example of a book? Or does FDA review or CSM review or department of health guidelines trump it?-- Literaturegeek | T@1k? 17:56, 2 April 2009 (UTC)
Colin, I think perhaps you misinterpreted me or perhaps it is my fault in how I worded the issue. I was not in anyway shape or form saying that primary sources are superior to secondary sources. I was raising an occasional isolated problem of what happens basically if a secondary source says something which is nonsense. For example should we change the mechanism of action of benzos to say they are reuptake inhibitors because a good quality book made a mistake? Or in such a scenario would a peer reviewed secondary source trump it so we can add accurate data? What happens if the book is demonstratly misrepresenting their sources etc. I was talking about isolated examples. These examples didn't happen in real life on wikipedia but I just noticed a potential from spotting several inaccuracies and thought that I would raise it. I have noticed this is less problematic in the peer reviewed literature especially secondary sources which have been published in medical journals. The inaccuracies I have spotted in sources (particularly books which often briefly skim a topic) are not necessarily POV issues but just a matter of an inaccurate factoids. Another one I have noticed is flunitrazepam is short acting when it is long acting.-- Literaturegeek | T@1k? 18:03, 2 April 2009 (UTC)
Speaking of misrepresenting primary sources, you appear again to be misrepresented me. I never said nor implied that I should resynthesise an authors opinion. I was asking what do we do in that scenario? Do we accept the demonstrately intentional or unintentional inaccurate factoids or opinions of a book which often briefly touched on one aspect of medicine,,, or does a peer reviewed secondary source such as a meta-anaylis or review or FDA, department of health etc etc trump it? I came here just to ask for guidance on what to do. Initially I misread the book guidelines on this project and striked out my text above but still wanted some guidance or discussion on what to do in these isolated scenarios I have mentioned. Instead I appear to be getting responses trivialising and mocking me as an idiot by distorting what I was saying and asking.-- Literaturegeek | T@1k? 19:28, 2 April 2009 (UTC)
Thank you Tim this is what I was asking for, some guidance. Could you also give me your opinion on whether official national reviews by say the FDA or Department of Health, meta-analyis or review in a journal would be superior to a book? What happens if a book says for example SSRIs work by stimulating the release of serotonin when the truth is they block its reuptake or something like that? Do we delete the book ref and replace it with a more accurate secondary source? Or do we leave the mistake of the book in even though we know that it is false? I guess I would like this project to state whether reviews or meta-analysises (secondary sources) in medical journals are superior to a (secondary source) book if content is in dispute.-- Literaturegeek | T@1k? 19:28, 2 April 2009 (UTC)
Okie dokie Tim, problems with specific sources, try and sort out on article talk page or else if that fails go to RS noticeboard is what you are saying I believe. So no need to alter guidance. You have answered my question, thank you.-- Literaturegeek | T@1k? 19:47, 2 April 2009 (UTC)
Ok thank you Colin for your reply and good advice, makes sense.-- Literaturegeek | T@1k? 20:00, 2 April 2009 (UTC)
Just to clarify it wasn't a "benzo book", but a clinical psychopharmacology text book (see above) and also another medical text book. Anyway like I said the inaccurate data wasn't cited on wiki so I was raising a potential issue I had noted with isolated books saying inaccurate things eg benzos are reuptake inhibitors or distorting sources. Anyway like Tim said discuss on article talk page to reach consensus, use better secondary sources or as a last resort go to RS noticeboard in such a scenario.-- Literaturegeek | T@1k? 21:52, 2 April 2009 (UTC)
This has been bugging me and I would like to end this by saying that I apologise for the confusion generated by myself initially misreading (due to skim reading when half asleep) the policy regarding books and I now know why Colin reacted the way he did. He is only trying to defend wikipedia. Ironically I was trying to do the same in my posting and had nothng to gain and the policy actually reads the way I thought it should read but I misread it initially. Anyway I got my questions answered in the end so all is good. :) I would like to just end this conversation here by saying I support Colin's efforts in defending this project and wikipedia and I am glad we now understand each other's misinterpretation of each other. No need for anyone to reply.-- Literaturegeek | T@1k? 02:15, 6 April 2009 (UTC)
I hope I can raise a query here without offending! But regarding the determination of 'review ' status for a paper, does listing as a review by the NIH generally differentiate it. To fit the criteria, Ideal sources for these articles include general or systematic reviews in reputable medical journals, Given A secondary source in medicine summarizes one or more primary or secondary sources and that not all reviews particularily narrative type necessarily label themselves as reviews, but the NIH might list them as such? Leaving aside of course arguments about various journals. Peerev ( talk) 22:37, 20 May 2009 (UTC)
Is it worth mentioning the {dangerous|idiotic|POV-pushing|your favorite adjective here} practice of citing popular media reports on studies that have not (yet) been published? This practice isn't very common, but it seems to be most common in things that turn out to be lucrative for the scientist but false later, i.e., Andrew Wakefield's long-delayed publications in the MMR hoax.
While I think relying on a news article instead of the proper paper is undesirable (and common), "science by unsubstantiated press release" is dramatically worse. WhatamIdoing ( talk) 17:59, 23 May 2009 (UTC)
If anyone wants to comment or has some insight, I've a question about the Journal of Mental Health over at RSN. WLU (t) (c) Wikipedia's rules: simple/ complex 14:33, 26 May 2009 (UTC)
I have posted this at the RS/N, but want to make sure the medical matters contained are addressed by readers here. I have concerns about the way a source is being used. The way it is being used is consistent with the way it has been used in internet conspiracy theories regarding the supposed myriad dangers of aspartame, but I believe it grossly misrepresents the nature of the original source. I would appreciate more eyes on the matter. This is a medical and scientific matter, so to some degree WP:MEDRS would apply to any interpretation of the scientific matters discussed in the source. The original source seems to bear evidence of being influenced by the fringe conspiracy theories, while fortunately noting the mainstream POV from governmental and medical sources. -- Brangifer ( talk) 04:27, 28 May 2009 (UTC)
The very new Medicinal clay article is in need of a thorough checking. Lots of undoumented claims are made. -- Brangifer ( talk) 04:47, 1 June 2009 (UTC)
Under WP:MEDRS#Websites, could we mention some of the major government websites, like the CDC? We have ongoing problems (e.g., this) with people insisting that only peer-reviewed journals are acceptable. Perhaps a mention of major (international?) charities would also be appropriate: they often have decent statistics and can be accurate sources for statements about whether a treatment is common or only used for refractory cases, etc. WhatamIdoing ( talk) 15:49, 4 June 2009 (UTC)
Sadly, there is no language that will completely prevent some of our fellow editors from trying to sneak www.associationforsnakeoilstudies.com or rife.org into the encyclopedia under the same aegis as the CDC. I would suggest wording along the lines of "information from reputable major medical and scientific organizations may be a valuable encyclopedic source." If we reach the point where the words "reputable major scientific organization" have lost their meaning, then it's time to abandon this ship anyway. MastCell Talk 22:55, 4 June 2009 (UTC)
Looking at it another way, the word "Websites" in the section header WP:MEDRS #Websites is problematic. Whether info is on a website is reasonably independent of how reliable it is. After all, JAMA is a website, and it's generally reliable. Even medical books are now commonly accessed via websites. So I propose the following change, along the lines suggested above (and with some wording shamelessly stolen from MastCell's comments):
Eubulides ( talk) 07:25, 12 June 2009 (UTC)
Seems a very good change.-- Garrondo ( talk) 07:15, 16 June 2009 (UTC)
How about this change to Books, to mention online books and The Merck Manuals?
While we're at it, Formatting citations should probably give an example of a book. Something like this, perhaps?
{{
cite book}}
: CS1 maint: multiple names: authors list (
link)"Eubulides ( talk) 21:02, 16 June 2009 (UTC)
No further comment, so I installed the proposed changes. Eubulides ( talk) 19:09, 22 June 2009 (UTC)
When considering studies for inclusion in clinical articles, I have usually kept a rule of thumb that phase II trials need to be absolutely earth-shattering to deserve inclusion. Even phase III trials need to be included with caution, because their findings don't necessarily mean that a procedure or substance will ever be used in a widespread fashion.
I was wondering if there was any scope for anchoring this rule of thumb into this guideline. After all, this applies to all medicine articles. JFW | T@lk 18:35, 21 June 2009 (UTC)
I think ImperfectlyInformed's reaction illustrates the need for guidance on the inclusion of phase I/II trials. This is not a current major issue but it happens constantly in numerous articles, sometimes driven by media reports and sometimes driven by editors who have read something in a journal and find it highly fascinating and surely worth including. More is not always better; this applies to huge topics such as Alzheimer's but I can't see why pancreatic cancer (which receives a fair bit of research attention) doesn't fall under such guidance. Again, just because a very small trial has found some marginally interesting results for "some scary illness" doesn't automatically mean we are including it, because in the larger subsequent studies such effects may well regress to the mean or shown to be marred by toxicity. I can say with confidence that many of the drugs in Alzheimer's disease clinical research will never hit the shelves. What was then the purpose of giving them so much airtime? JFW | T@lk 14:15, 22 June 2009 (UTC)
On the other hand, the evidence base for specific medical practices varies widely. In some areas (pancreatic cancer being an example), interventions are often adopted wholesale on the basis of very limited data, and Phase III trials may or may not ever be done (certainly the impetus for a drug company to fund such a trial evaporates rather quickly once their drug becomes de facto standard-of-care).
Basically, our articles should be in line with respected, expert medical thought and opinion, since our goal is to produce a serious and respectable reference work. If such opinion is based on Phase II trials, then it would be OK to cite them (hence I can't really get behind a cast-in-stone prohibition). On the other hand, we shouldn't be emphasizing the latest, greatest preliminary result at the expense of a balanced treatment of a topic. It might be OK to have a section in an article like pancreatic cancer where we discuss areas of active investigation - preclinical work and early Phase I/II results - with the clarity that this is the cutting edge and may or may not pan out. That would probably do readers a service - by informing them of current avenues of research - without misleading them into thinking that a single-institution, uncontrolled Phase II abstract definitively represents the wave of the future. MastCell Talk 18:31, 22 June 2009 (UTC)
Absolutely. My main point was with regards to discussing treatments in clinical articles. I think we need to think really carefully about whether we go along with the mindless hype of newspapers to write hysterically about every in vitro study (in the UK, the Daily Mail is especially good at this) or try to educate by providing balanced high-quality context-driven content. JFW | T@lk 07:24, 28 June 2009 (UTC)
Summarize relevant, currently accepted knowledge
Research is underway in nearly all areas of medicine. Although the results of a recent study might interest many people, from patients to investors, Wikipedia is not a newspaper and includes only encyclopedic information, in due proportion to its long-term importance. Medicine-related articles should present the current state of medical knowledge. Editors should normally not include speculative proposals and should avoid presenting early-stage research in ways that suggest it is widely accepted.
For example, the results of an early-stage clinical trial are unlikely to be appropriate for inclusion in the "Treatment" section of an article about a disease, because a possible future treatment has no bearing on current treatment practices. However, the results might, in some cases, be appropriate for inclusion in an article dedicated to the drug or treatment in question, or to the researchers or businesses involved in it. Such information might also be appropriate for a well-documented section on "Research directions" in an article about a disease. If including this information in this situation, it is frequently helpful to the reader to clearly identify the level of research (e.g., "first-in-human safety testing," " Phase II clinical trial") to prevent misunderstandings.
I'd like some clarification on an issue that I'm not entirely sure is addressed by the main page (or perhaps I just didn't understand it). Let's say Dr. Watson writes an article in a highly-reliable source like The Lancet, and this article is cited in a Wikipedia article. His peer, Dr. Seuss, later writes a critical response to the original article, which also gets published in The Lancet. The response is, presumably, considered editorial in nature being only one person's opinion. Is it appropriate and/or desirable to include that response within the body of an article, assuming it's relevant? Something along the lines of "In an article in The Lancet, Dr. Watson wrote that all bunnies are fluffy, but this claim was countered by Dr. Seuss who dismissed Dr. Watson's claims." This is basically the point of peer review is it not?
Just as a point of note, I'm not a doctor, researcher, or anything else of that nature, so I don't have a good understanding of the amount/quality of review that would go into any given article or response in order for it to actually be published in a reliable source like The Lancet. Us computer nerds tend to just blog everything. :) Thanks in advance for any clarification on this question. -- RobinHood70 ( talk) 21:03, 12 July 2009 (UTC)
Question about when MEDRS is not MEDRS. I have interest in conditions with medically unexplained symptoms, i edit articles on Morgellons, chronic Lyme, Fibromyalgia, Chronic fatigue syndrome. The reviews on CFS and FM say, the cause is not known, but i use the phrase "medically unexplained symptoms" and other editors do not like. I think some editors think MUS is the same as "functional somatic syndrome" so they do not like that, but i do not think it is, it means medically unexplained.
Editors say I need to proove MUS is used in the fibromyalgia literature, i am ok with it, and they say no article on fibromyalgia uses MUS, i am not ok with that! A week now, i am giving reference and more reference like at my sandbox User:RetroS1mone/MUSreferences and the articles Talk:Fibromyalgia#Primary_sources, Talk:Fibromyalgia#MUPS and user talks, also with quotes, many from the reviews and articles I am giving have "medically unexplained" in abstract or title. Reviews on FM and articles use MUS or MUPS, reviews in the MUPS literature say FM and CFS, textbooks also. Reviews in the psych literature say MUPS and FSS and CFS and FM. There is more support for CFS and FM "medically unexplained" then most of the things in these articles. The editors are saying, these MEDRS are not good enough bc the articles they find in there searches have only a few citations. but the articles i am giving, some have in hundreds of citations, i do not know why they do not look at those.
The question, is there a total citation number before a MEDRS can be used, and how many MEDRS reviews does it take, for supporting a statement in article?? Thx RetroS1mone talk 11:53, 20 July 2009 (UTC)
See Linksearch: [42]. Should these links be removed as not up to WP:MEDRS? Seems all very worthy in intention, but it's ultimately a celebrity doctor site. Gordonofcartoon ( talk) 20:49, 21 July 2009 (UTC)
Here is the first cut at a replacement for the Assess evidence quality section, for discussion. It's too long and wordy, but I thought I'd get it out the door now and we can trim it later. The basic idea is to incorporate some of the discussion mentioned above, and to trim away some of the unnecessary detail that's in the section now.
Several systems exist for assessing the quality of available evidence on medical subjects, and these should be kept in mind while assessing whether a particular viewpoint is a majority or minority one, and in deciding what constitutes evidence-based medicine. [1] [2] The best evidence comes from meta-analyses of randomised controlled trials (RCTs), and from systematic reviews of bodies of literature of overall good quality and consistency addressing the specific recommendation. Narrative reviews can help establish the context of evidence quality. Roughly in descending order of quality, lower-quality evidence in medical research comes from individual RCTs, other controlled studies, quasi-experimental studies, and non-experimental studies such as comparative, correlation, and case control studies. Although expert committee reports or opinions, along with clinical experience of respected authorities, are weaker evidence than the scientific studies themselves, they often provide helpful overviews of evidence quality. Case reports, whether in the popular press or a peer-reviewed medical journal, are a form of anecdote and generally fall below the minimum requirements of reliable medical sources.
If an notable important scientific result is so new that no reliable reviews have been published on it, it may be helpful to cite the primary source that reported the result. Although popular-press news articles and press releases often tout the latest
phase II clinical trial, such trials are rarely notable important enough to mention in an encyclopedia. Any such results should be described as being from a single study, for example:
After enough time has passed for a review to be published in the area, the review should be cited in preference to the primary study. If no review is published in a reasonable amount of time, the primary source should be removed as not reporting an notable important result. When in doubt, omit mention of the primary study, as per
WP:RECENTISM.
Speculative proposals and early-stage research should not be cited in ways that suggest wide acceptance. For example, the results of an early-stage clinical trial are unlikely to be appropriate for inclusion in the Treatment section of an article about a disease, because a possible future treatment has little bearing on current treatment practice. However, the results might, in some cases, be appropriate for inclusion in an article dedicated to the treatment in question, or to the researchers or businesses involved in it. Such information, particularly if citing a secondary source, might also be appropriate for a well-documented section on "Research directions" in an article about a disease. To prevent misunderstandings, the text should clearly identify the level of research cited, e.g., "first-in-human safety testing".
End of draft replacement. Eubulides ( talk) 16:57, 2 July 2009 (UTC)
No further comment, so I replaced the text in question with the above draft. I copied the previous version to #Previous version of "Address evidence quality" below, as it looks like it could well be useful in an article somewhere. Eubulides ( talk) 06:42, 23 July 2009 (UTC)
Several systems exist for assessing the quality of available evidence on medical subjects, and these should be kept in mind while assessing whether a particular viewpoint is a majority or minority one, and in deciding what constitutes evidence-based medicine. [1] [3]
Two of the most commonly used schemes are the US Agency for Healthcare Research and Quality one:
Class | Requirements |
Ia | Evidence from meta-analysis of randomised controlled trials (RCTs) |
Ib | Evidence from at least one RCT |
IIa | Evidence from at least one well-designed controlled study without randomisation |
IIb | Evidence from at least one other type of well-designed quasi-experimental study |
III | Evidence from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies, and case control studies |
IV | Evidence from expert committee reports or opinions and/or clinical experience of respected authorities |
And the slightly simpler NHS one:
Grade | Evidence | Description |
A | Ia, Ib | Requires at least one RCT as part of the body of literature of overall good quality and consistency addressing the specific recommendation |
B | IIa, IIb, III | Requires availability of well-conducted clinical studies but no RCTs on the topic of recommendation |
C | IV | Requires evidence from expert committee reports or opinions and/or clinical experience of respected authorities. Indicates absence of directly applicable studies of good quality. |
Case reports, whether in the popular press or a peer-reviewed medical journal, are a form of anecdote and generally fall below the minimum requirements of either scheme.
Primary research often, if not usually, includes introduction and discussion sections which cite other sources. Can these be then considered as "secondary" sources? - Tekaphor ( TALK) 14:26, 20 July 2009 (UTC)
Hi everyone, i cannot believe, but Medical Hypotheses journal is discussed again as MEDRS Talk:Chronic_fatigue_syndrome#Herpes_and_CFS, a single purpose account editor thinks it has a MEDRS review about Herpes causes CFS. I tried explain them, it is not MEDRS, but editor has very good arguments for MEDRS by calling me uninformed and a conservative, ha ha if they knew!! I am sorry for bugging every body about it, pls can we say the journal is, is not MEDRS. Thx RetroS1mone talk 13:51, 30 July 2009 (UTC)
We need some wording to disambiguate between different sources regarding alternative medicine. I propose something like the following:
ScienceApologist ( talk) 19:14, 10 August 2009 (UTC)
@ScienceApologist, re above proposal for poorly sourced claims: that sounds fine to me as long as we're not construing it to say that
Quackwatch can be cited as fact rather than attributed with an inline citation, or that it supersedes other MEDRS's. Quackwatch is certainly fine to use, per
WP:PARITY, but you go too far with your argument
here when you hold Quackwatch as a superior source to the
Institute of Medicine, viz:
Quackwatch can be a valuable source, but it's not the best MEDRS out there, and certainly isn't as good as sources like the Cochrane Collaboration and other mainstream, peer-reviewed sources. I doubt that I'd put it in the same tier as sources mentioned under Wikipedia:MEDRS#Medical_and_scientific_organizations, either, because (its advisory board notwithstanding) there's no apparent mechanism of peer review.
When a topic is not discussed by superior MEDRS's, Quackwatch can be an ideal counter to self-published, WP:VANITY claims; but when a topic is discussed by superior MEDRS's, Quackwatch can still be cited, but with less weight. In that light, I agree with Eubulides' caveat above about throwing out the baby with the bathwater. My position is simply that we should give Quackwatch no more or less than its due weight per WP:PARITY, and always use inline attribution with a wikilink (which is the default, safe, wise approach on WP anyway). -- Middle 8 ( talk) 19:59, 11 August 2009 (UTC)
Okay. I have tried to take all the comments and considerations into play. Middle 8, we're going to have to agree to disagree about what this particular paragraph can be construed as -- but actually I think that's okay for now. ScienceApologist ( talk) 17:16, 14 August 2009 (UTC)
← I think there is a real need for language like this. If anyone doesn't believe this is a problem, I'll point them to a series of articles demonstrating the issue. Combine the following:
The result is a low-quality article which can never be anything other than a) credulous snake-oil promotion or b) original-synthesis deconstruction of the nonsensical claim. And with one dedicated single-purpose editor (and a few of the usual suspects to chime in) the article can never be deleted through AfD. This is a real barrier to the goal of creating a serious, respectable reference work, so I would support some language clarifying the ways in which Wikipedia's core principles apply to such situations. MastCell Talk 04:11, 15 August 2009 (UTC)
Broadly speaking, there seems to be agreement here that something along these lines is a positive addition to the guideline, yes? Does anyone mind if we go ahead and drop it in? - 2/0 ( cont.) 06:12, 18 August 2009 (UTC)
Hi, there is an ongoing discussion in the Wikipedia:Reliable sources/Noticeboard#Sources appropriate for medical and health-related articles about the use of an inconclusive commentary as a source for a medical and health-related article, that relates with WP:MEDRS. So your opinion is welcome.-- Nutriveg ( talk) 20:17, 16 August 2009 (UTC)
Most journals also publish pieces that are not scientific articles, such as editorials, op-ed pieces, commentaries, and letters to the editor. These sources may provide interesting ideas, but they are never peer-reviewed and are rarely even fact-checked, and therefore they should be treated with caution. In general, such pieces must comply with Wikipedia's standard rules for self-published works, including rejecting claims outside the author's expertise and requiring direct attribution of the claims to the source.
How about this?
Some reputable journals also publish pieces that are not strictly journal papers, such as editorials, op-ed pieces, commentaries, and letters to the editor. These sources may provide interesting ideas, but they should be treated with caution as the peer-review status and accuracy of the text can be nebulous. In general, such pieces must comply with Wikipedia's standard rules for self-published works, including rejecting claims outside the author's expertise and requiring direct attribution of the opinions of the author to the source.
ScienceApologist ( talk) 20:15, 17 August 2009 (UTC)
This edit inserted a paragraph saying that editorials etc. must have direct attribution of claims to the source. If I understand that correctly, it goes too far: if (say) a NEJM editorial says that the use of Lupron to treat autism is controversial, we need not have the article text say "Mr. Schmoe wrote that the use of Lupron to treat autism is controversial". Also, if a letter to the editor by an article's author corrects information in that article, surely a citation to the letter suffices; we don't need intext attribution. Furthermore, the change caused the project page to be incoherent: in one paragraph it says that editorials are articles, and in the next paragraph it says they aren't. I'm not sure what this change is motivated by, but I suggest that it be discussed here further before installing.
Eubulides (
talk) 16:47, 17 August 2009 (UTC)
(Unindenting, as the above is too hard to follow.) I have some concerns about ScienceApologist's above proposal (dated 20:15, 17 August 2009). I am mostly concerned about Letters to the Editor. Since these are the standard method by which errors in published work are discussed, I think it would be a mistake to craft a rule that permits an erroneous paper to be cited but not a Letter to the Editor describing the error. Consequently, I think care is needed. In particular, I don't think that we should classify this material as self-published. It's considerably more reliable than that. At the very least, it will have received the attention of the Editor, who will have made the decision to publish (based, presumably, on merit). And some journals (for example the International Journal of STD and AIDS) apply a full peer-review process for Letters to the Editor. I suggest simply stating that such material should be treated with caution, that it may be worth determining what review process (if any) applies, and that extra care should be taken to watch for dubious or surprising claims that may require stronger sourcing. Jakew ( talk) 13:55, 18 August 2009 (UTC)
Review in Nat Clin Pract Gastroenterol Hepatol. Free full text at Medscape, could be a useful source. Fvasconcellos ( t· c) 16:46, 22 August 2009 (UTC)
There are good reasons for the existence of specific medicine-related reliability criteria. But the guidelines fail to explain them with the result that its application is too wide.
Are there any essays, guidelines or policies that talk about pharmanoia, and the idea that sources shouldn't be trusted because of Big Pharma having sticky fingers in things? I've been treating such arguments as spurious without a specific source criticizing a specific paper. I'm also interested in whether there's something similar for when alt med advocates cite the pharmanoia argument to support the idea that vitamins are a panacea and preventive wonder for all things (also would be nice to have something to point to that states the alt med advocates often have their own conflict of interest, and are not immune merely because they aren't Pfizer). WLU (t) (c) Wikipedia's rules: simple/ complex 20:47, 3 September 2009 (UTC)
I am in doubt about a reference that has been added. To me it sounds like dubious woo-woo advice by pushers of dietary supplements that isn't backed up with good evidence. The ref is being used to justify mentioning that aspartame can produce migraines. While there is a subset of individuals that are sensitive to it, the ref is being used to imply that it causes migraines, without qualifying the subset it applies to:
The edit seems to be pushing an unjustified and POV use of the source. Brangifer ( talk) 04:43, 11 November 2009 (UTC)
An IP editor ( 131.215.40.141 and 131.215.6.110) seems to need advice regarding the importance of not depending on primary sources, on the difference between in vitro and in vivo, and on how the dose makes the poison. -- Brangifer ( talk) 04:51, 17 November 2009 (UTC)
This article needs to be gone through. I suspect there are many false claims backed up by sources that appear to be official medical journals, but are really fringe journals not even listed in PubMed. -- Brangifer ( talk) 15:23, 22 November 2009 (UTC)
This section seems to be one huge special pleading section with peacock language and undue weight given to alt med advocates like Haley and Blaxil from SafeMinds, and ancient claims made by Bowen. (Yes, believe it or not, Bowen does rant about Satan, Zionism, and the Illuminati, and in his letter to Martini explains why his medical license was revoked.) While the fringe position should be stated clearly, it shouldn't be allowed to deceive the public by making their claims seem plausible through a presentation marred by undue weight. -- Brangifer ( talk) 00:10, 23 November 2009 (UTC)
I've been looking through some conversations from earlier this year, and I have run across an area that WP:MEDRS#Assess_evidence_quality may need to provide a little more clarity. It seems that this section is being occasionally (mis)understood as requiring editors to decide whether a study (or review) has sufficient data to support the conclusions that it draws.
So what we mean -- and what I thought we said -- was that if you're faced with contradictory papers, or trying to decide whether something's important enough to include, then you prefer reviews and meta-analyses to original RCT reports, and that you prefer RCTs to case studies, and so forth.
I'm seeing this invoked as a justification for WP:OR: I didn't think that their data sample was big enough to justify that conclusion... and the review cites Smith's trial for this fact, so that's just a single original paper... and Smith's paper is a little old, anyway, even though the review is recent... and probably the reviewer is twisting Smith's conclusions... -- even though we're citing the review instead of Smith.
I think that the problem might actually be in the section's title. Could we consider renaming it to something less open-ended, like "Prefer well-designed studies"? WhatamIdoing ( talk) 19:58, 19 October 2009 (UTC)
Why not just rename the section to "Use high-quality sources"? That matches the section's contents better anyway, and would help avoid the possible misunderstandings noted above. Eubulides ( talk) 23:25, 19 October 2009 (UTC)
How about Consider study design? I think asking editors to conduct assessments of studies is wildly inappropriate, and maybe even insisting on "preferences" can be construed problematically, but exhorting people to consider the designs of studies when writing prose is okay in my book. ScienceApologist ( talk) 03:35, 20 October 2009 (UTC)
The new template is interesting, on the one hand, but based on its sole use to date, [50] I suspect that it may be no more useful than Template:Verify credibility, and may be misused. MEDRS doesn't presume to provide standards for strictly social facts, such as whether scientists "should" publicly oppose quackery, or whether a country devotes sufficient resources to health care for a given marginalized population, or what the polite term is for a given condition, or that sort of thing. Instead, it cares mostly about physical facts, of the type that you can determine with a well-designed trial or three. The other RS-related guidelines are quite sufficient for these non-scientific statements.
Does anyone else have any thoughts about this new template? WhatamIdoing ( talk) 02:52, 1 November 2009 (UTC)
This guideline implicitly defines its scope as all medical articles. While reasonable in principle this is probably not precisely what is intended, or at least should not be. I believe the situation is parallel to WP:BLP, which generally talks about biographic articles but really means biographic information in any article.
Here are two real examples of the problem.
The first problem is addressed by a paragraph in WP:MEDRS#Popular press. It makes clear that for non-medical sections in medical articles there is a relaxed standard. It does not try to define this standard; clearly such an attempt would be out of proportion in this guideline. It would be more efficient to delegate this to WP:RS.
I can't see that the more serious second problem is addressed anywhere: Medical information in List of common misconceptions seems to be outside the scope of this guideline! Therefore I propose adding a new section at the end of the lead:
Hans Adler 11:12, 2 November 2009 (UTC)
Hans, is there an active dispute that centers around this distinction, or is this purely hypothetical? WhatamIdoing ( talk) 03:27, 3 November 2009 (UTC)
I have started a thread and hope readers here will chime in there:
We need a parallel noticeboard to deal with medical sourcing: WP:MEDRS/N. Currently such matters end up at Wikipedia talk:Reliable sources (medicine-related articles) and Wikipedia talk:WikiProject Medicine, but that's unsatisfactory. We need a separate noticeboard which is watched by medical professionals who understand the complexities of medical matters and medical research, understand our RS policy, and understand the MEDRS guideline. What think ye?
Please discuss it there, not here. -- Brangifer ( talk) 00:50, 23 November 2009 (UTC)
Is there any guidance anywhere on the use of conference abstracts and symposia? My find function doesn't turn anything up, and who wants to read all that WLU (t) (c) Wikipedia's rules: simple/ complex 13:38, 3 December 2009 (UTC)
FWIW, I proposed a long time ago that conference proceedings and low-impact journals be considered primary source documents that have not undergone strict review for the intents and purposes of Wikipedia. My concern was outlined here: Wikipedia:Reliable_sources/Noticeboard/Archive_9#Low impact journals used to POV-push. ScienceApologist ( talk) 22:47, 3 December 2009 (UTC)
Sorry to raise this thread from its deathbed, but it might be worth looking at how the Center for Integrative Medicine at M.D. Anderson Cancer Center approaches conference abstracts:
The problem with these [conference] abstracts is that they do not contain all the available details of the study methodology and data, and are not reviewed by experts in the same field (peer-reviewed) for how well the data supports the conclusions. In fact, it is not uncommon for such abstracts to be subsequently published in greater detail in peer-reviewed scientific and clinical journals with modified conclusions from the original abstract, or to be rejected for publication because the methodology or data was judged to not support the conclusions. Because of this problem with abstracts, the CIMER Web site has a policy for its content of only drawing conclusions from the most carefully reviewed information available in complete articles published in peer-reviewed journals. [51]
This mirrors the approach (and reasoning) we should be using fairly closely, and might be a useful addition (or not). Anyhow... MastCell Talk 21:32, 15 January 2010 (UTC)
Would someone independent please have a look at [ this edit]? Prior discussion on the article's talk page pertains. Thank you, LeadSongDog come howl 20:08, 7 December 2009 (UTC)
Hello all,
I'm more and more convinced that the definitions used in MEDRS are unjustifiably limited to medical articles. The definitions found at WP:PSTS gives the impression that a peer-reviewed article on a scientific subject is a secondary source, when really if there is any debate the appropriate secondary source would be a review article. Is there any discussion elsewhere that points to this? For a celebutard's personal life, a news article is appropriate, but for a discussion of the impact of different drivers on human bipedalism, a review article would seem a better source than a journal article - where it is easy to cherry-pick sources to provide the illusion of being a respected hypothesis. Any wikilinks to policies or guidelines that would be helpful to me? WLU (t) (c) Wikipedia's rules: simple/ complex 13:14, 21 January 2010 (UTC)
This guideline appears to be about medical articles, but it's titled "medicine". A Quest For Knowledge ( talk) 17:05, 21 March 2010 (UTC)
We talked about this a while ago and never got very far. My bold change rearranges a bit, but it's the first and last paragraphs that are (mostly) new.
I didn't get very far with wordsmithing, so if you've got any ideas about how to improve it, please go ahead. WhatamIdoing ( talk) 00:32, 27 March 2010 (UTC)
There is currently an ongoing discussion about the future of this and others MoS naming style. Please consider the issues raised in the discussion and vote if you wish GnevinAWB ( talk) 21:00, 25 April 2010 (UTC)
BMJSystematicReviews
was invoked but never defined (see the
help page).{{
cite journal}}
: CS1 maint: date and year (
link)